Certain individuals are 'at risk' of infection:
and heterosexual partners
- Babies born to infected individuals
- Recipients of blood products, e.g. haemophiliacs.
The incidence of HIV infection in 'at risk' groups varies considerably. Sex education, supply of clean needles to addicts, active drug-dependence programmes and specific precautions in the preparation of blood products are necessary to limit its spread. Current prevalence of HIV - USA 140/million (New York 991/million).
CLINICAL COURSE OF HIV INFECTION
± glandular fever-like symptoms
HIV antibody + ve (4-12 weeks)
Detected on antibody screening
- counselling _
- prevention of spread
PERSISTENT GENERALISED LYMPHADENOPATHY
months or years
AIDS RELATED COMPLEX (ARC)
- weight loss
Range of severe opportunistic infections and tumours. Presenting illness:
- PNEUMOCYSTITIS CARINII PNEUMONIA - 50%
- KAPOSI'S SARCOMA (multiple violaceous skin lesions) - 20%
CNS LYMPHOMA NON-HODGKIN LYMPHOMA
- hyperplasia of neck lymph glands
- HIV isolation
- lack of response to skin antibody tests
Results as in ARC but cellular immunity impaired. - T cell lymphocyte suppression especially CD4 (helper subset) with reversal of normal CD4: CD8 ratio
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