傳染病-AIDS艾滋病-課件

AIDSCONCEPTETIOLOGYEPIDEMIOLOGY&PREVENTIONCLINICALMANIFESTATIONDIAGNOSISTREATMENT

1ppt課件AIDSAcquired

ImmuneDeficiencySyndrome,isthemostseveremanifestationofaclinicalspectrumofillnesscausedbyhumanimmuno-Deficiencyvirus(HIV).Thesyndromeisdefinedbythedevelopmentofseriousoppoutunisticinfections,neoplasms,orotherlife-threateningmanifestationsresultingfromprogressiveHIV-inducedimmunosuppression.2ppt課件Viraletiology

--HIV

(humanimmunodeficiencyvirus)HIVbelongstoretroviridaefamilyandincludesHIV1and2.Containingpositive-sense,single-strandedRNA.ThemajortargetofHIVinfectionisCD4+Tcell.3ppt課件EPIDEMIOLOGYInmid-1981,thefirstAIDScasewasidentifiedinNewYorkCity,USA.4ppt課件UntilDec.1,2010,

CumulativeNumberofReportedCases

ofAIDSAllovertheworld,totalnumberofHIVinfectionismorethan70millions,deathnumberisabout46millions.5ppt課件UntilDec.1,2010,

CumulativeNumberofReportedCases

ofAIDSInChina,totalnumberofHIVinfectionisaboutmorethan1million,livingHIV/AIDScasesareabout0.74million.6ppt課件ContentsofChineseHIVinfectionandAIDSCases:Drugusersandblooddonators,about40%;Sexualworkers,morethan20%；Familymembersandcommonpeople,about20%；7ppt課件ContentsofChineseHIVinfectionandAIDSCases:Bloodorbloodproductsusers,about10%;Malegay,about8%；Mathertoinfant,about2%.8ppt課件UntilDec.1,2009,

CumulativeNumberofReportedCases

ofAIDSInChongqing,from1989toOct.30,2006,therewereabout2509casesofHIVinfection,In2009,morethan6000HIVinfection.InChongqing,thereareabout30thousandfemalesexualworkers,about5%havebeeninfectedbyHIV.9ppt課件EPIDEMIOLOGYSourceofinfection:

HIVinfectionsandAIDSpatients.10ppt課件EPIDEMIOLOGYMajorroutesoftransmission:viablood,tissuesandbodyfluidseitherthroughinoculation;bysexualcontact;Verticaltransmission.11ppt課件EPIDEMIOLOGYSusceptibilityofpopulation:allagesaresusceptible,butmostcasesoccurinyoungadults.12ppt課件PREVENTION1.Casefindingandearlyisolationofasymptomaticindividuals.2.Cutofftherouteoftransmission:Heighteninginfectioncontrolinhigh-risksituations.Quarantineofhigh-riskpopulations.3.Protectionofsusceptiblepopulation:

PubliceducationaboutAIDS.13ppt課件LittleBushaskedteenagersinUSAtobe

safer

sex

behaviors

：

AbstainBe

faithful

Condom

use

14ppt課件CLINICALMANIFESTATIONSIncubationperiod:2~10yearsinadults,severalmonthsto2yearsininfantsandyoungchildren.15ppt課件CLINICALMANIFESTATIONSNaturalhistoryofthedisease:

Phase1:lastingfordaystoweeksPatientsinitiallydevelopmononucleosis-likesymptoms:fever,lymphadenopathy,sweats,malaise,myalgia,headache,andrigors.16ppt課件CLINICALMANIFESTATIONSNaturalhistoryofthedisease:

Phase2:lastingfor2to10yearsAsymptomaticperiod.17ppt課件CLINICALMANIFESTATIONSNaturalhistoryofthedisease:

Phase3:PGL,

persistentgeneralizedlymphadenopathy.Itisdefinedasthepresenceoftwoormoreextrainguinalsitesoflymphadenopathyfor3to6monthsforwhichnootherexplanation.18ppt課件CLINICALMANIFESTATIONSNaturalhistoryofthedisease:

Phase3:PGL,

ItspathogenesisisrelatedtotherapidinfectionofCD4+cellsinlymphnodesbyHIV.Biopsyspecimensoflymphnodesusuallyrevealafollicularhyperplasiawithoutspecificpathogens.19ppt課件CLINICALMANIFESTATIONSNaturalhistoryofthedisease:

Phase4:AIDS,ARC,AIDSrelatedcomplications.persistentfever,weightlossandPGL.20ppt課件CLINICALMANIFESTATIONSNaturalhistoryofthedisease:

Phase4:AIDS,Severeopportunisticinfections,pathogensincludefungi,suchaspneumocystisJiroveci(PJ,PC,p.carinii),tuberclebacillus,herpesvirus,cta.

21ppt課件CLINICALMANIFESTATIONSNaturalhistoryofthedisease:

Phase4:AIDS,Sarcomafollowedimmunecompromise,suchasKaposi’sSarcoma(KS),humanherpesvirustype8isrelatedtothepathogenesisofKS.22ppt課件CLINICALMANIFESTATIONSNaturalhistoryofthedisease:

Phase4:AIDS,KSisavascularneoplasticdisorderinAIDSpatients.AlthoughKSalsoaffectsvisceralorgans,thecharacteristicfindingsarecutaneousred-purplenodulesorplaques.Sitescommonlyinvolvedincludethelegs,feet,mucousmembranes,hardpalate,nose,trunk,andscalp.23ppt課件CLINICALMANIFESTATIONSPulmonarymanifestationsofAIDS:

PJP,pneumocystis

jirovecipneumonia,occurringinabout80%ofAIDSpatients.Symptoms:Radiographicabnormality:24ppt課件CLINICALMANIFESTATIONSGastrointestinalandhepatobiliarymanifestationsofAIDS:

suchasCandidaesophagitis,cryptosporidiosis,andcytomegalovirus(CMV)colitis,chronicviralhepatitis.25ppt課件CLINICALMANIFESTATIONSOraldiseases:

oralcandidiasis

oralhairyleukoplakiaoralulcers:causedbyherpessimplexvirustype1and2,CMV,cta.otherorallesions:KS26ppt課件CLINICALMANIFESTATIONSAnusdiseases:

anusulcers:causedbyherpessimplexvirustype1and2,cta.

27ppt課件CLINICALMANIFESTATIONSpudendum

diseases:

Condyloma

acuminatum28ppt課件CLINICALMANIFESTATIONSNeurologicmanifestationsofAIDS:

opportunisticinfectionsofCNS,

encephalar

toxoplasmosis,viralencephalitisopportunisticcancerinvolvedinCNS,Symptoms:headache,seizures,disturbanceofcognitivefunction,andfocalneurologicdeficits.29ppt課件clinicaltypesCD4+TLLABC

(×109/L)

asymptomaticmildlysymptomaticAIDS

infectionorPGLinfection

>0.5>2.0AIBICI0.2~0.491.0~1.9AIIBIICII<0.2<1.0AIIIBIIICIIICDC&WHO’sclassifystandard30ppt課件DIAGNOSISClinicaldiagnosisPathogenicdiagnosis31ppt課件Clinicaldiagnosis

Highriskpopulationsappearoneoffollowingmanifestations:Feverlastingformorethan1month;Chroniccoughand/ordiarrhea;PGL;opportunisticinfections,especiallycausedbyfungi;