ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)

AIDS is an infectious disease caused by a transmissible infectious agent named as Human Immunodeficiency virus.

Mode of spread:

Studies show that AIDS virus is found in all body fluids like: blood, semen, saliva, tears etc but
they are present in blood and semen in high concentration and responsible for spread of infection.

      Proof of spread through saliva and other body fluids is lacking

Time for spread:

After being infected with virus, it takes 29 months in adults and 12 months in children for virus to produce symptoms, however it may remain for a period of 5 yrs before producing symptoms of AIDS or AIDS-related complex (ARC), a milder form of AIDS in which opportunistic infections are not life threatening.

Study shows that within 2-5 years of infection only 2%-5% patients develop AIDS, 23-26 % develop ARC, and 60-70 % remain symptom free but  may be carriers.

Geographical Distribution:

AIDS began to spread in Asia in late 1980s as the incubation period for many patients completed by 2005.  The number oh HIV  infected individuals  in the  Asian region was expected to exceed the number of cases all over Africa. It is estimated that about ten million Asians, mainly South Asians will die of AIDS before 2015.

AIDS in Pakistan:

HIV infection is reported from all four provinces of Pakistan, Federally Administered Tribal Areas and Azad Jamu and Kashmir.

                    By the end of year 2000  ,1549 case of HIV and 202 of AIDS were reported to National AIDS Control Program.

                   It is a fact that majority of the infected cases are male with a male: female ratio of 7:1, mostly between the age group 20 to 40 years old.

                    The increase in number of HIV cases has been found in high-risk groups. Report says that these cases not only suffer physical pains of the disease but also suffering from social isolation, humiliation, discrimination and community abuse.

Routes of Infection:

Transmission is grossly by:

• Sexual Contacts
• Sharing of therapeutic blood
• Blood products
• Syringes used for illicit drugs
• From infected mother to new born child

There are no specific symptoms for AIDS alone, but four patterns of disease are observed in AIDS patients.

1. Pulmonary pattern:

Patient experiences difficulty in breathing, lack of oxygen, chest pain and x-ray findings shows diffuse pulmonary infiltrates.

2. Gastrointestinal patterns:

Diarrhea with weight loss, however the cause of symptoms remain unclear.

3. Central Nervous System Pattern:

 It is observed in about 30 % of cases.

• Infection of brain membrane is called meningitis.
•  Tumors such as cerebral lymphomas.
• Vascular changes like bleeding from brain vessels with deficiency of platelets.

4. AIDS in Children

 AIDS transmission from mother to new born can be recognized by a small head, box like forehead, flattened nose bridge and wide set eyes. Transmission of virus through breast milk may occur resulting in nervous system problems with degeneration of brain tissues and aseptic meningitis.

GENERAL PATTERN

            Fever of unknown origin, massive weight loss, weakness and malaise is observed.

FUTURE RISKS

             The risk factors that can put Pakistan in danger with aspect of AIDS are:-

 According to AIDS surveillance center at Karachi, among professional donors of blood, 20% were found infected with Hepatitis C, 10% with Hepatitis B, and 1% with HIV.

 There is a high risk of HIV transmission with inappropriate screening of blood. About 40% of transfused blood is not screened previously.

3.Injecting Drug Users:

 About 1million people in Pakistan are addicted to injecting drugs. A few studies suggest a possible increase in trend of drug injections.

 Large numbers of workers leaving their villages and cities, overseas employments and refugees from other countries lead to increased risk of HIV infections due to higher risk of unprotected sex and abusing drugs.

 Hectic efforts are required to increase awareness about HIV among the general population as common people in our country, do not have an opportunity to seek knowledge about this lethal diseases due to low literacy and education rates.

The government of Pakistan began its efforts in raising public awareness about this disease by initiating a national aids prevention and control program in 1987. This program was expanded in collaboration with a number of non governmental and donor agencies and came to be known as the National HIV AIDS strategic framework. Priorities  identified for the effective control of this epidemic are:-

Preventive Strategies.

Testing and Screening Programs.

Regulations on Blood Transfusion & reuse of syringes.

Providing treatment, care and support  to infected persons.