UNIVERSITY OF PORTHARCOURT

COLLEGE OF HEALTH SCIENCES

FACULTY OF CLINICAL SCIENCES
DEPARTMENT OF NURSING

GROUP FIVE (5)

ASSIGNMENT
ON
HUMAN IMMUNO DEFICIENCY VIRUS (HIV)

COURSE TITLE: COMMUNITY HEALTH NURSING

COURSE CODE: NSC 305.2
COURSE LECTURER: MRS FLORENCE UGWU

30th OCTOBER 2023

SOMIARI EMMANUELLA NENE
U2019/4730020
 INTRODUCTION
• HIV is an acronym for Human Immuno-deficiency Virus.

• HIV is an infection that attacks the body's immune system , specifically

the white blood cells, called the CD4 cells.

• It destroys this CD4 cells, weakening a person's immunity against

opportunistic infections such as tuberculosis and fungal infections,
several bacterial infections and some cancers.

• People with HIV who receive appropriate treatment rarely develop

stage 3 HIV, or AIDS. They can manage their condition and live long
and healthy lives.
• People diagnosed with HIV should be offered and linked to antiretroviral
treatment (ART). At diagnosis or soon after starting ART, a CD4 cell count
should be checked to assess a person’s immune status.
• The normal range of CD4 count is from 500 to 1500 cells/mm3 of blood,
and it progressively decreases over time in persons who are not receiving

• The World Health Organization (WHO) estimates there were nearly

39 million people living with HIV worldwide by the end of 2022. In
the United States, there were 1.2 million people living with HIV at the
end of 2021.
MAGNITUDE OF THE PROBLEM
• HIV knows no geographical boundaries, social, racial, or cultural
boundaries. Although it was first reported in the US in 1980 earlier cases
where found in Equatorial Africa.

• HIV/AIDS remains one of the world most significant public health

challenges, particularly in low and middle and middle income countries.

• According to the USAIDS as of the end of 2020, around 3.7 million

people where living with HIV globally.
• Sub Saharan Africa is the most affected region with approximately
two third of the worlds new cases of infection

Beyond the enormous human toll, HIV/AIDS also has severe economic
implications.it reduces the labour cost and imposes substantial cost
on businesses and healthcare.
EPIDEMIOLOGICAL FEATURES OF
HIV/AIDS
• Since the beginning of the epidemic, 85.6 million [65.0–113.0 million]
people have been infected with the HIV virus and about 40.4 million
[32.9–51.3 million] people have died of HIV. Globally, 39.0 million
[33.1–45.7 million] people were living with HIV at the end of 2022.
Our modelled HIV prevalence in Nigeria varies by state,
with Benue (5.7%, 95% CI: 5.0–6.3) having the highest p
followed by Rivers (5.2%, 95% CI: 4.6–5.8%),
Akwa Ibom (3.5%, 95% CI: 2.9–4.1%),
Edo (3.4%, 95% CI: 2.9–4.0%) and
Taraba (3.0%, 95% CI: 2.6–3.7%)
• The epidemiological features of a disease refer to the characteristics and
patterns of how that disease spreads within a population.
• Agent Factors: Agent factors refer to characteristics of the
microorganism or pathogen causing the disease. These factors include
the pathogen’s
virulence; the severity or harmfulness of a disease
infectiousness; ​the ability of a disease to be passed easily from one person to another
genetic variations; Genetic variation is a result of subtle differences in our DNA
• Rate of infection
• Affected demographics (age, gender etc.):
• Transmission Method
 Causative organism

• The causative agent of HIV is Human Immunodeficiency Virus’

• it is a retro virus that attacks the immune system, specifically the T-CELLS or
CD4 cells, it weakens the body's ability to fight off infections and diseases.
• There are two main types of HIV; HIV1 and HIV2 , with HIV1
being the most common and the type that causes AIDS.

Once it enters the body, it attacks the CD4 cells, which are a
type of immune cell. Over time, the virus destroys more and
more CD4 cells, making it difficult for the body to fight off
infections. Eventually, the immune system becomes so
weakened that it can't fight off even minor infections, and
this is when the HIV infection progresses to AIDS.
 MODE OF TRANSMISSION
• Sexual transmission

• Blood contact and organ transplant

• Maternal and fetal transmission

• Sharing needles or syringes

PATHOPHYSIOLOGY
STEPS OF PATHOPHYSIOLOGY

1. Viral Entry
2. Reverse Transcription
3. Integration
4. Transcription and Translation
5. Assembly and Budding
6. Maturation and Release
7. Infection of Other Cells
8. Immune Response
9. Progression to AIDS
WONDAH FAVOUR EBERECHI

U2019/4730028
SIGNS AND SYMPTOMS OF HIV

This is divided into two categories;

MINOR SIGNS AND SYMPTOMS

MAJOR SIGNS AND SYMPTOMS

MINOR SIGNS AND SYMPTOMS
• HIV infections may not show any specific signs or symptoms.
However, some people may have flu-like symptoms that can include:
• - Fever
• - Headache
• - Sore throat
• - Fatigue
• - Swollen lymph nodes
• - Rash
MAJOR SIGNS AND SYMPTOMS
• As the virus progresses, the following signs and symptoms of HIV may begin to appear:
• - Weight loss
• - Chronic diarrhea
• - Night sweats
• - Chronic fatigue
• - Recurring fever
• - Skin rashes or flaky skin
• - Mouth, genital, or anal sores
• - Thrush (a fungal infection of the mouth)
• - Pneumonia
• - Persistent headaches or confusion
• - Memory loss or brain fog
• - Depression
CLINICAL FEATURES OF HIV
• 1. Acute HIV Infection
• Occurs within the first few weeks after exposure to the virus.
Symptoms can be flu-like and include fever, fatigue, swollen lymph
nodes, sore throat, rash, and muscle aches.
• may not experience noticeable symptoms during acute infection.

• 2. Clinical Latency (Chronic) Stage

• After the initial acute stage, HIV enters a clinical latency or chronic
stage, which can last for many years. During this phase, HIV
reproduces at low levels, and there may be no obvious symptoms.
Without treatment, the virus gradually weakens the immune system.
• 3. Symptomatic HIV Infection
• As the immune system weakens, people with HIV may develop
symptoms and conditions that are indicative of immune suppression.
symptoms : persistent fever, night sweats, unexplained weight loss,
chronic diarrhea, and oral or genital sores.
• Opportunistic infections or malignancies may occur, which are
uncommon in individuals with a healthy immune system.
4. AIDS (Acquired Immunodeficiency Syndrome)
most advanced stage of HIV infection. To be
diagnosed with AIDS, an individual's immune
system must be severely damaged, with a very
low CD4 cell count (a type of immune cell) or the
occurrence of specific AIDS-defining illnesses.
AIDS-defining illnesses can include conditions
like Kaposi's sarcoma, Pneumocystis pneumonia,
and certain types of aggressive lymphomas.
 Complications
• 1. Opportunistic Infections:
• opportunistic infections for people living with HIV include the following:
• Herpes simplex virus: sores around the mouth or genitals. For people with HIV, it can be
especially problematic and lead to recurrent sores. It may cause infections in the bronchus
(breathing tube) or the esophagus (the tube that connects the mouth and stomach). It can
also lead to pneumonia.
• Candidiasis: This fungal infection causes a thick, white coating to form on the skin, nails, and
mucous membranes. Candidiasis commonly affects the mouth, vagina( vulvovaginal )
• Pneumonia: Pneumonia is a lung condition that results from an infection by one of many
bacteria, viruses, or fungi. It can be severe or life-threatening for people with HIV.
• Symptoms of pneumonia include:
• Chills
• difficulty breathing
• fever
• Tuberculosis: Tuberculosis is a bacterial infection of the lungs but may
spread to other parts of the body, including the kidneys, spine, and
brain. It can lead to symptoms such as:
• a cough
• fatigue
• fever
• weight loss
• Co-infections
• People may also develop co-infections. This is where more than one
infection is active at the same time.
• Common co-infections with HIV include:
• tuberculosis
• hepatitis B
• hepatitis C
• . pregnancy complications
• Chronic pelvic pain
PROGNOSIS
• prognosis of a patient with HIV and a CD4 count greater than 500
(normal) results in a life expectancy as someone without HIV. A
person with untreated AIDS has a life expectancy of about 1 to 2 years
after the first opportunistic infection.

• Antiretroviral treatment can increase CD4 counts and change the

patient's status from AIDS to someone with HIV
PROGNOSTIC PRINCIPLES
•
• Certain factors are correlated with a worse prognosis from AIDS
related conditions: African American or mixed races, the number of
OIs, poor functional and nutritional status, anemia, active substance
abuse, a low CD4+ count, and a high HIV viral load (7-10).
• For patients who do not receive cART with a CD4 count < 50
cells/mm3, survival ranges between 12-27 months; those with CD4+
counts <20 cells/mm3 have a median survival of 11 months (2).
• Many patients die with HIV or AIDS, not from it
Diagnosis
• HIV can be diagnosed through blood or saliva testing. Available tests include:
• Antigen/antibody tests. These tests usually involve drawing blood from a vein. Antigens are
substances on the HIV virus itself and are usually detectable — a positive test — in the blood
within a few weeks after exposure to HIv
• Antibodies are produced by your immune system when it's exposed to HIV. It can take weeks to
months for antibodies to become detectable. The combination antigen/antibody tests can take
2 to 6 weeks after exposure to become positive.
• Antibody tests. These tests look for antibodies to HIV in blood or saliva. Most rapid HIV tests,
including self-tests done at home, are antibody tests. Antibody tests can take 3 to 12 weeks
after you're exposed to become positive.
• Nucleic acid tests (NATs). These tests look for the actual virus in your blood (viral load). They
also involve blood drawn from a vein. If you might have been exposed to HIV within the past
few weeks, your health care provider may recommend NAT. NAT will be the first test to become
positive after exposure to HIV.
Tests to Know stage Of disease and treatment
• .If you receive a diagnosis of HIV/AIDS, several tests can help your
health care provider determine the stage of your disease and the best
treatment, including:

• CD4 T cell count. CD4 T cells are white blood cells that are specifically
targeted and destroyed by HIV. Even if you have no
symptoms, HIV infection progresses to AIDS when your CD4 T cell
count dips below 200.
• Viral load (HIV RNA). This test measures the amount of virus in your
blood. After starting HIV treatment, the goal is to have an
undetectable viral load. This significantly reduces your chances of
opportunistic infection and other HIV-related complications.

• Drug resistance. Some strains of HIVare resistant to medications. This

test helps your health care provider determine if your specific form of
the virus has resistance and guides treatment decisions.
 U2018/4792065
OKURE BLESSING
ENOBONG
 CONTROL
MEASURES
 Get tested for HIV
 Total abstinence.
 Choose less risky sexual behaviors
 Use condoms every time you have sex.
 Limit your number of sexual partners.
 Get tested and treated for STDs.
 Talk to your health care provider about pre-exposure
prophylaxis (PrEP)
 Do not inject drugs if you do ensure that sterile equipments
are used and do not share them with others
 Avoid sharing of sharp objects with others
 Avoid sharing of personal items like toothbrush
 NURSING
MANAGEMENT
Education Care Coordination
Medication Management Encouraging Regular Check-ups
Psychosocial Support Support for Family Members
Preventing Infections End of Life Care
Nutritional Guidance
Pain Management
 Treatment
 Nucleoside/Nucleotide Reverse Transcriptase
Inhibitors (NRTIs):Examples: Zidovudine (AZT),
Lamivudine (3TC), Tenofovir disoproxil fumarate
(TDF), and Abacavir (ABC).
 Non-Nucleoside Reverse Transcriptase Inhibitors
(NNRTIs):Examples efavirenz (EFV), Nevirapine
(NVP), and Rilpivirine (RPV).
 Protease Inhibitors (PIs):Examples: Atazanavir (ATV),
Darunavir (DRV), and Lopinavir/ritonavir (LPV/r).
 Treatment
 Integrase Strand Transfer Inhibitors
(INSTIs):Examples: Raltegravir (RAL), Dolutegravir
(DTG), and Elvitegravir (EVG).
 Entry and Fusion Inhibitors:Examples: Maraviroc
(MVC) and Enfuvirtide (T-20).
 CCR5 Antagonists:Examples: Maraviroc (MVC).
 Pharmacokinetic Enhancers:Ritonavir (RTV) and
Cobicistat (COBI) are often used to boost the
effectiveness of other protease inhibitors by
increasing their levels in the blood.
Prevention
• There are four levels of prevention .They include • PRIMARY PREVENTION
• 1.Primordial prevention • These are strategies undertaken to prevent or
• 2.Primary prevention avoid the development of disease .most
populations based health promotion activities
• 3.Secondary prevention
are primary preventive measures. They include
• 4.Tertiary prevention
• •Health promotion eg. maintaining a balance
diet and a healthy life style to help support the
• Primordial prevention immune system
• These includes the following • •Health education eg.safe sex practice I.e use of
• •Prevention of the risk factors condoms ,know your partner statues,personal
hygiene ,awareness about HIV infection
• •Prevention of emergency or development of
risk factors • •Specific protection eg. chemoprophylaxis,
immunization
• •Discourage harmful lifestyle
•
• •Encourage or promote a healthy eating habit
 Levels of prevention
• SECONDARY PREVENTION • TERTIARY PREVENTION
• These stage involves to detect
and treat problems at there early
• These level of prevention limits
stage,stopping the problem from further negative effects from a
causing serious or long term problem,it keeps existing problems
effects or from harming others. from getting worst.it alleviates the
These level is being
implemented after the problem effects of disease and injury and
has already began.but before the restores the individual to there
appearance of signs and optimal functioning levels .it is
symptoms. They involve implemented after the injury or
• Early diagnosis eg.regular HIV disease has occurred .the common
testing
control to this level is
• Prompt medical intervention
REHABILITATION,support care for
• Prevent complications people living with HIV
 CONCLUSION
HIV/AIDS epidemic has had a profound impact on Global health
since it's emergence in the 1980's. It's pattern of transmission
varies While sexual intercourse, needle sharing, and mother-to-
child transmissionremain primary routes of infection. Early
detection is crucial for timely intervention and prevention of
further transmission.
Prevention strategies, such as safe sex practices, needle exchange
programs, and education, are crucial in reducing new
infections.Antiretroviral therapy (ART) plays a central role in
managing the disease, improving the quality of life for individuals
living with HIV and reducing transmission rates. There is need for
ongoing global collaboration, public health measures, and
research to combat the epidemic effectively. By addressing
the social and structural factors that contribute to HIV
transmission and ensuring equitable access to prevention and
treatment, we can strive towards ending the HIV/AIDS epidemic
and improving the health and well-being of affected individuals
and communities.