Human Immunodeficiency Virus Acquired Immunodeficiency syndrome first described in 1981 HIV-1 isolated in 1984, and HIV-2 in 1986 Belong to the lentiv
|
|
- Emma Wheeler
- 7 years ago
- Views:
Transcription
1 Global HIV/AIDS Manju Gaglani, M. D. Pediatric Infectious Diseases Scott & White Clinic
2 Human Immunodeficiency Virus Acquired Immunodeficiency syndrome first described in 1981 HIV-1 isolated in 1984, and HIV-2 in 1986 Belong to the lentivirus subfamily of the retroviridae Enveloped RNA virus, 120nm in diameter HIV-2 shares 40% nucleotide homology with HIV-1 Genome consists of 9200 nucleotides (HIV-1): gag core proteins - p15, p17 and p24 pol - p16 (protease), p31 (integrase/endonuclease) env - gp160 (gp120:outer membrane part, gp41: transmembrane part) Other regulatory genes ie. tat, rev, vif, nef, vpr and vpu
3 HIV particles
4 HIV Genome
5 Replication The first step of infection is the binding of gp120 to the CD4 receptor of the cell, which is followed by penetration and uncoating. The RNA genome is then reverse transcribed into a DNA provirus which is integrated into the cell genome. This is followed by the synthesis and maturation of virus progeny.
6 Schematic of HIV Replication
7
8 HIV-1 Genotypes There are 3 HIV-1 genotypes; M (Main), O (Outlayer), and N (New) M group comprises of a large number subtypes and recombinant forms Subtypes - (A, A2, B, C, D, F1, F2, G, H, J and K) Recombinant forms - AE, AG, AB, DF, BC, CD O and N group subtypes not clearly defined, especially since there are so few N group isolates. As yet, different HIV-1 genotypes are not associated with different courses of disease nor response to antiviral therapy. However, certain subgroups may be difficult to detect by certain commercial assays.
9
10 Natural History of HIV Infection without Antiretroviral Therapy Fauci A, Pantaleo D, Stanley S, Weismann D. Annals of Internal Medicine 124: , 1996.
11 HIV infection and AIDS Human Immunodeficiency virus infection at this time essentially is an uncontrolled global epidemic spreading mainly by heterosexual contact Acquired immunodeficiency syndrome is the last symptomatic stage of HIV infection after a latent stage, lasting months to several years
12
13 Adults and children estimated to be living with HIV, 2007 Western & Eastern Europe Central Europe & Central Asia North America 1.6 million [ million] [ million] 1.3 million [ million] Middle East & North Africa Caribbean [ ] Sub-Saharan Africa 1.6 million [ million] [ ] [ ] Latin America East Asia 22.5 million [ million] South & South-East Asia 4.0 million [ million] Oceania [ ] 000] Total: 33.2 ( ) million
14 Over 6800 new HIV infections a day in 2007 More than 96% are in low and middle income countries About 1200 are in children under 15 years of age About 5800 are in adults aged 15 years and older of whom: almost 50% are among women about 40% are among young people (15-24)
15
16
17
18
19
20
21
22
23
24
25
26
27 HIV Transmission Mother to Baby During Pregnancy or Birth Through Breast Feeding
28 Of 100 Babies Born to HIV HIV--infected Mothers infected during breast feeding 17 infected during birth 67 not infected* 5 infected in utero *Without treatment for parents, most will be orphaned
29 Timing of MotherMother-to to--child HIV Transmission with Breastfeeding and No ARV Early Postpartum (0-6 months) Early Antenatal (<36 wks) Late Postpartum (6-24 months) Labor and Delivery Late Antenatal (36 wks to labor) 0% 20% 40% Proportion of Infections 60% 80% 100%
30
31
32
33
34 Transmission of HIV inutero, during labor labor,, or via breastmilk Counseling and Voluntary testing of all pregnant women at early prenatal visit Assess HIVHIV-positive women for HAART and mode of delivery (Perinatal Guidelines) For Prevention of Perinatal Transmission PACTG 076 based: AZT to mother if asymptomatic, after 14 weeks, and also AZT infusion during labor, AZT to newborn to start immediately and give for 44-6 weeks Other alternatives available for special circumstances Look for maternal coinfections including TB, syphilis, toxoplasmosis, hepatitis B or C, cytomegalovirus, and herpes simplex virus
35
36
37
38 Management of HIV Exposed Infant H&P, look for coinfections e.g. Hep B/C, syphilis, TB, CMV, toxoplasma, HSV AZT (with or without 3TC or NVP) for 6 weeks HIV DNA Qualitative PCR (or RNA Quantitative at or 2-3 wks, 1-2 m and 4-6 mons testing (24 (24 hr if mother had high virus load, 4 weeks And 4 months) For nonnon-breastfeeding infants - Two neg PCRs at or after 2 weeks and 4 weeks, one neg PCR at or after 8 weeks and 1 neg HIV 1&2 AB EIA at or after 6 m needed for presumptive exclusion of HIV For nonnon-breastfeeding infants - definitive exclusion 2 neg PCR at or after 1 month and 4 months or 2 neg HIV1 HIV1&2 AB EIA after 6 months of age No Breastfeeding For breast feeding infants, similar testing using date after breastfeeding completely ceased instead of DOB CBC at 24 hrs, 4 wks, 8 wks FU if anemia Start PCP prophylaxis at 4-6 weeks and d/c when 4 mos testing is neg Confirm absence of HIV 1&2 AB at months 2 neg tests 1 month apart Immunization If not severely immunosuppressed, Ok to give live viral vaccines
39
40
41
42 Clinical Manifestations of HIV infection and AIDS in Children Multi-organ system involvement and MultiOpportunistic Infections For Clinical Classification System Refer 2006 AAP Redbook N, A, B, C (Asymptomatic, mild, moderate, and severe; and Immune Supression categories 1, 2, 3. eg N1, C3.
43
44
45 Pneumocystis jirovecii pneumonia
46 Lymphoid interstitial pneumonitis / pulmonary lymphoid hyperplasia (LIP/PLH)
47 LIP/PLH - parotid gland enlargement
48 Herpes simplex virus
49 Pseudomembranous candidiasis
50 Severe tinea corporis
51 Severe encephalopathy
52 Generalized brain atrophy
53 Cardiomegaly
54 Severe HIV wasting
55 Abdominal lymphoma
56 ELISA for HIV 1&2 antibody Microplate ELISA for HIV antibody: coloured wells indicate reactivity
57 Western blot for HIV 1 or 2 antibody There are different criteria for the interpretation of HIV Western blot results e.g. CDC, WHO, American Red Cross. The most important antibodies are those against the envelope glycoproteins gp120, gp160, and gp41 p24 antibody is usually present but may be absent in the later stages of HIV infection
58 Four FDAFDA-approved Rapid HIV Tests Sensitivity (95% C.I.) Specificity (95% C.I.) OraQuick Advance - whole blood - oral fluid - plasma 99.6 ( ) 99.3 ( ) 99.6 ( ) 100 (99.7 ( ) 99.8 ( ) 99.9 ( ) Uni Uni--Gold Recombigen - whole blood - serum/plasma 100 ( ) 100 ( ) 99.7 ( ) 99.8 ( )
59 Four FDAFDA-approved Rapid HIV Tests Sensitivity (95% C.I.) Specificity (95% C.I.) Reveal G2 - serum - plasma 99.8 ( ) 99.8 ( ) 99.1 ( ) 98.6 ( ) Multispot - serum/plasma - HIV HIV ( ) 100 ( ) 99.9 ( )
60 OraQuick Advance HIVHIV-1/2 CLIA-waived for finger CLIAstick, whole blood, oral fluid; moderate complexity with plasma Store at room temperature Screens for HIVHIV-1 and 2
61 Reactive Control Positive HIV-1/2 Positive Negative Read results in minutes
62 Goals of Antiretroviral therapy Suppress HIV replication as much as possible, for as long as possible Prevent immune destruction Delay or prevent viral resistance - a major contributor to treatment failure - by the use of highly active antiretroviral therapy Achieve normal survival
63 Targets for Antiretrovirals
64 Important Terms ART ARVs HAART Triple Therapy Anti ntir Retroviral Treatment Anti ntir RetroV etrovirals Highly Active Anti ntir Retroviral Treatment Three Antiretrovirals Basically it all means the same thing!
65 Triple Therapy Now we understand why triple therapy works. Two drugs can keep HIV from multiplying, even if it has mutated BUT, three drugs can work even better! Unfortunately, triple therapy is NOT able to cure HIV HIV is a very tricky virus. While most of it is getting killed by triple therapy, a few viruses find places to hide where they are safe from triple therapy
66 Managing Complications from HIV infection Opportunistic Infections: prevention and treatment eg: TMPTMP-SMX for PCP Other Complications: LIP, Apthous Stomatitis, Malignancies Nutrition, Immunizations Neuropsychological complications Palliative Care and pain management
67 Elements of Comprehensive Care and Support Human rights and legal support Socioeconomic support People, children, and families affected by AIDS Medical and Psychological nursing care support
68 Multidisciplinary (Team) Effort Administrator ART Care Model Social worker or Counsellor Physician Patient Nursing Nutritionist Laboratory SWs & MAs Community worker Pharmacist Minimum team members: RN, MD, Nutritionist, Pharmacist
69 Care of a child/adolescent with HIV infection or AIDS A team of dedicated professionals from multiple disciplines with a good understanding of the complexity of issues involved Patient education and counseling regarding hygiene, behavior, adherence Scrupulous use of standard precautions Respect for patient confidentiality
70 Why is HIV so Hard to Treat? 10 billion copies of the virus are made every day! Challenge of adherence Problem of resistance Difficulty of side effects
71 What Is Resistance? HIV reproduces very quickly, making billions of new viruses every day Because the virus often makes errors while copying itself, each new generation of viruses differs slightly from the one before Some changes to the structure of the virus can improve its ability to reproduce despite high levels of antianti-hiv drugs being present These new changes to the structure of the virus make it able to reproduce even in the presence of ARVs and thus, are said to be resistant to those drugs
72 Reducing Resistance The BEST way to reduce the development of resistance is to ensure maximum viral suppression using three drugs, taken as the correct dose, dose, at the correct time,, in the correct time way
73 % patients with viral suppression <400 copies/ml What Rate of Adherence Is Needed in ARV Therapy? % 70-80% 80-90% 90-95% >95% Percent adherence to therapy Source: Paterson D et al, 6th Conf ROI 1999 abstr #92
74 What does Adherence Look Like? * Twice a day regimen * Morning Dose 8 AM 8 PM Threshold of Therapeutic Viral Suppression Drug Level Drug concentration Evening Dose Higher toxicity (side effects) 8 AM Source: David Pantalone, Dept of Psychology, UW
75 and NonNon-Adherence? Drug resistant virus Drug resistant virus * Twice a day regimen * 8 AM 8 PM 8 AM Threshold of Viral Suppression Drug concentration Therapeutic Drug Level Achieved Source: David Pantalone, Dept of Psychology, UW
76 Effectiveness of Highly Active Antiretroviral Therapy (HAART) Before HAART On HAART
77 ABCs to Prevent HIV/STDs A = Abstinence B = Be Faithful C = Condom use
What is HIV? What is AIDS? The HIV pandemic HIV transmission Window period Stages of HIV infection
Module 1 Overview of HIV Infection Purpose Pre-requisite Modules Learning Objectives To provide you with the basic terms and concepts related to HIV infection. None At the end of this module, you will
More informationPediatric HIV - The World At It's Best
VIH/SIDA en Pediatría: Epidemiología Mundial, Transmisión Perinatal, Manejo Integral. Juan Carlos Salazar, M.D. Universidad de Connecticut, EE.UU. End-1998 global estimates Children (
More informationChapter 21. What Are HIV and AIDS?
Section 1 HIV and AIDS Today What Are HIV and AIDS? Human immunodeficiency virus (HIV) is the virus that primarily affects cells of the immune system and that causes AIDS. Acquired immune deficiency syndrome
More informationCore Competencies: HIV/AIDS: HIV Basics HIV/AIDS JEOPARDY* Overview. To change category names: Instructions. 2. Introduce session.
Core Competencies: HIV/AIDS: HIV Basics HIV/AIDS JEOPARDY* ABOUT THIS ACTIVITY Time: 60 minutes Objectives: By the end of this session, participants will be able to: Reviewed their knowledge of HIV/AIDS
More informationChapter 36. Media Directory. Characteristics of Viruses. Primitive Structure of Viruses. Therapy for Viral Infections. Drugs for Viral Infections
Chapter 36 Media Directory Drugs for Viral Infections Slide 23 Slide 27 Slide 29 Zidovudine Animation Saquinavir Mesylate Animation Acyclovir Animation Upper Saddle River, New Jersey 07458 All rights reserved.
More informationAntiretroviral therapy for HIV infection in infants and children: Towards universal access
Antiretroviral therapy for HIV infection in infants and children: Towards universal access Executive summary of recommendations Preliminary version for program planning 2010 Executive summary Tremendous
More informationFAQs HIV & AIDS. What is HIV? A virus that reduces the effectiveness of your immune system, meaning you are less protected against disease.
HIV & AIDS What is HIV? A virus that reduces the effectiveness of your immune system, meaning you are less protected against disease. What does HIV stand for? Human Immunodeficiency Virus Where did HIV
More informationThe Basics of Drug Resistance:
CONTACT: Lisa Rossi +1-412-641-8940 +1-412- 916-3315 (mobile) rossil@upmc.edu The Basics of Drug Resistance: QUESTIONS AND ANSWERS HIV Drug Resistance and ARV-Based Prevention 1. What is drug resistance?
More informationHIV/AIDS: General Information & Testing in the Emergency Department
What Is HIV? HIV/AIDS: General Information & Testing in the Emergency Department HIV is the common name for the Human Immunodeficiency Virus. HIV is a retrovirus. This means it can enter the body s own
More informationMANAGEMENT OF INFANTS BORN TO HIV POSITIVE MOTHERS
MANAGEMENT OF INFANTS BORN TO HIV POSITIVE MOTHERS Introduction Perinatal management of infants born to HIV-infected mothers requires a coordinated multidisciplinary team approach. The consultant leads
More informationBasic Presentation HIV/AIDS. For Use by Students, Teachers and the Public Seeking Basic Information About HIV/AIDS
Basic Presentation HIV/AIDS For Use by Students, Teachers and the Public Seeking Basic Information About HIV/AIDS Objectives- Define and understand the difference between HIV Infection and AIDS Describe
More informationHIV/AIDS. HIV- Human Immunodeficiency Virus. AIDS immume system severely damaged
HIV/AIDS HIV- Human Immunodeficiency Virus Person is infected with virus. May have no s/s (but may transmit virus) More common to have brief flu-like illness 2-6 wks after becoming infected (swollen lymph
More informationCase Finding for Hepatitis B and Hepatitis C
Case Finding for Hepatitis B and Hepatitis C John W. Ward, M.D. Division of Viral Hepatitis Centers for Disease Control and Prevention Atlanta, Georgia, USA Division of Viral Hepatitis National Center
More informationCombination Anti-Retroviral Therapy (CART) - Rationale and Recommendation. M Dinaker. Fig.1: Effect of CART on CD4 and viral load
Combination Anti-Retroviral Therapy (CART) - Rationale and Recommendation M Dinaker INTRODUCTION The wide availability of effective, safe and mostly well tolerated combined anti-retroviral therapy (CART)
More informationYes, I know I have genital herpes:
Counseling Messages for Herpes Simplex Type II (HSV-II) Genital herpes Always take the time to attend to the participant s feelings and emotional state; for some people, this is the most devastating news
More informationZika Virus. Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases
Zika Virus Fred A. Lopez, MD, MACP Richard Vial Professor Department of Medicine Section of Infectious Diseases What is the incubation period for Zika virus infection? Unknown but likely to be several
More informationSOGC recommendation on ZIKA virus exposure for clinicians caring for pregnant women and those who intend to get pregnant
SOGC recommendation on ZIKA virus exposure for clinicians caring for pregnant women and those who intend to get pregnant Foreword The rapid emergence of Zika virus as a potential causative agent for fetal
More informationTuberculosis and HIV/AIDS Co-Infection: Epidemiology and Public Health Challenges
Tuberculosis and HIV/AIDS Co-Infection: Epidemiology and Public Health Challenges John B. Kaneene, DVM, MPH, PhD University Distinguished Professor of Epidemiology Director, Center for Comparative Epidemiology
More informationGeneral information about HIV
HIV and pregnancy 1 To the reader The brochure is intended for women and families that are either pregnant or planning a pregnancy. The brochure discusses the matters that must be taken into consideration
More informationCommonly Asked Questions About Chronic Hepatitis C
Commonly Asked Questions About Chronic Hepatitis C From the American College of Gastroenterology 1. How common is the hepatitis C virus? The hepatitis C virus is the most common cause of chronic viral
More informationHIV/AIDS Care: The Diagnosis Code Series 2. Prepared By: Stacey L. Murphy, MPA, RHIA, CPC AHIMA Approved ICD-10-CM/ICD-10-CM Trainer
HIV/AIDS Care: The Diagnosis Code Series 2 Prepared By: Stacey L. Murphy, MPA, RHIA, CPC AHIMA Approved ICD-10-CM/ICD-10-CM Trainer Learning Outcomes Identify and explain the difference between ICD-9-CM
More informationExposure. What Healthcare Personnel Need to Know
Information from the Centers for Disease Control and Prevention National Center for Infectious Diseases Divison of Healthcare Quality Promotion and Division of Viral Hepatitis For additional brochures
More informationOutpatient/Ambulatory Health Services
Outpatient/Ambulatory Health Services Service Definition Outpatient/ambulatory medical care includes the provision of professional diagnostic and therapeutic services rendered by a physician, physician
More informationBorderless Diseases By Sunny Thai
Borderless Diseases By Sunny Thai Millennium Development Goal #6 6. Combat HIV/AIDS, malaria and other borderless diseases. A. Halt and begin reversing spread of HIV by 2015. B. Achieve universal access
More informationIn Tanzania, ARVs were introduced free-of-charge by the government in 2004 and, by July 2008, almost 170,000 people were receiving the drugs.
ANTIRETROVIRAL TREATMENT What is ART and ARV? ART is a short form for Antiretroviral Therapy (or Treatment). Antiretroviral therapy is a treatment consisting of a combination of drugs which work against
More informationHIV/AIDS Prevention and Care
HIV/AIDS Prevention and Care Nancy S. Padian, PhD, MPH Professor, Obstetrics, Gynecology & Reproductive Sciences Associate Director for Research, Global Health Sciences and AIDS Research Institute: University
More informationSuggested Reporting Language for the HIV Laboratory Diagnostic Testing Algorithm
Suggested Reporting Language for the HIV Laboratory Diagnostic Testing Algorithm November 2013 Introduction In March 2010, the Centers for Disease Control and Prevention (CDC) and the Association of Public
More informationHuman Immunodeficiency Virus: The Genetic Bottleneck in Mother-to-Child Transmission
Human Immunodeficiency Virus: The Genetic Bottleneck in Mother-to-Child Transmission 1 Abstract Human Immunodeficiency Virus (HIV) has become a global epidemic, with an estimated 2.5 million children currently
More informationRoutine HIV Monitoring
Routine HIV Monitoring Guideline of the HIV/AIDS Division at San Francisco General Hospital Statement of Guideline: Patients will be routinely evaluated and monitored for HIV parameters, antiretroviral
More informationhiv/aids Programme Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants
hiv/aids Programme Programmatic update Use of Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV Infection in Infants EXECUTIVE SUMMARY April 2012 EXECUTIVE SUMMARY Recent developments
More informationThe Stigma of HIV and AIDS. A Brief History of HIV/AIDS. A Brief History of HIV/AIDS. Opportunistic Infections and Modes of Transmission
Nurse Caring Concepts 1A The Stigma of HIV and AIDS Opportunistic Infections and Modes of Transmission Week 17 12-8 -03 1926-1945 HIV may have spread from monkeys to humans (may have first jumped from
More informationGuidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis
Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency
More informationCME Article Hiv Disease Surveillance
CME Article Hiv Disease Surveillance hiv disease surveillance cme Collaboration between Medicine and Public Health Sindy M. Paul, md, mph; Helene Cross, phd; Linda Dimasi, mpa; Abdel R. Ibrahim, phd; and
More informationUp to $402,000. Insight HIV. Drug Class. 1.2 million people in the United States were living with HIV at the end of 2011 (most recent data).
HIV Background, new developments, key strategies Drug Class Insight INTRODUCTION Human Immunodeficiency Virus (HIV) is the virus that can lead to Acquired Immunodeficiency Syndrome, or AIDS. No safe and
More informationGuideline. Treatment of tuberculosis in patients with HIV co-infection. Version 3.0
Guideline Treatment of tuberculosis in patients with HIV co-infection Version 3.0 Key critical points Co-infection with Tuberculosis (TB) and HIV is common in many parts of the world, especially sub-saharan
More informationViral load testing. medical monitoring: viral load testing: 1
medical monitoring: viral load testing: 1 medical monitoring: viral load testing Viral load testing medical monitoring: viral load testing: 2 Slide 1 Viral load The viral load test measures HIV in the
More informationFrequently Asked Questions (FAQs)
Frequently Asked Questions (FAQs) Research Rationale 1. What does PrEP stand for? There is scientific evidence that antiretroviral (anti-hiv) medications may be able to play an important role in reducing
More informationACCESS TO AFFORDABLE TREATMENT FOR HIV/AIDS: THE ISSUES
ACCESS TO AFFORDABLE TREATMENT FOR HIV/AIDS: THE ISSUES AIDS Law Unit Legal Assistance Centre July, 2002 INTRODUCTION Although there is currently no cure for HIV/Aids, treatment has, however, been developed
More informationRegister for e-mail notification of guideline updates at http://aidsinfo.nih.gov/e-news.
Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States Visit the AIDSinfo website
More informationIV. Counseling Cue Cards. ICAP International Center for AIDS Care and Treatment Mailman School of Public Health Columbia University
IV. Counseling Cue Cards ICAP International Center for AIDS Care and Treatment Mailman School of Public Health Columbia University How to Use These Counseling Cue Cards ABOUT THE CUE CARDS This set of
More informationPOST-EXPOSURE PROPHYLAXIS IN THE HEALTH CARE SETTING
MARCH 2014 A Quick Guide to POST-EXPOSURE PROPHYLAXIS IN THE HEALTH CARE SETTING HIV PROVIDER REFERENCE SERIES A PUBLICATION OF THE MOUNTAIN PLAINS AIDS EDUCATION AND TRAINING CENTER MountainPlains AIDS
More informationEPIDEMIOLOGY OF HEPATITIS B IN IRELAND
EPIDEMIOLOGY OF HEPATITIS B IN IRELAND Table of Contents Acknowledgements 3 Summary 4 Introduction 5 Case Definitions 6 Materials and Methods 7 Results 8 Discussion 11 References 12 Epidemiology of Hepatitis
More informationHow can herpes simplex spread to an infant?
CHAPTER 3 HERPES AND PREGNANCY As an expectant parent eagerly awaiting the birth of your new baby, you are probably taking a number of steps to ensure your baby s health. One step many experts recommend
More informationHBV screening and management in HIV-infected children and adolescents
HBV screening and management in HIV-infected children and adolescents Linda Aurpibul M.D. Research Institute for Health Sciences, Chiang Mai University 8% HIV and Hepatitis B Co-infection Among Perinatally
More informationAppendix E-- The CDC s Current and Proposed Classification System for HIV Infection
Appendix E-- The CDC s Current and Proposed Classification System for HIV Infection The Centers for Disease Control (CDC) has developed a classification system for human immunodeficiency virus (HIV) infection
More informationCONNECTICUT DEPARTMENT OF PUBLIC HEALTH HEALTH CARE AND SUPPORT SERVICES HIV MEDICATION ADHERENCE PROGRAM PROTOCOL
CONNECTICUT DEPARTMENT OF PUBLIC HEALTH HEALTH CARE AND SUPPORT SERVICES HIV MEDICATION ADHERENCE PROGRAM PROTOCOL Revised July 2013 HIV MEDICATION ADHERENCE PROGRAM PROGRAM OVERVIEW People living with
More informationWilliam Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016
William Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016 Advisory Committee on Immunization Practices (ACIP) The recommendations to be discussed are primarily those of the ACIP composed of 15
More informationTreatment Information Service 1 800 HIV 0440 HIV/AIDS. HIV and Its Treatment What You Should Know. 2nd edition
HIV/AIDS Treatment Information Service 1 800 HIV 0440 HIV and Its Treatment What You Should Know 2nd edition HIV/AIDS TREATMENT INFORMATION SERVICE 2nd Edition HIV and Its Treatment: What You Should Know
More informationDidactic Series. Updated Post-Exposure Prophylaxis (PEP) Guidelines. Daniel Lee, MD UCSD Medical Center, Owen Clinic January 9, 2014
Didactic Series Updated Post-Exposure Prophylaxis (PEP) Guidelines Daniel Lee, MD UCSD Medical Center, Owen Clinic January 9, 2014 ACCREDITATION STATEMENT: University of California, San Diego School of
More informationMother s blood test to check her unborn baby s blood group
Mother s blood test to check her unborn baby s blood group This leaflet explains why it is important to have a blood test to check the baby s blood group, so that only those who need it, receive anti-d
More informationPERINATAL HIV. AIIMS- NICU protocols 2008. Sunil Saharan 1, Rakesh Lodha 2, Ramesh Agarwal 2, Ashok Deorari 3, Vinod Paul 3 1
PERINATAL HIV Sunil Saharan 1, Rakesh Lodha 2, Ramesh Agarwal 2, Ashok Deorari 3, Vinod Paul 3 1 Senior resident, 2 Assistant Professor, 3 Professor Division of Neonatology, Department of Pediatrics All
More informationTOWARDS AN HIV VACCINE
why is it so hard to make an HIV vaccine and where are we now? Neal Nathanson, MD Emeritus Professor Department of Microbiology University of Pennsylvania School of Medicine 1 Estimated number of persons
More informationAccent on Health Obgyn, PC HERPES Frequently Asked Questions
1. What is herpes? 2. How common is herpes? 3. Is there a cure for herpes? 4. What is oral herpes (cold sores)? 5. How is oral herpes spread? 6. What is genital herpes? 7. How is genital herpes spread?
More informationCytomegalovirus (HHV5/CMV) Roseolovirus (HHV6 & 7)
Betaherpesvirinae Cytomegalovirus (HHV5/CMV) Roseolovirus (HHV6 & 7) CYTOMEGALOVIRUS CMV is thought to be amongst the oldest type of herpesvirus in evolutionary terms. CMV is the prototype of beta-herpesviruses
More informationSpecial Considerations
Special Considerations Women and cart to Treatment What is medication adherence? taking medication exactly the way it is prescribed by the doctor taking the right amount of medication at the right time
More informationTitle: Post Exposure Prophylaxis Page 1 of 8 Policy No: 1 CLN 010 Effective Date 04/15/11
Title: Post Exposure Prophylaxis Page 1 of 8 OBJECTIVE To standardize medical care following a Blood or Bodily Fluid Exposure (BBFE). SCOPE All Exposed Individuals (as defined below) who present for post-exposure
More informationBASIC INFORMATION ABOUT HIV, HEPATITIS B and C, and TUBERCULOSIS Adapted from the CDC
BASIC INFORMATION ABOUT HIV, HEPATITIS B and C, and TUBERCULOSIS Adapted from the CDC HIV What are HIV and AIDS? HIV stands for Human Immunodeficiency Virus. This is the virus that causes AIDS. HIV is
More informationHIV/AIDS. Information booklet
HIV/AIDS Information booklet Content Introduction 1 What is HIV/AIDS 2 How is HIV spread? 4 Symptoms of HIV infection 7 Testing for HIV 8 Preventing the spread of HIV 10 Sexually Transmitted Infections
More informationPregnancy and Tuberculosis. Information for clinicians
Pregnancy and Tuberculosis Information for clinicians When to suspect Tuberculosis (TB)? Who is at risk of TB during pregnancy? Recent research suggests that new mothers are at an increased risk of TB
More informationViral hepatitis. Report by the Secretariat
SIXTY-THIRD WORLD HEALTH ASSEMBLY A63/15 Provisional agenda item 11.12 25 March 2010 Viral hepatitis Report by the Secretariat THE DISEASES AND BURDEN 1. The group of viruses (hepatitis A, B, C, D and
More informationAim of Presentation. The Role of the Nurse in HIV Care. Global Epidemic 7/24/09
Aim of Presentation The Role of the Nurse in HIV Care Eileen Nixon HIV Nurse Consultant Brighton and Sussex University Hospitals Overview of key issues that affect people with HIV Identify the role of
More information1 2 3 4 5 6 Figure 4.1: Gel picture showing Generation of HIV-1subtype C codon optimized env expressing recombinant plasmid pvax-1:
Full-fledged work is in progress towards construction and cloning of codon optimized envelope with subsequent aims towards immunization of mice to study immune responses. 1 2 4 5 6 Figure 4.1: Gel picture
More information12/2/2015 HEPATITIS B AND HEPATITIS C BLOOD EXPOSURE OBJECTIVES VIRAL HEPATITIS
HEPATITIS B AND HEPATITIS C BLOOD EXPOSURE DISEASE 101 ONLINE CONFERENCE SARAH WENINGER, MPH VIRAL HEPATITIS.STD.HIV PREVENTION COORDINATOR DECEMBER 3, 2015 OBJECTIVES Describe the populations that should
More informationHow Does a Doctor Test for AIDS?
Edvo-Kit #S-70 How Does a Doctor Test for AIDS? S-70 Experiment Objective: The Human Immunodefi ciency Virus (HIV) is an infectious agent that causes Acquired Immunodefi ciency Syndrome (AIDS) in humans.
More informationGUIDELINES FOR TUBERCULOSIS PREVENTIVE THERAPY AMONG HIV INFECTED INDIVIDUALS IN SOUTH AFRICA
GUIDELINES FOR TUBERCULOSIS PREVENTIVE THERAPY AMONG HIV INFECTED INDIVIDUALS IN SOUTH AFRICA 2010 1 TB prophylaxis GUIDELINES FOR TUBERCULOSIS PREVENTIVE THERAPY AMONG HIV INFECTED INDIVIDUALS Background
More informationMUSC Occupational Blood Borne Pathogen Protocol Off-Campus Procedure Packet
MUSC Occupational Blood Borne Pathogen Protocol Off-Campus Procedure Packet MUSC Medical Center has established these protocols in accordance with the OSHA Blood Borne Pathogen Standard and Center for
More informationROYAL HOSPITAL FOR WOMEN
HEPATITIS B POSITIVE MOTHERS AND THEIR BABIES This LOP is developed to guide clinical practice at the Royal Hospital for Women. Individual patient circumstances may mean that practice diverges from this
More informationChickenpox in pregnancy: what you need to know
Chickenpox in pregnancy: what you need to know First published December 2003 Revised edition published November 2008 What is chickenpox? Chickenpox is a very infectious illness caused by a virus called
More informationViral Replication. Viral Replication: Basic Concepts
Viral Replication Scott M. Hammer, M.D. Viral Replication: Basic Concepts Viruses are obligate intracellular parasites Viruses carry their genome (RNA or DNA) and sometimes functional proteins required
More informationWhooping cough and pregnancy
Whooping cough and pregnancy Your questions answered on how to help protect your baby 2014 edition the safest way to protect yourself and your baby 1 There is a lot of whooping cough around at the moment
More informationGetting to zero new infections in children: what will it take? Dr Lee Fairlie 27 September2014
Getting to zero new infections in children: what will it take? Dr Lee Fairlie 27 September2014 Content What will it take from us individually? Back to basics Pressure points for PMTCT What else do we need?
More informationHIV Continuum of Care Monitoring Framework 2014
HIV Continuum of Care Monitoring Framework 2014 Addendum to meeting report: Regional consultation on HIV epidemiologic information in Latin America and the Caribbean HIV Continuum of Care Monitoring Framework
More informationWhen an occupational exposure occurs, the source patient should be evaluated for both hepatitis B and hepatitis C. (AII)
XI. OCCUPATIONAL EXPOSURES TO HEPATITIS B AND C RECOMMENDATION: When an occupational exposure occurs, the source patient should be evaluated for both hepatitis B and hepatitis C. (AII) The risk of transmission
More informationFEDERAL BUREAU OF PRISONS REPORT ON INFECTIOUS DISEASE MANAGEMENT
FEDERAL BUREAU OF PRISONS REPORT ON INFECTIOUS DISEASE MANAGEMENT What is the purpose of this report? The purpose of this report is to present the administrative policies and clinical guidelines for the
More informationHIV TESTING AND D IAGNOSIS IN I NFANTS AND C HILDREN
CHAPTER 1 HIV TESTING AND D IAGNOSIS IN I NFANTS AND C HILDREN 12/04 I. INTRODUCTION Although there have been tremendous advances in the care of HIV-infected adults and children in the last several years,
More informationPediatric Latent TB Diagnosis and Treatment
Date Updated: April 2015 Guidelines Reviewed: 1. CDC Latent TB Guidelines 2. Harborview Pediatric Clinic Latent TB Management, 2010 3. Pediatric Associates Latent TB Guidelines, 2013 4. Seattle Children
More informationNICHD s Pediatric, Adolescent, & Maternal AIDS Branch
Friends of NICHD Webinar: NICHD s Pediatric, Adolescent, & Maternal AIDS Branch Lynne Mofenson, MD Branch Chief December 19, 2008 Please call in-dial: 888-517-2197 Code:7080363 Webinar Guidelines All participants
More informationMolecular Diagnosis of Hepatitis B and Hepatitis D infections
Molecular Diagnosis of Hepatitis B and Hepatitis D infections Acute infection Detection of HBsAg in serum is a fundamental diagnostic marker of HBV infection HBsAg shows a strong correlation with HBV replication
More informationCoding and Billing for HIV Services in Healthcare Facilities
P a g e 1 Coding and Billing for HIV Services in Healthcare Facilities The Hawai i State Department of Health STD/AIDS Prevention Branch is pleased to provide you information on billing and reimbursement
More informationPOST EXPOSURE PROPHYLAXI S
Departments of Infectious Diseases & Emergency Medicine POST EXPOSURE PROPHYLAXI S QUI CK GUI DE FOR EMERGENCY DEPT Adapted from Irish National PEP Guidelines and St James s Hospital GUIDE Clinic/Emergency
More informationBloodborne Pathogens (HIV, HBV, and HCV) Exposure Management
Bloodborne Pathogens Exposure Policy and Procedures Employees of the State of South Dakota Department of Health Bloodborne Pathogens (HIV, HBV, and HCV) Exposure Management PEP Hotline 1-888-448-4911 DOH
More informationGuidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents Visit the AIDSinfo website to access the most up-to-date guideline. Register for e-mail notification of guideline
More informationINITIATING ORAL AUBAGIO (teriflunomide) THERAPY
FOR YOUR PATIENTS WITH RELAPSING FORMS OF MS INITIATING ORAL AUBAGIO (teriflunomide) THERAPY WARNING: HEPATOTOXICITY AND RISK OF TERATOGENICITY Severe liver injury including fatal liver failure has been
More informationAn overview of CLL care and treatment. Dr Dean Smith Haematology Consultant City Hospital Nottingham
An overview of CLL care and treatment Dr Dean Smith Haematology Consultant City Hospital Nottingham What is CLL? CLL (Chronic Lymphocytic Leukaemia) is a type of cancer in which the bone marrow makes too
More informationin hiv diagnostics the role of phls
Issues in Brief: HIV Diagnostics UPDATE Association of Public Health Laboratories August 2011 Conference calls Focus on New trends in hiv diagnostics the role of phls In February 2011, the Association
More informationGARPR Online Reporting Tool
GARPR Online Reporting Tool 0 Narrative Report and Cover Sheet 1) Which institutions/entities were responsible for filling out the indicator forms? a) NAC or equivalent Yes b) NAP Yes c) Others Yes If
More informationDiseases that can be spread during sex
Diseases that can be spread during sex Did you know... over 65 million people in the United States have a chronic, incurable sexually transmitted disease (STD)? and that every year another 19 million persons
More informationDiagnosis of HIV-1 Infection. Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University
Diagnosis of HIV-1 Infection Estelle Piwowar-Manning HPTN Central Laboratory The Johns Hopkins University Tests Used to Diagnose HIV-1 Infection HIV antibody (today s topic) HIV p24 antigen HIV DNA HIV
More informationFact Sheet for Health Care Providers: Interpreting Results from the Aptima Zika Virus Assay. June 17, 2016
Dear Health Care Provider: Fact Sheet for Health Care Providers: Interpreting Results from the Aptima Zika Virus Assay June 17, 2016 The U.S. Food and Drug Administration (FDA) has issued an Emergency
More informationViruses. Viral components: Capsid. Chapter 10: Viruses. Viral components: Nucleic Acid. Viral components: Envelope
Viruses Chapter 10: Viruses Lecture Exam #3 Wednesday, November 22 nd (This lecture WILL be on Exam #3) Dr. Amy Rogers Office Hours: MW 9-10 AM Too small to see with a light microscope Visible with electron
More informationThe State Hospital HIV / AIDS
The State Hospital HIV / AIDS The red ribbon is the international symbol of HIV & AIDS awareness. What is HIV? HIV stands for Human Immunodeficiency Virus: H is for Human - This virus infects human beings.
More informationHIV (Human Immunodeficiency Virus) Screening and Pre-Exposure Prophylaxis Guideline
HIV (Human Immunodeficiency Virus) Screening and Pre-Exposure Prophylaxis Guideline Background... 2 Screening... 2 Recommendations... 2 Ordering and consent... 2 Indications for Periodic HIV Screening...
More informationManagement of HIV in Pregnancy
Green-top Guideline No. 39 June 2010 Management of HIV in Pregnancy Management of HIV in Pregnancy This is the second edition of this guideline, which was originally published in 2004 under the same title.
More informationHEPATITIS WEB STUDY Acute Hepatitis C Virus Infection: Epidemiology, Clinical Features, and Diagnosis
HEPATITIS WEB STUDY Acute C Virus Infection: Epidemiology, Clinical Features, and Diagnosis H. Nina Kim, MD Assistant Professor of Medicine Division of Infectious Diseases University of Washington School
More informationA guide for people with genital herpes
A guide for people with genital herpes Contents Getting the facts 4 The key facts 6 What is genital herpes? 8 Genital herpes symptoms 10 Getting tested 12 The first outbreak 14 Recurrent outbreaks 16 Common
More information2015 Outpatient Chronic Hepatitis B Management
2015 Outpatient Chronic Hepatitis B Management Hepatitis B Hepatitis B Info 70% of acute infections are subclinical More severe symptoms when in addition to other liver disease Fulminant Hepatitis
More informationPERINATAL NUTRITION. Nutrition during pregnancy and lactation. Nutrition during infancy.
PERINATAL NUTRITION Nutrition during pregnancy and lactation Nutrition during infancy. Rama Bhat, MD. Department of Pediatrics, University of Illinois Hospital Chicago, Illinois. Nutrition During Pregnancy
More informationPREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION
PREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION Health Plan of Nevada and Sierra Health and Life suggest that health plan members get certain screening tests, exams and shots to stay healthy. This document
More informationTheonest Ndyetabura KILIMANJARO CHRISTIAN MEDICAL CENTRE / KILIMANJARO CLINICAL RESERCH
TREATMENT FAILURE AND PATTERNS OF GENOTYPIC DRUG RESISTANCE MUTATIONS AMONG HAART EXPERIENCED HIV-1 PATIENTS AT KCMC Theonest Ndyetabura KILIMANJARO CHRISTIAN MEDICAL CENTRE / KILIMANJARO CLINICAL RESERCH
More information