AIDS

(ACQUIRED
IMMUNODEFICIENCY
SYNDROME)
ETOLOGI
CLINICAL FINDINGS (1)

■ Systemic complaints/ Symptoms

– Many individuals with HIV infection remain asymptomatic for
years without antiretroviral therapy (ART/ARV)  approximate
10 years between exposure of HIV and development of AIDS
– A combination of complains base on opportunistic infections
– Fever  persistent fever
– Night sweats
– Weight loss
– Anorexia nausea  vomiting
– Diarrhea
CLINICAL FINDINGS (2)

■ Signs
– Physical examination may be entirely normal
– Abnormal findings range from completely nonspesific to highly spesific for HIV
infection
■ Hairy leukoplakia of the tongue
■ Disseminated Kaposi’s sarcoma
■ Cutaneous bacillary angiomatosis
■ Oral candidiasis
– Opportunistic infections
OPPORTUNISTIC INFECTIONS (1)

– 1. Sinopulmonary disease
■ Pneumocystic carinii pneumonia
■ Other infectious pulmonary diseases
■ Noninfectious pulmonary diseases  Kaposi’s sarcoma
■ Sinusitis
– 2. Central nervous system disease
■ Toxoplasmosis
■ Central nervous system lymphoma
■ AIDS dementia complex
■ Cryptococcal meningitis
■ HIV myelopathy
■ Progressive multifocal leukoencephalopathy (PML)
OPPORTUNISTIC INFECTIONS (2)

– 3. Peripheral nervous system

– 4. Rheumatologic manifestation
– 5. Myopathy
– 6. Retinitis
– 7. Oral lesions
– 8. Gastrointestinal manifestations
■ Oral candidiasis
■ Candidal esophagitis
■ Hepatic disease  neoplasma & infection
■ Biliary disease  cholecystitis
■ Enterocolitis
OPPORTUNISTIC INFECTIONS (3)

– Endocrinologic manifestation  hypogonadism

– 10. Skin manifestations
■ Herpes simplex infections
■ Herpes zozter
■ Molluscum contagiosum
■ Staphylococcus infections
■ Bacillary angiomatosis
■ Fungal rashes
■ Seborreic dermatitis
■ Xerosis
■ Psoriasis
■ PPE (Pruritic Papular Eruption)
OPPORTUNISTIC INFECTIONS (4)

– HIV-related malignancies
■ Kaposi’s sarcoma
■ Non-Hodgkin’s lymphoma
■ Anal dysplasia & squamous cell carcinoma
■ Cervical dysplasia & neoplasia
– 12. Gynecologic manifestations
– 13. Inflammatory reactions (immune reconstitution syndrome = IRIS)
PERJALANAN INFEKSI HIV/AIDS
DIAGNOSTIK

■ Faktor-faktor risiko penularan HIV-AIDS

■ Dilakukan Tes ELISA  didapatkan hasil tes reaktif dengan
3 kali pemeriksaan dengan reagen yang berbeda
■ CD4 Count
STAGING HIV/AIDS
MENURUT WHO
GEJALA-GEJALA HIV/AIDS STADIUM KLINIS WHO

Asimptomatik 1

Gejala Ringan 2

Gejala Sedang 3

Gejala Berat 4
KLASIFIKASI NILAI HITUNG CD4
<11 bulan 12-25 bulan 36-59 bulan >5 tahun
Stadium
(%CD4+) (%CD4+) (%CD4+) (/mm3)

1 >35 >30 >25 >500

2 30-35 25-30 20-25 350-499

3 25-29 20-24 15-19 200-349

4 <25 <20 <15 <200

TREATMENT

1. Supportive therapy
2. Opportunistic infections & malignancies
3. Prophylaxis of opportunistic infections
4. Antiretroviral treatment (ARV/ART)
5. Hematopoietic stimulating factors
SLOW AIDS WASTING

– Fever control  antipyretic drugs

– Food supplementation with hight-caloric drinks
– Total parentral nutrition (NTN)
– Progestational agent: megestrol acetate
– Antiemetic agent: dromabinol  marjuana
– Growth hormone
– Anabolic steroid testosteron for 2-4 weeks
– Nausea  weight loss  metoclopramide, dromabinol
– Antideppresant
PROGNOSIS

■ With improvements in therapy, patients are living longer after the diagnosis of AIDS.
This has resulted in dramatic decreases in AIDS deaths. Despite new therapeutic
options, people continue to die from HIV infection.
■ Depend on:
– The stage of HIV/AIDS (I, II, III, IV)
– The Adherence of ARV
– The number of CD4 count
TERIMA KASIH