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HIV/AIDS

Dr. Fazah Akhtar Bt. HanapiahPegawai Perubatan,

Perkhidmatan Kesihatan SekolahDaerah Klang.

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DEFINISI

HIVAIDS

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Sejenis retrovirus yang diketahui pada awal tahun 1980an. Jangkitan ini menyebabkan kemusnahan sistem daya tahan melawan penyakit dan barah.

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‘Acquired Immunodeficiency Syndrome’

Peringkat terakhir Jangkitan HIV.Sistem daya tahan tubuh melawan penyakit dan kanser telah lumpuh. Pada peringkat ini pesakit akan mendapat gejala jangkitan oportunis dan barah tertentu.

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SEJARAH JANGKITAN HIV

Kes pertama tahun 1981 di California USA Peringkat awal - golongan homoseksual Diikuti biseksual/heteroseksual Dalam tempoh 15 tahun - 20 juta telah dijangkiti HIV Di Malaysia, Kes pertama dikesan pada tahun 1986 Ujian saringan HIV terhadap darah pada tahun 1986 Ujian HIV untuk ibu-ibu mengandung mula pada tahun

1998 (pengawasan mulai tahun 1994)

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CARA JANGKITAN

3 cara utama :SeksDarah Ibu ke anak

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Sexually Transmitted Diseases and AIDS ProgrammeWorld Health Organization Western Pacific Regional Office

Spektrum Jangkitan HIVSpektrum Jangkitan HIV

Tempoh Jangkitan

PeringkatJangkitan

Mati

2 bulan HIV Negative(Window Period)

10 tahun HIV Positive

2 tahunKlinikal AIDS

110102

Pembawa

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Pembawa HIV

kelihatan sihat

tiada tanda penyakit

tidak boleh dikenali

purata 10 tahun

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PERINGKAT AIDS : Tanda-tanda

Hilang berat badan mendadak (> 10%) Cirit birit atau demam berpanjangan (> 1 bulan) Jangkitan Pneumocystis carinii pneumonia (PCP) Jangkitan Cytomegalovirus (lung, brain, retina) Tibi (paru-paru/extra pulmonary) Jangkitan fungus spt. Candida, cryptococosis, histoplasma Toxoplasmosis (brain) Herpes simplex (GIT), herpes zooster Jangkitan spt. Cryptococosis, microsprodium, isospora Barah spt. Lymphoma Kaposi sarcoma

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Pesakit AIDS

tidak sihat

ada tanda penyakit– susut berat badan– demam

berpanjangan– sakit kulit– jangkitan paru-paru– bengkak kelenjar

2 tahun

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Hilang Berat Badan

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Herpes Zoster

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Oral Thrush

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Non Hodgkin’s Lymphoma

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110101

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AIDS and HIV Infection

Global Global EpidemiologyEpidemiology

110101

Adults and children estimated to be living Adults and children estimated to be living with HIV/AIDS as of end 2000with HIV/AIDS as of end 2000

Western Europe540 000540 000

North Africa & Middle East

400 000400 000Sub-Saharan

Africa25.3 million25.3 million

Eastern Europe & Central Asia700 000700 000

South & South-East Asia

5.8million5.8millionAustralia & New Zealand

15 00015 000

North America920 000920 000

Caribbean390 000390 000

Latin America1.4 million1.4 million

Total: 36.1 millionTotal: 36.1 million

East Asia & Pacific640 000640 000

Estimated adult and child deaths due to HIV/AIDSEstimated adult and child deaths due to HIV/AIDSfrom the beginning of the epidemic to end 2000from the beginning of the epidemic to end 2000

Western Europe210 000210 000

North Africa & Middle East

70 00070 000Sub-Saharan

Africa13.7 million13.7 million

Eastern Europe &Central Asia17 00017 000

East Asia & Pacific40 00040 000South

& South-East Asia1.1 million1.1 million

Australia & New Zealand

8 0008 000

North America450 000450 000

Caribbean160 000160 000

Latin America520 000520 000

Total: 21.8 millionTotal: 21.8 million99000-E-3 – 1 December 1999

Estimated adult and child deaths Estimated adult and child deaths from HIV/AIDS during 2000from HIV/AIDS during 2000

Western Europe7 0007 000

North Africa & Middle East

24 00024 000Sub-Saharan

Africa2.4 million2.4 million

Eastern Europe &Central Asia14 00014 000 East Asia & Pacific

25 00025 000South & South-East Asia

470 000470 000

Australia & New Zealand

< 500< 500

North America20 00020 000

Caribbean32 00032 000

Latin America50 00050 000

Total: 3 millionTotal: 3 million99000-E-5 – 1 December 1999

Estimated number of adults and childrenEstimated number of adults and childrennewly infected with HIV during 2000newly infected with HIV during 2000

Western Europe30 00030 000

North Africa & Middle East

80 00080 000Sub-Saharan

Africa3.8 million3.8 million

Eastern Europe &Central Asia250 000250 000East Asia & Pacific

130 000130 000South & South-East Asia

780 000780 000Australia & New Zealand

500500

North America45 00045 000

Caribbean60 00060 000

Latin America150 000150 000

Total: 5.3 millionTotal: 5.3 million99000-E-7 – 1 December 1999

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About 15 000 new HIV infections a day in 2000About 15 000 new HIV infections a day in 200034/734/7

More than 95% are in developing countries

About 1 700 are in children under 15 years of age

About 13 000 are in persons aged 15 to 49 years, of whom:

— 47% are women— over 50% are 15–24 year olds

99000-E-11 – 1 December 1999

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HIV/AIDS in Asia

Status and trendsPerspectives

110301

Country/Area HIV prevalence adults (15-49)

HIV prev. rate adults (15-49)

% Women HIV pos

Sexual contact

Injecting drug use Others

Cambodia 180 000 3.70% 30% 95% 3% 2%Thailand 740 000 2.14% 50% 75% 10% 15%Myanmar 447 000 1.87% 20% 30% 70% 10%India 4 900 000 0.98% 25%Malaysia 45 000 0.35% 20% 20% 75% 5%Nepal 34 000 0.33% 40%Viet Nam 80 000 0.20% 20% 20% 75% 5%Papua New Guinea 4 400 0.19% 50% 95% <1% <5%Singapore 3 800 0.18% 20% 95% <1% 5%Australia 10 800 0.11% 5% 91% 5% 4%Hong Kong / China 3 400 0.09% 40% 80% 15% 5%China 400 000 0.09% 12% 10% 50% 40%Philippines 29 000 0.08% 30% 90% <5% 6%Sri Lanka 7 000 0.07% 30%New Zealand 1 200 0.06% 15% 95% 3% 2%Indonesia 60 000 0.05% 25%Lao PDR 1 200 0.05% 50% 95% 3% 2%Bangladesh 23 000 0.04% 15%Republic of Korea 3 400 0.01% 13% 93% <1% 7%Japan 7 300 0.01% 5% 50% <5% 46%Total 7 000 000110308

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Estimated / projected HIV prevalence rateEstimated / projected HIV prevalence rateselected countries - Asia - 1980-2000selected countries - Asia - 1980-2000

%

110313

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Trends in AIDS ReportedTrends in AIDS ReportedSelected countries 1989-1997Selected countries 1989-1997

0 100 200 300 400 500 600 700 800 900

1 000

89 90 91 92 93 94 95 96 97

AIDS cases reported New ZealandAustraliaHong KongJapanS. KoreaSingapore

110507

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HIV/AIDS in Malaysia

Status and trendsPerspectives

0

1,000

2,000

3,000

4,000

5,000

6,000

BILA

NGA

N KE

S

TAHUN

HIV 200 778 1,794 2,512 2,507 3,393 4,198 4,597 3,924 4,624 4,692 5,117

AIDS 2 18 60 73 71 105 233 347 568 875 1,200 1,095

MATI 1 10 19 46 55 80 165 271 473 689 874 853

89 90 91 92 93 94 95 96 97 98 99 2000

HIV, AIDS DAN KEMATIAN MALAYSIA, 1989 – 2000

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Peratusan Jangkitan HIV Mengikut Jantina Di Malaysia dari

Tahun 1985-1997

Lelaki96%

Perempuan4% Lelaki

Perempuan

PERATUS KES HIV BERKAITAN DENGAN “IDU”,MALAYSIA 1986 – 2000

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

TAHUN

% K

ES H

IV

IDU 33.33 50.00 11.11 74.00 60.41 64.27 75.32 78.58 81.84 75.92 82.66 76.81 77.68 71.91 72.801986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

PERATUS KES HIV BERKAITAN DENGAN HUBUNGAN SEKS, MALAYSIA 1986 – 2000

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

TAHUN

% K

ES H

IV

SEX 66.70 0.00% 11.11 16.00 5.30% 8.50% 6.80% 7.50% 1.20% 7.70% 8.40% 11.50 14.80 18.10 18.001986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

PERATUS KES HIV MENGIKUT UMUR,MALAYSIA 1988– 2000

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

< 20 22.2% 6.5% 1.4% 3.0% 2.0% 2.0% 2.4% 2.4% 1.9% 1.6% 2.2% 4.3% 3.9%20 - 29 44.4% 53.5% 47.7% 44.9% 44.6% 45.7% 41.9% 40.5% 36.3% 36.3% 36.3% 34.5% 32.6%30 - 39 33.3% 32.5% 37.5% 43.3% 43.0% 42.6% 44.5% 42.6% 45.7% 44.4% 41.2% 42.5% 42.5%40 - 49 0.0% 2.5% 6.2% 6.3% 7.6% 7.3% 9.1% 9.7% 12.6% 14.2% 15.8% 14.4% 17.0%> 50 0.0% 5.0% 7.2% 2.4% 2.8% 2.3% 2.1% 4.5% 3.5% 3.5% 4.4% 4.2% 3.2%

1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

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Pengurusan Kes

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RawatanRawatan

Tiada ubat atau vaksin

Mencegah jangkitan opportunis

ubat kebersihan diri rehat senaman pemakanan

sempurna

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RawatanRawatan Melewatkan

peringkat AIDS- ubat - pemeriksaan klinikal- merawat komplikasi &

jangkitan opportunis

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