CERTIFICATE

This is to certify that this project work is submitted by

POOJA YADAV, XII, Surmount International School. This
Project was carried out by her under the supervision of MRS.
TALAT PARVEEN
During the
Academic year of 2016-17.

PRINCIPAL TEACHER
Mrs. Asha Kapoor Mrs. Talat Parveen
 ACKNOWLEDGMENT
I would like to express my thanks of gratitude to my teacher
Mrs. Talat Parveen as well as my principal Mrs. Asha Kapoor
who gave me the golden opportunity to do this wonderful
project on the topic “AIDS”which help me in doing a lot of
research.
I am really thankful to them.
Secondly I would also like to thank my Parents and friends who
helped me a lot in finishing this project within the limited time.
I am making this project not only for marks, but also to increase
my knowledge.
THANKS AGAIN TO ALL WHO HELPED ME.
 PREFACE
My project provides complete information on the topic
“AIDS”and maximum effort have been taken to make the
project more comprehensive and lucid to understand.
 CONTENTS
1. Introduction
2. Signs And Symptoms
3. Causes Of Aids
4. Introduction Of Aids Virus
5. Screening Test Of Aids
6. Manifestation Of Aids
7. Treatment
8. Preventions From Aids
9. Conclusion
10.Observation
11.Hypothesis
 Introduction

Human immunodeficiency virus infection and acquired immune

deficiency syndrome (HIV/AIDS) is a spectrum of conditions caused
by infection with the human immunodeficiency virus (HIV). Following initial
infection, a person may not notice any symptoms or may experience a brief
period of influenza-like illness. Typically, this is followed by a prolonged
period with no symptoms. As the infection progresses, it interferes more with
the immune system, increasing the risk of common infections like tuberculosis,
as well as other opportunistic infections, and tumors that rarely affect people
who have working immune systems. These late symptoms of infection are
referred to as AIDS. This stage is often also associated with weight loss.

HIV is spread primarily by unprotected sex (including anal and oral sex),

contaminated blood transfusions, hypodermic needles, and from mother to
child during pregnancy, delivery, or breastfeeding. Some bodily fluids, such as
saliva and tears, do not transmit HIV. Methods of prevention include safe
sex, needle exchange programs, treating those who are infected, and male
circumcision. Disease in a baby can often be prevented by giving both the
mother and child antiretroviral medication. There is no cure or vaccine;
however, antiretroviral treatment can slow the course of the disease and may
lead to a near-normal life expectancy. Treatment is recommended as soon as
the diagnosis is made. Without treatment, the average survival time after
infection is 11 years.

Signs and symptoms

Acute infection

The initial period following the contraction of HIV is called acute HIV,
primary HIV or acute retroviral syndrome. Many individuals develop
an influenza-like illness or a mononucleosis-like illness 2–4 weeks post
exposure while others have no significant symptoms. Symptoms occur in 40–
90% of cases and most commonly include fever, large tender lymph
nodes, throat inflammation, a rash, headache, and/or sores of the mouth and
genitals. The rash, which occurs in 20–50% of cases, presents itself on the trunk
and is maculopapular, classically. Some people also develop opportunistic
infections at this stage. Gastrointestinal symptoms such as nausea, vomiting
or diarrhea may occur, as may neurological symptoms of peripheral
neuropathy or Guillain–Barré syndrome. The duration of the symptoms varies,
but is usually one or two weeks.

Due to their nonspecific character, these symptoms are not often recognized as

signs of HIV infection. Even cases that do get seen by a family doctor or a
hospital are often misdiagnosed as one of the many common infectious
diseases with overlapping symptoms. Thus, it is recommended that HIV be
considered in people presenting an unexplained fever who may have risk
factors for the infection.

Clinical latency
The initial symptoms are followed by a stage called clinical latency,
asymptomatic HIV, or chronic HIV.[1] Without treatment, this second stage of
the natural history of HIV infection can last from about three yearsto over
20 years (on average, about eight years). While typically there are few or no
symptoms at first, near the end of this stage many people experience fever,
weight loss, gastrointestinal problems and muscle pains. Between 50 and 70%
of people also develop persistent generalized lymphadenopathy, characterized
by unexplained, non-painful enlargement of more than one group of lymph
nodes (other than in the groin) for over three to six months.

Although most HIV-1 infected individuals have a detectable viral load and in

the absence of treatment will eventually progress to AIDS, a small proportion
(about 5%) retain high levels of CD4+ T cells (T helper cells)
without antiretroviral therapy for more than 5 years.[25][30] These individuals are
classified as HIV controllers or long-term non progresses’ (LTNP). Another
group consists of those who maintain a low or undetectable viral load without
anti-retroviral treatment, known as "elite controllers" or "elite suppressors".
They represent approximately 1 in 300 infected persons.
 Causes of AIDS
The main causes of AIDS is a disorder of cell mediated immune system of
the body. The disorder is characterized by a reduction in the number of helper.
T-cell which stimulate antibody production by B-cells. This result in the loss of
natural defense against viral infection.

HIV is a retrovirus that infects the vital organs of the human immune system.
The virus progresses in the absence of antiretroviral therapy. The rate of virus
progression varies widely between individuals and depends on many factors
(age of the patient, body's ability to defend against HIV, access to health care,
existence of coexisting infections, the infected person's genetic inheritance,
resistance to certain strains of HIV).

HIV can be transmitted through:

 Sexual transmission. It can happen when there is contact with infected

sexual secretions (rectal, genital or oral mucous membranes). This can
 happen while having unprotected sex, including vaginal, oral and anal sex or
sharing sex toys with someone infected with HIV.

 Perinatal transmission. The mother can pass the infection on to her child
during childbirth, pregnancy, and also through breastfeeding.

 Blood transmission. The risk of transmitting HIV through blood transfusion

is nowadays extremely low in developed countries, thanks to meticulous
screening and precautions. Among drug users, sharing and reusing syringes
contaminated with HIV-infected blood is extremely hazardous.

Thanks to strict protection procedures the risk of accidental infection for

healthcare workers is low.

Individuals who give and receive tattoos and piercings are also at risk and
should be very careful.
 INTRODUCTION OF AIDS VIRUS

It is 100 to 140 nm. in diameter and has a cylindrical core. It is found in blood
and semen and to a lesser extent in milk tears and saliva. It is a retrovirus, i.e.
its genetic material is - RNA (single stranded linear) which can make a DNA
copy of itself with the help of the reverse transcriptase enzyme. The virus bind
specifically to a surface receptor on a helper T-cell and introduce its RNA and
reverse transcriptase enzyme into the cells here it multiplies and the release of
new virus destroys the cell. AIDS occurs when the helper T-cell falls too low to
fight the disease.
 Screening Test of AIDS
AIDS Patient generally have circulating antibodies which can be detected. In
many countries this test is done as a routine on blood, donor, screening may
prove harmful to victims. Persons found to be HIV positive become depressed
and suicidal and are denied insurance, evicted from their houses, fired from
their jobs only a small minority of such persons are likely to develop full blown
AIDS. However the infected persons may spread infection to others.

 Today ‘ELISA’ test is done identify this pandemic disease (AIDS).

 Manifestation of AIDS

Manifestation :-  It can manifest in two major ways -

i)  Maligent tumours in connective tissue

ii) Viral, bacterial, protozoan and fungalin-fection of any system of the body.
There are destruction of WBC’S, damage to brain,. unexplained fever,
unexplained loss of appetite, unexplained  loss weight over a short time,
chronic diarrhea, cough, night sweats, enlargement of lymph glands, shortness
of breath, weakness.
AIDS Treatment :-   Medical treatment of AIDS consist of :

i)  Antiviral therapy against the causative agent

ii) Immuno simulative therapy to increase the number of resistance - providing

cells in the body or both. However  no specific treatment has been found so far
and the mortality form AIDS is virtually 100%. A victim of full blown AIDS
dies with in 3 year from infection of many drugs tried, azithmidine  transmitted
by blood sucking insects such as mosquitoes, AIDS virus has been found in
urine, tears saliva, breast milk and vaginal secretions, but is seems not to
transmitted by these fluids unless it gets a cut.

Treatment
There is currently no cure or effective HIV vaccine. Treatment consists of
highly active antiretroviral therapy (HAART) which slows progression of the
disease. As of 2010 more than 6.6 million people were taking them in low and
middle income countries. Treatment also includes preventive and active
treatment of opportunistic infections.

Antiviral therapy
Current HAART options are combinations (or "cocktails") consisting of at least
three medications belonging to at least two types, or "classes,"
of antiretroviral agents. Initially treatment is typically a non-nucleoside reverse
transcriptase inhibitor (NNRTI) plus two nucleoside analog reverse
transcriptase inhibitors (NRTIs). Typical NRTIs include: zidovudine (AZT)
or tenofovir (TDF) and lamivudine (3TC)
or emtricitabine (FTC). Combinations of agents which include protease
inhibitors (PI) are used if the above regimen loses effectiveness.

The World Health Organization and United States recommends antiretrovirals

in people of all ages including pregnant women as soon as the diagnosis is
made regardless of CD4 count. Once treatment is begun it is recommended that
it is continued without breaks or "holidays".Many people are diagnosed only
after treatment ideally should have begun. The desired outcome of treatment is
a long term plasma HIV-RNA count below 50 copies/mL. Levels to determine
if treatment is effective are initially recommended after four weeks and once
levels fall below 50 copies/mL checks every three to six months are typically
adequate. Inadequate control is deemed to be greater than 400 copies/mL.
Based on these criteria treatment is effective in more than 95% of people during
the first year.

Benefits of treatment include a decreased risk of progression to AIDS and a

decreased risk of death. In the developing world treatment also improves
physical and mental health. With treatment there is a 70% reduced risk of
acquiring tuberculosis. Additional benefits include a decreased risk of
transmission of the disease to sexual partners and a decrease in mother-to-child
transmission. The effectiveness of treatment depends to a large part on
compliance. Reasons for non-adherence include poor access to medical
care, inadequate social supports, mental illness and drug abuse. The complexity
of treatment regimens (due to pill numbers and dosing frequency) and adverse
effects may reduce adherence. Even though cost is an important issue with
some medications, 47% of those who needed them were taking them in low and
middle income countries as of 2010and the rate of adherence is similar in low-
income and high-income countries.

Specific adverse events are related to the antiretroviral agent taken. Some

relatively common adverse events include: lipodystrophy
syndrome, dyslipidemia, and diabetes mellitus, especially with protease
inhibitors. Other common symptoms include diarrhea, and an increased risk
of cardiovascular disease. Newer recommended treatments are associated with
fewer adverse effects. Certain medications may be associated with birth
defects and therefore may be unsuitable for women hoping to have children.

Treatment recommendations for children are somewhat different from those for
adults. The World Health Organization recommends treating all children less
than 5 years of age; children above 5 are treated like adults. The United States
guidelines recommend treating all children less than 12 months of age and all
those with HIV RNA counts greater than 100,000 copies/mL between one year
and five years of age.[156]

Opportunistic infections

Measures to prevent opportunistic infections are effective in many people with

HIV/AIDS. In addition to improving current disease, treatment with
antiretrovirals reduces the risk of developing additional opportunistic
infections. Adults and adolescents who are living with HIV (even on anti-
retroviral therapy) with no evidence of active tuberculosis in settings with high
tuberculosis burden should receive isoniazid preventive therapy (IPT),
the tuberculin skin test can be used to help decide if IPT is
needed. Vaccination against hepatitis A and B is advised for all people at risk
of HIV before they become infected; however it may also be given after
infection. Trimethoprim/sulfamethoxazole prophylaxis between four and six
weeks of age and ceasing breastfeeding in infants born to HIV positive mothers
is recommended in resource limited settings. It is also recommended to prevent
PCP when a person's CD4 count is below 200 cells/uL and in those who have
or have previously had PCP. People with substantial immunosuppression are
also advised to receive prophylactic therapy
for toxoplasmosis and Cryptococcus meningitis. Appropriate preventive
measures have reduced the rate of these infections by 50% between 1992 and
1997. Influenza vaccination and pneumococcal polysaccharide vaccine are
often recommended in people with HIV/AIDS with some evidence of benefit.

Diet

The World Health Organization (WHO) has issued recommendations regarding

nutrient requirements in HIV/AIDS. A generally healthy diet is promoted.
Some evidence has shown a benefit from micronutrient supplements. Evidence
for supplementation with selenium is mixed with some tentative evidence of
benefit.[167] There is some evidence that vitamin A supplementation in children
reduces mortality and improves growth. In Africa in nutritionally compromised
pregnant and lactating women a multivitamin supplementation has improved
outcomes for both mothers and children. Dietary intake of micronutrients
at RDA levels by HIV-infected adults is recommended by the WHO; higher
intake of vitamin A, zinc, and iron can produce adverse effects in HIV positive
adults, and is not recommended unless there is documented deficiency.

Alternative medicine

In the US, approximately 60% of people with HIV use various forms
of complementary or alternative medicine, even though the effectiveness of
most of these therapies has not been established. There is not enough evidence
to support the use of herbal medicines. There is insufficient evidence to
recommend or support the use of medical cannabis to try to increase appetite or
weight gain.

PREVENTIONS FROM AIDS

Sexual contact

Consistent condom use reduces the risk of HIV transmission by approximately

80% over the long term. When condoms are used consistently by a couple in
which one person is infected, the rate of HIV infection is less than 1% per
year. There is some evidence to suggest that female condoms may provide an
equivalent level of protection. Application of a vaginal gel
containing tenofovir (a reverse transcriptase inhibitor) immediately before sex
seems to reduce infection rates by approximately 40% among African women.
By contrast, use of the spermicide nonoxynol-9 may increase the risk of
transmission due to its tendency to cause vaginal and rectal irritation.

Circumcision in Sub-Saharan Africa "reduces the acquisition of HIV by

heterosexual men by between 38% and 66% over 24 months".Due to these
studies, both the World Health Organization and UNAIDS recommended male
circumcision as a method of preventing female-to-male HIV transmission in
2007 in areas with a high rates of HIV. However, whether it protects against
male-to-female transmission is disputed, and whether it is of benefit
in developed countries and among men who have sex with men is
undetermined. The International Antiviral Society, however, does recommend
for all sexually active heterosexual males and that it be discussed as an option
with men who have sex with men. Some experts fear that a lower perception of
vulnerability among circumcised men may cause more sexual risk-taking
behavior, thus negating its preventive effects.

Programs encouraging sexual abstinence do not appear to affect subsequent

HIV risk. Evidence of any benefit from peer education is equally
poor. Comprehensive sexual education provided at school may decrease high
risk behavior. A substantial minority of young people continues to engage in
high-risk practices despite knowing about HIV/AIDS, underestimating their
own risk of becoming infected with HIV. Voluntary counseling and testing
people for HIV does not affect risky behavior in those who test negative but
does increase condom use in those who test positive. It is not known whether
treating other sexually transmitted infections is effective in preventing HIV.

Pre-exposure
Antiretroviral treatment among people with HIV whose CD4 count ≤ 550
cells/µL is a very effective way to prevent HIV infection of their partner (a
strategy known as treatment as prevention, or TASP). TASP is associated with
a 10 to 20 fold reduction in transmission risk. Pre-exposure prophylaxis (PrEP)
with a daily dose of the medications tenofovir, with or without emtricitabine, is
effective in a number of groups including men who have sex with men, couples
where one is HIV positive, and young heterosexuals in Africa. It may also be
effective in intravenous drug users with a study finding a decrease in risk of 0.7
to 0.4 per 100 person years.[125]

Universal precautions within the health care environment are believed to be

effective in decreasing the risk of HIV. Intravenous drug use is an important
risk factor and harm reduction strategies such as needle-exchange
programs and opioid substitution therapy appear effective in decreasing this
risk.

Post-exposure

A course of antiretrovirals administered within 48 to 72 hours after exposure to

HIV-positive blood or genital secretions is referred to as post-exposure
prophylaxis (PEP). The use of the single agent zidovudine reduces the risk of a
HIV infection five-fold following a needle-stick injury. As of 2013, the
prevention regimen recommended in the United States consists of three
medications—tenofovir, emtricitabine and raltegravir—as this may reduce the
risk further.

PEP treatment is recommended after a sexual assault when the perpetrator is

known to be HIV positive, but is controversial when their HIV status is
unknown. The duration of treatment is usually four weeksand is frequently
associated with adverse effects—where zidovudine is used, about 70% of cases
result in adverse effects such as nausea (24%), fatigue (22%), emotional
distress (13%) and headaches (9%).[46]

Mother-to-child

Programs to prevent the vertical transmission of HIV (from mothers to

children) can reduce rates of transmission by 92–99%.[72][127] This primarily
involves the use of a combination of antiviral medications during pregnancy
and after birth in the infant and potentially includes bottle feeding rather
than breastfeeding. If replacement feeding is acceptable, feasible, affordable,
sustainable, and safe, mothers should avoid breastfeeding their infants; however
exclusive breastfeeding is recommended during the first months of life if this is
not the case. If exclusive breastfeeding is carried out, the provision of extended
antiretroviral prophylaxis to the infant decreases the risk of transmission.

Major causes & steps to prevent it

Reasons of spreading AIDS among world people

More than 90% of the infected persons are belong to developing countries.

REASONS :-

(i) Low-level of socio-economic development.

(ii) Low health consciousness and facilities

(iii)  A growing unmarried youth population due to delayed marriage

(iv) High rate of labour migration.

(v)  Low level of literacy among high-risk groups.

(vi)High incidence  of sexuality transmitted diseases and reproductive tract

infections among men and women.

Steps taken to prevent the spreading of AIDS :

(i) National AIDS programme of south East Asian countries are beginning to
yield encouraging results. The 100% condom use programme in Thailand and
the Sonagachi project in Calcutta, a model peer education programme among
sex workers, have helped  bring down AIDS  infection and also reduced the
incidence of STD.

(ii) Non-government organizations have brought Baptist interest litigations

against such cases of discrimination and the courts have pronounced the rights
of such peoples. This has helped alleviate the misery of affected persons.
 CONCLUSION
After studying the cause and effects of ‘AIDS’ from different views, we
conclude that it is a pandemic disease.  It is mainly spreading sexually and
person of the age group of 25-45 years are the most affected group.  There are
some methods like ‘Antiviral Therapy’ and Immuno Stimulative therapy which
bring some hope that even then no specific treatment has been found so for and
morality form is virtually 100%.  So only prevention in the test medicine care.
 OBSERVATION
AIDS immersed as pandemic disease. It is nondurable.  It is more common in
developing countries.  Now every day 1000 peoples are going to become HIV
infected in world.  This is mainly due to blood transfusion & Sexual contact.  In
whole world about 3 crore 30 lakhs people are HIV +ve & in India 3 lakh 70
thousands are HIV +ve.  The number of HIV +ve persons are higher in
Tamilnadu Bombay, Calcutta and Kerala and Manipur.
 HYPOTHESIS
AIDS is non curable due to its nature of pathogen.  It also damage immune
system of the body. Therefore any medicine (Antiviral) drugs are not effective
against HIV virus.  Ignorance and lack of knowledge about this disease is the
root cause of wide spread of this disease.
 BIBLOGRAPHY
The following books were used in the completion of this
project:

 Biology lab manual class 12.

 NCERT Textbook class 11.

Also, the following websites were consulted for relevant

material:

www.wikipedia.org
www.google.com
www.icbse.in
www.yahoo.com
www.passmyexam.in