Aids 20 years since

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Information about Aids 20 years since

Published on December 16, 2016

Author: DrShadSalimAkhterAkh

Source: slideshare.net

1. AIDS 20 Years Since Dr. Shad Salim Akhtar MB, MD, FRCP, MAUICC Fellows Consultant Medical Oncologist Medical Director KFSH, Buraidah, Al-Qassim, KSA

2. AIDS Revisited  June 5th 1981  Pneumocystis carinii pneumonia in 5 homosexual men  July 3rd 1981  26 cases of new immunodeficiency syndrome  June 18th 1982  Cluster in southern California  July 9th 1982  Haitian cases  July 16th 1982 hemophiliacs added

3. AIDS Revisited  September 24th 1982  “Acquired Immune Deficiency Syndrome” or AIDS used for the first time  Previous term=  Gay Related Immune Deficiency (GRID)

4. AIDS Revisited-1980s  Virus identified  Antiretroviral drugs produced  Opportunistic infections identified and appropriate prophylaxis found

5. AIDS Revisited-1990s Early  Highly active antiretroviral therapy  AIDS care concept evolved  Viral load vs. CD4 cell count pivotal for therapy  Decline  in incidence and  mortality due to AIDS in US  Optimal time to start therapy!!!!

6. US New cases US AIDS related deaths US AIDS prevalence US AIDS federal spending Sepkowitz KA NEJM 2001; 344:1764

7. Reported deaths among reported AIDS cases in Canada 0 200 400 600 800 1000 1200 1400 1600 90 91 92 93 94 95 96 97 98 99 NumberofAIDSdeaths Source: Health Canada, HIV and AIDS in Canada. Surveillance Report to December 31, 1999

8. A Survey By UNFP?  Can you please give your opinion on the food shortage in the rest of the world?  The survey was an utter failure?  Why?

9. Answers  In West Europe the people did not know the word  Shortage?  In Latin America the people did not understand the meaning of:  Please?  In Africa the people did not understand the word  Food?  In Middle East people did not know what is  Opinion?  In USA the people did not understand what the REST of THE WORLD meant

10. AIDS Revisited-Late 1990 Global Crisis  Sub-Saharan Africa  SE Asia  East Europe  Caribbean  Two distinct epidemics  Horizontal epidemic  Vertical epidemic

11. AIDS Revisited  That is not all

12. 00002-E-12 – 1 December 2002 Global summary of the HIV/AIDS epidemic December 2002 Number of people living with HIV/AIDS Total 42 million Adults 38.6 million Women 19.2 million Children under 15 years 3.2 million People newly infected with HIV in 2002 Total 5 million Adults 4.2 million Women 2 million Children under 15 years 800 000 AIDS deaths in 2002 Total

13. 00002-E-13 – 1 December 2002 Regional HIV/AIDS statistics and features, end of 2002 * The proportion of adults (15 to 49 years of age) living with HIV/AIDS in 2002, using 2002 population numbers ** Hetero: heterosexual transmission – IDU: transmission through injecting drug use – MSM: sexual transmission among men who have sex with men Sub-Saharan Africa North Africa & Middle East South and South-East Asia East Asia & Pacific Latin America Caribbean Eastern Europe & Central Asia Western Europe North America Australia & New Zealand TOTAL late ’70s early ’80s late ’80s late ’80s late ’80s late ’70s early ’80s late ’70s early ’80s early ’90s late ’70s early ’80s late ’70s early ’80s late ’70s early ’80s 29.4 million 550 000 6.0 million 1.2 million 1.5 million 440 000 1.2 million 570 000 980 000 15 000 42 million 8.8% 0.3% 0.6% 0.1% 0.6% 2.4% 0.6% 0.3% 0.6% 0.1% 1.2% 58% 55% 36% 24% 30% 50% 27% 25% 20% 7% 50% Hetero Hetero, IDU Hetero, IDU IDU, Hetero, MSM MSM, IDU, Hetero Hetero, MSM IDU MSM, IDU MSM, IDU, Hetero MSM Epidemic started Adults & children living with HIV/AIDS Adult prevalence rate * % of HIV- positive adults who are women Main mode(s) of transmission for those living with HIV/AIDS ** Adults & children newly infected with HIV 3.5 million 83 000 700 000 270 000 150 000 60 000 250 000 30 000 45 000 500 5 million

14. 00002-E-14 – 1 December 2002 Global estimates forGlobal estimates for adults andadults and childrenchildren end 2002end 2002 People living with HIV/AIDS New HIV infections in 2002 Deaths due to HIV/AIDS in 2002 42 million 5 million 3.1 million

15. 00002-E-15 – 1 December 2002 Adults and children estimated to beAdults and children estimated to be livingliving with HIV/AIDS as of end 2002with HIV/AIDS as of end 2002 Total: 42 million Western Europe 570 000570 000 North Africa & Middle East 550 000550 000 Sub-Saharan Africa 29.429.4 millionmillion Eastern Europe & Central Asia 1.2 million1.2 million South & South-East Asia 6 million6 million Australia & New Zealand 15 00015 000 North America 980 000980 000 Caribbean 440 000440 000 Latin America 1.51.5 millionmillion East Asia & Pacific 1.2 million1.2 million

16. 00002-E-16 – 1 December 2002 Estimated number of adults andEstimated number of adults and childrenchildren newly infected with HIV during 2002newly infected with HIV during 2002 Total: 5 million Western Europe 30 00030 000 North Africa & Middle East 83 00083 000 Sub-Saharan Africa 3.53.5 millionmillion Eastern Europe & Central Asia 250 000250 000East Asia & Pacific 270 000270 000South & South-East Asia 700 000700 000 Australia & New Zealand 500500 North America 45 00045 000 Caribbean 60 00060 000 Latin America 150 000150 000

17. 00002-E-17 – 1 December 2002 Estimated adult and child deathsEstimated adult and child deaths from HIV/AIDS during 2002from HIV/AIDS during 2002 Total: 3.1 million Western Europe 8 0008 000 North Africa & Middle East 37 00037 000 Sub-Saharan Africa 2.42.4 millionmillion Eastern Europe & Central Asia 25 00025 000East Asia & Pacific 45 00045 000South & South-East Asia 440 000440 000 Australia & New Zealand <100<100 North America 15 00015 000 Caribbean 42 00042 000 Latin America 60 00060 000

18. 00002-E-18 – 1 December 2002 ChildrenChildren (<15 years)(<15 years) estimated to be livingestimated to be living with HIV/AIDS as of end 2002with HIV/AIDS as of end 2002 Western Europe 5 0005 000 North Africa & Middle East 40 00040 000 sub-Saharan Africa 2.82.8 millionmillion Eastern Europe & Central Asia 16 00016 000East Asia & Pacific 4 0004 000South & South-East Asia 240 000240 000 Australia & New Zealand < 200< 200 North America 10 00010 000 Caribbean 20 00020 000 Latin America 45 00045 000 Total: 3.2 million

19. 00002-E-19 – 1 December 2002 Estimated deaths in children (<15 years) from HIV/AIDS during 2002 Western Europe < 100< 100 North Africa & Middle East 6 8006 800 sub-Saharan Africa 550 000550 000 Eastern Europe & Central Asia < 100< 100 East Asia & Pacific 2 0002 000South & South-East Asia 43 00043 000 Australia & New Zealand < 100< 100 North America < 100< 100 Caribbean 7 0007 000 Latin America 5 0005 000 Total: 610 000

20. 00002-E-20 – 1 December 2002 Estimated number of children (<15 years) newly infected with HIV during 2002 Western Europe < 500< 500 North Africa & Middle East 13 00013 000 sub-Saharan Africa 720 000720 000 Eastern Europe & Central Asia 1 0001 000 East Asia & Pacific 3 0003 000South & South-East Asia 60 00060 000 Australia & New Zealand < 100< 100 North America < 500< 500 Caribbean 7 0007 000 Latin America 10 00010 000 Total: 800 000

21. 00002-E-21 – 1 December 2002 About 14 000 new HIV infections a day in 2002 More than 95% are in developing countries 2000 are in children under 15 years of age About 12 000 are in persons aged 15 to 49 years, of whom: — almost 50% are women — about 50% are 15–24 year olds

22. 00002-E-22 – 1 December 2002 Children living with HIV/AIDS New HIV infections in 2002 Deaths due to HIV/AIDS in 2002 End-2002 global HIV/AIDS estimates Children (<15 years) 3.2 million 800 000 610 000

23. Reported incidence of syphilis and gonorrhoeaReported incidence of syphilis and gonorrhoea in China, 1989 to 1998in China, 1989 to 1998 0 5 10 15 20 25 30 89 90 91 92 93 94 95 96 97 98 Reportedcasesper100,000Reportedcasesper100,000 Gonorrhoea Syphilis Source: Chen X-S et al. Sex Transm Dis 2000, 27:138-142

24. Trends in gonorrhoea 91-200

25. Trends in infectious syphilis 1995-2000 Eng & Wales

26. Trends in new HIV cases to Euro HIV by exposure category Nicoll A et al. BMJ 2002;324:1324

27. Proportion of men reporting casual sex in theProportion of men reporting casual sex in the past year and condom use with their last non-past year and condom use with their last non- regular partner, Tamil Nadu, India, 1996 to 1998regular partner, Tamil Nadu, India, 1996 to 1998 0 10 20 30 40 50 60 70 1996 1997 1998 % casual sex, truckers casual sex, factory workers condom use, truckers condom use, factory workers Source: AIDS Prevention and Control Project, Tamil Nadu, India, 1999

28. HIV prevalence rate among teenagersHIV prevalence rate among teenagers in Kisumu, Kenya, by agein Kisumu, Kenya, by age 0 0 3.6 2.2 8.68.3 17.9 29.4 22 33.3 0 5 10 15 20 25 30 35 15 16 17 18 19 Age in years HIVprevalence(%) boys girls Source: National AIDS Programme, Kenya, and Population Council, 1999

29. HIV prevalence among people consuming alcoholHIV prevalence among people consuming alcohol and among non-drinkers, Carletonville, South Africa,and among non-drinkers, Carletonville, South Africa, 19981998 0 10 20 30 40 50 60 70 men women women in commercial sex areas HIVprevalence(%) drinkers non-drinkers Source: Campbell et al. (unpublished data)

30. ` Leading causes of death in Africa,Leading causes of death in Africa, 19991999  1 HIV/AIDS  2 Acute lower respiratory infections  3 Malaria  4 Diarrhoeal diseases  5 Perinatal conditions  6 Measles  7 Tuberculosis 20.6 10.3 9.1 7.3 5.9 4.9 3.4 Source: The World Health Report 2000, WHO Rank % of total

31. Projected population structure with andProjected population structure with and without the AIDS epidemic, Botswana, 2020without the AIDS epidemic, Botswana, 2020 80 75 70 65 60 55 50 45 40 35 30 25 20 15 10 5 0 020406080100120140 0 20 40 60 80 100 120 140 Males Females Deficits due to AIDS Projected population structure in 2020 Population (thousands) Ageinyears Source: US Census Bureau, World Population Profile 2000

32. Newly diagnosed AIDS cases and medical expenditureNewly diagnosed AIDS cases and medical expenditure on an agricultural estate in Kenya, 1989 to 1997on an agricultural estate in Kenya, 1989 to 1997 0 20 40 60 80 100 120 89 90 91 92 93 94 95 96 97 NumberofnewlydiagnosedAIDScases 0 5 10 15 20 25 Medicalexpenditure(KShmillions) new AIDS cases medical spending Source: Rugalema et al. HIV/AIDS and the commercial agricultural sector of Ken UNDP/FAO, 1999

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