What is HIV/AIDS?
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- HIV stands for human immunodeficiency virus. HIV is a virus that gradually attacks the immune system, which is our body’s natural defenses against illness and cause AIDS
- AIDS stands for acquired immune deficiency syndrome
- AIDS is a clinical disease/syndrome caused by the HIV virus.
- It is when a person’s immune system is too weak to fight off many infections, and develops when the HIV infection is very advanced.
- This is the last stage of HIV infection where the body can no longer defend itself and may develop various diseases, infections and if left untreated, death.
What is Hepatitis B /Hepatitis C?
- Hepatitis B is a liver disease caused by the hepatitis B virus (HBV). The virus interferes with the functions of the liver and causes pathological damage.
- Hepatitis Cis a disease caused by a hepatitis C virus that infects the liver, it can lead to cirrhosis, liver cancer, and liver failure.
How is HIV spread?
HIV is commonly transmitted/spread through
- Unprotected sex with HIV infected person
- Transmitted during drug injection by the sharing of HIV-contaminated needles and syringes
- Transfusion o f blood or blood products contaminated with HIV from an HIV-infected woman to her baby – during pregnancy at the time of birth, or during breastfeeding.
- HIV is transmitted from an HIV-infected person’s body to another through blood, semen, vaginal secretions and breast milk.
How is HIV not spread?
HIV infection does not spread through food, water, by air or by coughing, mosquito or insect bites, clothes, urine or stool, saliva and tears.
- By touching, kissing, or hugging
- By sharing food
- By sharing a bed, or through insect bites
- By sharing or washing clothes, towels, bed covers
- Using latrines, or toilets
- By caring for someone with HIV/AIDS, if you follow the precautions
How are Hepatitis B & Hepatitis C spread?
Hepatitis B & C Spreads same as HIV
What are the Opportunistic infections?
These are disease-producing germs (organisms) that remain within our environment and also inside our body. In normal conditions they cannot produce any diseases because our healthy immune system easily fights them off. These germs produce diseases when the immune system is damaged and weakened by HIV. We call these diseases “opportunistic infections” as they attack a weakened immune system.
The common opportunistic infections are Tuberculosis, respiratory infections, viral, other bacterial and fungal infections, hepatitis C and B and neoplasm’s etc.
Who are at risk of HIV exposure?
A person of any age, sex, race, ethnic group, religion, economic background, or sexual orientation can get HIV.
Those who are most at risk are:
- People who have “unprotected sex” with someone who has HIV. Unprotected sex means vaginal, anal, or oral sex without using a condom.
- People who share needles, syringes, or other equipment to inject drugs, steroids, or even vitamins or medicine with someone who has HIV.
- Babies can potentially become infected during their mothers’ pregnancy, during delivery, or after birth in the immediate post-partum period. They can also become infected through breastfeeding.
- Health care and maintenance workers who may be exposed to blood and/or body fluids at work sometimes get infected through on-the-job exposures like needle-stick injuries.
Is it safe for clinician to take care of HIV /Hepatitis B & C patients at home setting?
Yes, it is safe for the clinician to take care of HIV/Hepatitis B & C patients provided they follow universal precautions / Use of personal protective equipment
Universal precautions include:
- Wearing latex or nitrile gloves when coming into contact with blood, skin and mucous membrane cuts, or any open skin lesion
- Using gloves only for the care of one person, and then discarding the gloves
- Washing hands after discarding the gloves
- Properly disposing of contaminated materials exposed to blood, such as needles
- Use of PPE like gloves, mask, goggles, gown and shoe covers for specific procedures.
What is meant by exposure to HIV?
If person comes in contacts directly with blood and body fluids over the open wound, needle stick injury and splash of blood and body fluids on clinician mouth/eyes of HIV patient is called Exposure.
What should a clinician do when exposed to HIV /Hepatitis B& C patient‘s blood and body fluids?
- Contaminated needle stick, sharps injury, bite or scratch – encourage bleeding, wash with soap and running water.
- Blood or body fluid in the eyes or mouth – irrigate with copious quantities of cold water.
- Blood or body fluid on broken skin – encourage bleeding if possible and wash with soap under running water (but without scrubbing).
Managing spills at home
- Wear gloves and eye protection
- First clean organic material from surfaces or items
- Wash with soap and detergent.
- House hold bleach is 3–8% sodium hypochlorite solution
- Make a 1:10 dilution of 5.25%–6.15% sodium hypochlorite with water (1 part bleach to 9 parts water)
- Leave on the surface for 10 minutes and allow to air dry
What are the precautions to be taken by the clinician when taking care of patient with Hepatitis B &C?
The precautions to be followed are same as for HIV
Is there cure for HIV?
There is no cure for HIV and AIDS yet. However, treatment can control HIV and enable people to live a long and healthy life.
Is there cure for Hepatitis B & C?
Similar to HIV there is no cure for Hepatitis B
The Hepatitis C virus is considered “cured” if the virus is not detected in your blood when measured with a blood test 3 months after treatment is completed. This is called a sustained virologic response (SVR) and data suggest that you will stay virus free indefinitely
Is there a vaccine for HIV?
We currently do not have a vaccine for HIV.
Is there a vaccine for Hepatitis B & C?
There is a vaccine for hepatitis B .The Hepatitis B vaccine is typically given as a series of 3 shots over a period of 6 months. The entire series is needed for long-term protection.
There is no vaccine for Hepatitis C virus
Prevention of avoidable exposure in an occupational setting
This is of prime importance. The Health and care excellence advises the following
General measures
- Wash hands before and after contact with each patient and before putting on and after removing gloves.
- Change gloves between patients.
- Cover with waterproof dressings any existing wounds, skin lesions and all breaks in exposed skin; wear gloves if hands are extensively affected.
- Wear gloves where contact with blood can be anticipated.
- Avoid usage of sharps where possible and, where such usage is essential, exercise particular care in handling and disposal.
- Avoid wearing open footwear in situations where blood may be spilt, or where sharp instruments or needles are handled.
- Clear up spillage of blood promptly and disinfect surfaces.
- Pre-employment occupational health assessment should identify those with damaged skin (eg, fissured hand eczema), who may be at higher risk of occupationally acquired infection; ensure that advice is given about minimizing any occupational health risk to which they may be exposed.
- Wear gloves when cleaning equipment prior to sterilization or disinfection, when handling chemical disinfectant and when cleaning up spillages.
- Follow safe procedures for disposal of contaminated waste.
Specific measures
This will obviously depend on the procedure being undertaken but may include:
- Use of new, single-use disposable injection equipment for all injections is highly recommended. Sterilisable injection should only be considered if single-use equipment is not available and if the sterility can be documented with Time, Steam and Temperature indicators.
- Discard contaminated sharps immediately (and without recapping) in puncture- and liquid-proof containers that are closed and sealed and destroyed before completely full.
- Wash hands with soap and water before and after procedures; use protective barriers such as gloves, gowns, aprons, masks and goggles where there is direct contact with blood and other body fluids.
- Disinfect instruments and other contaminated equipment.
- Handle soiled linen properly. (Soiled linen should be handled as little as possible. Gloves and leak proof bags should be used if necessary. Cleaning should occur outside patient areas, using detergent and hot water.
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