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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
26110301
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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