HIV AIDS PREGNANCY|definition|cause|signs symptoms|pathophysiology|how transmission|risk factors|examination|treatment|cure|prevention
Definition of HIV AIDS
Human immunodeficiency virus (HIV) is a retrovirus that infects cells of the immune system and destroy its
function. As long as the infection progresses, the immune system becomes weak and people become
susceptible to infection. Further stages of HIV infection is acquired immunodeficiency syndrome (AIDS).
This may take 10-15 years to people with HIV to develop into AIDS, antiretroviral drugs can slow down the
process even further.
Pregnant women are more at risk of contracting the Human Immunodeficiency Virus (HIV) compared with
women who are not pregnant. If HIV positive, pregnant women can pass HIV more often to those who are
infected than women who are not pregnant.
According to a report of the CDR (Center for Disease Control) of the United States that the number of
female AIDS sufferer in the world continues to grow, especially in the reproductive age. About 80% of
people with AIDS children undergoing prenatal infection from his mother. Seroprevalency prenatal maternal
HIV is 0.0-1.7%, while labor 0.4-0.3% and 29.6% at-9.4 pregnant women who used to use intravenous drugs.
The cause of HIV AIDS
The cause of AIDS is a type of virus that belongs to the Retrovirus called Human Immunodeficiency Virus
(HIV). The HIV live in the blood, saliva, semen, tears and easy to die outside the body. HIV can be also found
in the cells of the monocyte, macrophage and glia cells of brain tissue. The virus transmission occurs due to
several things, among them :
a. Through blood transmission, transmission through sex (sexual harassment).
b. A sexual relationship which alternated between a couple.
c. The women who use injection drugs and took turns wearing the syringes.
d. Individuals exposed to semen or vaginal fluids during sex-correlate with people infected with HIV.
e. Person who do blood transfusion with people with HIV, means any person who exposed tainted blood
through transfusions or contaminated needles.
Signs and symptoms of HIV AIDS
Signs and symptoms that appear to be divided into two, namely :
The major symptoms
a. Prolonged fever more than 3 months
b. Chronic diarrhea over a month repeatedly or continuously
c. Loss of appetite
d. Weight loss of over 10% in 3 months
e. Sweating
The minor symptoms
a. Chronic cough
b. A yeast infection in the mouth caused by the fungus Candida Albicans
c. Swollen lymph nodes residing in the whole body
d. The emergence of recurring shingles and itchy patches all over the body
Pathophysiology of HIV AIDS
Pregnancy age is prone to contracting HIV AIDS. Pregnant women with HIV AIDS occurred through sexual
intercourse with her husband who was already infected with HIV. HIV belongs to the retrovirus that is
standard RNA (single wrapped). When it enters the body, the virus will attach to the receptors CD4 cells
infected. Then the virus uses the enzyme reverse transcriptase, which is capable of forming DNA doubles.
Standard double DNA is able to enter the cell circulation towards the point and united with the original
cell nucleus DNA. DNA viruses may form infected RNA and RNA which will carry the sign (News) so as to
form a protein.
The growth of the HIV virus is limited to lymphocytes, monocytes, macrophages and the source of certain
bone marrow-forming. In intracellular, viruses can split ourselves so that after his cell was destroyed can
be issued new HIV virus will attack other cells. The form of the HIV virus has always been fickle, in
accordance with the cells that attack so it is difficult to make antibodies. Therefore, the remedy is still
difficult to be made up to this point.
HIV transmission from Mother to Baby
The way of transmission of the AIDS virus HIV in pregnant women can be through sexual intercourse. One
researcher suggested that transmission of HIV infected husband to his wife a number of 22% and wife with
HIV to her husband a number of 8%. But other studies get seroconversion (from negative into positive
examination laboratory) in 1-3 year in which obtained 42% from 38% of the husband and the wife to the
husband is considered to be the same.
HIV transmission from mother to child occurs because women who suffer from HIV AIDS is still largely a
lush old so there is a risk of transmission of infections that occurred during pregnancy. In addition, because
the infected from the husband or partner already infected with HIV AIDS have changed because of frequent
partner and a less healthy lifestyle. This transmission can occur in 3 periods :
1. Gestation Period
During pregnancy, the chances of babies infected with HIV is very small. This is because there is the placenta
that cannot be penetrated by the virus itself. Oxygen, food and medicine, antibodies can indeed penetrate
the placenta, but not by HIV. The placenta is precisely to protect the fetus from HIV infection. The protection
became ineffective when the mother :
a. Suffered an infection viral, bacterial, and parasitic (mainly malaria) in the placenta during pregnancy.
b. HIV-infected during pregnancy make increasing payload of the virus at the time.
c. Body durability has decreased.
d. Experiencing malnutrition during pregnancy which indirectly contribute to the occurrence of transmission
from mother to child.
2. Period of Childbirth
In this period, the risk of the occurrence of HIV is greater in comparison of the period of pregnancy.
Transmission occurs through fetomaternal transfusions or contact between the skin or mucous membrane
with secretions or blood infant maternal childbirth. The longer the process of childbirth, the greater the risk
of transmission to occur. Therefore, the length of labor can be shortened with section caesaria. Factors
affecting the high risk of transmission from mother to child during the birth process is a long period of
tearing the membrane.
a. Acute Chorioamnionitis
b. Invasive techniques during childbirth that increase the contact of blood with the baby's mother for
example, episiotomy.
c. First child in the birth of twins
3. Period of Postpartum
The transmission method in question here, namely transmission through breast milk. Based on research
data De Cock, et al (2000), it is known that mothers who breastfeed her baby had HIV infection risk of
10-15% compared to mothers who do not breastfeed her baby. The risk of transmission through BREAST
MILK depends on :
a. The pattern of breast feeding, the baby gets BREAST MILK exclusively would have less risk than with the
giving of a mix.
b. Breast Pathology: mastitis, rips nipple, bleeding putting milk and other breast infections.
c. Duration of breast feeding ( the longer the giving of milk increased risk )
d. A bad mother's nutritional Status.
Risk factors for HIV AIDS
Originally estimated to factor risk HIV infection only homosexuals and drug users, who use the injections
were infected, but the number is getting bigger. HIV infection especially attacked the T cell lymphocytes
and central nervous system. The way influx into the cell begins to bond with the receptors on the cell
lymphocytes and followed the breakdown of core and then resolve itself into some of the HIV virus. The
HIV virus will attack the CD4 lymphocytes so that eventually took place decrease of durability of the body
as a whole and is called acquired immunodefeciency syndrome (AIDS). A group of people who are infected
with the HIV Virus high risk as follows :
a. The fetus by the mother who contracted HIV
b. The women who use injection drugs and took turns wearing the syringes.
c. Commercial sex workers
d. A couples heterosex by the presence of venereal disease
Examination of HIV AIDS
The current tests do not differentiate between antibodies mother/baby, and the baby may show a negative
test at the age of 9 to 15 months. Research trying to develop an inexpensive ready-made to distinguish the
response of antibodies infants and mothers.
a. Histologic examination, sitologis a complete blood count, urine, feces, fluid spina, sores, secretions and
sputum.
b. Neurological tests (EEG, MRI, CT Brain scans, EMG)
c. Other tests such as a chest x-ray stated the development of interstitial filtration of the advanced stage of
a PVC or other complications, pulmonal function tests for early detection of Interstitial pneumonia, gallium
Scan, biopsy, bronchoscopy.
Treatment for HIV AIDS
In particular, it has been reported that the antiretroviral (ARV) is a good intervention for mother with HIV
or HIV-exposed fetus. In significantly reduce the risk of HIV transmission through breastfeeding post birth.
Where a national authority is promoting breast feeding and ARVS, the known HIV-infected mothers are
now recommended to breastfeed their babies at least until the age of 12 months.
The recommendation that the substitute food must not be used unless acceptable, affordable, sustainable
and safe. There is no cure for AIDS so prevention is done. But, when infected with the Human
Immunodeficiency Virus (HIV) then its therapy :
a. Zidovudine therapy. These drugs inhibit the replication of HIV by inhibiting the antiviral enzyme inverters
transcriptase.
b. New antiviral Therapies. To increase the activity of the immune system by inhibiting viral replication or
viral reproduction chain decided on his process. These drugs are didanosine, ribavirin, dideoxycytidine,
recombinant CD4 can dissolve.
c. Vaccines and the reconstruction of the virus (vaccine being used is interferon)
d. Rehabilitas. Aim to give mental-psychological support
HIV AIDS Prevention
Prevention of HIV transmission from mother to baby can be prevented through three ways and can be
started during pregnancy, during childbirth and after childbirth. That way, namely :
a. The use of Antiretroviral drugs during pregnancy, during childbirth and for the new baby is born.
Administering antiretroviral aims so that the viral load becomes lower so that the amount of virus present
in the blood and body fluids are less effective to transmit HIV. One tablet of nevirapine on the start time of
the pain of childbirth then one tablet again given in infants 2 to 3 days after birth. Combining nevirapine
and ZIDOVUDINE during labor reduced transmission to 2 percent.
b. Handling obstetrics during labor. Labor should be selected using the method this method because
caesaria Sectio proved to reduce the risk of HIV transmission from mother to infant to 80%. When surgery
is accompanied by the use of antiretroviral therapy, then the risk can be lowered to 85%. However, this
surgery has risks because of the condition of the mother's immunity is low can slow wound healing.
Therefore, the labor per vagina or sectio caesaria should consider appropriate nutritional conditions,
financial and other factors.
c. Treatment during breast-feeding. The giving of milk formula as a substitute for BREAST MILK is highly
recommended for infants with mothers who are HIV positive because in accordance with the results of
the study, obtained that ± 14% of infants infected with HIV through infected BREAST MILK.
Komentar
Posting Komentar