![• According to the International Union of Immunological
Societies, more than 150 primary immunodeficiency
diseases (PIDs) have been characterized.[1] However,
the number of acquired immunodeficiencies exceeds the
number of PIDs.
• It has been suggested that most people have at least one
primary immunodeficiency. Due to redundancies in the
immune system, though, many of these are never
detected](https://image.slidesharecdn.com/drsujeetkumarjha-180324143825/85/Dr-sujeet-kumar-jha-8-320.jpg)
![• Many specific diseases directly or indirectly cause
immunosuppression. This includes many types of cancer,
particularly those of the bone marrow and blood cells
(leukemia, lymphoma, multiple myeloma), and certain
chronic infections. Immunodeficiency is also the hallmark
of acquired immunodeficiency syndrome (AIDS),[7]
caused by the human immunodeficiency virus (HIV). HIV
directly infects a small number of T helper cells, and also
impairs other immune system responses indirectly.](https://image.slidesharecdn.com/drsujeetkumarjha-180324143825/85/Dr-sujeet-kumar-jha-16-320.jpg)
![• This is between two thirdsand nearly that of the general population. If
treatment is started late in the infection, prognosis is not as good: for
example, if treatment is begun following the diagnosis of AIDS, life
expectancy is ~10–40 years.Half of infants born with HIV die before two
years of age without treatment.opportunistic infections and cancer, both of
which are frequently the result of the progressive failure of the immune
system.Risk of cancer appears to increase once the CD4 count is below
500/μL. The rate of clinical disease progression varies widely between
individuals and has been shown to be affected by a number of factors such
as a person's susceptibility and immune functiontheir access to health care,
the presence of co-infections and the particular strain (or strains) of the virus
involved.Tuberculosis co-infection is one of the leading causes of sickness
and death in those with HIV/AIDS being present in a third of all HIV-infected
people and causing 25% of HIV-related deaths.HIV is also one of the most
important risk factors for tuberculosis.Hepatitis C is another very common co-
infection where each disease increases the progression of the other.[197]
The two most common cancers associated with HIV/AIDS are Kaposi's
sarcoma and AIDS-related non-Hodgkin's lymphoma](https://image.slidesharecdn.com/drsujeetkumarjha-180324143825/85/Dr-sujeet-kumar-jha-38-320.jpg)
Dr sujeet kumar jha
- 1. JALA-LABAD STATE MEDICAL UNIVERSITY PROJECT =PATHOLOGY,IMMUNO PATHOLOGY ,AIDS DR SUJEET KUMAR JHA
- 2. PATHOLOGY • Pathology (from the Greek roots of pathos (πάθος), meaning "experience" or "suffering" whence the English word "path" is derived by transliteration, and -logia (- λογία), "study of") is a significant component of the causal study of pathogens and a major field in modern medicine and diagnosis. Hence, 'the study of paths', by which disease comes.
- 3. A pathologist examines a tissue section for evidence of cancerous cells while a surgeon observes
- 4. PRINCIPAL PATHOLOGY= Disease Infection Neoplasia Cause Pathogenesis Hemodynamics Ischemia Inflammation Cell damage Wound healing, Cellular adaptation Atrophy Hypertrophy Hyperplasia Dysplasia Metaplasia Squamous Glandular • Cell death Necrosis Coagulative necrosis Liquefactive necrosis Gangrenous necrosis Caseous necrosis Fat necrosis Fibrinoid necrosis Programmed cell death Apoptosis Pyknosis Karyorrhexis Karyolysis • Accumulations pigment Hemosiderin Lipochrome/Lipofuscin Melanin Steatosis
- 5. • Anatomical pathology =Surgical pathology Cytopathology Autopsy Molecular pathology Forensic pathology Oral and maxillofacial pathology • Gross examination Histopathology Immunohistochemistry Electron microscopy Immunofluorescence Fluorescence in situ hybridization • Clinical pathology • Clinical chemistry Hematopathology Transfusion medicine Medical microbiology Diagnostic immunology Immunopathology
- 6. IMMUNO-PATHOLOGY • Immunopathology is a branch of medicine that deals with immune responses associated with disease. It includes the study of the pathology of an organism, organ system, or disease with respect to the immune system, immunity, and immune responses. • In biology, it refers to damage caused to an organism by its own immune response, as a result of an infection. It could be due to mismatch between pathogen and host species, and often occurs when an animal pathogen infects a human (e.g. avian flu leads to a cytokine storm which contributes to the increased mortality rate)
- 7. IMMUN DISORDER • An immune disorder is a dysfunction of the immune system. These disorders can be characterized in several different ways: • By the component(s) of the immune system affected • By whether the immune system is overactive or underactive • By whether the condition is congenital or acquired
- 8. • According to the International Union of Immunological Societies, more than 150 primary immunodeficiency diseases (PIDs) have been characterized.[1] However, the number of acquired immunodeficiencies exceeds the number of PIDs. • It has been suggested that most people have at least one primary immunodeficiency. Due to redundancies in the immune system, though, many of these are never detected
- 9. AUTO-IMMUN DISEASES • An autoimmune disease is a condition arising from an abnormal immune response to a normal body part.There are at least 80 types of autoimmune diseases. Nearly any body part can be involved. Common symptoms include low grade fever and feeling tired.Often symptoms come and go. • Main article: autoimmune disorders • Scleroderma • Certain types of hemolytic anemia • Rheumatoid arthritis • Type one diabetes
- 10. IMMUNO-DEFICIENCY • Immunodeficiency (or immune deficiency) is a state in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. Most cases of immunodeficiency are acquired ("secondary") due to extrinsic factors that affect the patient's immune system. Examples of these extrinsic factors include HIV infection,
- 11. BY AFFECTED COMPONENT • Humoral immune deficiency (including B cell deficiency or dysfunction), with signs or symptoms depending on the cause, but generally include signs of hypogammaglobulinemia (decrease of one or more types of antibodies) with presentations including repeated mild respiratory infections, and/or agammaglobulinemia (lack of all or most antibody production) which results in frequent severe infections and is often fatal. • T cell deficiency, often causes secondary disorders such as acquired immune deficiency syndrome (AIDS).
- 12. • Granulocyte deficiency, including decreased numbers of granulocytes (called as granulocytopenia or, if absent, agranulocytosis) such as of neutrophil granulocytes (termed neutropenia). Granulocyte deficiencies also include decreased function of individual granulocytes, such as in chronic granulomatous disease. • Asplenia, where there is no function of the spleen • Complement deficiency is where the function of the complement system is deficient
- 13. PRIMARY-IMMUNO DEFICIENCY • A number of rare diseases feature a heightened susceptibility to infections from childhood onward. Primary Immunodeficiency is also known as congenital immunodeficiencies. Many of these disorders are hereditary and are autosomal recessive or X-linked. There are over 80 recognised primary immunodeficiency syndromes; they are generally grouped by the part of the immune system that is malfunctioning, such as lymphocytes or granulocytes.
- 14. • The treatment of primary immunodeficiencies depends on the nature of the defect, and may involve antibody infusions, long-term antibiotics and (in some cases) stem cell transplantation.The characteristics of lacking and/or impaired antibody functions can be related to illnesses such as X-Linked Agammaglobulinemia and Common Variable Immune Deficiency
- 15. SECONDARY-IMMUNO-DEFICIENCY • Secondary immunodeficiencies, also known as acquired immunodeficiencies, can result from various immunosuppressive agents, for example, malnutrition, aging, particular medications (e.g., chemotherapy, disease-modifying antirheumatic drugs, immunosuppressive drugs after organ transplants, glucocorticoids) and environmental toxins like mercury and other heavy metals, pesticides and petrochemicals like styrene, dichlorobenzene, xylene, and ethylphenol.
- 16. • Many specific diseases directly or indirectly cause immunosuppression. This includes many types of cancer, particularly those of the bone marrow and blood cells (leukemia, lymphoma, multiple myeloma), and certain chronic infections. Immunodeficiency is also the hallmark of acquired immunodeficiency syndrome (AIDS),[7] caused by the human immunodeficiency virus (HIV). HIV directly infects a small number of T helper cells, and also impairs other immune system responses indirectly.
- 17. • Various hormonal and metabolic disorders can also result in immune deficiency including anemia, hypothyroidism, diabetes and hypoglycemia. • Smoking, alcoholism and drug abuse also depress immune response.
- 18. ACQUIRED IMMUNO DEFFICENCY DISEASE( AIDS)
- 19. • 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
- 20. • people who have working immune systems. These late symptoms of infection are referred to as acquired immunodeficiency syndrome (AIDS).This stage is often also associated with weight loss. • SIGN & SYMPTOM = There are three main stage of HIV -INFECTION (1) ACUTE LATENCY (2) CLINICAL LATENCY AND (3) AIDS
- 21. ACUTE LATENCY • 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
- 22. • and is maculopapular, classically. Some people also develop opportunistic infections at this stage.Gastrointestinal symptoms, such as vomiting or diarrhea may occur. Neurological symptoms of peripheral neuropathy or Guillain–Barré syndrome also occurs. The duration of the symptoms varies, but is usually one or two weeks.
- 24. • The initial symptoms are followed by a stage called clinical latency, asymptomatic HIV, or chronic HIV.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.
- 25. • Acquired immunodeficiency syndrome (AIDS) is defined in terms of either a CD4+ T cell count below 200 cells per µL or the occurrence of specific diseases in association with an HIV infection. In the absence of specific treatment, around half of people infected with HIV develop AIDS within ten years.The most common initial conditions that alert to the presence of AIDS are pneumocystis pneumonia (40%), cachexia in the form of HIV wasting syndrome (20%), and esophageal candidiasis.Other common signs include recurring respiratory tract infections.
- 26. • Opportunistic infections may be caused by bacteria, viruses, fungi, and parasites that are normally controlled by the immune system.Which infections occur depends partly on what organisms are common in the person's environment.These infections may affect nearly every organ system. • People with AIDS have an increased risk of developing various viral-induced cancers, including Kaposi's sarcoma, Burkitt's lymphoma, primary central nervous system lymphoma, and cervical cancer.
- 27. • Kaposi's sarcoma is the most common cancer occurring in 10 to 20% of people with HIV. The second most common cancer is lymphoma, which is the cause of death of nearly 16% of people with AIDS and is the initial sign of AIDS in 3 to 4%.Both these cancers are associated with human herpesvirus 8. Cervical cancer occurs more frequently in those with AIDS because of its association with human papillomavirus (HPV).Conjunctival cancer (of the layer that lines the inner part of eyelids and the white part of the eye) is also more common in those with HIV.
- 28. • Additionally, people with AIDS frequently have systemic symptoms such as prolonged fevers, sweats (particularly at night), swollen lymph nodes, chills, weakness, and unintended weight loss.Diarrhea is another common symptom, present in about 90% of people with AIDS. They can also be affected by diverse psychiatric and neurological symptoms independent of opportunistic infections and cancers.
- 30. TRANSMISSION • HIV is transmitted by three main routes:(1) sexual contact, (2)significant exposure to infected body fluids or tissues, and(3) from mother to child during pregnancy, delivery, or breastfeeding (known as vertical transmission). There is no risk of acquiring HIV if exposed to feces, nasal secretions, saliva, sputum, sweat, tears, urine, or vomit unless these are contaminated with blood.It is possible to be co-infected by more than one strain of HIV—a condition known as HIV superinfection
- 31. DIAGNOSIS • HIV/AIDS is diagnosed via laboratory testing and then staged based on the presence of certain signs or symptoms. HIV screening is recommended by the United States Preventive Services Task Force for all people 15 years to 65 years of age including all pregnant women.Additionally, testing is recommended for those at high risk, which includes anyone diagnosed with a sexually transmitted illness. In many areas of the world, a third of HIV carriers only discover they are infected at an advanced stage of the disease when AIDS or severe immunodeficiency has become apparent
- 32. A generalized graph of the relationship between HIV copies (viral load) and CD4+ T cell counts over the average course of untreated HIV infection. CD4+ T Lymphocyte count (cells/mm³) HIV RNA copies per mL of plasma
- 33. 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.
- 34. • 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.
- 35. Stribild – a common once-daily ART regime consisting of elvitegravir, emtricitabine, tenofovir and the booster
- 36. DIET • The World Health Organization (WHO) has issued recommendations regarding nutrient requirements in HIV/AIDS.A generally healthy diet is promoted. 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. Dietary supplementation for people who are infected with HIV and who have inadequate nutrition or dietary deficiencies may strengthen their immune systems or help them recover from infections, however evidence indicating an overall benefit in morbidity or reduction in mortality is not consistent.
- 37. PROGNOSIS • HIV/AIDS has become a chronic rather than an acutely fatal disease in many areas of the world.Prognosis varies between people, and both the CD4 count and viral load are useful for predicted outcomes. Without treatment, average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype.After the diagnosis of AIDS, if treatment is not available, survival ranges between 6 and 19 months.HAART and appropriate prevention of opportunistic infections reduces the death rate by 80%, and raises the life expectancy for a newly diagnosed young adult to 20–50 years.
- 38. • This is between two thirdsand nearly that of the general population. If treatment is started late in the infection, prognosis is not as good: for example, if treatment is begun following the diagnosis of AIDS, life expectancy is ~10–40 years.Half of infants born with HIV die before two years of age without treatment.opportunistic infections and cancer, both of which are frequently the result of the progressive failure of the immune system.Risk of cancer appears to increase once the CD4 count is below 500/μL. The rate of clinical disease progression varies widely between individuals and has been shown to be affected by a number of factors such as a person's susceptibility and immune functiontheir access to health care, the presence of co-infections and the particular strain (or strains) of the virus involved.Tuberculosis co-infection is one of the leading causes of sickness and death in those with HIV/AIDS being present in a third of all HIV-infected people and causing 25% of HIV-related deaths.HIV is also one of the most important risk factors for tuberculosis.Hepatitis C is another very common co- infection where each disease increases the progression of the other.[197] The two most common cancers associated with HIV/AIDS are Kaposi's sarcoma and AIDS-related non-Hodgkin's lymphoma