Dr. Ashok Jaisingani

The type I immunodeficiency virus is one of the virus of surgical importance as it can be transmitted by body fluid, particularly blood.

It is retrovirus and its prevalence inc. via 1- Sexual Transmission 2- Homo & Heterosexual individuals3- IV – drugs addictions 4- Through infected blood in treating haemophlias.

The risk in surgery mostly through the needle stick injury during the operation.

After the exposure the virus is bind to CD4 receptors with a subsequent loss of CD4+ cells, T helper cells and other cells involved in cell – mediated immunity, antibody production and delayed hypersensitivity.

Macrophages and gut associated lymphoid tissues are also affected.

The risk of the opportunistic infections increase are 1- Pneumocystitis Carinii pneumonia 2- Tuberculosis 3- Cytomegalovirus 4- Neoplasm (Kaposi’s sarcoma & lymphoma)

In the early weeks after the HIV infection there may be a flu – like illness

During the phase of seroconversion patients present the greatest risk of HIV transmission

It is during these early phases that drug treatment, “highly active anti-retroviral therapy” (HAART) is most effective through the ability of these drugs to inhibit the reverse transcriptase and protease synthesis.

Transcriptase and protease synthesis are principle mechanisms through which HIV can progress

Within 10 – years untreated HIV can progress to AIDS in 25 – 35% of the patients, which is considered to be fatal.