HIV/AIDS

Dr. Fazah Akhtar Bt. Hanapiah

Pegawai Perubatan,
Perkhidmatan Kesihatan Sekolah
Daerah Klang.

DEFINISI
HIV
AIDS
2

Sejenis retrovirus yang

diketahui pada awal
tahun 1980an. Jangkitan
ini menyebabkan
kemusnahan sistem
daya tahan melawan
penyakit dan barah.
3

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.

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)

CARA JANGKITAN
3 cara utama :
Seks
Darah
Ibu ke anak
6

Spektrum J angkitan HI V
Jangkitan

Tempoh
J angkitan

Peringkat

2 bulan

HIV Negative
(Window Period)

10 tahun

HIV Positive

2 tahun

Pembawa

Klinikal AIDS

Mati
110102

Sexually Transmitted Diseases and AIDS Programme

World Health Organization
Western Pacific Regional Office

Pembawa HIV

kelihatan sihat
tiada tanda

penyakit

tidak boleh

dikenali

purata 10 tahun
8

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

Pesakit AIDS

tidak sihat

ada tanda penyakit

susut berat badan
demam
berpanjangan
sakit kulit
jangkitan paru-paru
bengkak kelenjar

2 tahun
10

Hilang Berat Badan

11

Herpes Zoster

12

Oral Thrush

13

Non Hodgkins
Lymphoma

14

15
110101

AIDS and HIV Infection

Global Epidemiology

16
110101

Adults and children estimated to be living

with HIV/AIDS as of end 2000
North America

920 000

Caribbean

390 000

Latin America

1.4 million

Eastern Europe
Western Europe & Central Asia

540 000 700 000 East Asia & Pacific

North Africa
640 000
South
& Middle East
& South-East Asia
400 000
5.8million
Sub-Saharan
Africa

25.3 million

Total: 36.1 million

Australia
& New Zealand

15 000

Estimated adult and child deaths due to HIV/AIDS

from the beginning of the epidemic to end 2000
North America

450 000

Caribbean

160 000

Latin America

520 000

Western Europe

Eastern Europe &

Central Asia

210 000 17 000

East Asia & Pacific
North Africa
40 000
South
& Middle East
& South-East Asia
70 000
1.1 million
Sub-Saharan
Africa

13.7 million

Total: 21.8 million

99000-E-3 1 December 1999

Australia
& New Zealand

8 000

Estimated adult and child deaths

from HIV/AIDS during 2000
Western Europe

North America

7 000

20 000

Caribbean

32 000

Latin America

50 000

North Africa
& Middle East

Eastern Europe &

Central Asia

14 000 East Asia & Pacific

25 000
South

24 000

Sub-Saharan
Africa

& South-East Asia

470 000

2.4 million

Total: 3 million
99000-E-5 1 December 1999

Australia
& New Zealand

< 500

Estimated number of adults and children

newly infected with HIV during 2000
North America

45 000

Caribbean

60 000

Latin America

150 000

Western Europe

30 000

North Africa
& Middle East

Eastern Europe &

Central Asia

250 000East Asia & Pacific

130 000
South

80 000

Sub-Saharan
Africa

& South-East Asia

780 000

3.8 million

Total: 5.3 million

99000-E-7 1 December 1999

Australia
& New Zealand

500

About 15 000 new HIV infections a day in 2000

34/7

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 1524 year olds

99000-E-11 1 December 1999

21

HIV/AIDS in Asia
Status and trends
Perspectives

110301

22

Country/Area

Cambodia
Thailand
Myanmar
India
Malaysia
Nepal
Viet Nam
Papua New Guinea
Singapore
Australia
Hong Kong / China
China
Philippines
Sri Lanka
New Zealand
Indonesia
Lao PDR
Bangladesh
Republic of Korea
Japan
Total
110308

HIV prevalence
adults (15-49)

180 000
740 000
447 000
4 900 000
45 000
34 000
80 000
4 400
3 800
10 800
3 400
400 000
29 000
7 000
1 200
60 000
1 200
23 000
3 400
7 300
7 000 000

HIV prev. rate

adults (15-49)

% Women
HIV pos

Sexual
contact

Injecting
drug use

Others

3.70%
2.14%
1.87%
0.98%
0.35%
0.33%
0.20%
0.19%
0.18%
0.11%
0.09%
0.09%
0.08%
0.07%
0.06%
0.05%
0.05%
0.04%
0.01%
0.01%

30%
50%
20%
25%
20%
40%
20%
50%
20%
5%
40%
12%
30%
30%
15%
25%
50%
15%
13%
5%

95%
75%
30%

3%
10%
70%

2%
15%
10%

20%

75%

5%

20%
95%
95%
91%
80%
10%
90%

75%
<1%
<1%
5%
15%
50%
<5%

5%
<5%
5%
4%
5%
40%
6%

95%

3%

2%

95%

3%

2%

93%
50%

<1%
<5%

7%
46%

Estimated / projected HIV prevalence rate

selected countries - Asia - 1980-2000
%

110313

24

Trends in AIDS Reported

Selected countries 1989-1997
New Zealand
Australia
Hong Kong
Japan
S. Korea
Singapore

AIDS cases reported

1 000
900
800
700
600
500
400
300
200
100
0
89
110507

90

91

92

93

94

95

96

97

25

HIV/AIDS in Malaysia

Status and trends

Perspectives

26
110301

HIV, AIDS DAN KEMATIAN MALAYSIA, 1989 2000

6,000

BILANGAN KES

5,000
4,000
3,000
2,000
1,000
0

89

90

91

92

93

94

95

96

97

98

99

2000

HIV

200

778

1,794

2,512

2,507

3,393

4,198

4,597

3,924

4,624

4,692

5,117

AIDS

18

60

73

71

105

233

347

568

875

1,200

1,095

MATI

10

19

46

55

80

165

271

473

689

874

853

TAHUN

Peratusan Jangkitan HIV Mengikut

Jantina Di Malaysia dari
Tahun 1985-1997
Perempuan
4%

Lelaki
Perempuan

Lelaki
96%

28

PERATUS KES HIV BERKAITAN DENGAN IDU,

MALAYSIA 1986 2000
90.00%
80.00%

% KES HIV

70.00%
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%

1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

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 72.80

TAHUN

PERATUS KES HIV BERKAITAN DENGAN HUBUNGAN SEKS,

MALAYSIA 1986 2000
80.00%
70.00%

% KES HIV

60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

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 18.00

TAHUN

PERATUS KES HIV MENGIKUT UMUR,

MALAYSIA 1988 2000
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

< 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%

Pengurusan Kes

32

Rawatan

Tiada ubat atau

vaksin
Mencegah jangkitan
opportunis

ubat
kebersihan diri
rehat
senaman
pemakanan
sempurna
33

Rawatan

Melewatkan
peringkat AIDS
- ubat
- pemeriksaan klinikal
- merawat komplikasi &
jangkitan opportunis

34

35