infectious disease

Question 1

Describe the epidemiology of AIDS

Answer 1

a few men had an unexplained disease
gay, white, male
died
GRID - Gay Related Immune Deficiency
env factor: club drug/infection
case control study: 75% living cases questioned, controls for each. cases more partners, history of syphilis, case clustering
drug users, transfusion/factor VIII recipients
look at cases with clear source of infection: monogamous sexual partners of affected people, babies, haemophiliacs
virus found in 1983
test for virus ‘84
no treatment

Question 2

2017 AIDS stats

Answer 2

37million had HIV
22 million didn’t take medicine
1.8million new infections
940000 dies

Question 3

Geography of AIDS

Answer 3

started in southern part of the world

spread

Question 4

how can we ‘get AIDS to zero’

Answer 4

no new infections
no new babies infected
no more HIV related deaths
elimination of mother to child transmission in cuba

Question 5

Why is mortality higher in low income countries

Answer 5

treatment not available

Question 6

Antiretroviral therapy

Answer 6

percentage of people surviving after AIDS diagnosis increasing
need to reduce incidence as well as mortality otherwise burden keeps increasing
number of people taking ART is increasing, but its unsustainable because people take it everyday
scientifically possible to eliminate AIDS but have to think about human nature
number of children infected - decreased from <1996 -2004

Question 7

What is the main driver of transmission

Answer 7

viral load

Question 8

How do we get untransmissible

Answer 8

HPTN 052 is a game changer - prevention - public health
START and Temprano studies - early treatment - individual
undetectable=untransmissible
90-90-90 - 90% people with HIV will know their status, 90% diagnosed receive therapy, 90% with therapy will have durable suppression by 2020
gaps from the 90-90-90 target because people not getting tested

Question 9

AIDS and causes of deaths in LIC 2011

Answer 9

AIDS 3rd biggest

Question 10

WHO top 10 causes of deaths - AIDS - 2016

Answer 10

AIDS not one of them

Question 11

Funding

Answer 11

need to discuss with patients and politicians

preventing the infections in the UK would have saved £1.1 billion

Question 12

origins of human infection

Answer 12

inherited from ancestors
acquired from livestock - pig, chicken and duck
acquired from wildlife - more intimate contact with wildlife
Amsterdam map out infuenza network with genetic mapping
more dense population the faster it spreads and more evolution

Question 13

The changing world

Answer 13

population still increasing
airlines mean people travel further
H1N1 spread from Mexico and America world wide
chickens mainly in Europe and asia