Indian Scenario

• First case: 1986, Estimates 2007: 2.47 million

PLHAs,
• 86.5% -15-49 years age group (27.9 % in 15-29
and 58.6% in 30-49 age groups)
• Epidemic concentrated in H.R.Gs; Spreading
From : H.R.Gs to the general population &
Urban to Rural areas
• Feminization (39.3% - women) of epidemic
• 4,65,500 HIV +VE Regd. In HIV Care At ART
Centers
• 1,55,000 (44%) Initiated on ART
 DELHI SCENARIO
• Total Population – 17.2 million, First case- 1988
• Low Prevalence State (Prevalence in Gen population- 0.3%)
• Estimated PLHAs (2007)- 51,818
• ICTC Data: Total HIV +ve detected from 2003-08: 31,295
-2008-09 Total General clients Counselled & Tested: 1,59,989 (HIV +ve-
6291, 3.9%)
-2008-09 Total Antenatal women Counselled & Tested: 1,22,310 (HIV +ve-
272- 0.25%)
-Low referrals from TI to ICTC: only 15,000 of 51,500 HRGs counselled &
tested in 2008.
• Highly Vulnerable State- (Migrant - 0.88 million, Truckers
stationed/day-35000)
• Total high risk population ->1.00 Lakh (FSW-61261, MSM- 28999, IDU-
17173)
-Consistent condom use: 91.6% FSWs, 84.4% MSMs
• Youth Population: 49%- Knowledge of HIV/AIDS, 92% Aware of condom
use, 74% aware of link b/w STI & HIV, 15% Sex with Non Regular partner in
last 12 months with 80% response to condom usage.
• HIV Prevalence in STI clinic attendees- 5.2%, High incidence of STI in
MSMs ( 57%) in Delhi – Highest in the country, 35% IDUs with STI symptom
• HIV +VE Regd in HIV Care At ART Centers : 18501
• Currently Alive & on ART: 5273
 Existing Service Outlets Under DSACS

S.No. Components Achievement (Feb 09)

1 Targeted Interventions for core groups 65

2 Integrated Counseling & Testing Centers 87

3 Integrated Counseling & Testing Centers 5
(PPP)-In Pvt. Hospitals/Labs
4 STD Clinics 15

5 Regional STD lab 1 UP

6 Blood Component Separation Unit 5
7 Major Blood Banks 6
8 District Blood Banks 6
9 Blood Storage Units 3

10 Community Care Centers 7 + 2 under process

11 Drop in Centers for PLHAs 5

12. ART centers 9

13 COE in ART at MAMC 1

14 Link ART Centers 7

15 Sentinel Surveillance Sites 20

HIV ENTRY IN CD4 T-LYMPHOCYTE

AttachedFile_03321.zip
ANIMATION- HIV LIFE CYCLE

AttachedFile_03320.zip
 Site of Action of ARV Drugs
• Nucleoside analog reverse transcriptase inhibitors are the first
antiretroviral drugs, zidovudine, was approved in 1987. structural
similarity of these drugs to the building blocks of nucleic acids (RNA,
DNA)
• Nonnucleoside reverse transcriptase inhibitors bind directly and
noncompetitively to the enzyme reverse eg nevirapine, efavirenz.
• Protease inhibitors: Inhibition of the protease enzyme results in
the release of structurally disorganized and noninfectious viral eg
ritonavir
• Fusion Inhibitor: Enfuvirtide (also known as T-20) is the first, and
thus far the only, fusion inhibitor blocks the formation of the 6-helix
bundle necessary for fusion.Enfuvirtide is not orally bioavailable, a
subcutaneous injection, twice daily.
• Integrase inhibitors: Prevents integration of HIV’s genetic code
into the genetic code of the host cell. e.g. S-1360