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ObjectivesTo evaluate the risk of heart failure (HF) linked to human immunodeficiency virus (HIV) infection, how risk varies by demographic characteristics, and whether it is explained by atherosclerotic disease or risk factor treatment.Patients and MethodsWe performed a retrospective cohort study of persons with HIV (PWHs) from January 1, 2000, through December 31, 2016, frequency-matched 1:10 to persons without HIV on year of entry, age, sex, race/ethnicity, and treating facility. We evaluated the risk of incident HF associated with HIV infection, overall and by left ventricular systolic function, and whether HF risk varied by demographic characteristics.ResultsAmong 38,868 PWHs and 386,586 matched persons without HIV, mean ± SD age was 41.4±10.8 years, with 12.3% female, 21.1% Black, 20.5% Hispanic, and 3.9% Asian/Pacific Islander. During median follow-up of 3.8 years (interquartile range, 1.4-9.0 years), the rate (per 100 person-years) of incident HF was 0.23 in PWHs vs 0.15 in those without HIV (P<.001). The PWHs had a higher adjusted HF rate (adjusted hazard ratio [aHR], 1.73; 95% confidence interval [CI], 1.57 to 1.91), which was only modestly attenuated after accounting for interim acute coronary syndrome events. Results were similar by systolic function category. The adjusted risk of HF in PWHs was more prominent for those 40 years and younger (aHR, 2.45; 95% CI, 1.92 to 3.03), women (aHR, 2.48; 95% CI, 1.90 to 3.26), and Asian/Pacific Islanders (aHR, 2.46; 95% CI, 1.27 to 4.74).ConclusionHIV infection increases the risk of HF, which varied by demographic characteristics and was not primarily mediated through atherosclerotic disease pathways or differential use of cardiopreventive medications.  相似文献   

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One hundred and twenty-three patients with human immunodeficiencyvirus infection have been referred to rheumatologists at ourhospitals between October 1985 and April 1989 because of musculoskeletalsymptoms. Thirty-four homosexual men presented with acute, peripheral,non-erosive arthritis (mean number of four joints affected)with the knees being involved in 23. Other features developingconcurrently with arthritis included psoriasis, keratodermablenorrhagica, plantar fasciitis, urethritis, conjunctivitisand anterior uveitis. Four of five patients investigated wereHLA-B27- positive; none of 15 patients tested had raised titresof rheumatoid or antinuclear factors. Various infections wereassociated with the onset of arthritis and two patients witha recent history of diarrhoea had serological evidence of yersiniainfection. No micro-organisms were identified within the jointexcept for HIV itself. At the time of onset of arthritis fourof these individuals had the acquired immunodeficiency syndrome(AIDS); 11 were not known to be HIV-positive before testingwhich was performed following referral for arthritis. Six patientshave since developed AIDS and four have died. In 15 individuals,including those who progressed to AIDS, joint symptoms havebeen severe, persistent and poorly responsive to non-steroidalanti-inflammatory drugs. In only five patients has the arthritisbeen known to resolve. Synovitis has also been seen in two women:in one of these HIV infection was thought to have been acquiredthrough intravenous drug abuse. Other rheumatic lesions included myalgia/myositis, non-inflammatoryperipheral arthritis, spinal pain, soft tissue lesions, arthralgiaor myalgia of unknown cause and infective lesions includingseptic arthritis and bony infection due to histoplasmosis andatypical mycobacterial infection. It appears likely that HIV infection is a risk factor for thedevelopment of seronegative arthritis and other rheumatic lesions.  相似文献   

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This review focuses on the prevalence, causes, evaluation, and treatment of headache in individuals infected with human immunodeficiency virus type 1 (HIV-1). Headaches, one of the commonest medical complaints in the general population, occur frequently in patients infected with the HIV-1. HIV-related headaches can occur at any time during the infection: at seroconversion, during the incubation period, in patients with symptomatic HIV-1 infection, or after an AIDS-defining illness. Causes of HIV-related headaches include HIV-1 itself, opportunistic conditions, or HIV-specific medications. Migraines, tension-type headaches, depression, and substance abuse enter into the differential diagnosis, particularly in the early stages of disease. The headaches seen in this population reflect a complex web of interactions imposed by immune competency, multiple etiologies, treatments, and premorbid conditions. Prompt recognition and early treatment of headache is essential since it may improve quality of life and, depending on the diagnosis, prolong survival. Physicians need to be alert and adaptable when assessing HIV-infected individuals with headache since multiple causes can exist in the same patient and new syndromes, complications, and investigational drugs are continually being identified.  相似文献   

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获得性免疫缺陷综合征(AIDS),是由于人免疫缺陷病毒(HIV)感染引起,本病发展缓慢,宿主免疫系统进行性衰竭,疾病晚期特别容易发生机会性感染、神经疾病和肿瘤.……  相似文献   

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Exocrine pancreatic function and fat absorption were determinedusing a ‘tubeless’ test in 25 human immunodeficiencyvirus (HIV) antibody positive subjects (23 males, two females),CDC criteria groups II (four), III(one), and IV (20). In 12fat absorption was poor but in only three of these were theresults indicative of pancreatic insufficiency and in all threethis was mild. In nine of the cases the results were compatiblewith small intestinal malabsorption. Mild, but not severe, exocrine pancreatic insufficiency mayoccur in acquired immune deficiency syndrome; however fat malabsorptionis more commonly associated with a small intestinal cause.  相似文献   

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获得性免疫缺陷综合征(AIDS),是由于人免疫缺陷病毒(HIV)感染引起,本病发展缓慢,宿主免疫系统进行性衰竭,疾病晚期特别容易发生机会性感染、神经疾病和肿瘤.由于免疫系统改变、继发感染、恶性肿瘤及治疗等因素大多数患者出现血液学异常,此外HIV感染亦可直接影响骨髓细胞和造血前体细胞.  相似文献   

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目的探讨人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者行纤维支气管镜(fibro bronchoscopes,FB)检查的护理方法。方法回顾性分析2008年5月至2011年7月在广西龙潭医院治疗的58例HIV感染者的临床资料,总结该类患者在FB检查前、检查时及检查后的护理要点。结果 58例HIV感染者均能配合操作,顺利完成FB诊疗,为其治疗及护理的工作人员无一例发生职业暴露。结论良好的护理可使患者主动配合FB检查,有利于其术后的身心康复,增强其对有创诊治信心,同时也减少了医护人员发生职业暴露的潜在危险。  相似文献   

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Objectives: The authors sought to determine staff satisfaction with an emergency department (ED) rapid human immunodeficiency virus (HIV) testing program. Methods: A survey was conducted in an urban ED that has provided rapid HIV testing (routine screening and physician‐initiated testing) since August 2007. From May 1, 2008, to August 31, 2008, the survey was administered to all ED staff involved with HIV testing. The primary outcome was satisfaction, and secondary outcomes were the staff attitudes toward the program. Results: Surveys were administered to 215 of the 217 staff members, and 207 surveys were returned (96% response rate); 201 surveys had complete data available for analysis. The response rate by staffing type was as follows: physicians 64/64 (100%), nurses 124/134 (93%), and registration staff 16/19 (84%). The majority of ED staff (99%; 95% confidence interval [CI] = 95% to 100%) were satisfied with the HIV testing program. Physicians, however, rated the program more favorably than nurses or registration staff. Most staff members agreed that HIV testing improved overall care (93%; 95% CI = 89% to 96%) and felt that HIV testing did not interfere with their ability to provide care (82%; 95% CI = 76% to 87%). The majority of staff perceived that patients were satisfied with the procedures for obtaining consent (73%; 95% CI = 67% to 79%) and with the way HIV testing was performed (83%; 95% CI = 77% to 87%). Conclusions: Emergency department staff satisfaction and overall attitudes with the HIV testing program is high. ED staff does not appear to be a barrier to program implementation. ACADEMIC EMERGENCY MEDICINE 2010; 17:561–565 © 2010 by the Society for Academic Emergency Medicine  相似文献   

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Compared with the general population, people living with human immunodeficiency virus are at a higher risk of developing mental health conditions such as depression, substance use disorders, posttraumatic stress disorder, suicidality, psychosis, and generalized anxiety disorder. These conditions can negatively impact the patient’s treatment options, adherence to treatment, and eventual health outcome. Unfortunately, these conditions often go undetected and the correlation with the disease unrecognized. Primary care providers for people living with human immunodeficiency virus need to screen and manage these mental health disorders for improved prognosis.  相似文献   

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As a result of effective antiretroviral treatment, patients with human immunodeficiency virus are living nearly normal life spans and are presenting to primary care nurse practitioners for management of comorbidities. Substance use disorders are common but often unexpected in aging patients due to the misconception that older patients do not abuse drugs. When symptoms of substance use are attributed to the normal aging process and overlooked, the diagnosis can be missed, which leads to high morbidity and mortality rates, especially in patients with human immunodeficiency virus. Through early recognition, nurse practitioners can facilitate timely diagnosis and comprehensive treatment that can improve patient outcomes.  相似文献   

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目的 探讨成都市无偿献血者中的人类免疫缺陷病毒(HIV)感染特征,从而控制和阻断HIV的经输血传播.方法 选择2007年1月至2009年12月成都市无偿献血者中被检出为HIV感染者144例为研究对象,收集并整理其基本信息,并对这些数据进行统计学分析.(本研究遵循的程序符合本中心人体试验委员会所制定的伦理学标准,得到该伦理会批准,分组征得受试对象本人的知情同意,并与之签订临床研究知情同意书).结果 近3年,成都市无偿献血人群中的HIV流行率分别为0.029%,0.034%和0.035%;感染者年龄要集中在18~35岁;受教育程度为高中以下学历多于高中及高中以上学历;从事自由职业人群高于固定职业人群.结论 近3年,成都市无偿献血人群中HIV流行率呈逐年上升趋势,做好献血筛查和献血者招募,对确保供血安全至关重要.  相似文献   

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