江苏省439例HIV/AIDS患者KIR3DS1基因的检测分析

目的了解KIR3DS1基因在HIV/AIDS患者中的分布情况,初步分析其与艾滋病的相关性。方法以江苏省疾病预防控制中心(CDC)确认的439例HIV/AIDS患者为研究对象,应用PCR-SSP方法进行KIR3DS1基因的检测。分类资料用频数和百分比进行统计描述,用χ2检验分析病例组与历史性对照组携带KIR3DS1基因的差异。使用非条件Logistic回归分析KIR3DS1基因与HIV/AIDS疾病进程的关联性。结果 439例研究对象KIR3DS1基因出现频率为34.4%,基因频率为0.19。HIV/AIDS患者与江苏历史性健康对照组间携带KIR3DS1基因之间的差异无统计学意义(P>0.05),但与美国健康白人间有统计学差异(P<0.01)。调整年龄、性别、感染途径等因素后,携带KIR3DS1基因对HIV进展到AIDS无明显影响(P=0.188)。结论我国汉族人群KIR3DS1基因与艾滋病的相关性有待进一步研究。     

KIR基因多态性与HIV/AIDS关联性研究的Meta分析

目的系统评价杀伤细胞免疫球蛋白样受体(KIR)基因多态性与HIV感染/AIDS的相关性。方法通过文献检索Medline和中国生物医学文献(CBM)数据库等,收集KIR基因多态性与HIV感染/AIDS关系的全文文献,剔除不符合要求者,在全面回顾文献的基础上对各病例对照研究结果进行Meta分析。结果 6篇有关KIR基因多态性与HIV/AIDS关系的研究认为KIR3DS1基因是HIV感染或(和)艾滋病的保护基因(P<0.05),其合并OR值为0.65,95%CI为0.48～0.88。结论携带KIR3DS1基因可能降低HIV/AIDS的危险性,其他KIR基因与HIV/AIDS之间的关联无显著性。     

HAART治疗初期HIV感染者/AIDS病人社会支持与生存质量调查

[目的]调查上海市人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)病人社会支持和生存质量的现状以及相关影响因素。[方法]采用方便抽样法对上海市某艾滋病定点诊疗机构门诊随访的136例HIV感染者/AIDS病人进行调查。[结果]HIV感染者/AIDS病人医疗社会支持量表总分为(62.48±18.08)分,4个维度得分由高到低依次为情感性支持、社会互动性支持、实际性支持、讯息与情绪性支持。HIV感染者/AIDS病人生存质量总分为(74.31±14.05)分,健康感受维度得分最差为(54.19±19.21)分。抗病毒治疗初期病人生存质量处于中等偏上水平,人口学资料与生存质量无相关性。抗病毒治疗初期病人获得社会支持度不足,人口学资料与社会支持得分无相关性(P0.05)。HIV感染者/AIDS病人医疗社会支持与生存质量存在明显相关性(P0.01)。[结论]医护人员应重视HIV感染者/AIDS病人抗病毒治疗初期的社会支持与生存质量。     

载脂蛋白B mRNA编辑酶催化多肽样蛋白3GmRNA表达水平与HIV/AIDS患者疾病进展的相关性研究

目的 探讨河南省46例HIV/AIDS患者外周血单个核细胞载脂蛋白B mRNA编辑酶催化多肽样蛋白3G(APOBEC3G)mRNA表达水平与艾滋病疾病进展的相关性.方法 采用实时定量PCR方法检测HIV感染不同疾病进展期患者外周血单个核细胞APOBEC3G mRNA表达水平;采用流式细胞仪进行CD4+T淋巴细胞的绝对和相对计数;采用全自动载量仪检测血浆HIV病毒载量.结果 河南省46例HIV/AIDS患者外周血单个核细胞APOBEC3G mRNA水平明显低于健康对照(t=4.887,P<0.01),缓慢进展组APOBEC3G mRNA水平显著高于HIV组和AIDS组(P<0.05).HIV/AIDS患者APOBEC3G mRNA表达水平与CD4+T淋巴细胞数呈正相关(R2=0.190,P=0.002),与病毒载量呈负相关(R2=0.094,P=0.038).结论河南省HIV/AIDS患者外周血单个核细胞APOBEC3G mRNA表达水平与HIV感染疾病进程密切相关,APOBEC3G高表达可能是延缓疾病进程的保护性因素之一.     

艾滋病合并急性肾功能损害血液透析病人的护理

人体感染人类免疫缺陷病毒(HIV)后可导致机体多个器官受累。近年来,关于艾滋病(AIDS)相关性肾病的报告逐渐增多[1],HIV相关性肾脏疾病是指在HIV感染基础上,出现水、电解质、酸碱平衡失调和急性肾衰竭,以及与HIV直接有关的肾小球疾病。无症状的HIV感染者和艾滋病早期均有特征性     

艾滋病感染者分类管理策略实施前后传播风险的流行病学特征分析

目的了解浙江省宁波市艾滋病病毒感染者/艾滋病患者(HIV/AIDS)分类管理策略实施前后传播风险的流行病学特征。方法2017年11月底,对现住址在宁波市的在访HIV/AIDS进行为期1年的随访研究,定期开展传播风险评估,针对传播风险不同实施分类管理策略,分析人口学特征、风险评估结果、行为学特征、性病感染情况以及抗病毒治疗情况等数据。结果共有2905例HIV/AIDS纳入研究。经过1年的分类管理策略实施,HIV/AIDS高传播风险比例从11.74%降低至5.23%(χ^2=66.786,P<0.05)。除20岁以下年龄组、小学以下文化程度和吸毒传播的HIV/AIDS高传播风险比例无明显下降外(P>0.05),其他人群的高传播风险比例均显著下降(P<0.05)。通过分类管理策略的实施,高传播风险的HIV/AIDS发生性行为比例、多性伴的比例和未使用安全套比例显著降低(P<0.05),梅毒阳性比例显著降低(P<0.05),未接受抗病毒治疗比例和病毒载量≥400拷贝/ml比例显著降低(P<0.05)。结论宁波市分类管理策略能够有效减少高传播风险HIV/AIDS的比例,降低高传播风险HIV/AIDS的多性伴高危性行为和性病感染比例。应进一步加强HIV/AIDS的随访管理工作以及高传播风险的HIV/AIDS抗病毒治疗动员和转介工作,减少传播。     

无锡人群KIR3DS1基因与HIV-1感染的病例-对照研究

目的探讨无锡地区人群的KIR3DS1基因是否影响HIV-1易感性及与疾病进程的关系。方法收集并调查343例HIV-1/AIDS患者及354例体检健康者的临床资料及样本,用PCR-SSP法检测其KIR3DS1基因表达水平;根据多次CD4+T淋巴细胞计数的随访记录,对HIV/AIDS人群进行病程进展分组(缓慢进展组与典型进展组),采用非条件Logistic回归分析KIR3DS1基因与HIV-1易感性及疾病进程间的关系。结果病例组与对照组的KIR3DS1基因检出率分别为37.0%(127/343)和52.5%(186/354),对应的基因频率分别为0.206和0.311,两者间差异有统计学意义(χ2=16.952,P=0.000)。调整性别和年龄因素后,单因素Logistic回归分析发现KIR3DS1基因可降低HIV-1的易感性(OR=0.498,95%CI:0.363~0.685)。调整性别、年龄及感染途径等因素后,多因素Logistic回归分析发现KIR3DS1基因可抑制HIV-1/AIDS患者的疾病进程(OR=0.343,95%CI:0.137~0.860)。结论携带KIR3DS1基因可能降低无锡地区HIV-1的易感性,抑制HIV-1/AIDS患者的疾病进程。     

HLA—DR、DQ座位等位基因与HIV感染及AIDS发病相关性的研究

[目的]研究中国人HLA—DR、DQ座位等位基因与HIV感染及AIDS发病的相关性，为HIV的预防、治疗提供依据，并从免疫学指标作进一步观察。[方法]应用微量聚合酶链反应-序列特异性引物(PCR～SSP)技术对18例AIDS患者及18例HIV抗体阴性高危人群进行了HLA—DR、DQ座位等位基因的检测，并与81例中国人群的正常对照组进行了比较。同时对AIDS患者组的免疫球蛋白(IgG、IgM)、补体(C3、C4)、抗溶血性链球菌O(ASO)、类风湿因子(RF)、白细胞介素(IL-2、IL-6)进行了检测。[结果]发现AIDS患者组的HLA—DR8的基因频率为38．9％，正常对照组的基因频率为12．3％，AIDS患者组明显高于正常对照组，P值为0．007；HIV抗体阴性高危人群组的HLA—DR9的基因频率为0．0％，正常对照组的基因频率为19．8％，HIV阴性高危人群组明显低于正常对照组，P值为0．040。AIDS患者组与正常对照组相比较，IgG、IgM、ASO、RF有显著性差异，C3、C4、IL-2、IL-6无显著性差异。[结论]本文发现HLA—DR9与中国人HIV的易感性有关，是HIV的易感基因；HLA—DR8与中国人HIV感染后的疾病进程有关，造成AIDS的快速发展；同时伴有免疫异常，说明有内在关联性。     

HIV/AIDS目前实验诊断方法及其价值

人类免疫缺陷病毒(HIV)感染的实验室检测,是HIV感染者和艾滋病(AIDS)患者的最基本诊断依据[1]。在实践中,即使有HIV的流行病学暴露史,或有与HIV相关的临床症状或疾病症候群,但缺乏HIV感染的实验室依据,也无法作出HIV/AIDS的诊断。     

孕产妇艾滋病相关知识了解情况调查及对策

获得性免疫缺陷综合征(AIDS)又称艾滋病,是一种由人免疫缺陷病毒(HIV)感染引起的性传播疾病。HIV母婴垂直传播是指HIV病毒感染的妇女在妊娠期、分娩期或产后哺乳过程中将HIV病毒传播给胎儿或新生儿,导致感染的过程。目前我国艾滋病流行正处于快速增长期,已从高危人群走向普通人群,妇女感染比例增加。随着育龄妇女感染艾滋病病毒人数的增加,通过母婴传播导致婴儿感染艾滋病的人数必然会快速增加。     

Genetic polymorphism of cytochrome P450 1A1 (Cyp1A1) and glutathione transferases (M1, T1 and P1) among Africans.

The co-ordinate expression and regulation of the drug metabolising enzymes, cytochrome P4501A1 (CYPlAl) and glutathione transferases (GSTM1, GSTT1 and GSTP1), and their metabolic balance in the cells of target organs may determine whether exposure to carcinogens results in cancer. Besides showing variability in activity due to induction and inhibition, these enzymes also exhibit genetic polymorphism that alter enzyme levels and activity. We determined frequencies of common allelic variants of CYP1A1 and glutathione (M1, T1 and P1) among Tanzanians, South African Venda and Zimbabweans using PCR/restriction fragment length polymorphism techniques. The CYP1A1 Val462 mutant variant was found at a frequency of 1.3% among 114 subjects. The GSTM1*0 genotype was found at a frequency of 29% and 33% among Tanzanian psychiatric patients and healthy volunteers, respectively. Similarly, the GSTT1*0 polymorphism was present with a frequency of 25% in both the psychiatric patients and healthy controls. The frequency of GSTP1 Val105 variant was 16%, 12% and 21% among Tanzanians, South African Venda and Zimbabweans, respectively. We conclude here that CYP1A1 Val462 polymorphism is very rare among Africans. This is the first report of the GSTP1 Val105 variant frequency in African populations. We show here that there are no differences in frequencies of the variant alleles for CYP1A1, GSTM1, GSTT1 and GSTP1 in the three African populations.     

Influenza A (H1N1) vs non-H1N1 ARDS: Analysis of clinical course

Purpose

The purpose of the study is to compare H1N1-induced acute respiratory distress syndrome (ARDS) with ARDS due to other causes of severe community-acquired pneumonia focusing on pulmonary function.

Materials and methods

This is a retrospective data analysis of adult ARDS patients between January 2009 and December 2010 in an ARDS referral center. Patient characteristics, severity of illness scores, modalities, and duration of extracorporeal lung support were evaluated as well as intensive care unit stay and survival. Parameters of mechanical ventilation and pulmonary function were analyzed on day of admission and over the consecutive 10 days using a nonparametric analysis of longitudinal data in a 2-factorial design. In a logistic regression analysis, risk factors for extracorporeal lung support were investigated.

Results

Twenty-one patients with H1N1-ARDS and 41 with non-H1N1-ARDS were identified. Gas exchange was more severely impaired in patients with H1N1-ARDS over course of time. Extracorporeal membrane oxygenation was more frequently needed in H1N1-ARDS. Despite significantly prolonged weaning off extracorporeal lung support and intensive care unit stay in H1N1 patients, the proportion of survivors did not differ significantly. Only Sepsis-Related Organ Failure Assessment score could be identified as an independent predictor of extracorporeal lung support.

Conclusions

Clinical course of H1N1-ARDS is substantially different from non-H1N1-ARDS. Affected patients may require extensive therapy including extracorporeal lung support in ARDS referral centers.     

Effect of OATP1B1 (SLCO1B1) variant alleles on the pharmacokinetics of pitavastatin in healthy volunteers

BACKGROUND: Pitavastatin is a potent, newly developed 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor for the treatment of hyperlipidemia. We characterized the effects of organic anion transporting polypeptide 1 B 1 (OATP 1 B 1) alleles *1a, *1b, and *15 on the pharmacokinetics of pitavastatin. METHODS: Twenty-four healthy Korean volunteers who had previously participated in a pharmacokinetic study of pitavastatin (single oral dose, 1--8 mg) were further investigated. Subjects were grouped according to OATP 1 B 1 genotype. Dose-normalized area under the plasma concentration-time curve (AUC) and peak plasma concentration (C(max)) values were analyzed, because different dosages were administered to subjects, whereas the pharmacokinetics showed linear characteristics. RESULTS: Dose-normalized pitavastatin AUCs for *1b/*1b (group 1), *1a/*1a or *1a/*1b (group 2), and *1a/*15 or *1b/*15 (group 3) were 38.8+/-13.3, 54.4 +/-12.4, and 68.1+/-6.3 ng.h.mL(-1).mg(-1) (mean+/-SD), respectively, with significant differences between all 3 groups (P=.008) and between subjects carrying and those not carrying the *15 allele (P = .004). Dose-normalized pitavastatin C(max) values were 13.2+/- 3.3, 18.2+/-5.7, and 29.4+/- 9.6 ng.mL(-1).mg(-1) in groups 1, 2, and 3, respectively, and also showed significant differences (P=.003) in a manner similar to that shown by AUC. No significant differences were found between the genotype groups in terms of dose-normalized AUC or C(max) values of pitavastatin lactone. CONCLUSION: OATP 1 B 1 variant haplotypes were found to have a significant effect on the pharmacokinetics of pitavastatin. These results suggest that the *15 allele is associated with decreased pitavastatin uptake from blood into hepatocytes and that OATP 1 B 1 genetic polymorphisms have no effect on the pharmacokinetics of pitavastatin lactone.