百色市无偿献血者HIV感染现状调查

目的探讨2007年至2014年百色市无偿献血者人类免疫缺陷病毒（HIV）感染情况并进行分析,为采供血机构及相关部门制定血液安全保障决策提供参考。 方法对百色市中心血站2007年至2014年无偿献血者血液标本（抗-HIV）常规筛查资料进行统计分析。 结果共检测献血者血液标本198 308份,百色市中心血站筛查抗-HIV阳性253例,经百色市疾病与预防控制中心（CDC）HIV确认实验室确认抗-HIV阳性76例,HIV感染率约为0.040%。HIV筛查阳性与确认阳性例数差异具有统计学意义（χ²= 95.306,P < 0.001）;抗-HIV确认阳性例数性别差异具有统计学意义（χ²= 17.790,P < 0.001）。 结论百色市无偿献血者HIV感染率处于较高水平,血站应采取措施缩短检测"窗口期",提高检测灵敏度,降低输血传播HIV危险,保障临床中输血安全。     

血液透析患者透析前感染性疾病标志物检测的临床意义

目的探讨血液透析患者透析前进行感染性疾病标志物检测的临床意义。 方法对在本院进行血液透析的2 568例患者,透析前进行乙型肝炎病毒标志物（HBsAg、HBsAb、HBeAg、HBeAb和HBcAb）、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）、梅毒螺旋体抗体（抗-TP）检测,并对结果进行分析,抗-HIV阳性标本结果送疾控中心应用免疫蛋白印迹（Western blot）法进行确证试验。 结果2 568例血透患者中HBsAg阳性人数252例,阳性率为9.81%;抗-HCV阳性人数28例,阳性率为1.09%;抗-HIV初筛阳性7例,确诊5例,阳性率为0.19%;抗-TP阳性人数7例,阳性率为0.27%。 结论对需行血液透析的患者在透析前进行感染性疾病标志物检测,能够及时发现潜在感染源,对感染者采取必要的隔离,切断感染性疾病的交叉传播途径,预防医院感染避免医疗纠纷的发生。     

七例艾滋病病毒感染者烧伤的诊治特点

临床资料:1999年6月～2 0 0 2年2月,笔者单位收治艾滋病病毒(HIV)感染的烧伤患者7例,其中男6例、女1例,年龄19～2 7岁,均有吸毒史。多因快速静脉推注海洛因后失去知觉,跌倒在火源上致伤,与热源接触时间较长,创面较深。入院时患者及家属隐瞒烧伤原因,否认有吸毒或不正常的性行为史。患者面色灰黄、消瘦,四肢浅静脉处或腹股沟区可见密集成行的注射针眼,有静脉硬化或静脉炎表现。烧伤总面积1%～70 % ,其中Ⅲ度1%～5 5 %TBSA,部分患者骨关节外露。检查:(1)抗 HIV:患者入院前均不知已感染HIV,入院后采用酶联免疫吸附(ELISA)法或胶体金标…     

深圳市人类免疫缺陷病毒感染初治者梅毒螺旋体共感染率及影响因素

目的探讨深圳市初治人类免疫缺陷病毒（HIV）感染者梅毒螺旋体共感染率及其高危因素。 方法以2015年1月至2018年12月深圳市第三人民医院收治的未接受过抗逆转录病毒治疗（ART）的成年HIV感染者作为研究对象，收集其临床资料，分析纳入研究对象的梅毒螺旋体共感染率。采用多变量Logistic回归模型分析HIV和梅毒螺旋体共感染的影响因素。 结果共纳入4 493例初治HIV感染者，梅毒螺旋体共感染率为19.72%（886/4 493）。男性和女性HIV感染者梅毒螺旋体合并感染率分别为20.96%（872/4 160）和4.20%（14/333），差异有统计学意义（χ² = 54.690、P < 0.001）。HIV合并梅毒螺旋体感染者中RPR滴度≥ 1︰8者占62.75%（556/886）。不同RPR滴度患者异常ALT（χ² = 3.353、P = 0.851）、AST（χ² = 7.791、P = 0.351）和TB（χ² = 8.957、P = 0.256）比例差异均无统计学意义。多因素Logistic回归分析显示，男性（OR = 4.876、95%CI：2.770～8.583、P < 0.001）、同性传播感染HIV（OR = 1.307、95%CI：1.077～1.585、P = 0.007）、确诊至初治时间> 12个月（OR = 1.360、95%CI：1.115～1.657、P = 0.002）、抗-HCV阳性（OR = 2.728、95%CI：1.252～5.945、P = 0.012）均为HIV感染者合并梅毒螺旋体感染的危险因素。 结论深圳市初治HIV感染者合并梅毒螺旋体感染率较高，尤其男性、男男同性感染HIV、HIV确诊至初治时间超过12个月、抗-HCV阳性者为合并梅毒螺旋体感染的高风险人群，建议在HIV感染人群中加强梅毒螺旋体感染防控相关健康教育，并常规进行梅毒螺旋体筛查。     

孕妇产前四项传染病指标检测结果的分析

目的：了解孕妇产前乙型肝炎病毒、丙型肝炎病毒、梅毒螺旋体和人类免疫缺陷病毒感染的4项检测结果的临床意义。方法对在本院待产的2352例孕妇进行乙型肝炎病毒表面抗原（HBsAg）、丙型肝炎病毒抗体（抗-HCV）、人类免疫缺陷病毒抗体（抗-HIV）、梅毒（抗-TP）检测结果进行分析,HBsAg阳性者采用酶联免疫吸附试验（ELISA）检测HBV表面标志物,抗-HIV阳性者标本送往省疾病预防控制中心艾滋病确认实验室进行免疫印迹（Western blot）确认试验。结果2352例孕妇中,HBsAg阳性率6.54%、抗-HCV阳性率0.97%、抗-HIV阳性率0.12%和抗-TP阳性率0.21%,HBV分布模式和交叉感染情况各异。结论为阻断和降低上述感染性疾病的母婴传播、避免医疗纠纷、预防医院感染等,孕妇产前感染4项检测具有重要意义。     

2006年青岛市HIV抗体检测结果分析

目的 分析青岛市艾滋病网络实验室2006年HIV抗体检测结果,为青岛市艾滋病防治提供依据.方法 按照<全国艾滋病检测技术规范>要求,对待检血清进行HIV抗体筛查、复检,Western blot(WB)试验确认.结果 2006年35家HIV实验室共检测207 521份血清,158份筛查阳性,经复检91份阳性,WB确认54份HIV-1抗体阳性.检测26个人群,11个人群检出HIV阳性者,其中以在押人员构成比最高(14/54),其次为自愿咨询检测者(8/54)、临床可疑(6/54)、孕产妇(6/54)和术前检查(6/54).感染者多为文化水平较低的20～40岁的青壮年(41/54),多数为流动人口(34/54),HIV感染者的子女中2例HIV阳性.结论 艾滋病网络实验室对各种人群的筛查,能提高感染者的发现率,确定HIV感染依赖于WB确认试验.建议进一步加大HIV筛查力度,尤其是加强对流动人口的检测和管理,以提高对HIV感染者的发现率,促进艾滋病的控制.     

铜梁县门诊男性患者丙肝、艾滋病及梅毒检测分析

目的:分析男性患者中丙型肝炎(HCV)、艾滋病病毒(HIV)、梅毒等疾病的感染状况.为临床治疗及诊断提供数据及相应方法.方法:对396例患者进行酶联免疫法及肢体金法等临床检测方法进行检测,并对所得结果进行分析.结果:所收治患者中,丙肝(抗-HCV)共确诊感染2例,阳性率为0.5％.艾滋病(抗-HIV)共确诊0例,阳性率为0.梅毒螺旋体感染患者共确诊15例,日性率为3.8％.结论:本院皮肤科、泌尿外科门诊收治的男性患者中,主要的流行性痰病为梅毒螺旋体及丙型肝炎.两者之间并无交叉感染.     

精液中丙型肝炎病毒的研究

目的 :检测精液中是否存在丙型肝炎病毒 (HepatitisCviruse,HCV) ,探讨HCV性传播途径的可能性。　方法 :用双抗体夹心ELISA法检测 147例精浆HCV抗原 ;HCV抗原阳性者检测其夫妻双方血清中抗HCV IgM和抗HCV IgG ;同时采用 90 %和 45 % 2层Percoll梯度离心 ,分离HCV抗原阳性病人的精子 ,用RT PCR分别检测其精浆(组分 1)、90 %Percoll层精子 (组分 2 )、45 %Percoll层精子 (组分 3)及最上层圆形细胞 (组分 4)中的HCV RNA。　结果 :147例精浆中HCV抗原阳性的 4例 (2 7% ) ;4例HCV抗原阳性病人夫妻双方血清抗HCV抗体均为阴性 ;4例HCV抗原阳性病人有 2例精浆中检测出HCV RNA ,而Percoll分离后 3个组分中HCV RNA均为阴性。　结论 :①HCV感染存在性传播途径 ;②人工授精中供精者HCV的检测必不可少 ;③采用Percoll梯度离心分离精子 ,可大大降低感染HCV的风险。     

潍坊市人民医院妇科就诊者高危型人乳头瘤病毒感染危险因素分析

目的 分析潍坊市人民医院就诊妇女人乳头瘤病毒(HPV)的感染情况及高危型HPV感染的危险因素.方法 对2010年1月至2012年12月来潍坊市人民医院妇科就诊妇女的宫颈分泌物进行HPV DNA分型检测,从符合纳入标准的391例HPV阳性妇女中选出高危型HPV感染妇女(356例)作为病例组,采用1∶1配对病例-对照的方法,选取HPV检测阴性妇女作为对照组.所有研究对象接受问卷调查,包括基本人口学信息、孕期情况、生活环境史、性行为特征和家族史等50个项目.采用逐步条件Logistic回归分析高危型HPV感染的危险因素.结果 391例HPV阳性妇女中,HPV单一高危亚型318例(81.3％),单一低危亚型35例(9.0％),多重感染38例(9.7％).对356例高危型HPV感染妇女进行逐步条件Logistic回归分析发现,已婚、初次性行为＜20岁,多个性伴侣,有口交史,有商业性行为史和阴道冲洗≥1次/周是高危型HPV感染的危险因素(OR=4.053,1.861,1.587,2.420,5.125和1.943,P＜0.01).结论 不安全性行为方式与高危型HPV感染有关.应提倡健康的性行为方式,并加强对妇女高危型HPV感染检测和预防控制.     

核酸检测技术在无偿献血者血液筛查中的应用分析

目的探讨我国无偿献血者血液筛查采用核酸检测技术的必要性。方法采用Roche Cobas S201系统对血站常规ELISA检测阴性的献血者18751份标本进行HBV、HCV和HIV3项联合筛查,并对NAT筛查阳性的标本做确证实验。结果 18751份ELISA检测阴性标本中,用NAT检测共检出阳性15例,阳性检出率为0.08%。结论 NAT系统应用于无偿献血者血液筛查,有助于提高献血者的血液质量,保证输血安全。     

Prevalence of infection with human immunodeficiency virus in elective surgery patients.

An anonymous survey of elective surgery patients was performed to assess prevalence of antibody to human immunodeficiency virus (HIV) in a large urban hospital. Of 4087 patients evaluated, 18 (0.4%) were found to be infected with HIV as confirmed by a positive Western blot antibody test. Assessment of risk factors demonstrated that patients with a history of a blood transfusion did not differ in demographics or rate of infection from the population as a whole. Of the 18 HIV infected patients, 13 gave an admission history of one or more risk factors, including 10 with a history of a prior positive test. Only five, or 0.12% of the patients, provided no history of a risk factor or a history of transfusion only. The authors conclude that the prevalence of HIV infection among elective surgery patients is low, and that there would not be any substantial benefit from screening such patients for antibody against HIV.     

Minimizing the risk of non‐vertical,non‐sexual HIV infection in children – beyond mother to child transmission

After witnessing an episode of poor injection safety in large numbers of children in a rural under‐resourced hospital in Uganda, we briefly review our own experience and that of others in investigating HIV infection in children considered unlikely to be through commonly identified routes such as vertical transmission, sexual abuse or blood transfusion. In the majority of cases, parents are HIV uninfected. The cumulative experience suggests that the problem is real, but with relatively low frequency. Vertical transmission is the major route for HIV to children. However, factors such as poor injection safety, undocumented surrogate breast feeding, an HIV‐infected adult feeding premasticated food to a weaning toddler, poor hygienic practice in the home and using unsterilised equipment for minor surgical or traditional procedures are of cumulative concern.     

Sperm characteristics and accessory sex gland functions in HIV-infected men

A comparative study was carried out in the andrology clinic, Parirenyatwa Hospital, Harare, Zimbabwe, to investigate the sperm characteristics and accessory sex gland functions in HIV-infected individuals. Sixty-two patients with infertility problems who attended the clinic were requested to donate semen and blood after consent was obtained. HIV antibodies in paired semen and blood samples, sperm morphology, sperm count, sperm motility, seminal leucocytes, seminal fructose, seminal neutral alpha-glucosidase, and citric acid were analyzed. Nine out of 31 blood samples tested positive, while 21 out of 62 semen samples were positive for HIV. Leucocytospermia was associated with HIV-seropositive men (p < .01). The accessory sex gland function, as evaluated by biochemical markers, was not affected in HIV-seropositive men. HIV causes impairment of sperm motility by activating seminal leucocytes, which in turn induce oxidative stress on the sperm. Leucocytospermia is almost always present in HIV-seropositive men.     

血液结核分枝杆菌液体培养在HIV感染者结核筛查中的应用评价

目的评价血液结核分枝杆菌液体培养对HIV感染者活动性结核病的诊断价值。方法 2006年8月至2008年7月,对广西省4个诊疗机构中HIV感染者进行包括临床、胸片、痰涂片、痰快速结核分枝杆菌培养和血液快速结核分枝杆菌培养在内的综合筛查以诊断活动性结核。分析结核分枝杆菌血培养在HIV感染者中的总体阳性率和在不同CD4水平患者中的阳性率,总结血培养阳性的结核病患者的临床特点,探讨血培养对结核的诊断价值。结果 602例HIV感染者在结核筛查时进行了血液结核分枝杆菌培养,7例检出结核分枝杆菌菌血症,血结核分枝杆菌培养在HIV感染者中的总体阳性率为1.2%。在CD4计数〈200/μl、〈100/μl和〈50/μl患者组中,血培养阳性率分别为1.4%、1.8%和2.4%,逐渐增高。共诊断活动性结核133例,其中结核分枝杆菌菌血症的阳性率为5.3%。血培养阳性的结核患者中位CD4仅为17/μl,均有明确的肺部影像学改变,2例有粟粒样表现,6例同时行痰结核分枝杆菌培养,其中5例（83%）阳性,5例患者伴有明确的肺外结核。与无结核分枝杆菌菌血症的结核/HIV合并感染者相比,有结核分枝杆菌菌血症的患者BMI和CD4计数较低,盗汗症状更常见。结论血液快速结核分枝杆菌培养在广西HIV感染者中的阳性率总体较低,但随着患者免疫缺陷的加重,阳性率逐渐增高。本研究中有结核分枝杆菌菌血症的HIV感染者均有明显肺部病变,且痰培养的阳性率高,提示结核分枝杆菌血培养对提高HIV感染者中结核的诊断率作用可能有限。     

Identification of HIV patients with active pulmonary tuberculosis using urine based polymerase chain reaction assay

BACKGROUND: Despite the increased dissemination of tuberculosis among HIV infected patients, the diagnosis is difficult to establish. Traditional microbiological methods lack satisfactory sensitivity. We have developed a highly sensitive and specific nested polymerase chain reaction (PCR) capable of detecting Mycobacterium tuberculosis DNA in urine specimens and have used this test to examine urine specimens from HIV patients with active pulmonary tuberculosis. METHODS: Urine specimens from 13 HIV infected patients with microbiologically proven active pulmonary tuberculosis, 10 AIDS patients with non-tuberculous mycobacterial infection (documented by blood culture), 53 AIDS patients with no evidence of mycobacterial disease, and 80 healthy subjects (25 with positive skin test to purified protein derivative) were tested for M tuberculosis using PCR, acid fast staining (AFS), and culture. RESULTS: Of the urine specimens from patients with active tuberculosis, all tested positive by PCR, two by culture, and none by AFS. No reactivity was observed in urine specimens from patients with non-tuberculous mycobacterial infection. Of the 53 AIDS patients without mycobacterial infection, one had a positive urine PCR. Normal subjects were all negative. CONCLUSIONS: Urine based nested PCR for M tuberculosis may be a useful test for identifying HIV patients with pulmonary tuberculosis.     

Frequency of dual tuberculosis/human immunodeficiency virus infection in patients presenting at tertiary care centers at karachi

Objective: To determine the frequency of dual infection of Tuberculosis and Human Immunodeficiency Virus (HIV) and document the sexual practices of infected patients. Design: Cross-sectional study. Place and Duration of Study: Medical Unit-IV of Civil Hospital, Karachi, Pakistan, in collaboration with Sindh AIDS Control Program at Services Hospital, Karachi, from January 2003 to December 2004. Patients and Methods: Patients were recruited in the study at both centers and tested for both HIV and TB if any one disease was identified. Diagnosis of TB was based on positive sputum AFB smear / caseous granulomatous lesion on histopathology. Diagnosis of HIV was based on positive anti-HIV serology by LISA technique. A questionnaire was also administered to all the study participants regarding demographics, sexual practices, blood transfusion and intravenous drug abuse. Results: A total of 196 patients of HIV and TB were screened for the presence of dual infection (TB/HIV). Dual infection was present in 38 (19.39%) of patients. Out of 126 patients of HIV, evidence of TB was detected in 38 (30.16%). During the same duration, 70 patients of tuberculosis were screened for HIV and none was tested positive for HIV. History of illicit sexual relationship was found in 121 (96.03%) patients and 5 of these were homosexuals. Conclusion: Dual infection was present in patients of HIV with TB but vice versa was not documented in this study.     

Prevalence of hepatitis C, hepatitis B and HIV infection among haemodialysis patients in Ibn-Rochd university hospital, Casablanca

The viral infections are frequent in haemodialysis patients, notably those due to the hepatitis C virus (HCV), the hepatitis B virus (HBV) and the human immunodeficiency virus (HIV). The objective of this study is to determine the prevalence of the hepatitis C, the hepatitis B, the HIV infection in haemodialysis patients and the main risk factors for hepatitis C in the chronic haemodialysis patients treated in haemodialysis unit of Ibn Rochd University Hospital in Casablanca. This retrospective study was performed in 186 chronic haemodialysis patients and showed a high prevalence of HVC infection (76%), the prevalence of HBV infection was at 2%, none of the patients had detectable antibodies of HIV. Among the patients infected by the HCV, the mean duration of dialysis was 8,7 years. The mean number of blood units transfused was 16,5. Seventeen patients (11%) had no history of blood transfusion. In conclusion, the blood transfusion is not considered to be a like a major risk factor of the HCV infection in haemodialysis patients and this since the systematic detection of the anti-HCV antibodies in the blood donors. The nosocomial transmission of HCV seems to be the main risk factor HCV infection in the haemodialysis units requiring a strict adherence to infection control procedures for prevention of HVC infection in haemodialysis patients.     

AIDS -- diagnosis and management

HIV infection causes AIDS, a fatal disease. Viral types HIV-1 and HIV-2 have thus far been identified, the latter form presenting mainly in West Africa. HIV-1 is in countries throughout the world, demonstrating a pattern of infection which varies by region. 960 HIV-positive cases have been detected in Pakistan, 52 of which had progressed to AIDS. HIV can be transmitted either horizontally by blood and semen or vertically through the placenta. However, transmission is most common in individuals involved in risk activities or who belong to high-risk groups. Once infected with HIV, people may remain healthy for several years. Clinical progression and the criteria for the diagnosis of AIDS are discussed. Except for the recently exposed, individuals infected with HIV have antibodies which can be detected through laboratory assays. ELISA, polymerase chain reaction, and virus culturing are ways of diagnosing the presence of HIV. The laboratory diagnosis of HIV/AIDS infection, treatment, the prevention of HIV infection, and the need for a practical vaccine against HIV infection are discussed.     

Incidence and risk factors of hepatitis C virus infection in a haemodialysis unit

BACKGROUND: Hepatitis viruses have become one of the main infectious problems in patients on maintenance haemodialysis. The aim of this study was to prospectively investigate the incidence of de novo hepatitis C virus (HCV) infection in a haemodialysis unit and to identify factors currently involved in HCV transmission to haemodialysis patients. METHODS: One hundred and fourteen anti-HCV negative and HCV-RNA negative patients who started long-term haemodialysis were followed for a mean period of 36 months (range 18- 56). Liver tests and anti-HCV were performed at 6-month intervals. Factors that might be implicated in HCV transmission, such as blood transfusions, sexual habits, surgery and other invasive procedures, were recorded. HCV markers were re-examined in transfused blood and the HCV genotype was investigated in seroconverters to anti-HCV and in patients with previous HCV infection who were treated in the vicinity of those who seroconverted. RESULTS: Eight patients (7%) seroconverted to anti-HCV and seven of them became HCV-RNA positive. HCV markers, including HCV-RNA, were negative in the blood transfused to seroconverters. No differences between seroconverters and non- seroconverters. No differences found in other risk factors not directly related to haemodialysis. The investigation of HCV genotype suggested that HCV transmission was not restricted to patients treated in the vicinity of previously HCV infected patients. Occasional failure to observe strict measures of asepsis was detected in the haemodialysis unit and this was the only factor that might be incriminating. CONCLUSIONS: HCV acquisition in patients on haemodialysis is currently not related to blood transfusion, and nosocomial transmission within the haemodialysis unit seems to be the main mechanism of HCV infection. Extremely careful observation of preventive measures seems essential to eradicate HCV transmission in haemodialysis units.