预防艾滋病母婴传播新生儿喂养不耐受相关因素分析与对策

目的分析影响预防艾滋病母婴传播(PMTCT)新生儿喂养不耐受(FI)的相关因素,提出有效的应对措施。方法选取2014年1月-2016年6月医院收治的113例实施PMTCT的新生儿为研究对象,根据是否发生FI分成不耐受组与耐受组,比较两组新生儿胎龄、出生体质量等基础状况以及高胆红素血症、心肌损害、贫血、感染性疾病等出生合并症发生率的差异。结果 113例实施PMTCT的新生儿共发生新生儿喂养不耐受38例,FI的发生率为33.63%;新生儿胎龄小、出生体质量低、小于胎龄儿、合并感染性疾病、贫血是FI发生的相关因素,其中低出生体质量与合并感染性疾病是PMTCT发生FI的独立相关因素。结论该群体中出生体质量低、合并感染性疾病的新生儿更容易发生FI,预防围生期感染、新生儿感染可减少PMTCT新生儿FI的发生,保证母婴阻断顺利进行。     

CD4、CCR5、CXCR4和DC-SIGN分子在 HIV-1感染者及正常人晚孕胎盘及早孕绒毛的表达

目的 明确CD4、CCR5、CXCR4和DC-SIGN分子在HIV-1不同感染状态晚孕胎盘和早孕绒毛的存在及表达情况,为探索HIV-1宫内传播的分子机制提供理论依据.方法 收集11例HIV-1感染孕妇胎盘、13例正常孕妇胎盘和10例早孕流产绒毛,免疫组化检测并比较3组孕妇胎盘或绒毛组织中HIV-1相关受体CD4、CCR5、CXCR4和DC -SIGN分子的存在情况及其表达强度.结果 CD4在早孕绒毛和晚孕胎盘中的表达存在个体差异,早孕组、对照组和病例组CD4阳性率分别为70.00％、61.54％、72.73％,3组阳性率差异无统计学意义(P=0.902).CCR5、CXCR4和DC-SIGN分子在胎盘均有表达,均定位于滋养细胞和绒毛间质细胞和/或Hofbauer细胞,且在早孕绒毛中的表达强度均低于晚孕胎盘组,差异均有统计学意义(t1=-4.09,P1＜0.001;t2=-4.80,P2＜0.001;t3=-4.57,P3=0.001).结论 胎盘组织中存在多种HIV-1受体相关分子,具备感染的分子基础.胎盘滋养细胞上是否存在CD4分子具有个体差异;CCR5、CXCR4和DC-SIGN分子在晚孕胎盘中的表达高于早孕的绒毛,可能是HIV-1感染宫内传播多发生于孕晚期的原因之一.     

转换艾考恩丙替及联合索磷布韦/维帕他韦治疗慢性丙型肝炎初治的HIV/HCV合并感染者的效果及对血脂水平的影响

目的 观察转换艾考恩丙替及联合索磷布韦/维帕他韦治疗慢性丙型肝炎初治的HIV/HCV合并感染者的疗效及血脂水平变化。方法 本研究为前瞻性队列研究。纳入2019年7月—2021年5月于空军军医大学第二附属医院传染科就诊的已接受抗逆转录病毒治疗（ART）并获得HIV持续抑制的、慢性丙型肝炎初治的HIV/HCV合并感染患者10例,将原ART方案转换为艾考恩丙替抗HIV治疗共32周,于转换后第4周开始联合索磷布韦/维帕他韦抗HCV治疗12周,监测10例患者转换艾考恩丙替抗HIV治疗及联合索磷布韦/维帕他韦抗HCV治疗前后体质量、BMI、HCV基因型、AFP、肝脏硬度值、CD4⁺ T淋巴细胞（简称CD4细胞）数量、CD4⁺T/CD8⁺T（简称CD4/CD8）比值、肝肾功能相关指标、血脂相关指标、HIV RNA、HCV RNA、SVR12、SVR24及不良反应发生。计量资料两组间比较采用Mann-Whitney U检验。相关性分析采用Spearman相关性检验。结果 相较于抗HIV治疗基线（原ART方案）,10例患者（HCV基因2a...     

广东省2011年HIV/AIDS患者流行病学特点分析

目的了解广东省2011年新增抗病毒治疗HIV/AIDS患者的流行病学特征。方法选取2011年就诊于广州市第八人民医院,并经过实验室证实HIV抗体阳性但未进行高效抗反转录病毒治疗的835例广东省HIV/AIDS患者,登记性别、年龄、感染途径等基本情况,检测CD4+T和CD8+T淋巴细胞计数、WBC、HGB、PLT、ALT、AST、TBIL、HBV标志物及丙型肝炎抗体等指标。运用SPSS13.0软件进行统计描述及分析。结果 835例年龄(39.7±11.8)岁,其中男性感染率(70.1%,585例)高于女性(29.9%,250例)。感染途径主要为性传播(82.5%,689例)[包括异性性传播557例(66.7%)及同性性传播132例(15.8%)]、静脉吸毒感染126例(15.1%)和输血感染20例(2.4%)。在725例资料完整的患者中,HIV/HBV/HCV合并感染率较高,其中,HIV单一感染(A组)514例(70.9%)、HIV/HBV合并感染(B组)103例(14.2%)、HIV/HCV/HBV三重感染(C组)83例(11.4%)、HIV/HCV合并感染者(D组)25例(3.4%)。各组感染途径有明显差异(χ2=415.358,P=0.000):A组和B组以异性性传播为主,C组和D组以静脉吸毒为主。65例(7.8%)PLT下降,且B组较A组下降比例更高,差异有统计学意义(χ2=10.451,P=0.001)。合并感染可加重肝损伤:合并感染组均较单一感染组AST升高明显(χ2AB=20.012,PAB=0.000;χ2AC=14.237,PAC=0.000;χ2AD=26.725,PAD=0.000);D组较A组ALT升高明显(χ2=8.395,P=0.004);B组较A组TBIL升高明显(χ2=9.130,P=0.003)。结论广东省2011年新增HIV/AIDS患者以青壮年男性为主,性传播感染为主。HIV与HBV/HCV合并感染率较高,且合并HCV感染者主要为静脉吸毒感染,合并感染是加重肝损伤及骨髓抑制的一个重要原因。     

HIV/HCV混合感染CD4+细胞计数与HCV病毒载量的相关性研究

目的:通过分析HIV/HCV混合感染的CD4+细胞计数与HCV病毒载量(HCVVL)的相关性,探讨HIV感染时细胞免疫状况对HCV病毒水平的影响。方法:同时测定CD4+细胞计数与HCV-RNA定量,研究两者的相关性。结果:CD4+细胞计数与HCV-RNA定量不相关(r=-0.120,P=0.479)。结论:HIV/HCV混合感染时,细胞免疫状态对HCV病毒载量没有明显影响。     

艾滋病患者马尔尼菲青霉菌优势株酵母相全长cDNA文库的构建和初步分析

Objective To construct a full length cDNA library of the dominant strain of Penicillium marneffei (PM) in yeast phase isolated from AIDS patients in Guangdong province and screen UniGenes as well as full-length genes, so as to establish the foundation for the study of PM's functional genes and pathogenic mechanisms. Methods CloneMiner cDNA construction kit was utilized to extract mRNA of the dominant PM strain isolated from AIDS patients in Guangdong province. The mRNA was reversed into cDNA, then cloned into a pDONR222 vector by BP recombination to obtain an Uncut cDNA library, which was homogenized later to construct a normalized cDNA library with the principal of saturation hybridization for DNA genome. 2000 clones were chosen randomly to make a bi-directional sequencing and analyzed with bioinformatics for screening UniGenes and full-length genes. Results The total clone number of the Uncut cDNA library was 1.16 × 107 cfu/mL, with a recombination rate of 95% and an average insertion element being over 1 kb. The total clone number of the normalized cDNA library was 1.18 × 106 cfu/mL, with a recombination rate of 95% and an average insertion element being over 1 kb as well. 1945 genes which DNA length were longer than 1 kb were obtained by sequencing and merged into 1360 UniG enes, of which 632 genes were full-length ones. Conclusions The full-length cDNA library of the dominant strain of PM from AIDS patients in Guangdong province possesses good quality.Meanwhile, the technical routine presents high efficiency in obtaining full-length genes and establishing a gene expression spectrum, which can contentedly meet the needs of future experiments.     

马尔尼菲青霉菌溶血磷脂酶基因的识别和序列分析及功能预测

Objective To identify the gene encoding lysophospholipase from the full length cDNA library of Penicllium marneffei (PM) in yeast phase and predict the structure and function of its deduced protein, to provide with theoretical evidences for further experiments. Methods The PM full-length cDNA library in yeast phase was screened to identify the gene encoding lysophospholipase with the help of NCBI on-line analytical tool. Then, by utilizing the software package of Vector NTI suite 8.0, the protein deduced by the gene was analyzed to predict its corresponding structure and functions, and its molecular cladogram was constructed. Results The gene was composed of 1014 base pairs in the length and was presumed to be the full-length gene encoding lysophospholipase by Blastx, with a complete open reading frame (ORF) comprised of 729 base pairs encoding 243 amino acids with relative molecular weight being 26 800 and the predicted isoelectric point being S.49. The deduced protein included 47.7% hydrophobic amino acids, 26.8% hydrophilic amino acids, 12.7% acid amino acids and 12.8% basic amino acids. The protein had 2 potential casein kinase Ⅱ phosphorylation site, 3 potential protein kinase C phosphorylation site and 7 N-myristoyl site. Conclusions The amino acid sequence belongs to this kind of protease with lysophospholipase-like domain. The protein is most close to Coccidioides posadasii in genetic relationship. A novel gene encoding lysophospholipase is successfully found and the work has made necessary preparations for further research on the gene's function.     

26例AIDS合并隐球菌脑膜炎患者的护理

总结26例AIDS合并隐球菌脑膜炎的临床护理经验。针对隐球菌脑膜炎及AIDS的临床特点,总结了AIDS合并隐球菌脑膜炎的护理要点:做好腰椎穿刺术的护理及职业防护;注意病情的观察与处理;做好特殊用药的护理;关注患者的心理。最终18例患者病情好转出院,4例死亡,4例自动出院。     

HIV感染者/AIDS患者的家属及朋友感染HIV的相关因素分析

目的 探讨人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者/获得性免疫缺陷综合征（acquired immunodeficiency syndrome,AIDS）患者的家属及朋友感染HIV的现状和相关影响因素。方法 采取横断面研究设计,通过方便抽样方法和自行设计的调查问卷,于2013年3～6月对广州市第八人民医院感染科住院及门诊部的192名HIV感染者/AIDS患者的家属及朋友进行面对面问卷调查。结果 192位HIV感染者/AIDS患者的家属及朋友中,感染者家属占86.5%（166/192）,感染者家属及朋友的HIV感染率为36.5%（70/192）。多因素Logistic回归分析表明,与感染者的关系为配偶或性伴（OR=4.464,95%CI:2.128～9.366）、同性恋/双性恋（OR=4.523,95%CI:1.676～12.209）、吸毒（OR=6.755,95%CI:1.720～26.528）是感染者家属及朋友感染HIV的危险因素;与感染者感情关系亲密（OR=0.229,95%CI:0.097～0.539）是其感染HIV的保护因素。结论 HIV感染者/AIDS患者的配偶或性伴与其存在着性关系,故感染HIV风险较其他亲友高,但与HIV感染者/AIDS患者感情亲密的配偶或性伴较感情疏远者感染HIV风险低。同性恋/双性恋、吸毒是感染HIV的高危因素。关于与HIV感染者/AIDS患者感情关系和除配偶或性伴以外其他亲友感染HIV的相关关系,仍需进一步研究。