Post-exposure prophylaxis for HIV infection after sexual assault: When is it indicated?

To date there are no published studies on the effectiveness of HIV post-exposure prophylaxis (PEP) after sexual exposure. However, as emergency physicians we are faced with the dilemma of assessing the risk of HIV transmission and providing appropriate care for patients who present to us after sexual assault. Current practice in UK emergency departments and genitourinary clinics varies from trust to trust. There is no direct evidence that HIV PEP after rape prevents transmission or is cost effective. However, there may be certain rape cases where HIV PEP should be prescribed or at least considered. While we wait for more definitive clinical studies, HIV PEP after rape should be considered on a case to case basis. This article aims to provide emergency physicians with current scientific evidence on HIV PEP enabling them to make an informed decision on when HIV PEP is indicated after rape.     

检测HIV IgA早期诊断婴儿HIV感染

本文介绍一种简单而可靠早期诊断婴幼儿HIV感染方法,试验前,用重组蛋白G 除去IgG,以提高IgA 和IgM HIV 检测的敏感性和特异性。将25μl 婴儿血清与10μl 蛋白G 混匀,交连于琼脂糖珠上,在37℃轻轻混匀孵育1h.离心去除珠子,将处理过的血清用于HIV 抗体检测。检查用蛋白G 处理前与处理后IgG HIV 滴度以评价去除IgG 的效果。在某种情况下,高滴度的标本需要第二次或三次处理以去除IgG.用HIV 免疫斑点法。蛋白处理血清以牛奶缓冲液最后稀释为1/50和1/10。将HIV 蛋白点于硝酸纤维薄膜上,装入微型点样器中,将50μl 稀释血清加入到相应的槽中,于室温震荡1h,然后用牛奶缓冲液冲洗该斑点器槽,将膜去除,再用9%甲醛固定。在牛奶缓冲液冲洗涤后,该HIV 膜与碱性磷酸酶和抗人     

Low sexual desire--is it all in her head? Pathophysiology, diagnosis, and treatment of hypoactive sexual desire disorder

Hypoactive sexual desire disorder (HSDD) is thought to be the most prevalent form of female sexual dysfunction (FSD), affecting up to 1 in 10 US women. Hypoactive sexual desire disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) as persistent or recurrent deficiency or absence of sexual fantasies and thoughts, and/or desire for, or receptivity to, sexual activity, which causes personal distress or interpersonal difficulties and is not caused by a medical condition or drug. This definition has recently received criticism and recommendations for changes encompass the inclusion of duration, intensity, and frequency, and the elimination of distress as a diagnostic criterion. More recently, it has been suggested that arousal and desire be combined into one disorder for the upcoming DSM-V. Causes of low desire include chronic medical conditions, medications, surgeries, and psychosocial factors, but not necessarily increased age; both pre- and postmenopausal women can have HSDD, although the frequency appears to vary by age. Sexual function requires the complex interaction of multiple neurotransmitters and hormones, both centrally and peripherally, and sexual desire is considered the result of a complex balance between inhibitory and excitatory pathways in the brain. For example, dopamine, estrogen, progesterone, and testosterone play an excitatory role, whereas serotonin and prolactin are inhibitory. Thus, decreased sexual desire could be due to a reduced level of excitatory activity, an increased level of inhibitory activity, or both. A number of validated self-report and clinician-administered instruments are available for assessing female sexual function; however, most have been used primarily in clinical research trials. The Decreased Sexual Desire Screener (DSDS) was developed for practicing clinicians who are neither trained nor specialized in FSD to assist in making an accurate diagnosis of generalized acquired HSDD. As our understanding of the pathophysiology of HSDD increases, it may become easier for physicians to identify and treat women with low sexual desire.     

HIV检测三步曲

标本验收合格后，用筛查试剂进行检测，如呈阴性反应，报告HIV抗体阴性；对呈阳性反应的标本，需进行重复检测。     

怎样预防HIV

在艾滋病盛行的今天 ,所有的护士都有责任预防 HIV的感染。作者提供的护理干预模式为我们提供了指导。阻止 HIV传播的规则　 ( 1 )不要吸毒。( 2 )不要婚外性生活。 ( 3)如果你是个感染了 HIV的女人 ,不要怀孕。 ( 4 )如果你的工作经常与血液接触 ,注意保护自己 ,避免被针头刺伤自己。为什么要谈论预防 HIV　因为并非所有的人都能遵守这些规则。另一个原因是 ,行为的改变是很难的。一套简单的规则不会被人们同样成功地采用 ,因为他们有不同的年龄、性别、文化、社会经济状况或性要求。统计数字表明 ,改变性行为和吸毒实际上是非常困难…     

控制HIV交叉感染

当医务人员接触病人的血液时,就有感染乙肝病毒(HBV)及人类免疫缺陷病毒(HIV)的危险。采取免疫接种的方法可以预防乙肝,促进对病毒感染者的疫情报告,及时予以处理可有助于减少这种危险。作者收集了从1989年1月～1991年6月所有这种交叉感染的报道。总共447例,其中3/4(337例)是与注射针头及尖锐的仪器有关,另110倒是由飞沫、蚊虫叮咬传染的。已知源病人345例。     

HIV阳性育龄妇女的抗病毒治疗及HIV母婴阻断

随着艾滋病在全球范围的迅速蔓延,妇女儿童中HIV的感染流行情况以及如何控制其进一步传播扩散也受到越来越多的关注。目前,全球存活的HIV感染者中约有50%为育龄妇女,而15岁以下儿童感染HIV的90%经母婴垂直传播。鉴于HIV阳性育龄妇女的抗病毒治疗对于阻断HIV的母婴传播以及控制HIV感染进一步扩散蔓延具有极其重要的作用,本文将从育龄妇女HIV感染及母婴传播情况、HIV阳性育龄妇女的抗病毒治疗以及HIV母婴阻断等方面进行综述。     

用HIV RNA扩增早期检测围产期HIV Ⅰ型病毒感染

美国儿童新感染HIV病毒者几乎都是通过围产期传染。因而婴儿HIV病毒感染的早期检测日益重要。已有的DNAPCR法对3个月婴儿HIV感染的检出率虽可达90％～100％，但对刚出生的婴儿却极少检出。而细胞外HIVRNA在感染后不久便可升到较高水平，作者认为检测血浆HIVRNA试验的敏感性足以胜任围产期感染的早期诊断，便对其进行了分析研究．并与DNAPCR结果进行了比较，介绍如下：样本来源为1990年4月～1994年8月在纽约市围产期HIV传染联合研究机构登记的感染HIV病毒的产妇所生的婴儿。从49例被HIV感染婴儿取108份样本（每例从初生到31…     

手术室医务人员HIV防护

HIV是人类免疫缺陷性病毒引起的一种致死性传染性疾病,又称为获得性免疫缺陷综合症。随着流行形势的日益严重,HIV患者手术的机率增多,而手术室医务人员进行的是创伤性操作,存在发生HIV感染的可能性。但我院2009年以来,手术室共发生锐器刺伤事件31起,其中护士19人,医生8     

职业性HIV感染不容忽视

艾滋病（ＡＩＤＳ）在全球流行日趋广泛，世界卫生组织（ＷＨＯ）提供的数字表明，到１９９６年６月３０日世界各国报告的病例数是１３９３６４９例，比上年同期增加了１９％。由于诊断漏报和报告延迟等原因，估计至少有７７０万人已经成为ＡＩＤＳ病人。另据ＷＨＯ估计，...     

HIV感染的表现

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.……     

携带HIV但HIV抗体检测阴性献血者的筛检对策

本文结合HIV感染经过与血清学特征,探讨阳性带毒者血清学呈阴性表达的原因,并展望了减少献血者HIV漏检的对策。     

携带HIV但HIV抗体检测阴性献血者的筛检对策

本文结合HIV感染经过与血清学特征，探讨阳性带毒者血清学呈阴性表达的原因，并展望了减少献血者HIV漏检的对策。     

不同HIV检测试剂盒检测HIV感染的检测效能评价

目的 探讨3种人类免疫缺陷病毒(HIV)试剂盒检测HIV感染的能力,为HIV早期诊断提供参考。方法 选取2017年3月至2020年7月送至河北省承德市中心血站的12 856份血液标本作为研究对象,使用的3种HIV检测试剂盒(A试剂盒为HIV抗原抗体诊断试剂盒、B、C试剂盒均为HIV抗体诊断试剂盒)对12 856份血液标本进行检测,分析3种HIV检测试剂盒对于HIV检出时间相比于核酸检测天数差异原因及检验效能。结果 B试剂盒、C试剂盒检测HIV的阳转血清盘,检测相比于核酸检测的平均检测天数相当,分别为(16.25±3.04)、(16.75±3.32)d, A试剂盒对于HIV检出时间相比于核酸检测天数最短,为(13.50±3.58)d; 12 856份血液标本中A试剂盒检测的误诊率、漏诊率分别为0.06%、0.00%,B试剂盒分别为0.02%、0.00%,C试剂盒为0.03%、0.00%,差异无统计学意义(P>0.05)。结论 3种试剂盒对HIV感染均有较好的检测效果,HIV抗原检测试剂盒诊断效能与其他2种试剂盒相当,对早期检出HIV具有一定的意义。