小儿HIV感染和艾滋病诊断及处理建议

艾滋病即获得性免疫缺陷综合症 (AIDS) ,是由人类免疫缺陷病毒 (HIV)感染所致的一种传播迅速、病死率极高的恶性病。我国目前HIV感染人群已超过 10 0万 (2 0 0 2年 ) ,且大多数集中在生育期成人。如果控制不好 ,10年后HIV感染者可能超过 10 0 0万。HIV感染的母婴传播率高达 2 2 %～6 5 %。小儿HIV感染与成人比较 ,其发生率增长快、潜伏期短、疾病进展快、死亡率高。因此小儿HIV感染和AIDS防治已成为我国儿科所面临的严峻挑战和紧迫任务。本建议适用于各级儿科医疗机构对HIV感染和AIDS患儿的诊断、报告和处理。一、诊断标准小…     

小儿感染及传染病诊治进展

1　病毒感染性疾病1.1　小儿艾滋病(AIDS)　自从1981年发现首例人类免疫缺陷病毒(HIV)感染以来,该病在全世界迅速蔓延,至2 0 0 2年全世界已达36 0 0万例,其中儿童病例为12 0万,我国目前HIV感染人群已超过10 0万(2 0 0 2年) ,且大多数集中在生育期成人[1] 。我国中部某艾滋病高发农村15岁以下儿童HIV感染情况调查研究表明,儿童HIV阳性病例中,母婴传播途径感染占89 2 % ,输血感染占8 1% ,艾滋病状态母亲母婴传播率为6 8 8% ,HIV携带状态母亲母婴传播率为2 0 4 % [1] 。因此,小儿艾滋病的预防、诊治工作已成为我国医务界所面临的严峻…     

重视儿童人类免疫缺陷病毒感染和艾滋病的防治

198 1年发现首例人类免疫缺陷病毒 1(humanimmunod eficiencyvirustype 1,HIV 1)感染 ,即获得性免疫缺陷综合征(acquiredimmunodeficiencysyndrome,AIDS ,艾滋病 ) ,至今该病在全世界 190多个国家和地区迅速传播流行 ,2 0 0 2年已有36 0 0万人被HIV 1感染。联合国艾滋病规划署公布的全球艾滋病最新报告显示 2 0 0 2年新发病人数达 5 0 0万例 ,已有30 0万人死于艾滋病。 2 0 0 2年亚太地区感染人数达 72 0万 ,其中艾滋病病人 97万 ,比 2 0 0 1年增长 10 %。估计到 2 0 10年全球艾滋病病人将达到 4 5 0 0万例 ,其中 4 0 %在亚洲和太平洋…     

小儿人类免疫缺陷病毒感染的临床诊断和处置原则

艾滋病即获得性免疫缺陷综合征(acquiredimmunode ficiencysyndrome ,AIDS) ,是由人类免疫缺陷病毒(HIV)感染所致的一种传播迅速、病死率极高的恶性传染病。小儿HIV感染主要由母婴传播途径获得,其次由输入的血液(全血和血浆)和血液制品获得。小儿HIV感染发生率的增长较成人快、潜伏期短,疾病进展快、病死率高。因此小儿HIV感染暨艾滋病防治已是我国儿科界所面临的严峻挑战和紧迫任务。1　HIV感染和AIDS的诊断小儿HIV感染和AIDS的诊断,需结合流行病史、临床和实验室检查等进行综合分析。小儿HIV感染包括无症状HIV感染和AIDS…     

艾滋病发病机制研究进展

艾滋病又称获得性免疫缺陷综合征 (acquiredimmunode ficiencysyndrome,AIDS) ,是由于感染人类免疫缺陷病毒 (hu manimmunodeficiencyvirus,HIV)所导致的以CD4 T淋巴细胞减少为特征的免疫衰竭 ,患者常于感染后 10～ 15年因并发各种机会性感染或恶性肿瘤而死亡。自 1981年发现首例艾滋病患者以来 ,HIV感染蔓延十分迅速。例如 1981年全世界HIV感染人数仅 15 2例 ,而到2 0 0 2年全球感染人数已达 4 2 0 0万例 ,其中 32 0万例是 15岁以下儿童 ,并且新感染人数仍以每天 1.6万例的速度急剧攀升。在我国 ,HIV感染的传播速度也极快 ,目前…     

儿科医生应重视艾滋病的防治工作

自从 1981年发现首例人类免疫缺陷病毒 1(humanimmunodeficiencyvirus ,HIV 1)感染 即获得性免疫缺陷综合征 (acquiredimmunodeficiencysyndrome ,AIDS ,艾滋病 )以来 ,该病在全世界 190多个国家和地区迅速传播流行 ,1990年全世界病例为80 0～ 10 0 0万 ,1993年 14 0 0万 ,1995年 180 0万 ,至2 0 0 2年已达 36 0 0万人。仅 2 0 0 2年发病数即达 5 0 0万例 ,死亡病例为 30 0万。估计到 2 0 10年全球患者将达到 4 5 0 0万。我国于 1985年在北京市发现首例外籍AIDS患者以来 ,HIV 1流行情况可分为 3个时期 :(1) 1989年云南省中缅交界地…     

人类免疫缺陷病毒感染的母婴传播及其预防

我国自1985年发现首例艾滋病(即获得性免疫缺陷综合征,AIDS)病例以来,人类免疫缺陷病毒(HIV)感染例数增长速度惊人。值得注意的是,我国女性HIV感染者近年明显增加,2 0 0 0年已经接近感染者的2 0 % ,2 0 0 1年达到了2 6 %。随着育龄妇女感染例数的增加,母婴传播在我国也会日趋严重。所以有必要提高对HIV感染及其母婴传播的认识,从而阻断艾滋病的母婴传播。1　HIV的传播途径与母婴传播1.1　艾滋病的传播途径　人体感染HIV后,HIV主要存在于体液中,如血液、精液、阴道分泌液、乳液、唾液、泪液、尿液、汗液和痰液等。有传播意义的是血…     

小儿艾滋病7例报告

艾滋病（AIDS）是由人类免疫缺陷病毒（HIV）所引起的一种传播迅速、病死率极高的疾病。目前我国小儿HIV感染状况尚不清楚,临床报道较少。现对1999—2005年在本科诊断的7例小儿艾滋病患儿资料分析如下。     

儿童HIV感染

近年，儿童人类免疫缺陷病毒(HIV)感染已成为世界关注的问题。世界卫生组织(WHO)和联合国艾滋病规划署(UNAIDS)统计，至2002年底全球存活HIV／AIDS人数已达4200万，2002年新感染的HIV人数为500厅，其中成人420万(妇女200万)，15岁以下儿童80万。迄今全世界已有400万儿童死于爱滋病。我国情况也不容乐观，1995年发现     

小儿艾滋病9例

目的研究小儿艾滋病9例的临床表现、并发症及传播途径。方法回顾性分析本院2000年3月-2006年6月收治的9例艾滋病患儿流行病学资料、临床表现、实验室检查、并发症、治疗及转归情况。结果9例患儿人类免疫缺陷病毒（HIV）抗体均为阳性,分别通过母婴传播、输注感染HIV的血液或血制品传播,发病年龄1-10岁,平均潜伏期5（2-10）a。死亡6例,3例治疗中。结论儿童艾滋病常以发热伴反复咳嗽或迁延性腹泻为主要临床表现,真菌感染是儿童艾滋病的主要并发症之一。母婴垂直传播和血源性传播是儿童艾滋病的重要传播途径。     

Proteus syndrome and immunodeficiency

A 10 year old boy with Proteus syndrome presented with a pericardial effusion of unknown aetiology. Immunological investigation revealed low serum IgG and IgA, accompanied by low levels of specific antibodies to pneumococcal and haemophilus type B polysaccharides. Circulating lymphocyte surface marker profile revealed T and B cell lymphopenia. This is the first report of hypogammaglobulinaemia occurring in the Proteus syndrome.     

Epidemiology of acquired immunodeficiency syndrome and human immunodeficiency virus infection in adolescents

The epidemiology of acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus infection (HIV) in adolescents is important for purposes of prevention and car, since sexual and drug behavior is formed during this period. For 1990 the Centers for Disease Control reports .4% of AIDS cases are among adolescents 13-19 years old; this figure has steadily risen since 1982. 53% of the reported AIDS cases were from New York, Florida, California, Texas, Puerto Rico, and New Jersey, and has remained stable since 1984. 72% were from metropolitan areas of 1 million population, with a small decreasing trend between 1986-88. 75% of reported cases occurred between 17-19 years, and usually among males (80%) and ethnic minorities (36% African Americans and 18% Hispanics). The sex ratio dropped from 4:1 to 3:1 in 1988. Modes of transmission; indicator diseases and mortality; HIV seroprevalence data; risk of HIV transmission in adolescents; knowledge, attitudes, beliefs, and behavior; research needs; and prevention are discussed. From the studies available, it is reported that adolescents are aware that sexual intercourse and sharing IV drug needles are the main modes of HIV transmission. HIV transmission is more likely to be associated with homosexual contact. Misconceptions are that one could tell if a person were infected with HIV. Knowledge does not always translate to appropriate behavior. Perceived risk does decrease risky behavior, i.e., through abstinence or condom use. More information was desired. Research needs were identified as lagging behind present knowledge of children and adults, and necessary in clinical, epidemiologic, behavioral, and prevention aspects. The natural history of infection is limited to studies of hemophilia, where infected adolescents may have a lower rate of progression to AIDS or a longer incubation period or higher tolerance to severe immunodeficiency. Questions arise concerning the unique factors, such as hormonal changes, that influence the clinical course of the infection. Health care models need to be assessed. Identification of subpopulations that are at the highest risk is needed, i.e., the influence of the crack cocaine epidemic on HIV transmission. Prevention is seen in terms of new creative approaches, comprehensive school and nonschool health education, and behavioral techniques to avoid risky behavior throughout the health community.     

儿童人类免疫缺陷病毒/艾滋病的治疗

在过去的 15年 ,儿童人类免疫缺陷病毒 (humanimmun odeficiencyvirus,HIV)治疗策略有了很大变化 ,从单一用药发展到 3类抗逆转录病毒药物的联合治疗。高效抗逆转录病毒治疗 (highactiveanti retroviraltherapy ,HAART)俗称“鸡尾酒疗法” ,是指抗HIV药物的联合治疗 ,包括蛋白酶抑制剂(proteaseinhibitor ,PI)在内的 2种或多种药物的联合应用[1,2 ] 。联合用药比单一用药更能迅速有效地控制HIV复制 ,减少剂量及毒副作用 ,防止耐药株产生。虽然儿童与成人HIV感染的发病机制及抗逆转录病毒药物应用的病毒学及免疫学原则是相似的 ,但对…     

Breast-feeding and human immunodeficiency virus

Breast-feeding provides nutritional, immunological, and psychological benefits. It protects children from mortality and morbidity associated with diarrheal diseases, pneumonia and other infections. Breast feeding has also been shown to prolong the interval between births and thereby improve child survival and maternal health. However, studies suggest that in certain populations, breast feeding may account for nearly 14% of perinatal human immunodeficiency virus type 1 (HIV-1) transmission. It is therefore important that the risk of HIV-1 infection through breast feeding be weighed against the morbidity and mortality associated with bottle feeding. This paper discusses the literature dealing with breast feeding in women with HIV-1 infection. Specifically, the review addresses the issues surrounding infant mortality in areas of different HIV-1 prevalence where breast-feeding or bottle-feeding may be employed. Analysis suggests that the benefits of breast-feeding or bottle-feeding may be employed. Analysis suggests that the benefits of breastfeeding can substantially outweigh the putative risk of HIV-1 transmission unless the prevalence of HIV-1 infection is high or the difference in mortality between breast-fed and bottle-fed infants is very low.