人免疫缺陷病毒感染的化疗现状和前景

随着对人免疫缺陷病毒1型(HIV-1)的深入了解,已经研制出许多作用于病毒特异性部位的药物。叠氮脱氧胸腺嘧啶核苷(Zidovudine,AZT)仍是主要的抗HIV-1药。最近的对照研究表明,AZT应以更小剂量用于早期感染。可是对艾滋病病人延长AZT疗程常引起病毒抗药性。更新的逆转录酶抑制性核苷衍生物正投入Ⅱ～Ⅲ期临床试验。临床研究中的其他HIV-1复制的作用部位包括病毒结合和穿入、囊膜蛋白糖基化及病毒组装和释放。作用于蛋白酶、整合酶、核糖核酸酶H及调节基因(如tat等的产物)的药物正在研制中。作用于不同病毒复制部位的联合治疗可使用中毒浓度以下的各种药物,并有助于预防抗药性。     

温州市新报告HIV-1感染者治疗前耐药分析

目的 了解温州市2019年新报告艾滋病病毒Ⅰ型(HIV-1)感染者治疗前耐药(PDR)情况,为指导艾滋病抗病毒治疗提供依据.方法 选择温州市2019年新报告的232例尚未经抗反转录病毒治疗(ART)的HIV-1感染者为研究对象,采集血浆样本,提取HIV-1病毒RNA,采用反转录PCR和巢式PCR扩增pol区基因并测序,...     

6份人类免疫缺陷病毒的基因亚型分析

艾滋病是由于人类免疫缺陷病毒(human immunodeficiency virus。HIV)引起的一类高感染率、高发病率、高死亡率的传染病。由于HIV的高度变异性使得机体的免疫机制难以适应病毒的变异速度。造成感染者的免疫功能部分或全部丧失。而使感染者病死率极高。同时。HIV的这种高度变异性也使其自身发展成为一组复杂的病毒种群。其中包括HIV-1和HIV-2两个型别。目前引起全世界范围内大面积流行的HIV-1病毒主要为HIV-1型M组中的A-J(除E以外)9个亚型和14种流行重组模式(CRF01～CRF14)毒株。而不同亚型病毒的生物学特性、分子流行病学特征、疾病进程和相关治疗手段均有所不同。笔者根据通过复合套式PCR鉴定HIV-1基因亚型的方法。对沈阳医学院附属中心医院门诊和住院患者中筛查出的HIV-1阳性感染者进行基因亚型的鉴定与分析。报告如下。     

体外研究HIV-1潜伏库实验方法进展

HIV-1在未治疗的艾滋病患者体内,虽可以持续复制,但也可潜伏在细胞内以逃避宿主的免疫清除,这一现象即病毒潜伏.由于病毒潜伏对抗病毒治疗带来了挑战,也引起人们的高度关注.此文对体外研究HIV-1潜伏库的实验方法 进展进行综述.     

体外研究HIV-1潜伏库实验方法进展

HIV-1在未治疗的艾滋病患者体内,虽可以持续复制,但也可潜伏在细胞内以逃避宿主的免疫清除,这一现象即病毒潜伏.由于病毒潜伏对抗病毒治疗带来了挑战,也引起人们的高度关注.此文对体外研究HIV-1潜伏库的实验方法 进展进行综述.     

体外研究HIV-1潜伏库实验方法进展

HIV-1在未治疗的艾滋病患者体内,虽可以持续复制,但也可潜伏在细胞内以逃避宿主的免疫清除,这一现象即病毒潜伏.由于病毒潜伏对抗病毒治疗带来了挑战,也引起人们的高度关注.此文对体外研究HIV-1潜伏库的实验方法 进展进行综述.     

体外研究HIV-1潜伏库实验方法进展

HIV-1在未治疗的艾滋病患者体内,虽可以持续复制,但也可潜伏在细胞内以逃避宿主的免疫清除,这一现象即病毒潜伏.由于病毒潜伏对抗病毒治疗带来了挑战,也引起人们的高度关注.此文对体外研究HIV-1潜伏库的实验方法 进展进行综述.     

体外研究HIV-1潜伏库实验方法进展

HIV-1在未治疗的艾滋病患者体内,虽可以持续复制,但也可潜伏在细胞内以逃避宿主的免疫清除,这一现象即病毒潜伏.由于病毒潜伏对抗病毒治疗带来了挑战,也引起人们的高度关注.此文对体外研究HIV-1潜伏库的实验方法 进展进行综述.     

体外研究HIV-1潜伏库实验方法进展

HIV-1在未治疗的艾滋病患者体内,虽可以持续复制,但也可潜伏在细胞内以逃避宿主的免疫清除,这一现象即病毒潜伏.由于病毒潜伏对抗病毒治疗带来了挑战,也引起人们的高度关注.此文对体外研究HIV-1潜伏库的实验方法 进展进行综述.     

体外研究HIV-1潜伏库实验方法进展

HIV-1在未治疗的艾滋病患者体内,虽可以持续复制,但也可潜伏在细胞内以逃避宿主的免疫清除,这一现象即病毒潜伏.由于病毒潜伏对抗病毒治疗带来了挑战,也引起人们的高度关注.此文对体外研究HIV-1潜伏库的实验方法 进展进行综述.     

Position of The Canadian Dietetic Association and The American Dietetic Association: nutrition intervention in the care of persons with human immunodeficiency virus infection

The goals of nutrition intervention in HIV disease include early assessment and treatment of nutrient deficiencies, the maintenance and restoration of lean body mass, and support for activities of daily living and quality of life. The maintenance and restoration of nutritional stores is closely interrelated and interdependent with each of the other recommended medical therapies. Therefore, it is vital to the health of persons with HIV/AIDS to have access to the services of a registered dietitian, who is the essential member of the health care team for providing nutrition care (48). The registered dietitian should take an active role in developing nutrition care protocols for HIV/AIDS in their practice setting. The dietetic professional must take responsibility for obtaining and maintaining current knowledge in this area and take the lead in translating current nutrition knowledge and research into practical and realistic nutrition guidelines for the individual with HIV/AIDS. Further research is needed in the area of HIV/AIDS and nutrition. Registered dietitians and other members of the health care team are encouraged to conduct nutrition research in the area of nutrition interventions and outcomes of nutrition therapy. Additionally, government health related agencies, national AIDS-related organizations, and private industry should be encouraged to provide funding sources and support to the issue of research in nutrition related problems and interventions in HIV/AIDS.     

AIDS: understanding cause and effect

This article discusses the history, pathology, and symptoms of AIDS. Caused by Human Immunodeficiency Virus (HIV), AIDS was first detected in 1981 among the American homosexual population, later spreading to other populations, including hemophiliacs and intravenous drug users. This led epidemiologists to deduce that AIDS spreads through body fluids. In 1983, French scientists isolated the virus which late came to be known as HIV-1. And in 1987, scientists identified another virus capable of producing the AIDS symptoms, HIV-2. Belonging to the group of retroviruses, HIV incorporates itself into the genetic constitution of the host cell, allowing it to reproduce alongside the host cell and causing a permanent infection. The retrovirus, however, may not cause any ill effect for years. AIDS develops from a breakdown of the immune system, a result of the fact that HIV infects and destroys a specialized group of white blood cells called T-helper of T-4 cells. And with the breakdown of the immune system, severe opportunistic infections develop. Since it spreads through body fluids, HIV transmissions occur through sexual activity, blood transfusions, and from infected mother to child before or shortly after birth. The period from the time of infection to the development of HIV symptoms varies considerably, anywhere between 4 months to 10 years or longer. Although a person may be free of symptoms, he or she can still pass the virus to someone else. An estimated 75% of those infected with HIV develop AIDS by the end of ten years. The major signs of AIDS include: at least a 10% body weight loss, chronic diarrhea for over a month, and prolonged fever (whether intermittent or constant). Currently, no cure for AIDS exists, only treatment drugs that help delay death.     

因子分析在艾滋病中医证候研究中的应用

目的探讨因子分析在艾滋病中医证候研究中的应用,为艾滋病的中医证侯分类和艾滋病中医量表的制定提供科学依据。方法采用多阶段整群随机抽样的方法,在某中部省份抽取HIV/AIDS患者1279例进行问卷调查,对中医四诊信息共40个指标进行因子分析,比较不同证候人群因子得分。结果特征根为1时,提取出12个公因子,累计贡献率为52.39%;艾滋病患者的主要症状是全身皮肤异常(r=0.636)、神疲乏力(r=0.589)、胸闷胸痛(r=0.570)、纳呆食少(r=0.569)等;调查对象综合因子得分最低为-0.567,最高为3.018,平均因子得分-0.082;多个独立样本的秩和检验表明:不同中医实证和虚证的人群,其因子得分也不同(H=183.867,P<0.001;H=210.643,P<0.001)。结论因子分析方法在一定程度上揭示了艾滋病中医证候的主要特点,在艾滋病中医证侯研究中有很好的应用前景。     

Quality-of-Care Indicators for HIV/AIDS

As care for HIV/AIDS becomes more concentrated within specific providers and organisations, it would be useful to have indicators to describe the quality of care. This paper reviews concepts related to quality of care, and practical issues including sampling and risk adjustment. Indicators can be collected using a combination of administrative, chart review and survey data to reflect clinical, patient and societal perspectives. We suggest that for adults with HIV/AIDS, indicators might include measures of health status and patient satisfaction, and essential care processes. Health status measures could include CD4+ T-lymphocyte count and HIV-RNA, progression to AIDS, symptom scores, health-related quality of life scores, patient utility and disability days. Essential care processes could include receipt of acceptable antiretroviral treatment, CD4+ and HIV-RNA monitoring, screening for opportunistic infections, prophylaxis against Pneumocystis carinii pneumonia, handling of symptoms and pneumococcal vaccination. For those at increased risk for HIV, potential indicators include screening for HIV risk behaviours and HIV testing. Data from indicators such as these could be used by individuals to select among providers, purchasers of care to select among health plans and payors to hold provider groups accountable. In addition, data could be used by groups of providers to improve the quality of care.     

Knowledge,Attitudes and Risk Behaviour Related to HIV and AIDS: The Case of International Students in a Finnish University

The purpose of this pilot study was to illustrate international university students’ knowledge of HIV and AIDS, attitudes towards HIV and AIDS and risk behaviours in relation to HIV and AIDS. Questionnaires were posted to 140 students, and 32 responded. Data were analysed statistically. The results indicated a fairly good knowledge level of HIV and AIDS. The majority of students were well aware of the general facts about HIV and AIDS, modes of transmission and main risk groups, and they were also aware of the universal precautions. The majority of students had positive attitudes towards persons with HIV and AIDS and were willing to care for them. The students identified well with risk behaviours. Most agreed that their knowledge level of HIV and AIDS did affect their risk behaviours, while others felt it was a matter of choice, personal attitude and practice. Choice is a determining factor for decisions made by students in relation to HIV and AIDS. Future research focusing on factors influencing these choices that put them at risk of contracting the HIV virus is recommended. Students also need to be enlightened on matters concerning symptoms of HIV and AIDS.     

HIV Risk Continuum

Education is essential in the prevention of HIV infection transmission and in subduing misconceptions and prejudice toward AIDS. Children should have access to reliable information regarding this disease. The HIV Risk Continuum is proposed as an effective method for teaching children about HIV infection and appraising students AIDS/HIV knowledge. It is designed to assist children in identifying credible information concerning HIV risk, in differentiating accurate information from rumors, in decreasing irrational fears, and improving communication abilities. Materials required for this proposal include 5" x 7" cards displaying age-appropriate terms, 8" x 24" posterboard labeled :HIV RISK CONTINUUM", 2 individual 8 1/2" x 11" posterboard labeled "HIGH RISK" and "NO RISK", making tape, and an open wall space. Students are taught terms which may be either high or low risk for HIV transmission. By using method, it is hoped that children can identify and avoid behavior or activities which are at high risk for AIDS.     

Aidsmap.com: A Comprehensive HIV/AIDS Information Resource

Aidsmap <http://www.aidsmap.com> is a frequently updated, comprehensive source of information on HIV and AIDS and is for people living with AIDS, their families, health care professionals, patients, and members of the public wishing to know more about this field. Strengths of the site include the broad range of information it contains, the constantly updated newsfeeds, online tools to assist people living with HIV and AIDS, and the catalogue of resources in 21 languages in addition to English. Much of the information is categorized by complexity and language to one of four levels, enabling quick identification of target audiences.     

HIV感染者/AIDS病人的营养状况和需求评估

[目的]了解HIV感染者/AIDS病人的营养状况和营养需求,为进一步干预研究收集基线资料.[方法]于2005年底～2006年初对阜阳市某村选定的研究对象进行基线调查,采用问卷法对病人的家庭经济状况、人口数、基本健康状况等进行调查,并用自行设计的问卷对研究对象营养知识、态度和行为进行了调查;采用询问和记录法,以户为单位,进行连续3 d的入户膳食回顾问卷调查;按常规方法分别测量身高、体重.[结果]HIV感染者/AIDS病人饮食基本有规律,素食为主、品种单一,动物性食物摄入较少.宏量营养素基本满足,微量营养素摄入不足,营养缺乏病相关症状检出率较高,牙龈出血44.1%、夜盲49.1%,皮肤炎症27.3%.营养知识得分不高,满分10分,最高分8分,最低0分,6分以下的调查对象占68.6%.[结论]研究对象宏量营养素营养状况无明显不足,微量营养素缺乏较常见,营养知识水平低下.     

Leishmania / HIV co-infections

Visceral leishmaniasis (VL), which is transmitted by sandflies, is always present in at least 62 countries and is spreading to areas where it had not existed in the past. VL/HIV co-infections are becoming more and more common. In southern Europe, 25-70% of adult VL cases also have HIV infection. 1.5-9% of AIDS cases have newly acquired or reactivated VL. In the Mediterranean area, VL is the most common opportunistic parasitic infection among AIDS cases (i.e., 100 CD4/mcl). AIDS patients with VL have a much shorter survival period than other AIDS patients. VL can lie dormant for years but emerge clinically if an infected person has immunosuppression. Most VL/HIV co-infections in the western hemisphere are in Brazil. East African countries reporting VL/HIV co-infections include Ethiopia, Kenya, Malawi, and Sudan. Only one VL/HIV co-infected case has been found in Cameroon and in Guinea Bissau. VL/HIV co-infection cases tend to not have the usual VL clinical signs and symptoms (fever, weight loss, hepatosplenomegaly, polyadenopathies), making clinical diagnosis difficult. Since VL test sensitivity in HIV positive patients is reduced 20-40%, it is also difficult to make a serological diagnosis. In the first VL episode of HIV-infected patients, clinicians should use BMA, the safest and most sensitive test. Drug options for VL treatment include pentavalent antimonials, pentamidine, amphotericin B, and amphotericin B encapsulated in liposomes. Treatment failure is rather common in VL/HIV co-infected patients. Researchers from different centers need to conduct trials of various multi-therapy schedules. 70% of VL/HIV co-infected cases in southern Europe use intravenous drugs, suggesting that sharing of needles may account for the co-infection. The World Health Organization has mobilized against VL/HIV co-infections, including setting up a minimal surveillance system.