AIDS and HIV infection in Poland in 2003

The cumulative number of AIDS cases diagnosed in Poland from 1986 through 2003 reached 1421, and 676 AIDS deaths were registered during this time. Compared to previous years there was a slight increase in number of diagnosed AIDS cases (139 in 2003, incidence 0.36 per 100,000, comparing to 116 in 2002). Moreover the upward trend in AIDS mortality, which began in 2002, continued in 2003, with 61 reported deaths (a 27% increase as compared to 2002 and 45% increase as compared to 2001). Additionally, taking into account the official life statistics data, AIDS deaths might be underreported. In 2003, 610 newly detected HIV infections were reported (incidence 1.5 per 100,000), which is within the range observed in the past years. Injecting drug users constituted the most numerous risk group both among the AIDS cases (59.7%) and the HIV infection cases (35.6%). The proportion of reports of HIV infections with missing information on the risk group, however, remained very high (55% of all reports). In order to monitor the epidemiological situation better quality of data will need to be assured.     

Progress in the control of HIV infection and AIDS in Navarre, 1985-2003

The epidemiological situation of HIV infection and AIDS in Navarre in 2003 is reviewed. Up until December 2003, 1,610 HIV infections had been diagnosed in residents of Navarre, of whom 41% had died. The new diagnoses of HIV fell by some 81% between 1993 and 2003, a year in which 28 cases were diagnosed (4.8 per 100,000 inhabitants). The fall basically occurred in infections in injection drug users, since the cases due to sexual transmission had remained stable. Over half of the infections diagnosed in the period 2000-2003 (58%) were attributable to heterosexual transmission, 18% occurred in parenteral drug users and 12% in homosexual men. Thirty-three percent were persons originally from other countries. The incidence of AIDS fell from 75 cases in 1996 to 20 in 2003, and mortality from 65 to 8 cases, respectively. In the 2000-2003 period, the average annual incidence of AIDS was 4.2 per 100,000 inhabitants and the average annual rate of mortality was 1.6 per 100,000 inhabitants. At the end of 2003, there were 902 living persons with a diagnosis of HIV monitored by the health system (1.6 known infections per 1,000 inhabitants). In 2003, 65% of the youths aged between 15 and 29 referred to coital sexual relations, a higher percentage than in previous years, but their level of information on the prevention of AIDS was acceptable. It is necessary to insist on prevention and to adapt this to the new situation.     

The natural history, current status, and future trends of HIV infection

Nearly 50 million people worldwide have been infected with human immunodeficiency virus (HIV), and an estimated 12 to 13 million children have been orphaned by the acquired immune deficiency syndrome (AIDS) epidemic. The natural history of HIV infection continues to evolve as researchers and clinicians unearth new facts about the virus and develop new treatment regimens for patients. The status of anti-HIV treatments is never static but constantly changing. Patients and providers struggle with adherence issues. Vaccine development, viewed as an essential step in controlling the epidemic, is complicated by the genetic diversity of the virus and the inability of the body to clear the virus. Tremendous strides have occurred in the HIV/AIDS arena, yet daunting challenges remain. This overview article presents the natural history, the current status, and future trends of HIV infection.     

Hospital-based surveillance of HIV infection: Epidemiological trends in BOrdeaux,France, 1983–1989

A hospital-based surveillance system of infection by the human immunodeficiency virus (HIV) has been implemented in nine wards of the Bordeaux University Hospital by the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA). The aim was to systematically collect clinical, biological and epidemiological data on HIV-infected patients who were followed by physicians from the participating hospitals. The analysis of the data at enrollment was performed on the 1,242 patients whose infection was diagnosed between January 1983 and December 1989. The male to female ratio was 2.5:1 and the proportion of women has increased over time. For men, 39.8% were homosexual or bisexual, 36.9% were intravenous drug users (IVDU's) and 2.6% had both risk behaviours. For women, the most frequently reported high-risk behaviour was IVDU (50.3%), followed by heterosexual contacts with an HIV-infected or at-risk person (HET) (28.6%). The distribution of risk behaviour has changed over time, with an increase in the proportion of HET and a decrease in the proportion of IVDU's for both sexes. The proportion of patients included that fulfilled the definition for AIDS was 18.9%. Based on this system, the incidence rate of diagnosis of HIV infection in the Aquitaine region, regardless of the clinical stage of the infection was estimated to be at least 63.4 per million inhabitants and per year in 1988-1989. The GECSA surveillance system points out some of the specificities of the progression of the HIV epidemic in the Aquitaine region.(ABSTRACT TRUNCATED AT 250 WORDS)     

人类免疫缺陷病毒感染相关肠屏障损伤及其靶向治疗的研究进展

高效抗逆转录病毒治疗(HAART)能有效地抑制人类免疫缺陷病毒(HIV)复制,大大降低获得性免疫缺陷综合征(艾滋病,AIDS)的患病率和病死率,却无法彻底清除病毒,进而发展为慢性病毒感染性疾病。慢性HIV感染破坏宿主免疫系统导致肠屏障破坏、肠黏膜功能紊乱及菌群易位加快疾病进程。而重建肠道微生态平衡和改善肠黏膜功能对重建宿主免疫系统至关重要。以下综述近年来关于艾滋病相关肠屏障损伤及其靶向治疗的研究进展,为进一步研究和改进艾滋病治疗措施、降低HIV感染患病率和病死率提供参考。     

Monitoring the levels and trends of HIV infection: the Public Health Service's HIV surveillance program

A comprehensive, multifaceted approach to HIV surveillance is needed to provide the information necessary for public health management and policy. Because HIV infection is not readily or uniformly ascertained, survey methods and sentinel surveillance approaches must be used. At least some of the surveys must be blinded, that is, anonymous and unlinked to identifiable persons, to avoid the uninterpretable impact of self-selection bias that could lead to both significant underestimates and occasional overestimates of HIV prevalence. Other surveys must be nonblinded, with careful interviews of volunteer participants to evaluate risk factors for HIV infection. These various surveys must continue over time to evaluate trends in infection. A comprehensive family of complementary HIV surveys and studies and a national household-based HIV seroprevalence survey have been undertaken by the Public Health Service in collaboration with other Federal agencies, State and local health departments, blood collection agencies, and medical research institutions. These projects focus on accessible segments of the general population, childbearing women, persons at high risk for HIV, and persons in special settings such as prisons and colleges. This comprehensive surveillance approach will help monitor the levels and trends of HIV infection in the United States and help prioritize, target, and evaluate HIV prevention activities.     

住院患者艾滋病感染现状分析及对策

目的 了解住院患者人群中人类免疫缺陷病毒(HIV)感染现状及特征,为预防医院感染提供科学依据.方法 对医院2007年1月-2010年12月所有住院患者HIV检测筛查数据进行回顾性调查,并对其人群分布特征进行分析.结果 2007年1月-2010年12月住院患者45 689例,共发现HIV抗体阳性105例,确诊艾滋病患者45例,其中2007-2010年的感染率分别为0.13％、0.15％、0.24％、0.36％,呈逐年增长趋势;患者几乎分布于全院各科室,老年人发病率较高且男性大于女性,文化程度越低发病率越高,职业以农民占的比例最高,感染途径以性传播为主.结论 近年来在医院住院患者中HIV抗体阳性病例呈逐年增长,且有从高危人群向一般人群传播的趋势,应做好这部分患者在医院内的健康教育及治疗中的医院感染控制工作.     

我国2010－2019年新报告青年学生HIV/AIDS基本特征及趋势分析

目的 分析2010－2019年我国新报告青年学生HIV/AIDS的基本特征及变化趋势,为制定青年学生艾滋病防治措施提供参考依据。方法 资料来源于我国艾滋病防治基本信息系统2010－2019年新报告15~24岁青年学生HIV/AIDS。描述和分析不同年份和性别的青年学生HIV/AIDS分布特征,采用Joinpoint回归模型分析各年龄段报告率时间变化趋势。结果 新报告青年学生HIV/AIDS共23 307例,男女性别比为33.9：1（22 640：667）,诊断时年龄（19.9±2.05）岁。新发现率变化趋势分2个阶段,2010－2015呈上升趋势,年度变化百分比（APC）为32.1;2015－2019年趋于平稳,APC=0.1,差异无统计学意义（P>0.05）。2010－2015年各年龄组新发现率均呈上升趋势,15~17岁组新发现率上升最快,APC=30.2;2015－2019年23~24岁组新发现率呈下降趋势,APC=-17.0,其他2组趋势无统计学意义（P≥0.05）。男性以同性性传播为主,女性以异性性传播为主,异性性传播的青年学生中,男、女性均以非婚非商业性行为为主;男性主要来源于自愿咨询检测点,女性主要来源于医疗机构;男性首次CD₄⁺T淋巴细胞计数明显高于女性（t=3.917,P=0.000）。结论 2010－2019年我国新报告青年学生HIV/AIDS整体疫情上升趋势有所减缓,但15~17岁年龄组新发现率仍呈上升态势。应积极开展青年学生的性健康教育、减少不安全性行为和扩大检测。     

2003-2008年南京市浦口区HIV/AIDS感染发病情况研究

目的：初步掌握该地区艾滋病（AIDS）感染发病的特征,为更好地开展艾滋病防制工作提供依据。方法利用中国疾病预防控制疫情网及流调资料统计分析。结果全区03-08年分别报告3、0、3…4、7、13例,累计报告艾滋病病例及感染者共30例,死亡3例,分布在7个镇街,占全部镇街的63．63％。男女性分别报告23、7例,性别比为1：0．3,感染发病年龄段主要集中在20—59岁之间,其中20—44岁之间占96．67％,这其中男性占95．65％,女性7例全部集中在20—29岁之间。分布的职业主要有9种之多,以从事商业服务、学生、农民和农民工为多,医务人员、干部等职业均有报告,其感染途经以经性途经为主,占76．92％,其中经异性传播占90％,无经职业暴露和母婴途经感染报告,报告主要来源于临床、VCT、监管和娱乐场所等筛查中发现。结论全区感染率为0．0051％,呈局部散发状态,但随着综合防制工作力度加大,感染率将明显上升,要进一步加强健康教育、重点人群的干预、筛查和HIV／AIDS的管理工作。     

广西HIV感染流行分析

目的 对广西HIV感染流行性进行分析，了解广西HIV感染在广西的流行特点，为制定有效的预防措施提供依据。方法 采用哨点监测结果和历年预测HIV感染进行分析。结果 静脉吸毒是目前广西HIV感染的主要流行传播模式。经过11年的时间，广西HIV感染的流行从局部流行到广泛流行。结论 对于目前广西日趋严重的HIV感染流行状况应采取有有效的干预措施以减缓流行速度。