青少年人类免疫缺陷病毒感染的影响因素

获得性免疫缺陷综合征(AIDS),即艾滋病,是由人类免疫缺陷病毒(HIV)感染引起的一种严重的传染病.目前,HIV感染呈低龄化流行趋势,青少年已成为HIV的易感群体.静脉注射吸毒和性行为是青少年感染HIV的主要途径.吸毒和性行为的发生受多种个人及环境因素的影响.文章就青少年HIV感染现状及影响因素进行综述.     

230例人类免疫缺陷病毒感染／艾滋病临床分析

目的　提高对人类免疫缺陷病毒 (HIV)感染 /艾滋病 (AIDS)的认识。方法　对 2 30例HIV/AIDS患者进行回顾性综合分析。结果　HIV/AIDS占被检查者的 3 4 %,2 0 0 3年以来占历年HIV总人数的 76 5 %。男女之比 5. 8∶1 ,年龄 1 8～ 5 0岁占 95 . 2 %(2 1 9/ 2 30 ) ,平均 (34. 2± 5 . 6 )岁。吸毒 5 4 . 3%,性乱 1 9 1 %,两者兼有、其他或不详原因 2 6 . 3%。首诊症状 :发热、消瘦、咳嗽 6 2 . 2 %,以发热为第一症状 82 . 1 %,咳嗽 79 .6 %,消瘦 77 .8%;并发活动性肺结核 (PTB) 87. 0 %,继发肺部感染 4 6 . 5 %。结论　HIV感染呈年递增态势 ,正在向周围人群逐步扩散。重视HIV/AIDS早期发现 ,是防止HIV/AIDS并发结核病传播和保证人民健康的重要手段。     

230例人类免疫缺陷病毒感染/艾滋病临床分析

目的提高对人类免疫缺陷病毒(HIV)感染/艾滋病(AIDS)的认识.方法对230例HIV/AIDS患者进行回顾性综合分析.结果HIV/AIDS占被检查者的3.4%,2003年以来占历年HIV总人数的76.5%.男女之比5.81,年龄18～50岁占95.2%(219/230),平均(34.2±5.6)岁.吸毒54.3%,性乱19.1%,两者兼有、其他或不详原因26.3%.首诊症状发热、消瘦、咳嗽62.2%,以发热为第一症状82.1%,咳嗽79.6%,消瘦77.8%;并发活动性肺结核(PTB)87.0%,继发肺部感染46.5%.结论HIV感染呈年递增态势,正在向周围人群逐步扩散.重视HIV/AIDS早期发现,是防止HIV/AIDS并发结核病传播和保证人民健康的重要手段.     

人类免疫缺陷病毒感染对坦桑尼亚妇女妊娠结局的影响

目的 探讨人类免疫缺陷病毒（HIV）感染对坦桑尼亚妇女妊娠结局的影响。方法 采用回顾性分析的方法，研究86例感染HIV的孕妇的妊娠结局，应用酶联免疫吸附法测定孕妇及婴儿外周血HIV抗体。结果 在感染HIV的孕妇中，流产、早产、低体重儿及小于胎龄儿的发生率分别为9．3％、14．0％、16．3％及10．5％，明显高于正常孕妇对照组，差异具有显性意义（P＜0．05）。结论 孕妇感染HIV后可显增加流产、早产、低体重儿及小于胎龄儿等不良妊娠结局的发生。     

人类免疫缺陷病毒感染与免疫:希望和思考

在人体感染人类免疫缺陷病毒（HIV）的进程中,免疫系统在控制病毒复制中发挥了重要作用,也是保护HIV暴露未感者及疾病长期不进展者等HIV感染相关特殊人群的重要因素。多年来,对于HIV感染免疫应答的研究在一定程度上明确了HIV与免疫系统作用的规律,为艾滋病的治疗、疫苗的研发提供了依据和思路。随着研究的系统深入,不断有新的问题和热点有待于进一步阐明。     

人类免疫缺陷病毒感染与T淋巴细胞损伤

人类免疫缺陷病毒(HIV)是具有包膜的正链RNA病毒,以人体免疫系统中最重要的CD4+T淋巴细胞为感染和攻击目标,通过损伤细胞膜、干扰细胞自身蛋白合成直接杀伤CD4+T细胞,诱导感染细胞生成某些细胞因子间接杀伤CD4+T细胞,gp120与CD4分子交联,诱导CD4+T细胞凋亡。在HIV感染及多种细胞因子作用下,T淋巴细胞分化为细胞毒性T细胞,特异性识别和清除病毒感染的细胞;分化为调节性T细胞,发挥免疫抑制功能,防止免疫过激;分化为记忆性T细胞,介导再次免疫应答。     

人类免疫缺陷病毒感染相关性肺动脉高压

自1981年美国报导首例艾滋病（AIDS）病例以来，AIDS已经成为人类所面临的最严重的灾难性疾病。根据（2004年全球艾滋病疫情年度报告》，目前全球有3800万名艾滋病病毒携带者，其中亚洲地区艾滋病感染人数增长最快。2003年共有290万人死于艾滋病。而我国自1995年至今，人类免疫缺陷。病毒（HIV）感染已进入了广泛流行期，且已处在由高危人群向普通人群扩散的临界点.随着抗逆转录病毒治疗的广泛应用，HIV感染患者的生存时间以及机会性感染在很大程度上得到了控制，而非感染性并发症包括肺动脉高压在国际上受到越来越多的重视，相关研究不断增加。若患者合并肺动脉高压，生存时间将会明显降低，实际上肺动脉高压已成为HIV感染患者死亡的独立危险因素。自20世纪80年代后期开始，国外对HIV感染合并肺动脉高压的流行病学调查，发病机制和治疗方法都有了大量的研究，但国内文献仅阜外心血管病医院报导过一例HIV感染相关性肺动脉高压（PAHRH）的病例，在这一方面的相关研究几乎空白。本文将就PAHRH的流行病学资料，发病机制，临床特点，治疗方法进行详细阐述。     

人类免疫缺陷病毒感染者睡眠障碍发生率及其影响因素研究

目的 探讨人类免疫缺陷病毒（HIV）感染者睡眠障碍发生率及其影响因素。方法 选取2022年10月至2023年2月浙江大学医学院附属杭州市西溪医院就诊的HIV感染者260例为研究对象,收集患者临床资料和睡眠障碍发生率,并对其情况进行单因素及多因素logistic回归分析。结果 260例HIV感染者中,睡眠障碍110例。单因素分析结果显示,HIV感染者不同工作类型、药物类型、焦虑、抑郁、不同治疗时间HIV感染者比较,差异有统计学意义（P<0.05）。多因素分析结果显示,不同工作（无稳定工作）[OR(95%CI)=0.479(0.287～0.801)]、药物类型（EFV）[OR(95%CI)=3.179(1.011～10.000)]、焦虑（有）[OR(95%CI)=16.721(8.786～31.822)]、抑郁（有）[OR(95%CI)=8.050(4.219～15.360)]、治疗时间（≥3个月）[OR(95%CI)=0.178(0.099～0.321)]是HIV感染者睡眠障碍的影响因素（P<0.05）。结论 不同工作、焦虑、抑郁、治疗时间是HIV感染者睡眠障碍的影响因素,应...     

人类免疫缺陷病毒感染的辅助受体及相关的抗人类免疫缺陷病毒治疗的研究进展

近年来的研究发现人类免疫缺陷病毒 (ｈｕｍａｎｉｍｍｕｎｏｄｅｆｉｃｉｅｎｃｙｖｉｒｕｓ,ＨＩＶ 1)侵入宿主细胞除需要有ＣＤ4分子外还必需要有某些趋化因子受体作为辅助受体。这一发现促进了对ＨＩＶ 1致病机制的研究 ,同时为抗ＨＩＶ 1的治疗开辟了一个新途径。一、趋化因子受体与ＨＩＶ 1感染1 趋化因子及其受体 :趋化因子是由淋巴细胞、单核细胞、血小板、中性粒细胞、纤维母细胞、肿瘤细胞等分泌的小分子肽类物质 ,绝大多数分子中均含有 4个保守的半胱氨酸(ｃｙｓｔｅｉｎｅ ,Ｃｙｓ ,Ｃ) ,根据其第 1个和第 2个Ｃｙｓ的排列形式…     

广西部分地区人类免疫缺陷病毒感染者合并丙型肝炎病毒感染情况分析

目的 了解广西人类免疫缺陷病毒(HIV)感染者中HIV/丙型肝炎病毒(HCV)的混合感染率及其HCV RNA的阳性率,为今后HIV患者丙肝筛查及预防提供参考.方法 采用ELISA法检测HIV感染者血清中的丙肝病毒抗体,按结果分成抗-HCV(+)组和抗-HCV(-)组,再用巢式PCR法检测血清的HCV RNA,分析比较HCV RNA阳性率.结果 在300例HIV感染者中,有146例抗-HCV阳性,154例抗-HCV阴性;在抗-HCV阳性组中,HCV RNA的阳性率为78.08％(114/146);在抗-HCV阴性组中,HCV RNA阳性率为26.62％(41/154);ELISA法和巢式PCR法检测HCV感染的符合率为75.67％[(113+114)/300].结论 在广西的HIV感染者中HCV感染状况较严重.对HIV感染者进行丙肝筛查时,为减少漏诊率,建议采用PCR方法检测抗-HCV阴性血清中的HCV RNA.     

青少年网络成瘾的影响因素

目的探讨青少年网络成瘾及其影响因素。方法采用Young氏网络成瘾诊断量表,和青少年网络应用与心理状况调查表,对1712个青少年进行测评。结果1712人中网络成瘾170人,发生率10.51%。网络成瘾与青少年的心理特征、网络的吸引因素及上网时间有相关性(P<0.05,P<0.01),而与家庭情况、开始上网的原因、主要上网途径、上网是否便利、付费方式、网费承担者等无相关性(P>0.05)。结论对青少年开展有针对性的心理健康教育,培养其良好的个人兴趣爱好。使其摆脱网瘾,以达到促进其身心健康的目的。     

Hepatitis B virus/human immunodeficiency virus coinfection: interaction among human immunodeficiency virus infection, chronic hepatitis B virus infection, and host immunity

Objective  This review discusses progress in the studies of hepatitis B virus (HBV)/human immunodeficiency virus (HIV) coinfection and focuses on the interaction among HIV infection, chronic HBV infection, and host immunity.

Data sources  Data and studies published mainly from 2008 to 2011 were selected using PubMed.

Study selection  Original articles and critical reviews concerning HBV/HIV coinfection and HBV and HIV pathogenesis were selected.

Results  HIV may accelerate HBV progression by lowering CD4 count, weakening HBV-specific immunity, “enriching” HBV mutants, causing immune activation, etc. On the other hand, HBV may enhance HIV replication by activating HIV long terminal repeat (LTR) with X protein (HBX) and cause immune activation in synergy with HIV. Paradoxically, HBV may also inhibit HIV dissemination via dendritic cells.

Conclusions  The interaction among HIV, HBV, and host immunity remains poorly understood. Further research is warranted to elucidate the detailed molecular mechanisms and to translate these mechanisms into clinical practice.

     

人类免疫缺陷病毒阴性病人Jiroveci氏肺孢子菌感染

对人类免疫缺陷病毒阴性病人Jiroveci氏肺孢子菌（基诺威茨肺孢菌或基瓦肺孢菌）感染的流行病学、临床表现、诊断、治疗和预防进行了简要回顾。     

青少年网络成瘾行为的影响因素

目的 了解青少年网络成瘾行为的影响因素,为网络成瘾的识别和矫正提供更多的参考依据. 方法 采用整群简单随机抽样方法,选取孝义市初一至高三年级18个班的中学生1 156名为研究对象,采用自编网络使用情况问卷和网络成瘾诊断量表进行调查. 结果 不同年级和性别的青少年网络成瘾人数和比例不同;上网时间和网络成瘾成正比;在网吧上网的成瘾率最高,不同网上行为中网络游戏成瘾率最高;青少年所处的家庭内外环境和网络成瘾有关. 结论 性别、上网时间、地点、上网行为及家庭、学校因素对青少年的网络成瘾有影响,应采取有效措施进行干预以改善青少年的网络成瘾现状.     

人类免疫缺陷病毒与乙型肝炎病毒重叠感染的临床分析

目的提高对人类免疫缺陷病毒 (HIV)与乙型肝炎病毒 (HBV)重叠感染的认识。方法对赤道几内亚巴塔地区医院1999年 1月 - 2 0 0 0年 6月确诊的 4 6例HIV/HBV重叠感染进行分析。结果HIV/HBV重叠感染患者临床表现主要为 :长期发热 (5 3 4 % )、近期消瘦 (47 8% )、全身酸痛 (6 9 6 % )、浅表淋巴结肿大 (45 7% )、慢性腹泻 (2 3 9% )及瘙痒性皮炎 (13 0 % )。HB sAg、HBeAg双阳性为 5 2 2 % ;血清谷丙转氨酶轻微异常为 6 5 2 % ;病死率为 2 8 3%。结论临床医师应加强对HIV/HBV重叠感染诊断的警惕性 ,对高危人群应常规进行血清抗HIV抗体和HBV标志检测     

Ocular lesions associated with human immunodeficiency virus infection

Introduction: This study was undertaken to document the various ocular manifestations in human immunodeficiency virus (HIV) infected individuals and to correlate such findings with CD4+ T lymphocyte levels in individuals with ocular manifestations.     

SAT法检测人巨细胞病毒pp67 mRNA在人类免疫缺陷病毒合并人巨细胞病毒感染患者临床诊疗中的价值探讨

目的 探讨实时荧光核酸恒温扩增检测技术(simultaneous amplification and testing,SAT)检测人巨细胞病毒(human cytomegalovirus, HCMV)基质表层蛋白pp67(phosphoprotein67, pp67) mRNA在人类免疫缺陷病毒(human immunodeficiency virus,HIV)合并HCMV感染患者临床诊疗中的价值。方法 利用SAT技术构建检测HCMV pp67 mRNA的方法,评估SAT法检测HCMV pp67 mRNA重复性、特异性以及检测下限;收集HIV阳性HCMV活动性感染患者69例、HIV阳性HCMV非活动性/潜伏感染154例、HIV阴性HCMV非活动性/潜伏感染 79例患者的血清、肺泡灌洗液、脑脊液等样本进行HCMV pp67 mRNA检测,评估特异度、灵敏度、正确率、阴性预测值、阳性预测值以及约登指数,评估HCMV pp67 mRNA在辨别HCMV活动性感染中的临床价值。结果 SAT法检测HCMV pp67 mRNA的精密度(变异系数<10%)可满足临床检测要求,与其他病原体无交叉反应,特异性良好,试剂检测下限为400 copies/mL;特异度87.55%,灵敏度60.87%,正确率81.46%,阴性预测值0.88,阳性预测值0.59以及约登指数0.48;SAT法检测HCMV pp67 mRNA结果阳性率与临床诊断结果差异无统计学意义(P=0.894)。结论 SAT法检测HCMV pp67 mRNA可用于HCMV活动性感染的辅助诊断。     

Epidemiologic study on human immunodeficiency virus infection among children in a former paid plasma donating community in China

Background Illegal plasma collecting activities in mid 1990s caused a large number of human immunodeficiency virus (HIV) infections in rural areas of central-eastern China. Although most of these activities have been stopped, there were few reports on secondary transmission from infected former plasma donors to their spouses and from infected mothers to their children. This study was to determine the extent of HIV infections among young children in a rural community with a large proportion of plasma donors. Methods A survey was conducted among children aged under 7 years in a former plasma donating community in September 2000: finger blood was collected for HIV antibody testing. Another survey was repeated among children aged under 8 years and their families in the same community in April 2001: urine samples were collected for HIV testing. HIV positive children and samples of HIV negative children, whose mothers were positive based on 2001 survey, were followed up until September 2002 to investigate HIV seroconversion, disease progression and HIV strain analysis. Questionnaires were administered to collect information on children‘s delivery, breast feeding, medical history and their parents‘ commercial blood donation history and HIV status. Results Among 169 children surveyed in 2000, 10 (5.9%) were HIV positive. Of 224 children, 11 were positive in 2001. The overall prevalence rate in the two surveys was 5.0% (17/337) when counting 56 repeated children only once. Of children born to HIV positive mothers, 28.9% were infected. A seroconversion rate of 2.5 per 100 child-years was observed by following up 28 HIV negative children. No statistically significant associations were found between children‘s HIV infection and their histories of blood transfusion, surgery, immunization injection or medical injections. All infections were HIV-1 subtype B‘ strain, the average dispersion rate is 7.4%. DNA sequence analysis showed a close relationship between the seroconverted children and their infected mothers. Conclusions HIV vertical transmissions in the rural former plasma donating community was significant. Intervention measures should be taken to prevent further transmission. It was estimated that the HIV spread in this community occurred in 1994 or even earlier. Many infected people are developing AIDS now: treatment and care are urgently needed for these sick people.     

Preliminary research on the co-infection of human immunodeficiency virus and hepatitis virus in intravenous drug users

Objective To confirm the close relationship of high co-infection rate between HIV and hepatitis virus in intravenous drug users (IVDUs).Methods Anti-HIV, HBV and HCV were detected by ELISA in the serum from 35 scattered and 15massed IVDUs. PCR and RT-PCR were performed to confirm the infection of HIV, HBV, HCV, HGVand TTV among the 15 massed intravenous drug abusers.Results Among the 50 IVDUs, the positive rates of anti-HCVl HBsAg, anti-HBe and anti-HBc were 92% (46/50), 12% (6/50), 10% (5/50) and 66% (33/50), respectively. In the samples of HBsAg positive, their HBeAg was also positive. Although the positive rate of serum markers was different in the massed IVDUs compared to the scattered IVDUs, no significant difference was shown.In the cases of massed IVDUs, the positive rates of HIV DNA, HBV-DNA, HCV-RNA, HGV-RNA,and TTV-DNA were 100% (15/15), 26. 6% (4/15), 53. 3% (8/15), 33. 3% (5/15) and 26. 6%(4/15), respectively. Among the 15 massed intravenous drug users, one was infected with HIV,HBV, HCV, HGV and TTV; two were infected with HIV, HBV, HCV and HGV; three were infected only with HIV; and the remaining had other forms of co-infection.Conclusion The co-infection rate of HIV, HBV, HCV, HGV and TTV in intravenous drug users is very high.