住院结核患者HIV抗体检测资料分析

目的 了解住院结核患者艾滋病病毒(HIV)感染情况及其特征.方法 采用酶联免疫吸附试验(ELISA法),对2010～2011年住院结核患者进行HIV抗体检测(初筛),初筛阳性标本送云南省疾病预防控制中心进行确认试验.结果 检测住院结核患者1 471例,HIV抗体阳性32例(2.17％),可疑HIV阳性11例(0.75％),经“省疾控中心”确认HIV阳性15例(1.02％),TB/HIV双重感染者年龄以青壮年为主,男性多于女性.结论 结核病专科医院将住院患者的HIV抗体检测列为常规检查十分必要,对防治TB/HIV双重感染工作有重要意义.     

结核菌、艾滋病病毒双重感染的预防管理探讨

目的了解结核菌、艾滋病病毒双重感染患者的情况,探讨有利于双重感染预防的管理模式为建立TB/HIV双重感染患者的监测系统,制定治疗和管理机制提供依据。方法在同一单位整合AIDS/TB医疗负责小组,负责患者的诊断治疗管理工作,对结核患者进行AIDS咨询及人类免疫缺陷病毒(HIV)抗体检测,具体为结核患者抽取静脉血4mL,进行艾滋病病毒抗体检测,如两次酶联免疫吸附试验(ELISA)检测阳性,再做蛋白印迹试验(WB)确认,WB阳性者确认为艾滋病病毒阳性。另一方面对有咳嗽、咳痰、发热的AIDS患者筛查TB,检测上述化验的准确性。根据户籍、年龄、性别等因素统计分析TB/HIV双重感染者的分布特征。结果临湘市疾病预防控制中心提供300例结核患者中检出HIV阳性5例,双重感染为1.67%,男女无显著性差异(P>0.05),市区与农村也没有统计学意义(P>0.05)。结论同一单位小组管理模式有利于提高检测率和及时确诊,减少患者丢失、中断治疗、提高治愈率、降低病死率,对隔离治疗有益,值得进一步推广。     

怀化市2个（市、区）实施全球基金结核病项目TB／HIV双重感染项目情况分析

目的调查TB／HIV双重感染情况。方法对怀化市2（市、区）项目报表汇总分析。结果476例结核病患者HIV阳性1例,感染率为0．21％,152例HIV／AIDS患者中TB14例,感染率为9．21％。结论怀化市2（市、区）HIV／AIDS患者结核感染率明显高于结核病患者HIV感染率,加大了结核病的控制难度。     

TB/HIV双重感染病人114例治疗管理分析

目的 了解TB/HIV双重感染病人的发病特点,探讨治疗管理方法。方法 采用回顾性研究方法,对2007年1月—2012年12月新蔡县114例TB/HIV双重感染病人病例的临床特征和治疗转归情况进行分析。结果114例TB/HIV双重感染病人以发热、咳嗽为主要症状（分别占发病人数的80.70%和69.30%）,其中17例涂阳肺结核病人治愈13例,治愈率76.47%,82例涂阴及其他结核病人完成疗程,涂阴结核病人规则治疗率81.94%,总的抗结核治疗成功率83.33%。结论 建立结防艾防合作机制,全面实施DOTS策略,有利于提高TB/HIV双重感染病人的治疗成功率。     

肺结核患者的痰涂片检测及结核杆菌耐药性分析

目的:总结肺结核患者痰涂片检测和结核杆菌耐药性情况。方法:回顾性分析阜阳地区结核病患者资料100例,对其标本开展分枝杆菌分离,实施鉴定,通过绝对浓度法检验结核杆菌对于六种抗结核药物异烟肼、链霉素、丙硫异烟肼、利福平、氧氟沙星以及卡那霉素耐药性情况。结果:五种类型痰结核杆菌检出率分布情况:粘液痰占据5.0%,脓样痰占据12.0%,水样痰占据8.0%,干酪样痰占据24.0%,血痰占据51.0%,五种类型比较存在统计学差异;100例结核杆菌痰结核分枝杆菌阳性患者中初治组耐药率为20.0%,复治组耐药率80.0%,两组比较存在统计学差异。结论:结核杆菌存在极大耐药性,需要提高抗结核药物耐药性的检测工作,降低耐药菌株的出现,所留取痰标本质量直接影响到结核杆菌检出情况,所以需要保证痰标本的质量,从而提升结核杆菌阳性率。     

结核感染T细胞斑点试验对抗结核治疗效果预测的作用评价研究

目的研究T细胞斑点试验(T-SPOT.TB)对于预测抗结核治疗效果的作用。方法纳入某院收治的60例T-SPOT.TB与结核抗体(Mtb-Ab)检测的住院病例,抽选时间为2011年3月~2019年3月,24例明确诊断的结核患者为A组,其余36例非结核患者为B组,观察比较其结果。结果在检测后,T-SPOT.TB敏感度、特异度、阳性预测值、阴性预测值依次为83.33%、80.56%、74.07%、87.88%;Mtb-Ab敏感度、特异度依次为20.83%、91.67%。在检测后,T-SPOT.TB检测结核病的总阳性率对比Mtb-Ab更高,差异具有统计学意义(P<0.05)。在抗结核治疗3个月后,共18例患者对T-SPOT.TB进行复诊,在6个月后,共16例患者对T-SPOT.TB进行复诊,其抗原A、抗原B中特异性斑点形成细胞中位数比治疗前更低,差异具有统计学意义(P<0.05)。结论对于结核病患者而言,T-SPOT.TB对其进行诊断具有更高的敏感度,其可以被当作对抗结核治疗效果进行评价的一个关键指标。     

289例结核感染患者外周全血T-SPOT.TB检测与结核抗体IgM比较结果分析

目的 分析T-SPOT.TB检测结核感染的敏感度和特异性,其作为快速、准确的检测手段,给临床提供诊断依据,控制结核感染蔓延新法.方法 选择本院门诊及住院的结核病患者289例,分别进行T-SPOT.TB及结核抗体IgM检测.结果 外周血检测T-SPOT.TB阳性263例,结核抗体IgM检测阳性243例,对照阳性率:T-SPOT.TB检测阳性率为91.0%(263/289),结核抗体IgM检测阳性为84.1%(243/289),经统计学处理P ＜ 0.05,T-SPOT.TB检测优于结核抗体IgM检测.T-SPOT.TB优于结核抗体IgM检测,T-SPOT.TB检测诊断,可在保持高灵敏性,高特异性的同时,进一步提高结核分枝杆菌检出率.结论 对早期诊断可获得较好治疗效果的肺结核和肺外结核患者,该选择灵敏度高,特异性强,T-SPOT.TB快速检测有一定优势.     

24例艾滋病合并结核病的护理研究

目的研究艾滋病合并结核病患者的临床特点，为相关护理工作提供借鉴。方法以2005年～2012年期间本院收治的24例艾滋病合并结核病患者作为研究对象，对其临扇；特点进行分析。结果24例患者中13例为单纯性肺结核，11例为淋巴结核；13例患者同时采用抗结核和抗病毒治疗，9例患者给予抗结核治疗，2人给予抗病毒治疗，全部给予优质护理，6个月内9例患者死亡。结论艾滋病合并结核病其临床表现不明显，但T淋巴细胞和CD2明显较低，HIV病毒载量值高，病死率较高，护理人员应该提高护理标准，特别是做好医嘱，严密监视患者临床症状。     

人类免疫缺陷病毒/获得性免疫缺陷综合征合并结核患者TB-IGRA阳性表达及影响因素

<正>结核病是艾滋病的主要机会感染之一,本研究通过分析获得性免疫缺陷综合征(AIDS)合并结核TB-IGRA检测结果,初步探讨HIV/AIDS合并结核患者TB-IGRA阳性表达及影响因素,希望对AIDS合并结核的及早诊断提供相关数据,报告如下。1对象与方法1.1研究对象:选取2016年1月至2019年1月确诊的HIV/AIDS合并结核患者56例(确诊结核依据为:痰涂片抗酸杆菌阳性、痰培养抗酸杆菌阳性、GeneXpertMTB/MTB/RIF阳性及组织病理检测诊断结核患者)作为研究对象。所有     

520例HIV患者治疗前后CD＋4细胞结果分析

艾滋病病毒（HIV）感染人体进入靶细胞后,主要受体为CD4分子,造成CD＋4T淋巴细胞数量进行性减少,损害细胞的免疫功能导致各种机会性感染和肿瘤的发生。因此,CD＋4T细胞绝对数是筛查艾滋病（AIDS）病人,判断HIV感染者病程进展,稳妥地推动高效抗病毒治疗工作,适时有效地监控治疗效果的重要指标。本地区为AIDS高发区,对艾滋病的治疗及监控治疗效果成为我州的首要任务,就此对我州HIV患者治疗前后的CD4细胞进行比较研究,来预测临床HIV抗病毒药物治疗效果。     

艾滋病合并结核相关免疫重建炎症反应综合征的研究进展

20世纪80年代以来,艾滋病（AIDS）在全球范围内蔓延,严重危害人类健康。结核病（TB）是艾滋病病人常见的一种机会性感染,同时也是导致病人死亡的重要原因之一。当病人同时感染人类免疫缺陷病毒（HIV）及结核分枝杆菌（MTB）,两者可相互促进,使艾滋病病人病情变得更加复杂,并最终可能发展为艾滋病（AIDS）合并结核相关免疫重建炎症反应综合征（TB-IRIS）。目前针对这类疾病的研究不多,主要依赖临床医师的经验进行诊断和治疗。该文对AIDS合并TB-IRIS的发病机制及其疾病发生进展的关系进行分析,探讨如何更好地防治并发症,以期为临床诊断、治疗和研究提供参考性意见。     

Tuberculosis in rural northwest Ethiopia: community perspective

A community based cross sectional study was conducted in April 1997 to assess the perspective of the rural community towards Tuberculosis (TB) and TB patients and identify prevailing misconceptions and other problems related with TB in the south Gonder administrative zone of the Amhara region. A total of 1000 heads of household were interviewed and disease information was obtained for 5078 family members. The prevalence of productive cough lasting more than 3 weeks was 4.6% (233/5078) and cervical, axillary or inguinal swelling with or with out a sinus tract that lasted more than 12 months was 1.0% (52/5078). TB treatment defaulters were found in 10% of the rural households. Apparent clinical improvement after the intensive phase was the commonest reason for defaulting (45%) followed by far distance of the health institution (25.3%). Evil spirit and sexual intercourse were incriminated as a cause for TB in 19.9% and 4.7% of respondents respectively. TB was believed as curable disease by 66.7% of the respondents. The rural community exhibited a great deal of ostracism towards TB patients. Majority (76.2%) of the respondents have heard about HIV/AIDS out of whom 19.4% disclosed that there could be an association between HIV/AIDS and TB. It was demonstrated that misconceptions about TB, its treatment, patients and families were prevalent among the communities in South Gonder. Community based awareness creating strategies should be designed and dissemination of TB information and education are strongly recommended.     

Survey of protective behaviour practiced against HIV/AIDS in adult TB patients at Almata Zonal Hospital

OBJECTIVES: To assess the level of protective behaviour against the spread of HIV infection and TB transmission in a health facility setting. PATIENTS AND METHODS: A cross-sectional study involving 190 adult TB patients on anti-TB treatment was conducted at Alamata Zonal hospital, Southern Tigray, in September 2001. RESULTS: The study showed that among the study population 83% knew TB is a communicable disease, 124 (65.2%) correctly knew the mode of its transmission but only 26 (16.6%) practiced the appropriate preventive measures. Of the study population 99 (52%) had previous history of sexually transmitted diseases (STDs), and 120 (63%) had multiple sexual partners among whom 94 (78%) had not used condom because 34 (39%) did not know the role of condom. Similarly, 64 (34%) were not volunteer to use condom, and 25 (13%) did not know what condom is, in spite of the fact that 181 (95%) have heard of HIV/AIDS and 169 (89%) knew unprotected sex as its usual route of transmission. One hundred sixty nine (89%) knew that HIV is preventable and the perceived preventive measures were mainly 1:1 sexual partner in 140 (74%) and use of condom in 98 (52%) whereas 14 (7%) had no idea about HIV prevention methods. The majority, 167 (88%) considered HIV a real national problem. CONCLUSION: The study population's level of protective behaviour against HIV and TB transmission is very low. Measures need to be taken to ensure 100% condom availability. Massive campaigns are required to make condom use socially acceptable. Health education on prevention of HIV and TB transmission should be strengthened to achieve an acceptable level of protective behaviour against these diseases.     

HIV蛋白酶抑制剂与细胞凋亡

HIV感染人体后造成大量CD4 + T淋巴细胞的凋亡 ,从而破坏免疫系统 ,使机体无法抵抗病毒的入侵 ,导致免疫缺陷。目前的药物靶点都针对病毒本身 ,无法清除体内储存病毒的感染细胞 ,而HIV蛋白酶抑制剂治疗HIV/AIDS患者后可以减少HIV感染引起的细胞凋亡 ,帮助机体恢复免疫功能 ,并且这种作用与其抑制病毒的作用是相独立的 ,这提示了可以通过免疫重建的策略来治疗AIDS。本文综述了HIV蛋白酶抑制剂的研究和发展概况 ,其作用特点以及对细胞凋亡的影响。明确HIV蛋白酶抑制剂与细胞凋亡的关系 ,可以启发新的思路从细胞着手 ,通过恢复机体的免疫能力来对抗病毒 ,从根本上治疗AIDS。     

The pharmacological challenges of treating tuberculosis and HIV coinfections

Introduction: Tuberculosis (TB) is the most prevalent opportunistic infection among HIV patients, and the leading cause of death among HIV patients worldwide. Simultaneous treatment of both diseases is recommended by current guidelines, but can be challenging due to the potential for drug-drug interactions, overlapping toxicities, difficulty adhering to medications, and an increased risk for immune reconstitution inflammatory syndrome (IRIS). Clinical manifestations of TB can also vary between HIV-infected patients and uninfected patients, which can increase the risk for delayed diagnosis.

Areas covered: Topics covered in this review include the following: the inter-related pathophysiology of HIV and TB; clinical manifestations and diagnosis; drug-drug interactions, particularly the rifamycins with the antiretrovirals; IRIS presentation and treatment, as well as a discussion on overlapping toxicity between the two disease states.

Expert commentary: The complexity of managing these two disease states simultaneously requires a multidisciplinary approach to care and dedicated resources. If properly funded, TB/HIV co-infection will continue to decline over the coming years.     

An Assessment of the Knowledge,Attitudes, and Risk Perceptions of Pharmacy Students Regarding HIV/AIDS

Objective

To evaluate the level of knowledge, attitudes, and risk perceptions of University Sains Malaysia final-year pharmacy students regarding human immunodeficiency virus (HIV) and acquired immunity deficiency syndrome (AIDS).

Method

A cross-sectional study among pharmacy students. Data were analyzed with Chi-square to find difference at p value < 0.05.

Results

The majority of students (83.07%) responded showing a difference in gender and race. Students showed low willingness (9.2%) to assist patients and low confidence (36.1%) in their education about HIV/AIDS patients. Students recommended HIV testing for health care professionals (69.4%) and patients (75.9%) before surgical procedures. Students knew little about Post Exposure Prophylaxis (18.5%) or about the time for HIV to develop into AIDS (57.4%). About 40% of students were unaware of the inability of antivirals to treat HIV/AIDS. Students had low awareness for opportunistic infections (18.5%), and low agreement on competency to treat and counsel HIV patients (12.9%).

Conclusion

The study highlighted students'' misconceptions, negative attitudes, and risk perceptions towards HIV/AIDS.     

Burnout in substance abuse counselors. Impact of environment, attitudes, and clients with HIV

Due to associations between acquired immunodeficiency sydnrome (AIDS) and substance abuse, many substance abuse treatment counselors have clients with human immunodeficiency virus (HIV)/AIDS. We assess the contribution of various hypothesized predictors of burnout among 134 substance abuse counselors working with clients with HIV/AIDS. Counselors reported practice-related variables, including support from coworkers and supervisors, caseload, percentage of HIV-positive clients, and whether they worked at a methadone clinic, and personal characteristics of job efficacy and education. The three burnout dimensions were emotional exhaustion, depersonalization, and personal accomplishment. Emotional exhaustion was significantly predicted by less support, less efficacy, and working in a methadone clinic. Depersonalization was predicted by less efficacy, less support, and working in a methadone clinic. Personal accomplishment was predicted by having a lower percentage of clients with HIV/AIDS, and more efficacy, support, and education. We present empirically based suggestions for interventions that can prevent or limit burnout.     

吸毒人群性病、HIV检测结果分析

目的··:了解吸毒人群性病、HIV/AIDS感染情况。方法·· :对来我院戒毒的208例吸毒人员性病、HIV检测结果进行统计分析。结果··:梅毒12例 (5.77 % ) ,淋病47例 (22.60 % ) ,非淋病性尿道炎26例 (12.50 % ) ,HIV感染者6例(2.89 % ) ,性病、HIV的感染率为43.75 %。结论··:来我院戒毒的吸毒人员性病、HIV感染率较高 ,建议在戒毒场所建立性病、HIV/AIDS监测室 ;重视对吸毒人群中性病、HIV/AIDS的治疗 ;广泛开展性病、HIV/AIDS的预防教育工作。     

广西河池市美沙酮门诊海洛因依赖人群HIV、HCV、TB、梅毒感染情况调查

目的獉獉:了解河池市美沙酮门诊海洛因依赖人群的特征,HIV、HCV、TB和梅毒感染情况及其危险因素。方法獉獉:对参加美沙酮维持治疗的388名海洛因依赖者进行治疗前的问卷调查,HIV、HCV、TB、梅毒血清学检测及胸部X线摄片检查。结果獉獉:87.11%的海洛因依赖者采用静脉注射方式吸毒,46.15%的静脉吸毒者共用注射器。HIV抗体阳性率7.99%(31/388),其中静脉注射吸毒HIV抗体阳性率8.88%(30/338)。HCV抗体阳性率72.16%(280/388),其中静脉注射吸毒HCV抗体阳性率74.85%(253/338)。TB抗体阳性率0.26%(1/388),梅毒抗体阳性率13.66%(53/388)。结论獉獉:河池市美沙酮门诊海洛因依赖人群,尤其是静脉吸毒者中HCV和梅毒感染较高。在海洛因依赖人群中推广针具交换、安全套免费发放和相关知识的健康教育、行为干预尤为重要。