315例HIV／AIDS患者心电图与CD4＋细胞的关系

目的：分析HIV/AIDS患者心电图与CD4＋细胞的关系。方法按CD4＋细胞计数的多少将315例HIV/AIDS患者分为A、B两组,并对两组患者的常规心电图进行对比分析。结果两组患者心电图异常总数、窦性心动过速、左心室高电压和ST-T改变比较,差异有统计学意义（P＜0．05）。两组窦性心动过缓、异位搏动、心电轴偏移、束支阻滞比较,差异无统计学意义（P＞0．05）。结论 HIV病毒及高强度的抗病毒治疗对心血管系统有明显损害,与患者C D4＋细胞水平及病程进展密切相关。     

云南省成人与青少年HIV/AIDS患者抗病毒治疗10年结果分析

目的回顾和总结云南省成人和青少年AIDS抗病毒治疗10年结果,讨论取得的成绩和存在的问题。方法利用《艾滋病综合防治系统——抗病毒治疗管理》数据库的数据进行统计分析。结果云南省的治疗人数和覆盖率都有了显著增长,在50 241例进行过抗病毒治疗的患者中,截至2013年12月底仍然继续治疗的占82.3%;感染途径为静脉吸毒患者的失访、停药和病死率显著高于性途径感染者;患者的治疗基线CD4+T淋巴细胞计数越低,治疗期间的病死率越高;1年的治疗队列中,基线CD4+T淋巴细胞计数<350个/mm3患者的终止治疗率低于CD4+T淋巴细胞计数≥350个/mm3的患者;治疗第1年的患者治疗保持情况不佳,停药、失访和病死率较后期的高;治疗6个月以上的患者有82.9%达到病毒检测不到水平;耐药率低于5%;接受治疗患者的病死率逐年下降,已经低于2%。结论云南省抗病毒治疗取得了一定的成绩,但在扩大治疗的策略和目前情况下仍然面临着挑战。     

HIV／AIDS患者合并神经系统损伤和精神异常

1981年,美国首次报道人类获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)以来,目前统计全世界已有人类免疫缺陷病毒(humanimmunodeficiency virus,HIV)感染者和 AIDS 患者7000余万。我国在1985年报道了第1例 AIDS 患者,此后 HIV 阳性人数迅速增加至85万,分布在全     

HIV/AIDS合并梅毒患者临床特征及长期抗病毒治疗研究

[摘要]　目的　探讨HIV/AIDS合并梅毒患者临床特征及长期抗反转录病毒治疗（anti-retroviral therapy, ART）的病毒学、免疫学效果以及梅毒复发和/或再感染情况。方法?收集2017年1月1日—2019年12月31日在首都医科大学附属北京佑安医院进行初始ART的HIV/AIDS患者的基本信息和实验室检测数据,分析患者的临床特征及其ART后病毒学、免疫学效果以及梅毒复发及再感染情况。结果?共纳入728例HIV合并梅毒感染者,其中99.6%为男性,97.7%为同性性传播感染者,ART时间中位数为950（691,1217） d,从诊断到开始ART的中位时间为15.5（8.0,41.0） d,诊断至开始ART时间≥180 d以上的患者占14.7%（107/728）。经过治疗,患者CD4+ T淋巴细胞计数增加了242（130,369）个/μl,99.3%（723/728）的患者HIV载量控制在400拷贝ml以内。经足量、规律驱梅治疗6～12个月后,梅毒复发和/或再感染率为18.4%（134/728）。结论?HIV/AIDS合并梅毒患者经长期ART后病毒学、免疫学效果良好,梅毒的复发和/或再感染率较高,梅毒足量规则治疗的同时,加强性健康宣教和定期随访复查至关重要。     

抗病毒治疗对HIV感染儿童身高的影响

迄今为止，全世界有超过4千4百万人口感染人类免疫缺陷病毒（human immunodeficiency virus，HIV），其中包括200多万的儿童。生长发育迟缓甚至停滞是HIV感染患儿常见表现之一，最终会影响感染儿童的终身高。随着抗病毒治疗的进步，尤其是高效抗逆转录酶病毒联合疗法（highly active antiretroviral therapy，HAART）的出现，以及相应各种内分泌疗法的发展，HIV感染儿童的身高有了一定的改观。     

HIV感染及AIDS就诊分析

为对获得性免疫缺陷综合征 (ＡＩＤＳ)有进一步的了解 ,特将北京佑安医院感染科在 1990年 4月～1999年 4月收治的人类免疫缺陷病毒 (ＨＩＶ )感染者及ＡＩＤＳ患者 2 4例的临床诊断分析报告如下。1　一般资料收治的 2 4例ＨＩＶ感染及ＡＩＤＳ患者 ,均经抗ＨＩＶ抗体确诊试验 (蛋白印迹法 ,ＷＢ法 )证实。其中ＨＩＶ感染者 5例 ,ＡＩＤＳ 19例 ,男性 19例 ,女性 5例。年龄 11～ 2 0岁 1例 ,2 1～ 30岁 8例 ,31～ 4 0岁9例 ,4 1～ 5 0岁 2例 ,5 0岁以上 4例。文化程度 :大学以上 14例 ,初高中 10例。感染途径 :静脉吸毒 1例 ,性传播 14例 ,其…     

郑州市HIV/AIDS患者免费抗病毒治疗的临床疗效评价

目的评价郑州市HIV／AIDS患者接受免费抗病毒治疗的效果。方法收集2004-2009年在我院接受抗病毒治疗的144例HIV／AIDS患者的临床资料并随访至2010年6月,比较分析治疗基线及治疗结束后CD4^＋T淋巴细胞水平、HIV载量变化,统计抗病毒治疗方案、机会性感染的发生、药物的不良反应等情况。结果144例中,死亡12例;存活的132例中,102例HIVRNA〈50copies／ml。132例存活患者CD4^＋T淋巴细胞计数在治疗前后比较差异有统计学意义。抗病毒治疗过程中发生药物不良反应109例次。目前达到病毒学治疗成功目标的102例中,91例采用一线抗病毒治疗方案。结论郑州市接受抗病毒治疗的绝大部分HIV／AIDS患者采用一线方案取得了良好的病毒学及免疫学效果,同时治疗过程中也出现了一定比例的不良反应。     

HIV/AIDS患者治疗前后补体C1q水平及相关实验室指标检测结果分析

目的了解HIV/AIDS患者治疗前后补体C1q水平及相关实验室指标检测结果的变化情况。方法选取2011-09~2014-10在广西艾滋病临床治疗中心(南宁)进行抗逆转录病毒治疗的患者共96例。观察所有病例处于基线时和治疗6个月后血清补体C1q水平及其他相关实验室指标检测结果变化情况。结果 HIV/AIDS患者抗病毒治疗后补体C1q总浓度水平比治疗前降低,差异具有统计学意义(P0.05);治疗后补体C1q浓度升高者33例,不变或降低者63例,升高例数和降低例数比较差异具有统计学意义(P0.05);治疗后6个月CD3、CD4、CD8、CD4/CD8、病毒载量检测结果与治疗前比较,CD3、CD4、CD8、CD4/CD8的检测结果升高,病毒载量的检测结果降低,差异具有统计学意义(P0.01)。结论 HIV/AIDS患者治疗前后联合检测补体C1q水平及相关实验室指标对指导临床治疗具有重要的意义。     

获得性免疫缺陷综合征抗病毒治疗

获得性免疫缺陷综合征(AIDS)抗病毒治疗经历了近20年的发展,治疗思路从抑制人类免疫缺陷病毒(HIV)的逆转录酶到抑制蛋白酶,目前又开发出抑制宿主细胞的病毒受体、与受体结合的病毒包膜蛋白以及病毒整合到宿主细胞核酸中所需要的整合酶药物。     

AIDS抗病毒治疗研究进展

高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)是AIDS防治的主要手段,当前抗病毒药物发展迅速,一些新的治疗策略不断出现.本文就近年来HAART药物的最新研究进展、治疗方案及治疗时机的改进、新的治疗思路进行概述.     

心理干预对新确诊HIV/AIDS患者接受抗病毒治疗意愿的影响

目的探讨心理干预对新确诊HIV/AIDS患者接受抗病毒治疗意愿的影响。方法随机抽取2014年12月30日—2018年12月30日在我中心新确诊的HIV/AIDS患者240例作为研究对象,采用随机数表法分为实验组和对照组各120例,实验组实施心理干预,对照组实施常规护理干预,对比2组患者干预前后心理健康变化及抗病毒治疗意愿。结果新确诊HIV/AIDS患者抑郁发生率为59.58%,焦虑发生率为59.17%;干预后,2组患者抑郁自评量表(self-rating depressionscale,SDS)、焦虑自评量表(self-rating anxiety scale,SAS)得分和抑郁、焦虑发生率均比干预前显著降低(P均<0.05),且干预后实验组SDS、SAS得分和抑郁、焦虑发生率均显著低于对照组(P均<0.05);干预后,实验组接受抗病毒治疗人数比例(97.5%)显著高于对照组(85.0%),差异有统计学意义(χ^2=11.742,P=0.001)。结论心理干预能提高新确诊HIV/AIDS患者抗病毒治疗的意愿,值得临床采纳推广。     

182例HIV/AIDS实施高效抗反转录病毒治疗的疗效评价

目的分析182例HIV/AIDS实施高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)的效果及其影响因素,为进一步有效治疗提供依据。方法采用回顾性调查方法,对我院接受规范HAART的182例HIV/AIDS患者的CD4+T淋巴细胞绝对计数和病毒载量进行分析。结果 182例中,157例治疗后CD4+T淋巴细胞计数增加,且在治疗后前6个月内增加速度最快,随着治疗时间延长则较为缓慢。病毒载量在治疗后的6个月内下降最快,大部分降至血浆检测不到的水平,6个月后比较稳定;但随着治疗时间延长,部分患者的病毒载量出现反弹,可能与患者服药依从性差和病毒耐药性的出现有关。治疗前后CD4+T淋巴细胞计数差异有统计学意义(P0.05)。多因素logistic回归分析表明年龄和病毒载量是影响HAART疗效的危险因素,基线CD4+T淋巴细胞计数和按时服药是保护因素。结论 HAART能明显增加CD4+T淋巴细胞计数,降低病毒载量,有效控制机会感染,治疗效果显著。影响HAART疗效的因素是多方面的,在治疗过程中应综合考虑各种可能影响因素以提高疗效,对符合条件的患者应尽早进行规范的抗病毒治疗。     

HIV/AIDS合并非结核分枝杆菌肺病97例临床分析

目的 探讨HIV/AIDS合并非结核分枝杆菌(nontuberculosis mycobacteria, NTM)肺病的临床特点,以提高诊疗水平. 方法 对我院2009—2012年97例HIV/AIDS合并NTM肺病患者进行回顾性分析. 结果 97 例中咳嗽 93 例(95.88%),咳痰88例(90.72%),气喘71例(73.20%),发热70例(72.16%),消瘦69例(71.13%),乏力58例(59.79%),胸痛 47 例(48 . 45%),腹泻36例(37.11%). HIV感染途径为性乱史64例(65.98%),静脉吸毒史26例(26.80%),输血史2例(2.06%),不详5例(5.15%). 胸部影像学表现以双肺中下叶多见,多为左下肺受累,形态多种多样,并容易形成空洞及支气管扩张样改变,可见胸膜病变. 结论 HIV/AIDS合并NTM肺病的临床症状、胸部影像学表现、痰涂片、PPD试验和结核抗体检查酷似肺结核,在痰培养结果未回报前,临床上二者鉴别诊断非常困难.患者通常合并多处浅表淋巴结肿大,反复痰涂片抗酸杆菌阳性. 痰培养药物敏感性试验提示对一线抗结核药物耐药率高,应引起临床足够重视.     

HIV and India: looking into the abyss

Serosurveillance of high risk groups started in India in October 1985. The first positive case were detected in 1986. As of mid-1994, official figures stood at 15 000 HIV positive cases and 559 cases of AIDS. This is most certainly an underestimate because of under reporting. Among high risk groups, prevalence has risen rapidly. Between 1986 and 1994, prevalence has risen from 1.6 to 40.0% in sex workers, 1.4 to 40% in STD clinics and 0 to 70% in i.v. drug abusers in various studies. The penetration into the general population is uncertain. As in Africa, infection has been mainly by heterosexual intercourse, with commercial sex workers, long distance truck drivers and migrant labour serving as vehicles of spread. Other routes of infection are transfusion of blood and blood products and i.v. drug use. Dependence on professional blood donors is the main cause of infected blood supplies. Ninety per cent of cases with HIV infection are aged between 15 and 45 years and belong to socioeconomically disadvantaged groups. The male to female ratio is 5:1, with female cases being mainly sex workers. The predominant virus is HIV-1 but cases with HIV-2 and mixed infection are being reported from port cities. The present situation in India is similar to the early pattern in Africa where a sharp increase in seroprevalence among high risk groups was followed by spread to the general population. Clinical AIDS is still infrequent. From experience so far, pulmonary tuberculosis has been the most common clinical presentation. So far AIDS associated tuberculosis has responded to standard therapy but the development of multi-drug resistant mycobacteria and their spread to the large tuberculous population in the country is a potential threat. Key factors of AIDS/HIV prevention are public education and counselling about the infection and safe sex practices, especially in high risk groups; STD control; promotion of voluntary blood donation and adequate screening of blood products and general and equitable progress in the economic development of the country and its people—much high risk behaviour is driven by poverty.     

Clinical outcome of HIV-infected haemophiliac patients in Hong Kong

Summary . About half of the haemophiliacs in Hong Kong have been infected by human immunodeficiency virus (HIV). This study aimed to determine their clinical course of progression. Forty-seven adult patients with congenital coagulation factor deficiency being followed up regularly from January 1992 onward in the Department of Medicine of Queen Mary Hospital, Hong Kong, were included in this study. Twenty were positive for HIV antibody and the remaining 27 were negative. Three other HIV-positive patients who died before 1992 were excluded. From January 1992 to June 1996, the 47 patients included in the study were followed up in the clinic every 3–6 months with regular CD4, CD8 lymphocyte counts and β2 microglobulin levels. At the initiation of the study in January 1992, the HIV-infected patients had already a lower mean CD4 count (360.4 μL^?1 versus 658.8 μL^?1, P<0.01), a reversed CD4/CD8 ratio (0.53) and a higher mean serum β2 microglobulin level (1.853 μg mL^?1 versus 1.315 μg mL^?1, P>0.05). On regular follow-up, HIV-positive patients had a more significant progressive fall in their mean CD4 count (301.6 μL^?1 versus 360.4 μL^?1, P<0.01) and rise in their mean serum β2 microglobulin level (2.60 μg mL^?1, versus 1.853 μg mL^?1, P<0.05). The CD4 and CD8 counts of HIV-positive patients were falling at a rate of 1.44 μL^?1 month^?1 and 4.03 μL^?1 month^?1 respectively. During the follow-up period, two of the 20 HIV-positive patients developed clinical acquired immunodeficiency syndrome (AIDS) at 15 and 36 months from the initiation of the study. Both patients had typical features of AIDS with a low CD4 count, reversed CD4/CD8 ratio and elevated β2 microglobulin level. The former patient eventually died of fungal brain abscess. The remaining 18 HIV-positive patients so far remained clinically asymptomatic. Eleven patients were put on antiretroviral drug therapy when their CD4 counts fell below 200 μL^?1. Only two of the 20 HIV-infected patients developed AIDS during the observation period of 4 years; this figure of 10% is relatively slow. Two of our patients died of AIDS before the study was initiated in 1992. Even if they were included, still only 17.4% had progressed. The figure is in the lowest rate of progression expected from Western experience. Although our study population is small, it remains unclear why our HIV-infected Chinese haemophiliacs have a slow rate of progression to AIDS.     

Human immunodeficiency virus (HIV) associated non-Hodgkin's lymphomas in Denmark: report of three cases

High grade malignant non-Hodgkin's lymphoma (NHL) was the presenting manifestation of the acquired immunodeficiency syndrome (AIDS) in 3/81 reported cases of AIDS in Denmark (by April 2, 1986). Asymptomatic HIV infection, 1 and 5 yr prior to the onset of lymphoma, was documented in 2 cases. 1 patient became infected by Factor VIII treatment, 2 were male homosexuals. 2 patients had an uncommon tumour presentation in the oral cavity, 1 patient presented with an abdominal mass. The histologic subtypes were immunoblastic (2), and small noncleaved cell, Burkitt's (1). Helper/suppressor T-cell ratio was decreased at onset of lymphoma in 2 cases. All 3 patients have died, 4, 6, and 24 months after diagnosis of NHL. Only 1 patient died of NHL, 1 died of an unclassified pneumonia and the third developed progressing supranuclear HIV-associated polyneuropathy without evidence of CNS lymphoma. Thus, high grade malignant B-cell NHL is a regular initial manifestation of AIDS, and may develop after years of asymptomatic HIV infection.     

AIDS抗病毒治疗死亡病例临床分析

目的了解AIDS抗病毒治疗死亡病例特点,为开展AIDS抗病毒治疗提供有价值的参考信息。方法对2005—2012年在我院门诊抗病毒治疗过程中死亡患者的病历进行回顾性分析,总结其临床特点。结果在我院治疗过程中患者累计死亡102例,年龄(46.13±15.24)岁,男性占77.45%,女性占22.55%,病死率为3.20%。死亡患者的基线CD4+T淋巴细胞计数为(72.61±77.15)个/mm3,CD4+T淋巴细胞计数<100个/mm3者占72.55%,治疗12个月内死亡者占71.57%,CD4+T淋巴细胞计数>50个/mm3的患者死亡年龄大于CD4+T淋巴细胞计数≤50个/mm3的患者(P<0.05)。结论 AIDS相关疾病是患者死亡的主要原因,死亡多发生于CD4+T淋巴细胞计数<100个/mm3和治疗后的1年内。     

抗病毒治疗时间对AIDS患者生命质量的影响研究

目的 探讨接受高效抗反转录病毒治疗时间的长短对AIDS患者生命质量的影响.方法 采取典型抽样的方法,选取1个省级、2个州级、5个县级抗病毒治疗医院为研究现场,选择2009年4月前在这8个研究现场入组并接受抗病毒治疗的AIDS患者作为研究对象,使用中文版SF-36量表和自编基本情况调查表对其进行横断面调查,应用EpiDa...