黑龙江省首例新生儿经母婴传播感染HIV分析

黑龙江省自1993年发现首例艾滋病病毒(HIV)感染者以来，截止2004年3月末，全省共报告HIV感染者134例，除近日发现1例新生儿经母婴垂直传播途径外，其余均经性和血传播途径感染。现将首例母婴传播途径感染新生儿的流行病学及实验室检测情况报告如下。     

围产期HIV感染研究现状

人类免疫缺陷病毒（ＨＩＶ）感染的发病呈逐年增长趋势，尤其女性发病率明显高于男性，且８０％ＨＩＶ感染妇女处于生育期。本文就围产期ＨＩＶ感染的流行病学特点、母婴传播高危因素、诊断及预防综述如下。１流行病学特点围产期ＨＩＶ感染的流行病学与普通人群相似，但有...     

艾滋病常见肺部感染的诊断和治疗

概述 艾滋病即获得性免疫缺陷综合征(AIDS),由人免疫缺陷病毒(HIV)感染所致.自1985年我国首次报道以来,AIDS在我国的传播呈快速增长的趋势[1～3],湖北地区也有类似趋势[3～4],主要集中在有偿献血者,多数是1994～1996年因不规范采供血途径感染的[4],近年有向普通人群蔓延的趋势.HIV感染后,随着CD4 细胞数量下降,合并包括病毒、真菌、结核和弓形虫在内的机会性感染的概率增加[5～6].本文简要讨论AIDS患者几种常见肺部机会性感染的诊断和治疗.     

对艾滋病抗逆转录病毒治疗成效的回顾

2006年5月30日联合国艾滋病规划署公布了艘环菹灿遣伟氲谋ǜ?随着各国投资额增加、致力于AIDS防治人数的增加,AIDS流行25年来首次呈现新发感染及患者总数走缓趋势.高效抗逆转录病毒治疗(HAART)的覆盖面扩大是阻断母婴垂直传播,明显延长HIV感染者生存期的重要手段.     

儿童艾滋病抗病毒治疗8例临床分析

随着我国成人艾滋病(AIDS)发病率迅速上升,现已影响儿童.儿童艾滋病与成人有诸多不同,艾滋病病毒(HIV)感染潜伏期较成人短.由母婴传播的HIv感染儿童中,近50%在1岁时发展为AIDS病人,严重的多在3岁内死亡.     

艾滋病常见机会性感染诊断和治疗

艾滋病即获得性免疫缺陷综合征(acquired im-munodeficiency syndrome,AIDS),是由人免疫缺陷病毒(human immunodeficiency virus,HIV)引起的一种慢性传染病。HIV侵入人体后,特异性地破坏CD4 T淋巴细胞,造成机体细胞免疫功能严重受损。一些侵袭力较低、致病力较弱的病原体,在人体免疫功能正常时不能致病;但当人体免疫功能降低时则为这类微生物创造了感染条件,导致病原体乘机侵袭人体致病。这种感染称为机会性感染。     

深圳市儿童HIV抗体检测情况分析

自1983年报道首例婴儿艾滋病(AIDS)以来,至今已有400万15岁以下儿童死于艾滋病,其中95%以上艾滋病病毒(HIV)感染儿童生活在发展中国家。在全球3 720万成人HIV携带者中女性几乎占到了一半,全球每年有240万感染HIV的妇女生育孩子造成每年约80万个、每天约2 000个新生儿感染HIV。为提高对儿童艾滋病的认识,关注AIDS在儿童中的流行特点,现将2005-2006年深圳市儿童HIV抗体检测情况分析如下。1对象与方法1·1调查对象2005年5月至2006年12月,在深圳市儿童医院因其他疾病就诊的门诊和住院患儿共5 804例。1·2检测方法患儿均于清晨空腹采集…     

HAART可减少儿童艾滋病脑病的发病率

据Medscape．com7月6日报道（原载Arch Pediatr Adolesc Med 2005：159：651-656），在围产期感染了HIV的儿童经HAART治疗会减少其进行性艾滋病脑病的发病率。     

第十五届国际艾滋病会议报道之四——HIV重叠感染和同时感染

重叠感染或称为不同病毒株的再次感染，在HIV感染中有重要影响。它能够对HIV感染的患者在临床进程方面和对HIV传播的有关方针具有重大作用。是否可能出现重叠感染曾经引起过讨论，尽管它并不常见，但目前已证实它确实存在。     

受艾滋病影响儿童的关怀需求及干预措施的研究现状

通过收集近年相关文献,综述了受艾滋病影响儿童所面临的生长发育、学习、生活、心理等诸多问题,以及针对这些问题所采取的政策、医疗、教育、生活、心理等干预措施。受艾滋病影响儿童主要存在生活、教育和心理关怀需求,应开展综合干预措施,特别是开展对受艾滋病影响儿童的心理关怀研究,以探讨适合不同关怀需求的干预模式。     

HIV/AIDS treatment and HIV vaccines for Africa

Increased support from the global HIV/AIDS community is driving advances in HIV treatment and vaccine development in the developing world. Care of patients with AIDS includes many biomedical, nutritional, psychosocial, and behavioural interventions. In resource-poor settings, antiretroviral drugs should be given with use of standardised treatment regimens and streamlined algorithms for monitoring use. A safe and effective HIV vaccine will supplement prevention efforts to protect uninfected people against infection, or might possibly be able to modify the course of HIV infection. Advances have been made in understanding the immune response and immunisation to HIV, and new ideas for candidate vaccines have been developed, including several based on HIV-1 strains prevalent in Africa. HIV vaccine efficacy trials are needed in Africa to determine whether these advances can be translated into clinical and public health benefits. In this review, we discuss the prospects for use of treatment and vaccines in resource-poor settings.     

HIV感染者和AIDS病人使用复方新诺明预防机会性感染的现状及影响因素

摘要：通过检索分析国内外文献及指南,收集国内外与复方新诺明预防机会性感染的相关文献,分析在艾滋病病毒（HIV）感染者和艾滋病（AIDS）病人中,开展复方新诺明针对机会性感染预防用药的效果和影响其推广使用的因素。结果表明：无论是否开展抗病毒治疗,复方新诺明预防用药能够降低HIV感染者和AIDS病人的肺孢子菌肺炎（PCP）、弓形虫病、腹泻的发病率,其相对危险度（RR）值分别为0．3、0．7、0．4,并可降低20％～40％的病死率。患者对复方新诺明的认知、医务人员的水平和医疗实践、交通条件、药物供应、国家政策等,是影响复方新诺明预防用药使用及推广的主要因素。因此,在抗病毒治疗的同时或之前,开展复方新诺明的预防用药,对CD4^＋T淋巴细胞〈200个／mm^3的AIDS病人有着重要意义。要结合各地的实际情况,有效推广复方新诺明预防用药的策略。     

Factors associated with disclosure of diagnosis to children with HIV/AIDS

Disclosure of the diagnosis of human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome (AIDS) to a child is a controversial and emotionally laden issue. To understand the factors that affect the process of disclosure and its consequences, we studied 99 parent-child dyads recruited from patients being treated at the National Cancer Institute (NCI). Parents and HIV-infected children were interviewed and administered several standardized measures. Parental depression, family environment, social support satisfaction, socioeconomic status, child and parent gender, child's age, parental HIV serostatus, and disease severity were used to predict disclosure status. Results indicate that the majority of caregivers do disclose the diagnosis to the child, usually with no ill effects, and that age is the most significant predictor of whether or not a child has been told. The Centers for Disease Control and Prevention currently estimate that there are over 6611 children with AIDS (under age 13), and 2184 adolescents with AIDS (ages 13-19) in America. As an increasing number of children who are born infected with HIV live to older ages, the question of when and how to talk with them about their illness becomes more crucial. In addition to the growing number of children infected with HIV, there are many thousands of children profoundly affected by the impact of this disease on a close family member--a mother, father, sibling, or other relative in the kinship network. Yet, the initial reaction most adults have upon learning of their own, or of a family member's, HIV diagnosis is that the diagnosis must be kept a closely guarded secret. One reason frequently cited by parents and family members is their fear that the stigma of AIDS will have a negative impact on their children and their families. Disclosure of an HIV diagnosis to a child is a controversial and emotionally laden issue in the pediatric health-care community as well. However, no systematic research has studied the issues that surround disclosure of an HIV diagnosis to the patient and the factors that predict disclosure.     

Socio-economic status and HIV/AIDS stigma in Tanzania

Tanzania has a generalised AIDS epidemic but the estimated adult HIV prevalence of 6% is much lower than in many countries in Southern Africa. HIV infection rates are reportedly higher in urban areas, among women and among those with more education. Stigma has been found to be more common in poorer, less-educated people, and those in rural areas. We examined associations between poverty and other variables and a stigmatising attitude (belief that HIV/AIDS is punishment for sinning). The variables we examined in a multivariate model included: food sufficiency (as an indicator of poverty), age, sex, marital status, education, experience of intimate partner violence, condom-related choice disability, discussion about HIV/AIDS, sources of information about HIV/AIDS and urban or rural residence. Of the 1,130 men and 1,803 women interviewed, more than half (58%) did not disagree that "HIV/AIDS is punishment for sinning". Taking other variables into account, people from the poorest households (without enough food in the last week) were more likely to believe HIV/AIDS is punishment for sinning (Odds Ratio [OR] 1.29, 95% confidence intervals [CI] 1.06-1.59). Others factors independently associated with this stigmatising attitude were: having less than primary education (OR 1.29, 95% CI 1.03-1.62); having experienced intimate partner violence in the last year (OR 1.40, 95% CI 1.12-1.75); being choice disabled for condom use (OR 1.36, 95% CI 1.08-1.71); and living in rural areas (OR 1.76, 95% CI 1.06-2.90). The level of HIV and AIDS stigma in Tanzania is high with independent associations with several disadvantages: poverty, less education and living in rural areas. Other vulnerable groups, such as survivors of intimate partner violence, are also more likely to have a stigmatising attitude. HIV prevention programmes should take account of stigma, especially among the disadvantaged, and take care not to increase it.     

HIV/AIDS患者并发新型隐球菌脑膜炎的诊疗新进展

随着HAART时代的到来,HIV/AIDS患者中隐球菌病的发病率已经明显下降,但仍然是最常见的机会性感染之一。尤其是由新型隐球菌引起的脑膜炎,在全球仍有着很高的发病率和病死率。本文将就HIV/AIDS患者并发新型隐球菌脑膜炎的病原学、流行病学、发病机理、临床表现及治疗等方面的研究进展进行综述。     

安徽省HIV／AIDS儿童的免疫学及病毒学现况调查

目的全面了解和掌握安徽省感染艾滋病病毒／艾滋病（HIV／AIDS）儿童的免疫学及病毒学状况。方法对2007年安徽省HIV／AIDS儿童进行病史调查,并检测CD4、CD8细胞计数和CD4／CD8比值以及病毒载量。结果安徽省HIV／AIDS儿童的传播途径以母婴传播为主,治疗组和未治疗组儿童病毒载量的对数值存在统计学差异（P〈0．01）,治疗组62．5％的儿童病毒载量低于最低检出限,未治疗组儿童病毒载量均高于最高检出限。母婴传播感染HIV／AIDS儿童的感染时间与CD4细胞计数和病毒载量水平呈反向相关关系（P〈0．05）,CD8细胞计数与CD4细胞计数呈正向回归关系（r=0．553）,病毒载量对数值与CD4细胞计数呈反向回归关系（r=0．273）。结论安徽省HIV／AIDS儿童以母婴传播为主,抗病毒药物能有效抑制HIV的增殖。     

儿童遗传代谢性肝病诊治现状及展望

代谢性肝病是儿童肝损伤的病因之一,因其复杂的临床表现及常规诊断方法的局限,难以早期诊断。检测技术水平的进步为儿童代谢性肝病早期确诊奠定了基础。如能早期确诊,通过适当的饮食或药物治疗,一部分代谢性肝病预后良好。今后应注重儿童代谢性肝病的预防,加强基础与临床的进一步研究,为诊断及治疗提供新的手段和方法。