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自1981年美国首次从男同性恋患者中报道艾滋病(AIDS)以来,相同症状的患者不断被发现,该疾病也以其惊人的速度在世界范围内传播开来。由于丙型肝炎病毒(HCV)与艾滋病病毒(HIV)有相同的传播途径,使HCV在HIV感染者中得到广泛的传播。据报道,全球HCV感染者中大约6%~10%合并HIV感染,HIV感染者中大约有30%合并HCV感染。因此HIV/HCV重叠感染成为AIDS最关注的领域之一。现对HIV/HCV重叠感染者疾病进展及病毒间在人体内相互作用机制的最新研究进展综述如下。 相似文献
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目的 评价国产艾滋病抗病毒药物治疗吸毒成瘾艾滋病病毒感染者/病人(HIV/AIDS)的疗效及对治疗时机的探讨. 方法 采用回顾性研究方法,调查随访2004~2007年在北京佑安医院确诊并经抗病毒治疗的吸毒成瘾HIV/AIDS患者114例,按照疾病进展将随访对象分成艾滋病组( AIDS)和HIV感染组(free of AIDS) ,所有患者均用3种抗病毒药物(奈韦拉平 司他夫定 拉米夫定)治疗,疗程48周.常规方法检测患者治疗前后血CD4 T淋巴细胞数,核酸序列扩增技术(NASBA)测定病毒载量. 结果 114例吸毒成瘾HIV/AIDS患者CD4细胞数平均增加(182.39±90.70)个/mm3;其中35例吸毒成瘾HIV/AIDS患者中85.71%病毒载量下降至50 copies/ml以下, 下降2.5个Log数;艾滋病组与HIV感染组治疗后3、6、9和12个月CD4 T淋巴细胞差异有统计学意义(P<0.05);治疗6个月后,HIV感染组病毒载量下降趋势较艾滋病组明显,但治疗12个月后 HIV感染组病毒载量较艾滋病组有反弹现象. 结论 吸毒成瘾HIV/AIDS患者选用国产艾滋病抗病毒药物奈韦拉平 司他夫定 拉米夫定治疗取得良好效果,并且对艾滋病患者的疗效好于HIV感染者. 相似文献
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艾滋病合并结核病研究进展 总被引:1,自引:0,他引:1
艾滋病(AIDS)合并结核病已经成为公共卫生系统的重大负担,在疾病的诊断和治疗方面都面临巨大挑战。艾滋病病毒(HIV)感染是结核分枝杆菌(MTb)感染和发病的最重要的危险因素,也会使潜伏结核感染发病风险增高20倍。HIV和MTb共同作用加速了机体免疫系统的破坏,病死率高。但是,目前两个病原体相互作用的免疫学机制以及疾病的临床特点,尚不十分清楚。文章着重从两个病原体的相互作用机制和临床特点等方面进行综述,为临床诊断和治疗提供参考。 相似文献
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目的了解经静脉注射吸毒(IDU)感染了的艾滋病病毒(HIV)和艾滋病(AIDS)的病人,对艾滋病和抗病毒治疗的认识程度和态度。方法以深度访谈和焦点座谈会的方式做定性研究。结果对71例因共用针具感染的AIDS病人和感染者研究发现,影响AIDS病人依从性的主要因素有:家庭因素、个人的控制能力、性别;次要因素有药物、经济和服药的不同时期。结论家庭的支持能使IDU的AIDS病人和感染者获得良好依从性,针对主要和次要因素,通过培训和干预能促进依从性并保持良好。 相似文献
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中华医学会热带病与寄生虫学分会艾滋病学组 《传染病信息》2019,32(6):481-489
非结核分枝杆菌(nontuberculous mycobacteria, NTM)感染是艾滋病患者住院和病死率上升的主要原因。HIV合并NTM感染后的诊治与结核病的诊治不尽相同,针对不同细菌,治疗药物的选择不同,病变累及的组织器官不同,疗程也不同。此外,因涉及到抗NTM和抗HIV治疗两个方面,药物的不良反应和依从性以及药物的相互作用均会影响治疗效果。为了进一步规范HIV/AIDS患者合并NTM感染的诊治,中华医学会热带病与寄生虫学分会艾滋病学组基于我国艾滋病合并NTM病的流行及诊治现状,参考既往相关指南,并结合国际指南制订了本专家共识。 相似文献
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Despite substantial attention in the past decade to the co-morbidity of mental health problems among people living with HIV/AIDS
(PLWHA), these problems remain a significant barrier to maintaining health and secondary prevention. To address these issues,
program staff from the Center for Mental Health Research on AIDS at the NIMH convened a meeting on 19th and 20th July 2007
to discuss the intersection of mental health and HIV. The conveners brought together leaders in the fields of mental illness
and HIV to discuss current gaps in the research related to the prevention, diagnosis, and treatment of mental disorders among
PLWHA, and how attention to mental health can affect a variety of health outcomes. Attendees were asked to discuss key questions
that, if addressed through empirical investigation, could move the field toward the aim of reducing or alleviating the burden
of mental illness for those living with HIV disease. The purpose of this brief report is to summarize this meeting’s proceedings,
overview key points of discussion, and outline areas that may be useful to consider for clinical researchers in the field. 相似文献
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Chesney M 《AIDS patient care and STDs》2003,17(4):169-177
The problem of inadequate adherence to prescribed highly active antiretroviral therapy (HAART) drug regimens to treat HIV infection and AIDS is ubiquitous. Adherence can be inadequate despite both provider and patient understanding of the consequences of nonadherence. Successful long-term treatment of HIV/AIDS requires at least 95% adherence to HAART in order to prevent emergence of drug-resistant HIV variants that lead to regimen failure and limit options for future therapy. Despite the prevalence of inadequate adherence, many patients succeed, and HAART has transformed HIV infection into a chronic illness increasingly managed in primary care. The barriers to adherence observed in HIV treatment resemble barriers to the successful treatment of other chronic diseases: regimen complexity, side effects resulting in poor tolerability, patient lifestyle factors, and patient-provider relationships. Treatment of HIV infection has shown that patient-provider collaboration can result in the selection of a lifestyle-tailored regimen characterized by convenient dosing, low pill burden, and tolerable side effects that enhances adherence, effectiveness, and the patient's willingness to remain on anti-HIV therapy long term. This review focuses on the current understanding of adherence reporting, improvement of adherence, and, hence, improvement of treatment outcomes in HIV infection and AIDS. 相似文献
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Uldall KK Palmer NB Whetten K Mellins C;HIV/AIDS Treatment Adherence Health Outcomes Cost Study Group 《AIDS care》2004,16(Z1):S71-S96
Adherence to antiretroviral medications is central to reducing morbidity and mortality among people living with HIV/AIDS. Relatively few studies published to date address HIV adherence among special populations. The purpose of this article is to review the existing literature on HIV antiretroviral adherence, with an emphasis on studies among the triply diagnosed population of people living with HIV/AIDS, mental illness, and chemical dependency. In order to reflect the most current information available, data from conference proceedings, federally funded studies in progress, and the academic literature are presented for consideration. 相似文献
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The heightened risk of persons with serious mental illness (SMI) to contract and transmit human immunodeficiency virus (HIV) is a public health problem. Our objective was test the effectiveness of a community-based advanced practice nurse intervention to promote adherence to HIV and psychiatric treatment regimens call Preventing AIDS Through Health for Positives (PATH+). We enrolled 238 HIV-positive subjects with SMI who were in treatment at community HIV provider agencies from 2004 to 2009. Participants in the intervention group were assigned an advanced practice nurse who provided community-based care management at a minimum of one visit/week and coordinated their medical and mental healthcare for 12 months. A parallel process latent growth curve model using three data points for biomarkers (baseline, 12 and 24 months) and five data points for health related quality of life (baseline, 3, 6, 12, and 24 months) showed moderate to excellent fit for modeling changes in CD4, viral load, and mental and physical SF-12 subscales. Results suggest that positive effects for PATH+ persisted at 24 months; 12 months after the intervention ended. This project demonstrates the effectiveness of a nurse-led, community-based, individually tailored adherence intervention. We demonstrated improved outcomes in individuals with HIV/SMI and regarding health-related quality of life and reductions in disease burden. 相似文献
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M. Claire Greene Jianping Zhang Jianhua Li Mayur Desai Trace Kershaw 《AIDS and behavior》2013,17(5):1775-1784
The burden of HIV/AIDS in China is due to injection drug use. Non-clinical caregivers provide much of the care for HIV patients but are often not included in HIV care or research. The objective of this study is to examine the relationships between the caregiver context and mental health of HIV-positive injection drug users and their caregivers. We interviewed 96 patient–caregiver dyads using quantitative methods. A conceptual model was developed as a framework for multivariate linear regression modeling. The strongest predictor of poor patient mental health was lack of social support, which was largely determined by the caregiver’s stigma towards HIV/AIDS and caregiver burden. Patient disability and caregiver burden were the primary predictors of poor caregiver mental health. The interrelated nature of caregiver and patient mental health supports the inclusion of caregiver health into the patient’s HIV/AIDS treatment to maximize support provision and health for the patient and caregiver. 相似文献
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《African Journal of AIDS Research》2013,12(2):101-122
The relationship between mental illness and HIV/AIDS is complex and bidirectional. A significant amount of research has been performed in high-income countries but less is known about HIV and mental health in sub-Saharan Africa. The objectives of the review were to search the literature for quantitative studies conducted in sub-Saharan Africa on mental health and HIV and to critically evaluate and collate the studies in order to identify research needs and priorities. The databases Ovid, MEDLINE, PsycINFO and the Social Sciences Citation Index (SSCI) were searched for variations of search terms related to HIV/AIDS and mental health and studies limited to the populations of African countries. In addition, we hand-searched indexes of key journals and the databases of academic theses. We included 104 papers or research publications. The majority of these were published after 2005. The major topics covered were: mental-health-related HIV-risk behaviour, HIV in psychiatric populations, and mental illness in HIV-positive populations. The reported prevalence levels of mental illness among people living with HIV or AIDS (PLHIV) was high, with all but one study noting a prevalence of 19% or higher. Neurocognitive changes in adults with HIV were also prevalent, with reported deficits of up to 99% in symptomatic PLHIV and 33% in non-symptomatic PLHIV. Research on HIV in relation to mental health is increasing; however, there is a need for good-quality prospective studies to investigate the bidirectional effects of mental illness and HIV on each other. 相似文献
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Kathleen J. Sikkema Melissa H. Watt Anya S. Drabkin Christina S. Meade Nathan B. Hansen Brian W. Pence 《AIDS and behavior》2010,14(2):252-262
Secondary HIV prevention, or “positive prevention,” is concerned with reducing HIV transmission risk behavior and optimizing
the health and quality of life of people living with HIV/AIDS (PLWHA). The association between mental health and HIV transmission
risk (i.e., sexual risk and poor medication adherence) is well established, although most of this evidence is observational.
Further, a number of efficacious mental health treatments are available for PLWHA yet few positive prevention interventions
integrate mental health treatment. We propose that mental health treatment, including behavioral and pharmacologic interventions,
can lead to reductions in HIV transmission risk behavior and should be a core component of secondary HIV prevention. We present
a conceptual model and recommendations to guide future research on the effect of mental health treatment on HIV transmission
risk behavior among PLWHA. 相似文献
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HIV infection is associated with an increased prevalence of common mental disorders and with the development of HIV associated neurological disorders (HAND). The aim of this research was to determine the reliability of lay adherence counsellors in the administration of the substance abuse and mental illness symptom screener (SAMISS) for common mental disorders and International HIV Dementia Scale (IHDS) for HAND in a South African sample of 269 people living with HIV/AIDS and on HAART in a primary healthcare setting. We used a cross-sectional design with each patient assessed by a mental health nurse and counsellor, 1 week apart. Reliability was fair for the SAMISS overall (κ = 0.39, CI(95) 0.29-0.49, P < 0.01), but was higher for the substance abuse component compared to the mental illness component. Reliability for the IHDS between counsellors and nurses was slight (κ = 0.11, CI(95) 0.00-0.27, P < 0.02). Counsellors tended not to miss symptoms, and detected symptoms more often than nurses for the both the SAMISS and IHDS. Strategies to improve the ability of primary healthcare providers to screen for neurocognitive disorders as well as avoiding over-detection of mental illness and substance abuse symptoms need to be developed and implemented for the primary healthcare setting. 相似文献
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Angelino AF 《Topics in HIV medicine : a publication of the International AIDS Society, USA》2008,16(2):99-103
Mental illness continues to fuel the HIV epidemic. There is a high prevalence of mental disorders in the HIV-infected population and a high prevalence of HIV infection in the mentally ill. Without effective treatment of mental disorders, HIV treatment outcome is poor, and transmission of disease continues. High frequencies of mental illness are found in corrections facilities, among the homeless, among injection drug users, and in patients attending sexually transmitted disease clinics. Such populations must be targeted for effective mental health treatment if overall outcomes of HIV treatment are to be improved and transmission of HIV is to be reduced. This article summarizes a presentation on mental illness and the HIV epidemic made by Andrew F. Angelino, MD, at the 10th Annual Ryan White HIV/AIDS Program Clinical Update in June 2007. 相似文献