PBMCs中miR-21、miR-223表达与HIV/AIDS患者抗逆转录病毒治疗效果的相关性

目的 探讨人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)患者抗逆转录病毒治疗效果与外周血单个核细胞(PBMCs)中微小RNA(miR)-21、miR-223表达水平的关系。方法 选取2020年3月至2022年3月期间南通市第三人民医院门诊就诊行抗逆转录病毒治疗的142例HIV/AIDS患者为观察组,根据其治疗效果分为有效组(n=110)和无效组(n=32);选取同期体检健康者139例为对照组。采用实时荧光定量聚合酶链反应法检测PBMCs中miR-21、miR-223表达水平;采用多因素Logistic回归分析HIV/AIDS患者抗逆转录病毒治疗无效的影响因素。结果 观察组PBMCs中miR-21、miR-223表达水平高于对照组(P<0.05)。无效组治疗后3个月、治疗后6个月、治疗后12个月的PBMCs中miR-21、miR-223表达水平均高于有效组(P<0.05)。有效组随治疗时间延长,PBMCs中miR-21、miR-223表达水平逐渐降低(P<0.05)。无效组治疗前世界卫生组织(WHO)分期3期患者比例高于有效组(P<0.05)。miR...     

高效抗逆转录病毒疗法治疗HIV感染和艾滋病患者的观察

目的观察高效抗逆转录病毒疗法(HAART)治疗HIV感染和艾滋病(AIDS)患者的疗效和副作用。方法8例HIV感染和AIDS患者CD4+T细胞计数基线水平范围为1×106/L~443×106/L,均值231×106/L,HIV鄄1病毒载量为3.66log~>5.70log拷贝/mL。接受茚地那韦(indinavir)加双汰芝(combivir,含齐多夫定和拉米夫定)治疗12个月,每月用流式细胞仪MultiSET绝对计数法检测患者CD4+T细胞水平,bDNA法(检测范围1.70log~5.70logRNA拷贝/mL)检测血浆HIV鄄1病毒载量1次,并对患者进行严密的临床观察。结果治疗后12个月CD4+T细胞计数平均升高267×106/L(P<0.01)。病毒载量于治疗后1~4个月全部降至可测水平(1.70log拷贝/mL)以下,平均下降2.13log拷贝/mL。1例患者有过1次因漏服药物所致的小幅度且短暂的病毒载量反弹,其他患者的病毒载量均维持在可测水平之下或仅在可测的水平。1例晚期艾滋病患者(CD4+T细胞基线水平为1×106/L)的卡氏肺孢子虫肺炎和皮肤真菌感染消失,临床症状明显改善,恢复正常工作。其他患者也见临床好转。药物副作用有:8例患者中有早期胃肠道反应6例,一过性白细胞减少3例,轻度贫血2例,血淀粉酶升高2例,血总胆红素升高4例,血糖升高1例。无药物相关的心、肝、肾功能损害,亦无肾结石和胰腺炎的表现。结论茚地那韦加双汰芝的规     

HIV感染者T淋巴细胞亚群与HIV载量的相关性分析

目的 研究艾滋病病毒(HIV)感染者T淋巴细胞亚群与HIV载量的相关性。方法 选取某院从2022年5月-2023年6月收治的100例HIV感染者为研究对象,记作感染组。另取同期健康志愿者30例为健康组。对比两组各项T淋巴细胞亚群指标水平,并以受试者工作特征曲线(ROC)分析各项T淋巴细胞亚群指标诊断感染者的效能。此外,将感染组按照病毒载量的差异分为A组(<10³ copies/ml)29例、B组(10³-10⁴ copies/ml)22例、C组(10⁴copies/ml<病毒载量<10⁵ copies/ml)25例及D组(>10⁵ copies/ml)24例。对比不同HIV载量患者各项T淋巴细胞亚群指标水平。以Spearman相关性分析明确感染者T淋巴细胞亚群指标水平与HIV载量的关系。结果 感染组CD3⁺T、CD4⁺T、CD4⁺T/CD8⁺T水...     

HIV感染者抗病毒治疗效果的非治疗影响因素分析

目的:考察HIV感染者抗病毒疗效的非治疗影响因素。方法:依据治疗指南对177例HIV感染者进行抗病毒治疗,并进行流行病学调查和治疗随访。在接受抗病毒治疗前后测定患者CD4~+T淋巴细胞计数并采用多元回归模型分析影响疗效的非治疗因素。结果:治疗后患者CD4~+T淋巴细胞计数为(336.9±78.0)个/μL显著高于治疗前的(187.3±65.3)个/μL(P0.01)。经多元回归分析,年龄、BMI指数、感染途径和治疗依从性是影响抗病毒治疗非治疗影响因素的影响因素。结论:增加治疗依从性,改善患者营养水平有助于改善HIV感染者的抗病毒疗效。     

基于知信行模式的HIV/AIDS患者高效抗逆转录病毒治疗服药依从性及影响因素分析

目的 了解大理地区人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)患者高效抗逆转录病毒治疗(HAART)服药依从性相关知识、态度和行为及其影响因素,为提高HAART效果提供依据。方法 采用便利抽样方法,于2021年1月至4月对大理地区528例HIV/AIDS患者进行面对面问卷调查,分析调查结果。结果 服药知识总体知晓率26.1%,其中30～<40岁患者(P<0.01,OR=6.829)是服药知识的危险因素;生活好而不需为生活担忧的患者(P=0.006,OR=0.349)是服药知识的促进因素。服药信念总得分、必要性、顾虑性及必要性顾虑性得分之差分别为(34.26±5.86)、(18.78±3.50)、(15.83±3.29)及(3.29±3.43)分。患者总体服药依从性较高,Logistic回归分析结果显示,相较于≥50岁患者,<30岁患者(B=1.026,P<0.05)的依从性行为最高,其次是30～<40岁(B=0.680,P<0.05),经常饮酒是服药依从性的危险因素。结论 HIV/AIDS患者HAART服药知识和态度不理想,但服药依从性...     

HIV/AIDS患者抗病毒治疗效果评估及基因型耐药分析

目的 对人类免疫缺陷病毒(HIV)携带者和艾滋病(AIDS)患者(简称HIV/AIDS患者)抗病毒治疗效果进行评估并分析其基因型耐药情况.方法 选取2018年6月至2020年6月无锡市第二人民医院收治的81例HIV/AIDS患者作为研究对象.对所有患者进行抗病毒治疗,测定CD4+T淋巴细胞计数与病毒载量,分析抗病毒失败...     

高效抗逆转录病毒治疗对艾滋病患者外周血淋巴细胞亚群的影响

目的:探讨HAART治疗对AIDS患者外周血淋巴细胞亚群的影响。方法:选取我院近期收治的AIDS患者90例,分为A、B、C三组,并分别于治疗前、治疗后3个月,6个月,12个月及24个月进行血浆病毒载量和外周血T淋巴细胞CD4+亚群水平检测,分析外周血淋巴细胞CD4+亚群动态变化情况。结果:治疗前A组患者T淋巴细胞CD4+亚群水平显著高于B组和C组(P0.05);治疗后3个月B组患者T淋巴细胞CD4+亚群水平显著低于C组(P0.05);治疗后6个月B组患者T淋巴细胞CD4+亚群水平显著低于A组和C组(P0.05);治疗后12个月B组患者T淋巴细胞CD4+亚群水平显著低于C组(P0.05);治疗后24个月C组患者T淋巴细胞CD4+亚群水平显著高于A组和B组(P0.05);A组患者治疗前T淋巴细胞CD4+/CD28+亚群水平显著高于B、C组(P0.05);三组患者治疗后3、6、12及24个月T淋巴细胞CD4+/CD28+亚群水平比较差异无统计学意义(P0.05)。结论:HAART治疗有助于恢复AIDS患者T细胞免疫功能,,这与CD4+T淋巴细胞亚群水平动态变化密切相关。     

叫喊疗法结合认知干预疗法对HIV/AIDS患者负面情绪与治疗效果的影响

目的 探讨叫喊疗法结合认知干预疗法对人类免疫缺陷病毒(HI V)/获得性免疫缺陷综合征(AIDS)患者负面情绪与治疗效果的影响.方法 选取2019年1月至10月在湖南省长沙市第一医院就诊的72例HIV/AIDS患者作为研究对象.将患者随机分为观察组(n=36)和对照组(n=36).观察组采用叫喊疗法结合认知干预疗法进行...     

护理干预对艾滋病患者抗逆转录病毒治疗依从性与生活质量的影响

目的在抗逆转录病毒治疗期间加强对艾滋病患者的护理干预,观察其生活质量与依从性。方法选取我院收治的80例HIV抗体阳性患者(2018年1月～2019年1月),按照随机数字表法将其分成观察组与对照组,对照组采用常规模式提供护理服务,观察组在其基础上提供全面护理服务。结果观察组生活质量优良率明显高于对照组,P 0.05;观察组治疗依从性评分明显高于对照组,P 0.05。结论对艾滋病患者实施全面的护理干预,可显著提升其抗逆转录病毒治疗依从性,同时改善其生活质量,具有较高的临床应用价值。     

云南省盈江县924例接受高效抗逆转录病毒治疗HIV／AIDS患者的死亡情况分析

目的通过分析参加高效抗逆转录病毒治疗HIV／AIDS患者的死亡情况,为研究感染者的死亡及提高其生存率提供参考。方法利用SPSS统计软件包对924例HIV／AIDS患者的人口学资料、死亡情况进行分析。结果接受高效抗逆转录病毒治疗的924例HIV／AIDS患者有52例退出,81例死亡。发现近50％（40例）的死亡时间是发生在刚开始治疗的当年内,有36％（29例）的死亡时间是在治疗后的一年内,病死率为9．3％,结论高效抗逆转录病毒治疗方法能够有效地减少HIV／AIDS患者的死亡。     

艾滋病合并马尔尼菲青霉病患者二期预防性治疗影响因素的回顾分析

目的 探讨影响艾滋病合并马尔尼菲青霉病（PSM）患者预防PSM复发的二期预防性治疗时间长短的因素。方法 回顾性分析92例广西壮族自治区疾病预防控制中心/无国界门诊确诊的艾滋病合并PSM成人患者,以停用二期预防性治疗时患者血CD4+ T淋巴细胞计数水平为标准,将病例分两组,Ⅰ组在 CD4+ T细胞≥200 × 106/L后、Ⅱ组在100 × 106/L ~ < 200 × 106/L后停用PSM二期预防性治疗,比较两组的疗程和疗效,并分析患者临床脏器累及、合并症、抗真菌方案、抗病毒治疗时机等不同因素对二期预防性治疗时间的影响。运用SPSS 13.0统计软件包完成数据分析。结果 92例患者都得到高效抗逆转录病毒治疗（HAART）,两组患者在性别、年龄、随访时间上差异均无统计学意义（P值均 ＞ 0.05）,在器官累及、合并症、抗真菌治疗方案的构成以及疗效、抗真菌治疗时间的差异均无统计学意义（P均 ＞ 0.05）,但Ⅱ组患者二期预防性治疗时间［（8.13 ± 5.13）个月］较Ⅰ组［（12.44 ± 9.51）个月］短（P < 0.05）。HAART开始于PSM治疗后、合并其他感染、合并结核感染等因素导致二期预防性治疗时间延长,且三者的影响依次从大到小;而HAART开始于PSM治疗前较开始于PSM后二期预防性治疗时间短（P < 0.05）。结论 艾滋病合并PSM患者HAART后,当CD4+ T淋巴细胞恢复到≥100 × 106/L后3 ~ 6个月可以停用二期预防性治疗;影响二期预防性治疗用药时间的积极因素是抗马尔尼菲青霉治疗前开始HAART,负面因素有HAART开始于抗马尔尼菲青霉治疗后、合并其他感染或合并结核感染等。     

HIV/AIDS皮肤病变的临床分析

目的 探讨HIV/AIDS患者皮肤粘膜病变的临床特征及其与疾病进展的相关性。方法 对45例HIV/AIDS患者的皮肤病变进行临床分析,并同时检测其CD4细胞计数与HIV病毒载量。结果 45例HIV/AIDS患者中有30创(66.7％)伴有皮肤病变,其中以真菌和疱疹病毒感染引起的皮肤病最常见,各占66.7％;其次为脂溢性皮炎,占36.7％;其它类型的皮肤病占50.0％。90.0％的AIDS皮肤病变发生在CD4细胞数<200个/μl,HIV-RNA载量>4 log。而HIV/且AIDS皮肤病变随着HARRT治疗后而缓解。结论 HIV/AIDS皮肤病变发生率很高,早期诊断与治疗对于监测HIV/AIDS患者疾病的进展有重大意义。     

大连市HIV感染者/AIDS病人行为习惯的调查分析

目的:了解大连市HIV感染者/AIDS病人的现状及其行为习惯。方法:对参加大连市艾滋病自愿咨询与检测门诊的HIV感染者/AIDS病人进行问卷调查,进行相关的统计描述与分析。结果:发出问卷200份,有效问卷151份。其中男性136人(90.1%),女性15人(9.9%)。近期(7d以内)调查中92.2%的患者并未存在漏服,但在既往史调查中发现有多半数患者曾经存在漏服。感染后有性生活的为67.4%,58.3%与配偶每次都会使用安全套,与其他性伴使用安全套的频率为87.0%。被调查人群感染后至今有性接触的在不同性别上有统计学意义(χ2=7.06,P0.05),感染后再有性接触者男性多于女性;在不同文化程度上有统计学意义(χ2=4.49,P0.05),感染后再有性接触者学历高中以上者多于初中以下者。认为与配偶发生性行为有必要使用安全套的占77.3%。临时性伴中92.9%的人群并不知晓患者的病情。同性性行为(MSM)人群中,有固定同性性伴的占50.5%;群交行为发生率19.6%。男性性工作者(MB)人群中目前每天的性伴数目,1个以上者占62.5%。有群交行为62.5%。结论:应有计划地在普通人群中进行宣传教育,制定有效的措施,降低社会对艾滋病的恐慌、歧视,减少由艾滋病病毒感染者引发的社会问题。为艾滋病患者提供社会关怀和感情支持,为今后有针对性的开展艾滋病防治工作提供依据。     

Water,electrolytes, and acid-base alterations in human immunodeficiency virus infected patients

The clinical spectrum of human immunodeficiency virus (HIV) infection associated disease has changed significantly over the past decade, mainly due to the wide availability and improvement of combination antiretroviral therapy regiments. Serious complications associated with profound immunodeficiency are nowadays fortunately rare in patients with adequate access to care and treatment. However, HIV infected patients, and particularly those with acquired immune deficiency syndrome, are predisposed to a host of different water, electrolyte, and acid-base disorders (sometimes with opposite characteristics), since they have a modified renal physiology (reduced free water clearance, and relatively increased fractional excretion of calcium and magnesium) and they are also exposed to infectious, inflammatory, endocrinological, oncological variables which promote clinical conditions (such as fever, tachypnea, vomiting, diarrhea, polyuria, and delirium), and may require a variety of medical interventions (antiviral medication, antibiotics, antineoplastic agents), whose combination predispose them to undermine their homeostatic capability. As many of these disturbances may remain clinically silent until reaching an advanced condition, high awareness is advisable, particularly in patients with late diagnosis, concomitant inflammatory conditions and opportunistic diseases. These disorders contribute to both morbidity and mortality in HIV infected patients.     

Cutaneous Manifestations of HIV/AIDS in the Era of Highly Active Antiretroviral Therapy: Evidence from Bangladesh

Objective: Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy (HAART). However, little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh. This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the...     

p16ink4a expression decreases during imiquimod treatment of anal intraepithelial neoplasia in human immunodeficiency virus-infected men and correlates with the decline of lesional high-risk human papillomavirus DNA load

BACKGROUND: Human papillomavirus (HPV)-associated anogenital cancers and their precursor lesions occur in excess in human immunodeficiency virus (HIV)-infected patients despite the initiation of highly active antiretroviral therapy. In this context, a drastically increased relative risk for anal intraepithelial neoplasia (AIN) exists in HIV-infected men having sex with men (MSM). In a pilot study, imiquimod, a topical immune response modifier, has been reported to be beneficial in the treatment of AIN. OBJECTIVES: To investigate the role of several biomarkers as potential adjuncts in the course of imiquimod treatment for AIN, and to determine whether these markers correlate with the course of high-risk HPV DNA load during imiquimod therapy. METHODS: Immunohistochemical staining was performed for p16(ink4a), minichromosome maintenance protein (MCM), Ki67, proliferating cell nuclear antigen (PCNA) and p21(waf1) expression before and after 16 weeks of imiquimod treatment for AIN. High-risk HPV DNA load determinations were performed by real-time polymerase chain reaction with type-specific primers and probes for HPV types 16, 18, 31 and 33. RESULTS: Histopathological and virological analyses were performed in 21 HIV-infected MSM with histologically confirmed AIN. Eighteen (86%) patients had a complete histological clearance of AIN after imiquimod therapy. As previously shown, lesional high-risk HPV DNA load significantly decreased during imiquimod therapy. Moreover, a significant decline of p16(ink4a), Ki67, MCM and PCNA expression after treatment was observed, while p21(waf1) expression changed nonsignificantly after imiquimod therapy. A significant correlation between the course of high-risk HPV DNA load and p16(ink4a) expression was observed during imiquimod treatment of AIN, whereas the decline of high-risk HPV DNA load did not significantly correlate with MCM, Ki67, PCNA or p21(waf1) expression. CONCLUSIONS: The significant decrease in p16(ink4a) expression in correlation with the drop of lesional high-risk HPV load suggests that p16(ink4a) may be a useful adjunct for the evaluation of treatment response in HPV-associated malignancies and their precursor lesions.     

Skin diseases and sexually transmitted diseases in HIV‐infected patients on HAART compared to a non‐infected population – results of a retrospective study

Background: The prevalence of skin diseases and sexually transmitted diseases has always played a special role in studying HIV infections, both because of immunosuppression and simultaneous transmission. In the early years of the HIV epidemic, skin diseases were often a pathognomonic sign in heavily immunosuppressed patients. With highly active antiretroviral therapy (HAART), HIV infection has become a treatable chronic disease. For this reason the spectrum as well as the prevalence of skin diseases has changed. Pathognomonic skin diseases have become rare and the wide spectrum today ranges from infectious to iatrogenic skin diseases. Patients and methods: From April to October 2007 166 HIV‐infected patients and 173 patients of a comparison group were surveyed in retrospect by means of a questionnaire about skin diseases and sexually transmitted diseases that appeared over the entire year 2006. Results and conclusions: The study confirmed the shift to a wide variety of mostly trivial skin diseases and away from severe opportunistic skin diseases. HIV‐infected patients today have more numerous skin problems than the non‐infected population and thus need regular dermatologic control examinations.     

Terbinafine in the treatment of onychomycosis: a review of its efficacy in high-risk populations and in patients with nondermatophyte infections

BACKGROUND: The prevalence of onychomycosis is higher in certain high-risk populations, such as the immunocompromised, diabetics and human immunodeficiency virus (HIV)-positive patients. These patients can also develop onychomycosis due to nondermatophyte fungi. Although the efficacy of terbinafine is well demonstrated in the treatment of conventional dermatophyte nail infection, there are few data on the efficacy of terbinafine in high-risk patient groups or in nondermatophyte fungi, which can be difficult to treat. OBJECTIVES: To review previously published data regarding the safety and efficacy of terbinafine in special patient populations, such as those with diabetes mellitus or HIV infection, those receiving immunosuppressive therapy, and patients with onychomycosis due to nondermatophyte fungi. METHODS: A Medline literature search up to October 2002 was performed in order to identify relevant studies. Pertinent abstracts presented at international meetings were also included. Cure rates (per-protocol and intention-to-treat) were extracted or calculated. All available safety data were also collated. RESULTS: Terbinafine was highly effective and well tolerated in patients with diabetes mellitus. Mycological cure rates of 62-78% were achieved in three studies, which is comparable with the efficacy in nondiabetic populations. Mycological cure rates of 64-91% were achieved in subsets of diabetic patients with Candida-positive nail cultures. The efficacy of terbinafine in patients receiving immunosuppressive therapy was also similar to that reported in immunocompetent patients. Levels of ciclosporin in the blood clearly decreased, with little clinical consequence; however, consideration should be given to the monitoring of ciclosporin levels in patients concomitantly receiving immunosuppressive therapy and terbinafine. Two small studies reported that terbinafine was also effective in treating onychomycosis in HIV-positive patients. Terbinafine was also effective and well tolerated in the treatment of nondermatophyte onychomycosis. CONCLUSIONS: This review suggests that terbinafine is a safe and effective treatment for onychomycosis in high-risk populations. However, the majority of these studies only included small numbers of patients and larger clinical trials are needed, especially in patients with HIV infection.     

银屑病患者血清C3的表达及其与银屑病的相关性

目的:明确银屑病患者血清C3与银屑病发生及代谢紊乱的相关性。方法:收集63例未系统治疗的寻常型银屑病患者(体重正常或偏瘦者30例,超重或肥胖者33例)及健康对照30名,t检验分析体重正常或偏瘦的银屑病患者血清C3与正常对照组间的差异,pearson或spermen相关性分析银屑病患者血清C3与体重指数、PASI评分、血脂、血糖、血压及代谢综合征的之间的相关性。结果:超重或肥胖的银屑病患者,体重正常或偏瘦的银屑病患者及健康对照中血清C3水平分别为1.37±0.21g/L,1.12±0.14 g/L,1.07±0.10 g/L。银屑病患者血清C3水平与体重指数、PASI评分、甘油三脂、及代谢综合征的发生显著正相关(均P0.05),与高密度脂蛋白水平显著负相关(P0.05)。结论:血清C3可能与银屑病的发生及代谢紊乱相关。     

Comparison between an oral hydrolytic enzyme combination and oral acyclovir in the treatment of acute zoster:a double-blind, controlled multicentre trial

Background Today's standard treatment of zoster in immunocompetent patients is oral acyclovir. Other therapies are no longer customary because of their insufficient efficacy and frequent side effects. The positive results obtained with an orally administered enzyme combination led to the assumption that this might represent an alternative therapy. The purpose of our study was therefore to determine whether the enzyme combination differs from acyclovir with regard to efficacy and tolerance. Patients and Methods In a double-blind, controlled multicenter trial immunocompetent patients with zoster were randomly assigned to receive one of the two test drugs for 7 days. Parameters of pain and skin lesions were measured over 14–21 days. Forty-four patients were enrolled in the enzyme group (ET) and 46 in the acyclovir group (AT). Results There were no significant differences with respect to anamnestic and clinical data at entry into the study. Neither were there significant differences regarding the statistically evaluated parameters of efficacy: “segmental pain on day 7” (P= 0.496) and “vesicle duration” (P= 0.803). Paracetamol use and total pain over 14 days also failed to show any notable differences between the two groups. The beginning of crust formation and the duration of skin lesions showed a very similar frequency distribution. Side effects occurred in four patients in the ET group and in three in the AT group. Conclusions Our trial suggests that the therapy of zoster with an orally applied enzyme combination is a valid alternative to the therapy using acyclovir.