AIDS合并巨细胞病毒性视网膜炎13例眼底改变

人免疫缺陷病毒(human immunodeficiency vi-rus,HIV)感染者及获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS)患者中有30%～50%出现眼部并发症,其中最常见、对视功能威胁最大的是晚期HIV感染者中巨细胞病毒引起的视网膜感染[1].作者对郑州市第二人民医院4 a来确诊为HIV感染者或AIDS并发巨细胞病毒(cytomegalo-virus,CMV)感染的13例患者的眼底改变特征进行总结,报道如下.     

艾滋病合并肺孢子菌肺炎与肺结核1例及文献复习

<正>人类免疫缺陷病毒(human immunodeficiency virus,HIV)严重威胁人类健康及公共安全。艾滋病(acquired immunodeficiency syndrome,AIDS)患者免疫力低下,易合并各种机遇性感染疾病,肺结核及肺孢子菌肺炎(pneumocystis carinii pneumonia,PCP)是艾滋病最常见的机会感染和死亡原因,发病率高且病     

艾滋病合并隐球菌脑膜炎患者的护理

<正>艾滋病,即获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS),是人类因为感染人类免疫缺陷病毒(human immunodeficiency virus,HIV)后导致免疫缺陷,并发一系列机会性感染及肿瘤,严重者可导致死亡的综合征。隐球菌性脑膜炎是艾滋病患者中枢神经系统最常见的机会性感染,是由新型隐球菌引起的一种慢性非化脓性脑膜炎[1]。     

辅助受体在HIV感染中的作用

人类免疫缺陷病毒(human immunodeficiency virus,HIV)是引起获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)的病原微生物.1981年发现首例AIDS患者以来,全球已经有4 000万人感染HIV,1 600万人死于AIDS.     

CMV感染对HIV感染者预后影响的研究进展

巨细胞病毒(CMV)与人类免疫缺陷病毒(HIV)的共感染率极高,当伴有活动性CMV感染时,将加速HIV感染者向获得性免疫缺陷综合征(AIDS)的进展。虽抗反转录病毒治疗后,CMV终末器官疾病的发生率大大降低,但是CMV感染仍然是HIV感染者远期非AIDS相关死亡以及导致免疫衰老的一个重要因素。CMV感染对HIV感染者抗反转录病毒治疗后的免疫重建、异常免疫激活、炎症、心脑血管疾病、免疫衰老、HIV储存库的大小均有重要影响,而CMV特异性的T细胞与B细胞免疫在其中发挥重要作用。阐明相关机制并寻求可行的预防性治疗策略,如开发CMV疫苗,将有助于更好地临床管理CMV与HIV共感染患者。     

艾滋病的机会性感染及预防

艾滋病是由人免疫缺陷病毒(human immunodeficiency virus,HIV)引起的慢性传染病,简称获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS)。本病主要经性接触、血液及母婴传播。HIV感染宿主免疫细胞后直接使CD4+T细胞破坏。从初始感染HIV到终末期,往往经历较为漫长的过程,当出现严重的机会性感染或机会性肿瘤阶段即进入AIDS发病期。机会性感染包括了细菌、真菌、病毒、原体等多种病原体,波及全身多个系统。外周血CD4+T淋巴细胞的水平可反应患者机体的细胞免疫状况,CD4+T细胞计数越低,表明机体免疫水平越低,发生机会性感染的可能性越大。当前最有效的预防机会性感染发生的方法仍是高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)。     

艾滋病对个人和家庭经济影响的研究

<正>艾滋病(acquired immunodeficiency syndrome,AIDS),即获得性免疫缺陷综合症,是由人类免疫缺陷病毒(human immunodeficiency viru positive,HIV)感染引起的、以人体免疫系统受损为主要特征的全身性疾病。     

首诊艾滋病合并梅毒性葡萄膜炎1例

人体免疫缺陷病毒(human immunodeficiency virus,HIV)感染能严重损害人体的免疫系统,使机体的免疫能力下降或丧失,引起各种机会性感染等并发症,在HIV感染者中,梅毒所致的眼内感染是最常见的[1].梅毒是一种可以引起全身各系统病变的性传播疾病,各期梅毒患者都可有眼部损害[2].许多梅毒患者是以眼部症状作为首发症状被明确诊断的[3].尽管葡萄膜炎是最常见的并发症,但因在其早期缺乏特征性的眼部体征常导致误诊或漏诊,我们报告以眼部表现首诊的获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)又称艾滋病合并梅毒性葡萄膜炎的患者,旨在为广大临床眼科医生提供更多的临床资料.     

HIV相关眼底病研究进展

随着获得性免疫缺陷综合征（AIDS）患者逐渐增多,跟科医生发现AIDS病程中有75％以上的患者发生眼部病变,造成视力损害,重者失明。有相当一部分人类免疫缺陷病毒（HIV）感染人群在视力未发生改变时,其服底早就发生病变。最常见的是HIV性视网膜病（棉絮斑、微血管瘤、视网膜出血）及巨细胞病毒（CMV）性视网膜炎。     

艾滋病血清学诊断技术

艾滋病是由人类免疫缺陷病毒(Human immunodeficiency virus,HIV)感染人体后引起的一种获得性免疫缺陷综合征(Acquired immunodeficiency syndrome,AIDS)。在HIV感染人体后,HIV所侵犯的细胞可表达HIV抗原。核心抗原p24、包膜糖蛋白抗原gp41、gp120、gp160及酶抗原等可刺激机体产生相应HIV特异性抗体,其中特异性IgG抗体一般在HIV感染1～3个月出现,且终生存在。检出特异性IgG抗体指示体内存在HIV,因此血清学诊断是     

艾滋病患者巨细胞病毒性视网膜炎的临床观察

目的:探讨艾滋病患者巨细胞病毒(CMV)性视网膜炎发病影响因素、临床特点.方法:对艾滋病患者合并巨细胞病毒性视网膜炎7例(13眼)患者进行回顾性临床分析.结果:7例(13眼)患者都有不同程度视力下降,眼底镜检查具有特征性视网膜微血管病变,其中5例CMV IgM阳性,2例定量血CMV PCR检测为阳性,2例定量尿CMV PCR检测为阳性.经过高效抗逆转录病毒治疗、更昔洛韦治疗和免疫调节治疗后视力好转,CD4+T细胞计数大于100个/μ1.结论:CMV性视网膜炎是AIDS严重的机会性感染,是造成视力丧失的主要原因,通过眼科检查早期发现,及时抗巨细胞病毒治疗,有利于控制病情,而高效抗逆转录病毒治疗对CMV性视网膜炎的预后产生重要意义.     

Chronic vaginal candidiasis in women with human immunodeficiency virus infection

Twenty-four percent (7/29) of human immunodeficiency virus-infected women seen at Walter Reed Army Medical Center between 1983 and 1986 presented with a history of chronic refractory vaginal candidiasis. In addition to vaginal candidiasis, all patients were found to have oral thrush on physical examination, severe T-helper cell depletion (mean T-helper cell count of 90), and markedly decreased T4/T8 ratios (mean, 0.3); six of seven women were anergic by delayed-type hypersensitivity skin testing. The conditions of six (86%) of these seven women have progressed to acquired immunodeficiency syndrome (WR6 classification). Chronic refractory vaginal candidiasis may be a presenting symptom of human immunodeficiency virus infection. Women with human immunodeficiency virus infection and unexplained oral and vaginal candidiasis are at high risk to develop other opportunistic infections.     

Antibodies to AIDS-associated retrovirus distinguish between pediatric primary and acquired immunodeficiency diseases

Antibody to acquired immunodeficiency syndrome (AIDS)-associated retroviruses (ARVs) was investigated in 68 pediatric patients with abnormalities of T-cell and/or B-cell immunity. All except seven patients conformed to a specific World Health Organization classification for immunodeficiency disease. These seven patients had polyclonal hypergammaglobulinemia and T-cell immunodeficiency. Six of the seven patients had antibody to ARV and had risk factors associated with AIDS. The one patient without antiviral antibody had no AIDS risk factors. No antibody was detected in 61 patients with other primary immunodeficiency disorders. We conclude that ARV first appeared in our population of immunodeficient pediatric patients prior to 1978, is associated with a distinctive immunologic phenotype consisting of polyclonal hypergammaglobulinemia and T-cell immunodeficiency, and does not appear as an opportunistic infection in other immunodeficiency disorders. Detection of the retrovirus associated with AIDS is of value in identifying infants and children who may have unique medical and social problems that occur with AIDS.     

Risk of developing AIDS in HIV-infected cohorts of hemophilic and homosexual men

The latency period and/or incidence of the acquired immunodeficiency syndrome (AIDS) may differ in persons infected with the human immunodeficiency virus by different routes or having different "cofactors." We compared 79 hemophilic men in Pennsylvania and 117 homosexual and bisexual men in California, all having known dates of infection and long postinfection observation periods, to examine these hypotheses. By 1987, twenty-one percent of the hemophilic and 27% of the homosexual men had developed AIDS. However, seroconversion patterns differed for the two groups, and when this was taken into account, the conditional odds ratio for AIDS was 1.20. Kaplan-Meier survival analysis showed no significant difference in the cumulative proportion with AIDS, from time of infection. These results are limited by the small size and geographically localized nature of our study populations, but they suggest that currently the relative length of human immunodeficiency virus infection is of primary importance in comparing disease outcome for different populations.     

Sexual practices and risk of infection by the human immunodeficiency virus. The San Francisco Men's Health Study

The San Francisco Men's Health Study is a prospective study of the epidemiology and natural history of the acquired immunodeficiency syndrome in a cohort of 1034 single men, 25 to 54 years of age, recruited by multistage probability sampling. At entry, June 1984 through January 1985, the seropositivity rate for human immunodeficiency virus (HIV) infection among homosexual/bisexual study participants was 48.5%. No heterosexual participants were HIV seropositive. Among homosexual/bisexual men reporting no male sexual partners in the two years before entry into the study, seropositivity was 17.6%. For those reporting more than 50 partners, seropositivity was 70.8%. Only receptive anal/genital contact had a significantly elevated risk of HIV infection. Douching was the only ancillary sexual practice that contributed significantly to risk of infection.     

CD4 T-lymphocyte counts and Pneumocystis carinii pneumonia in pediatric HIV infection.

The relationship between CD4 T-lymphocyte counts and infection with the human immunodeficiency virus (HIV) is retrospectively investigated for 266 HIV-infected and uninfected children who were born to infected women, including 39 with Pneumocystis carinii pneumonia (PCP), in a population-based surveillance study. Of 21 perinatally HIV-infected children with PCP only 10 (48%) had CD4 T-lymphocyte counts that were less than 500 x 10(6) cells/L (500 cells/mm3), compared with all 18 who were infected via blood transfusions or clotting factors. Among 68 children who were 1 year or younger, 18 (90%) of 20 PCP cases had CD4 T-lymphocyte counts that were less than 1500 x 10(6) cells/L (1500 cells/mm3) compared with only five (10%) of 48 children who did not have the acquired immunodeficiency syndrome (odds ratio, 77.4; 95% confidence interval, 19.7 to 313.4). The mean CD4 T-lymphocyte count was lower for the 39 PCP cases when compared with the 188 children who were at different stages of HIV infection and did not have the acquired immunodeficiency syndrome (AIDS) independent of age. The majority of perinatally HIV-infected children with PCP were 6 months or younger and 50% were previously unknown to be infected. Thus, HIV-positive children should be identified early and followed closely. CD4 T-lymphocyte counts may be useful in monitoring HIV-positive children and determining when to begin PCP prophylaxis.     

青少年人类免疫缺陷病毒感染的影响因素

获得性免疫缺陷综合征（AIDS）,即艾滋病,是由人类免疫缺陷病毒（HIV）感染引起的一种严重的传染病。目前,HIV感染呈低龄化流行趋势,青少年已成为HIV的易感群体。静脉注射吸毒和性行为是青少年感染HIV的主要途径。吸毒和性行为的发生受多种个人及环境因素的影响。文章就青少年HIV感染现状及影响因素进行综述。     

Acquired immunodeficiency with reversed T4/T8 ratios in infants born to promiscuous and drug-addicted mothers

A new syndrome of acquired immunodeficiency has been identified in seven children who were small for gestational age at birth and subsequently have exhibited failure to thrive, lymphadenopathy, parotitis, hepatosplenomegaly, interstitial pneumonia, and recurrent infections. All have a profound cell-mediated immunodeficiency with reversed T4/T8 ratios. Six are hypergammaglobulinemic and one has low IgG levels. The mothers of five of the seven children are sexually promiscuous and/or drug addicts. Three mothers have an immunodeficiency similar to that found in their infants. One of them died at age 33 years with a diagnosis of acquired immunodeficiency syndrome. In five of the children and in three of their mothers, there is evidence of a persistent Epstein-Barr virus (EBV) infection. We speculate that a perinatal or in utero transmission of EBV can induce an "infectious immunodeficiency." The clinical, histopathologic, and immunologic features resemble those described in adult homosexuals and drug addicts.     

The influence of HIV infection on antibody responses to a two-dose regimen of influenza vaccine

We studied whether a two-dose regimen of inactivated influenza virus vaccine was more effective than a single dose in inducing protective hemagglutination-inhibition antibody responses in patients infected with human immunodeficiency virus (HIV). Participants included subjects with acquired immunodeficiency syndrome, subjects with acquired immunodeficiency syndrome-related complex, and HIV-seropositive individuals with either lymphadenopathy only or no symptoms. Control subjects were HIV-seronegative heterosexuals and HIV-seronegative homosexuals. Two doses of inactivated influenza vaccine containing 15 micrograms of the hemagglutinin of influenza A/Taiwan/1/86(H1N1), A/Leningrad/360/86(H3N2), and B/Ann Arbor/1/86 were administered intramuscularly in the deltoid region 1 month apart. The second dose of vaccine did not significantly increase the frequency or magnitude of antibody responses of either HIV-seropositive or HIV-seronegative subjects over that achieved by a single dose. The two-dose regimen induced a protective level (greater than or equal to 1:64) of hemagglutination-inhibition antibody to influenza A(H1N1) or (H3N2) virus less often in subjects with symptomatic HIV infection than in uninfected control subjects (39% vs 87% or 46% vs 97%, respectively). Our results suggest that a substantial proportion of individuals with symptomatic HIV infection might remain unprotected from influenza, even after immunization with a two-dose regimen.     

青少年人类免疫缺陷病毒感染的影响因素

获得性免疫缺陷综合征(AIDS),即艾滋病,是由人类免疫缺陷病毒(HIV)感染引起的一种严重的传染病.目前,HIV感染呈低龄化流行趋势,青少年已成为HIV的易感群体.静脉注射吸毒和性行为是青少年感染HIV的主要途径.吸毒和性行为的发生受多种个人及环境因素的影响.文章就青少年HIV感染现状及影响因素进行综述.