简介：摘要目前人免疫缺陷病毒（human immunodeficiency virus，HIV）感染已经成为可防可控的慢性感染性疾病，HIV感染者的健康相关生活质量问题日益凸显。解决艾滋病最常见的心理健康问题，对于实现和维持病毒抑制，结束艾滋病流行也是必需的。本文综述了近年来HIV感染领域中筛查和解决精神心理健康的相关研究进展，为HIV感染人群的精神心理健康的临床应用提供可参考的依据。

简介：摘要 目的：探讨HIV-1核酸定量检测在HIV-1抗体确证试验不确定和阴性样本中的应用，为艾滋病及时诊断提供科学依据。方法：对204例HIV-1抗体确证试验不确定和阴性样本进行核酸定量检测，通过随访分别进行HIV-1抗体确证试验和核酸定量检测并结合流行病学资料确定其感染状况。结果：204例样本中，抗体不确定样本9I例，核酸定量检测≥5000CPs/ml 53例，低于检测线38例。抗体阴性样本II3例，核酸定量检测≥5000CPs/ml 2例，低于检测线111例。核酸定量检测≥5000CPs/ml 55中随访检测38例，抗体阳转38例占I00%，核酸定量检测≥5000CPs/ml 38例占100%，失访17例。核酸定量检测低于检测线的149例中，未见阳转病例，核酸定量检测低于检测线149例。结论：核酸检测作为补充试验的其中之一，在HIV-1抗体不确定和阴性样本中采用核酸定量检测有助于更快、更早对个体艾滋病感染者进行诊断。

简介：AbstractImportance:Bacteremia tuberculosis (TB) is a severe form of extrapulmonary TB. Studies assessing bacteremia TB in children are limited, especially for HIV-negative children.Objective:To explore the detailed clinical features of the bacteremia TB in children under 18 years of age.Methods:We reviewed the clinical records of the patients retrospectively and collected the strains isolated from their blood cultures. We used mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) to characterize the bacterial genotypes and alamarBlue to determine their drug susceptibility profiles. Polymerase chain reactions and DNA sequencing were used to identify drug-resistant mutations.Results:There were 13 pediatric bacteremia TB patients, 10 of whom were diagnosed with Bacillus Calmette–Guérin (BCG) bacteremia TB. Thirteen patients aged from 0.30 to 11.58 years were enrolled, of whom 76.92% were boys. All had fevers before hospitalization, and 76.92% had respiratory symptoms. All had received BCG vaccinations, and 46.15% had adverse post-vaccination reactions. Compared with Mycobacterium tuberculosis, BCG bacteremia was more likely to appear in younger children. Patients with BCG bacteremia had primary immunodeficiency diseases, and lower CD4, IgA, and IgE levels.Interpretation:Bacteremia TB was rapidly fatal in a large proportion of the immunodeficient children. Because classic findings may not be diagnostically specific, a high level of clinical suspicion is required, especially for patients with certain types of immunosuppression. Studies are needed to develop rapid diagnostic tests and to determine the value of empirical therapy in childhood bacteremia TB.

简介：摘要HIV-1储存库的持续存在是治愈HIV的主要障碍，在临床研究中，需要可靠的生物标志物对其进行标记。HIV-1 DNA在HIV-1储存库中可被持续检测到，在HIV-1感染诊断、预测病毒反弹和监测治疗效果等方面具有重要应用价值。PCR的检测技术是临床上常用的HIV-1 DNA检测方法，随着技术的不断创新与进步，可更准确地通过定性或定量检测感染细胞中总的、整合的和未整合的HIV-1 DNA。感染细胞中不同形式的HIV-1 DNA作为生物标志物在HIV感染监测和艾滋病治疗相关研究中报道日益增多。本文对感染细胞中HIV-1 DNA的检测方法及其作为生物标志物的临床应用进展进行综述。

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简介：【摘要】：目的 探讨中药配合艾灸治疗获得性免疫缺陷综合征(HIV/AIDS)的临床疗效。方法 选择本院收治的112例HIV/AIDS患者（2020.09-2022.05），随机分为配合组(56例)和配合组(56例)。非中医组实施一线抗艾滋病治疗方案，配合组在非中医组基础上增加中药配合艾灸治疗，对比两组疗效和免疫指标变化，并监测用药安全性。结果 配合组总有效率（96.43%，54/56）显著高于非中医组（76.79%，43/56）（P

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简介：摘要HIV感染的窗口期是从HIV暴露到可持续量化检出病毒标志物的时期，抗体阳转的窗口期是从HIV暴露到稳定检出HIV抗体的时期。隐匿期(eclipse period)是从HIV暴露到血液中稳定检出病毒核酸的时期。理解窗口期是HIV检测咨询的基础，可以回答暴露后多长时间检测及重复检测、多长时间后检测的阴性结果可以排除HIV感染等关键问题，对于制定暴露后检测策略、选择检测方法和解释检测结果具有直接指导意义。本文介绍了窗口期的定义，强调了准确理解窗口期的要点，分析了影响窗口期的因素，特别是抗病毒药物对病毒标志物应答及检测的影响，提出了依据窗口期长短进行暴露后检测随访的方法和策略，以期为正确应用窗口期的概念指导暴露后检测暨急性期诊断提供参考。

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简介：摘要：目的 本文讨论向HIV感染孕妇开展关爱式健康教育的价值。方法本次实验研究对象全部来自2019年12月-2020年12月来我院接受产检并分娩的HIV感染孕妇，共选择72例孕妇，随机把孕妇分成观察组与对照组，各组36例。观察组采用关爱式健康教育，对照组实施常规健康教育，比较两组成效。结果 观察组掌握疾病情况远远优于对照组（P＜0.05）。同对照组比较，观察组的用药依从性比率更高，新生儿感染HIV比率更低（P＜0.05）。结论 关爱式教育应用于HIV感染孕妇，可以增加孕妇的HIV相关知识，提升治疗依从性。

简介：摘要:目的研究分析人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（ADIS）并结核病20例患者的临床特征。方法：以HIV/ADIS并结核病患者40例为对象，本研究在2019年3月开始，在2020年3月结束。详细统计所有患者一般资料，分析临床特征。结果：HIV相关指标如下所示：CD4+水平是2-591个/uL，平均值是（231.12±12.45）个/uL；CD8+水平是24-837个/uL，平均值是（401.58±12.46）个/uL；CD4+/CD8+水平是0.03-1.99%，平均值是（1.01±0.23）%。实施抗酸染色涂片诊断，阳性检出7例（35.00%）。严重免疫抑制患者5例，中度6例，轻度8例。实施胸片X线诊断，CD4+水平为2-350患者，表现多样，且多见粟粒样渗出、肺中间质性病变、下叶间质性病变；CD4+水平为350-591患者，可见肺上叶阴影，不伴或者伴有空洞。实施组织病理学诊断，严重免疫抑制患者典型结核肉芽肿形成不良，其中2例患者无典型结核肉芽肿形成。结论HIV/ADIS并结核病患者不具有特异性，表现复杂，病情严重，具有较高的致残率、死亡率，多采用抗结核、激素、抗感染等综合治疗，改善生活质量。

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简介：摘要目的分析云南省德宏傣族景颇族自治州（德宏州）HIV感染者抗病毒治疗后HIV-1 DNA载量的动力学变化及影响因素，为HIV-1 DNA定量检测的临床应用提供参考依据。方法研究对象来源于德宏州CDC建立的2009-2018年HIV新发感染队列，构建HIV-1 DNA载量随抗病毒治疗时间动力学变化曲线图。采用logistics回归模型进行抗病毒治疗后最近1次随访的HIV-1 DNA载量值的影响因素分析。采用SPSS 17.0软件进行统计学分析。结果新发队列113例HIV感染者中，HIV新发感染者占49.6%（56/113），男性、性传播和注射吸毒传播分别占53.1%（60/113）、80.5%（91/113）和19.5%（22/113）。抗病毒治疗前，HIV-1 DNA载量值较高（>800 拷贝/106 PBMCs）；抗病毒治疗1年后，HIV-1 DNA载量值迅速下降至<400 拷贝/106 PBMCs；随着抗病毒治疗的持续进行，HIV-1 DNA载量值下降不明显，第6年载量值仍维持在269 拷贝/106 PBMCs。进行HIV-1感染者抗病毒治疗后最近1次随访HIV-1 DNA载量值的影响因素分析，单因素logistics回归分析结果显示，基线CD8、基线CD4/CD8和基线HIV-1 DNA载量值OR值（95%CI）分别为1.00（1.00~1.00）、0.30（0.09~1.05）和1.01（1.00~1.01），多因素logistics回归分析结果显示，基线HIV-1 DNA载量值的OR值（95%CI）为1.00（1.00~1.01）。结论在抗病毒治疗后第1年内，HIV-1 DNA载量值下降显著，随后下降到一定水平之后保持稳定，该水平与HIV-1 DNA载量值基线密切相关，基线越低，HIV-1 DNA载量值水平越低。感染HIV后尽早开始抗病毒治疗，有利于控制HIV-1 DNA载量值。

简介：目前，全球范围内的艾滋病患者越来越多，HIV自我检测成为了艾滋病防治的主要且关键的环节。HIV自我检测能够帮助人们减少高危性行为，遏制性病、艾滋病病毒的传播，帮助更多的人接受艾滋病和HIV的检测基础知识，对国家的相关政策进行了解，帮助HIV感染者乐观面对生活。那么如何发挥HIV自我检测的作用，是艾滋病防治的主要环节。

简介：AbstractObjective: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 era of HAART.Materials:This descriptive cross-sectional study was carried out in Chittagong Medical College Hospital, Bangladesh from January 2017 and December 2020. Diagnosed case of HIV/AIDS for HAART therapy and all cases of HIV/AIDS who are already on HAART therapy were included in this study. Descriptive statistical analysis was carried out by using frequencies and percentages.Results:Of 40 patients with HIV/AIDS, 22 (55.0%) were male and 18 (45.0%) were female. The patients ranged in age from 8 to 60 years, with a mean age of 38 ± 0.966 years. Among all age groups, the highest 19 (47.5%) patients were in the 31- to 40-year age group. Most of the patients were migrant workers [22/40 (55.0%)] with low socioeconomic status [32/40 (80.0%)], and the most common transmission mode was heterosexual activity [36/40 (90.0%)]. Most of the patients [32/40 (80.0%)] had mucocutaneous disorders, 30/40 (75.0%) had infective dermatoses, and 21/40 (52.5%) had non-infective inflammatory dermatoses. Eight of forty (20.0%) patients presented with three or more skin disorders. The most common infective dermatoses were fungal infections [15/40 (37.5%)], followed by viral infections [8/40 (20.0%)], bacterial infections [4/40 (10.0%)], and scabies [3/40 (7.5%)]. The most common non-infective dermatosis was generalized pruritus [6/40 (15.0%)], followed by prurigo simplex [4/40 (10.0%)], psoriasis [4/40 (10.0%)], eczema [3/40 (7.5%)], pruritic papular eruption [1/40 (2.5%)], seborrheic dermatitis [1/40 (2.5%)], urticaria [1/40 (2.5%)], and xerosis [1/40 (2.5%)]. Patients treated with HAART had decreased rates of oral candidiasis and herpes simplex but increased rates of drug reactions [19/40 (47.5%)]. The most common drug eruption following HAART was a morbilliform rash [11/40 (27.5%)], and the most common offending agent was nevirapine. The prevalence of mucocutaneous disorders was higher in patients with a CD4 cell count of <200 cells/mm3.Conclusions:A wide range of mucocutaneous disorders is observed in Bangladeshi patients with HIV/AIDS, and HAART has an impact on the spectrum of HIV/AIDS-associated mucocutaneous disorders. Skin and mucocutaneous disorders are seen at every stage of HIV/AIDS and are the initial presentation in most patients in Bangladesh. There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of patients with HIV/AIDS.

简介：摘要严重急性呼吸综合征冠状病毒2 （severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）感染导致的新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）引发全球大流行。HIV感染者/艾滋病患者是一个特殊人群，由于其免疫系统受损及各种并发症，对SARS-CoV-2的感染风险、疾病严重程度和预后等产生重要影响。本文对HIV-1/SARS-CoV-2合并感染的流行病学特点、临床特征和转归等进行综述。

简介：摘要艾滋病，也称获得性免疫缺陷综合征（acquired immune deficiency syndrome，AIDS），是由人类免疫缺陷病毒（human immunodeficiency virus，HIV）引起的慢性传染病，目前仍位居全球最重要的三大公共卫生问题之首。抗病毒治疗能够有效地抑制病毒复制，达到降低HIV相关的发病率、死亡率的治疗目标。然而，部分患者在标准的抗逆转录病毒治疗后不能实现病毒学抑制（virological suppression，VS），发生低病毒血症（low-level viremia，LLV）。目前国内外一些临床研究发现，该人群发生病毒传播、病毒学失败（virological failure，VF）、免疫活化等的风险增加。LLV作为一个新出现的临床问题逐渐受到关注。本文对LLV的流行病学概况、危险因素、及其危害展开简要陈述，有助于临床医生更全面了解LLV，以期提高LLV患者的预后。

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