Acquired immunodeficiency syndrome

获得性免疫缺陷综合征
  • 文章类型: Journal Article
    人类免疫缺陷病毒(HIV)感染在过去的四十年中已经发展成为一种全球性的流行病;然而,尽管在全球范围内进行了大量的研究投资,对HIV相关发病机制至关重要的确切潜在机制仍不清楚.单细胞核糖核酸(RNA)测序方法越来越多地用于鉴定HIV感染中特定细胞类型的转录变化。在这次范围审查中,我们考虑了从14项已发表的HIV相关单细胞RNA测序相关研究中提取的信息,希望阐明艾滋病毒感染和发病机理的潜在机制,并探索HIV疾病进展和抗病毒治疗的潜在候选生物标志物。一般来说,HIV阳性个体倾向于表现出多种细胞类型的频率紊乱,并且特别表现出CD4+T细胞水平降低和CD8+T细胞数量富集。细胞特异性转录变化往往与细胞的放任有关,超急性或急性HIV感染,病毒血症,和细胞生产力。在HIV阳性糖尿病个体中,CD4+T细胞和CD8+T细胞亚群的转录组也观察到变化。自发的HIV控制者,艾滋病毒病毒血症水平高的个体,以及处于HIV感染急性期的患者。在B细胞中看到的转录变化,自然杀伤(NK)细胞,和骨髓树突状细胞(mDCs)的HIV感染的个体证明,抗病毒反应,和免疫反应调节,分别,都是HIV感染后改变的。抗逆转录病毒治疗(ART)在实现免疫重建中起着至关重要的作用,在改善免疫破坏方面,在减轻艾滋病毒感染者的免疫系统失衡方面,而不能完全恢复固有的细胞转录水平在HIV阴性个体。前面的观察不仅说明了对HIV相关免疫发病机制的理解取得了令人信服的进展,而且还确定了特定细胞类型的转录变化,这些变化可能作为HIV疾病监测和治疗靶向的潜在生物标志物。
    Human immunodeficiency virus (HIV) infection has evolved into an established global pandemic over the past four decades; however, despite massive research investment globally, the precise underlying mechanisms which are fundamental to HIV-related pathogenesis remain unclear. Single cell ribonucleic acid (RNA) sequencing methods are increasingly being used for the identification of specific cell-type transcriptional changes in HIV infection. In this scoping review, we have considered information extracted from fourteen published HIV-associated single-cell RNA sequencing-related studies, hoping to throw light on the underlying mechanisms of HIV infection and pathogenesis, and to explore potential candidate biomarkers for HIV disease progression and antiviral treatment. Generally, HIV positive individuals tend to manifest disturbances of frequency of multiple cellular types, and specifically exhibit diminished levels of CD4+ T-cells and enriched numbers of CD8+ T-cells. Cell-specific transcriptional changes tend to be linked to cell permissiveness, hyperacute or acute HIV infection, viremia, and cell productivity. The transcriptomes of CD4+ T-cell and CD8+ T-cell subpopulations are also observed to change in HIV-positive diabetic individuals, spontaneous HIV controllers, individuals with high levels of HIV viremia, and those in an acute phase of HIV infection. The transcriptional changes seen in B cells, natural killer (NK) cells, and myeloid dendritic cells (mDCs) of HIV-infected individuals demonstrate that the humoral immune response, antiviral response, and immune response regulation, respectively, are all altered following HIV infection. Antiretroviral therapy (ART) plays a crucial role in achieving immune reconstitution, in improving immunological disruption, and in mitigating immune system imbalances in HIV-infected individuals, while not fully restoring inherent cellular transcription to levels seen in HIV-negative individuals. The preceding observations not only illustrate compelling advances in the understanding of HIV-associated immunopathogenesis, but also identify specific cell-type transcriptional changes that may serve as potential biomarkers for HIV disease monitoring and therapeutic targeting.
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  • 文章类型: Systematic Review
    背景:自我伤害和自杀的患病率高于艾滋病毒/艾滋病感染者(PLWHA)的普通人群。然而,现有研究报告的结果在中国差异很大。本系统评价和荟萃分析的目的是综合现有的高质量证据,以探讨中国PLWHA人群中自我伤害和自杀的患病率和影响因素。
    方法:我们通过PubMed、Embase,WebofScience,科克伦图书馆,SinoMed,CNKI,万方数据库,和CQVIP从成立到2022年9月1日。采用Sata16.0软件进行分析。
    结果:共纳入28项研究,样本量为1,433,971,质量评分令人满意,≥5。中国PLWHA的自杀意念(SI)患病率为30%,5%的自杀未遂(SA),8%为自杀计划(SP),7%为自杀未遂(AS),完成自杀为3‰。高柱头(OR=2.94,95CI:1.90-4.57),抑郁症(或,3.17;95CI,2.20-4.57),焦虑(或,3.06;95CI,2.23-4.20),低自尊(或,3.82、95CI、2.22-6.57),高艾滋病毒相关压力(OR,2.53;95CI,1.36-4.72),和失业(OR,2.50;95CI,1.51-4.15)是SI的危险因素;高社会支持(OR,0.61;95CI,0.44-0.84)和配偶感染艾滋病毒(OR,0.39;95CI,0.21-0.74)是SI的保护因素;抑郁(OR,1.62;95CI,1.24-2.13),高侵略性(或,4.66;95CI,2.59-8.39),和更多的负面生活事件(或,2.51;95CI,1.47-4.29)是AS的危险因素;教育水平高(OR,1.31;95CI,1.21-1.43)是CS的危险因素。
    结论:数字表明,大约三分之一的PLWHA有自杀意念,在中国,千分之三的人完成了自杀。阳性事件是PLWHA患者自我伤害和自杀的保护因素,而负面事件是危险因素。这表明应将社会心理支持和风险评估纳入PLWHA的护理中。
    BACKGROUND: The prevalence of self-injury and suicide is higher than the general population of people living with HIV/AIDS (PLWHA). However, the results reported in existing studies are highly variable in China. The purpose of this systematic review and meta-analysis was to synthesize the currently available high-quality evidence to explore the prevalence and influence factors of self-injury and suicide among PLWHA in China.
    METHODS: We retrieve literature written in Chinese and English through databases such as PubMed, Embase, Web of Science, Cochrane Library, SinoMed, CNKI, WanFang Database, and CQVIP from inception to 1 September 2022. Sata 16.0 software was used for analysis.
    RESULTS: A total of 28 studies were included with a sample size of 1,433,971 and had a satisfactory quality score of ≥ 5. The prevalence among PLWHA in China were 30% for suicidal ideation (SI), 5% for suicide attempt (SA), 8% for suicide plan (SP), 7% for attempted suicide (AS), and 3‰ for completed suicide. High stigma (OR = 2.94, 95%CI: 1.90 - 4.57), depression (OR, 3.17; 95%CI, 2.20 - 4.57), anxiety (OR, 3.06; 95%CI, 2.23 - 4.20), low self-esteem (OR, 3.82, 95%CI, 2.22 - 6.57), high HIV related stress (OR, 2.53; 95%CI, 1.36 - 4.72), and unemployment (OR, 2.50; 95%CI, 1.51 - 4.15) are risk factors for SI; high social support (OR, 0.61; 95%CI, 0.44 - 0.84) and spouse infected with HIV (OR, 0.39; 95%CI, 0.21 - 0.74) are protective factors for SI; depression (OR, 1.62; 95%CI, 1.24 - 2.13), high aggression (OR, 4.66; 95%CI, 2.59 - 8.39), and more negative life events (OR, 2.51; 95%CI, 1.47 - 4.29) are risk factors for AS; high level of education (OR, 1.31; 95%CI, 1.21 - 1.43) is risk factor for CS.
    CONCLUSIONS: Figures indicate that approximately one-third of PLWHA had suicidal ideation, and three out of 1,000 completed suicide in China. Positive events are protective factors for self-injury and suicide among PLWHA, while negative events are risk factors. This suggests that psychosocial support and risk assessment should be integrated into the care of PLWHA.
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  • 文章类型: Journal Article
    A progresszív multifokális leukoencephalopathiát a John Cunningham-vírus reaktiválódása okozza, amely szinte kizárólag immunhiányos betegeknél fordul elő. A betegség tüneteit elsősorban a demyelinisatiós gócok lokalizációja határozza meg; a betegség a kezdeti szakaszban tünetszegény lehet, és a neurológiai tünetek csak később jelennek meg. Diagnosztikájában elsősorban a képalkotó vizsgálatok és a vírus-DNS liquorból történő kimutatása játszik fontos szerepet. Specifikus terápiája nem ismert, a cél az immunrendszer működésének helyreállítása. Kazuisztikánkban egy pszichiátriai osztályon észlelt páciens kórtörténetét ismertetjük, akinek esetében AIDS-hez köthető jobb féltekei progresszív multifokális leukoencephalopathia képe igazolódott. Korai differenciáldiagnosztikai nehézséget jelentettek a páciensnél észlelhető patológiás személyiségjegyek, illetve az élethelyzeti nehézségek és a párkapcsolati veszteség talaján kialakult krízisállapot. Esetünkkel szeretnénk felhívni a figyelmet az immunhiányos betegeknél jelentkező pszichiátriai tünetek fontosságára. Orv Hetil. 2024; 165(33): 1295–1302.
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  • 文章类型: Journal Article
    艾滋病毒感染是一种世界性流行病。抗逆转录病毒疗法可以使艾滋病毒感染者(PLHIV)寿命延长,生活质量更好。在监测PLHIV临床演变的各种方法中,握力(HGS)是一种有前途的策略,因为该测试可用于以低成本快速评估健康状况。在这个意义上,本研究旨在描述,通过文献综述,HGS与PLHIV临床进化之间的关系,尤其是病态。最初,它强调了衰老,HIV感染,和过量的身体脂肪与PLHIV中HGS的损失有关。此外,PLHIV更有可能出现心脏代谢疾病,这些疾病可以通过降低HGS而加重。因此,在没有艾滋病毒血清学阳性的人中,间接低HGS,通过存在危险因素或心脏代谢疾病,或直接增加死亡的机会。总之,强调缺乏对PLHIV的研究,和更多的纵向研究,包括对照组,是需要的。
    HIV infection is a worldwide epidemic. Antiretroviral therapy allows people living with HIV (PLHIV) increased longevity and a better quality of life. Among the various ways of monitoring the clinical evolution of PLHIV, handgrip strength (HGS) is a promising strategy, as this test can be used to assess the health condition quickly and at a low cost. In this sense, the present study aims to describe, through a literature review, the relationship between HGS and the clinical evolution of PLHIV, especially with morbimortality. Initially, it is highlighted that aging, HIV infection, and excess body fat are related to the loss of HGS in PLHIV. Furthermore, PLHIV is more likely to present cardiometabolic diseases that can be aggravated by reduced HGS. Thus, in people without positive HIV serology, low HGS indirectly, through the presence of risk factors or cardiometabolic diseases, or directly increases the chance of mortality. In conclusion, the lack of studies on this topic for PLHIV is highlighted, and more longitudinal studies, including control groups, are needed.
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  • 文章类型: Journal Article
    目的:关于女性抗逆转录病毒治疗(ART)后治疗相关不良事件(AE)发生率的信息有限。所以,本综述旨在描述感染HIV/AIDS的女性ART不良事件的发生率.
    方法:系统评价和荟萃分析。
    方法:Medline,Embase,科克伦图书馆,认识论,丁香花和谁索引,从成立到2023年4月9日。
    方法:我们纳入了至少12周随访的随机对照试验,并评估了任何年龄感染艾滋病毒/艾滋病的女性的ART不良事件。没有地位限制,年份或出版语言。我们排除了事后或二次分析以及没有比较器的开放标签扩展,以及涉及孕妇或哺乳期妇女或重点关注结核病合并感染的试验,乙肝或丙肝的主要结局是任何临床和/或实验室AE相关或不相关的参与者的发病率ART和治疗中断.
    方法:两名独立的审阅者提取数据并使用Cochrane的偏倚风险工具2评估偏倚风险。我们使用贝叶斯随机效应荟萃分析来总结事件发生率。结果表示为每1000人年的事件发生率(95%可信度间隔,95%CrI)。估计了每1000人年的合并发病率,并根据持续时间和随访损失进行了调整。我们使用建议分级评估证据的确定性,评估,发展和评价。
    结果:共有24339项研究被确定用于筛查,其中10项研究(2871名女性)符合资格标准,11种不同的抗逆转录病毒药物(ARV)方案。七项研究仅包括女性,而在剩下的三个中,女性比例从11%到46%不等。九项研究获得了行业资助。汇总分析显示,ART相关临床和实验室不良事件的平均发生率为每1000人年341.60例(95%CrI133.60-862.70),治疗终止事件为20.78/1000人年(95%CrI5.58-57.31),ART相关终止事件为4.31/1000人年(95%CrI0.13-54.72).由于研究数量有限和数据稀疏,汇总估计存在很大的不确定性。对于所有评估的结果,证据的确定性被评为非常低。
    结论:现有的随机试验没有提供足够的证据证明抗逆转录病毒治疗在HIV/AIDS女性患者中的安全性结局发生率。需要在特征明确的人群中进行大量比较研究,以更全面地了解这些抗逆转录病毒疗法在艾滋病毒/艾滋病女性中的安全性。
    CRD42021251051。
    OBJECTIVE: There is limited information regarding the incidence of treatment-related adverse events (AE) following antiretroviral therapy (ART) in women. So, this review aimed to describe the incidence of AE of ART in women living with HIV/AIDS.
    METHODS: Systematic review and meta-analysis.
    METHODS: Medline, Embase, Cochrane Library, Epistemonikos, Lilacs and Who Index, from inception to 9 April 2023.
    METHODS: We included randomised controlled trials with at least 12 weeks of follow-up and evaluated AE of ART in women at any age living with HIV/AIDS, without restrictions on status, year or language of publication. We excluded post hoc or secondary analyses and open-label extensions without comparator, and trials involving pregnant or breastfeeding women or with a focus on coinfection with tuberculosis, hepatitis B or C. The primary outcomes were the incidence rate of participants with any clinical and/or laboratory AE related or not to ART and treatment discontinuation.
    METHODS: Two independent reviewers extracted data and assessed the risk of bias using Cochrane\'s risk of bias tool 2. We used Bayesian random-effects meta-analysis to summarise event rates. Results were presented as event rates per 1000 person-years (95% credibility intervals, 95% CrI). The pooled incidence rate per 1000 person-years adjusted for duration and loss to follow-up was estimated. We assessed the certainty of the evidence using Grading of Recommendations, Assessment, Development and Evaluation.
    RESULTS: A total of 24 339 studies were identified for screening, of which 10 studies (2871 women) met the eligibility criteria, with 11 different antiretrovirals (ARVs) regimens. Seven studies included exclusively women, while in the remaining three, the proportion of women ranged from 11% to 46%. Nine studies received industry funding. The pooled analysis showed a mean incidence rate of ART-related clinical and laboratory AE of 341.60 events per 1000 person-years (95% CrI 133.60-862.70), treatment discontinuation of 20.78 events per 1000 person-years (95% CrI 5.58-57.31) and ART-related discontinuation of 4.31 per 1000 person-years (95% CrI 0.13-54.72). Summary estimates were subject to significant uncertainty due to the limited number of studies and sparse data. The certainty of the evidence was graded as very low for all outcomes assessed.
    CONCLUSIONS: Existing randomised trials do not provide sufficient evidence on the incidence rates of safety outcomes from antiretroviral treatment in women living with HIV/AIDS. Large comparative studies in well-characterised populations are needed to provide a more comprehensive landscape of the safety profile of these ARV therapies in women with HIV/AIDS.
    UNASSIGNED: CRD42021251051.
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  • 文章类型: Journal Article
    背景:人类免疫病毒或获得性免疫缺陷综合征,是对全球数百万人健康的重大威胁。在埃塞俄比亚,有超过一百万人感染艾滋病毒/艾滋病。持续和适当使用避孕套,特别是那些有艾滋病毒阳性客户的人,对于采取全面和长期的方法来避免艾滋病毒和其他性传播感染以及意外怀孕至关重要。但经常报告不规律使用避孕套。关于埃塞俄比亚经常使用避孕套的流行率和相关性的报告不一致。本研究的目的是概述埃塞俄比亚艾滋病毒感染者使用安全套的最新研究。
    方法:PubMed的四个数据库,科学直接,Scopus,和谷歌学者被使用。最后,系统评价和荟萃分析包括10项符合资格标准的研究。数据是使用有条理的检查表进行数据提取收集的,STATA14用于分析。据报道,在研究之前的每次性接触中都使用了避孕套。通过将经常使用避孕套的患者总数除以HIV/AIDS患者总数并将结果乘以100来计算HIV/AIDS患者中一致使用避孕套的患病率。使用合并比值比(OR)描述与一致使用避孕套相关的因素,并根据纳入的主要研究的二元结果进行计算。基于相关因子确定统计显著性,因为它们的置信水平不应包括1。通过使用随机效应模型进行按地区和出版年份的亚组分析。多震级信号的STATA命令,使用随机xlab(.1,5,10)lcols(作者)by(变量)文本(120)xsize(18)ysize(14)进行亚组分析.为了评估发表偏见的存在,漏斗图,计算了5%显著水平的Egger检验和Begg检验。漏斗图的不对称性和Egger检验和Begg检验P值0>0.5表明不存在发表偏倚。CochraneQ检验统计量和I2检验用于评估异质性。
    结果:一致使用安全套的合并幅度为50.56%(95CI:38.09-63.02)。持续使用避孕套的预测因素包括城市居住(AOR=3.46;95%CI:2.24-5.35),婚姻状况(AOR=0.33;95%CI:0.18-0.61),和艾滋病毒披露状态(AOR=5.61;95CI:2.29-13.73)。
    结论:我们研究中一半的HIV/AIDS患者经常使用避孕套。根据这项研究,城市居住权,披露状态,和婚姻状况均与HIV/AIDS患者一致使用安全套相关.因此,应向已婚夫妇和农村地区的人们提供有关安全套使用的健康教育。此外,披露艾滋病毒感染状况和持续使用避孕套的必要性对于持续使用避孕套至关重要。
    BACKGROUND: The human immune virus or acquired immune deficiency syndrome, is a major threat to the health of millions of people worldwide. In Ethiopia, there were more than a million people living with HIV/AIDS. The continuous and appropriate use of condoms, particularly among those who have HIV-positive clients, is essential to a comprehensive and long-term approach to avoiding HIV and other STIs as well as unintended pregnancy. But irregular condom use is regularly reported. There is inconsistent reports of the prevalence and correlates of frequent condom use in Ethiopia. This study\'s goal is to provide an overview of the most recent research on magnitude condom use among people living with HIV in Ethiopia.
    METHODS: Four databases of PubMed, Science Direct, Scopus, and Google Scholar were used. Finally, 10 studies that satisfied the eligibility criteria were included in the systematic review and meta-analysis. The data were collected using a methodical checklist for data extraction, and STATA 14 was utilized for the analysis. The consistent condom use was reported as use of condom in every sexual encounter preceding the study. The prevalence of consistent condom usage among HIV/AIDS patients was calculated by dividing the total number of patients who regularly used condoms by the total number of HIV/AIDS patients and multiplying that result by 100. The factors associated with a consistent use of condom were described using the pooled odds ratio (OR) and calculated based on binary outcomes from the included primary studies. The statistical significance was determined based on the correlation factor as their confidence level should not include 1. Subgroup analyses by region and publication years were carried out by using a random-effects model. The STATA commands of metan magnitude semagnitude, random xlab(.1,5,10) lcols (authors) by (variables)texts(120) xsize(18) ysize (14) were used to carried out the subgroup analysis. To assess the presence of publication bias, funnel plot, Egger test and Begg\'s test at 5% significant level were computed. The asymmetry of funnel plot and the Egger test and Begg\'s test P value of 0 >0.5 showed the absence of publication bias. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity.
    RESULTS: The pooled magnitude of consistent condom use was 50.56% (95%CI: 38.09-63.02). The predictors of consistent condom use includes urban residence (AOR = 3.46; 95% CI: 2.24-5.35), marital status (AOR = 0.33; 95% CI: 0.18-0.61), and HIV disclosure status (AOR = 5.61;95%CI: 2.29-13.73).
    CONCLUSIONS: Half of the HIV/AIDS patients in our study regularly used condoms. According to this study, urban residency, disclosure status, and marital status were all associated with consistent condom use among HIV/AIDS patients. Therefore, health education about condom use should be provided to married couples and people living in rural regions. In addition, disclosing HIV status and the necessity of constant condom usage would be crucial for consistent condom use.
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  • 文章类型: Journal Article
    增强术后恢复(ERAS),这是基于循证医学,专注于患者,旨在减少患者的心理和生理创伤应激反应和并发症,从而缩短了住院时间,促进快速康复和减少医疗费用,再入院率和死亡率。获得性免疫缺陷综合征(AIDS)是由人类免疫缺陷病毒(HIV)感染引起的。艾滋病毒/艾滋病患者,与其他患者人群一样,可能患有几种手术相关疾病。因此,这类患者存在手术需求,艾滋病患者所需的手术服务逐渐成为一个迫切关注的问题。根据相关文献和作者的临床经验,本综述总结了目前基于ERAS的HIV感染患者的手术方法.在本次审查中,在手术的不同阶段观察到的相关问题,包括术前,术中,术后和随访阶段,正在讨论。
    Enhanced recovery after surgery (ERAS), which is based on evidence-based medicine, focuses on patients and aims to reduce the psychological and physiological trauma stress reactions and complications of patients, thus shortening the duration of hospitalization, promoting rapid recovery and reducing medical expenses, readmission rate and mortality rates. Acquired immunodeficiency syndrome (AIDS) is caused by human immunodeficiency virus (HIV) infection. Patients with HIV/AIDS, as with other patient populations, can suffer from several surgical-related diseases. Therefore, the need for surgery in this group of patients exists and the surgical services required by patients with AIDS has gradually become an urgent matter of concern. According to relevant literature and the authors\' clinical experience, the present review summarizes the current surgical approaches for patients infected with HIV based on ERAS. In the present review, the related issues observed at different stages of surgery, including pre-operative, intra-operative, post-operative and follow-up stages, are discussed.
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  • 文章类型: Journal Article
    智利是拉丁美洲和全球新的人类免疫缺陷病毒(HIV)病例发生率最高的国家,尽管在治疗方面正在进行大量投资。这项全面的研究,源自PUBMED和Google搜索,ANID数据,和各种组织报告,突出了需要改进的关键领域。在过去的十年里,智利的年感染率已经上升,这表明迫切需要详细分析和有效的解决方案。该研究包括44个参考文献,由世界卫生组织和泛美卫生组织等实体的32篇科学文章和12份报告组成。通过各种手段精心收集数据,比如科学大会,与当局会面,和直接数据请求。确定了解决智利艾滋病毒流行的十四个关键点,从立法改革到加强预防运动。主要建议包括普遍诊断,分散的医疗保健,自我测试的可用性,关注心理健康和移民的影响。尽管智利的经济指标强劲,性教育不足等因素,过时的立法,和集中的诊断过程有助于新病例的持续增加。该研究强调迫切需要增加对预防政策的投资。智利在实现90/90/90目标方面面临重大挑战,然而,到2030年实现95/95/95战略是乐观的。实现成功需要全球承诺,强调预防,以及当局之间的合作,医疗保健提供者,和病人。克服这些已确定的障碍对于智利实现其雄心勃勃的目标并最终结束艾滋病毒流行至关重要。
    Chile is contending with the highest rates of new human immunodeficiency virus (HIV) cases in both Latin America and globally, despite substantial ongoing investments in treatment. This comprehensive study, derived from PUBMED and Google searches, ANID data, and various organizational reports, highlights key areas for improvement. Over the past decade, Chile\'s annual infection rate has risen, signaling an urgent need for detailed analysis and effective solutions. The study includes 44 references, comprising 32 scientific articles and 12 reports from entities like the WHO and the Pan American Health Organization. Data was meticulously collected through diverse means, such as scientific congresses, meetings with authorities, and direct data requests. Fourteen critical points are identified for addressing the HIV epidemic in Chile, spanning from legislative reforms to enhanced prevention campaigns. Key recommendations include universal diagnosis, decentralized healthcare, the availability of self-tests, and a focus on mental health and the impact of migration. Despite Chile\'s strong economic indicators, factors such as inadequate sexual education, outdated legislation, and centralized diagnostic processes contribute to the persistent increase in new cases. The study underscores the pressing need for enhanced investment in prevention policies. Chile faces significant challenges in meeting the 90/90/90 targets, yet there is optimism in aiming for the 95/95/95 strategy by 2030. Achieving success requires a global commitment, an emphasis on prevention, and collaborative efforts among authorities, healthcare providers, and patients. Overcoming these identified barriers is essential for Chile to reach its ambitious goal and ultimately end the HIV epidemic.
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  • 文章类型: Journal Article
    背景:艾滋病毒携带者(PLWH)很容易受到社会孤立的污名和歧视,这不仅降低了抗逆转录病毒治疗的依从性,而且增加了再次入院的风险,抑郁症,和死亡率。然而,目前尚无针对HIV感染者中社会隔离的发生和影响的系统评价.因此,本研究对现有文献进行了全面的系统回顾和荟萃分析,以研究PLWH中与社会隔离相关的患病率和影响因素.
    方法:PubMed,EMBASE,CINAHL,科克伦图书馆,WebofScience,谷歌学者,中国科技期刊数据库,中国国家知识基础设施,万方数据和中国生物医学文献数据库将从数据库建立到最新的检索日期进行检索。文学筛选,数据提取和文献质量评估将由两名研究人员独立完成,结果将进行交叉引用。数据分析将使用stata15.1软件进行。发表偏倚的风险将使用Begg和Egger的方法进行评估。然后将使用I2指数及其95%CI和Q统计数据评估研究之间的异质性。异质性的来源将通过亚组和敏感性分析来解释。
    结果:该结果可能揭示了PLWH中社会隔离的患病率,并为了解其病因和预防提供数据支持。
    结论:通过系统回顾有关PLWH中社会隔离的现有文献,这项研究旨在全面了解该人群中社会孤立的患病率,阐明它对受艾滋病毒影响的人造成的有害影响,并有效告知高危人群有针对性的干预措施。此外,这些发现为支持公共卫生政策中的循证决策提供了有价值的见解.
    背景:PROSPERO注册号:CRD42024499044。
    BACKGROUND: People living with HIV (PLWH) are susceptible to social isolation as a result of stigma and discrimination, which not only diminishes adherence to antiretroviral therapy but also heightens the risks of hospital readmission, depression, and mortality. However, there is currently no systematic review addressing the occurrence and impact of social isolation in individuals with HIV. Therefore, this study undertook a comprehensive systematic review and meta-analysis of existing literature to examine the prevalence and influencing factors associated with social isolation among PLWH.
    METHODS: PubMed, EMBASE, CINAHL, Cochrane Library, Web of Science, Google Scholar, China Science and Technology Journal Database, The China National Knowledge Infrastructure, WanFang Data and Chinese Biomedicine Literature Database will be searched from the establishment of the database to the latest search date. Literature screening, data extraction and literature quality assessment will be done independently by two researchers and results will be cross-referenced. Data analysis will be performed using stata15.1 software. Risk of publication bias will be assessed using Begg\'s and Egger\'s methods. Heterogeneity between studies will then be assessed using the I2 index and its 95% CI and Q statistics. Sources of heterogeneity will be accounted for by subgroup and sensitivity analyses.
    RESULTS: The results may reveal the prevalence of social isolation among PLWH and provide data support for understanding its etiology and prevention.
    CONCLUSIONS: By systematically reviewing the existing literature on social isolation among PLWH, this study aims to provide a comprehensive understanding of the prevalence of social isolation within this population, elucidate the detrimental effects it poses for people affected by HIV, and effectively inform targeted interventions for high-risk groups. Furthermore, these findings offer valuable insights to support evidence-based decision-making in public health policy.
    BACKGROUND: PROSPERO registration number: CRD42024499044.
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  • 文章类型: Journal Article
    高质量的睡眠是由其最小化干扰的能力来定义的,提供足够的持续时间,并在睡眠阶段保持平衡。睡眠障碍是艾滋病毒/艾滋病患者的常见主诉。尽管睡眠障碍对治疗依从性有影响,生活质量,工作效率,慢性病的风险。研究报告了撒哈拉以南非洲国家(SSA)的艾滋病毒/艾滋病患者的睡眠障碍,在国家一级产生不同的结果。因此,进行系统的回顾和荟萃分析是必不可少的。本系统评价和荟萃分析旨在评估撒哈拉以南非洲国家艾滋病毒/艾滋病患者睡眠质量差的患病率,并确定相关因素。我们系统地搜索了各种数据库,包括PubMed,非洲在线期刊,Scopus,科克伦图书馆,Hinari,科学直接。此外,我们使用Google和GoogleScholar搜索引擎进行搜索。MicrosoftExcel用于数据提取,并使用STAT17.0版分析数据。我们使用Cochran的Q检验和I2检验评估异质性,并使用漏斗图对称性和Egger检验检查小的研究效果。使用随机效应模型以95%置信区间(CI)和P<0.05的显著性水平估计合并的患病率和相关因素。确定与艾滋病毒/艾滋病感染者睡眠质量差相关的因素,计算比值比(OR)及其相应的95%CI.该分析结合了来自15项独立研究的数据,涉及5176名参与者的总样本量。SSA国家HIV/AIDS患者睡眠质量差的总患病率为49.32%(95%CI41.32-56.8%)。与睡眠质量差显著相关的因素包括抑郁(OR2.78;95%CI1.21-6.40)和CD4计数<200个细胞/mm3(AOR3.15;95%CI2.41-4.15)。在这项研究中,SSA中HIV/AIDS患者睡眠质量差的患病率较高,并且各国之间存在差异。从21.7%到73.7%不等。研究结果强调了迫切需要制定旨在改善睡眠质量的计划,特别是在解决诸如参与者收入和抑郁等与艾滋病毒/艾滋病患者睡眠质量差相关的因素方面。系统审查注册:PROSPEROCRD42024517229。
    Good-quality sleep is defined by its ability to minimize disturbances, provide adequate duration, and maintain a balanced progression through sleep stages. Sleep disturbance is a common complaint in people living with HIV/AIDS. Despite the influence of sleep disturbance on treatment adherence, quality of life, work productivity, risk of chronic illness. Studies have reported sleep disturbances among HIV/AIDS patients in sub-Saharan African countries (SSA), yielding varied results at the country level. Therefore, conducting a systematic review and meta-analysis is essential. This systematic review and meta-analysis aimed to evaluate the prevalence of poor sleep quality and identify associated factors among HIV/AIDS patients in sub-Saharan African countries. We systematically searched across various databases, including PubMed, African Journals Online, Scopus, Cochrane Library, HINARI, and Science Direct. Additionally, we conducted searches using Google and Google Scholar search engines. Microsoft Excel was used for data extraction, and the data were analysed using STAT version 17.0. We assessed heterogeneity using Cochran\'s Q test and I2 test and checked for small study effects using funnel plot symmetry and Egger\'s test. Pooled prevalence and associated factors were estimated using a random-effects model at a 95% confidence interval (CI) and significance level of p < 0.05. To identify factors associated with poor sleep quality among individuals living with HIV/AIDS, odds ratios (ORs) and their corresponding 95% CI were calculated. This analysis combined data from 15 separate studies involving a total sample size of 5176 participants. The pooled prevalence of poor sleep quality among HIV/AIDS patients in SSA countries was 49.32% (95% CI 41.32-56.8%). Factors significantly associated with poor sleep quality included depression (OR 2.78; 95% CI 1.21-6.40) and CD4 count < 200 cells/mm3 (AOR 3.15; 95% CI 2.41-4.15). In this study the prevalence of poor sleep quality among HIV/AIDS patients in SSA was higher and differs across the countries, ranging from 21.7 to 73.7%. The findings underscore the urgent necessity for programs aimed at improving sleep quality, particularly in addressing factors such as participant income and depression that are linked to poor sleep quality in HIV/AIDS patients.Systematic review registration: PROSPERO CRD42024517229.
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