Acquired immune deficiency syndrome

获得性免疫缺陷综合征
  • 文章类型: Journal Article
    受人类免疫缺陷病毒(HIV)影响的个体由于心血管疾病的风险增加和预期寿命延长,对冠状动脉旁路移植术(CABG)的需求不断增长。然而,HIV患者的CABG结果尚未确定,仅从小型案例系列研究中获得见解。这项研究进行了全面的,对HIV患者的院内CABG结局进行基于人群的检查.在2015-2020年第四季度的全国住院患者样本中确定了接受CABG的患者。年龄<18岁和伴随手术的患者被排除在外。1:5倾向评分匹配用于解决术前组间差异。在接受CABG的患者中,613名(0.36%)患有HIV,与167,569名非HIV患者中的3119名相匹配。对于选定的HIV患者,CABG相对安全,呈现大致相似的结果。匹配后,艾滋病毒和非艾滋病毒患者的住院死亡率相当(2.13%vs.1.67%,p=0.40)。与HIV患者死亡率相关的危险因素包括既往CABG(aOR=14.32,p=0.01),慢性肺病(aOR=8.24,p<0.01),晚期肾衰竭(aOR=7.49,p=0.01),和外周血管疾病(aOR=6.92,p=0.01),可用于术前风险分层。而HIV患者的急性肾损伤较高(AKI;26.77%vs.21.77%,p=0.01)和感染(8.21%vs.4.18%,p<0.01),其他并发症组间比较.
    Individuals affected by human immunodeficiency virus (HIV) have a growing demand for coronary artery bypass grafting (CABG) due to heightened risk for cardiovascular diseases and extended life expectancy. However, CABG outcomes in HIV patients are not well-established, with insights only from small case series studies. This study conducted a comprehensive, population-based examination of in-hospital CABG outcomes in HIV patients. Patients underwent CABG were identified in National Inpatient Sample from Q4 2015-2020. Patients with age < 18 years and concomitant procedures were excluded. A 1:5 propensity-score matching was used to address preoperative group differences. Among patients who underwent CABG, 613 (0.36%) had HIV and were matched to 3119 out of 167,569 non-HIV patients. For selected HIV patients, CABG is relatively safe, presenting largely similar outcomes. After matching, HIV and non-HIV patients had comparable in-hospital mortality rates (2.13% vs. 1.67%, p = 0.40). Risk factors associated with mortality among HIV patients included previous CABG (aOR = 14.32, p = 0.01), chronic pulmonary disease (aOR = 8.24, p < 0.01), advanced renal failure (aOR = 7.49, p = 0.01), and peripheral vascular disease (aOR = 6.92, p = 0.01), which can be used for preoperative risk stratification. While HIV patients had higher acute kidney injury (AKI; 26.77% vs. 21.77%, p = 0.01) and infection (8.21% vs. 4.18%, p < 0.01), other complications were comparable between the groups.
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  • 文章类型: Journal Article
    我们旨在在蛋白质组学水平上区分获得性免疫缺陷综合征(AIDS)患者的不同中医(CM)综合征。
    我们收集了渭氏县诊断为不同CM综合征的艾滋病患者,开封市,河南省,中国,包括气虚证(QD组)和湿热证(DH组)。从渭氏县收集健康人群作为对照,开封市,河南省,中国。三组的血浆用ITRAQ标记,LC/MC用于蛋白质定量分析。最后,进行序列搜索和聚类分析。
    总的来说,发现了27种不同的蛋白质。QD组有3种蛋白上调,2种蛋白下调,DH组中11种蛋白质上调,13种蛋白质下调。与DH组相比,QD组有7种不同的蛋白质,其中5种蛋白下调,2种蛋白上调。当DH组的靶蛋白上调时,HC组蛋白表达下调。
    蛋白质结果的显著性分析和聚类表明,在蛋白质水平上,DH组与QD组和HC组差异有统计学意义(P<0.05)。然而,QD组与HC组无法有效区分.AAT,PF4、C反应蛋白和c4bp可作为DH组潜在的生物标志物。基于特征选择的质谱可用于对不同的CM综合征进行分类。
    UNASSIGNED: We aimed to distinguish the different Chinese medicine (CM) syndromes of acquired immune deficiency syndrome (AIDS) patients at the proteomics level.
    UNASSIGNED: We collected AIDS patients diagnosed with different CM syndromes from Weishi County, Kaifeng City, Henan Province, China, including Qi-deficiency syndrome (named QD group) and dampness-heat syndrome (named DH group). Healthy people were collected as controls from Weishi County, Kaifeng city, Henan Province, China. The plasma from three groups were labeled with ITRAQ, LC/MC was used for protein quantitative analysis. Finally, sequence search and cluster analysis were performed.
    UNASSIGNED: Overall, 27 different proteins were found. Three proteins were up-regulated and 2 proteins down-regulated in the QD group, 11 proteins up-regulated and 13 proteins down-regulated in the DH group. Compared with DH group, there were 7 different proteins in QD group, among which 5 proteins were down-regulated and 2 proteins were up-regulated. When the target protein of DH group was up-regulated, the protein of HC group was down-regulated correspondingly.
    UNASSIGNED: The significance analysis and clustering of protein results showed that DH group was significantly different from QD group and HC group at the protein level (P<0.05). However, the QD group could not be effectively distinguished from the HC group. AAT, PF4, C-reactive protein and c4bp may be used as potential biomarkers in DH group. Mass spectrometry based on feature selection can be used to classify different CM syndromes.
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  • 文章类型: Journal Article
    Hepatitis B is a major infectious disease that seriously endangers the health of the people of China. Patients with hepatitis B have a large base in our country, and the core indicators such as detection and antiviral treatment ratio are far from the real goal of eliminating the public health threat of uiral hepatitis.Notably, the chronic hepatitis B prevention and control system lacks a wide targeted strategies. This paper systematically analyzes our country\'s main successful experience with AIDS prevention and control and, on that basis, proposes the ideas and strategic paths for the construction of a chronic hepatitis B prevention and control system, analyzes and discusses the current difficulties and problems in prevention and control, and looks forward to future prevention and control efforts.
    乙型肝炎是严重危害我国人民群众健康的重大传染性疾病,我国乙型肝炎患者基数大,检测发现和抗病毒治疗比例等核心指标距离实现消除病毒性肝炎作为公共卫生危害目标差距较大,缺乏针对性的慢性乙型肝炎防控体系和防控策略、措施。该文系统分析了我国艾滋病防控的主要成功经验,在此基础上提出了我国慢性乙型肝炎防控体系建设和防控策略的思路和路径,对目前存在的防控难点及问题进行了分析和探讨,并对未来防控工作进行了展望。.
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  • 文章类型: Journal Article
    这项研究调查了与HIV感染者在接受抗逆转录病毒治疗(ART)的前3年中的保留相关的因素。
    在雅加达一家三级医院进行了一项使用电子健康记录的回顾性研究,印度尼西亚。包括从2010年到2020年开始ART的成年HIV阳性患者。使用二元逻辑回归模型来确定与前3年ART保留相关的因素。
    总共,535名受访者被纳入分析。第一个的ART保留率,第二,第三年为83.7%。,79.1%,77.2%,分别。多变量分析显示,开始ART时的CD4计数与保留之间呈负相关。CD4计数>200细胞/mL的患者保留良好的可能性比CD4计数≤200细胞/mL的患者低0.65倍。开始ART的年份也与保留显着相关。在2010-2013年或2014-2016年开始ART的患者比在2017-2020年开始ART的患者保留良好的可能性较小,调整后的比值比分别为0.52和0.40。接受基于依非韦仑的治疗的患者保留良好的可能性是接受奈韦拉平的患者的1.69倍(95%CI,1.05-2.72)。
    我们的研究显示,第三年ART保留率下降。CD4计数,入学年份,基于依非韦伦的方案与滞留显著相关.长期以来,患者参与一直是艾滋病毒项目的优先事项,正在实施干预措施来解决这一问题。
    OBJECTIVE: This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment.
    METHODS: A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years.
    RESULTS: In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72).
    CONCLUSIONS: Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.
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  • 文章类型: Journal Article
    受访者驱动抽样(RDS)通常用于从没有抽样框架的关键群体中进行抽样,因为传统方法无法有效地调查它们。调查这些人口通常需要告知服务提供情况,评估项目的有效性,并确定疾病的患病率。然而,由于RDS的许多假设,人们对RDS在实践中的工作方式感到担忧。为了评估其中的一些假设,我们使用地理数据开发诊断,并通过在坎帕拉的女性性工作者和男男性行为者中进行的调查中确定缺乏趋同和描述RDS范围来证明其实用性,乌干达。
    Respondent-driven sampling (RDS) is commonly used to sample from key populations without a sampling frame since traditional methods are unable to efficiently survey them. Surveying these populations is often desirable to inform service delivery, assess effectiveness of programs, and determine prevalence of diseases. However, there are concerns about how RDS works in practice due to its many assumptions. To assess some of these assumptions, we develop diagnostics using geographical data and demonstrate their utility by identifying lack of convergence and characterizing RDS reach in surveys conducted among female sex workers and men who have sex with men in Kampala, Uganda.
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  • 文章类型: Review
    塔拉真菌病是由马尔尼菲塔拉真菌病引起的一种严重的机会性传染病,主要发生在免疫功能低下的患者。该病主要流行于东南亚和南亚的热带国家和地区,但非流行地区也有塔拉真菌病患者。本病无特征性临床表现,诊断困难。延迟诊断通常会导致死亡。
    两名患者均有细胞免疫缺陷。病例1有获得性免疫缺陷综合征病史,病例2有肾移植史和葡萄糖-6-磷酸脱氢酶缺乏症。他们都发烧了,贫血,疲劳,和皮肤损伤。病例1有消化道出血,淋巴结肿大,和肝脾肿大.病例2有咳嗽和呼吸困难。两名患者均有血小板减少症和低白蛋白血症;中性粒细胞比率增加,降钙素原,和C反应蛋白;肝功能异常和凝血功能障碍。病例1痰培养,血培养,支气管肺泡灌洗液为马尔尼菲氏杆菌阳性。在病例2的血液培养中检测到马尔尼菲T.Marneffei,并感染了近叶念珠菌和肺孢子虫。胸部CT扫描主要表现为肺渗出性病变。尽管这两名患者得到了积极的治疗,他们死于疗效不佳。
    塔拉真菌病发病隐匿,漫长的课程,不典型的临床症状,成像性能和实验室结果,诊断困难,和高死亡率。因此,重要的是要及时考虑和治疗感染后免疫功能低下患者的塔拉真菌病,以降低死亡率。
    UNASSIGNED: Talaromycosis is a serious opportunistic infectious disease caused by Talaromyces marneffei, which mostly occurs in immunocompromised patients. The disease is mainly prevalent in tropical countries and regions of Southeast Asia and South Asia, but non-endemic areas also have patients with Talaromycosis. The disease has no characteristic clinical manifestations and is difficult to diagnose. Delayed diagnosis often leads to death.
    UNASSIGNED: Both patients had cellular immunodeficiency. Case 1 had a history of acquired immune deficiency syndrome, and case 2 had a history of renal transplantation and glucose-6-phosphate dehydrogenase deficiency. They all had fever, anemia, fatigue, and skin lesions. Case 1 had gastrointestinal bleeding, enlarged lymph nodes, and hepatosplenomegaly. Case 2 had cough and dyspnea. Both patients had thrombocytopenia and hypoalbuminemia; an increased neutrophil ratio, procalcitonin, and C-reactive protein; and abnormal liver function and coagulation dysfunction. Case 1 sputum culture, blood culture, and bronchoalveolar lavage fluid were positive for T. marneffei. T. marneffei was detected in the blood culture of case 2, with infection of Candida parapsilosis and Pneumocystis jirovecii. Chest computed tomography scan mainly showed pulmonary exudative lesions. Although these two patients were actively treated, they died of poor efficacy.
    UNASSIGNED: Talaromycosis has an insidious onset, long course, atypical clinical symptoms, imaging performance and laboratory results, difficult diagnosis, and high mortality. Therefore, it is important to promptly consider and treat Talaromycosis in immunocompromised patients upon infection in order to reduce mortality.
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  • 文章类型: Case Reports
    开始抗逆转录病毒治疗(ART)后的免疫重建炎症综合征(IRIS)的发病率不同,但并不少见,并且有可能在HIV患者中引起长期后果和致命后果。噬血细胞性淋巴组织细胞增生症(HLH)是一种过度免疫激活的单独综合征,但可能与IRIS共存,需要独特的治疗方法。在这份报告中,本文介绍了一例新诊断的HIV/AIDS患者,该患者同时患有分枝杆菌IRIS和HLH.
    Immune reconstitution inflammatory syndrome (IRIS) following initiation of antiretroviral therapy (ART) has variable incidence but is not uncommon and has the potential to cause long-term consequences and fatal outcomes in patients with HIV. Hemophagocytic lymphohistiocytosis (HLH) is a separate syndrome of excess immune activation, but may coexist with IRIS and necessitate a unique treatment approach. In this report, the case of a patient with newly diagnosed HIV/AIDS who was found to have both mycobacterial IRIS and HLH is presented.
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  • 文章类型: Journal Article
    背景:2009年在河南省引入了二线抗逆转录病毒治疗(ART)。开始这种治疗的患有人类免疫缺陷病毒(HIV)的人数正在增加。
    目的:本研究旨在调查该组患者的生存率和影响死亡率的因素。
    方法:我们对2010年5月1日至2016年5月1日期间转为二线ART的HIV感染者(PLHIV)进行了回顾性队列研究。,使用Kaplan-Meier方法和Cox比例风险模型。
    结果:我们追踪了3,331PLHIV,持续了26,988人年,其中508人(15.3%)死亡。死亡率为1.88/100人年。在调整混杂因素后,我们发现是一个女人(危险比[HR],0.66;95%置信区间[CI]0.55-0.79),>50岁(HR,2.69;95CI,2.03-3.56),单/窗口(HR,1.26;95CI,1.04-1.52),拥有>6年的教育(HR,0.78;95CI,0.65-0.94),中医(HR,0.75;95CI,0.52-0.96),肝损伤(HR,1.58;95CI,1.19-2.10),和CD4+T细胞计数<200细胞/μl(HR,1.94;95CI,1.47-2.55),或200-350细胞/μl(HR,1.37;95CI,1.03-1.82)与死亡风险相关。
    结论:我们发现转到二线ART的PLHIV患者的死亡率低于大多数以前的研究。回顾性队列的局限性可能,因此,有偏见的数据,需要前瞻性研究来确认结果。此外,中药联合二线ART显示出治疗HIV的潜力。
    BACKGROUND: Second-line antiretroviral therapy (ART) was introduced in Henan Province in 2009. The number of people living with human immunodeficiency virus (HIV) starting this therapy is increasing.
    OBJECTIVE: This study aimed to investigate the survival and factors affecting mortality among this group.
    METHODS: We conducted a retrospective cohort study of people living with HIV (PLHIV) who switched to second-line ART between May 1, 2010, and May 1, 2016., using the Kaplan-Meier method and Cox proportional hazards models.
    RESULTS: We followed 3,331 PLHIV for 26,988 person-years, of whom 508 (15.3%) died. The mortality rate was 1.88/100 person-years. After adjusting for confounding factors, we found being a woman (hazard ratio [HR], 0.66; 95% confidence interval [CI] 0.55-0.79), > 50 years old (HR, 2.69; 95%CI, 2.03-3.56), single/windowed (HR, 1.26; 95%CI, 1.04-1.52), having > 6 years of education (HR, 0.78; 95%CI, 0.65-0.94), Chinese medicine (HR, 0.75; 95%CI, 0.52-0.96), liver injury (HR, 1.58; 95%CI, 1.19-2.10), and CD4+ T cell count <200 cells/µl (HR, 1.94; 95%CI, 1.47-2.55), or 200-350 cells/µl (HR, 1.37; 95%CI, 1.03-1.82) were associated with mortality risk.
    CONCLUSIONS: We found lower mortality among PLHIV who switched to second-line ART than most previous studies. The limitations of a retrospective cohort may, therefore, have biased the data, and prospective studies are needed to confirm the results. Moreover, Chinese medicine combined with second-line ART shows potential as a treatment for HIV.
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  • 文章类型: Case Reports
    背景:与嗜酸性粒细胞性胃肠炎相关的获得性免疫缺陷综合征(AIDS)很少见。我们报告了一例AIDS患者十二指肠“结石”诱发急性胰腺炎伴嗜酸性胃十二指肠炎的病例。
    方法:一名73岁女性艾滋病患者因反复腹痛20天来医院就诊。计算机断层扫描(CT)显示胰腺炎有渗出,胃窦下有高密度阴影。胃镜检查显示十二指肠的下降部分被“结石”阻塞。十二指肠粘膜粗糙,在胃体上发现了一个红色息肉。病理结果为十二指肠粘膜和胃体息肉中嗜酸性粒细胞慢性炎症。
    结论:当艾滋病患者患有急性胰腺炎时,需要考虑嗜酸性粒细胞性胃肠炎的可能性,以使患者能够接受及时的治疗。
    BACKGROUND: Acquired immune deficiency syndrome (AIDS) associated with eosinophilic gastroenteritis is rare. We report a case of duodenal \"stone\" inducing acute pancreatitis with eosinophilic gastroduodenitis in an AIDS patient.
    METHODS: A 73-year-old female AIDS patient came to the hospital with recurrent abdominal pain for 20 days. Computed tomography (CT) showed pancreatitis with exudation and a high-density shadow under the gastric antrum. Gastroscopy showed that the descending part of the duodenum was blocked by a \"stone\". The mucosa of the duodenum was rough, and a red polyp was found on the gastric body. The pathology result was chronic inflammation with eosinophilic granulocytes in the duodenal mucosa and gastric body polyp.
    CONCLUSIONS: When AIDS patients suffer acute pancreatitis, the possibility of eosinophilic gastroenteritis needs to be considered to enable the patient to accept timely treatment.
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  • 文章类型: Case Reports
    本文旨在报道高效抗逆转录病毒治疗(HAART)的眼部不良反应。在病例1中,一名26岁的男性患者出现视力下降。在没有活性巨细胞病毒(CMV)视网膜炎和超过100细胞/μL的CD4计数激增超过四个月,他被诊断为免疫恢复性葡萄膜炎(IRU)。他对局部类固醇和环麻痹症反应良好。在病例2中,虽然干眼症是HAART的常见不良反应,我们53岁的女性患者进展到干燥性角膜结膜炎的视觉困扰阶段.她对润滑油做出了回应,并继续使用。在病例3中,一名14岁女性患者在没有及时干预的情况下,因奈韦拉平而导致Stevens-Johnson综合征的视力下降。虽然不常见,使用HAART可以看到使人衰弱的眼部不良反应。需要进一步的研究和报告,以提高医生和患者的认识。
    Our article aims to report the ocular adverse effects of highly active antiretroviral therapy (HAART). In case 1, a 26-year-old male patient presented with a diminution of vision. In the absence of active cytomegalovirus (CMV) retinitis and a surge in CD4 count of more than 100 cells/µL over four months, he was diagnosed as a case of immune recovery uveitis (IRU). He responded well to topical steroids and cycloplegics. In case 2, while dry eye is a common adverse effect of HAART, our 53-year-old female patient progressed to a visually distressing stage of keratoconjunctivitis sicca. She responded to lubricants and continues to be on the same. In case 3, a 14-year-old female patient\'s vision succumbed to Stevens-Johnson syndrome due to nevirapine in the absence of timely intervention. Though uncommon, debilitating ocular adverse effects may be seen with HAART. Further studies and reporting are required for an increased awareness among physicians and patients.
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