HIV, Human immunodeficiency virus

艾滋病毒,人类免疫缺陷病毒
  • 文章类型: Journal Article
    一氧化氮(NO)是一种重要的气体发射器,对许多细菌和病毒感染的先天免疫反应的发展具有重要意义。同时还调节血管生理学。从内源性一氧化氮合酶的上调产生NO是抑制宿主防御中病毒复制的有效方法,并需要对抗病毒疗法的开发进行研究。随着与几种呼吸道病毒感染有关的全球大流行的发病率增加,有必要开发广泛的治疗平台来抑制病毒复制并实现更有效的宿主清除,以及制造新材料来阻止医疗设备中的病毒传播。在产生稳定的NO供体化合物及其掺入大分子支架和聚合物基材中的最新进展为开发基于NO的治疗剂以在杀菌和接触血液的表面的应用中长期释放NO创造了新的范例。尽管有大量的研究,很少考虑释放NO的支架和基质来减少病毒感染的被动传播或治疗几种呼吸道病毒感染。这篇综述的目的是强调开发气态NO的最新进展,没有前药,和NO供体化合物用于抗病毒治疗;讨论NO作为抗病毒剂的局限性;并概述了指导材料设计下一代NO释放抗病毒平台的未来前景。
    Nitric oxide (NO) is a gasotransmitter of great significance to developing the innate immune response to many bacterial and viral infections, while also modulating vascular physiology. The generation of NO from the upregulation of endogenous nitric oxide synthases serves as an efficacious method for inhibiting viral replication in host defense and warrants investigation for the development of antiviral therapeutics. With increased incidence of global pandemics concerning several respiratory-based viral infections, it is necessary to develop broad therapeutic platforms for inhibiting viral replication and enabling more efficient host clearance, as well as to fabricate new materials for deterring viral transmission from medical devices. Recent developments in creating stabilized NO donor compounds and their incorporation into macromolecular scaffolds and polymeric substrates has created a new paradigm for developing NO-based therapeutics for long-term NO release in applications for bactericidal and blood-contacting surfaces. Despite this abundance of research, there has been little consideration of NO-releasing scaffolds and substrates for reducing passive transmission of viral infections or for treating several respiratory viral infections. The aim of this review is to highlight the recent advances in developing gaseous NO, NO prodrugs, and NO donor compounds for antiviral therapies; discuss the limitations of NO as an antiviral agent; and outline future prospects for guiding materials design of a next generation of NO-releasing antiviral platforms.
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  • 文章类型: Journal Article
    计划生育服务对于减少孕产妇死亡以及改善妇女的生殖健康和性健康至关重要。尽管计划生育服务经常以妇女为重点,男性往往是主要的决策者。我们进行了一项研究,以探讨男性伴侣对妇女选择和利用计划生育服务在Mufulira区的影响,赞比亚。
    进行了定性探索性研究设计,该设计利用了两个焦点小组讨论(n=20)和涉及育龄妇女的深入访谈(n=30)。采用方便的抽样来选择参与者。记录了深入访谈和焦点小组讨论,翻译,逐字抄写。通过代码分类和主题识别来利用内容分析。将数据导入NVivo。×64用于编码和节点生成。
    这项研究揭示了男性伴侣影响避孕使用的关键主题,例如对不忠的恐惧,害怕身体虐待,偏爱大家庭,破坏性快感,和感知到的避孕药的副作用。这些主题突出了文化驱动的性别和权力动态对男性伴侣避孕态度的影响。参与者描述了他们的男性伴侣如何表现出产前态度和对他们的控制,从而限制了他们对避孕使用的决策权。不理想的避孕副作用,如阴道润滑减少,导致男性性快感中断。对女性使用避孕药具可能导致不忠的担忧也导致男性伴侣不赞成使用避孕药具。
    了解男性伴侣在避孕方面的障碍对于防止避孕中断至关重要,并且可以增加女性的避孕能力。我们的发现强调了文化驱动的性别和权力动态对男性伴侣避孕态度的影响。因此,关于计划生育服务的男性伴侣教育是关键。此外,在规划和实施计划生育方案时,男子需要被纳入关键利益攸关方。
    UNASSIGNED: Family planning services are essential in reducing maternal deaths as well as improving the reproductive and sexual health of women. Although family planning services are frequently focused on women, men are often the primary decision-makers. We conducted a study to explore male partner influence on women\'s choices and utilisation of family planning services in Mufulira district, Zambia.
    UNASSIGNED: A qualitative explorative study design that utilised two focus group discussions (n = 20) and in-depth interviews (n = 30) involving women of reproductive age was conducted. Convenient sampling was employed to select participants. In-depth interviews and focus group discussions were recorded, translated, and transcribed verbatim. Content analysis was utilised through code classification and theme identification. Data were imported into NVivo.×64 for coding and node generation.
    UNASSIGNED: The study revealed key themes on male partner influence on contraception use such as fear of infidelity, fear of physical abuse, preference for a large family size , disruption of sexual pleasure, and perceived side effects of contraceptives. These themes highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Participants described how their male partners exhibited prenatal attitudes and control over them thereby limiting their decision-making power on contraception use. Undesirable contraception side effects such as reduced vaginal lubrication contributed to sexual pleasure disruption among men. Concerns that women\'s use of contraception can lead to infidelity also contributed to male partner disapproval of contraception use.
    UNASSIGNED: Understanding barriers to contraception utilisation presented by male partners is essential in preventing contraception discontinuation and can increase contraception uptake among women. Our findings highlight the influence of culturally driven gender and power dynamics on male partner attitudes towards contraception. Therefore, male partner education on family planning services is key. Also, men need to be incorporated as key stakeholders when planning and implementing family planning programmes.
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  • 文章类型: Journal Article
    UNASSIGNED:在2019年,美国有超过110万人患有人类免疫缺陷病毒(HIV),240万人患有丙型肝炎病毒(HCV)。七分之一(14%)不知道他们的HIV感染,几乎一半的HCV感染未被诊断。住房不稳定的人不成比例地受到艾滋病毒和HCV的影响。本研究将评估社区药剂师的干预措施,这些干预措施可能会减少HIV和HCV的传播并促进与护理的联系。
    UNASSIGNED:这项研究是在斯波坎的一家独立社区药房进行的,华盛顿。符合条件的研究参与者是药房的步入式患者,18岁以上,经历无家可归。如果药房患者有HIV或HCV诊断史,则将其排除在外。在过去6个月内接受了HIV或HCV筛查,或无法给予知情同意.干预措施包括使用血液样本进行HIV和HCV即时检测(POCT),风险确定面试,全面的HIV和HCV教育,以及个性化的测试后和风险缓解咨询,然后转诊到合作的健康诊所。
    UNASSIGNED:最终数据分析包括50名参与者。22名参与者(44%)有反应性HCVPOCT,和一个参与者有一个反应性HIVPOCT。在94%报告使用非法药物的参与者中,74%的人报告使用注射药物。百分之七十六(n=38)符合PrEP。对28名参与者进行了药剂师转诊,其中71%被确认为已建立的护理。
    未经评估:由于危险的性行为和物质滥用,无家可归的人感染艾滋病毒和HCV的风险增加。PrEP在美国未得到充分利用,药剂师参与HIV和HCV连续护理可能对改善联系和保留难以治疗人群的护理产生重大影响。
    UNASSIGNED: In 2019, there were over 1.1 million people living with human immunodeficiency virus (HIV) and 2.4 million people living with hepatitis C virus (HCV) in the United States. One in seven (14%) are unaware of their HIV infection and almost half of all HCV infections are undiagnosed. People with unstable housing are disproportionately affected by HIV and HCV. The present study will evaluate interventions by community pharmacists that may reduce HIV and HCV transmission and promote linkage to care.
    UNASSIGNED: This study was conducted in an independent community pharmacy in Spokane, Washington. Eligible study participants were walk-in patients of the pharmacy, over the age of 18, and experiencing homelessness. Pharmacy patients were excluded if they had a history of HIV or HCV diagnosis, received a screening for HIV or HCV in the last six months or were unable to give informed consent. The intervention included administration of HIV and HCV point-of-care testing (POCT) using a blood sample, risk determination interview, comprehensive HIV and HCV education, and personalized post-test and risk mitigation counseling followed by referral to partnering health clinics.
    UNASSIGNED: Fifty participants were included in the final data analysis. Twenty-two participants (44%) had a reactive HCV POCT, and one participant had a reactive HIV POCT. Of the 94% of participants who reported illicit drug use, 74% reported injection drug use. Seventy-six percent (n = 38) qualified for PrEP. Pharmacist referrals were made for 28 participants and 71% were confirmed to have established care.
    UNASSIGNED: Individuals experiencing homelessness are at an increased risk for acquiring HIV and HCV due to risky sexual behaviors and substance misuse. PrEP is underutilized in the U.S. and pharmacist involvement in the HIV and HCV care continuum may have a significant impact in improving linkage and retention in care of difficult to treat populations.
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  • 文章类型: Journal Article
    高调的国际目标已被设定为到2030年消除乙型肝炎病毒(HBV)感染作为公共卫生威胁。发展和扩大公平,因此,代表现实世界人群的可访问的转化HBV研究计划是临床和学术界的当务之急。我们提出的经验和见解,由一个专家跨学科小组侧重于障碍,阻碍生活在乙肝病毒感染的成年人参与临床研究。我们的观点描述了我们通过在南非的各种环境中工作而发现的障碍,包括缺乏教育和意识,耻辱和歧视的经历,治理和数据管理的挑战,和复杂发病率的负担。通过识别这些挑战,我们提出解决方案和干预措施,强调新的方法,并为未来的研究提供框架。
    High profile international goals have been set for the elimination of hepatitis B virus (HBV) infection as a public health threat by the year 2030. Developing and expanding equitable, accessible translational HBV research programmes that represent real-world populations are therefore an urgent priority for clinical and academic communities. We present experiences and insights by an expert interdisciplinary group focusing on barriers that impede adults living with HBV infection from participating in clinical studies. Our viewpoint describes barriers we have identified through working in a variety of settings across South Africa, including lack of education and awareness, experiences of stigma and discrimination, challenges for governance and data management, and a burden of complex morbidity. Through identifying these challenges, we propose solutions and interventions, highlight new approaches, and provide a framework for future research.
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  • 文章类型: Journal Article
    UNASSIGNED:研究发现,由于多种原因,亚洲地区的男男性行为者(MSM)感染艾滋病毒和性传播感染(STIs)的风险非常高。尽管亚洲普通人群中艾滋病毒的流行率被认为很低,该地区MSM中艾滋病毒和梅毒的患病率很高,通常,它被忽视了。这项研究旨在检查艾滋病毒的流行和趋势,梅毒,以及它们在亚洲MSM中的共同感染。
    UNASSIGNED:2021年1月5日在PubMed进行了系统搜索,WebofScience,和谷歌学者数据库。为了评估异质性,Q-tests,我2被使用。为了探索出版偏见,使用Eggers\'测试和漏斗图。由于存在显著的异质性,进行了随机效应模型和亚组分析。
    未经批准:共确定了2872篇文章,66篇文章被纳入最终分析。考虑到66项研究的69项估计值,估计了MSM中HIV和梅毒的总体患病率,而在17项研究中发现了19项共感染的估计值。合并的HIV患病率为8.48%(CI:7.01-9.95),合并的梅毒患病率为9.86%(CI:8.30-11.41),具有显着的异质性和发表偏倚。HIV和梅毒合并感染的合并患病率为2.99%(CI:1.70-4.27),具有显着的异质性,没有发表偏倚。艾滋病毒,梅毒,在2002-2017年期间,HIV-梅毒合并感染率估计值呈上升趋势.
    未经批准:艾滋病毒,梅毒,它们的共同感染在亚太地区的MSM中相当普遍。综合和强化干预战略,艾滋病毒检测,需要改善获得抗逆转录病毒治疗的机会,并提高人们的认识,以减少艾滋病毒,梅毒,以及他们在讨论的弱势群体中的共同感染。
    UNASSIGNED: Studies found that the group of men who have sex with men (MSM) is at a very high level of risk of HIV and sexually transmitted infections (STIs) in Asian regions due to multiple reasons. Although the prevalence of HIV among general people in Asia is considered low, the prevalence of HIV and Syphilis among MSM in this region was found very high and usually, it goes unnoticed. This study aimed to inspect the prevalence of and trends in HIV, Syphilis, and their co-infection among MSM in Asia.
    UNASSIGNED: A systematic search was performed on January 5, 2021, in PubMed, Web of Science, and Google Scholar databases. To evaluate the heterogeneity, Q-tests, and I 2 were used. To explore the publication bias, Eggers\' test and funnel plot were used. The random-effect model and subgroup analysis were performed due to the significant heterogeneity.
    UNASSIGNED: A total of 2872 articles were identified, and 66 articles were included in the final analysis. The overall prevalence of HIV and Syphilis among MSM was estimated considering 69 estimates from 66 studies whereas 19 estimates of co-infection were found in 17 studies. The pooled HIV prevalence was 8.48% (CI: 7.01-9.95) and the pooled Syphilis prevalence was 9.86% (CI: 8.30-11.41) with significant heterogeneity and publication bias. The pooled prevalence of HIV and Syphilis co-infection was 2.99% (CI: 1.70-4.27) with significant heterogeneity and no publication bias. The HIV, Syphilis, and HIV-Syphilis co-infection prevalence estimates exhibited an upward trend during 2002-2017.
    UNASSIGNED: HIV, Syphilis, and their co-infection are quite prevalent among MSM in the Asia-Pacific region. Integrated and intensified intervention strategies, HIV testing, and improved access to antiretroviral treatment as well as increased awareness are needed to reduce HIV, Syphilis, and their co-infection among the discussed vulnerable group.
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  • 文章类型: Journal Article
    HIV患者表现出血小板活化和心血管疾病风险增加,其预防尚不完全清楚。55名HIV阳性患者随机接受氯吡格雷治疗,阿司匹林,或者14天没有治疗,并评估血小板表型和诱导内皮炎症的能力。氯吡格雷与阿司匹林相反,未治疗可降低血小板活化(P-选择素和PAC-1表达)。与基线相比,在分配给氯吡格雷的患者中,血小板诱导的培养内皮细胞的促炎转录表达降低,阿司匹林和不治疗臂没有变化。在艾滋病毒中,氯吡格雷预防心血管疾病的临床试验是必要的.(HIV的抗血小板治疗;NCT02559414)。
    Patients with HIV exhibit platelet activation and increased risk of cardiovascular disease, the prevention of which is not fully known. Fifty-five HIV-positive patients were randomized to clopidogrel, aspirin, or no-treatment for 14 days, and the platelet phenotype and ability to induce endothelial inflammation assessed. Clopidogrel as opposed to aspirin and no-treatment reduced platelet activation (P-selectin and PAC-1 expression). Compared with baseline, platelet-induced proinflammatory transcript expression of cultured endothelial cells were reduced in those assigned to clopidogrel, with no change in the aspirin and no-treatment arms. In HIV, clinical trials of clopidogrel to prevent cardiovascular disease are warranted. (Antiplatelet Therapy in HIV; NCT02559414).
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  • 文章类型: Case Reports
    未经证实:本报告描述了一例69岁女性感染性巩膜炎的病例和治疗,该病例是由关节炎诺卡氏菌引起的。
    未经证实:我们的患者在白内障手术后左眼(OS)出现严重的持续疼痛。她有相关的既往病史,对肾移植有重要意义(口服他克莫司,霉酚酸酯,和泼尼松)。裂隙灯检查OS(白内障手术后1个月)显示3+注射时间伴随巩膜增厚和多部位脓肿伴结膜小糜烂脓性引流。脓肿被清创并送去革兰氏染色和培养。患者接受反复结膜下注射抗生素和抗真菌药物治疗;局部两性霉素,万古霉素,和阿米卡星;和口服甲氧苄啶-磺胺甲恶唑(双重强度)。带有培养物的两个单独的革兰氏染色证实了诊断和物种鉴定。除了规定的治疗方案外,患者早期对重复结膜下注射反应良好,在最后一次随访时(就诊后12个月)保持无疾病。
    UNASISIGNED:这个独特的病例显示了由罕见的诺卡氏菌引起的感染性巩膜炎(N。关节炎),已通过其他已报道的诺卡氏菌物种的类似策略成功治疗。由于诺卡氏菌巩膜炎会导致不良结局,如果不及时和适当的治疗,在最近的任何眼科手术后出现急性眼部症状的免疫功能低下患者的鉴别诊断中,应考虑这一点。
    UNASSIGNED: This report describes a case and management of a 69-year-old female with infectious scleritis found to be caused by Nocardia arthritidis species.
    UNASSIGNED: Our patient presented with severe constant pain in the left eye (OS) following cataract surgery. She had a pertinent past medical history significant for renal transplantation (on oral tacrolimus, mycophenolate, and prednisone). Slit lamp examination OS (1 month after cataract surgery) demonstrated 3+ injection temporally accompanied by scleral thickening and multiloculated abscesses with purulent drainage from small conjunctival erosions. The abscesses were debrided and sent for gram stain and culture. The patient was treated with repeated subconjunctival injections of antibiotics and an antifungal; topical amphotericin, vancomycin, and amikacin; and oral trimethoprim-sulfamethoxazole (double strength). Two separate gram stains with cultures confirmed the diagnosis and species identification. The patient responded well to repeat subconjunctival injections early on in addition to the prescribed regimen, remaining free of disease at the last follow-up (12 months following presentation).
    UNASSIGNED: This unique case demonstrates infectious scleritis caused by an uncommon Nocardia species (N. arthritidis) that was successfully treated with similar strategies used for other reported Nocardia species. As Nocardia scleritis can lead to adverse outcomes if not treated promptly and properly, it should be considered on the differential diagnoses in an immunocompromised patient who presents with acute ocular symptoms after any recent ocular surgery.
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  • 文章类型: Case Reports
    胃肺炎(GP)是一个罕见的发现。它可以在胃气肿(GE)和气肿性胃炎(EG)中看到;然而,两种情况都存在相似,并且在射线照相上难以区分2种情况。此外,两种情况的治疗方法都有很大不同,其中GE的治疗重点是支持治疗,而EG的治疗甚至可能涉及胃切除术。区分GE和EG是至关重要的,因为GE有一个良性的临床过程,而EG具有显著的死亡率。早期内窥镜检查可能是区分两种情况并指导进一步治疗的有用工具。在这里,我们提供了2例免疫功能低下患者的病例系列,这些患者的症状和影像学证据与胃肺炎一致。我们发现,早期内窥镜检查有助于风险分层,并有助于指导我们的管理策略。我们建议考虑将内窥镜评估作为对患有胃肺炎的患者进行仪式化评估的一部分。
    Gastric pneumatosis (GP) is a rare finding. It can be seen with both gastric emphysema (GE) and emphysematous gastritis (EG); however, both conditions present similarly and differentiating between the 2 is difficult radiographically. Moreover, the treatment is vastly different for both conditions, in which treatment for GE is focused on supportive care while treatment for EG may even involve gastrectomy. Making the distinction between GE and EG is crucial because GE has a benign clinical course, while EG carries significant mortality. Early endoscopy may be a useful tool in differentiating between the 2 conditions and to guide further management. Herein, we present a case series of 2 immunocompromised patients who presented with symptoms and radiographic evidence consistent with gastric pneumatosis. We found that early endoscopy assisted in risk stratification and helped guide our management strategy. We recommend consideration of endoscopic evaluation as part of ritualized evaluation of patients presenting with gastric pneumatosis.
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  • 文章类型: Case Reports
    一名48岁男性出现自发性气胸,需要在COVID-19感染的情况下放置胸管。胸部CT提示双侧磨玻璃样及多发,大,充气,双侧肺的空洞性病变。这些影像学发现导致最初的HIV诊断,患者的CD4+计数<32细胞/μL。他被发现还感染了kansasii分枝杆菌,巨细胞病毒,肺孢子虫jirovecii,和白色念珠菌.发生恶化的低氧性呼吸衰竭后,他在双侧发展了额外的气胸,需要反复放置胸管。他的潜在感染接受了抗菌治疗,随后开始接受联合抗逆转录病毒治疗。
    A 48-year-old male presented with spontaneous pneumothorax requiring chest tube placement in the setting of COVID-19 infection. CT chest revealed bilateral ground-glass opacities and multiple, large, gas-filled, cavitary lesions in the lungs bilaterally. These imaging findings led to an initial HIV diagnosis with the patient presenting at a CD4+ count of <32 cells/µL. He was found to additionally have infections with Mycobacterium kansasii, cytomegalovirus, Pneumocystis jirovecii, and Candida albicans. After developing worsening hypoxic respiratory failure, he developed additional pneumothoraces bilaterally, requiring repeated chest tube placement. He was treated with antimicrobial therapy for his underlying infections and subsequently started on combined antiretroviral therapy.
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  • 文章类型: Case Reports
    中枢神经系统结核是仅次于结核性脑膜炎的第二常见部位。在一些西方国家,它占颅内扩张性病变的0.2%,而在发展中国家,这一比例为10%-30%。我们报告了一个1岁零2个月大的婴儿的病例,他出现了15天的抽搐伴虚弱,低张力,没有发烧。临床检查和实验室检查没有异常。他父亲患有肺结核,但婴儿没有肺结核的临床或放射学征象。脑部MRI显示多个点状脑部病变,首先提示脑内结核瘤,鉴于临床和放射学外观和父亲的结核病史。患者接受抗惊厥和抗细菌治疗。通过这个案子,我们可以看到脑结核瘤的临床和放射学多态性。确定性的诊断仍然是解剖学病理学。晚期发现预后较差。
    Tuberculosis of the central nervous system is the second most common site after tuberculous meningitis. It represents 0.2% of intracranial expansive lesions in some Western countries compared to 10%-30% in developing countries. We report the case of an infant of 1 year and 2 months old who presented for 15 days with convulsions with asthenia, hypotonia, without fever. The clinical examination and laboratory workup were without abnormalities. His father had ongoing pulmonary tuberculosis, but the infant had no clinical or radiological signs of pulmonary tuberculosis. A brain MRI was showed multiple punctiform brain lesions, suggesting intracerebral tuberculomas in the first place, given the clinical and radiological appearance and the father\'s history of tuberculosis. The patient was put on anti-convulsant and antibacillary treatment. Through this case, we can see the clinical and radiological polymorphism of cerebral tuberculoma. The diagnosis of certainty remains anatomopathological. The prognosis is poor when it is detected late.
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