ObjectiveTo analyze the effectiveness and problems existing in implementing acquired immune deficiency syndrome (AIDS) control and prevention in community health service centers, and to provide scientific evidence for promoting AIDS control and prevention. MethodsRelated information on AIDS control and prevention in community health service centers in a community in the whole year of 2013 was acquired. The effectiveness and problems existing in case management, laboratory testing and highly active antiretroviral therapy (HAART) based on the current community health service system were analyzed. ResultsBy the end of 2013, the rate of AIDS case management was from zero to 100%, the rate of CD4 T detection was from 76.60% (360/470) to 88.35% (508/575), and the rate of receiving highly active antiretroviral therapy among AIDS patients was from 81.40% (175/215) to 84.41% (287/340). But in the actual work on AIDS in community health service centers, there were still some common problems needing to be solved. ConclusionThe community level management mode of AIDS can promote the accuracy of AIDS patients' information, improve the rate of case management, the rate of CD4 T detection and HAART. It is suggested that the community level management mode of AIDS should be promoted in the cities where AIDS patients are concentrated.
In recent years, the incidence rate of ischemic stroke in people living with HIV/AIDS (PLWHA) is increasing, attracting wide attention from scholars at home and abroad. In addition to traditional risk factors of stroke, the secondary ischemic stroke in PLWHA is also affected by HIV infection. This study reviews the incidence rate and risk factors of secondary ischemic stroke in PLWHA, in order to provide a theoretical basis for preventing and reducing the incidence of ischemic stroke in PLWHA.
Objective To analyze the clinical epidemiological characteristics and trends of newly reported human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients in Panzhihua Central Hospital, and provide a scientific basis for general hospitals to formulate precise prevention and control measures. Methods The information such as gender, age, ethnicity, and transmission route of the newly reported HIV/AIDS patients in Panzhihua Central Hospital from 2010 to 2019 was retrospectively analyzed. Results A total of 551545 patients were screened for HIV in Panzhihua Central Hospital between 2010 and 2019, among them, 1091 patients were confirmed as HIV infection finally, with a confirmed positive rate of 0.20%. The number of confirmed cases and the positive rate continued to increase from 2010 to 2017, and obviously declined after 2018. The male to female ratio of newly diagnosed HIV/AIDS patients was 2.86∶1, and the 31-45 years old middle-aged and young adults were the majority (31.16%). The majority of HIV/AIDS patients were identified as married (58.02%), primary school education (40.70%), farmers (46.38%), and Han nationality (79.84%). Yi nationality also had a high proportion (18.52%) with an increasing trend year by year (χ2trend=8.131, P=0.004). Yi nationality patients were mainly from Liangshan Yi Autonomous Prefecture (58.42%). A high proportion of 50.32% of patients came from other cities, among them, the proportion of patients from Liangshan Yi Autonomous Prefecture increased over time (χ2trend=13.608, P<0.001). The transmission routes were mainly through heterosexual sex (90.93%), with an upward tendency of proportion (χ2trend=22.137, P<0.001), and transmission through drug abuse was following (4.49%), with an downward tendency of the proportion (χ2trend=11.758, P=0.001). Significant differences in transmission routes were observed between males and females (P=0.020), and between Han nationality and Yi nationality (P<0.001). Conclusion The newly repored HIV/AIDS patients in Panzhihua Central Hospital have a high proportion of minority nationality, and heterosexual transmission is the main transmission route.
【摘要】 目的 研究人类免疫缺陷病毒(HIV)感染者和获得性免疫缺陷综合症(AIDS)患者CD4+T淋巴细胞数变化(ΔCD4+T)和外周血淋巴细胞总数变化(ΔTLC)的相关性。探讨用ΔTLC预测ΔCD4+T在监测HIV/AIDS患者疾病进展以及高效抗逆转录病毒治疗(HAART)疗效的价值。 方法 回顾性分析2005〖CD3/5〗2008年确诊的91例HIV/AIDS患者的临床资料。 结果 ΔTLC与ΔCD4+T呈直线正相关(r=0809,Plt;001),好于TLC与CD4+T的相关性(r=0712,Plt;001)。分别用ΔTLC 170、330、630、910个/μL细胞预测ΔCD4+T 50、100、200、300个/μL细胞时具有较好的预测价值,各项评价指标符合率基本达到90%以上,显著高于相同时间下用TLC预测CD4+T计数的价值。 结论 应用ΔTLC预测ΔCD4+T,可比TLC更加直观、准确的反映HIV感染者疾病进展和评价AIDS患者HAART的疗效。【Abstract 】Objective To assess the utility of total lymphocyte count (TLC) changes (ΔTLC) in place of TLC to predict the development of HIV/AIDS. To investigate the monitoring value of ΔCD4+T on progress of HIV/AIDS and HAART which predicted by ΔTLC. Methods Clinical data of 91 patiens with HIV/AIDS diagnosed from 2005 to 2009 were retrospectively analyzed. Results A linear correlation was found between the value of ΔTLC and the value of CD4+T changes(ΔCD4+T)(r=0809,Plt;001),which was better than the correlation between TLC and CD4+T (r=0712,Plt;001).Using ΔTLC as 170,330,630,910 cells/μL,respectively for forecasting ΔCD4+T as 50,100,200,300 cells/μL,respectively,had a better predictive value with the area under ROC curve near to 09,significantly higher than using TLC for predicting CD4+T counts. Conclusion ΔTLC is more accurate than TLC to reflect the development of HIV/AIDS.
Objective To investigate the long-term dynamic changes of liver function and glucose-lipid metabolism in human immunodeficiency virus (HIV)-infected patients with metabolic dysfunction-associated fatty liver disease (MAFLD) after antiretroviral therapy (ART). Methods HIV-infected patients who visited Public Health Clinical Center of Chengdu between October 1st, 2012 and June 30th, 2013 were recruited and divided into two groups according to whether they had MAFLD or not. All of them were treated with the first-line regimen of tenofovir + lamivudine + efavirenz for 156 weeks, and the anthropometric indices, liver function, and levels of glucose, lipids and uric acid were measured at baseline and at each follow-up time point. In addition, the long-term dynamic characteristics of liver function and glucose and lipid metabolism parameters of the two groups were compared during the 156 weeks of ART treatment. Results A total of 61 male HIV-infected patients were enrolled. The prevalence of MAFLD in them was 31.1% (19/61) at baseline and increased by 4.9 percentage points per year after ART. Before the start of follow-up (week 0), the levels of alanine aminotransferase (ALT) [(46.23±27.09) vs. (28.00±17.43) U/L, P=0.002] and γ-glutamyl transpeptidase (GGT) [(41.46±9.89) vs. (24.02±10.72) U/L, P<0.001] were higher in the MAFLD group than those in the non-MAFLD group, while the between-group differences in the levels of aspartate aminotransferase (AST) [(33.33±15.61) vs. (28.98±12.43) U/L, P=0.248] and alkaline phosphatase [(85.30±21.27) vs. (83.41±24.47) U/L, P=0.773] were not statistically significant. During the 156-week follow-up period, the 4 items of liver function gradually increased in the MAFLD group, especially from week 120 onwards, 3 of which (ALT, AST and GGT) were significantly higher than those in the non-MAFLD group (P<0.05). In addition, the levels of fasting blood glucose, triglyceride, total cholesterol, and low-density lipoprotein were also significantly higher in the MAFLD group than those in the non-MAFLD group at some time points during the 156-week follow-up period (P<0.05). Conclusions Compared with HIV-infected patients without MAFLD, HIV-infected patients with MAFLD are more likely to develop impaired liver function and disorders of glucose and lipid metabolism during long-term tenofovir + lamivudine + efavirenz regimen ART treatment. Therefore, close clinical monitoring of liver function and glucose and lipid metabolism related parameters is required for such patients.
ObjectiveTo compare the value of CURB-65 score and expanded CURB-65 score in evaluating prognosis of pneumonia in non-HIV infected patient and HIV infected patient.MethodsThe study included 206 hospitalized pneumonia patients without HIV infection and 299 pneumonia patients with HIV infection. According to their clinical prognosis within 4 weeks of treatment, they were divided into a deterioration group and an improvement group. The basic situation and the differences of clinical indicators between the two groups were compared. The predictive value of CURB-65 score and expanded CURB-65 score for clinical prognosis of pneumonia in non-HIV infected patients and HIV infected patients was compared by using receiver operator characteristic (ROC) curve.ResultsFor the pneumonia patients without HIV infection, the area under ROC curve (AUC) of CURB-65 score and expanded CURB-65 score were 0.862 and 0.848, respectively. There was no significant difference in AUC between CURB-65 score and expanded CURB-65 score (Z=0.661, P=0.5084). The Youden indexes of CURB-65 score and expanded CURB-65 score were 60.11% and 54.92%, respectively. For the pneumonia patients with HIV infection, the AUC of CURB-65 score and expanded CURB-65 score were 0.588 and 0.634, respectively. There was no significant difference between them (Z=1.416, P=0.1567). The Youden index of the two scores was 19.53% and 20.52%, respectively.ConclusionsThe CURB-65 score and expanded CURB-65 score can effectively evaluate the clinical prognosis of pneumonia in non-HIV infected patients, but their predicted values are limited in evaluating the prognosis of pneumonia in HIV infected patients.
Objective To investigate the feasibility and methods of surgical treatment for HIV/AIDS patients with otolaryngology diseases. Methods From January 2016 to February 2017, nineteen patients with HIV/AIDS who underwent otolaryngology surgery were included in this study. The demographic data of patients, including age, gender, course of disease, CD4+ T lymphocyte count before operation and disease type were collected and the clinical treatment methods were summarized. The curative effect was analyzed retrospectively. Results The operations of all the 19 patients were successful without occupational exposure among medical staff. One patient with papillary squamous cell carcinoma did not received further treatment. The other 18 patients recovered well and their life quality was significantly improved. Conclusions If HIV/AIDS patients with otolaryngological diseases are examined preoperatively and have no surgical contraindications, the operation shloud be performed by controlling the surgical indications strictly. The life quality of the patients may be improved and the patients’ life may be prolonged after the surgery.
Acquired Immunodeficiency Syndrome (AIDS) is a severe infectious disease induced by human immuno deficiency virus (HIV). Laboratory testing plays an important role in the diagnosis of HIV/AIDS. In general, laboratory testing includes detection of virus antibodies and antigens, virus RNA, immune cells (CD4+, CD8+) and anti-HIV drug resistance. During the past twenty years, great progress has been made in laboratory testing. As research on HIV/AIDS has advanced and biotechnology has developed rapidly, different methods of testing have been discovered. In recent years, the application of molecular biotechnology and immunology has led to important advances for epidemiological surveys, clinical diagnosis and treatment of HIV. The existence of a testing method with high sensitivity and specificity is not only helpful for early diagnosis and prediction, monitoring and evaluation of therapeutic efficacy, but can also reduce the risk of false-negative results. HIV laboratory testing is now developing towards a simple, rapid, sensitive, accurate and automatic way of diagnosing this condition.
Objective To investigate the level and influencing factors of perceived HIV stigma and discrimination among people living with HIV/AIDS (PLWHA). Methods By using convenience sampling method, 123 patients were recruited from the department of infectious diseases in a tertiary hospital in Chengdu from April to May in 2017. Berger HIV stigma scale was used to measure the level of perceived HIV stigma. Results The mean score of Berger HIV stigma scale was 113.72±17.890, which revealed a middle to upper level. Among the four subscales, the score of disclosure concerns (3.07±0.462) was the highest, while the score of negative self-image (2.70±0.494) was the lowest. Multiple regression analysis showed that gender and self-perceived health status were the influencing factors of perceived HIV stigma. Conclusions The level of perceived HIV stigma among PLWHA is from middle to upper level. Female gender and poor self-perceived health status are associated with a higher level of perceived HIV stigma. Individualized interventions are required in order to reduce the level of HIV stigma.
Objective To investigates the awareness of medical staff on prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) . Methods Between April and July 2014, health workers from towns and cities of Liangshan Prefecture participated in the class of prevention of HIV PMTCT for key areas in Sichuan province. Those participants, together with some other health workers from the same area whose daily work was related to prevention of PMTCT, were selected as the study subjects. PMTCT prevention knowledge survey questionnaire was given out for the investigation, and chi-square test was used for statistical analysis. Results We retrieved altogether 447 (out of 450) valid questionnaires. Of all the respondents, 94.18% were aware of proper time for HIV antibody testing and routes of transmission in the perinatal period, 95.30% knew the strategy of applying as early as possible antiviral drugs during pregnancy, and 86.58% learned to know when to give the first dose to the newborns and avoidance of breast-feeding. However, the awareness of relevant applied knowledge was relatively low. The total awareness rate of medical workers from women and children’s hospitals were significantly better than that of medical workers from general hospitals (P<0.05), and differences of the awareness depended on different specialties, professional titles and working age (P<0.05). Conclusions The majority of medical personnel in the surveyed area have grasped basic knowledge of PMTCT of HIV, but the ability of applying relevant knowledge precisely, promptly and standardly in daily practices needs to be improved. We recommend that, in addition to strengthening routine training on knowledge of PMTCT of HIV, the mastering and practice of key technical intervention strategies should be followed up and evaluated, especially for those from general hospitals. And it is also important to give training and after-training assessment based on different specialties.