2016—2023年内蒙古自治区TB/HIV双重感染流行特征及治疗情况分析

目的:通过对内蒙古自治区2016—2023年TB/HIV双重感染流行特点进行数据分析,为全区TB/HIV防控提供科学依据。方法:采用描述流行病学方法,运用“登记率”、“检查率”和“治疗成功率”等指标分析内蒙古自治区TB/HIV双重感染患者的流行病学特点;运用趋势卡方检验及Fisher确切概率法分析内蒙古TB/HIV双重感染患者在2016-2023年间的三间分布、治疗情况。结果:2016—2023年全区登记HIV/AIDS患者43703例,接受胸片或痰涂片检查41049例,检出结核病患者158例,检查率为93.93%,检查率呈逐年上升态势(χ^(2)_(趋势)=272.970,P<0.001),结核病检出率为0.36%,检出率总体呈下降趋势(χ^(2)_(趋势)=21.623,P<0.001);2016—2023年新检出7595例HIV/AIDS患者,6866例进行了胸片或痰检,检查率为90.40%,检出结核病患者93例,检出率为1.35%;既往HIV/AIDS患者进行胸片或痰检累计34183例次,检出结核病患者65例,2016—2023年既往HIV/AIDS患者结核病检出率均低于新检出HIV/AIDS患者结核病检出率;2016-2023年全区结核病患者HIV抗体阳性筛查比例为23.69%,呈明显升高态势(χ^(2)_(趋势)=5764.882,P<0.001);内蒙古TB/HIV双重感染患者的登记率2016-2018年逐年上升(χ^(2)_(趋势)=4.685,P=0.03),2019-2023年基本不变(χ^(2)_(趋势)=1.084,P趋势=0.179);不同盟(市)双感患者平均登记率存在差异(χ^(2)=41.565,P<0.001);25~44岁年龄组累计TB/HIV双重感染者最多(57.40%);2016—2023年发现的169例双重感染患者在结核病专报系统的登记率为85.21%。接受抗结核治疗的为133例,治疗成功率71.43%。结论:内蒙古2016-2023年TB/HIV双筛率逐年提高。每年的TB/HIV双重感染病例约为20例,登记率水平有所波动。今后要继续做好对重点地区、重点人群的监测管理工作,及时登记并提供优质的治疗管理服务。

Associations of PNPLA3 and LEP genetic polymorphisms with metabolic-associated fatty liver disease in Thai people living with human immunodeficiency virus

BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.

Factors of Adherence to Concurrent Tuberculosis Treatment and Antiretroviral Therapy among HIV-TB Co-Infected Individuals in the East Region, Cameroon in the COVID-19 Era: A Retrospective Cohort Study

Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed in all situations where patients are required to administer their own medication, whatever the type of illness. The general objective of this study was to assess the factors affecting adherence to treatment among HIV-TB co-infected patients in health facilities in the East Region in the COVID context. Method: A retrospective cohort study before and during COVID-19 was conducted in HIV care units in 13 health districts in the East Region of Cameroon. Data were collected using a questionnaire recorded in the Kobo Collect android application, analyzed using SPSS version 25 software and plotted using Excel. Results: The pre-COVID-19 cohort compared to the during-COVID-19 cohort had a 1.90 risk of not adhering to treatment (OR: 1.90, CI {1.90 - 3.37}) and the difference was statistically significant at the 5% level (p-value = 0.029). Frequency of adherence was 65.4% (140/214). Adherence before COVID-19 was 56.9% whereas during COVID-19, it was 74.3%. Conclusion: The implementation of targeted interventions in the COVID-19 context, using evidence-based data and integrating the individual needs of HIV-TB co-infected patients, improved adherence to concurrent anti-tuberculosis treatment and antiretroviral therapy during the COVID-19 Era.

Epidemiology of Lower Extremity Artery Disease in People Living with HIV Followed at the Departmental University Hospital Center Ouémé-Plateau in 2019

Introduction: Lower extremity artery disease (LEAD) is a serious cardiovascular disease. People living with the human immunodeficiency virus (HIV) are at risk. The aim of the study was to determine the prevalence of LEAD and identify the associated factors among people living with HIV who were followed at the departmental university hospital Ouémé-Plateau in Benin. Methods: This was a cross-sectional study. It included all HIV-infected people who were monitored at the department of medicine of the target hospital during the study period and met the inclusion criteria (followed for at least three months, aged at least 25 years, and having given their written consent to participate). Data were collected during an individual interview, followed by the measurement of parameters. The ankle brachial index ≤ 0.9 was used for the diagnosis of LEAD. Associated factors were searched through a multivariable logistic regression. Results: The prevalence of LEAD was 34.2% among 222 respondents having a mean age was 42.9 ± 10.8 years and a female predominance (77.5%). No significant association was found between the presence of LEAD and sociodemographic factors. The presence of LEAD was significantly associated with hypertension and antiretroviral therapy. Hypertensive patients had a higher risk of LEAD compared to non-hypertensive patients (OR = 1.98, 95% CI [1.04-3.83], p = 0.037). Those who were receiving second-line therapy also had a higher risk of LEAD compared to those on first-line therapy (OR = 2.95, 95% CI [1.14-7.60], p = 0.025). Conclusion: This study showed a high prevalence of LEAD especially among hypertensive patients and those who were receiving second-line antiretroviral therapy. LEAD diagnosis and management should be included in the routine care of people living with HIV in Benin.

Otorhinolaryngology Diseases in HIV-Positive Patients: 208 Cases at the Donka National Hospital

Introduction: Otorhinolaryngology (ENT) diseases in patients living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/ AIDS) are relatively common and of concern to ENT specialists and other health professionals. Aim: It was to describe the epidemiological and diagnostic aspects of ENT and cervicofacial diseases in patients living with HIV/ AIDS. Material and Methods: This was a descriptive study with prospective data collection, conducted over a period of six months (September 16, 2019 to March 16, 2020), carried out at the ENT and Infectious Diseases Departments of the Donka National Hospital. Results: Of 522 HIV-positive patients, 208 (39.8%) presented with ENT diseases. Women represented 62.5% with a sex ratio of 0.6. The mean age was 42.21 years with extremes of 16 and 64 years. Housewives were the most represented (29.8%). Married people were the most affected (76.4%). Cervical involvement was present in 7.7% of patients. Otologic involvement accounted for 43.7%. Oral cavity and pharyngolaryngeal involvement accounted for 50.9%. Nasosinus involvement accounted for 55.7%. HIV type I was the most common (99.5%). Conclusion: Otorhinolaryngology diseases were frequent in HIV positive patients. They may constitute the first reason for consultation. However, these ENT diseases remain in appendix of the opportunistic diseases of HIV/AIDS taking the front stage.

HIV/AIDS肺脾气虚证相关心脑血管疾病风险因素探析

目的通过检测血脂四项、血管内皮损伤因子、炎症相关因子,并结合前期的基因芯片结果,初步探讨人类免疫缺陷病毒(HIV)/艾滋病(AIDS)肺脾气虚证相关心脑血管疾病风险因素及机制,为中医药早期干预心脑血管疾病提供依据。方法2020年9月—2020年11月选取河南省某地区确诊的20例HIV/AIDS肺脾气虚证患者作为研究对象,同地区20例HIV抗体阴性作为健康对照组。检测CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)计数,并计算CD_(4)^(+)/CD_(8)^(+)比值;检测血脂四项甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);检测氧化低密度脂蛋白(Ox-LDL)、载脂蛋白A-I(ApoAⅠ)、载脂蛋白A-Ⅱ(ApoAⅡ)、载脂蛋白B(ApoB)、锌-α2-糖蛋白1(AZGP1)、可溶性血栓调节蛋白(sTM)、血管性血友病因子(vWF)、脂联素、瘦素(LEP)、超敏C反应蛋白(Hs-CRP)、单核细胞趋化因子1(MCP-1)、肿瘤坏死因子α(TNF-α)。结果HIV/AIDS肺脾气虚证患者与健康对照组比较CD_(4)^(+)降低,CD_(4)^(+)/CD_(8)^(+)比值倒置,TC降低,sTM、AZGP1、Ox-LDL、Hs-CRP升高。结论HIV/AIDS肺脾气虚证患者存在炎性反应、血脂异常的表现,罹患心脑血管疾病风险增加。为中医药早期干预心脑血管疾病的发生提供新思路。

82例门诊HIV感染者/AIDS患者人口学特征分析

目的:了解皮肤性病就诊者中HIV感染者/AIDS患者的人口学特征及发现方式,为制定HIV筛查策略提供参考依据。方法:收集某皮肤病专科医院2018年3月至2023年10月上报的82例HIV感染者/AIDS患者信息,对其人口学特征、伴发疾病和发现方式等进行频数和一般描述性统计分析。结果:82例HIV感染者/AIDS患者中,男80例,女2例,年龄17~71岁,平均(37.40±12.28)岁,单身55例,大专及以上学历26例。本省其它地市48例,其他省12例。76例有男男性接触史,56例因皮肤症状就诊发现,26例因高危性行为或曾患性病主动查体发现,71例在性病门诊发现。结论:皮肤性病就诊者中HIV感染/AIDS患者具有包括多数为男性、性活跃人群、单身、文化程度较低、外地人为主等特征,有高风险性行为和皮肤性病症状的就诊者应有针对性地加强筛查。

Human parvovirus B19-associated hematopathy in HIV disease:need for clinicopathological revisit

Persons living with HIV infection occasionally suffer from anemia due to varying causes.These include the use of zidovudine,malnutrition especially vitamin B12and iron deficiency,opportunistic infections by Mycobacterium tuberculosis,Pneumocystis jiroveci,and direct hematological effects of HIV infection itself within the marrow microenvironment.Persistent Parvovirus B19（B19V）infection is a clinically important and treatable etiology of anemia in HIV-infected persons.

Factors Associated with HIV/Tuberculosis Coinfection among People Living with HIV after Initiation of Antiretroviral Treatment in Lingwala Health Zone from 2021 to 2023

Context and objective: Around 8% of incident cases of tuberculosis (TB) were reported among people living with HIV worldwide in 2022. Tuberculosis is the leading cause of death among people living with HIV. Africa accounts for the majority of co-infection episodes, with over 50% of cases in some parts of southern Africa. In the Democratic Republic of Congo (DRC), around 9% of persons living with HIV (PLHIV) develop TB and 11% of TB patients are infected with HIV. The DRC is one of the 30 countries in the world bearing the brunt of co-infection. Despite the efforts made by countries to improve access to antiretroviral traitement (ART), TB remains a major problem among people living with HIV. The Lingwala Health Zone in the provincial city of Kinshasa recorded a large number of cases of HIV/TB co-infection during the study period. The aim of this study was to determine the factors associated with HIV/TB co-infection among PLHIV on ART in the Lingwala health zone (HZ) in Kinshasa. Methods: This was a case-control study conducted in the state-run HIV care facilities in the Lingwala health district among PLHIV who had visited the health facilities during the period 2021-2023. Cases were coinfected patients and controls were PLHIV who had not developed tuberculosis during the study period. Results: A total of 281 PLHIV were enrolled in the study, with 70 cases and 211 controls. Factors associated with HIV/TB co-infection after multivariate analysis were viral load (OR = 5.34;95% CI;1.8-15.8, p = 0.005). History of tuberculosis (OR = 20.84;95% CI;8.6-50.3, p -85.0, p = 0.005) and BMI Conclusion: The results of this study indicate that the detection of these enumerated factors should prompt providers to actively search for tuberculosis with a view to organising early management.

Graves’ Disease as a Late Manifestation of Immune Reconstitution Syndrome after Highly Active Antiretroviral Therapy in an HIV-1 Infected Patient

Context: Highly active antiretroviral therapy (HAART) inhibits the HIV replication and consequently increases CD4 levels and decreases viral load. This immune system improvement can trigger various immunological phenomena, entity called Immune Reconstitution Syndrome (IRS). Graves’ disease is a late Immune Reconstitution consequence. Patient: We report the case of a 48 years old man with HIV infection who developed Graves’ disease three years after he was on effective HAART because of the Immune Reconstitution Syndrome. At presentation he had a very low CD4 T-cell count (17 cells/μL). When he started HAART he presented a lipodystrophy syndrome. HAART was changed because of the persistent low CD4-T cells count (less than 100 cell/μL). Afterwards serum lipid levels began to decrease and that was the first manifestation of Graves’ disease, which was diagnosed when CD4 T-cells increased up to 343 cell/μL. Our patient developed Graves’ disease 36 months after initiating effective HAART with protease inhibitors which was coincident with viral suppression and a rise of CD4 T cells. Conclusion: The most immunosuppressed patients with a CD4 T cell count less than 100 cells/μL are at greatest risk for the development of Immune Reconstitution Syndrome after HAART initiation. We conclude that clinicians will have to consider the importance of the early diagnosis of thyroid disease to bring an adequate treatment.

猴痘合并HIV感染疾病特征的研究进展

猴痘病毒的传播对HIV感染者构成了巨大威胁。一方面,猴痘病毒在HIV感染者中的感染率居高不下,在其他性传播疾病中的感染率也较高,如梅毒、淋病等;另一方面,尽管猴痘是自限性疾病,但与非HIV感染的猴痘患者相比,猴痘合并HIV感染患者的重症和死亡风险显著提升,尤其是在免疫重建不全的HIV感染者中。此外,在猴痘合并HIV感染的患者中,尤其是在CD4^(+)T淋巴细胞计数小于200×10^(3)/L的免疫重建不全的HIV感染者中,其临床症状比普通猴痘患者更加持久和严重,诊疗难度大。因此,全面了解猴痘合并HIV感染患者的疾病特征对于有效预防及减少猴痘传播至关重要。本文对猴痘合并HIV感染患者的病原学特征、流行病学特点、临床特征、诊断治疗和预防等方面进行阐述,旨在增强对猴痘合并HIV感染患者的全面了解,为针对这一类特殊人群制定精准防控策略提供理论支持。

Microalbuminuria and Kidney Disease Risk in HIV Patients Taking Combined Antiretroviral Therapy

Objectives: This study proposes to evaluate risk factors for kidney disease in HIV patients treated chronically and correlate with microalbuminuria measurements. Methods: Review charts and analyses of microalbuminuria in subgroup of HIV patients treated at Ceara/Brazil. Results: 149 patients, 69.1% male, mean 38.5 years old, infection mean 86.8 months. Mean Creatinine Clearance 110.2%, Creatinine 0.97, Urea 27.76 mg/dl, CD4+ 600.37 cels/mm3 and detectable viral load 530.59 copies with 61.7% undetectable. Mean Dosages of microalbuminuria/24h 147, 46 ± 820, 45 (N = 48) and microalbuminuria (mg/dl) 32.05 ± 85.25 (N = 43). Kidney Diseases Classification analyses evidenced 6.4% patients in stages ≥3 and 6.2% presented altered Microalbuminuria/24h. Patients using Tenofovir (TDF) 27.27% had Stage 2 and protease inhibitors (PI) had 4.1% in Stage 3. Proteinuria was observed in 5% stage ≥3. Association PI/TDF had 4.1% in Stage 3. No statistical difference between CD4 > or 3 and microalbuminuria/24h > 300 mg (p = 0.69);detectable/undetectable viral load and microalbuminuria/24h (p = 0.63) or stage ≥3 (p = 0.17);relation to Diabetes or arterial hypertension and microalbuminuria 24 h (p = 0.5 and p = 0.21);relation stage ≥3 and microalbuminuria/24h (p = 0.33);relation HIV diagnoses >/< 60 months and stage ≥3 (p = 0.51);or microalbuminuria/24h and TDF (p = 0.4), PI (p = 1), TDF/PI (p = 0.69), Atazanavir (p = 0.4) or Lopinavir/r (p = 1) regimens. There was statistical significance comparing age > or or < 50 years and microalbuminuria/24h (p = 0.55) or microalbuminuria mg/d (p = 0.32). Relating comorbidities risk (Diabetes Mellitus plus Systemic Arterial Hypertension) to Kidney Diseases, it was found that 55.5% patients in Stage 3 or above with comorbidities compared with 15% with comorbidities in lower stages (P = 0.005). Nevertheless, comorbidities presence was not associated with microalbuminuria (p = 0.08). Conclusion: Kidney disease is a real risk for HIV patients and stages ≥3 have to be early detected. Microalbuminuria dosage did not demonstrate more sensibility than proteinuria to early diagnoses, even related to antiretroviral drugs. Major risk factor for kidney damage evidenced to be older than 50 years and there was no protective effect from CD4 or undetectable viral load.

Risk Factors of Renal Failure in HIV Patients at Initiation of ARV Treatment: Retrospective Study of 3118 Patients Followed in Infectious Diseases Department at Lom&#233;University Hospital

HIV infection is a major cause of chronic kidney disease, associated with high morbidity and mortality in sub-Saharan Africa. The objective of this study is to assess the prevalence and risk factors of renal disease at initiation of antiretroviral therapy. This was a descriptive and analytical retrospective study carried out in the infectious and tropical diseases department at Sylvanus Olympio University Hospital. The data have been extracted from the ESOPE software. Kidney disease was defined by a GFR, estimated by MDRD (Modification of Diet in Renal Disease) formula, less than 60 ml/min/1.73 m2. Risk factors associated with kidney disease were assessed using univariate and multivariate analysis. There were 3118 HIV-infected patients included in our study. The median estimated filtration rate was 94.7 ml/min/1.73 m2: 2.9% had an eGFR 2. 1303 had kidney disease (41.8%). Most patients (30.8%) were in the WHO clinical stage 1. The median CD4 count was 165/μL [IQR = 72 - 274/μL];the median hemoglobin level was 10.4 g/dL [IQR = 8.8 - 11.9 g/dL];all patients had thrombocytopenia less than 100.000/mm3;8.5% had leukocytosis greater than 10.000/mm3. Most of patients had HIV1. In the multivariate analysis, age greater than 40 years (p 3 were significantly associated with renal disease. The prevention of kidney disease must go through the identification of its risk factors in the target populations.

Epidemiological, Clinical and Biological Aspects of Kidney Disease in People Living with HIV Naive Antiretroviral Therapy at CHU Sylvanus Olympio of Lome (TOGO)

Introduction: Human immunodeficiency virus (HIV) infection is a common cause of kidney disease worldwide. HIV-related renal diseases are associated with high morbidity and mortality in Sub-Saharan African countries. The aim is to describe the epidemiological, clinical and biological aspects of kidney disease in people living with HIV naive antiretroviral therapy in Lomé in Togo. Methods: This was a cross-sectional study done in the department of Infectious and Tropical Diseases in Lomé from ESOPE database. Glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. Kidney disease was defined as GFR less than 90 mL/min/1.73 m2. Results: In total, 3118 HIV-infected ART-naive patients were included in this study. Among them, the prevalence of renal disease at the beginning of their care, was 41.8% or 1303 patients [95% CI: 40.0% - 43.5%]. The median estimated GFR was 94.7 ml/min/1.73 m2: 2.9% had eGFR 2. The median age was 40 years [IQR = 34 - 48 years] with a sex ratio at 0.45. BMI median was 20.6 Kg/m2. Most of patients (30.8%) were at clinic OMS stage 1. Median CD4 was 165/uL [IQR = 72 - 274/uL];median hemoglobin was 10.4 g/dl [IQR = 8.8 - 11.9 g/dl];median glycemia was 0.84 g/l [IQR = 0.75 - 0.95 g/l]. Most of patients (99.9%) had HIV-1. 8.5% had hyperleukocytosis, and all patients had thrombopenia. Conclusion: The incidence of kidney disease is high in Togolese HIV-infected ART naive patients.

Renal Disease among HIV Positive Patients in Senegal

Introduction: Renal disease (RD) in human immunodeficiency virus (HIV) infection is a decisive turning point in the development and prognosis of this disease. In Africa, the prevalence varies between 2.5% and 48.6%. In Senegal, little data are available in the literature. The objective of our study was to describe the epidemiological, clinical, paraclinical, therapeutic and progressional aspects in patients living with HIV (PLWHIV). Patients and methods: This was a retrospective, descriptive and analytical study carried out over a 10-year period in the Department of Internal Medicine and Nephrology at the Aristide Le Dantec Hospital in Dakar, Senegal. We included all 15-year old and above PLHIV with available CD4 count and viral load. Results: Out of 248 PLHIV, 32 had kidney disease (KD), which means a hospital prevalence of 12.9%. The mean age was 51.22 ± 10 years (extremes of 36 and 77 years) with a sex ratio (male/female) of 1.28. Renal signs were dominated by glomerular nephropathy syndrome. It was present at 80%. Tubulo-interstitial nephropathy syndrome and chronic uremic syndrome accounted for 6.25% and 3.1% of cases, respectively. Renal function Impairment was present in 21 patients with 18 cases of acute kidney injury (85.7%) and 3 cases of chronic renal failure (14.3%), including 2 in stage 5 of chronic kidney disease. Renal biopsy (RB) was indicated and performed in 20 (62.5%) patients with glomerular signs in 12 patients (60%). Glomerular lesions were dominated by focal and segmental glomerulosclerosis (FSGS) in 6 cases, membraneous nephropathy (MN) in 4 cases and minimal change disease (MCD) in 2 cases. Tubulo-interstitial and vascular lesions were present in 45% and 12.5% of cases, respectively. In highly active antiretroviral therapy (HAART), 12 (37.5%) patients had total remission, 9 (28.12%) had partial remission. One (3.12%) death from severe metabolic acidosis on chronic renal failure was deplored. Conclusion: This study illustrates the high prevalence of RD in PLHIV in our exercise context.

Unexpected Association of HIV, Hepatitis C Virus Infection, Lymph Node Tuberculosis, and Sickle Cell Disease: A Case Report in a 35-Year-Old Woman from Cameroon

Introduction: HIV infection is a public health issue. Developing countries are facing the challenge of patient populations that remain undiagnosed and under-served in combined antiretroviral treatment (cART) leading to opportunistic infections. Lymph node tuberculosis is one of the most common. His firm diagnosis is not always easy in resources limited country. Case Presentation: We report a case of a 35-year-old woman known HIV for the past 10 years but not on treatment. She presented with a four-month history of fatigue, weight loss and pain in the right flank. The diagnosis of lymph node tuberculosis, hepatitis c virus infection and sickle cell disease was done. After 6 months of treatment, there was a favourable clinical evolution. Conclusion: This case report highlights the necessity to screen for opportunistic and non-opportunistic co-infection in HIV infected patient.

HIV抗病毒治疗患者心血管疾病风险评估及危险因素分析

目的评估抗病毒逆转录治疗(anti-retroviral therapy,ART)患者心血管疾病(Cardiovascular disease,CVD)风险,了解昆明地区不同风险等级患者的差异情况,分析影响CVD的危险因素。方法2023年7至12月对已启动ART的患者调查问卷和收集相关资料,应用D:A:D模型评估风险并将评分分为低危组、中危组和高危组。χ2检验和秩和检验比较各因素组间差异,Logistic回归分析CVD影响因素。结果共纳入4139例患者,低危组3119例(75.4%)、中高危组1020例(24.6%)[中危组756例(18.3%)、高危组264例(6.3%)]。单因素Logistic回归分析结果为男性、年龄≥50岁、吸烟史、高血压史、CVD家族史、同性传播、消瘦、超重、肥胖、糖尿病史、血糖高值、大专及以上文化、血脂异常、ART≥10 a、CD4≥200(个/μL)、ART药物均与CVD风险≥10%有关(均P<0.05)。经多因素Logistic回归分析以上变量仅同性传播不具有统计学差异(P>0.05)。结论男性、年龄、合并非艾滋病定义性疾病(如糖尿病、高血压)、吸烟史、CVD家族史、超重、肥胖、ART超过10 a、血脂代谢异常、CD4细胞计数低和ART药物的患者CVD风险更高,在HIV全程管理中应重点监测血脂、血压和血糖等指标,评估患者CVD风险,及时干预和调整治疗方案。

Basic Knowledge and Attitudes to Promote Safe Behaviours to Grade 8 Learners Concerning Burden of Diseases Including HIV/AIDS

This paper focuses on knowledge and attitudes of Grade 8 pupils about HIV/AIDS and opportunistic diseases. In particular, people need to know what it is, how it is transmitted, how to protect themselves from it, and how to relate to people with the disease. According to the National policy for HIV/AIDS, schools are key settings for educating children about HIV/AIDS and for halting further spread of the infection. It has been noticeable that Grade 8 pupils in the rural areas around Mthatha district are particularly at risk of getting HIV. The focus is often more on Grade 11 and 12 pupils, so female Grade 10 pupils look for boys for attention. This resulted for the female pupils to fall pregnant. The fact that some of them are falling pregnant means they are also more vulnerable to contracting HIV. This shows that little information is available for them and this paper is contributing to that body of knowledge. Prevention therefore is the most effective strategy to combat pregnancy and against the spread of HIV/AIDS in schools. Measures should be taken to remove the social, cultural and political barriers that might block access to HIV/AIDS services and programmes. The results showed that while some Grade 8 pupils are aware of HIV/AIDS, there are others who said it does not exist. It has also been highlighted that the phenomenon of pupils having unprotected sex with older men for money, as well as pupils saying they did not have time to use condoms. It is therefore recommended that pupils need to have role models, people they can look up to. In the absence of parents, it should be teachers＇ responsibility to advise the pupils and inform them about Sexually Transmitted Infections （STIs） and HIV/AIDS in schools.

Mathematical Modeling of the Co-Infection Dynamics of HIV and Tuberculosis Incorporating Inconsistency in HIV Treatment

A non-linear HIV-TB co-infection has been formulated and analyzed. The positivity and invariant region has been established. The disease free equilibrium and its stability has been determined. The local stability was determined and found to be stable under given conditions. The basic reproduction number was obtained and according to findings, co-infection diminishes when this number is less than unity, and persists when the number is greater than unity. The global stability of the endemic equilibrium was calculated. The impact of HIV on TB was established as well as the impact of TB on HIV. Numerical solution was also done and the findings indicate that when the rate of HIV treatment increases the latent TB increases while the co-infected population decreases. When the rate of HIV treatment decreases the latent TB population decreases and the co-infected population increases. Encouraging communities to prioritize the consistent treatment of HIV infected individuals must be emphasized in order to reduce the scourge of HIV-TB co-infection.

TB/HIV双重感染防治工作机制研究

[目的]探索TB/HIV双重感染防治工作机制。[方法]在四川省选择结核病和艾滋病疫情均较重的两个县开展为期6个月的试点研究。[结果]通过研究,探索出了"4个一"工作协调机制和"一初筛、二转诊、三检查、四诊断、五鉴别"的工作模式,以及并由结防人员采血、告知阴性结果,由艾防人员检测、告知阳性结果的HIV抗体检测和咨询程序。结核病人中HIV检出率为2.40%,HIV/AIDS中结核病的检出率为5.06%。[结论]在结防机构和艾防机构间建立一套有机的协作机制是做好TB/HIV双重感染防治工作的基础。