目的:基于"冬病夏治"理论探讨参灵扶正胶囊对AIDS/HIV患者高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)后相关慢性腹泻的临床疗效及机制。方法:采用随机、阳性对照的临床试验方法,对符合慢性腹泻诊断...目的:基于"冬病夏治"理论探讨参灵扶正胶囊对AIDS/HIV患者高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)后相关慢性腹泻的临床疗效及机制。方法:采用随机、阳性对照的临床试验方法,对符合慢性腹泻诊断标准的65例HIV/AIDS患者随机分为两组,其中观察组33例,常规HAART基础上,基于"冬病夏治"理论,在"三伏天"期间给予参灵扶正胶囊8粒,2次/d;对照组32例,常规HAART基础上,服用洛哌丁胺4mg,2次/d,疗程均为6周。观察两组患者疗程结束及随访3、6、12个月时腹泻改善率,大便真菌感染情况,免疫功能及生存质量量表改善情况等。结果:疗程结束时,两组患者腹泻改善情况、生活质量量表、免疫功能等差异均无统计学意义(P>0.05),比较大便真菌感染率,对照组显著高于观察组(15.6%VS 6.1%,P<0.05)。随访到3、6、12个月时观察组腹泻复发率、大便真菌感染率显著低于对照组,差异有统计学意义(P<0.05);免疫功能及生活质量改善方面也优于对照组,差异均有统计学意义(P<0.05)。结论:基于"冬病夏治"理论指导下的参灵扶正胶囊能够有效改善HIV/AIDS患者HAART后相关腹泻的近期及远期疗效,减少肠道真菌感染率,在改善免疫功能和生活质量方面也有较好的临床疗效。展开更多
高效抗逆转录病毒疗法(Highly active antiretroviral treatment,HAART)是目前临床上最基本的艾滋病治疗方法,能有效降低患者病毒载量,延缓AIDS进程,显著延长患者寿命。随着制药成本的下降及我国"四免一关怀"政策的实施,绝大...高效抗逆转录病毒疗法(Highly active antiretroviral treatment,HAART)是目前临床上最基本的艾滋病治疗方法,能有效降低患者病毒载量,延缓AIDS进程,显著延长患者寿命。随着制药成本的下降及我国"四免一关怀"政策的实施,绝大多数艾滋病患者能及时获得有效的HAART治疗。然而,在长期用药过程中,HAART药物所致的不良反应也引起医护人员及患者的广泛关注。所有抗逆转录病毒药物均能在患者体内引起药物相关的毒副反应,包括皮疹、胃肠道反应、肝毒性、肾毒性、骨髓抑制、代谢紊乱及神经系统毒性等。部分严重不良反应可导致HAART治疗的中断,甚至出现机体生理功能的严重损伤,严重影响艾滋病患者预后。本文综述了艾滋病HAART治疗中出现的不良反应及其发生机制。展开更多
Cytomegalovirus(CMV)retinitis is an opportunistic infection that has traditionally affected those who have HIV/AIDS or immunosuppressed individuals.CMV retinitis previously infected one-third of AIDS patients in the p...Cytomegalovirus(CMV)retinitis is an opportunistic infection that has traditionally affected those who have HIV/AIDS or immunosuppressed individuals.CMV retinitis previously infected one-third of AIDS patients in the pre-highly active antiretroviral therapy(HAART)era,but since HAART,Western countries have seen an 80%decrease in the incidence of the disease.More recently,CMV retinitis has been reported in patients who are immunosuppressed,often due to chemotherapy or immunomodulatory medications.The diagnosis of CMV retinitis is often suspected based on clinical findings,with polymerase chain reaction for confirmation of CMV,especially in atypical cases.Highly active antiretroviral therapy and anti-CMV medications(systemic or local)remain the mainstay of treatment.However,for those who are not responsive to HAART,CMV retinitis remains a challenge,and can still lead to significant vision loss.Moreover,a regimen of anti-CMV medications can sometimes lead to viral resistance or organ toxicity.Complications such as immune recovery retinitis and rhegmatogenous retinal detachments continue to threaten the vision of patients who develop CMV retinitis.These complications can arise following initiation of treatment or if patients show disease progression.Proper vision screening for CMV retinitis in immunosuppressed patients at-risk is necessary for early detection and treatment.展开更多
Objective:Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)and may vary considerably by ethnic and geographic regions and by the ...Objective:Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy(HAART).However,little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh.This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the era of HAART.Materials:This descriptive cross-sectional study was carried out in Chittagong Medical College Hospital,Bangladesh from January 2017 and December 2020.Diagnosed case of HIV/AIDS for HAART therapy and all cases of HIV/AIDS who are already on HAART therapy were included in this study.Descriptive statistical analysis was carried out by using frequencies and percentages.Results:Of 40 patients with HIV/AIDS,22(55.0%)were male and 18(45.0%)were female.The patients ranged in age from 8 to 60 years,with a mean age of 38±0.966 years.Among all age groups,the highest 19(47.5%)patients were in the 31-to 40-year age group.Most of the patients were migrant workers[22/40(55.0%)]with low socioeconomic status[32/40(80.0%)],and the most common transmission mode was heterosexual activity[36/40(90.0%)].Most of the patients[32/40(80.0%)]had mucocutaneous disorders,30/40(75.0%)had infective dermatoses,and 21/40(52.5%)had non-infective inflammatory dermatoses.Eight of forty(20.0%)patients presented with three or more skin disorders.The most common infective dermatoses were fungal infections[15/40(37.5%)],followed by viral infections[8/40(20.0%)],bacterial infections[4/40(10.0%)],and scabies[3/40(7.5%)].The most common non-infective dermatosis was generalized pruritus[6/40(15.0%)],followed by prurigo simplex[4/40(10.0%)],psoriasis[4/40(10.0%)],eczema[3/40(7.5%)],pruritic papular eruption[1/40(2.5%)],seborrheic dermatitis[1/40(2.5%)],urticaria[1/40(2.5%)],and xerosis[1/40(2.5%)].Patients treated with HAART had decreased rates of oral candidiasis and herpes simplex but increased rates of drug reactions[19/40(47.5%)].The most common drug eruption following HAART was a morbilliform rash[11/40(27.5%)],and the most common offending agent was nevirapine.The prevalence of mucocutaneous disorders was higher in patients with a CD4 cell count of<200 cells/mm3.Conclusions:A wide range of mucocutaneous disorders is observed in Bangladeshi patients with HIV/AIDS,and HAART has an impact on the spectrum of HIV/AIDS-associated mucocutaneous disorders.Skin and mucocutaneous disorders are seen at every stage of HIV/AIDS and are the initial presentation in most patients in Bangladesh.There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of patients withHIV/AIDS.展开更多
高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)在HIV/AIDS治疗领域具有里程碑意义。HAART可有效控制病毒复制,延缓疾病进展,显著地改变了HIV感染者和艾滋病患者的预后。在过去三十多年间,多种类型的抗病毒药物不...高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)在HIV/AIDS治疗领域具有里程碑意义。HAART可有效控制病毒复制,延缓疾病进展,显著地改变了HIV感染者和艾滋病患者的预后。在过去三十多年间,多种类型的抗病毒药物不断问世,联合治疗方案不断更新。本文将概述国内外艾滋病抗病毒治疗现状及相关研究进展。展开更多
目的:分析江苏男男性行为(men who have sex with men,MSM)人群的艾滋病抗病毒治疗效果及其影响因素,首次建立江苏省MSM抗病毒治疗评价方法。方法:通过整群抽样的方式选取江苏两市接受免费高效抗逆转病毒治疗(highly active antiretrovi...目的:分析江苏男男性行为(men who have sex with men,MSM)人群的艾滋病抗病毒治疗效果及其影响因素,首次建立江苏省MSM抗病毒治疗评价方法。方法:通过整群抽样的方式选取江苏两市接受免费高效抗逆转病毒治疗(highly active antiretroviral therapy,HAART)的MSM作为研究对象,进行生活史和用药情况的问卷调查;从江苏省艾滋病治疗信息库中获知其CD4值,采用Epidata 3.0和SAS 9.0分别进行资料录入与统计分析。结果:157例MSM总体CD4值提高,服药依从性低。经单因素及多因素分析,确诊后安全套使用水平低、吸烟量大、确诊至治疗时间间隔长是影响治疗效果的危险因素;首次CD4值较高及服药天数较长是保护因素。结论:江苏目前男男性行为人群抗病毒治疗效果显著,建议对符合治疗条件的MSM进行早期治疗,并提高患者服药依从性。展开更多
高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)显著降低了HIV相关疾病的病死率,使HIV/AIDS的临床治疗取得了突破性进展,但HAART不能彻底清除患者体内的病毒。长期服药带来的不良反应、病毒耐药性、患者服药依从性...高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)显著降低了HIV相关疾病的病死率,使HIV/AIDS的临床治疗取得了突破性进展,但HAART不能彻底清除患者体内的病毒。长期服药带来的不良反应、病毒耐药性、患者服药依从性与经济负担等问题已成为抗病毒治疗失败的主要原因。本文就国内外AIDS抗病毒治疗的历史和现状进行回顾,并对抗病毒治疗的未来进行展望。展开更多
文摘目的:基于"冬病夏治"理论探讨参灵扶正胶囊对AIDS/HIV患者高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)后相关慢性腹泻的临床疗效及机制。方法:采用随机、阳性对照的临床试验方法,对符合慢性腹泻诊断标准的65例HIV/AIDS患者随机分为两组,其中观察组33例,常规HAART基础上,基于"冬病夏治"理论,在"三伏天"期间给予参灵扶正胶囊8粒,2次/d;对照组32例,常规HAART基础上,服用洛哌丁胺4mg,2次/d,疗程均为6周。观察两组患者疗程结束及随访3、6、12个月时腹泻改善率,大便真菌感染情况,免疫功能及生存质量量表改善情况等。结果:疗程结束时,两组患者腹泻改善情况、生活质量量表、免疫功能等差异均无统计学意义(P>0.05),比较大便真菌感染率,对照组显著高于观察组(15.6%VS 6.1%,P<0.05)。随访到3、6、12个月时观察组腹泻复发率、大便真菌感染率显著低于对照组,差异有统计学意义(P<0.05);免疫功能及生活质量改善方面也优于对照组,差异均有统计学意义(P<0.05)。结论:基于"冬病夏治"理论指导下的参灵扶正胶囊能够有效改善HIV/AIDS患者HAART后相关腹泻的近期及远期疗效,减少肠道真菌感染率,在改善免疫功能和生活质量方面也有较好的临床疗效。
文摘高效抗逆转录病毒疗法(Highly active antiretroviral treatment,HAART)是目前临床上最基本的艾滋病治疗方法,能有效降低患者病毒载量,延缓AIDS进程,显著延长患者寿命。随着制药成本的下降及我国"四免一关怀"政策的实施,绝大多数艾滋病患者能及时获得有效的HAART治疗。然而,在长期用药过程中,HAART药物所致的不良反应也引起医护人员及患者的广泛关注。所有抗逆转录病毒药物均能在患者体内引起药物相关的毒副反应,包括皮疹、胃肠道反应、肝毒性、肾毒性、骨髓抑制、代谢紊乱及神经系统毒性等。部分严重不良反应可导致HAART治疗的中断,甚至出现机体生理功能的严重损伤,严重影响艾滋病患者预后。本文综述了艾滋病HAART治疗中出现的不良反应及其发生机制。
基金supported by the National Eye Institute/National Institutes of Health core grant P30-EY06360(Department of Ophthalmology,Emory University School of Medicine)National Eye Institute,National Institutes of Health R01 EY029594(Yeh)and K23 EY030158(Shantha)+1 种基金Funding support was also provided via an Unrestricted Grant from Research to Prevent Blindness(Emory Eye Center,Emory University School of Medicine)Research support has also been provided by the Association for Research in Vision and Ophthalmology Mallinckrodt Award and the Stanley M.Truhlsen Family Foundation,Inc.
文摘Cytomegalovirus(CMV)retinitis is an opportunistic infection that has traditionally affected those who have HIV/AIDS or immunosuppressed individuals.CMV retinitis previously infected one-third of AIDS patients in the pre-highly active antiretroviral therapy(HAART)era,but since HAART,Western countries have seen an 80%decrease in the incidence of the disease.More recently,CMV retinitis has been reported in patients who are immunosuppressed,often due to chemotherapy or immunomodulatory medications.The diagnosis of CMV retinitis is often suspected based on clinical findings,with polymerase chain reaction for confirmation of CMV,especially in atypical cases.Highly active antiretroviral therapy and anti-CMV medications(systemic or local)remain the mainstay of treatment.However,for those who are not responsive to HAART,CMV retinitis remains a challenge,and can still lead to significant vision loss.Moreover,a regimen of anti-CMV medications can sometimes lead to viral resistance or organ toxicity.Complications such as immune recovery retinitis and rhegmatogenous retinal detachments continue to threaten the vision of patients who develop CMV retinitis.These complications can arise following initiation of treatment or if patients show disease progression.Proper vision screening for CMV retinitis in immunosuppressed patients at-risk is necessary for early detection and treatment.
文摘Objective:Skin diseases are common and striking features of patients with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)and may vary considerably by ethnic and geographic regions and by the influence of highly active antiretroviral therapy(HAART).However,little information exists regarding the cutaneous manifestations of patients with HIV/AIDS in Bangladesh.This study was performed to elucidate the spectrum of cutaneous disorders in patients with HIV/AIDS in the era of HAART.Materials:This descriptive cross-sectional study was carried out in Chittagong Medical College Hospital,Bangladesh from January 2017 and December 2020.Diagnosed case of HIV/AIDS for HAART therapy and all cases of HIV/AIDS who are already on HAART therapy were included in this study.Descriptive statistical analysis was carried out by using frequencies and percentages.Results:Of 40 patients with HIV/AIDS,22(55.0%)were male and 18(45.0%)were female.The patients ranged in age from 8 to 60 years,with a mean age of 38±0.966 years.Among all age groups,the highest 19(47.5%)patients were in the 31-to 40-year age group.Most of the patients were migrant workers[22/40(55.0%)]with low socioeconomic status[32/40(80.0%)],and the most common transmission mode was heterosexual activity[36/40(90.0%)].Most of the patients[32/40(80.0%)]had mucocutaneous disorders,30/40(75.0%)had infective dermatoses,and 21/40(52.5%)had non-infective inflammatory dermatoses.Eight of forty(20.0%)patients presented with three or more skin disorders.The most common infective dermatoses were fungal infections[15/40(37.5%)],followed by viral infections[8/40(20.0%)],bacterial infections[4/40(10.0%)],and scabies[3/40(7.5%)].The most common non-infective dermatosis was generalized pruritus[6/40(15.0%)],followed by prurigo simplex[4/40(10.0%)],psoriasis[4/40(10.0%)],eczema[3/40(7.5%)],pruritic papular eruption[1/40(2.5%)],seborrheic dermatitis[1/40(2.5%)],urticaria[1/40(2.5%)],and xerosis[1/40(2.5%)].Patients treated with HAART had decreased rates of oral candidiasis and herpes simplex but increased rates of drug reactions[19/40(47.5%)].The most common drug eruption following HAART was a morbilliform rash[11/40(27.5%)],and the most common offending agent was nevirapine.The prevalence of mucocutaneous disorders was higher in patients with a CD4 cell count of<200 cells/mm3.Conclusions:A wide range of mucocutaneous disorders is observed in Bangladeshi patients with HIV/AIDS,and HAART has an impact on the spectrum of HIV/AIDS-associated mucocutaneous disorders.Skin and mucocutaneous disorders are seen at every stage of HIV/AIDS and are the initial presentation in most patients in Bangladesh.There is a need for increased attention to the diagnosis and treatment of skin diseases affecting the quality of life of patients withHIV/AIDS.
文摘高效抗反转录病毒治疗(highly active antiretroviral therapy,HAART)在HIV/AIDS治疗领域具有里程碑意义。HAART可有效控制病毒复制,延缓疾病进展,显著地改变了HIV感染者和艾滋病患者的预后。在过去三十多年间,多种类型的抗病毒药物不断问世,联合治疗方案不断更新。本文将概述国内外艾滋病抗病毒治疗现状及相关研究进展。
文摘目的:分析江苏男男性行为(men who have sex with men,MSM)人群的艾滋病抗病毒治疗效果及其影响因素,首次建立江苏省MSM抗病毒治疗评价方法。方法:通过整群抽样的方式选取江苏两市接受免费高效抗逆转病毒治疗(highly active antiretroviral therapy,HAART)的MSM作为研究对象,进行生活史和用药情况的问卷调查;从江苏省艾滋病治疗信息库中获知其CD4值,采用Epidata 3.0和SAS 9.0分别进行资料录入与统计分析。结果:157例MSM总体CD4值提高,服药依从性低。经单因素及多因素分析,确诊后安全套使用水平低、吸烟量大、确诊至治疗时间间隔长是影响治疗效果的危险因素;首次CD4值较高及服药天数较长是保护因素。结论:江苏目前男男性行为人群抗病毒治疗效果显著,建议对符合治疗条件的MSM进行早期治疗,并提高患者服药依从性。
文摘高效抗逆转录病毒治疗(highly active antiretroviral therapy,HAART)显著降低了HIV相关疾病的病死率,使HIV/AIDS的临床治疗取得了突破性进展,但HAART不能彻底清除患者体内的病毒。长期服药带来的不良反应、病毒耐药性、患者服药依从性与经济负担等问题已成为抗病毒治疗失败的主要原因。本文就国内外AIDS抗病毒治疗的历史和现状进行回顾,并对抗病毒治疗的未来进行展望。
