Human immunodeficiency virus/acquired immune deficiency syndrome: Using drug from mathematical perceptive

Entry of acquired immune deficiency syndrome virus into the host immune cell involves the participation of various components of host and viral cell unit. These components may be categorized as attachment of the viral surface envelope protein subunit, gp120, to the CD4+ receptor and chemokine coreceptors, CCR5 and CXCR4, present on T cell surface. The viral fusion protein, gp41, the second cleaved subunit of Env undergoes reconfiguration and the membrane fusion reaction itself. Since the CD4+ T cell population is actively involved; the ultimate outcome of human immunodeficiency virus infection is total collapse of the host immune system. Mathematical modeling of the stages in viral membrane protein-host cell receptor-coreceptor interaction and the effect of antibody vaccine on the viral entry into the susceptible host cell has been carried out using as impulsive differential equations. We have studied the effect of antibody vaccination and determined analytically the threshold value of drug dosage and dosing interval for optimum levels of infection. We have also investigated the effect of perfect adherence of drug dose on the immune cell count in extreme cases and observed that systematic drug dosage of the immune cells leads to longer and improved lives.

Investigation of perceived stigma among people living with human immunodeficiency virus/ acquired immune deficiency syndrome in Henan Province, China

Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Methods:In total,161 PLWHA from Zhengzhou and Zhenping were investigated using the Berger HIV stigma scale.Results:The mean Berger stigma scale score was 105.70±15.20,indicating a middle stigma level.Among the four subscales of the Berger stigma scale,the disclosure concerns score was highest,while the negative self-image score was lowest.Multivariate analyses showed that factors influencing perceived HIV stigma included the level of education and route of infection.Conclusion:The level of perceived HIV stigma and discrimination among PLWHA in Henan Province is moderate and was affected by the level of education and route of infection.Special intervention should be established to address this problem.

Improvement in human immunodeficiency virus-1/acquired immune deficiency syndrome patients' well-being following administration of “Phyto V7”

AIM:To corroborate the capacity of Phyto V7,a complex of phytochemicals,to improve the physical well-being of human immunodeficiency virus-1(HIV-1) infected and acquired immune deficiency syndrome(AIDS) patients not undergoing antiretroviral treatment.METHODS:Two hundred and thirty nine HIV-1 seropositive male and female voluntary inmates were recruited through the Uruguay National Program of AIDS.The study participants received for 90 consecutive days every eight hours two tablets(760 mg/each) of Phyto V7,containing a mix of the following phytochemicals:flavonols(Kaempferol,Quercetin),flavones(Apigenin,Luteolin),hydroxycinnamic acids(ferrulic acid),carotenoids(Lutein,Lycopene,Beta carotene) and organosulfur compounds,all from vegetal origin.The participants did not receive any antiretroviral treatment during the study.At days 0,30,60 and 90(± 2 d) the participants were evaluated for body mass index(BMI),tolerance to Phyto V7 and Index of Quality of Life based on the Karfnosky scale.ANOVA,Tukey Post-test,χ2 test and Wilcoxon Signed Rank test were used to analyze the effect of treatment.RESULTS:One hundred and nighty nine study participants finished the study.Already after 30 d of Phyto V7 consumption,the weight,BMI and Karnofsky score statistically significantly improved(P < 0.001),and continued to improve until the end of the study.The mean weight gain per participant during the 90 d wasof 1.21 kg(approximately 2% of body weight).The overall increase in the mean Karnofsky score after 90 d was 14.08%.The lower the BMI and Karnofsky score of the participants were at the beginning of the study,the more notorious was the improvement over time.For example,the mean increment of Index of Quality of Life,among the participants with an initial Karnofsky score of 5 or below(n = 33) from day 0 to day 90,was of 35.67%(0.476 ± 0.044 vs 0.645 ± 0.09; P < 0.001).The tolerability to Phyto V7 was very good and no adverse reactions were recorded or reported.CONCLUSION:Administration of the Phyto V7 can be an important tool to improve the well-being of HIV-1 seropositive individuals and AIDS patients,not undergoing antiretroviral treatment.

Gut epithelial barrier dysfunction in humanimmunodeficiency virus-hepatitis C virus coinfectedpatients:Influence on innate and acquired immunity

Even in cases where viral replication has been controlled by antiretroviral therapy for long periods of time, human immunodeficiency virus(HIV)-infected patients have several non-acquired immunodeficiency syndrome(AIDS) related co-morbidities, including liver disease, cardiovascular disease and neurocognitive decline, which have a clear impact on survival. It has been considered that persistent innate and acquired immune activation contributes to the pathogenesis of these non-AIDS related diseases. Immune activation has been related with several conditions, remarkably with the bacterial translocation related with the intestinal barrier damage by the HIV or by hepatitis C virus(HCV)-related liver cirrhosis. Consequently, increased morbidity and mortality must be expected in HIV-HCV coinfected patients. Disrupted gut barrier lead to an increased passage of microbial products and to an activation of the mucosal immune system and secretion of inflammatory mediators, which in turn might increase barrier dysfunction. In the present review, the intestinal barrier structure, measures of intestinal barrier dysfunction and the modifications of them in HIV monoinfection and in HIV-HCV coinfection will be considered. Both pathogenesis and the consequences for the progression of liver disease secondary to gut microbial fragment leakage and immune activation will be assessed.

Elevated homocysteine levels in human immunodeficiency virus-infected patients under antiretroviral therapy: A meta-analysis

AIM: To evaluate the association between the levels of homocysteine(Hcy), folate, vitamin B12 in human immunodeficiency virus(HIV)-infected patients who were treated with antiretroviral therapy(ART) or not treated with ART.METHODS: The Pub Med and Scielo databases were searched. Eligible studies regarding plasma Hcy level in HIV-infected patients were firstly identified. After careful analysis by two independent researches, the identified articles were included in the review according to two outcomes(1) Hcy, folate and vitamin B12 blood concentration in HIV-infected subjects vs health controls and;(2) Hcy blood concentration in HIV-infected subjects under ART vs not treated with ART. RevM an(version 5.2) was employed for data synthesis.RESULTS: A total of 12 studies were included in outcome 1(1649 participants, 932 cases and 717 controls). Outcome 1 meta-analysis demonstrated higher plasma Hcy(2.05 μmol/L; 95% CI: 0.10 to 4.00, P < 0.01) and decreased plasma folate concentrations(-2.74 ng/m L; 95%CI:-5.18 to-0.29, P < 0.01) in HIV-infected patients compared to healthy controls. No changes in vitamin B12 plasma concentration were observed between groups. All studies included in the outcome 2 meta-analysis(1167 participants; 404 HIVinfected exposed to ART and 757 HIV-infected non-ART patients) demonstrated higher mean Hcy concentration in subjects HIV-infected under ART compared to nonART HIV subjects(4.13 μmol/L; 95%CI: 1.34 to 6.92, P < 0.01).CONCLUSION: This meta-analysis demonstrated that the levels of Hcy and folate, but not vitamin B12, were associated with HIV infection. In addition, Hcy levels were higher in HIV-infected patients who were under ART compared to HIV-infected patients who were not exposed to ART. Our results suggest that hyperhomocysteinemia should be included among the several important metabolic disturbances that are associated with ART in patients with HIV infection.

Water,electrolytes,and acid-base alterations in human immunodeficiency virus infected patients

The clinical spectrum of human immunodeficiency virus （HIV） infection associated disease has changed significantly over the past decade, mainly due to the wide availability and improvement of combination antiretroviral therapy regiments. Serious complications associated with profound immunodeficiency are nowa-days fortunately rare in patients with adequate access to care and treatment. However, HIV infected patients, and particularly those with acquired immune defciency syndrome, are predisposed to a host of different water, electrolyte, and acid-base disorders （sometimes with opposite characteristics）, since they have a modified renal physiology （reduced free water clearance, and relatively increased fractional excretion of calcium and magnesium） and they are also exposed to infectious, inflammatory, endocrinological, oncological variables which promote clinical conditions （such as fever,tachypnea, vomiting, diarrhea, polyuria, and delirium）, and may require a variety of medical interventions （antiviral medication, antibiotics, antineoplastic agents）, whose combination predispose them to undermine their homeostatic capability. As many of these disturbances may remain clinically silent until reaching an advanced condition, high awareness is advisable, particularly in patients with late diagnosis, concomitant inflammatory conditions and opportunistic diseases. These disorders contribute to both morbidity and mortality in HIV infected patients.

The default mode network is affected in the early stage of simian immunodeficiency virus infection:a longitudinal study

Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic changes in the default mode network following acquired immune deficiency syndrome infection and antiretroviral therapy.Specifically,when brain imaging data at only one time point are analyzed,determining the duration at which the default mode network is the most effective following antiretroviral therapy after the occurrence of acquired immune deficiency syndrome.However,because infection times and other factors are often uncertain,longitudinal studies cannot be conducted directly in the clinic.Therefore,in this study,we performed a longitudinal study on the dynamic changes in the default mode network over time in a rhesus monkey model of simian immunodeficiency virus infection.We found marked changes in default mode network connectivity in 11 pairs of regions of interest at baseline and 10 days and 4 weeks after virus inoculation.Significant interactions between treatment and time were observed in the default mode network connectivity of regions of interest pairs area 31/V6.R and area 8/frontal eye field(FEF).L,area 8/FEF.L and caudal temporal parietal occipital area(TPOC).R,and area 31/V6.R and TPOC.L.ART administered 4 weeks after infection not only interrupted the progress of simian immunodeficiency virus infection but also preserved brain function to a large extent.These findings suggest that the default mode network is affected in the early stage of simian immunodeficiency virus infection and that it may serve as a potential biomarker for early changes in brain function and an objective indicator for making early clinical intervention decisions.

Bilateral Central Retinal Vein Occlusions Combined with Artery Occlusions in A Patient with Acquired Immune Deficiency Syndrome

Purpose: This is the first report of a bilateral nonischemic central retinal vein occlusionscombined with artery occlusions in a patient with acquired immune deficiency syndrome(AIDS). Methods: Case report. Results: A 22-year-old Chinese(male) with a positive human immunodeficiency virus(HIV) infection developed bilateral nonischemic central retinal vein occlusions combinedwith artery occlusions and severe vision loss. The manifestations of the fundus andfluorescein angiography were similar in both eyes.Conclusion: This case report provides the evidences that central retinal vein and arteryocclusions are probably part of the spectrum of AIDS vascular diseases.

Hitting the bull’s eye of ending tuberculosis goal: The challenge of addressing tuberculosis in human immunodeficiency virus positive population in India

Eradicating tuberculosis in human immunodeficiency virus is all the more important to realise India’s ambitious goal of tuberculosis free India by 2025.Although,continuous efforts are being made to address tuberculosis in human immunodeficiency virus co-infection,it is imperative to closely monitor the implemented strategies,encourage and validate disease notification system in the country,and bring about societal change to view this disease as an ailment only and not as a stigma.

Twenty years of human immunodeficiency virus care at the Mayo Clinic:Past,present and future

The Mayo human immunodeficiency virus(HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a "Mayo Model" of HIV care that exceeds national outcomes and may be applicable in other settings.

Treatment of postoperative infectious complications in patients with human immunodef iciency virus infection

BACKGROUND: Antibiotics are widely given for surgical patients to prevent infection. Because of the lack of study on the rational use of antibiotics in patients with human immunodef iciency virus(HIV)-infected during surgical procedures, we analyzed the risk factors affecting postoperative infectious complications in HIV-infected patients and explore the rational use of perioperative antibiotics.METHODS: This retrospective study consisted of 308 HIV-infected patients, 272 males and 36 females, who had undergone operation at the Shanghai Public Health Clinical Center from November 2008 to April 2012. The patients were divided into postoperative infection and non-infection groups. Their age and clinical variables were compared. The correlation between surgical incision, surgical site infection(SSI) and postoperative sepsis was analyzed. Prophylactic antibiotics were used for patients with type I and II incisions for less than 2 days. Patients with type III incisions were given antibiotics until the infection was controlled. Antiretroviral therapy(ART) was prescribed preoperatively for patients whose preoperative CD4 count was <350 cells/μL. For those patients whose preoperative CD4 count was <200 cells/μL, sulfamethoxazole and fluconazole were given preoperatively as prophylactic agents controlling Pneumocystis carinii pneumonia and fungal infection.RESULTS: A total of 196 patients developed postoperative infectious complications, and 7 patients died. Preoperative CD4 counts, ratio of CD4/CD8 cells, hemoglobin level, and postoperative CD4 counts, hemoglobin and albumin levels were risk factors of perioperative infection in HIV-infected patients. Patients with a preoperative CD4 count <200 cell/μL, anemia, a postoperative CD4 count <200 cell/μL or albumin levels <35 g/L were correlated with a higher rate of perioperative infection. There was a signif icant correlation between SSI and the type of surgical incision. The rate of SSI in patients with type I surgical incision was 2% and in those with type II surgical incision was 38%. All the patients who received type III surgical incision developed SSI, and they were more likely to develop postoperative sepsis.CONCLUSIONS: HIV-infected patients are more likely to develop postoperative infectious complications. The rational use of antibiotics in HIV-infected patients could help to reduce the rate of postoperative infectious complications in these patients.

Chinese Herbal Medicine for the Treatment of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome-Associated Diarrhea: A Protocol for the Systematic Review and Meta-Analysis of Randomized Clinical Trials

Diarrhea can occur at an early or advanced stage of acquired immunodeficiency syndrome(AIDS)as a usual symptom in people with human immunodeficiency virus(HIV)infection.While it is usually not fatal,it can influence patients’quality of life seriously.It has shown to be efficacious and improves people’s immune status to a certain extent to treat HIV/AIDS-related diarrhea on the basis of syndrome differentiation and treatment or Chinese herbs plus conventional treatment.Therefore,it may have a good application potential.Here,we outline a protocol for the systematic review of this health-care intervention,with the aim to evaluate the beneficial effects and safety of Traditional Chinese Medicine(TCM)for patients who suffer from HIV/AIDS-associated diarrhea.Randomized controlled trials that compare Chinese herbs with placebo or other effective treatments will be searched and included,in spite of publication status or language.The primary outcomes include diarrhea frequency and fecal character.The databases we will search as follows:China Science and Technology Journal Database(VIP),Chinese Biomedical Literature Database(Sino Med),Wanfang Data,China National Knowledge Infrastructure,Pub Med and the CENTRAL in Cochrane Library.Two authors will respectively conduct the screening of trials,data extraction,and use the Cochrane risk of bias tool to assess the methodological quality.We will analyze the data and perform a meta-analysis if possible.We intend to identify potential therapeutic modalities that may be of benefit to inform clinical practice by supplying existing evidence of the helpful effects and safety of TCM to treat patients suffering from HIV/AIDS-associated diarrhea.

Fighting against Acquired Immunodeficiency Syndrome with Chinese Medicine:A Perspective from China

Continuing expansion of the human immunodeficiency virus （HIV）/ acquired immunodeficiency syndrome （AIDS） pandemic has been recognized as an exceptional challenge to global health. Taking highly active antiretroviral treatment （HAART）, a confirmed effective treatment, has its limitations. While a much cheaper and potential treatment--the Chinese medicine （CM） has not been paid enough attention from the worldwide. We explained the CM viewpoints about pathology and etiology to answer some questions about whether and how CM can treat AIDS. Some herbal formulae and their targeted patterns and common symptoms were also introduced. Chinese government has realized the important role of CM as an independent therapy for early management, bolstering immune-system functions depressed by HIV, and has funded large randomized double-blind controlled clinical trials to more accurately assess the benefits, and valued the fundamental research to establish a quantitative standardization of pattern diagnosis. Researchers of CM are looking for cooperation with all the world＇s top experts in the areas of AIDS and immunity to strive for victories in the fight against AIDS.

Bilateral Peripheral Facial Paralysis Combined with HIV Meningitis During Acute HIV-1 Infection: A Case Report

Here we reported a Chinese case of bilateral peripheral facial paralysis(PFP) in human immunodeficiency virusc(HIV) infected population. A 38-year-old homosexual male patient was referred to our hospital for bilateral facial paralysis. 21 days prior to admission he had developed high fever, chills, headache, fatigue, general malaise, nausea and vomiting. Neurological examination revealed bilateral ptosis of lower lip and cheeks, as well as failure of bilateral eyes closure. Analysis of cerebrospinal fluid(CSF) revealed pleocytosis, a marked rise of micro total protein and a marked rise of intrathecal lgG synthesis. The result of HIV-1 serology was positive by ELISA and that was confirmed by western blot. His CD4^+ cell count was 180 cells/mm^3. HIV-1 viral load in CSF was almost 10 times higher than that in plasma. The patient's condition improved steadily and experienced complete resolution of bilateral PFP after 2 months.

Risk Factors, Clinical Features, Baseline Alanine Aminotransferase and CD4+ Count of Children with HIV Co-Infection with Hepatitis B and C at a Tertiary Hospital in Southwest Nigeria

Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4+ count, CD4+ percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: Of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4+ count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4+ count and ALT.

A rare cause of drug-induced hepatitis in an immunocompromised patient and the role of glutathione

The Food and Drug Administration (FDA) has issued a warning on numerous herbal drugs, including many popular products at General Nutrition Centers (GNC), regarding unstudied hepatotoxicity. There have been recent reports of GNC products such as hydroxycut and herbalife, causing drug-induced hepatitis. Herbal medications are over-the-counter products and are not investigated thoroughly by the FDA. Given that the mostcommon outpatient laboratory abnormality is elevated liver transaminases, a sign of hepatocellular toxicity; it is not surprising that some of these products end up causing hepatic dysfunction, especially when taken in large volume. There are numerous herbal supplements that are hepatotoxic, however, these medications have a much more significant effect in human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome patients, which is secondary to depleted glutathione. We present a rare case of drug induced hepatitis secondary to herbal medications used to treat HIV and elucidate the role of glutathione depletion in immunocompromised patients.

Activation-induced pyroptosis contributes to the loss of MAIT cells in chronic HIV-1 infected patients

Background: Mucosal-associated invariant T(MAIT) cells are systemically depleted in human immunodeficiency virus type 1(HIV-1) infected patients and are not replenished even after successful combined antiretroviral therapy(cART).This study aimed to identify the mechanism underlying MAIT cell depletion.Methods: In the present study, we applied flow cytometry, single-cell RNA sequencing and immunohistochemical staining to evaluate the characteristics of pyroptotic MAIT cells in a total of 127 HIV-1 infected individuals, including 69 treatment-naive patients, 28 complete responders, 15 immunological non-responders, and 15 elite controllers, at the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.Results: Single-cell transcriptomic profiles revealed that circulating MAIT cells from HIV-1 infected subjects were highly activated, with upregulation of pyroptosis-related genes. Further analysis revealed that increased frequencies of pyroptotic MAIT cells correlated with markers of systemic T-cell activation, microbial translocation, and intestinal damage in cART-naive patients and poor CD4+ T-cell recovery in long-term cART patients. Immunohistochemical staining revealed that MAIT cells in the gut mucosa of HIV-1 infected patients exhibited a strong active gasdermin-D(GSDMD, marker of pyroptosis) signal near the cavity side, suggesting that these MAIT cells underwent active pyroptosis in the colorectal mucosa. Increased levels of the proinflammatory cytokines interleukin-12(IL-12) and IL-18 were observed in HIV-1 infected patients. In addition, activated MAIT cells exhibited an increased pyroptotic phenotype after being triggered by HIV-1 virions, T-cell receptor signals, IL-12 plus IL-18, and combinations of these factors, in vitro.Conclusions: Activation-induced MAIT cell pyroptosis contributes to the loss of MAIT cells in HIV-1 infected patients,which could potentiate disease progression and poor immune reconstitution.

2015-2022年深圳市龙岗区HIV/AIDS新发现病例流行趋势特征和灰色模型定量预测

目的探讨HIV感染者/AIDS患者(HIV/AIDS)新发现病例流行特征和判定趋势、定量预测,为科学防控提供参考依据。方法对深圳市龙岗区2015—2022年新发现HIV/AIDS病例用描述流行病学方法进行特征分析,用缓冲算子建立灰色均值GM(1,1)模型进行趋势判定和病例数预测。结果2015—2022年龙岗区新发现HIV/AIDS病例共2722例(1611/1111),年均报告病例数(340±25)例。病例以男性(92.43%)、20~<40岁(71.49%)、未婚(63.67%)、高中及以上文化水平(68.59%)、商业服务和家务及待业(62.12%)、市外户籍(80.79%)病例为主,男男同性传播(68.41%)为主要感染途径。50岁以下以男男性传播为主,50岁以上以异性传播为主。医疗机构检测(56.61%)和咨询检测(25.24%)为主要发现方式。疫情趋势为:40~50岁(χ^(2)_(趋势)=4.854,P<0.05)和>50岁(χ^(2)_(趋势)=25.241,P<0.001)病例组分布呈增长趋势;家务及待业病例组分布呈增长趋势(χ^(2)_(趋势)=6.533,P<0.05);医疗机构检测中其他就诊者检测分布呈增长趋势(χ^(2)_(趋势)=20.558,P<0.001)和咨询检测分布呈下降趋势(χ^(2)_(趋势)=10.562,P<0.05);新发现病例中AIDS构成比呈增长趋势(χ^(2)_(趋势)=8.382,P<0.05);青、中、老年男性病例随着年龄的增加,有同性传播占比下降、异性传播占比上升趋势(χ^(2)_(趋势)=252.478,P<0.001);男性未婚、离异或丧偶、已婚或有配偶组病例随着配偶的存在呈度同性传播占比下降、异性传播上升的趋势(χ^(2)_(趋势)=155.454,P<0.001)。弱化算子GM(1,1)灰色模型精度良好,显示近年疫情趋势平稳(发展系数<0.01),预测2023年病例数精度>95%,可用于HIV/AIDS新发现病例数预测。结论龙岗区AIDS疫情态势平稳,但有中老年病例增加的趋势,病例发展到AIDS阶段因症状就诊发现的比例有增加趋势,应继续推行扩大检测策略及早发现病例,深入开展高危、重点人群综合干预防治措施,多渠道(尤其是在学校教育工作中)加强全民AIDS宣传教育和提高防护技能。灰色预测模型可有效判定AIDS疫情趋势和定量预测,对风险评估和疫情防控具有较好的指导意义。

艾博韦泰联合多替拉韦治疗HIV感染/AIDS多重耐药1例报道

随着抗反转录病毒治疗(antiretroviral therapy,ART)的快速启动和推广,HIV感染已成为一种可以治疗的慢性传染病,然而治疗期间若ART不规范或患者依从性差可引起耐药变异。本研究报道1例30岁多重耐药HIV感染者使用艾博韦泰(albuvirtide,ABT)联合多替拉韦(dolutegravir,DTG)的治疗经过。患者治疗失败后行HIV耐药检测,结果显示患者对核苷类逆转录酶抑制剂、非核苷类逆转录酶抑制剂及蛋白酶抑制剂中的多种药物存在不同程度耐药,在既往药物中仅对整合酶抑制剂类药物敏感。结合患者HIV耐药检测结果,治疗方案更换为“ABT+DTG”,患者病毒复制被成功抑制,且患者在8个月治疗过程中免疫功能逐步提升。而后因个人原因,患者短暂停用“ABT+DTG”治疗1个月,免疫水平下降,病毒载量出现反跳。后行“ABT+DTG”方案治疗至2023年3月,CD4^(+)T淋巴细胞计数平稳升高至291×10^(6)个/L,病毒载量持续降低至小于40×10^(3)copies/L,治疗期间患者耐受性及安全性较好。提示ABT联合DTG方案是HIV多重耐药患者一种新的治疗选择。

深圳市龙岗区新发现≥50岁患者HIV感染/AIDS流行趋势特征和定量预测

目的掌握≥50岁患者的HIV感染/AIDS流行趋势特征,并进行定量预测,为指导疫情防控和风险评估提供科学依据。方法用描述流行病学方法分析深圳市龙岗区2018-2023年新发现≥50岁患者HIV感染/AIDS的趋势特征,用缓冲算子序列建立灰色均值GM(1,1)模型进行趋势判定和定量预测。结果2018-2023年深圳市龙岗区新发现≥50岁HIV感染/ADIS患者271例,年均(45±11)例;男/女性别比3.44∶1,50~59岁占62.37%,职业分布较广,以家务及待业(37.27%)和商业服务(15.87%)较多,已婚或有配偶占53.51%,初中以下文化占62.36%,外市户籍占81.18%;感染途径以异性传播(71.22%)为主,非婚异性性接触史高(63.10%);发现途径以医疗机构检测发现(76.38%)为主。各年≥50岁HIV感染/ADIS患者在人群特征、感染途径和检测样本来源等分布上未呈现趋势变化(P>0.05);在当年新发现HIV感染/ADIS患者构成比呈现出增长趋势(P<0.05)。建立的弱化算子GM(1,1)灰色模型优秀,平均相对误差<2.0%,精度>98.0%,发展系数为0.05,患者数呈增长趋势,预测2024-2028年≥50岁患者年发现数将可能从62例增长至75例。结论深圳市龙岗区≥50岁HIV感染/ADIS患者在构成占比和患者数上均呈增长趋势,应重点关注≥50岁HIV感染/ADIS患者,针对老年人群加强宣传教育、制定和完善AIDS综合干预和防治体系。灰色GM(1,1)预测模型可用于≥50岁人群中HIV感染/AIDS流行趋势判定和定量预测,对风险定量评估和疫情防控具有较好的指导意义。