HIV/AIDS患者ART过程中高三酰甘油血症、高胆固醇血症、高血糖发生情况及其影响因素

目的探讨艾滋病病毒感染(HIV/AIDS)者在抗逆转录病毒治疗(antiretroviral therapy,ART)过程中高三酰甘油血症(三酰甘油≥2.3 mmol/L)、高胆固醇血症(总胆固醇≥6.2 mmol/L)、高血糖(空腹血糖≥6.10 mmol/L)的发生情况及其可能影响因素。方法采用回顾性队列研究,收集广州市某传染病专科医院2004-2019年期间首次接受ART的HIV/AIDS患者基线和随访数据。采用多因素Cox比例风险回归模型分析高三酰甘油血症、高胆固醇血症、高血糖发生的可能影响因素。结果HIV/AIDS患者8839例。在ART过程中,新发高三酰甘油血症4255例(48.14%),高胆固醇症1234例(13.96%),高血糖2647名(29.95%),总发病密度分别为28.12/100人年、5.11/100人年和14.22/100人年。多因素Cox比例风险回归模型结果显示,基线BMI、开始ART年份、基线WHO临床分期、基线机会性感染、临床症状种类数、初始ART方案、基线CD4细胞计数与高三酰甘油血症的发生有关;性别、年龄、基线BMI、开始ART年份、基线WHO临床分期、基线机会性感染、初始ART方案、基线CD4细胞计数与高胆固醇症的发生有关;性别、年龄、基线BMI、开始ART年份、感染途径、基线机会性感染、基线CD4细胞计数与高血糖的发生有关。结论HIV/AIDS患者ART过程中易发生高三酰甘油血症、高胆固醇血症、高血糖,应动态监测患者的血脂、血糖情况,尤其是对采用含克力芝方案治疗的患者,以期对高风险患者及时进行早期干预,调整治疗方案,预防心血管疾病等慢性非传染性疾病的发生,提高患者生命质量。

HIV感染者/AIDS患者衰弱状况及影响因素分析

目的了解人类免疫缺陷病毒(HIV)感染/艾滋病(AIDS)患者(PLWHA)衰弱现状及其影响因素。方法选取2019年6—8月长沙市某医院≥18岁的PLWHA作为研究对象,采用自行编制的问卷以及蒂尔堡衰弱量表分别评估研究对象的基本情况以及衰弱情况。结果PLWHA衰弱发生率为26.4%,logistics回归分析显示,感染年限>5年的患者发生衰弱的风险为感染年限≤5年患者的2.33倍(95%CI:1.24~4.37,P=0.009);最高HIV载量≥10万拷贝/mL患者发生衰弱的风险为最高HIV载量<10万拷贝/mL患者的1.40倍(95%CI:1.05~1.85,P=0.022);CD4^(+)T淋巴细胞计数<200个/mm 3的患者发生衰弱的风险为CD4^(+)T淋巴细胞计数≥200个/mm 3患者的3.60倍(95%CI:1.96~6.62,P<0.001)。结论HIV感染年限越长、当前CD4^(+)T淋巴细胞计数越低、HIV载量越高的PLWHA更容易发生衰弱。

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.

The Role of Library and Information Science Education in the Development of Community Health Information Services for People Living with HIV/AIDS: Perspectives of Directors and Managers of Public Libraries

This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.

Assessment of the Level of Knowledge, Attitude, and Practice with Regard to Care of People Living with HIV/AIDS among Nursing and Midwifery Students in Fako, Cameroon

Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.

Stigma and Discrimination against People Living with HIV and AIDS in Malawi

A study was conducted to explore stigma and discrimination among people living with HIV and AIDS who were on home based care in the Lilongwe district of Malawi. The study design was descriptive through sectional and utilized qualitative data collection and analysis method. Fifteen people living with HIV and AIDS, aged between 15 and 60 years were purposively sampled from three organizations, which were: Light House, National Association for people living with HIV and AIDS in Malawi and Lilongwe Diocese. Qualitative data were collected using an open ended interview guide during in-depth face to face interviews with the participants. The data were analysed using ATLAS. ti 5.0. Results show that all the participants were facing stigma and discrimination because they were living with HIV and AIDS. Distant relatives were the main source of stigma and discrimination followed by friends and church members. Most participants indicated that they felt they were discriminated because HIV infection is associated with bad behaviours such as prostitution or promiscuity. However some of them complained that they contracted the virus from their married partners and hence they did not deserve to be stigmatized or discriminated against. Results show that there is a need for creation of awareness among community members on the transmission of HIV and the need for home based care for the chronically ill people living with HIV and AIDS.

Evaluation of Quality of Healthcare Service Avaeilable to People Living with HIVIAIDS： Evidence from Enugu State

The study evaluated the quality of healthcare services given to PLWHA （people living with HIV/AIDS） in different communities of Enugu State of Nigeria. Descriptive cross sectional survey design was employed for the study. The participants were PLWHA attending health facilities in different communities in the state. A sample of 180 PLWHA who participated in the study were selected using a multi-stage sampling procedure and were interviewed at community level. The data were analyzed using descriptive statistics. The results showed that 82.2% of the respondents were cared for by government health facilities, 75% were of the opinion that the health workers in those places do not discriminate against them, 81.7% felt that they were being given high quality healthcare, 82.8% stated that their drugs were readily available, 75% were of the opinion that the physical facilities in their care centers were adequate, 84.4% felt that grievance redressing were good while 90% felt that their healthcare providers maintain confidentiality about their conditions. It was concluded from the findings that quality of care provided to PLWHA in communities was of good quality as perceived by PLWHA and that the national antiretroviral programmes are making drugs available and affordable in the state. It was then recommended that all levels of government in the nation should strengthen the programmes on HIV prevention and control to maintain the continuity of care to PLWHA.

Can People Living With HIVIAIDS Be Teachers?

HIV is still a sensitive topic in China,which was once again thrust into the spotlight in September when a young aspiring teacher launched a lawsuit against local authorities in southwest China’s Guizhou Province for employment discrimination. The candidate,who went by the alias Xiao Hai,tested positive for HIV during a mandatory employment medical examination

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.

童年创伤与HIV感染者/AIDS患者焦虑抑郁及自杀倾向相关性研究

目的探讨HIV感染者/AIDS患者(PLWHA)的儿童期创伤经历与焦虑、抑郁及自杀风险间关系,为早期识别PLWHA心理问题风险与干预提供循证证据支持与流行病学依据。方法选取于西安市某医院艾滋病专科门诊接受治疗的患者为研究对象,采用广泛性焦虑症量表(GAD-7)评估患者焦虑水平,抑郁自评量表(PHQ-9)评定患者抑郁情绪,简明国际神经精神访谈自杀问卷部分(MINI)评估自杀风险,童年创伤问卷(CTQ)评估儿童期创伤;以频数和构成比描述定性资料,采用卡方检验进行各组间比较,通过优势比(OR)及其95%置信区间(CI)表示关联强度。结果在470例患者中,64.7%的PLWHA有过童年创伤经历,其中童年受情感虐待、躯体虐待的发生率均高于无焦虑症状者(P<0.05)。54.5%的PLWHA患有抑郁症状。童年受到情感虐待、躯体虐待者具有自杀倾向的风险分别是未受到的4.792倍(OR=4.792,95%CI:1.896~12.110)、3.130倍(OR=3.130,95%CI:1.430~6.851)。结论儿童期创伤经历的PLWHA更容易发展为焦虑抑郁,并增加自杀风险。应特别关注PLWHA的心理健康状况,尤其是有童年期情感虐待与躯体虐待经历者,尽早设计相应心理干预措施,预防自杀和其他不良事件的发生。

HIV感染者/AIDS患者情绪问题及其相关因素分析

目的:了解长沙市新确认的HIV感染者/AIDS患者情绪问题发生现状并分析其相关因素,为更好地开展该人群的精神卫生服务提供基础数据。方法:将2013年3月1日至2014年2月28日在长沙市艾滋病综合防治信息系统中新确认登记的、符合入组条件的感染者/患者作为连续样本,在知情同意的原则下,采用病人健康问卷抑郁量表(PHQ-9)、广泛性焦虑量表(GAD-7)、社会支持评定量表(SSRS)及艾滋病压力量表(HIV/AIDS Stress Scale)进行调查。结果:370例HIV感染者/AIDS患者的抑郁阳性率为40.3%(PHQ-9≥10分),焦虑阳性率为30.5%(GAD-7≥10分)。重度抑郁症状(PHQ-9≥20分)及重度焦虑症状(GAD-7≥15分)分别占8.1%,14.3%。分层回归分析结果显示:工作状况(b=–3.407,P<0.001;b=–2.799,P=0.001)、性取向(b=1.903,P=0.008;b=1.314,P=0.034)、居住情况(b=–1.995,P=0.012;b=–2.167,P=0.002)、出现HIV感染相关症状(b=4.578,P<0.001;b=3.652,P<0.001)、艾滋病相关压力(b=0.081,P<0.001;b=0.090,P<0.001)是HIV感染者/AIDS患者抑郁、焦虑情绪的预测因子,社会支持(b=–0.046,P=0.044)是抑郁情绪的预测因子,并且抑郁(ΔR2=55.8%,P<0.001)、焦虑(ΔR2=54.7%,P<0.001)互为强显著预测因子。结论:在新确认的HIV感染者/AIDS患者中,抑郁、焦虑等情绪问题较为严重,在对该人群进行登记管理的同时应考虑提供必要的心理社会支持及基本的精神卫生服务。

HIV感染者/AIDS患者CD_4^+细胞计数与机会性感染对应关系的临床分析

目的通过临床病例分析,观测CD4+细胞计数对机会性感染的预示作用。方法分析了176例艾滋病病毒(HIV)感染者/艾滋病(AIDS)患者的CD4+细胞计数与机会性感染并发症的对应关系。结果发现在CD4+细胞计数<200个/mm3的114例HIV感染者/AIDS患者中,有53例发生了多种机会性感染,其发生比例为46.5%;而CD4+细胞计数>200个/mm3的62例患者中,只有2例发生了机会性感染,其发生比例为3.2%。结论不同水平的CD4+细胞计数,机会性感染的发生几率不同,两者有着非常密切的关系。因而CD4+细胞计数作为开展机会性感染预防的参照指标,对于提高HIV感染者/AIDS患者的生活质量有着很重要的意义。

HIV感染者/AIDS病人生活质量及其影响因素研究

目的了解艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人的生活质量及其影响因素。方法采用世界卫生组织生活质量简表中文版测量其生活质量,对215名HIV感染者/AIDS病人进行匿名问卷调查。结果HIV感染者/AIDS病人生活质量四个维度的平均得分为50.74(生理领域)、46.01(心理领域)、53.78(社会关系领域)和43.94(环境领域)。单因素分析显示,性别、文化程度、收入、居住地、病情、感染途径、医疗费用占家庭收入比例、艾滋病知识水平和耻辱等因素与HIV感染者/AIDS病人的生活质量各个领域有关(P<0.05)。多元线性回归分析结果表明,工作、收入和艾滋病相关知识水平是影响生活质量的有利因素,而感受到的耻辱和医疗费用占家庭收入比例则是不利影响因素(P<0.05)。结论社会经济等因素在不同方面影响着HIV感染者/AIDS病人的生活质量。

重庆市HIV感染者和AIDS病人生存质量和医疗需求调查分析

目的了解艾滋病病毒(HIV)感染者和艾滋病(AIDS)病人的生存状况、求医行为和医疗需求,为制定相关的救治救助政策提供可靠的依据。方法对HIV感染者和AIDS病人进行面对面的问卷调查,资料用SPSS12.0统计分析。结果调查的122例HIV感染者和AIDS病人以经静脉吸毒感染为主,其次是性接触和血源感染。感染HIV后经济收入和生活水平都明显下降,感染HIV后失去主要的经济来源和巨额的医疗费用是导致生活水平下降的主要原因,而医疗费用主要由自己承担(除抗病毒治疗药物和CD4检测费用外)。他们的生存质量评分均在50分左右。结论HIV感染者和AIDS病人因感染HIV经济收入明显减少,医疗需求明显增加,生活水平明显下降,生活质量差。

云南省陇川县HIV/AIDS人群生命质量及影响因素分析

目的:了解云南省陇川县艾滋病病毒感染者/艾滋病病人(People Living with HIV/AIDS,PLWHA)的生存质量及其影响因素,为今后的深入研究提供依据。方法:采用横断面调查方法,对陇川县PLWHA采用一般情况调查问卷、MOS-HIV生存质量量表进行问卷调查。结果:PLWHA生存质量的躯体健康总分为(49.12±11.14)分,精神状况得分为(43.40±10.05)分;经抗病毒治疗组疼痛、精力或疲劳得分均高于未治疗组。女性总体健康感觉(57.88±24.78)分,高于男性的(44.13±26.85)分;女性的角色功能纬度得分和躯体健康总分分别为(72.73±45.23)分和(53.18±9.18)分,均高于男性。经过多元逐步回归分析,少数民族躯体健康总分低于汉族;并发症数越多,躯体健康总分越低。结论:抗病毒治疗能提高PLWHA的生存质量;性别、民族、治疗情况可能是PLWHA生存质量的影响因素。

HIV感染者/AIDS病人心理状况及生活质量调查

目的 了解 HIV感染者 /AIDS病人的心理状况、生活质量及其相关因素。方法 选择四川省 HIV感染率和 AIDS患病率较高的两个县 (资中县和凉山州昭觉县 )作为目标社区 ,在目标社区内共计调查了 71名 HIV感染者 /AIDS病人和 97名健康者 ,选用抑郁自评量表 (SDS)、焦虑自评量表 (SAS)、生活质量综合评定问卷(GQOL I- 74 )、社会支持评定量表 (SSS)及自制的一般情况记录表收集相关资料 ,对数据进行统计学分析。结果 HIV感染者 /AIDS病人的 SAS和 SDS评分高于正常对照 (分别为 t=5 .343,t=5 .2 72 ,P值均 <0 .0 0 1) ;HIV感染者 /AIDS病人 GQOL I- 74总分、各维度分均低于正常对照 (分别为 F=36 .5 12 ,F=2 .386 ,F=11.0 4 6 ,F=31.6 16 ,F=34.2 35 ,P值均 <0 .0 1) ;HIV感染者 /AIDS病人的 SAS和 SDS评分与疾病状况、物质滥用、社会支持及生活质量存在明显相关性 ;HIV感染者 /AIDS病人的生活质量总分与疾病状况、社会支持存在明显相关性。结论 焦虑和抑郁情绪在 HIV感染者 /AIDS病人中普遍存在 ,这些负性情绪主要与较多的疾病状况和物质滥用、较少的社会支持及较低的生活质量等因素有关 ;HIV感染者 /AIDS病人的生活质量普遍较低 ,这主要与较多的疾病状况。

HIV感染者/AIDS病人生存质量现状调查及相关影响因素研究

目的了解HIV感染者/AIDS病人(people living with HIV/AIDS,PLWHAS)的生存质量现状及其影响因素。方法采用简体中文版MOS-HIV量表评价371例PLWHAS的生存质量现状,同时调查可能影响其生存质量的人口学特征和HIV感染相关情况。采用t检验、方差分析和多元线性回归模型进行统计分析。结果生存质量得分:心理健康总分为(46.60±10.45)分,生理健康总分为(51.14±9.28)分。单因素分析结果显示:年龄、文化程度、职业等因素,与PLWHAS的生存质量各个领域有关(P<0.05)。多元线性回归分析结果显示:年龄、收入、文化程度和感染途径,是影响PLWHAS生存质量的主要因素。结论年龄、收入、文化程度和感染途径等,在不同方面影响着PLWHAS的生存质量。重点关注老年、收入较低、文化程度较低者的生存质量,对提高该人群生存质量有重要意义。

老年HIV/AIDS住院患者48例流行病学及临床特征分析

目的探讨分析老年艾滋病(AIDS)病人的流行病学、临床特点以及治疗经验。方法回顾性研究2003-2009年重庆市公共卫生医疗救治中心收治的年龄在50岁及以上的老年艾滋病病毒(HIV)感染者/AIDS病人的临床数据资料,包括人口统计学、免疫学指标、病毒学指标、机会性疾病及HIV/AIDS诊断情况,以及老年抗病毒治疗情况等。结果 48例病人中,男42例,女6例;年龄平均(61.92±9.16)岁(50～92岁);38例经过性途径感染,2例经过同性性行为传播,另有2例经吸毒感染,6例不详。CD4+T淋巴细胞1～415/mm3,平均(83.33±105.00)/mm3;CD8+T淋巴细胞67～1741/mm3,平均(612.02±389.78)/mm3;病毒载量检测结果 :4例<50拷贝/mL,23例平均(5.87±0.86)Log10拷贝/mL(4.36～7.73Log10拷贝/mL)。机会性感染中,细菌性肺炎34例(70.83%),口腔念珠菌感染26例(54.17%),结核病15例(31.25%),耶氏肺孢子菌肺炎(PCP)感染14例(29.17%)。48例中有18例进行了抗病毒治疗。结论近年来,老年人群中HIV/AIDS问题不断凸现;其不易及时检出,机会性感染严重、合并症复杂、治疗效果延迟等现象是AIDS防控的棘手问题,应引起高度重视。

HIV/AIDS病人生活质量及社会支持调查

目的了解皖北农村地区人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)病人的生活质量和社会支持现状,分析其相关的影响因素。方法通过典型抽样法采用一般情况问卷、感染史本底资料调查表、生活质量综合评定问卷(GQOLI-74)和社会支持评定量表(SSS)对85名HIV感染者/AIDS病人进行调查。采用单因素方差和多元线性回归方法对调查结果进行分析。结果单因素分析显示,不同性别、不同文化程度的HIV感染者/AIDS病人GQOLI-74总分差异有统计学意义(P<0.05);不同乡镇的HIV感染者/AIDS病人SSS总分差异有统计学意义(P<0.05)。多元线性回归分析结果表明,负性生活事件是影响HIV感染者/AIDS病人社会支持的不利因素,而好的邻里关系、烦恼诉说是影响HIV感染者/AIDS病人生活质量的有利因素。结论诸多因素影响皖北农村地区HIV感染者/AIDS病人的生活质量和社会支持,农村应加强艾滋病社区关爱、社会支持工作,建立以家庭、邻里为依托的社区关爱模式。