本科艾滋病英文版

AIDSDepartmentofInfectiousDiseases，TheYongchuanHospitalofChongqingmedicalUniversityliweiSummaryAIDS=AcquiredImmuno-DeficiencySyndromeHIV=HumanImmunodeficiencyVirusAIDS,whichfeaturesaprogressivedepletionofCD4+Tlymphocytes,leadingtolife-threateningopportunisticinfections,wasfirstrecognizedin1981intheunitedstates。HIV病毒模式图EtiologythestructureofHIV包膜蛋白跨膜蛋白逆转录酶核心蛋白蛋白酶外膜P17蛋白EpidemiologyAsof2012,approximately35.3millionpeoplearelivingwithHIVglobally.thedomesticsituationasof2012,morethan380,000peoplearelivingwithHIV.sourceofinfectionPatientswithHIVAsymptomaticHIVcarriersHIVinblood、semen、vaginalfluid、breastmilk。HIVinBodyFluidsSemen11,000Vaginalfluid7,000Blood18,000Amnioticfluid4,000Saliva1TherearedifferentamountsofHIVinvariousbodilyfluidsRouteoftransmissionSexualcontact（thepredominantmode）homosexheterosexBloodtobloodcontactVerticaltransmissionothers同之恋毒之祸血之灾susceptiblepopulationMostofpeoplearesusceptibletoHIVThechangehasmadethevirusspreadingfromdrugusersandsexworkerstogeneralpopulation.pathogenesisHIVcaninfectthosecellsthatexpressCD4onthesurface.DuringthecycleofHIVlife,CD4+TcellshavebeendirectlyandindirectlydamagedHIVLIFECYCLEHIV生长周期HIVcandamagethosecellsthatexpressCD4onthesurfaceCD4+TcellsCD8+TcellsBcellsLangerhanscellsmonocytes/macrophagesfolliculardendriticcellsClinicalManifestationsPeriodoflatentinfection：2～10yearsⅠstage:primaryinfectionⅡstage:asymptomaticinfectionⅢstage:AIDS010020030040050060070080090010000123451234567891011CD4+cellCountAsymptomaticHZVOHLOCPPEPCPCMCMV,MACTBMonthsYearsAfterHIVInfectionCommonNaturalCourseofHIVInfectionComplicationsAcuteHIVinfectionsyndromeRelativelevelofPlasmaHIV-RNACD4+TcellsManifestationsatlastperiodAIDS-relatedsyndromeRespiratorymanifestationsNeurologicalandocularmanifestationsGastrointestinalmanifestationsOthersystematicmanifestationsRespiratorymanifestationsRecurrentrespiratorytractinfectionsPneumocystispneumoniaTuberculosisMACfungusNeurologicalandocularmanifestationscryptococcalmeningitistubercularmeningitistoxoplasmicencephalitisHIVencephalopathyCMVRetinitisToxoplasmicencephalitisGastrointestinalmanifestationsThrushhairyleukoplakiaThrushHairyleukoplakiaOtherKaposisarcomaLymphomaShinglesKaposi’ssarcomaShingleslaboratoryexaminationsSerologyplasmaHIVviralloadImmunologiclaboratorytestsPlasmalaboratorymarkerdiagnosistwocriteriamustbemet.1、PositivetestforHIVinfectionbyconfirmatorytest2、oneofthefollowingcriteriaWeightlossof10%bodyweightwithin6months.Chronicdiarrheaofmorethan1monthduration.UnknownpersistentfeverOpportunisticinfectionKaposisarcoma/Lymphoma.NeurologicalimpairmentrestrictingdailyactivitiestreatmentHAART:highlyactiveanti-retroviraltherapyTreatmentgoalsEradicationofHIVinfectioncannotbeachievedwithavailableantiretroviralregimensSotheprimarygoalsofthemareto:reduceHIV-relatedmorbidity,mortality,improvethequalityoflife，restoreandpreserveimmunologicfunction，andmaximallyanddurablysuppressviralloadPreparationbeforetreatmentEachpatientinitiallyenteringcareshouldhavecompletemedicalhistory，physicalexam，andlaboratorytests。WhentotreatClinicalcategoryCD4COUNT(cells/mm3)recommendationPrimaryHIVinfectionregardlessofTreat.Asymptomaticinfection≥350,＜500＜350Shouldbeconsideration.Recommended.AIDSregardlessofTreat.Mainpoint:treatingpatientsearlier.ThereasonforstartingmedicationsearlierSomestudiessuggestthosewithlowerCD4cellcountsatgreaterriskofheartdisease,cancersanddementiaNostudyshowsmoreharmwithearlystartofHIVmedicationsBadthingsaregenerallyrareramongthosewithmorenormalCD4cellcountsTherapyiseasierandbettertoleratedTreatmentcanalsoreduceinfectiousnessSelectionofcombinationregimenEFV/TDF/3TCisrecommendedforinitialtherapy.PrettyeasytobeanHIVdoctorLong-termsideeffectsKidneys/bones(tenofovir)Liver(NNTRIs,PIs)Anemia(AZT)Nerves(ddI,d4T)ProphylaxisAtthepresent,thereisnoeffectiveADISvaccine.Currently,preventionisthebestandmostfeasibleapproachtoreverseandhaltHIVepidemic.itispossibletoprotectyourselfandothersfrominfectionbyfollowing5simplerulesRegardlessofwhattheyareusedfor–injecting(注射)drugs,steroids(类固醇),vitamins,fortattooing(纹身)orbodypiercing–theyshouldnotbeshared.Also,donotshareequipment(orworks)usedtopreparedrugsforinjection.Rule#1-Donotshareneedlesorsyringes(注射器).Asurefirewaytoavoidgettingsexuallytransmitteddiseases(性传播疾病)istobeinalongterm,monogamous(一夫一妻)relationshipwithahealthypartner.ForpeoplewhosesexualbehaviorsputthematriskforSTDs,alwaysusingamalelatexcondom(乳胶避孕套)correctlycanreducetherisk.Remember:noformofprotectionworks100%ofthetime.Rule#2DonothaveunprotectedsexSharingeitherofthesecreatesthepossibilityofcontactwithblood.Rule#3-Donotsharerazorsortoothbrushes.Ifyoumustcomeincontactwithsomeoneelse’sblood–forinstance,tohelpsomeonewhohasaninjury–youshouldwearrubbergloves.Rule#4-Avoidcontactwithotherpeople’sblood.Ifyouarepregnantorthinkyoumightbe,talktoadoctororyourlocalhealthdepartmentaboutbeingtestedforHIV.IfyouhaveHIV,treatmentsareavailabletohelpyouandreducethechancesofpassingHIVtoyourbaby.Rule#5-DonotbreastfeedifyouhaveAIDSorareHIVpositive.