ARCH PATHOL LAB MED:1984-2016年人类免疫缺陷病毒感染的死亡率趋势-基于尸检的研究

2020-05-30 MedSci原创 MedSci原创

随着抗逆转录病毒治疗人类免疫缺陷病毒(HIV)感染的使用和疗效的改善,由获得性免疫缺陷综合征(AIDS)导致的死亡人数出现逐年减少。

随着抗逆转录病毒治疗人类免疫缺陷病毒(HIV)感染的使用和疗效的改善,由获得性免疫缺陷综合征(AIDS)导致的死亡人数出现逐年减少。

本研究通过在纽约市一家主要医院调查1984年至2016年尸检的艾滋病毒感染患者的死亡趋势,回顾性回顾尸检记录和图表,使用多项式模型进行逻辑回归建模趋势。

研究人员通过尸体解剖确认了(根据1982年的定义)252例HIV感染患者。在广泛使用高活性抗逆转录病毒疗法之前,在1984-1995年,每年平均进行13次尸体解剖。在积极抗逆转录病毒治疗后,尸体解剖的平均数量下降到每年4.5例。1984年拟合的平均死亡年龄为35岁,2016年曲线早期增至46岁(95% CI, 43-49) (P < .001)。通过回归分析,CD4+ t细胞平均计数从1992年的6个增加到2016年的64个(P = .01)。定义艾滋病的机会性感染的比例从1984-1987年的79%下降到2008-2011年的41%和2012-2016年的29% (P = .04)。然而,非机会性感染的发生率从1984-1987年的37%上升到2008-2011年的73%和2012-2016年的57% (P = .001)。在研究期间,确定艾滋病和其他恶性肿瘤的频率没有显著变化。尸检中动脉粥样硬化的患病率显著上升,从1988-1991年的21%上升到2008-2011年的54% (P < .001)。

尽管尸检研究有一定的局限性,但许多艾滋病毒/艾滋病流行演变的趋势还是非常明显的。

原始出处:

Sobia Nizami, MD; Cameron Morales, BS;Trends in Mortality From Human Immunodeficiency Virus Infection, 1984–2016: An Autopsy-Based Study

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    2020-06-01 zhouqu_8
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目前抗逆转录病毒疗法(antiretroviral therapy, ART)普遍应用于人体免疫缺陷病毒感染,即便如此,50%以上的HIV患者仍表现出健忘、困惑、行为改变和运动缺陷等症状

Lancet:全球艾滋病、结核病以及疟疾医疗支出变化研究

研究认为,为实现SDG3目标,国际卫生中支出逐年增加,但各国家之间差异显著。

Lancet Infect Dis:HIV相关结核分枝杆菌感染的临床特征

研究发现,HIV阳性的危重结核病患者中,结核分枝杆菌感染十分常见,并导致患者30天内死亡风险增加,及时的抗结核治疗可有效降低患者不良预后风险。

BMJ:中国青少年传染病负担研究——2008-2017

近年来中国青少年传染病的预防工作取得了显著进展,但仍需持续的在减少区域不平等、扩大疫苗接种、防止青少年艾滋病传播方面努力。

恶性梅毒并发HIV感染1例

作者:李伶,郭中华,毛庆,成都市第五人民医院皮肤科