人类免疫缺陷病毒与深部真菌感染

人类免疫缺陷病毒（HIV）感染的发病率与致死率很高,已成为人类健康的一大威胁,其中约50％的HIV感染者最终因侵袭性真菌病而死亡。高效抗反转录病毒治疗（HAART）的应用大大降低了 HIV感染者深部真菌病的发生率。因此,深入研究HIV与深部真菌病的关系,对预防、诊断和治疗HIV感染者深部真菌病具有十分重要的意义。本文归纳了HIV感染者深部真菌病的流行病学调查、诊断与治疗进展,有助于临床医师预防和诊治HIV感染者深部真菌病,也为将来新型抗真菌药物的研发提供了思路和方向。     

降低我国艾滋病患者病死率的几个关键措施

随着人类免疫缺陷病毒(HIV)感染者逐渐进入获得性免疫缺陷综合征(AIDS)期,我国HIV感染者病死人数逐渐增加,已超过结核病与狂犬病的病死人数,位居第1.如何降低HIV/AIDS患者的病死率是我国目前亟待解决的重要课题.针对我国HIV/AIDS患者的特点,应采用多种措施.其中关键为:落实患者对药物的依从性,优化抗病毒治疗方案;扩大抗病毒治疗覆盖面,以增加接受抗病毒治疗的患者;加大检测力度,早诊断和早治疗以延长患者寿命,改善预后;注意对患者并发症的治疗,并科学分析病死原因.这些措施的实施需要社会各界共同参与和努力.     

HIV抗体检测技术研究进展

获得性免疫缺陷综合征,简称艾滋病(acquired immun-odeficiency syndrome,AIDS),是由免疫缺陷病毒(human im-munodeficiency virus,HIV)感染所引起的一种严重的传染性疾病。HIV/AIDS的流行已成为人类、社会和经济发展的灾难,全球活着的HIV感染者已超过4 300万人,每天约有14 000     

SHIV减毒株在AIDS疫苗研究中的应用

艾滋病,即获得性免疫缺陷综合症(Acquired Immunodeficiency Syndrome,AIDS)是由人免疫缺陷病毒(Human Immunodeficiency Virus,HIV)引起的,以全身免疫系统严重损害为特征的传染性疾病。感染者终身携带病毒,迄今仍缺乏有效的预防和治愈措施。艾滋病已成为威胁人类健康的最大传     

SHIV减毒株在AIDS疫苗研究中的应用

艾滋病,即获得性免疫缺陷综合症(Acquired Immunodeficiency Syndrome, AIDS)是由人免疫缺陷病毒(Human Immunodeficiency Virus, HIV)引起的,以全身免疫系统严重损害为特征的传染性疾病.感染者终身携带病毒,迄今仍缺乏有效的预防和治愈措施.艾滋病已成为威胁人类健康的最大传染性疾病之一.历史上对付传染性疾病最经济有效的方法就是发展安全有效的疫苗.     

人类免疫缺陷病毒解剖学病毒储存库与检测方法的研究进展

由于人类免疫缺陷病毒(human immunodeficiency virus, HIV)储存库的存在,获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者即便接受高效抗反转录病毒治疗也无法完全清除体内的潜伏病毒。本文就HIV在人体内可能存在的解剖学储存库、病毒储存库及检测方法进行综述,以增进参与AIDS防治的工作人员对HIV储存库在人体内研究进展的了解。     

艾滋病功能性治愈策略研究进展

高效抗逆转录病毒治疗(highly active anti-retroviral therapy,HAART)的广泛应用,显著延长了人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者的寿命,使艾滋病(acquired immune deficiency syndrome,AIDS)由一种致死性疾病转变为可控的慢性疾病。但是,由于病毒潜伏库及病毒库在HIV感染后快速形成、持续存在且难以清除,因此现有治疗策略无法实现AIDS的彻底治愈。目前,已经成功提出功能性治愈的概念,即通过改善现有的治疗策略实现长期抑制HIV复制,维持CD4+T细胞数量和机体免疫功能正常,尤其是在停药后能够长期控制病毒复制。因此,功能性治愈的成功实施可有效改善患者机体免疫功能紊乱,减轻长期应用HAART方案引起的严重的药物毒副作用及不良反应,有效提高患者的生活质量。现就AIDS功能性治愈的相关策略,包括HAART的早期治疗、激活并杀灭策略、基因治疗、免疫治疗和永久沉默等作一概述。     

AIDS猕猴模型在HIV疫苗研究中的应用

对HIV疫苗的研究一直是国际上艾滋病方面研究的热点和难点。动物模型则为疫苗研究必不可缺少的重要工具,缺乏合适的动物模型很大程度上制约了AIDS疫苗的研究。目前在国际上SIV或SHIV感染的猕猴模型为最常用的AIDS研究模型,受猕猴背景及病毒特性等多种因素的影响,使得以上两种模型在HIV疫苗研究中仍存在一定的局限性。为了更好地发挥猕猴模型在HIV疫苗研究中的巨大潜力,开发理想的AIDS猕猴模型已成为目前HIV疫苗研究的首要任务。本文简要介绍了AIDS疫苗的研发策略、研发概况以及SIV/SHIV猕猴模型在HIV疫苗中的应用,并对其中存在的问题及其应用前景进行了探讨。     

猕猴模型在HIV疫苗研究中的应用

对HIV疫苗的研究一直是国际上艾滋病方面研究的热点和难点。动物模型则为疫苗研究必不可缺少的重要工具,缺乏合适的动物模型很大程度上制约了AIDS疫苗的研究。目前在国际上SIV或SHIV感染的猕猴模型为最常用的AIDS研究模型,受猕猴背景及病毒特性等多种因素的影响,使得以上两种模型在HIV疫苗研究中仍存在一定的局限性。为了更好地发挥猕猴模型在HIV疫苗研究中的巨大潜力,开发理想的AIDS猕猴模型已成为目前HIV疫苗研究的首要任务。本文简要介绍了AIDS疫苗的研发策略、研发概况以及SIV/SHIV猕猴模型在HIV疫苗中的应用,并对其中存在的问题及其应用前景进行了探讨。     

HIV的基因结构与功能及致病机理

人获得性免疫缺陷病毒(HIV)是造成AIDS的主要病原体,HIV感染机体主要是通过侵嗜CD4~+T淋巴细胞、巨嗜细胞和神经细胞,随着CD4~+T淋巴细胞的耗竭,被感染者进行性免疫缺陷,导致于致命的机会性感染和肿瘤。其可怕的蔓延趋势和流行范围已经给人类的生存带来了巨大的威胁。目前,这一流行趋势将日益严重,因此,控制艾滋病的传播是全世界所面临的挑战。     

Strategy for AIDS Prevention and Treatment

HIV/AIDS has been circulating in China for over 25 year. While making progress and achievements on HIV/AIDS prevention,there still are great challenge and difficulties such as HIV epidemic controlling and vaccine research.     

Strategy for AIDS prevention and treatment

HIV/AIDS has been circulating in China for over 25 year. While making progress and achievements on HIV/AIDS prevention, there still are great challenge and difficulties such as HIV epidemic controlling and vaccine research.      

Non-Chinese Immigrants: Challenge Faced by Yunnan of China to Achieve the 90–90–90 Goals

正China’s AIDS epidemic started among people who inject drugs(PWID)in Ruili county-level city,a China–Myanmar border city of Yunnan Province,in 1989(Fig.1).Since then HIV has spread rapidly across the country(He and Detels 2005).China launched a‘‘Four Frees and One Care’’policy in 2003 to fight against HIV/AIDS.As one of     

From PMTCT to a more comprehensive AIDS response for women: a much-needed shift

Half of the 33.2 million people living with HIV today are women. Yet, responses to the epidemic are not adequately meeting the needs of women. This article critically evaluates how prevention of mother-to-child transmission (PMTCT) programs, the principal framework under which women's health is currently addressed in the global response to AIDS, have tended to focus on the prevention of HIV transmission from HIV-positive women to their infants. This paper concludes that more than ten years after their inception, PMTCT programs still do not successfully ensure the adequate treatment, care and support of HIV-infected women. Of particular concern is the continued widespread use of single-dose nevirapine despite World Health Organization recommendations to employ more effective combination therapies that do not potentially jeopardize women's future treatment outcomes. In response, the article calls for a more comprehensive approach that places women's health needs at the centre of AIDS responses. This is critical in settings where the pandemic is generalized and there is a push to greatly expand PMTCT programs, as a more effective and equitable way of meeting the needs of women in the context of HIV. Without such a comprehensive approach, women will continue to be impacted disproportionately by the pandemic, and current strategies for prevention, including PMTCT, and treatment will not be as effective and responsive as they need to be.     

全球抗病毒药物研发进展与展望

病毒是危害人体健康的主要病原体之一,病毒感染和传播造成的传染性疾病严重威胁人类健康。目前,艾滋病、病毒性肝炎等发病率高、治愈率低的病毒性疾病仍在全球蔓延,流感病毒、冠状病毒等呼吸道病毒不断发生变异,2019年以来,新冠病毒引起的全球疫情对世界各国产生巨大影响,疫情走向还存在很大不确定性,开发安全有效的抗病毒药物成为应对病毒性疾病的重要手段。拟在总结全球抗病毒药物研发整体现状的基础上,分析抗艾滋病病毒、肝炎病毒、新冠病毒等重点领域的新药研发进展,提出抗病毒药物的发展建议,为未来研发更加高效的抗病毒药物提供指引和参考。     

Coronavirus disease 2019 (COVID-19): diagnosis and prognosis

Coronavirus disease 2019 (COVID-19) has become a global pandemic with a high rate of transmission. Currently, there is a lack of vaccines and specific drugs for this newly-emerged virus. Timely diagnosis and treatment, as well as isolation of patients and virus carriers, contribute to the effective prevention and control of this epidemic. This review focuses on early stage COVID-19 diagnosis methods and strategies, highlighting the guiding role of laboratory indicators on treatment strategy formulation, and prognosis assessments.     

Modeling the epidemiological impact of the UNAIDS 2025 targets to end AIDS as a public health threat by 2030

BackgroundUNAIDS has established new program targets for 2025 to achieve the goal of eliminating AIDS as a public health threat by 2030. This study reports on efforts to use mathematical models to estimate the impact of achieving those targets.Methods and findingsWe simulated the impact of achieving the targets at country level using the Goals model, a mathematical simulation model of HIV epidemic dynamics that includes the impact of prevention and treatment interventions. For 77 high-burden countries, we fit the model to surveillance and survey data for 1970 to 2020 and then projected the impact of achieving the targets for the period 2019 to 2030. Results from these 77 countries were extrapolated to produce estimates for 96 others. Goals model results were checked by comparing against projections done with the Optima HIV model and the AIDS Epidemic Model (AEM) for selected countries. We included estimates of the impact of societal enablers (access to justice and law reform, stigma and discrimination elimination, and gender equality) and the impact of Coronavirus Disease 2019 (COVID-19). Results show that achieving the 2025 targets would reduce new annual infections by 83% (71% to 86% across regions) and AIDS-related deaths by 78% (67% to 81% across regions) by 2025 compared to 2010. Lack of progress on societal enablers could endanger these achievements and result in as many as 2.6 million (44%) cumulative additional new HIV infections and 440,000 (54%) more AIDS-related deaths between 2020 and 2030 compared to full achievement of all targets. COVID-19–related disruptions could increase new HIV infections and AIDS-related deaths by 10% in the next 2 years, but targets could still be achieved by 2025. Study limitations include the reliance on self-reports for most data on behaviors, the use of intervention effect sizes from published studies that may overstate intervention impacts outside of controlled study settings, and the use of proxy countries to estimate the impact in countries with fewer than 4,000 annual HIV infections.ConclusionsThe new targets for 2025 build on the progress made since 2010 and represent ambitious short-term goals. Achieving these targets would bring us close to the goals of reducing new HIV infections and AIDS-related deaths by 90% between 2010 and 2030. By 2025, global new infections and AIDS deaths would drop to 4.4 and 3.9 per 100,000 population, and the number of people living with HIV (PLHIV) would be declining. There would be 32 million people on treatment, and they would need continuing support for their lifetime. Incidence for the total global population would be below 0.15% everywhere. The number of PLHIV would start declining by 2023.

John Stover and co-workers assess the potential health impacts of UNAIDS’ HIV/AIDS targets.     

Social,Cultural and Demographic Aspects of AIDS

Both on national and international levels, the acquired immunodeficiency syndrome (AIDS) represents a formidable challenge to social institutions and to cultural assumptions. Its effect thus far, in what must be considered the very early stages of a protracted and unprecedented epidemic, has been to exacerbate existing social tensions and divisions over a surprisingly wide field. Though international leadership by the World Health Organization has been met with an unusually high degree of multinational cooperation, AIDS has also stimulated a degree of xenophobia and racial friction that, if allowed to grow, could handicap global AIDS control and prevention efforts.     

Levels of spending and resource allocation to HIV programs and services in Latin America and the Caribbean

Background

An estimated 1.86 million people are living with HIV in Latin America and the Caribbean (LAC). The region is comprised of mainly middle-income countries with steady economic growth while simultaneously there are enormous social inequalities and several concentrated AIDS epidemics. This paper describes HIV spending patterns in LAC countries including analysis of the levels and patterns of domestic HIV spending from both public and international sources.

Methods and Findings

We conducted an extensive analysis of the most recently available data from LAC countries using the National AIDS Spending Assessment tool. The LAC countries spent a total of US$ 1.59 billion on HIV programs and services during the latest reported year. Countries providing detailed information on spending showed that high percentages are allocated to treatment and care (75.1%) and prevention (15.0%). Domestic sources accounted for 93.6 percent of overall spending and 79 percent of domestic funds were directed to treatment and care. International funds represented 5.4 percent of total HIV funding in the region, but they supplied the majority of the effort to reach most-at-risk-populations (MARPs). However, prevalence rates among men who have sex with men (MSM) still reached over 25 percent in some countries.

Conclusions

Although countries in the region have increasingly sustained their response from domestic sources, still there are future challenges: 1) The growing number of new HIV infections and more people-living-with-HIV (PLWH) eligible to receive antiretroviral treatment (ART); 2) Increasing ART coverage along with high prices of antiretroviral drugs; and 3) The funding for prevention activities among MARPs rely almost exclusively on external donors. These threats call for strengthened actions by civil society and governments to protect and advance gains against HIV in LAC.