具水平抑制及母婴垂直传播的分数阶HIV/AIDS传染病模型的稳定性研究

研究了一类具水平抑制参数及母婴垂直传播的分数阶HIV/AIDS传染病模型.在该模型中,考虑易感人群的常数输入和母婴垂直传播的影响,并引入抑制参数,以反映水平方向上预防措施的功效.本文利用分数阶微分方程理论及数值模拟方法,研究了模型平衡点的稳定性,分析了水平控制参数对HIV/AIDS传染的抑制作用及母婴垂直传播对HIV/AIDS传染的影响.     

女性艾滋病患者的抗反转录病毒治疗与人类免疫缺陷病毒母婴阻断

自从对感染人类免疫缺陷病毒(HIV)的妊娠妇女实施抗反转录病毒治疗(ART)以预防母婴垂直传播以来,HIV母婴阻断成功率明显上升。而部分抗病毒药物,如依非韦伦和替诺福韦,也逐渐被证实用于妊娠期妇女对胎儿是安全的,这增加了HIV母婴阻断药物的选择范围。     

胎盘Hofbauer细胞在HBV母婴垂直传播的作用

目的:探讨胎盘Hofbauer细胞在乙型肝炎病毒(HBV)母婴垂直传播的作用。方法:垂直传播组(母亲及其新生儿血HBsAg和HBV-DNA均为阳性)、非垂直传播组(母亲血HBsAg和HBV-DNA阳性而新生儿阴性)和对照组(母亲及其新生儿血HBsAg和HBV-DNA均为阴性)各30例,透射电了显微镜观察其胎盘Hofbauer细胞超微结构变化及其与HBV颗粒的关系。结果:①对照组未发现Hofbauer细胞:在垂直传播组和非垂直传播组,Hofbauer细胞散在分布于胎盘间质中。②在垂直感染组,Hofba-uer细胞肿胀,胞浆突起减少,胞浆空泡变大;粗面内质网及高尔基复合体萎缩,线粒体缩小,溶酶体少见;胞核增大,染色质浓缩、边聚。在非垂直感染组,Hofbauer细胞呈圆形或卵圆形,细胞表面有大量胞浆突起,排列着微吞饮小体,细胞胞浆内有圆形空泡;线粒体呈杆状,峭排列紧密,溶酶体较多,高尔基体及粗面内质网欠发达;胞核偏位,核仁显著,染色质分布均匀。③在Hofbauer细胞胞质空泡、细胞间隙内存在单个或多个成熟病毒颗粒、病毒包涵体和病毒抗原颗粒。结论:HBV可引起胎盘Hofbauer细胞超微结构改变,并经Hofbauer细胞介导引起母婴垂直传播。     

1225例HIV/AIDS患者流行病学特征分析

目的:了解来陕西地区就诊的人类免疫缺陷病毒/艾滋病(Human immunodeficiency virus/Acquired immuno deficiency syndrome,HIV/AIDS)患者感染状况、流行特征。方法:收集来我院就诊的HIV/AIDS患者的基本信息,对其流行病学资料统计分析。结果:在调查的1225例HIV/AIDS患者中,男性占83.51%,平均年龄为(35.55±11.61)岁,50.98%为农民,小学及以下学历占33.55%,经血液途径感染250例,经性传播途径感染916例,其中同性性传播337例,经母婴垂直传播16例,就诊时CD4+T淋巴细胞计数平均值为(222.82±190.49)个/μL,56%的HIV/AIDS患者采用的抗病毒方案为齐多夫定(Zidovudine,AZT)/替诺福韦(Tenofovir Disoproxil Fumarate,TDF)+拉米夫定(Lamivudine,3TC)+依非韦伦(Efavirenz,EFV)方案。结论:陕西地区HIV/AIDS感染人数呈上升趋势,且年轻化加剧,同性性传播比例大幅增加。虽然治疗较为及时,应进一步在高危人群中积极宣传防艾知识与措施。     

积极开发研究人乳铁蛋白（1actoferrin，Lf）

在非洲,人们发现,约有85％的患有艾滋病的孕妇,在分娩后并没有将病毒传给婴儿,逃脱了最容易患病的母婴传播渠道。这是为什么呢？为什么有的人不易受艾滋病病毒（HIV）的感染呢？     

我国一例典型艾滋病家庭的确认及其病毒env基因片段的序列分析

报道一例我国典型的ＨＩＶ感染家庭,其中对新生儿通过垂直传播感染的早期诊断为我国首例报道。父亲通过静脉吸毒感染ＨＩＶ,经性途径传播给妻子,并通过母婴途径传播至婴儿,导致婴儿发病。通过血清学、ＰＣＲ检测和病毒培养确认为整个家庭的感染。序列分析结果强烈支持杂来自同一毒株,流行背景主实了上述感染的传播途径。     

乙型肝炎病毒携带孕妇母婴阻断的优化管理

我国是乙型肝炎病毒(Hepatitis B virus,HBV)感染的高流行区,HBV感染的育龄期女性是HBV传播的主要传染源,其中大多数育龄期的乙肝女性为乙型肝炎病毒携带状态,因此,乙型肝炎病毒携带孕妇的HBV母婴阻断成了临床愈发关注的问题。实践中,即使HBsAg阳性的孕妇分娩的新生儿接种乙肝疫苗和乙肝免疫球蛋白,仍有5%-10%的新生儿感染HBV,尤其母亲为HBe Ag阳性、高病毒载量者。因此,美国肝病研究学会(AASLD)、欧洲肝病学会(EASL)和英国国立优质卫生和保健研究所(NICE)指南推荐高病毒载量的孕妇在妊娠晚期口服抗病毒药物拉米夫定、替诺福韦、替比夫定进行母婴阻断,减少新生儿感染HBV的机率,但目前乙型肝炎病毒携带孕妇阻断HBV母婴传播的临床管理和预防策略尚未达成共识,尤其是母乳喂养和分娩方式等问题仍存在争议,本文谨从HBsAg筛查、垂直传播的危险因素、阻断方法、分娩方式、母乳喂养等方面进行综述,探讨如何优化管理乙型肝炎病毒携带孕妇,并对未来HBV母婴阻断的研究进行展望。     

寨卡病毒母婴传播及动物模型的研究进展

寨卡病毒(Zika virus)是属于黄病毒科黄病毒属的一种虫媒病毒,可经过埃及伊蚊和白纹伊蚊叮咬传播,也可通过血液、泪液传播,以及性传播和母婴垂直传播.寨卡病毒一旦感染孕妇,就会有导致胎儿感染的可能.成人多出现一些较轻的临床症状,但胎儿更容易受到中枢神经系统的伤害,继而诱发小头畸形,重症脑部发育缺陷以及一些神经系统性...     

平菇病毒dsRNA传播途径的探究

通过对平菇孢子dsRNA检测、单双杂交和单单杂交,从垂直传播和水平传播2个方面来研究平菇病毒dsRNA的传播途径,结果表明：病毒dsRNA通过孢子垂直传播的几率很小,通过细胞融合的水平传播几率相对比较高,在实际生产中平菇病毒dsRNA的主要传播途径还有待进一步的研究。     

TTV母婴传播研究进展

TTV是一种新发现的病毒，目前对其流行病学的了解尚不育分，其传播途径也未完全清楚，虽然对TTV经血液等途径传播的研究较多，但对母婴传播的研究相对较少，本文就近年有关TTV母婴传播的研究进展进行综述。     

Maternal-fetal transmission of human immunodeficiency virus

The World Health Organization estimates that by year 2000, 10 million children will be infected with human immunodeficiency virus type 1 (HIV-1) at birth and will subsequently develop AIDS. Perinatally acquired infections account for the majority of all HIV-1 cases in children, with an estimated mother-to-infant transmission rate of more than 30%. It is not clear why more than half of the children born to HIV-1-infected mothers are uninfected. Maternal transmission of HIV-1 occurs at three levels: prepartum, intrapartum, and postpartum. Several maternal parameters including advanced clinical stages of the mother, low CD4+ lymphocyte counts, maternal immune response to HIV-1, recent infection, high level of circulating HIV-1, and maternal disease progression have been implicated in an increased risk of mother-to-infant transmission of HIV-1. Viral factors influencing mother-to-infant transmission are not known. Furthermore, several other factors such as acute infection during pregnancy, presence of other sexually transmitted diseases (STD) or other chronic infections, vaginal bleeding, disruption of placental integrity, premature rupture of membrane (PROM), and preterm PROM have been associated with mother-to-infant transmission of HIV-1. In addition, tobacco and cigarette smoking during pregnancy have been shown to triple the rate of maternal transmission of HIV-1. The AIDS Clinical Trial Group (ACTG) suggested that zidovudine (ZDV) can reduce the rate of mother-to-infant transmission of HIV-1 if administered to HIV-1-infected pregnant women with CD4 counts greater than 200. Moreover, this study failed to take into consideration several factors that may influence maternal transmission of HIV-1. However, the molecular mechanisms involved in mother-to-infant transmission of HIV-1 are not understood, which makes it more difficult to define strategies for effective treatment and prevention of HIV-1 infection in children. Several groups are engaged in the understanding of the molecular and biological properties of HIV-1 influencing mother-to-infant transmission. Results from my and several other laboratories suggest that the minor genotypes, subtypes, or variants of HIV-1 found in a genetically heterogeneous virus population of infected mothers are transmitted to their infants. The minor HIV-1 genotype predominates initially as a homogeneous population in the infant and then becomes diverse as the infant matures. Furthermore, transmission of a major or multiple HIV-1 genotypes from mother to infant has been reported. Taken together, these results strongly suggest that there are differences among the molecular and biological properties of the maternal variants that are transmitted to the infants and the maternal variants that are not transmitted to the infants. The understanding of the molecular and biological properties of the transmitted viruses will enable researchers to target a particular subtype in the mothers that is transmitted to the infants.     

Associations between use of crack cocaine and HIV-1 disease progression: research findings and implications for mother-to-infant transmission

Recent in vitro and in vivo research has suggested that cocaine has a direct effect on the pathogenesis of AIDS. These findings are confirmed by epidemiological studies linking the use of injected, inhaled, and smoked (crack) cocaine and indicators of HIV disease progression, even among adherent users of highly active antiretroviral therapy. Recent studies of vertical HIV transmission suggest that cocaine use may play a role in mother-to-child infection via alteration of maternal immune responses, enhanced viral replication in maternal immune cells, or alterations in the immune systems of neonates or infants. The purpose of this article is to review research conducted over the past several decades on associations between use of cocaine and HIV disease progression, especially among HIV+ women, and to explore its potential relevance for understanding mother-to-infant transmission of HIV.     

丙型病毒性肝炎母婴传播的现状、进展及未来

丙型肝炎病毒(HCV)可引起急性和慢性病毒性肝炎,可发展成肝纤维化、肝硬化,甚至肝细胞癌。HCV经典的传播途径为经血液或血液制品传播,但1992年后献血员HCV的筛检已使输血后肝炎大为减少。在发达国家,HCV传播途径正在发生改变,儿童非血液制品的丙肝日渐增多。母婴间宫内、分娩时及产后感染已成为当前及今后的重要研究课题。研究证实,HCV可经胎盘引起胎儿感染,宫内感染是HCV传播的一条重要途径。尽管人们对HCV母婴传播中所涉及的风险因素逐渐明确,但到目前为止对具体的传播机制和传播时机仍知之甚少。我们就丙型病毒性肝炎母婴传播的现状、进展及未来做简要综述。     

THE EVOLUTION OF VIRULENCE IN PATHOGENS WITH VERTICAL AND HORIZONTAL TRANSMISSION

The idea that vertical transmission of parasites selects for lower virulence is widely accepted. However, little theoretical work has considered the evolution of virulence for parasites with mixed horizontal plus vertical transmission. Many human, animal, and plant parasites are transmitted both vertically and horizontally, and some horizontal transmission is generally necessary to maintain parasites at all. We present a population-dynamical model for the evolution of virulence when both vertical and horizontal transmission are present. In the simplest such model, up to two infectious strains can coexist within one host population. Virulent, vertically transmitted pathogens can persist in a population when they provide protection against more virulent, horizontally transmitted strains. When virulence is maintained by a correlation with horizontal transmission rates, increased levels of vertical transmission always lower the evolutionarily stable (ESS) level of virulence. Contrary to existing theory, however, increases in opportunities for horizontal transmission also lower the ESS level of virulence. We explain these findings in light of earlier work and confirm them in simulations including imperfect vertical transmission. We describe further simulations, in which both vertical and horizontal transmission rates are allowed to evolve. The outcome of these simulations depends on whether high levels of vertical transmission are possible with low virulence. Finally, we argue against the notion of a virulence-avirulence continuum between horizontal and vertical transmission, and discuss our results in relation to empirical studies of transmission and virulence.     

Transplacental transmission of HIV: a potential role for HIV binding lectins

Although the majority of vertical transmission of HIV occurs around the time of birth, 1.5-2% of pregnancies in HIV-positive women appear to result in the vertical transmission of HIV across the placenta. HIV infection of a number of placental cell types has been demonstrated, but the exact mechanisms of intrauterine vertical transmission remain obscure. The recent discovery of the HIV binding lectins dendritic cell-specific ICAM-grabbing non-integrin (DC-SIGN) and DC-SIGN-related molecule (DC-SIGNR) provides one possible explanation. Cells expressing these lectins are able to adsorb the virus and mediate high efficiency HIV infection of other cell types. Both lectins are expressed by the placenta, with DC-SIGN expression also being present on maternal cells intimately associated with the placenta. This review focuses on possible mechanisms by which these lectins may potentiate the intrauterine vertical transmission of HIV.     

Vertically transmitted HIV infection in the British Isles.

OBJECTIVE--To describe the epidemiology of vertically acquired HIV infection in the British Isles, the level of underreporting, the vertical transmission rate, and clinical spectrum of paediatric AIDS. DESIGN--Confidential, linked registers based on reporting from obstetricians and paediatricians; anonymous unlinked neonatal HIV serosurveys. SETTING--British Isles. SUBJECTS--Children born to mothers with HIV infection. MAIN OUTCOME MEASURES--Trends in HIV infection and vertical transmission rate. RESULTS--In Scotland and the Irish Republic, where most maternal HIV infection is related to drug misuse, the annual number of reports of children born to infected mothers has fallen since 1989. In England and Wales nearly half of maternal infections have been acquired overseas, and the number of children born to these women, and to women who became infected in Britain, is increasing. In south east England the proportion of live births to women whose infection was identified before delivery was only 17% (50/287), compared with 68% (26/38) in Scotland. The vertical transmission rate was 13.7% (23/168), and 23% of infected children developed AIDS in the first year of life. 41% (38/92) of children born to infected mothers who were ascertained after delivery were breast fed, compared with 5% (12/236) of those ascertained before delivery. CONCLUSIONS--The incidence of vertically transmitted HIV infection is increasing in England and Wales. More extensive antenatal testing would enable infected women to be counselled against breast feeding, which could prevent a substantial proportion of vertical transmission in some areas, and would increase opportunities for early diagnosis and treatment of infected children.     

Long‐term selection experiment produces breakdown of horizontal transmissibility in parasite with mixed transmission mode

Evolutionary transitions from parasitism toward beneficial or mutualistic associations may encompass a change from horizontal transmission to (strict) vertical transmission. Parasites with both vertical and horizontal transmission are amendable to study factors driving such transitions. In a long‐term experiment, microcosm populations of the protozoan Paramecium caudatum and its bacterial parasite Holospora undulata were exposed to three growth treatments, manipulating vertical transmission opportunities over ca. 800 host generations. In inoculation tests, horizontal transmission propagules produced by parasites from a “high‐growth” treatment, with elevated host division rates increasing levels of parasite vertical transmission, showed a near‐complete loss of infectivity. A similar reduction was observed for parasites from a treatment alternating between high growth and low growth (i.e., low levels of population turn‐over). Parasites from a low‐growth treatment had the highest infectivity on all host genotypes tested. Our results complement previous findings of reduced investment in horizontal transmission and increased vertical transmissibility of high‐growth parasites. We explain the loss of horizontal transmissibility by epidemiological feedbacks and resistance evolution, reducing the frequency of susceptible hosts in the population and thereby decreasing the selective advantage of horizontal transmission. This illustrates how environmental conditions may push parasites with a mixed transmission mode toward becoming vertically transmitted nonvirulent symbionts.     

Drugs of abuse and HIV infection/replication: implications for mother-fetus transmission

Human immunodeficiency virus (HIV) infection and progression of acquired immunodeficiency syndrome (AIDS) can be modulated by a number of cofactors, including drugs of abuse. Opioids, cocaine, cannabinoids, methamphetamine (METH), alcohol, and other substances of abuse have been implicated as risk factors for HIV infection, as they all have the potential to compromise host immunity and facilitate viral replication. Although epidemiologic evidence regarding the impact of drugs of abuse on HIV disease progression is mixed, in vitro studies as well as studies using in vivo animal models have indicated that drugs of abuse have the ability to enhance HIV infection/replication. Drugs of abuse may also be a risk factor for perinatal transmission of HIV. Because high levels of viral load in maternal blood are associated with increased risk of HIV vertical transmission, it is likely that drugs of abuse play an important role in promoting mother-fetus transmission. Furthermore, because the neonatal immune system differs qualitatively from the adult system, it is possible that maternal exposure to drugs of abuse would exacerbate neonatal immunity defects, facilitating HIV infection of neonate immune cells and promoting HIV vertical transmission. The availability and use of antiretroviral therapy for women infected with HIV increase, there is an increasing interest in determining the impact of drug abuse on efficacy of AIDS Clinical Trials Group (ACTG)-standardized treatment regimens for woman infected with HIV in the context of HIV vertical transmission.