中国消除艾滋病流行面临的挑战

遏制和终结获得性免疫缺陷综合征(艾滋病)(acquired immune deficiency syndrome, AIDS)是《“健康中国2030”规划纲要》的重要组成部分和联合国2030年可持续发展目标之一。虽然中国在应对人类免疫缺陷病毒(human immunodeficiency virus, HIV)/AIDS流行方面确实取得了实质性进展,但终结AIDS流行愿景仍面临重重挑战。在筛查和诊断方面:HIV的扩大筛查和早期发现仍是中国应对HIV的关键;在治疗方面:HIV感染者的免费抗病毒治疗策略存在局限性,HIV感染者拒绝或中途退出治疗的状况时有发生,AIDS难以治愈等,解决这些问题困难重重;在预防方面:预防药物推广存在难度,疫苗研究仍未取得突破;在社会支持方面:对HIV/AIDS患者的歧视依然存在,非政府组织的参与度存在局限性。因此,针对男男性行为者(men who have sex with men, MSM)、吸毒者、老年人等关键易感人群及流行率较高的特定地区设计和制定包括诊断、治疗、预防及社会支持在内的HIV感染防治综合策略,对中国消除AIDS流行具有重要意义。     

HIV-1辅受体及针对辅受体的艾滋病治疗策略

艾滋病(AIDS)是由人类免疫缺陷病毒(Human immunodeficiency virus, HIV)引起的严重危害人类健康的世界性传染病,目前尚无有效的预防和治疗措施.虽然近年高效抗逆转录病毒疗法(HAART)明显提高了AIDS的临床疗效,但由于HIV的高度变异性、化疗药物的毒副作用及价格昂贵等因素,多种新的抗HIV药物的开发研究仍有增无减[1].HIV-1辅受体的发现不仅有助于理解HIV-1感染靶细胞的发病机理,而且为抗HIV治疗提供了新的作用靶点.HIV-1辅受体及其抑制剂已成为目前抗HIV-1治疗研究的热点,现将有关的研究进展作一综述.     

HIV储存库特征及其主要检测方法

获得性免疫缺陷综合症(acquired immunodeficiency syndrome,AIDS),即艾滋病,是由人类免疫缺陷病毒(human immunodeficiency virus,HIV)引起的一种致死率极高的慢性传染病。如何有效控制和预防AIDS已成为全球共同面临的严峻挑战。HIV DNA整合在CD4+T细胞基因组中形成HIV储存库,使部分HIV逃避了宿主免疫清除和抗病毒药物的治疗作用。如何彻底清除患者体内HIV储存库成为功能性治愈艾滋病的重大障碍。了解HIV储存库的病毒学特征及其检测方法,是目前HIV研究的热点之一。现对HIV储存库特征及其主要检测方法作一综述。     

AIDS的血清流行病学

<正> 一、人类免疫缺陷病毒(HIV)感染症的病型 HIV感染症不仅限于AIDS。HIV感染后一周左右出现发热,并出现伴有淋巴结肿大的类传染性单核细胞增多症或流感样症状。多数是一过性的。经相当时间后成为AIDS相关症状(ARC)。在感染HIV的人群中,有10％左右在6个月或5年的潜伏期之后发病。AIDS是由于HIV感染造成免疫     

The Progress on the Studies of HIV/AIDS Vaccine

人类控制HIV感染长远的目标是发展安全、有效、廉价的HIV AIDS疫苗。但经 2 0多年的努力 ,人类探索HIV AIDS疫苗之路仍在继续。分析了疫苗研究的复杂性和发展HIV AIDS疫苗过程中所面临的挑战 ,并对发展HIV AIDS疫苗的可能性从实验和临床方面进行了阐述。同时结合HIV感染的免疫应答原理对现有的各种HIV AIDS疫苗研究策略作一综述 ,并根据以往HIV AIDS疫苗研究的经验和教训提出未来疫苗的发展思路及展望。     

静脉注射吸毒人群HIV／AIDS数学模型分析

建立了四川省西昌市静脉注射吸毒人群HIV／AIDS传播的数学模型,给出了模型的理论分析和数值模拟结果．通过必要的分析,给出了各类平衡点的存在性和稳定性,系统的一致持续生存,以及基本再生数的数学表达式和具体取值．揭示了该静注人群中的HIV／AIDS有进一步蔓延的趋势,但如果采取适当的干预措施,该静注人群中HIV／AIDS流行可得到有效的控制．     

核酶与AIDS治疗

 艾滋病(AIDS)是由人免疫缺陷病毒(HIV)感染并破坏人体免疫功能所导致的一种综合症. 作为具有核酸内切酶活性的RNA小分子,核酶能特异性结合及切割HIV病毒靶分子,并促进靶分子mRNA的裂解,且能相继与多个靶分子RNA作用,同时又不影响宿主细胞RNA. 利用核酶治疗艾滋病不仅没有化疗药物常见的副作用,而且由于核酶本身具有RNA剪切酶活性,可同时剪切HIV mRNA和HIV生命过程中重要的调节蛋白mRNA.因此,较其它基因疗法如RNAi、DNA decoy等,更能有效地抑制HIV复制,并且对由HIV变异而导致的耐药病毒株同样有效,同时对病毒突变的诱导作用也较其它抗病毒药物低.因此,在抗AIDS基因治疗研究中具有潜在的应用价值. 本文在对核酶的结构、催化作用机制及其对HIV-1的作用机制进行概述的基础上,重点讨论了近年来核酶作用于HIV的研究进展以及对AIDS治疗的应用前景.     

AIDS机理研究的转折点

从人类分离到AIDS病毒(HIV)以来已有九年了,HIV感染机体,导致CD_4+T细胞的死亡为AIDS的发病机理为大家所公认,可是1991年开始有关AIDS的发生机理研究领域里出现了新的争论,这场争论的结果将影响今后AIDS的机理研究,特别是HIV疫苗的研制。争论的起点是由加洲大学伯克利分校的Peter Duesberg挑起的,他认为HIV根本不是AIDS的病因,AIDS的机理是由机体产生抗T淋巴细胞的抗体,从而引起T细胞的损伤、清除,因而是一种自身免疫病,该论点的主要依据为HIV感染的T细胞仅为1/100,000,不可能引起大量T细胞的死亡,尽管大多数学者不同意此论点,但有些实验结果却令人感到困惑,     

静脉吸毒人群中性工作者对HIV/AIDS传播和流行的影响

本文利用数学模型,研究了静脉吸毒人群中的性工作者通过商业性活动对HIV/AIDS传播和流行的影响.讨论了基本再生数、边界平衡点的稳定性、系统的一致持续性和地方病平衡点的存在性,揭示了性工作者的商业性活动可加强HIV/AIDS的传播和流行.特别地,若无商业性活动且吸毒人群和嫖客人群中均无疾病流行时,商业性活动的存在将会导致两类人群中的疾病均流行起来.     

HIV/AIDS的细胞治疗

获得性免疫缺陷综合征(AIDS)是由人类免疫缺陷病毒(HIV)感染引起的危险性极高的慢性传染病。高效抗逆转录病毒疗法(HAART)能够阻断正在进行的病毒复制而不能清除潜伏的病毒,目前尚无有效根治AIDS方法。免疫细胞在HIV/AIDS发展过程的不同阶段发挥着十分复杂的作用。细胞治疗是通过筛选表达抗HIV基因型的细胞或转染抗HIV基因、受体基因等方法获得抗HIV免疫细胞,并在体外进行扩增,将其转输给HIV/AIDS患者。细胞疗法与HAART等疗法有协同作用,促进HIV/AIDS的治疗。本文综述抗HIV-CAR T细胞、aTCR T细胞、负载HIV抗原的树突状细胞等在HIV/AIDS治疗中的应用及其疗效。     

Challenges and Opportunities： the Expanded Government-led HIV/AIDS Programs in China

HIV/AIDS has posed an increasingly serious issue in China. In recent years,Chinese government has taken further intensified efforts to combat HIV/AIDS with high-level political commitment,supportive policy development,increased financial allocation,large-scale of government-led initiatives,expanded international cooperation and great involvement of non-governmental organizations. Meanwhile gaps and challenges coexist impacting the implementation and the results of national HIV/AIDS programs. Thus,further government efforts are needed to improve and tailor the actions to meet the requirement of HIV/AIDS control in China.     

艾滋病治疗药物--HIV 抑制剂作用机制及研究进展

艾滋病(AIDS)是由人类免疫缺陷病毒(HIV)感染而引起的慢性进行性致死性传染病,又称获得性免疫缺陷综合症,目前无有效治愈的方法,严重危害着人类的健康。现今,艾滋病治疗药物主要包括逆转录酶抑制剂、蛋白酶抑制剂、进入抑制剂、整合酶抑制剂四大类化学药物和一些中草药制剂。抗HIV药物虽然不能完全治愈艾滋病,但可以控制艾滋病病情的发展,延长患者的无病生存期,提高患者的生活质量。本文就艾滋病发病机制、HIV抑制药物的抗病机制、副作用及其研究进展做一综述。     

Challenges and opportunities: the expanded government-led HIV/AIDS programs in China

HIV/AIDS has posed an increasingly serious issue in China. In recent years, Chinese government has taken further intensified efforts to combat HIV/AIDS with high-level political commitment, supportive policy development, increased financial allocation, large-scale of government-led initiatives, expanded international cooperation and great involvement of non-governmental organizations. Meanwhile gaps and challenges coexist impacting the implementation and the results of national HIV/AIDS programs. Thus, further government efforts are needed to improve and tailor the actions to meet the requirement of HIV/AIDS control in China. Foundation item: China International Clinical, Operational, and Health Services Research and Training Award with NIH grant number of U2R TW006918.     

Care of HIV-infected patients in China

Compared with high infection areas of the world, the total HIV infection rate in China is relatively low. Nonetheless, because of China's vast territory and large population, the potential infection risk must be taken seriously. In the next few years, needle sharing among injection drug users will remain the most common route of transmission for the HIV/AIDS epidemic in China. Unprotected sex is gradually becoming a major route of transmission. China began to implement HAART in 1999 according to international standards. Prior to 2003, there were only about 150 HIV/AIDS patients were treated with HAART in some clinical trials and about 100 HIV/AIDS patients were treated by private sources. Results of those treatments are the scientific basis for development of the therapeutic strategies in China. In March of 2003, the Chinese government initiated China CARES program. In November of 2003, the Chinese Ministry of Health announced a national policy of free ARV treatment to all HIV+ Chinese citizens who were in poverty and required ARV therapy. There are total of 19,456 HIV/AIDS patients received free ARV drugs to date in 159 regions and 441 towns. Current challenges are how to follow-up and evaluate those patients in the clinical settings. The longer the therapy is postponed, the more side effects and the higher probability of drug resistance are going to occur. It remains unclear, therefore, when HAART regimen should be started in the HIV/AIDS population in China.     

艾滋病治疗药物-HIV抑制剂作用机制及研究进展

艾滋病（AIDS）是由人类免疫缺陷病毒（HIV）感染而引起的慢性进行性致死性传染病,又称获得性免疫缺陷综合症,目前无有效治愈的方法,严重危害着人类的健康。现今,艾滋病治疗药物主要包括逆转录酶抑制剂、蛋白酶抑制剂、进入抑制剂、整合酶抑制剂四大类化学药物和一些中草药制剂。抗HIV药物虽然不能完全治愈艾滋病,但可以控制艾滋病病情的发展,延长患者的无病生存期,提高患者的生活质量。本文就艾滋病发病机制、HIV抑制药物的抗病机制、副作用及其研究进展做一综述。     

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     

In Vitro Anti-HIV Effect of Voacamine from Voacanga africana Stapf Based on the SPRi Experiment

Russian Journal of Bioorganic Chemistry - AIDS/HIV is a serious life-threatening and public health problem that urges for new antiviral drugs to control. A bis-indole alkaloid voacamine has been...     

The HIV epidemic: medical and social challenges

The sudden appearance, rapid spread, and devastating clinical impact of HIV infection in Africa, Europe and North America has created a medical problem unprecedented in the modern era. HIV is sexually transmitted, afflicts sexual and racial minorities in developed countries, and appears likely to be fatal and incurable in a majority of infected people. Its epidemiology (transmission and natural history) and clinical manifestations have been well described, but treatment of HIV remains minimally effective, creating only a short respite from progressive deterioration. In the absence of effective vaccination, HIV will continue to spread, abetted by a long period of asymptomatic carriage during which carriers are infectious. It has spread internationally to most undeveloped countries aided by fear and ignorance. The problem will resist simple technological solutions and adversely impact the lives of tens of millions of people in these areas over the next several decades. In developed countries HIV will strain medical resources and kill several million people before the end of the century. Despite the tremendous problems created by the AIDS epidemic, it has driven a remarkable expansion of virologic and immunologic understanding which promises to ultimately lead to control of not only AIDS, but a variety of other serious diseases. The following reviews of pivotal issues in AIDS research document this progress.     

Mandela restores morale of AIDS conference

During the 13th international AIDS conference in Durban, former president Nelson Mandela pulled the morale of the conference highlighting the need to confront the needs and concerns of those suffering and dying of HIV/AIDS in South Africa, mostly in sub-Saharan. He also stated that to challenge the grave threat posed by HIV and AIDS, efforts should be combined to save the people. This concluding remark was in direct contrast to the opening words of South Africa's current president, Thabo Mbeki, who failed to deal with the impression he has created internationally that he has doubts about the etiology of AIDS. In addition, the need to focus on the accessibility and affordability of treatment for HIV/AIDS or the opportunistic infections associated with it was highlighted. The conference focused on this issue with the help of AIDS activists, who emphasized that pharmaceutical companies needed to address how their drugs could reach those who most need them.