目的研究分析我国HIV感染孕产妇应用抗逆转录病毒药物预防HIV母婴传播（prevention of mother to child transmission of HIV，简称PMTCT）的效果。方法2006年1月1日至2008年12月30日，在我国河北、山西、辽宁等23个省（自治区）的局部...目的研究分析我国HIV感染孕产妇应用抗逆转录病毒药物预防HIV母婴传播（prevention of mother to child transmission of HIV，简称PMTCT）的效果。方法2006年1月1日至2008年12月30日，在我国河北、山西、辽宁等23个省（自治区）的局部县（区）的医疗保健机构接受孕产期保健的1072对HIV感染孕产妇及所生满18月龄并有HIV抗体检测结果的婴幼儿作为研究对象，对感染孕产妇进行问卷调查，收集社会人口学资料、应用抗逆转录病毒药物、安全分娩、人工喂养等一系列PMTCT相关信息，运用Cochran．Mantel．Haenszel（简称CMH）卡方检验，分析不同时期用药方案的变化趋势；运用分层分析及Fisher精确χ^2检验，研究比较不同抗逆转录病毒药物方案对HIV母婴传播率的影响。抗逆转录药物应用方案主要为单一奈伟拉平（NVP）药物方案、预防性抗逆转录病毒药物联合方案及治疗性抗逆转录病毒联合方案。结果共调查1072对HIV感染产妇及所生婴幼儿，31名满18月龄HIV感染孕产妇所生儿童确认感染HIV，HIV母婴传播率为2．9％（31／1072）。（1）HIV感染孕产妇抗病毒药物应用比例从2006年的76．4％（306／395）上升至2008年的83．8％（372／444），呈逐年递增趋势（CMHχ^2=6．4，P〈0．05）。（2）2006年HIV感染孕产妇应用三联抗病毒药物的比例仅为3．4％（6／178），2008年，产妇应用三联药物的比例升至26．3％（104／395），逐年上升（CMHχ^2=53．1，P〈0．01），而单一NVP应用比例逐年下降，由2006年的88．8％（158／178）降至2008年的70．9％（264／372）（CMH）（2=48．5，P〈0．01）。（3）接受阴道分娩服务和人工喂养的产妇，联合抗病毒药物方案组发生HIV母婴传播水平仅为1．0％（1／104），低于应用单一NVP组HIV母婴传播率（5．9％，16／272）（Fisherχ^2=5．5，P〈0．05）。（4）在人工喂养的情况下，阴道展开更多
A substantial proportion of individuals with chronic hepatitis C virus(HCV) are co-infected with human immunodeficiency virus(HIV). Co-infected individuals are traditionally considered as one of the "special popu...A substantial proportion of individuals with chronic hepatitis C virus(HCV) are co-infected with human immunodeficiency virus(HIV). Co-infected individuals are traditionally considered as one of the "special populations" amongst those with chronic HCV, mainly because of faster progression to end-stage liver disease and suboptimal responses to treatment with pegylated interferon alpha and ribavirin, the benefits of which are often outweighed by toxicity. The advent of the newer direct acting antivirals(DAAs) has given hope that the majority of co-infected individuals can clear HCV. However the "special population" designation may prove an obstacle for those with co-infection to gain access to the new agents, in terms of requirement for separate pre-licensing clinical trials and extensive drug-drug interaction studies. We review the global epidemiology, natural history and pathogenesis of chronic hepatitis C in HIV co-infection. The accelerated course of chronic hepatitis C in HIV co-infection is not adequately offset by successful combination antiretroviral therapy. We also review the treatment trials of chronic hepatitis C in HIV co-infected individuals with DAAs and compare them to trials in the HCV mono-infected. There is convincing evidence that HIV co-infection no longer diminishes the response to treatment against HCV in the new era of DAA-based therapy. The management of HCV co-infection should therefore become a priority in the care of HIV infected individuals, along with public health efforts to prevent new HCV infections, focusing particularly on specific patient groups at risk, such as men who have sex with men and injecting drug users.展开更多
自从1996年HIV／AIDS抗逆转录病毒药物问世以来，抗逆转录病毒治疗（ART）取得重大进展，不同作用机制、对耐药病毒具有活性且耐受性好的新药不断获得批准。美国卫生和公众服务部（Depart-ment of Health and Human Service, DHHS）下...自从1996年HIV／AIDS抗逆转录病毒药物问世以来，抗逆转录病毒治疗（ART）取得重大进展，不同作用机制、对耐药病毒具有活性且耐受性好的新药不断获得批准。美国卫生和公众服务部（Depart-ment of Health and Human Service, DHHS）下属的成人和青少年ART指南制定小组是艾滋病研究和咨询委员会办公室（Office of AIDS Research Advisory Council, OARAC）的一个工作组，该小组的任务是关注HIV／AIDS在ART领域的新进展，定期更新成人和青少年ART指引[1]，将ART研究的最新进展提供给临床一线医护人员，以便更好地为HIV／AIDS患者服务。本文将该小组2014年7月更新的成人和青少年ART指南作一综述。展开更多
文摘目的研究分析我国HIV感染孕产妇应用抗逆转录病毒药物预防HIV母婴传播（prevention of mother to child transmission of HIV，简称PMTCT）的效果。方法2006年1月1日至2008年12月30日，在我国河北、山西、辽宁等23个省（自治区）的局部县（区）的医疗保健机构接受孕产期保健的1072对HIV感染孕产妇及所生满18月龄并有HIV抗体检测结果的婴幼儿作为研究对象，对感染孕产妇进行问卷调查，收集社会人口学资料、应用抗逆转录病毒药物、安全分娩、人工喂养等一系列PMTCT相关信息，运用Cochran．Mantel．Haenszel（简称CMH）卡方检验，分析不同时期用药方案的变化趋势；运用分层分析及Fisher精确χ^2检验，研究比较不同抗逆转录病毒药物方案对HIV母婴传播率的影响。抗逆转录药物应用方案主要为单一奈伟拉平（NVP）药物方案、预防性抗逆转录病毒药物联合方案及治疗性抗逆转录病毒联合方案。结果共调查1072对HIV感染产妇及所生婴幼儿，31名满18月龄HIV感染孕产妇所生儿童确认感染HIV，HIV母婴传播率为2．9％（31／1072）。（1）HIV感染孕产妇抗病毒药物应用比例从2006年的76．4％（306／395）上升至2008年的83．8％（372／444），呈逐年递增趋势（CMHχ^2=6．4，P〈0．05）。（2）2006年HIV感染孕产妇应用三联抗病毒药物的比例仅为3．4％（6／178），2008年，产妇应用三联药物的比例升至26．3％（104／395），逐年上升（CMHχ^2=53．1，P〈0．01），而单一NVP应用比例逐年下降，由2006年的88．8％（158／178）降至2008年的70．9％（264／372）（CMH）（2=48．5，P〈0．01）。（3）接受阴道分娩服务和人工喂养的产妇，联合抗病毒药物方案组发生HIV母婴传播水平仅为1．0％（1／104），低于应用单一NVP组HIV母婴传播率（5．9％，16／272）（Fisherχ^2=5．5，P〈0．05）。（4）在人工喂养的情况下，阴道
文摘A substantial proportion of individuals with chronic hepatitis C virus(HCV) are co-infected with human immunodeficiency virus(HIV). Co-infected individuals are traditionally considered as one of the "special populations" amongst those with chronic HCV, mainly because of faster progression to end-stage liver disease and suboptimal responses to treatment with pegylated interferon alpha and ribavirin, the benefits of which are often outweighed by toxicity. The advent of the newer direct acting antivirals(DAAs) has given hope that the majority of co-infected individuals can clear HCV. However the "special population" designation may prove an obstacle for those with co-infection to gain access to the new agents, in terms of requirement for separate pre-licensing clinical trials and extensive drug-drug interaction studies. We review the global epidemiology, natural history and pathogenesis of chronic hepatitis C in HIV co-infection. The accelerated course of chronic hepatitis C in HIV co-infection is not adequately offset by successful combination antiretroviral therapy. We also review the treatment trials of chronic hepatitis C in HIV co-infected individuals with DAAs and compare them to trials in the HCV mono-infected. There is convincing evidence that HIV co-infection no longer diminishes the response to treatment against HCV in the new era of DAA-based therapy. The management of HCV co-infection should therefore become a priority in the care of HIV infected individuals, along with public health efforts to prevent new HCV infections, focusing particularly on specific patient groups at risk, such as men who have sex with men and injecting drug users.
文摘自从1996年HIV／AIDS抗逆转录病毒药物问世以来，抗逆转录病毒治疗（ART）取得重大进展，不同作用机制、对耐药病毒具有活性且耐受性好的新药不断获得批准。美国卫生和公众服务部（Depart-ment of Health and Human Service, DHHS）下属的成人和青少年ART指南制定小组是艾滋病研究和咨询委员会办公室（Office of AIDS Research Advisory Council, OARAC）的一个工作组，该小组的任务是关注HIV／AIDS在ART领域的新进展，定期更新成人和青少年ART指引[1]，将ART研究的最新进展提供给临床一线医护人员，以便更好地为HIV／AIDS患者服务。本文将该小组2014年7月更新的成人和青少年ART指南作一综述。
