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1、青少年性病與愛滋病之診斷與治療衛(wèi)生署疾病管制局中區(qū)傳染病防治醫(yī)療網王任賢指揮官HIV/AIDSHumanImmunodeficiencyVirus/AcquiredImmunodeficiencySyndrome2WhatIsHIV/AIDS?Acquiredimmunodeficiencysyndrome(AIDS)iscausedbythehumanimmunodeficiencyvirus(HIV).HIVattacksanddestroyswhitebloodcells,causingadefectin

2、thebody’simmunesystem.TheimmunesystemofanHIV-infectedpersonbecomessoweakenedthatitcannotprotectitselffromseriousinfections.Whenthishappens,thepersonclinicallyhasAIDS.AIDSmaymanifestasearlyas2yearsoraslateas10yearsafterinfectionwithHIV.3ClinicalSpectrumofAIDSGr

3、oup1:Acuteinfection0-3weeksWindowperiod:Seroconversion3-12weeksGroup2:Asymptomaticinfection0-10yearsGroup3:PersistentgeneralizedLAPGroup4:OtherHIV-relateddiseasesConstitutionaldiseasesNeurologicaldisordersOpportunisticinfectionsSecondaryneoplasmsOthercondition

4、s4NaturalHistoryofHIVInfectionWithouttheUseofAntiretroviralTxSource:Fauci,A.,Pantaleo,D.,StanleyS.,Weismann,D.AnnalsofInternalMedicine124:6754-3,1996WeeksYearsCD4+TLymphocyteCount(cells/mmm3)HIV/RNACopiespermlPlasma107106105104103102036912123456789101112001100

5、10009008007006005004003002001000PrimaryInfection+AcuteHIVsyndromeWidedisseminationofvirusSeedingoflymphoidorgansClinicallatencyConstitutionalSymptomsOpportunisticDiseasesDeathSignsandSymptomsofAIDSFeverofunknownoriginEnlargedlymphglandsSkinrashesandcoughPer

6、sistentdiarrheaSevereweightlossSkinlesionsLossofappetiteandfatigue6SignsandSymptomsinHIVDiseaseSymptomPrevalence*Pain52%Tiredness50%Anxiety40%Sleepdisturbance37%Mouthsore33%Sadness32%Weightloss31%Nausea28%SymptomPrevalenceFever27%Cough27%Depression24%Diarrhea2

7、4%SkinProblem24%Pruritus23%Respiratoryproblem22%Vomiting20%JPalliativeCare,1994:10(2):95.*n=314DiagnosisofHIVMainlyserologicalThroughantibodytestingwithELISA;ifpositive,confirmationbyWesternBlotCultureofbloodandtissuesRT-PCR：mainlyforfollowup9HIVtestandcounsel

8、ingTreatmentofHIVInfectedPatientsAtpresent,nodrugortherapycancureAIDSAvailabilityofanti-AIDSvaccinesappearsunlikelyinthenearfutureAcombinationofthreeantiretrovirals(ARVs)isthegolds