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Needle Stick Injury by Aqueous Humor of a 31 Year Old PCR-Positive HIV Patient, a Case Report 31岁PCR阳性HIV患者体液针刺伤一例报告
Pub Date : 2021-08-09 DOI: 10.21203/rs.3.rs-727987/v1
Bahram Bohrani Sefidan, Amin Dehghani Sanij
Background Health worker Needle-stick injury (NSI) by internal body fluids can transmit serious pathogens like HIV. Considering Principles of personal and occupational care, plays an important role in prevention of such events. Case presentation A health worker suffered needle stick injury by aqueous humor of a PCR-positive HIV patient while he was recapping needle despite necessary preparations. Conclusions NSI by Aqueous humor which is secreted from blood, can theoretically transmit blood borne pathogens like HIV. Nevertheless, there is neither any report of aqueous humor NSI nor HIV transmission in this way. Based on our best knowledge this case is the first report represents HIV+ aqueous humor NSI and further evidence is required. Considering literature, we can not conclude whether there was a need for PEP in our case.
背景:由体液引起的针刺伤(NSI)可传播艾滋病毒等严重病原体。考虑到个人和职业护理原则,在预防此类事件中起着重要作用。一名卫生工作者不顾必要的准备,在重新扎针时被一名pcr阳性艾滋病患者的房水刺伤。结论由血液分泌的房水引起的自伤,理论上可传播HIV等血源性病原体。然而,没有任何关于房水自伤的报道,也没有艾滋病毒通过这种方式传播。据我们所知,这是首例HIV+房水性自伤的报道,需要进一步的证据。考虑到文献,我们不能断定在我们的案例中是否需要PEP。
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引用次数: 0
Comparison between Cervical Cancer and Anal Cancer Screening 宫颈癌和肛门癌筛查的比较
Pub Date : 2021-01-01 DOI: 10.37421/2155-6113.2021.12.858
Shambavi J. Rao, K. Pierre, Luis F. Barroso
When it comes to simple anatomy, the colon, rectum and anus all seem to be part of the same gastrointestinal highway, so wouldn’t the cancers that develop in these different...stretches, be the same? While colon and rectal cancers can be similar and are often referred to collectively as colorectal cancer, anal cancer is completely different in significant ways, including the cell type where cancer begins, the cause of the cancer, who gets this cancer, and how we treat it. Anal cancer is more similar to cervical cancer because the tissue that lines the anus (where anal cancer typically develops) is like the tissue that lines a woman’s cervix. Most anal cancers are related to human papillomavirus (HPV) infection like cervical cancer, and the precancerous and cancerous changes that we see in the anal canal are also similar to cervical cancer. Cervical disease and analcentric malignancy share numerous likenesses including causation by oncogenic human papillomaviruses; in any case, critical contrasts exist in their study of disease transmission, hazard factors, biologic conduct, the executives, and treatment. Albeit uncommon, the rate of anal-centric malignant growth is alarmingly high and keeps on expanding in high-hazard populaces, especially men who have intercourse with men paying little heed to their human immunodeficiency infection (HIV) status. There are no public evaluating rules for butt-centric malignancy. Utilizing the achievement of cervical malignant growth screening as a model, anal-centric disease screening approaches apply anal-centric cytology, high-goal anoscopy, and guided biopsy to direct treatment and the executives’ techniques.
当涉及到简单的解剖学时,结肠、直肠和肛门似乎都是同一条胃肠道高速公路的一部分,所以在这些不同的地方发生的癌症不会…拉伸,是一样的吗?虽然结肠癌和直肠癌可能相似,通常被统称为结直肠癌,但肛门癌在很多方面完全不同,包括癌症开始的细胞类型,癌症的原因,谁得了这种癌症,以及我们如何治疗它。肛门癌与子宫颈癌更相似,因为肛门(肛门癌通常发生的地方)的组织与女性子宫颈的组织相似。大多数肛门癌与宫颈癌一样与人乳头瘤病毒(HPV)感染有关,我们在肛管中看到的癌前病变和癌性病变也与宫颈癌相似。宫颈疾病和肛门中心性恶性肿瘤有许多相似之处,包括由致瘤性人乳头瘤病毒引起;无论如何,他们在疾病传播、危险因素、生物行为、管理人员和治疗方面的研究存在着关键的对比。虽然不常见,但以肛门为中心的恶性肿瘤的增长率高得惊人,并在高危人群中不断扩大,特别是那些与很少注意自己的人类免疫缺陷感染(HIV)状况的男性发生性关系的男性。对于以臀部为中心的恶性肿瘤尚无公开的评估规则。以宫颈恶性生长筛查成果为模型,以肛门为中心的疾病筛查方法应用肛门为中心的细胞学、高目标肛门镜检查和引导活检来指导治疗和执行人员的技术。
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引用次数: 0
Existence of a Safety-Net Sexually Transmitted Infection (STI) 存在一个安全网性传播感染(STI)
Pub Date : 2021-01-01 DOI: 10.37421/2155-6113.2021.12.859
M. Atkinson
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引用次数: 0
Incidence and Predictors of Sero-Conversion among HIV Discordant Couples at Amhara Region Selected Public Hospitals, Northwest Ethiopia, 2018: A Mixed Cohort Study 2018年埃塞俄比亚西北部阿姆哈拉地区选定公立医院HIV不一致夫妇血清转化发生率及预测因素:一项混合队列研究
Pub Date : 2021-01-01 DOI: 10.37421/2155-6113.2021.12.840
Lami Bayisa, Muktar Abadiga, Tadesse Tolosa, A. Oluma, T. Abera, Diriba Mulisa, Ebisa Turi, Eba Abdisa, G. Mamo
Background: Human immunodeficiency virus positive status disclosure deficit continues to drive the infection transmission. The major causes for expansion of HIV infection in developing were due to HIV infected individuals continue to have unprotected sex without informing their status to their sexual partner(s) who may be of negative or unknown sero-status. In the Ethiopia regarding disclosure deficit among people living with HIV there is no adequate findings. Thus, the aim of this study was to assess magnitude of disclosure deficit experienced by people living with HIV and application of the Health Belief Model at Nekemte Specialized Hospital Western, Ethiopia, 2020. Methods: A facility based cross-sectional study was conducted to explore HIV disclosure deficit of people living with HIV at ART Clinic of Nekemte specialized hospital, Western Ethiopia from March 5 to April 15, 2020. Systematic random sampling was used to recruit 380 PLHIV. Participants were interviewed to obtain socio-demographic and health belief related data. Relevant medical history was obtained from participants' chart records. The collected data were processed and analyzed using Epi data version 3.1 and STATA version 14.0. Binary logistic regression analysis with 95% CI was conducted. Results: The mean age of the 380 PLHIV was 31 (SD± 8.9) years. One fourth, (25%) of participants experienced disclosure deficit. Delayed to use, low level of education, using traditional healing and respondents’ level of knowledge were significantly associated with disclosure deficit. Importantly, Disclosure deficit had significantly affected by respondents’ perceived threat, perceived stigma and perceived low social support. Conclusion: Magnitude of disclosure deficit was low. Disclosure deficit is more likely when the patient use traditional healing, delayed to start ART, has lower level of education, and perceives stigma and low social support. This finding also insight that the health belief model dimensions would be a valuable framework for providers, planners and policy makers to develop guidelines and policies for early and further HIV sero-status disclosure.
背景:人类免疫缺陷病毒阳性状态披露不足继续推动感染传播。发展中国家艾滋病毒感染扩大的主要原因是,感染艾滋病毒的人继续进行无保护的性行为,而不将其状况告知其可能呈阴性或未知血清状态的性伴侣。在埃塞俄比亚,关于艾滋病毒感染者的信息披露不足,没有充分的调查结果。因此,本研究的目的是评估艾滋病毒感染者所经历的信息披露缺陷的程度和健康信念模型在埃塞俄比亚Nekemte西部专科医院的应用,2020年。方法:采用基于设施的横断面研究,探讨2020年3月5日至4月15日在埃塞俄比亚西部Nekemte专科医院ART诊所HIV感染者的HIV信息披露不足情况。采用系统随机抽样方法,共招募PLHIV感染者380例。对参与者进行访谈以获得社会人口统计和健康信念相关数据。从参与者的病历记录中获取相关病史。使用Epi数据3.1版和STATA数据14.0版对收集的数据进行处理和分析。采用95% CI的二元logistic回归分析。结果:380例PLHIV患者的平均年龄为31 (SD±8.9)岁。四分之一(25%)的参与者经历了信息披露不足。延迟使用、教育程度低、使用传统疗法和应答者的知识水平与披露缺陷显著相关。重要的是,被调查者的感知威胁、感知耻辱和感知低社会支持显著影响了披露赤字。结论:信息披露缺失程度较低。当患者使用传统疗法、延迟开始抗逆转录病毒治疗、教育水平较低、感到耻辱和社会支持不足时,更有可能出现信息披露不足。这一发现还表明,健康信念模型维度将成为提供者、规划人员和决策者制定早期和进一步披露艾滋病毒血清状况的指导方针和政策的宝贵框架。
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引用次数: 0
Factors Associated with HIV Viral Load suppression AmongAdults at HIV Care and Treatment Centers in Dodoma, Mtwaraand Lindi Region, July 2018-June 2019 2018年7月至2019年6月,Dodoma、mtwarand和Lindi地区艾滋病毒护理和治疗中心成年人艾滋病毒载量抑制相关因素
Pub Date : 2021-01-01 DOI: 10.37421/2155-6113.2021.12.844
O.I.N. Machangu
Despite the increase number of people living with HIV still there are limited information about the factors associated with viral load suppression among HIV+ individual enrolled into HIV care and treatment centers in Tanzania. Data reports that 87% of those who are living with HIV have attained viral suppression. However this is still low compare to the UNAIDS global targets that by 2020 of 90% on treatment must achieve viral suppression. Viral load remains a gold standard for assessing treatment outcome for those who are on treatment. In 2014 UNAIDS introduced 90- 90-90 goal so as to combat HIV epidemic by 2020. First 90% know there status, second 90 accessing treatment and Third 90% viral suppression. The aim of this study was therefore to identify factors affecting viral load suppression among HIV+ adults attending care and treatment services in the regions. Crossectional analytical study conducted at Dodoma, Mtwara and Lindi regions in randomly selected health facilities. 459 participants who are on ART for atleast 12 months and 18+ years were recruited for the study. Structured questionnaire was used. Data was entered, cleaned and analyzed using EPI info 7.2.2.16. Odds ratio was used to establish association, 95% CI, and P value of 0.05 were used for statistically significance. A total of 459 study participants were enrolled. The prevalence of viral load suppression was 79%. Viral load suppression was found to be association with Satisfaction to care OR, 11.6 (95% CI: 1.2, 113.6) and Stigma level OR, 2.5 (95% CI: 1.03, 6.1) and found to be statistically significant. Majority of participants were female 165 (68.6%), married 185 (40.3%), with primary education 309 (67.3%) and 280 (61%) had small business or self-employed. Those younger than 35 years had a 70% reduced chance of having viral load suppression OR 0.7 (95% CI: 0.41 OR 1.18), gender OR 0.85 (95% CI: 0.5,1.35), marital status OR, 0.93 ( 95% CI: 0.59, 1.47), those with primary education level OR, 0.47, (95% CI: 0.22 OR 0.99), duration on ART OR, 0.46 (95%:0.15,1.42) disclosure status OR, 0.39 (95% CI: 0.15, 1.01)there were found to be associated with viral suppression but not statistically significant. Satisfaction with care and low level of stigma were associated with viral load suppression.
尽管艾滋病毒感染者人数有所增加,但在坦桑尼亚艾滋病毒护理和治疗中心登记的艾滋病毒阳性个体中,有关抑制病毒载量的相关因素的信息仍然有限。数据显示,87%的艾滋病毒感染者实现了病毒抑制。然而,与联合国艾滋病规划署到2020年90%的治疗必须实现病毒抑制的全球目标相比,这一比例仍然很低。病毒载量仍然是评估那些正在接受治疗的人的治疗结果的金标准。2014年,联合国艾滋病规划署提出了“90-90 -90”目标,目标是到2020年防治艾滋病毒流行。前90%的人知道病情,后90%的人获得治疗,第三90%的人病毒受到抑制。因此,本研究的目的是确定在这些地区接受护理和治疗服务的HIV+成人中影响病毒载量抑制的因素。在多多马、姆特瓦拉和林迪地区随机选择的卫生设施中进行了横断面分析研究。这项研究招募了459名接受ART治疗至少12个月和18年以上的参与者。采用结构化问卷。使用EPI信息7.2.2.16录入、清理和分析数据。采用优势比确定相关性,95% CI, P值0.05表示差异有统计学意义。共有459名研究参与者被纳入研究。病毒载量抑制的患病率为79%。病毒载量抑制与护理满意度OR为11.6 (95% CI: 1.2, 113.6)和柱头水平OR为2.5 (95% CI: 1.03, 6.1)相关,且具有统计学意义。大多数参与者是女性165人(68.6%),已婚185人(40.3%),受过小学教育的309人(67.3%),有小生意或自雇的280人(61%)。年龄小于35岁的患者出现病毒载量抑制的几率降低70%,OR为0.7 (95% CI: 0.41或1.18),性别OR为0.85 (95% CI: 0.5,1.35),婚姻状况OR为0.93 (95% CI: 0.59, 1.47),初等教育水平OR为0.47 (95% CI: 0.22或0.99),抗逆转录病毒治疗持续时间OR为0.46 (95% CI: 0.15,1.42),披露状况OR为0.39 (95% CI: 0.15, 1.01),均与病毒抑制相关,但无统计学意义。对护理的满意度和低程度的病耻感与病毒载量抑制有关。
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引用次数: 0
Diagnostic Challenge of Tuberculous Meningitis with Tuberculoma in a Newly Diagnosed HIV Infected Patient ART Naandiuml;ve 新诊断的HIV感染者结核性脑膜炎伴结核瘤的诊断挑战
Pub Date : 2021-01-01 DOI: 10.37421/2155-6113.2021.12.856
Rehema H. Simbauranga, S. Kivuyo, Fadhili M Lyimo, S. Mfinanga
Tuberculous meningitis is a subacute disease with symptoms that may persist for several weeks before diagnosis. It can clinically present similarly to other forms of meningitis and this often leads to a delay in treatment. Detection of Mycobacteria Tuberculosis in cerebral spinal fluid remains the gold standard. However, there is low positive rate of mycobacterial detection. Treatment should be initiated as soon as clinical suspicion is supported by initial CSF findings after excluding other causes such as bacteria and fungus.
结核性脑膜炎是一种亚急性疾病,在诊断前症状可持续数周。它的临床表现与其他形式的脑膜炎相似,这往往导致治疗延误。脑脊液中结核分枝杆菌的检测仍然是金标准。但分枝杆菌的检出率较低。在排除细菌和真菌等其他原因后,一旦初步脑脊液检查结果支持临床怀疑,应立即开始治疗。
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引用次数: 0
SARS-CoV-2 Infection in HIV-Positive Adults: An Overview hiv阳性成人中SARS-CoV-2感染:综述
Pub Date : 2021-01-01 DOI: 10.37421/2155-6113.2021.12.869
L. Beyer
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引用次数: 0
Editorial Note on Developing an HIV Vaccine: Vaccinology Research 开发一种HIV疫苗:疫苗学研究
Pub Date : 2021-01-01 DOI: 10.37421/2155-6113.2021.12.850
E. Stewart
It is widely acknowledged that eradicating HIV from the human population will necessitate the development of an effective vaccine. Candidate vaccines that have been tested to date, on the other hand, have either failed or demonstrated very low and debatable efficacy. New vaccine trials based on producing both antibodies and T cell immunity have begun, and the findings of these trials will be known in the coming years. Simultaneously, a large body of evidence suggests that broadly neutralising antibodies (bnAbs) are created in natural HIV infection and that such antibody, delivered via passive transfer, can protect against HIV in animal models as well as alter HIV infection in humans.
人们普遍承认,从人口中消灭艾滋病毒将需要研制一种有效的疫苗。另一方面,迄今已测试的候选疫苗要么失败,要么显示出非常低的和有争议的效力。基于产生抗体和T细胞免疫的新疫苗试验已经开始,这些试验的结果将在未来几年内公布。同时,大量证据表明,广泛中和抗体(bnAbs)是在自然的HIV感染中产生的,这种抗体通过被动转移传递,可以在动物模型中防止HIV感染,也可以改变人类的HIV感染。
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引用次数: 0
COVID-19 Severity is Independently Linked to HIV COVID-19严重程度与艾滋病毒独立相关
Pub Date : 2021-01-01 DOI: 10.37421/2155-6113.2021.12.853
M. Atkinson
The international community must also do a lot more to get COVID-19 vaccinations to countries with high HIV and other illness prevalence. It is unacceptable that just about 3% of the African continent has received a single dose of the vaccine and less than 1.5% has received both doses as of today. Most analyses have been conducted on relatively small cohorts of individuals in specific settings, and the impact of HIV infection on the severity and mortality of COVID-19 has been limited and occasionally contradictory. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have issued health alerts and prevention instructions for those who are at a higher risk of serious health consequences and death as a result of COVID-19. These recommendations are based on the outcomes and characteristics of patients who were infected early in the COVID-19 epidemic. Emerging trends point to an increased risk for older people, people in longterm care facilities, men, and racial/ethnic minorities, who have historically faced health disparities for many chronic diseases.
国际社会还必须做更多工作,向艾滋病毒和其他疾病高发国家提供COVID-19疫苗接种。令人无法接受的是,截至今天,非洲大陆只有约3%的人接种了一剂疫苗,不到1.5%的人接种了两剂疫苗。大多数分析都是在特定环境中相对较小的人群中进行的,艾滋病毒感染对COVID-19严重程度和死亡率的影响有限,有时甚至是相互矛盾的。世界卫生组织(世卫组织)和美国疾病控制与预防中心(CDC)已向那些因COVID-19而面临严重健康后果和死亡风险较高的人发布了健康警报和预防说明。这些建议是根据COVID-19流行早期感染患者的结果和特征提出的。新的趋势表明,老年人、长期护理机构中的人、男性和种族/少数民族面临的风险增加,他们历来在许多慢性病方面面临健康差距。
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引用次数: 0
Editorial Note for AIDS and Clinical Research 艾滋病与临床研究编辑说明
Pub Date : 2021-01-01 DOI: 10.37421/2155-6113.2021.12.832
Steve Lance
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引用次数: 0
期刊
Journal of AIDS & clinical research
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