Despite effective antiretroviral therapy(ART),many individuals with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)achieve viral suppression but fail to fully restore cluster of differentia...Despite effective antiretroviral therapy(ART),many individuals with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)achieve viral suppression but fail to fully restore cluster of differentiation 4(CD4)^(+)T lymphocyte(CD4 cell)counts—a condition known as immunological non-response(INRs).INRs are associated with elevated health risks,including increased susceptibility to AIDS-related and non-AIDS-related complications.The pathogenesis of INRs remains incompletely understood,and no established therapeutic interventions exist,posing a major challenge in contemporary HIV/AIDS management.Emerging evidence indicates that INRs exhibit significant alterations in gut microbiota composition.Dysbiosis of the gut microbiota may contribute to persistent immune activation,cytokine imbalance,and cellular pyroptosis,all of which could impair immune reconstitution in people living with HIV/AIDS.Traditional Chinese medicine(TCM)has demonstrated potential immunomodulatory effects and is increasingly utilized in the management of INRs.Targeting the gut microbiota and elucidating the mechanisms by which TCM modulates this microbial ecosystem may offer new avenues for preventing and treating INRs.This review explores the interplay between gut microbiota and TCM,examines the association between gut dysbiosis and INRs,discusses the mechanistic pathways through which microbiota imbalance contributes to INRs development,and highlights how TCM interventions regulate gut microbiota to promote immune recovery.By focusing on the gut microbiota as a therapeutic interface,this article provides novel insights into TCM-based strategies for improving outcomes in INRs and supports the development of innovative treatment approaches.展开更多
Penicillium marneffei （R marneffei） infection usually occurs with skin, bone marrow, lung or hepatic involve- ment. However, no cases of P. mameffei infection with chylous ascites have been reported thus far. In thi...Penicillium marneffei （R marneffei） infection usually occurs with skin, bone marrow, lung or hepatic involve- ment. However, no cases of P. mameffei infection with chylous ascites have been reported thus far. In this re- port, we describe the first case of acquired immune de- ficiency syndrome （AIDS） which has been complicated by a P. marneffei infection causing chylous ascites. We describe the details of the case, with an emphasis on treatment regimen. This patient was treated with am- photericin B for 3 mo, while receiving concomitant ther- apy with an efavirenz-containing antiretroviral regimen, but cultures in ascitic fluid were persistently positive for P. marneffei. The infection resolved after treatment with high-dose voriconazole （400 mg every 12 h） for 3 too. R marneffei should be considered in the differential di- agnosis of chylous ascites in human immunodeficiency virus patients. High-dose voriconazole is an effective, well-tolerated and convenient option for the treatment of systemic infections with R marneffei in AIDS patients on an efavirenz-containing antiretroviral regimen.展开更多
Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi...Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi ed including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.展开更多
Health related quality of life(HRQOL) can better reflect changes in acquired immune deficiency syndrome(AIDS) patients and inform economic evaluation of AIDS treatment services,and the assessment of HRQOL can help us ...Health related quality of life(HRQOL) can better reflect changes in acquired immune deficiency syndrome(AIDS) patients and inform economic evaluation of AIDS treatment services,and the assessment of HRQOL can help us to detect problems that may influence the progression of the disease,hence HRQOL has become a particularly important assessment indictor for HIV comprehensive interventions.Being a multi-angle,multi-level,and diversified complex intervention,roles of Chinese medicine(CM) in AIDS treatment have been recognized and accepted by more and more patients,and HRQOL has been widely used to evaluate the comprehensive management effects of CM on AIDS.In this article,the authors analyze the definition and measurement of HRQOL,measurement of HRQOL of HIV/AIDS patients and effects of CM on AIDS,and give some reasonable advices for the usage of the scale of HRQOL.The authors hold that some new HRQOL instruments specific for CM treatment of AIDS should be developed and further prospective studies should be carried out to demonstrate the practicality,reliability and validity of HRQOL as an evaluation indictor for CM treatment of AIDS.展开更多
Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature select...Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature selection are as follows,deficiency of both qi and blood(pale complexion,fear of cold,easy to catch a cold,pale tongue,weak pulse);liver depression and qi stagnation with effulgent fire(anxiety,insomnia,chest and hypochondrium,irregular menstruation,thin and whitish coating on the tongue,stringy pulse);dual deficiency of qi and yin(low-grade fever and night sweating,yellow urine,pale complexion,dysphoria with feverish sensation in chest,dry cough with less phlegm,weakness,dizziness,dry and red tongue,little coating,thread and rapid pulse);deficiency of spleen and kidney,dampness pathogen blockage(diarrhea,loose stool,eat less and abdominal nausea,abdominal pain,sallow complexion,nausea,vomiting,loss of hair,deafness and tinnitus,pale tongue with whitish coating,deep and thready pulse,slippery and rapid pulse);qi deficiency with blood stasis(weakness,spontaneous sweating,dry mouth without desire to drink,easy to catch a cold,shortness of breath,sallow complexion,eat less and loose stools,dim tongue quality,hesitant pulse).Conclusion:Based on the feature selection method,we can find the main characteristics of Acquired Immune Deficiency Syndrome,and provide objective reference for clinical diagnosis and treatment.展开更多
Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic chang...Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic changes in the default mode network following acquired immune deficiency syndrome infection and antiretroviral therapy.Specifically,when brain imaging data at only one time point are analyzed,determining the duration at which the default mode network is the most effective following antiretroviral therapy after the occurrence of acquired immune deficiency syndrome.However,because infection times and other factors are often uncertain,longitudinal studies cannot be conducted directly in the clinic.Therefore,in this study,we performed a longitudinal study on the dynamic changes in the default mode network over time in a rhesus monkey model of simian immunodeficiency virus infection.We found marked changes in default mode network connectivity in 11 pairs of regions of interest at baseline and 10 days and 4 weeks after virus inoculation.Significant interactions between treatment and time were observed in the default mode network connectivity of regions of interest pairs area 31/V6.R and area 8/frontal eye field(FEF).L,area 8/FEF.L and caudal temporal parietal occipital area(TPOC).R,and area 31/V6.R and TPOC.L.ART administered 4 weeks after infection not only interrupted the progress of simian immunodeficiency virus infection but also preserved brain function to a large extent.These findings suggest that the default mode network is affected in the early stage of simian immunodeficiency virus infection and that it may serve as a potential biomarker for early changes in brain function and an objective indicator for making early clinical intervention decisions.展开更多
Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Me...Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Methods:In total,161 PLWHA from Zhengzhou and Zhenping were investigated using the Berger HIV stigma scale.Results:The mean Berger stigma scale score was 105.70±15.20,indicating a middle stigma level.Among the four subscales of the Berger stigma scale,the disclosure concerns score was highest,while the negative self-image score was lowest.Multivariate analyses showed that factors influencing perceived HIV stigma included the level of education and route of infection.Conclusion:The level of perceived HIV stigma and discrimination among PLWHA in Henan Province is moderate and was affected by the level of education and route of infection.Special intervention should be established to address this problem.展开更多
Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypog...Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypogammaglobulinemia often associated with autoimmune and/or lymphoproliferative manifestations. Late Onset Combined Immune Deficiency (LOCID) is a type of Variable Common Immune Deficiency (VCID) defined by a defect in antibody production (IgG and IgA ± IgM type), profound CD4 T-cell lymphopenia and frequent opportunistic infections. LOCID has been considered as a distinct entity from VCID due to its particular clinical and immunological profile.展开更多
This paper summarized professor LI Xiuhui's experience in treating acquired immune deficiency syndrome(AIDS) complicated with opportunistic infections(OIs) using the methodology of “turbid toxins entering the blo...This paper summarized professor LI Xiuhui's experience in treating acquired immune deficiency syndrome(AIDS) complicated with opportunistic infections(OIs) using the methodology of “turbid toxins entering the blood and expelling pathogens outwardly”. OIs are significant cause of morbidity and mortality among AIDS patients. Professor LI Xiuhui believes that the pathogenesis of OIs lies in turbid toxins entering the blood, infecting the Sanjiao, damaging the nutrient Qi and defensive Qi, consuming Qi and essence, and impairing the primordial Qi. As a result, the five organs are weakened, pathogenic toxins overflow, leading to the occurrence of some related opportunistic infectious diseases in various systems throughout the body. Therefore, in treatment, the “penetrating and supporting method” and the “tonifying and supporting method” are used to consolidate and support the healthy Qi, allowing the pathogenic toxins to be expelled smoothly,so that the opportunistic infectious diseases can be cured or controlled.展开更多
Background:Chronic rhinosinusitis(CRS)is a prevalent inflammatory disease of the nasal and paranasal sinuses,affecting millions worldwide and significantly impacting quality of life.The pathogenesis of CRS involves co...Background:Chronic rhinosinusitis(CRS)is a prevalent inflammatory disease of the nasal and paranasal sinuses,affecting millions worldwide and significantly impacting quality of life.The pathogenesis of CRS involves complex interactions between environmental and host factors,leading to chronic inflammation and tissue remodeling.Purpose of review:This narrative review synthesizes recent research on the predisposing factors of CRS and their potential influence on disease endotypes,aiming to enhance understanding of this multifaceted condition.Recent findings:Identified predisposing factors include allergy,asthma,immune deficiency,gastroesophageal reflux,nasal anatomical variations,microbial infections,and others.Bacteria and biofilms,particularly Staphylococcus aureus,are significant in disease onset and severity.Immune deficiency may predispose individuals to CRS,and NSAID-exacerbated respiratory disease(N-ERD)is associated with more severe symptoms.Gastroesophageal reflux disease(GERD)and primary ciliary dyskinesia(PCD)also contribute to CRS development,with PCD leading to impaired mucociliary clearance and chronic inflammation.Conclusion:CRS is a multifactorial disease with various predisposing factors influencing its development and endotypic classification.Understanding these factors and their interactions with the immune system is crucial for developing targeted treatments and improving patient outcomes.展开更多
Debate regarding the premature aging of knee joints in acquired immune deficiency syndrome(AIDS)patients has remained contentious,with conjectures pointing towards its correlation with distinct antiviral regimes.Prote...Debate regarding the premature aging of knee joints in acquired immune deficiency syndrome(AIDS)patients has remained contentious,with conjectures pointing towards its correlation with distinct antiviral regimes.Protease inhibitors(PIs)stand as a prominent class of antiviral agents frequently utilized in AIDS management and have been significantly linked to premature senescence.This study aimed to investigate whether PI-containing regimens would accelerate osteoarthritis(OA)development and explore the molecular mechanisms underlying this association.A retrospective cohort of 151 HIV-infected individuals,categorized into PI and non-PI groups,was established.Patients in PI group exhibited lower KOOS and a higher prevalence of radiological knee OA than those in non-PI group.Additionally,25 anti-HIV drugs were screened and among all antiviral drugs,lopinavir had the most detrimental impact on cartilage anabolism,accelerating cartilage senescence and promoting mouse OA development.Mechanistically,lopinavir accelerated cellular senescence by inhibiting Zmpste24 and interfering nuclear membrane stability,which leads to decreased binding between nuclear membrane-binding protein Usp7 and Mdm2 and activates Usp7/Mdm2/p53 pathway.Zmpste24 overexpression reduces OA severity in mice.These findings suggest that PI-containing regimens accelerate cartilage senescence and OA development through Zmpste24 inhibition,which provides new insights into the selection of HIV regimens.展开更多
Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the ...Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the sustainable development goals.In Ghana,scholarly research on the forms and prevalence of IPV is available,however knowledge of the prevalence of IPV among PLHIV is limited.To understand the prevalence of IPV among PLHIV and the intersectional factors that contribute to it,this study examined the overall prevalence of IPV among PLHIV and the associated sociodemographic factors across ten regions of Ghana.Methods:We administered face-to-face survey questionnaires to 661 randomly selected antiretroviral therapy(ART)clients using Research Electronic Data Capture tools.We used descriptive statistics(mean,standard deviation,minimum,and maximum),pairwise correlation,and multivariate regression analysis to look at the data.Results:The clients of ART experienced various forms of IPV,including sexual,physical,emotional,and economic violence and controlling behaviour.The overall prevalence of IPV among PLHIV was 27.5%.This result,although on par with the global IPV average(27%),is 1.5%higher than the national rate(26%).The Upper West Region had the highest prevalence in all the categories of IPV analysed,followed by Oti Region in second place and the Upper East Region in third,except for the prevalence of sexual violence,where Greater Accra Region ranks second.In specific regions of Ghana,sociodemographic factors shaped by patriarchal and economic considerations contribute to a higher prevalence of IPV among people living with HIV.Conclusion:The findings have implications for developing policies and interventions that address the specific factors associated with HIV-induced IPV in different regions of Ghana.These interventions should also include screening PLHIV receiving ART for their IPV status regardless of gender and deploying culturally appropriate education at the community level to foster empathy towards intimate partners living with HIV.展开更多
China’s Free ART Program was initiated in 2002 as an emergency response to save and improve the lives of AIDS patients living mainly in impoverished rural regions of central China. With little experience in HIV/AIDS ...China’s Free ART Program was initiated in 2002 as an emergency response to save and improve the lives of AIDS patients living mainly in impoverished rural regions of central China. With little experience in HIV/AIDS treatment and care and resource limitations, China’s efforts to provide widespread access to free antiretroviral therapy has been a process fraught with difficulty. However, the Free ART Program is progressing from an emergency response to a standardized treatment and care system. The development of national guidelines, training programs, a laboratory sup- port network, a national patient database, programs for special populations such as children and patients living with co- infections, and operational research has improved the scope and quality of the free treatment program. As of June 30, 2005, a total of 19,456 patients in 28 provinces, autonomous regions, and special municipalities had received free ART. Challenges stemming from the nature of China’s health system and patient population persist, but with strong govern- ment support and a diverse set of resources, China has the capacity to overcome these challenges and to provide nationwide access to high quality treatment and care.展开更多
Objective:In this study,we investigated the changes in peripheral blood inflammatory factors and intestinal flora in acquired immune deficiency syndrome(AIDS)and human immunodeficiency virus(HIV)-positive individuals(...Objective:In this study,we investigated the changes in peripheral blood inflammatory factors and intestinal flora in acquired immune deficiency syndrome(AIDS)and human immunodeficiency virus(HIV)-positive individuals(AIDS/HIV patients),and explored the relationships among intestinal flora,peripheral blood inflammatory factors,and CD4^+T lymphocytes.Methods:Thirty blood and stool samples from an AIDS group and a control group were collected.The levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were determined by enzyme-linked immunosorbent assay(ELISA),and the number of CD4^+T lymphocytes by a FACSCount automated instrument.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to determine the messenger RNA(mRNA)levels of Bifidobacterium,Lactobacillus,Escherichia coli,Enterococcus faecalis,and Enterococcus faecium.Correlations among intestinal flora,inflammatory factor levels,and CD4^+T lymphocyte values were evaluated using the Spearman correlation coefficient.Results:The levels of TNF-αand IL-6 in the AIDS group were higher than those in the control group,while the number of CD4^+T lymphocytes was lower.The amounts of Bifidobacterium and Lactobacillus in the AIDS group were significantly lower than those in control group,while the amounts of E.coli,E.faecalis,and E.faecium were much higher.The amounts of Bifidobacterium and Lactobacillus were negatively correlated with the content of TNF-αand IL-6 and the CD4^+T lymphocyte count,while those correlations were reversed for E.coli,E.faecalis,and E.faecium.Conclusions:The intestinal microbiota of AIDS/HIV patients were disordered,and there was a correlation between the amount of intestinal flora and the number of CD4^+T lymphocytes and the levels of TNF-αand IL-6.展开更多
Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying,enhancing,and restoring immune function.Thymosin alpha 1 has been utilized in the treatment of immunocompromi...Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying,enhancing,and restoring immune function.Thymosin alpha 1 has been utilized in the treatment of immunocompromised states and malignancies,as an enhancer of vaccine response,and as a means of curbing morbidity and mortality in sepsis and numerous infections.Studies have postulated that thymosin alpha 1 could help improve the outcome in severely ill corona virus disease 2019 patients by repairing damage caused by overactivation of lymphocytic immunity and how thymosin alpha 1 could prevent the excessive activation of T cells.In this review,we discuss key literature on the background knowledge and current clinical uses of thymosin alpha 1.Considering the known biochemical properties including antibacterial and antiviral properties,timehonored applications,and the new promising findings regarding the use of thymosin,we believe that thymosin alpha 1 deserves further investigation into its antiviral properties and possible repurposing as a treatment against severe acute respiratory syndrome coronavirus-2.展开更多
PNEUMOCYSTIS pneumonia (PCP) is among the most common opportunistic infections in patients with acquired immune deficiency syndrome (AIDS).Although trimethoprim-sulfamethoxazole (TMP-SMX) is the first line therapy for...PNEUMOCYSTIS pneumonia (PCP) is among the most common opportunistic infections in patients with acquired immune deficiency syndrome (AIDS).Although trimethoprim-sulfamethoxazole (TMP-SMX) is the first line therapy for that condition given its efficacy,approximately one third of patients experienced dose-limiting toxicity.1 For cases of severe to moderate PCP,if TMP-SMX treatment fails or is contraindicated,primaquine combined with clindamycin or intravenous pentamidine is recommended as second line therapy.2 However,both primaquine and pentamidine are associated with severe adverse reactions and often unavailable at hospitals in China.3 As a result,other treatment options have been explored.展开更多
For the purpose of developing an immune function on production accidents in a petrochemical enterprise, a new cultivation-evolution approach of preventive mechanism is suggested by analyzing various factors relating t...For the purpose of developing an immune function on production accidents in a petrochemical enterprise, a new cultivation-evolution approach of preventive mechanism is suggested by analyzing various factors relating to immune deficiency syndrome and by referring to immunity genetic algorithm and relevant concepts applied in medicine science. Accident-immunity system for highly hazardous petrochemical enterprise, which is made up of its productive system＇s Safety Organ and Safety Organization, is typically an evolution-cultivation progress for immune function, The new B immune cell is generated after several layers＇ screening, clone expanding, receptor editing, organizing in immune system of work accident in petrochemical enterprise. There is a B immune cell with high appetency and a manipulative function chain for accident-immunity. Taking the antigen of accidents in industry as the target function and the immune antibody as the solution, the authors carried out a computation diagram for prediction of appetency between the antigen and antibody.展开更多
Objective To investigate the response on late stage Chinese AIDS patients after highly active antiretroviral therapy （HAART）. Methods From October 2002 to March 2004, 20 cases of late stage Chinese AIDS patients we...Objective To investigate the response on late stage Chinese AIDS patients after highly active antiretroviral therapy （HAART）. Methods From October 2002 to March 2004, 20 cases of late stage Chinese AIDS patients were selected to participate in this opened and randomised study, we purposely chose those with CD4＋ T cell counts 〈 100/mm^3. All of them had one or two opportunistic infections and none had been treated with anti-HIV drugs. All patients were tested with CD4＋ （naive CD4＋ T cell defined by CD45RA＋ and CD62L＋, memory CD4＋ T cell defined by CD45RA-）, CD8＋ T cell, plasma HIV viral load, and clinical manifestations on before, during, and after HAART （5 different regimes） on 1, 3, 6, 9, and 12 months. Before HAART mean CD4＋ T cell counts were 32 ± 31 （range 2-91）/mm^3, and plasma HIV viral load were 5.07 ± 0.85（range 2.04-5.70） log copies/mL. In 1 month＇s time patients treated with HAAT had mean CD4＋ and CD8＋ T cell counts increasing rapidly. After 1 month the increasing speed turned to slow down, but HIV viral load decreased predominantly within the first 3 months. The major part of increasing CD4＋ T cells were memory CD4＋ T cells, as for naive CD4＋ T cells increasing low and slow. Clinical symptoms and signs improved, and opportunistic infections reduced. The quality of life will be far much better than before. Each patient was followed for 12 months, and had finished 12 months＇ HAAT. Conclusion This is the first report in China that late stage Chinese AIDS patients after HAART could have their immune reconstitution. The regular pattern is similar to what had been reported in Western countries and also in China. So it is worth to treat late stage Chinese AIDS patients with HAAT.展开更多
Retroviral replication proceeds through the integration of a DNA copy of the viral RNA genome into the host cellular genome, a process that is mediated by the viral integrase(IN) protein. IN catalyzes two distinct che...Retroviral replication proceeds through the integration of a DNA copy of the viral RNA genome into the host cellular genome, a process that is mediated by the viral integrase(IN) protein. IN catalyzes two distinct chemical reactions: 3'-processing, whereby the viral DNA is recessed by a di- or trinucleotide at its 3'-ends, and strand transfer, in which the processed viral DNA ends are inserted into host chromosomal DNA. Although IN has been studied as a recombinant protein since the 1980 s, detailed structural understanding of its catalytic functions awaited high resolution structures of functional IN-DNA complexes or intasomes, initially obtained in 2010 for the spumavirus prototype foamy virus(PFV). Since then, two additional retroviral intasome structures, from the α-retrovirus Rous sarcoma virus(RSV) and β-retrovirus mouse mammary tumor virus(MMTV), have emerged. Here, we briefly review the history of IN structural biology prior to the intasome era, and then compare the intasome structures of PFV, MMTV and RSV in detail. Whereas the PFV intasome is characterized by a tetrameric assembly of IN around the viral DNA ends, the newer structures harbor octameric IN assemblies. Although the higher order architectures of MMTV and RSV intasomes differ from that of the PFV intasome, they possess remarkably similar intasomal core structures. Thus, retroviral integration machineries have adapted evolutionarily to utilize disparate IN elements to construct convergent intasome core structures for catalytic function.展开更多
基金supported by the National Natural Science Foundation of China(No.82274474)。
文摘Despite effective antiretroviral therapy(ART),many individuals with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)achieve viral suppression but fail to fully restore cluster of differentiation 4(CD4)^(+)T lymphocyte(CD4 cell)counts—a condition known as immunological non-response(INRs).INRs are associated with elevated health risks,including increased susceptibility to AIDS-related and non-AIDS-related complications.The pathogenesis of INRs remains incompletely understood,and no established therapeutic interventions exist,posing a major challenge in contemporary HIV/AIDS management.Emerging evidence indicates that INRs exhibit significant alterations in gut microbiota composition.Dysbiosis of the gut microbiota may contribute to persistent immune activation,cytokine imbalance,and cellular pyroptosis,all of which could impair immune reconstitution in people living with HIV/AIDS.Traditional Chinese medicine(TCM)has demonstrated potential immunomodulatory effects and is increasingly utilized in the management of INRs.Targeting the gut microbiota and elucidating the mechanisms by which TCM modulates this microbial ecosystem may offer new avenues for preventing and treating INRs.This review explores the interplay between gut microbiota and TCM,examines the association between gut dysbiosis and INRs,discusses the mechanistic pathways through which microbiota imbalance contributes to INRs development,and highlights how TCM interventions regulate gut microbiota to promote immune recovery.By focusing on the gut microbiota as a therapeutic interface,this article provides novel insights into TCM-based strategies for improving outcomes in INRs and supports the development of innovative treatment approaches.
文摘Penicillium marneffei （R marneffei） infection usually occurs with skin, bone marrow, lung or hepatic involve- ment. However, no cases of P. mameffei infection with chylous ascites have been reported thus far. In this re- port, we describe the first case of acquired immune de- ficiency syndrome （AIDS） which has been complicated by a P. marneffei infection causing chylous ascites. We describe the details of the case, with an emphasis on treatment regimen. This patient was treated with am- photericin B for 3 mo, while receiving concomitant ther- apy with an efavirenz-containing antiretroviral regimen, but cultures in ascitic fluid were persistently positive for P. marneffei. The infection resolved after treatment with high-dose voriconazole （400 mg every 12 h） for 3 too. R marneffei should be considered in the differential di- agnosis of chylous ascites in human immunodeficiency virus patients. High-dose voriconazole is an effective, well-tolerated and convenient option for the treatment of systemic infections with R marneffei in AIDS patients on an efavirenz-containing antiretroviral regimen.
文摘Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance ofintrahepatic bile ducts. Multiple etiologies have been indentifi ed including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.
基金Supported by the National Special Science&Technology Program on Major Infectious Diseases(No.2012ZX-10005010-001)Research Project for Practical Development of National TCM Clinical Research Bases(No.JDZX2012023)+1 种基金Henan Province Education Science Programs in 11th Fiveyear Plan for 2010 Year Subjects(No.2010-JKGHAZ0047)Henan Province Colleges and Universities Key Youth Teachers Scheme(No.2013GGJS-095)
文摘Health related quality of life(HRQOL) can better reflect changes in acquired immune deficiency syndrome(AIDS) patients and inform economic evaluation of AIDS treatment services,and the assessment of HRQOL can help us to detect problems that may influence the progression of the disease,hence HRQOL has become a particularly important assessment indictor for HIV comprehensive interventions.Being a multi-angle,multi-level,and diversified complex intervention,roles of Chinese medicine(CM) in AIDS treatment have been recognized and accepted by more and more patients,and HRQOL has been widely used to evaluate the comprehensive management effects of CM on AIDS.In this article,the authors analyze the definition and measurement of HRQOL,measurement of HRQOL of HIV/AIDS patients and effects of CM on AIDS,and give some reasonable advices for the usage of the scale of HRQOL.The authors hold that some new HRQOL instruments specific for CM treatment of AIDS should be developed and further prospective studies should be carried out to demonstrate the practicality,reliability and validity of HRQOL as an evaluation indictor for CM treatment of AIDS.
基金National Key Research and Development Program of the Ministry of Science and Technology (2017YFC1703503):Innovative Research on Data Collection Of Medical Record Homepage and TCM Medical Quality Evaluation SystemNational Natural Science Foundation of China National Natural Science(NO. 81674101):Research on The Method of Discovering the Dynamic Target Relationship Between AIDS Prescriptions Based on Multi-example and Multi-marker LearningSpecial Fund for Basic Scientific Research Business Expenses of Central Public Welfare Scientific Research Institutes (NO. ZZ11-063):Exploring Research Based on The Performance Evaluation Method of DRG Chinese Medicine Hospitals
文摘Objective:To discover the population characteristics of the syndrome types of Acquired Immune Deficiency Syndrome.Methods:Data mining method for feature selection was used.Results:Main symptoms based on feature selection are as follows,deficiency of both qi and blood(pale complexion,fear of cold,easy to catch a cold,pale tongue,weak pulse);liver depression and qi stagnation with effulgent fire(anxiety,insomnia,chest and hypochondrium,irregular menstruation,thin and whitish coating on the tongue,stringy pulse);dual deficiency of qi and yin(low-grade fever and night sweating,yellow urine,pale complexion,dysphoria with feverish sensation in chest,dry cough with less phlegm,weakness,dizziness,dry and red tongue,little coating,thread and rapid pulse);deficiency of spleen and kidney,dampness pathogen blockage(diarrhea,loose stool,eat less and abdominal nausea,abdominal pain,sallow complexion,nausea,vomiting,loss of hair,deafness and tinnitus,pale tongue with whitish coating,deep and thready pulse,slippery and rapid pulse);qi deficiency with blood stasis(weakness,spontaneous sweating,dry mouth without desire to drink,easy to catch a cold,shortness of breath,sallow complexion,eat less and loose stools,dim tongue quality,hesitant pulse).Conclusion:Based on the feature selection method,we can find the main characteristics of Acquired Immune Deficiency Syndrome,and provide objective reference for clinical diagnosis and treatment.
基金supported by the National Natural Science Foundation of China,Nos.82271963(to HJL),81771806(to HJL),61936013(to HJL),82001914(to ZCT),81871511(to HZ)National Key R&D Program of China,No.2021YFA1301603(to ZCT)the Natural Science Foundation of Beijing,No.7212051(to HJL).
文摘Acquired immune deficiency syndrome infection can lead to cognitive dysfunction represented by changes in the default mode network.Most recent studies have been cross-sectional and thus have not revealed dynamic changes in the default mode network following acquired immune deficiency syndrome infection and antiretroviral therapy.Specifically,when brain imaging data at only one time point are analyzed,determining the duration at which the default mode network is the most effective following antiretroviral therapy after the occurrence of acquired immune deficiency syndrome.However,because infection times and other factors are often uncertain,longitudinal studies cannot be conducted directly in the clinic.Therefore,in this study,we performed a longitudinal study on the dynamic changes in the default mode network over time in a rhesus monkey model of simian immunodeficiency virus infection.We found marked changes in default mode network connectivity in 11 pairs of regions of interest at baseline and 10 days and 4 weeks after virus inoculation.Significant interactions between treatment and time were observed in the default mode network connectivity of regions of interest pairs area 31/V6.R and area 8/frontal eye field(FEF).L,area 8/FEF.L and caudal temporal parietal occipital area(TPOC).R,and area 31/V6.R and TPOC.L.ART administered 4 weeks after infection not only interrupted the progress of simian immunodeficiency virus infection but also preserved brain function to a large extent.These findings suggest that the default mode network is affected in the early stage of simian immunodeficiency virus infection and that it may serve as a potential biomarker for early changes in brain function and an objective indicator for making early clinical intervention decisions.
文摘Purpose:To investigate the level of and factors influencing perceived stigma and discrimination among people living with human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(PLWHA)in Henan Province.Methods:In total,161 PLWHA from Zhengzhou and Zhenping were investigated using the Berger HIV stigma scale.Results:The mean Berger stigma scale score was 105.70±15.20,indicating a middle stigma level.Among the four subscales of the Berger stigma scale,the disclosure concerns score was highest,while the negative self-image score was lowest.Multivariate analyses showed that factors influencing perceived HIV stigma included the level of education and route of infection.Conclusion:The level of perceived HIV stigma and discrimination among PLWHA in Henan Province is moderate and was affected by the level of education and route of infection.Special intervention should be established to address this problem.
文摘Variable Common Immune Deficiency (VCID) is a very heterogeneous condition both clinically and immunologically. It is a group of molecular abnormalities responsible for a defect in antibody production leading to hypogammaglobulinemia often associated with autoimmune and/or lymphoproliferative manifestations. Late Onset Combined Immune Deficiency (LOCID) is a type of Variable Common Immune Deficiency (VCID) defined by a defect in antibody production (IgG and IgA ± IgM type), profound CD4 T-cell lymphopenia and frequent opportunistic infections. LOCID has been considered as a distinct entity from VCID due to its particular clinical and immunological profile.
文摘This paper summarized professor LI Xiuhui's experience in treating acquired immune deficiency syndrome(AIDS) complicated with opportunistic infections(OIs) using the methodology of “turbid toxins entering the blood and expelling pathogens outwardly”. OIs are significant cause of morbidity and mortality among AIDS patients. Professor LI Xiuhui believes that the pathogenesis of OIs lies in turbid toxins entering the blood, infecting the Sanjiao, damaging the nutrient Qi and defensive Qi, consuming Qi and essence, and impairing the primordial Qi. As a result, the five organs are weakened, pathogenic toxins overflow, leading to the occurrence of some related opportunistic infectious diseases in various systems throughout the body. Therefore, in treatment, the “penetrating and supporting method” and the “tonifying and supporting method” are used to consolidate and support the healthy Qi, allowing the pathogenic toxins to be expelled smoothly,so that the opportunistic infectious diseases can be cured or controlled.
基金supported by the Health Science and Technology Development Project of Huaiyin District,Huai’an,Jiangsu Province(HYWJ2024009)of China.
文摘Background:Chronic rhinosinusitis(CRS)is a prevalent inflammatory disease of the nasal and paranasal sinuses,affecting millions worldwide and significantly impacting quality of life.The pathogenesis of CRS involves complex interactions between environmental and host factors,leading to chronic inflammation and tissue remodeling.Purpose of review:This narrative review synthesizes recent research on the predisposing factors of CRS and their potential influence on disease endotypes,aiming to enhance understanding of this multifaceted condition.Recent findings:Identified predisposing factors include allergy,asthma,immune deficiency,gastroesophageal reflux,nasal anatomical variations,microbial infections,and others.Bacteria and biofilms,particularly Staphylococcus aureus,are significant in disease onset and severity.Immune deficiency may predispose individuals to CRS,and NSAID-exacerbated respiratory disease(N-ERD)is associated with more severe symptoms.Gastroesophageal reflux disease(GERD)and primary ciliary dyskinesia(PCD)also contribute to CRS development,with PCD leading to impaired mucociliary clearance and chronic inflammation.Conclusion:CRS is a multifactorial disease with various predisposing factors influencing its development and endotypic classification.Understanding these factors and their interactions with the immune system is crucial for developing targeted treatments and improving patient outcomes.
基金supported by Natural Science Foundation of China(82472476)Fundamental Research Funds for the Central Universities(YG2023ZD15)+2 种基金The Youth Talent Program from Shanghai Health System(2022YQ020)AI-Driven Reform of Research Paradigms Empowers Discipline Advancement Initiatives from Shanghai Municipal Education Commission(Grant No.JWAIZD-7)the Natural Science Foundation of Shanghai(23ZR1437300).
文摘Debate regarding the premature aging of knee joints in acquired immune deficiency syndrome(AIDS)patients has remained contentious,with conjectures pointing towards its correlation with distinct antiviral regimes.Protease inhibitors(PIs)stand as a prominent class of antiviral agents frequently utilized in AIDS management and have been significantly linked to premature senescence.This study aimed to investigate whether PI-containing regimens would accelerate osteoarthritis(OA)development and explore the molecular mechanisms underlying this association.A retrospective cohort of 151 HIV-infected individuals,categorized into PI and non-PI groups,was established.Patients in PI group exhibited lower KOOS and a higher prevalence of radiological knee OA than those in non-PI group.Additionally,25 anti-HIV drugs were screened and among all antiviral drugs,lopinavir had the most detrimental impact on cartilage anabolism,accelerating cartilage senescence and promoting mouse OA development.Mechanistically,lopinavir accelerated cellular senescence by inhibiting Zmpste24 and interfering nuclear membrane stability,which leads to decreased binding between nuclear membrane-binding protein Usp7 and Mdm2 and activates Usp7/Mdm2/p53 pathway.Zmpste24 overexpression reduces OA severity in mice.These findings suggest that PI-containing regimens accelerate cartilage senescence and OA development through Zmpste24 inhibition,which provides new insights into the selection of HIV regimens.
基金supported by the Christian Health Association of Ghana under Global Fund New Funding Model 3(NFM 3)HIV/TB Community Systems Strengthening programme(CSS)。
文摘Objective:Intimate partner violence(IPV)among people living with the human immune deficiency virus(PLHIV)poses a significant threat to efforts to reduce the spread of human immune deficiency virus(HIV)and achieve the sustainable development goals.In Ghana,scholarly research on the forms and prevalence of IPV is available,however knowledge of the prevalence of IPV among PLHIV is limited.To understand the prevalence of IPV among PLHIV and the intersectional factors that contribute to it,this study examined the overall prevalence of IPV among PLHIV and the associated sociodemographic factors across ten regions of Ghana.Methods:We administered face-to-face survey questionnaires to 661 randomly selected antiretroviral therapy(ART)clients using Research Electronic Data Capture tools.We used descriptive statistics(mean,standard deviation,minimum,and maximum),pairwise correlation,and multivariate regression analysis to look at the data.Results:The clients of ART experienced various forms of IPV,including sexual,physical,emotional,and economic violence and controlling behaviour.The overall prevalence of IPV among PLHIV was 27.5%.This result,although on par with the global IPV average(27%),is 1.5%higher than the national rate(26%).The Upper West Region had the highest prevalence in all the categories of IPV analysed,followed by Oti Region in second place and the Upper East Region in third,except for the prevalence of sexual violence,where Greater Accra Region ranks second.In specific regions of Ghana,sociodemographic factors shaped by patriarchal and economic considerations contribute to a higher prevalence of IPV among people living with HIV.Conclusion:The findings have implications for developing policies and interventions that address the specific factors associated with HIV-induced IPV in different regions of Ghana.These interventions should also include screening PLHIV receiving ART for their IPV status regardless of gender and deploying culturally appropriate education at the community level to foster empathy towards intimate partners living with HIV.
文摘China’s Free ART Program was initiated in 2002 as an emergency response to save and improve the lives of AIDS patients living mainly in impoverished rural regions of central China. With little experience in HIV/AIDS treatment and care and resource limitations, China’s efforts to provide widespread access to free antiretroviral therapy has been a process fraught with difficulty. However, the Free ART Program is progressing from an emergency response to a standardized treatment and care system. The development of national guidelines, training programs, a laboratory sup- port network, a national patient database, programs for special populations such as children and patients living with co- infections, and operational research has improved the scope and quality of the free treatment program. As of June 30, 2005, a total of 19,456 patients in 28 provinces, autonomous regions, and special municipalities had received free ART. Challenges stemming from the nature of China’s health system and patient population persist, but with strong govern- ment support and a diverse set of resources, China has the capacity to overcome these challenges and to provide nationwide access to high quality treatment and care.
文摘Objective:In this study,we investigated the changes in peripheral blood inflammatory factors and intestinal flora in acquired immune deficiency syndrome(AIDS)and human immunodeficiency virus(HIV)-positive individuals(AIDS/HIV patients),and explored the relationships among intestinal flora,peripheral blood inflammatory factors,and CD4^+T lymphocytes.Methods:Thirty blood and stool samples from an AIDS group and a control group were collected.The levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were determined by enzyme-linked immunosorbent assay(ELISA),and the number of CD4^+T lymphocytes by a FACSCount automated instrument.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to determine the messenger RNA(mRNA)levels of Bifidobacterium,Lactobacillus,Escherichia coli,Enterococcus faecalis,and Enterococcus faecium.Correlations among intestinal flora,inflammatory factor levels,and CD4^+T lymphocyte values were evaluated using the Spearman correlation coefficient.Results:The levels of TNF-αand IL-6 in the AIDS group were higher than those in the control group,while the number of CD4^+T lymphocytes was lower.The amounts of Bifidobacterium and Lactobacillus in the AIDS group were significantly lower than those in control group,while the amounts of E.coli,E.faecalis,and E.faecium were much higher.The amounts of Bifidobacterium and Lactobacillus were negatively correlated with the content of TNF-αand IL-6 and the CD4^+T lymphocyte count,while those correlations were reversed for E.coli,E.faecalis,and E.faecium.Conclusions:The intestinal microbiota of AIDS/HIV patients were disordered,and there was a correlation between the amount of intestinal flora and the number of CD4^+T lymphocytes and the levels of TNF-αand IL-6.
文摘Thymosin alpha 1 is a peptide naturally occurring in the thymus that has long been recognized for modifying,enhancing,and restoring immune function.Thymosin alpha 1 has been utilized in the treatment of immunocompromised states and malignancies,as an enhancer of vaccine response,and as a means of curbing morbidity and mortality in sepsis and numerous infections.Studies have postulated that thymosin alpha 1 could help improve the outcome in severely ill corona virus disease 2019 patients by repairing damage caused by overactivation of lymphocytic immunity and how thymosin alpha 1 could prevent the excessive activation of T cells.In this review,we discuss key literature on the background knowledge and current clinical uses of thymosin alpha 1.Considering the known biochemical properties including antibacterial and antiviral properties,timehonored applications,and the new promising findings regarding the use of thymosin,we believe that thymosin alpha 1 deserves further investigation into its antiviral properties and possible repurposing as a treatment against severe acute respiratory syndrome coronavirus-2.
文摘PNEUMOCYSTIS pneumonia (PCP) is among the most common opportunistic infections in patients with acquired immune deficiency syndrome (AIDS).Although trimethoprim-sulfamethoxazole (TMP-SMX) is the first line therapy for that condition given its efficacy,approximately one third of patients experienced dose-limiting toxicity.1 For cases of severe to moderate PCP,if TMP-SMX treatment fails or is contraindicated,primaquine combined with clindamycin or intravenous pentamidine is recommended as second line therapy.2 However,both primaquine and pentamidine are associated with severe adverse reactions and often unavailable at hospitals in China.3 As a result,other treatment options have been explored.
文摘For the purpose of developing an immune function on production accidents in a petrochemical enterprise, a new cultivation-evolution approach of preventive mechanism is suggested by analyzing various factors relating to immune deficiency syndrome and by referring to immunity genetic algorithm and relevant concepts applied in medicine science. Accident-immunity system for highly hazardous petrochemical enterprise, which is made up of its productive system＇s Safety Organ and Safety Organization, is typically an evolution-cultivation progress for immune function, The new B immune cell is generated after several layers＇ screening, clone expanding, receptor editing, organizing in immune system of work accident in petrochemical enterprise. There is a B immune cell with high appetency and a manipulative function chain for accident-immunity. Taking the antigen of accidents in industry as the target function and the immune antibody as the solution, the authors carried out a computation diagram for prediction of appetency between the antigen and antibody.
文摘Objective To investigate the response on late stage Chinese AIDS patients after highly active antiretroviral therapy （HAART）. Methods From October 2002 to March 2004, 20 cases of late stage Chinese AIDS patients were selected to participate in this opened and randomised study, we purposely chose those with CD4＋ T cell counts 〈 100/mm^3. All of them had one or two opportunistic infections and none had been treated with anti-HIV drugs. All patients were tested with CD4＋ （naive CD4＋ T cell defined by CD45RA＋ and CD62L＋, memory CD4＋ T cell defined by CD45RA-）, CD8＋ T cell, plasma HIV viral load, and clinical manifestations on before, during, and after HAART （5 different regimes） on 1, 3, 6, 9, and 12 months. Before HAART mean CD4＋ T cell counts were 32 ± 31 （range 2-91）/mm^3, and plasma HIV viral load were 5.07 ± 0.85（range 2.04-5.70） log copies/mL. In 1 month＇s time patients treated with HAAT had mean CD4＋ and CD8＋ T cell counts increasing rapidly. After 1 month the increasing speed turned to slow down, but HIV viral load decreased predominantly within the first 3 months. The major part of increasing CD4＋ T cells were memory CD4＋ T cells, as for naive CD4＋ T cells increasing low and slow. Clinical symptoms and signs improved, and opportunistic infections reduced. The quality of life will be far much better than before. Each patient was followed for 12 months, and had finished 12 months＇ HAAT. Conclusion This is the first report in China that late stage Chinese AIDS patients after HAART could have their immune reconstitution. The regular pattern is similar to what had been reported in Western countries and also in China. So it is worth to treat late stage Chinese AIDS patients with HAAT.
基金Supported by United States National Institutes of Health grant,No.R01AI070042
文摘Retroviral replication proceeds through the integration of a DNA copy of the viral RNA genome into the host cellular genome, a process that is mediated by the viral integrase(IN) protein. IN catalyzes two distinct chemical reactions: 3'-processing, whereby the viral DNA is recessed by a di- or trinucleotide at its 3'-ends, and strand transfer, in which the processed viral DNA ends are inserted into host chromosomal DNA. Although IN has been studied as a recombinant protein since the 1980 s, detailed structural understanding of its catalytic functions awaited high resolution structures of functional IN-DNA complexes or intasomes, initially obtained in 2010 for the spumavirus prototype foamy virus(PFV). Since then, two additional retroviral intasome structures, from the α-retrovirus Rous sarcoma virus(RSV) and β-retrovirus mouse mammary tumor virus(MMTV), have emerged. Here, we briefly review the history of IN structural biology prior to the intasome era, and then compare the intasome structures of PFV, MMTV and RSV in detail. Whereas the PFV intasome is characterized by a tetrameric assembly of IN around the viral DNA ends, the newer structures harbor octameric IN assemblies. Although the higher order architectures of MMTV and RSV intasomes differ from that of the PFV intasome, they possess remarkably similar intasomal core structures. Thus, retroviral integration machineries have adapted evolutionarily to utilize disparate IN elements to construct convergent intasome core structures for catalytic function.
