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抗病毒治疗并非适用所有艾滋病患者 同性恋男生进校就坦白 染上艾滋病隐瞒室友两年
2010-11-29 39健康网 蔡明花
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| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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即将到来的2010年12月1日是第23个“世界艾滋病日”，截止目前为止，世界上依然未有治愈艾滋病的特效药面世。尽管如此，但是并不表示世界医学研究领域在研发艾滋病药物的进程中毫无进展。
国际医学对艾滋病防治的研发进展
以最近一则研究结果来看，全世界最大的艾滋病药物生产商——美国Gilead Sciences公司所研发的一款新药Truvada有助于防止同性恋或者双性恋者感染HIV。据新英格兰医学杂志(New England Journal of Medicine)周二公布的研究结果显示，Truvada能抑制已感染艾滋病患者体内的病毒，并将HIV的感染风险降低44%，而对于那些经常服用该药物的人而言，其感染HIV的几率最多可降低73%。
虽然此款新药如此受业内人士关注与看好，但对于其是否可以作为预防艾滋病药依然需要作进一步研究，因此，Truvada尚未获准作为预防艾滋病药使用。
我国抗艾滋病病毒治疗的近况
纵观我国的抗艾之路，近些年来也取得一定的成绩。一份刊发在美国《临床传染病》杂志上研究报告显示：在我国接受免费抗艾滋病病毒治疗的患者中，超过七成收到了艾滋病病毒被抑制的好效果。其中，接受治疗6-11个月者获艾滋病病毒抑制效果人数更达到了八成以上。
在此份报告中，中国疾病预防控制中心性病艾滋病预防控制中心治疗关怀室主任张福杰教授说，此项研究表明，我国接受免费抗艾滋病病毒治疗者病毒抑制率较高，但基层医疗机构和疾控机构在抗艾滋病病毒治疗规范化方面还有较大差距，其人员需进一步培训提高治疗水平。此项研究还提示，免费抗艾滋病病毒治疗在用药方案选择上，也需要进一步规范和增加品种。
据悉，目前我国为艾滋病患者提供的免费抗病毒治疗药物共有6种。包括齐多夫定(分胶囊和片剂)，司它夫定胶囊，去羟基苷(分散剂、片剂、咀嚼片和颗粒)，拉米夫定片剂，奈维拉平(分片剂和胶囊)，以及茚地那韦(分片剂和胶囊)等。
是不是所有的艾滋病患者都合适抗病毒治疗?
1、由于抗病毒药物的副作用和疗效原因，并非在任何情况下感染者都应该进行抗病毒治疗;
2、急性感染期病人HIV血清阳转6个月之内和所有出现艾滋病临床症状的患者应该给予抗病毒治疗;
3、对于无症状期感染者，其抗病毒治疗时机须参照CD4+T细胞计数及病毒载量综合判定。一般CD4﹤200/UL和/或出现艾滋病指征性症状(如卡氏肺囊虫肺炎等)时，就应该开始规范的抗病毒治疗。CD4在200—350/UL之间，参考病毒载量水平。
关于艾滋病检测，你应该了解这些项目的意义——
1、在HIV感染中，CD4+T淋巴细胞计数及血浆HIV RNA水平(病毒载量)可以为临床医生提供病人病毒水平、免疫状态的相关资料，是预测疾病进程的可靠指标。
2、流式细胞仪是检测CD4+T淋巴细胞计数的标准方法，可以得出CD4+T细胞占淋巴细胞的比值及绝对值。CD4+T细胞计数是艾滋病诊断、疾病分期的实验室标准指标。
3、用于病毒载量的检测方法有逆转录PCR、核酸序列扩增实验(NASBA)、分支DNA杂交实验(bDNA)等，其结果多用于监测HIV感染者的病程进展和抗病毒治疗效果。
对于未进行抗病毒治疗的HIV感染者，最好在诊断为HIV感染时检测CD4+T淋巴细胞绝对值及病毒载量，以后每3～6个月检查CD4+T细胞计数，每3～4个月检测病毒载量，以利于临床医生及时掌握HIV感染者和艾滋病人的疾病进展情况。
同性恋男生进校就坦白 染上艾滋病隐瞒室友两年
来源：中国经济网 2010年11月29日09:31
12月1日，又一个世界艾滋病日将来临。
日前成都18对同性恋首次向媒体公开亮相(本报27日报道)，
讲述他们的隐形人生活，渴望阳光、公平和理解。
今天起，我们将走近成都高校的大学生同性恋群体，
记录他们的渴望与梦想，他们的迷惘与担忧。
谢谢HIV，让我更进一步了解了生命的意义，体会到平淡中的平淡是那么弥足珍贵。谢谢HIV，让我明白不能奢求太多，但是我们可以用有限的时间争取更多。
李轩翔
李轩翔，23岁，成都某重点大学四年级学生，是男同性恋，也是一名艾滋病病毒感染者。在学校，他公开了自己的同性恋身份。作为成都市首个愿意面对媒体的在校大学生男同艾滋感染者，昨日，李轩翔在红星路附近的一家茶馆接受了成都晚报记者的采访，希望社会对大学生同性恋群体的HIV感染者多一些了解和理解。(本文人名均为化名，感谢全国艾滋病信息资源网络CHAIN提供帮助)
坦白，迎来惊喜
室友调侃我“可惜”
初中时，李轩翔就发现自己喜欢男生。上了高中，李轩翔无法控制内心的感情喜欢上了“校帅”，竟在学校公然追了3个月，将“初恋”追到了手，轰动了全年级，只有老师和家人蒙在鼓里。
进入大学的第一个学期，李轩翔就把同寝室的人召集来开会：“我必须向你们坦白，我是gay，我不想……”他边说边瞟室友脸上的变化。“切，早就知道了，没什么奇怪的嘛。”这些生于上个世纪80年代末的大学生从小就接触过同性恋漫画、影视剧，甚至不想去追问他，还说“为什么要问？这是你的私事嘛！”
当然，也有室友惊诧，“自己身边居然也有同性恋？”还曾有女生悄悄就此事问过李轩翔，得到肯定回答后叹息：“太可惜了，你不知道有多少女生喜欢你！”
李轩翔从不会将“另一半”带回寝室，也不会带到同学面前，“主要是他不愿意。”
隐瞒，承受恐惧
我怕生活全毁了
2008年，李轩翔被查出感染了艾滋病病毒，一向乐观的他表现得很释然，“要珍惜有限的时间。”在同学面前，李轩翔始终保持着阳光的笑容，没人发现他的变化。有时他也会无法克制内心的恐惧，独自承受巨大的压力。实在扛不住了，他就翘课，但几次下来就被老师发现了。
老师为他保密“为什么最近经常翘课？”李轩翔沉默了许久，鼓起勇气向老师坦白：“我感染了艾滋病病毒。”“怎么感染的？”老师一脸焦急，李轩翔又沉默了。老师没继续追问，只是嘱咐着：“多保养身体。”老师只有26岁左右，比较通融，之后的两年里，老师再没提过这件事，一直为他保守着秘密。从此，李轩翔懂得了生命的珍贵，并成为同乐健康咨询服务中心的一名志愿者。
不想成为悲剧马上就要毕业了，李轩翔希望自己能顺利拿到毕业证，找一份好工作，所以除了那位老师，全校只知道他是同性恋，没人知道他感染了艾滋病病毒。李轩翔担心，如果暴露了自己已染病，就会成为又一个悲剧，被学校踢出局，影响生活和前途，整日活在歧视中，“因为我身边就有一个类似的例子。”
解释，如何面对
我想在隐瞒时保护同学
“如果在你的隐瞒期间，同学因为你而感染艾滋，你如何面对他们？”记者问。
李轩翔听后立即表示，“如果同学被我感染，最有可能是通过血液。只要同学有伤口，我会远离他，如果我的血凑巧碰到他的伤口，我会立即告诉他，因为艾滋病病毒在感染内的24小时可以阻断。我不会因为不想让别人知道，而伤害同学。”
疑问
五个男友是谁让他“染艾”？
“上大学后，我交往了五个男朋友，但不知道是哪个让我感染了艾滋病病毒。”李轩翔说，让他爱得最深的人是王志林，他同样是艾滋感染者。
李轩翔和王志林的相遇，是在去年12月1日世界艾滋病日。学校男同性恋组织成立了好几年，成员最多的时候有近百人，主要目的是做防艾宣传，并组织大伙开展诸如唱歌、打羽毛球、定向寻宝等文体活动。在认识前，两人分别有男朋友，王志林是被前男友感染上艾滋病病毒的。
他们平时除了逛街，看电影，只要是节日都会相聚在一起。每天晚上，都会很准时分开，各自回去，然后打电话到凌晨2时许。逛街时，李轩翔习惯性地牵着王志林的手，在公交车上，坐在同一个座位，旁边没人时，他们会十指相扣。由于两个人都染上了艾滋病，他们的相处是“柏拉图式”的。
相处了10多个月，王志林主动提出了分手。“没有原因，没有解释，在圈子头，很多爱情的保鲜期只有一周。”
对话
老师不想毁他前途
昨日中午1时许，记者电话采访了为李轩翔保守秘密的老师。老师说，他知道艾滋病病毒不会通过日常生活传染，“李轩翔已经承受了巨大的心理压力，是一个生病了的孩子，需要关心。只要他不再去感染其他人，为了他的前途，我选择了保密，就是对他最大的关怀。
专家正常对待感染者
四川省疾控中心性病艾滋病预防控制所所长张灵麟说，艾滋感染者只要不和室友发生性行为，避免自己流的血滴到其他同学的伤口上，就完全可以避免被艾滋病病毒传染。对待艾滋感染者，只需要将其当成正常人对待，不要有歧视就行了。
作者：陈悦来源成都晚报)Antiretroviral treatment for all AIDS patients are not gay men infected with AIDS into the school to be honest roommate for two years to conceal
2010-11-2939 Health Network Cai flowers
Upcoming December 1, 2010 is the first of 23 "World AIDS Day," So far, the world is still not a cure for AIDS cure available. Still, however, does not mean that the field of medical research world AIDS drugs in research and development process of nowhere.
International Medical R & D progress on AIDS
One of the most recent results, the world's largest manufacturer of AIDS drugs - the U.S. company Gilead Sciences developed a new drug Truvada can help prevent infection in homosexual or bisexual HIV. According to the New England Journal of Medicine (New England Journal of Medicine) study released Tuesday showed, Truvada patients with AIDS can inhibit the virus and reduce the risk of HIV infection 44%, and those who regularly take the medications and words, the risk of HIV infection can be reduced up to 73%.
Although this section by the industry are also concerned that new drugs and good, but whether it can be used as drugs to prevent AIDS is still a need for further research, therefore, Truvada AIDS drugs not yet approved for use.
Our Recent anti-HIV treatment
Throughout China's anti-Ai Road, in recent years has made certain achievements. An issue in the United States, "Clinical Infectious Diseases" magazine study shows that: in China to receive free anti-HIV patients, more than Qi Cheng received the AIDS virus was inhibited good results. Among them, 6-11 months after treatment by the number of HIV viral suppression achieved more than Bacheng.
In this report, the Chinese Center for Disease Control and Prevention of STD and AIDS prevention and control center for treatment, said Professor Zhang Fujie, director of care, the study shows that China receive free anti-HIV treatment is higher viral suppression, but the primary health care agencies and disease control institutions in the standardization of anti-HIV treatment there is still a wide gap between the need for further training of its personnel to improve the treatment level. The study also suggested that free anti-HIV therapy in the treatment program choice, but also to further standardize and increase the variety.
It is reported that AIDS patients in China to provide free antiretroviral drugs a total of 6 species. Including zidovudine (sub-capsules and tablets), the Secretary determined that husband capsule, to hydroxy monophosphate (dispersing agent, tablets, chewable tablets and granules), lamivudine tablets, Naiwei La level (sub-tablet and capsules), and indinavir (sub tablets and capsules) and so on.
Is not all AIDS patients are appropriate antiviral therapy?
1, the efficacy of antiviral drugs cause side effects and is not infected in any case should be anti-viral treatment;
2, acute infection of patients with HIV seroconversion within 6 months and all patients with clinical symptoms of AIDS occur should be given anti-viral treatment;
3, for asymptomatic infection, the timing of antiretroviral therapy by reference to CD4 + T cell counts and viral load Comprehensive determination. Normal CD4 <200/UL and / or indications of the emergence of AIDS symptoms (such as Pneumocystis carinii pneumonia), they should begin to regulate anti-viral therapy. In 200-350/UL between CD4, viral load level of reference.
About HIV testing, you should understand the significance of these projects -
1, in HIV infection, CD4 + T lymphocyte count and plasma HIV RNA levels (viral load) can provide clinicians with the level of the patient virus, immune status of the relevant information to predict a reliable indicator of disease progression.
2, flow cytometry is the detection of CD4 + T lymphocyte count of the standard methods can be derived CD4 + T cells and the absolute value of the ratio of total lymphocytes. CD4 + T cell count, AIDS diagnosis, stage of disease laboratory standard indicators.
3, for viral load testing methods are reverse transcription PCR, nucleic acid amplification test (NASBA), branch DNA hybridization (bDNA), etc., and the results used for monitoring the progression of HIV infection and antiviral treatment.
No antiviral treatment for HIV-infected people diagnosed with HIV infection is best detected when the absolute value of CD4 + T lymphocytes and viral load, after every 3 to 6 months CD4 + T cell counts checked every 3 to 4 months, viral load testing, in order to facilitate the clinician to grasp the HIV infection and AIDS disease progress.
Gay men with AIDS into the school to be honest roommate for two years to conceal
Source: China Economic Net at 09:31 on November 29, 2010
December 1, another World AIDS Day will come.
Chengdu has 18 pairs of gay first public appearance to the media (newspaper reports, 27),
About their invisible life, eager to sunlight, fair and understanding.
Today, we will be college students approached the gay community in Chengdu,
Record their desire and dreams, their confusion and concern.
Thank HIV, let me further understand the meaning of life, feel the flat plain is so precious. Thank HIV, so I know not too much luxury, but we can use the limited time for more.
Xiang Li Xuan
Xuan Li, Xiang, 23 years old, and Chengdu University of fourth-grade students in a certain key is gay, is also an AIDS virus infection. At school, he disclosed his gay identity. Chengdu, as the first face of the media willing to male college students infected with HIV, yesterday, Li Xuan Xiang in the vicinity of Red Star received a teahouse in Chengdu Evening News interview, hope the gay community college students to know more about HIV infection and understanding. (The names are not his real name, for the National AIDS Information Network to help CHAIN)
Frankly, welcome surprise
Roommates laugh at me "pity"
Junior high school, Li Xuan Xiang to find something you love boys. On the high school, Li Xuan Xiang can not control the feelings of the heart like a "school handsome," suddenly openly in the school for 3 months to recover, the "first love" catch his hand, stir the whole year, only teachers and family members kept in the dark.
Entered the university's first semester, Xiang Li Xuan who took the same bedroom to attend the meeting convened: "I must confess to you, I'm gay, I do not want ... ..." he said as he cast a glance roommate's face changes. "Cut, long known, and no strange thing." Those born in the late 80s of last century's contact with homosexual students from an early age comic books, movies and television do not even want to ask him, he said "Why do you ask? This is Well you are a private matter! "
Of course, there roommate surprised, "his side could have a homosexual?" Also had the girl quietly asked the matter Xuan Li, Xiang, sighing after receiving a positive answer: "Too bad, you do not know how many girls like you!"
Li Xuan Xiang will not be from the "other half" back to the bedroom, nor to the front of their classmates, "mostly he did not want."
To hide, under fear
I'm afraid the whole life
In 2008, Li Xuan Xiang was found infected with the AIDS virus, has been relieved he was really optimistic, "to cherish for a limited time." At the front of their classmates, Li Xuan Xiang has maintained a sunny smile, no one made him change. Sometimes he would not restrain the fear, alone under enormous pressure. It could not carry, he would cut class, but several times down to the teacher found out.
Teacher for his secrecy, "Why are often skipped school recently?" Xiang Li Xuan a long silence, the teacher summoned the courage to confess: "I am infected with the AIDS virus." "How infection?" Teacher look of anxiety, Li Xuan Xiang and silent. Teachers did not continue to ask, just asked the: "The more a physician." Teacher only 26 years old, more accommodating, after two years, the teacher made no mention of the matter, has been conservative with his secret. Since then, Li Xuan Xiang understand the preciousness of life and fun to become a health counseling service center volunteer.
Do not want to become a tragedy about to graduate, Li Xuan Xiang hope I can successfully get a diploma, find a good job, so in addition to the teacher, the school only know that he is gay, no one knew he was infected with the AIDS virus. Li Xuan Xiang worried that they have infected if exposed, would be another tragedy, the school kicked out, of life and future, all day in discrimination in the living, "because to me there is a similar example."
Explain how to deal with
I want to hide to protect students
"If you hide in the period, students infected with HIV because of you, how do you face them?" The reporter asked.
Li Xuan Xiang hear immediately said, "If students are my infection, most likely through the blood. As long as students have a wound, I would stay away from him, if I happened to encounter blood of his wound, I'll tell him, because of AIDS virus infection can be blocked within 24 hours. I would not want to let others know, and hurt the students. "
Doubt
Who told her boyfriend of five he "dyed Ai?"
"After college, I dated for five boyfriends, but I do not know which infected with the AIDS virus." Xuan Li, Xiang said, let him love most people WANG Zhi-lin, who is also HIV infected.
Xuan Xiang and WANG Zhi-lin Li, encounter, is December 1 last year, World AIDS Day. Gay organizations have established schools for several years, members have nearly a hundred people up to the time, the main purpose is to make AIDS prevention information, and organize gang activities such as singing, playing badminton, orienteering treasure hunt and other sports activities. In recognition of the former, the two were boyfriend, WANG Zhi-lin former boyfriend was infected with HIV.
In addition to their usual shopping, watching movies, as long as the festival will gather together. Every evening, on time to separate their back, and then call at 2 am. When shopping, Li Xuan Xiang WANG Zhi-lin habit of holding hands, in the bus, sitting in the same seat, next to no one, they will tie the finger. Since two people have contracted AIDS, and their relationship is "Platonic," the.
Together for more than 10 months, WANG Zhi-lin offered a break. "No reason, no explanation, the circle head, a lot of love, one week shelf."
Dialogue
He did not want to ruin the future of teacher
Yesterday at 1 pm, a telephone interview with Lee Hin Cheung teacher confidentiality. The teacher said, he knew HIV is not transmitted through everyday life, "Li Xuan Xiang has been under great psychological pressure, is a sick child, need to care about. As long as he is no longer to infect other people, for his future, I choose confidentiality is the biggest concern for him.
Expert treatment of infected normal
Sichuan Provincial Center for Disease Control and Prevention, director of STD and AIDS, said Zhang Linglin, HIV infection and the roommate that they do not have sex, to avoid the drop of blood flow to his wounds on the other students, to completely avoid being infected with HIV. Treatment of HIV infection and need to be treated as normal people, do not be discriminated against on the line.
Of: Chen Yue from Chengdu Evening News)
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