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Objective@#To investigate the combined effects of hepatitis B virus and hepatitis C virus (HBV/HCV) infection on the cause of death in patients with acquired immunodeficiency syndrome (AIDS).@*Methods@#The causes of death of 111 cases of AIDS with HBV/HCV (combined infection group) and 210 AIDS patients (single infection group) admitted to our hospital from 2012 to 2016 data were compared using chi-square test.@*Results@#There was no statistically significant difference in gender composition and age in the combined infection groups (P > 0.05). The main causes of death in the combined infection group were severe pneumonia (44.1%), end-stage liver disease (18.9%), and central nervous system infection (14.4%). The main causes of death in the single infection group were severe pneumonia (47.6%) and central nervous system infection (14.3%) and tumor (13.3%). There was no case of end-stage liver disease. The ratio of end-stage liver disease in the former group was significantly higher than that in the latter group (χ2 = 42.511, P < 0.001). The main cause of death in 12 HIV/HBV/HCV triple-infected patients was end-stage liver disease, accounting for 41.7%, which was significantly higher than 18.9% of end-stage liver disease in HIV/HBV or HIV/HCV dual infection (99 cases). And the difference was statistically significant (χ2 = 4.539, P = 0.033); however, the ratio of end-stage liver disease in 50 HIV/HBV co-infected patients and 49 HIV/HCV co-infected patients was 16.0% vs. 16.3%, respectively, and the difference was not statistically significant (χ2 = 0.002, P = 0.965). In the co-infected group, 36 patients had CD4+ cell counts >100/μl, the primary cause of death was end-stage liver disease, accounting for 38.2%. 75 patients with CD4+ ≤ 100/μl died due to end-stage liver disease, accounting for 9.3% and the difference was statistically significant (χ2 = 13.852, P < 0.05).@*Conclusion@#End-stage liver disease is the main cause of death in patients with AIDS combined with HBV or HCV, especially triplet infection and CD4+ cell count > 100/μl. An early diagnosis and treatment of HBV or HCV infection should commence as soon as possible.
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Objective To understand the level of posttraumatic growth among people living with HIV/AIDS and analyze the influencing factors. Methods Totally 175 people living with HIV/AIDS were randomly selected via convenience sampling and investigated using patients′ general information, Post-Traumatic Growth Inventory(PTGI), HIV stigma scale and Social Support Rating Scale. Results The average score of PTGI among people living with HIV/AIDS was (60.76 ± 27.03) points. Single factor analysis showed that there was a difference among people living with HIV/AIDS who had different education status, health insurance and whether to tell others HIV positive (Z=21.534, t=2.607, 3.958, P<0.01). There was a difference between the level of social support and perceived discrimination among people living with HIV/AIDS (r=0.245-0.275, P<0.01). Multiple linear regression analysis showed that the level of social support, perceived discrimination and whether to tell others HIV positive could affect the total score of PTGI. All the variables could explain 24.0％variance of posttraumatic growth. Conclusions People living with HIV/AIDS havemoderate posttraumatic growth. The level of social support, perceived discrimination and whether to tell others HIV positive are related to the posttraumatic growth among people living with HIV/AIDS.
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Objective To know about the prevalence of recent human immunodeficiency virus (HIV) testing (in the last 12 months) and its associated factors among men who have sex with men (MSM) in western China. Methods A total of 1 245 MSM were recruited by convenient sampling from multiple sources and areas in Chongqing and Sichuan regions. The participants were interviewed with anonymous self-administered questionnaire and received HIV testing at the same time. Multivariate logistic regression was used to identify the factors associated with recent HIV testing behavior. Results A total of 1 245 questionnaires were completed, and 1 199 (96. 31%) were valid and included for analysis. Of the 1 199 MSM, 43. 45% (521/1 199) reported having HIV testing in recent one year. The overall HIV antibody positive rate was 21. 35% (256/1 199) in the present study; the HIV positive rate was significantly higher in those did not receive HIV testing in recent one year compared with those received HIV testing (24. 93% vs 16. 70%, χ2 = 11. 876 3,3 = 0. 000 6). Logistic regression analysis revealed that a score >10 in HIV/AIDS knowledge test (OR=1. 593, 95%CI: 1. 164-2. 180) was associated with increased recent HIV testing among MSM, and the factors associated with lower HIV testing rate in recent one year included not receiving free HIV counseling voluntarily over past years (OR=0. 284, 95%CI: 0. 218-0. 371), self-perceived low prevalence of HIV infection among MSM in city/district/county they were living (OR=0. 570, 95CCI: 0. 386-0. 841), and occasionally/never using condoms during anal sex with men in recent six months (OR=0. 688, 95CCI: 0. 514-0. 919; OR=0. 645, 95CCI: 0. 421-0. 987). Conclusion The proportion of recent HIV testing among MSM in western China is low, although the HIV prevalence is still alarmingly high. MSM not receiving any HIV testing in recent one year have higher HIV infection risk compared with those receiving. The community-based HIV-related risk education should be strengthened so as to further promote regular HIV testing among MSM in these high epidemic areas.
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Objective To determine the risk factors related to tuberculosis infection among people living with HIV/AIDS and to develop strategies for preventing the co-infection.Methods A 1:2matched nested case-control study was carried out to analyze the influencing factors of tuberculosis among people living with HIV/AIDS.Results 1018 people living with HIV/AIDS were followed up for one year with a total number of 736.75 person-years,among them 62 tuberculosis cases were diagnosed.The incidence density of tuberculosis among people living with HIV/AIDS was 8.42 persons per 100 person-years.Factors as education level(OR=0.483),vaccination history of Bacille Calmette Guerin(OR=0.561),CD_4~+ count T-lymphocyte(OR=0.356),unemployment(OR=1.976),living alone(OR=2.646),and smoking(OR=2.215)were significantly related to the prevalence of tuberculosis among people living with HIV/AIDS.Conclusion High education level,with vaccination history of Bacille Calmette Guerin and high level of CD_4~+ T-lymphocyte count were protective factors while being unemployed,living alone,and smoking habit were risk factors related to the prevalence of tuberculosis among people living with HIV/AIDS.
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Estudo qualitativo fenomenológico que buscou compreender o que é ser familiar cuidadora de uma criança com Aids, à luz do referencial filosófico de Martin Buber. As informantes foram sete mulheres, selecionadas de forma intencional junto ao hospital-escola de Porto Alegre - RS. A coleta das informações ocorreu entre setembro e outubro de 2006 por meio da entrevista fenomenológica e, para a interpretação, recorreu-se à filosofia hermenêutica. Emergiram cinco unidades de significação. Ser familiar de criança com Aids revela-se um fenômeno existencial complexo de mudanças, cuidados, diálogos e preocupações, na busca por um estar-melhor de ambos, no mundo. Compreende-se este cuidar como fenômeno também complexo, parte da existencialidade da mulher e da comunidade familiar. Ainda, considera-se a possibilidade de valorização da relação inter-humana entre o EU e o TU e do diálogo existencial para o cuidado humanístico.
This qualitative and phenomenological study sought to better understand what it is to be a family-member/caregiver of a child with AIDS, according to Martin Buber's philosophy. The participants in the study were 7 women, chosen by an intentional selection criterion from a university hospital in Porte Alegre - RS, Brazil. The phenomenological interviews with participants were carried out between September and October of 2006, and hermeneutic philosophy was applied for data interpretation. According to data analysis, five units of significance emerged. Being a family member of a child with AIDS reveals a complex existential phenomenon of changes, care, dialogues, and concerns in search of being-better of both in the world. We understand that this care is also a complex phenomenon, part of the existentialism of women and the family community. In conclusion, we believe that valuing the inter-human relationship between I-YOU, and the existential dialogue to humanistic caring is possible.
Estudio de carácter cualitativo fenomenológico, que buscó comprender, según el referencial filosófico de Martin Buber, lo qué es ser familiar cuidadora de un niño con SIDA. Las informantes fueron siete mujeres, seleccionadas de forma intencional, en el hospital-escuela de Porto Alegre - RS. La recolección de las informaciones fue hecha en los meses de septiembre y octubre de 2006, por medio de entrevista fenomenológica, y para su interpretación, se recurrió a la filosofía hermenéutica. Surgieron cinco unidades de significación. Ser familiar de un niño con SIDA se revela un fenómeno existencial complejo de cambios, cuidados y preocupaciones, en la búsqueda por un estar-mejor de ambos en el mundo. Ese cuidar se comprende como siendo un fenómeno también complejo, que forma parte de la existencia de la mujer y de la comunidad familiar. Además, se considera la posibilidad de valorar la relación interhumana entre el YO y el TÚ, y el diálogo existencial para el cuidado humanístico.
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Humans , Female , Pregnancy , Family , Women's Health , Acquired Immunodeficiency Syndrome , NursingABSTRACT
Objective To evaluate bone marrow smear examination in early diagnosis of AIDS complicated with disseminated Penicillium marneffei infection. Methods Seventy-three clinically suspected AIDS patients complicated with disseminated PeniciUium marneffei infection were included in the study. Peripheral blood and bone marrow smear examinations, and the fungal thermally dimorphic culture were performed in all cases. Results PeniciUium marneffei infection was identified in 44 patients by peripheral blood and bone marrow fungal thermally dimorphic culture. The features of the bone marrow smear were as follows : they were all hyperplastic or significantly hyperplastic; there were thickened and increased granules, vacuolization and band-formed in most granulocytes; there were increased and augmented histiocytes, and increased plasma cells. In 12 samples of bone marrow smear, there were phagncytized mulberry-like Penicillium marneffei organisms in the cytoplasm of the histiocytes or the organisms found extracellularly. One sample demonstrated the increased granulocytes and the phagocytized organisms in the neutrophils and monocytes. In 4 samples of peripheral blood smear, there were phagocytized Penicillium marneffe organisms in the neutrophils and monocytes. Conclusion Bone marrow smear examination is of value in early diagnosis of AIDS complicated with disseminated Penicillium marneffei infection, which is 7 to 10 days earlier than routine fungal thermally dimorphic culture.
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AIDS is a serious disease which threatens the health and safety of the doctors and nurses and the social colony,it also affects the development of society and the steady of economy. Our hospital has carried out country and army's documents, by enforcing management,developing special topic education, fulfiling prevention measures,foundding diagnose laboratory,practicing special report order, which has made remarkable effects.
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A 54-year-old homosexual man was diagnosed as human immunodeficiency virus-1-positive in 1992. He was admitted to a tertiary hospital in March, 2000 because of right flank pain, fever and intermittent cough. A chest roentgenogram showed right-sided pleural effusion, and closed thoracostomy was performed for drainage. Salmonella species and Escherichia coli were isolated from the pleural fluid. In spite of 6 weeks of antibiotic treatment, fever did not subside and the general condition gradually deteriorated, and under the diagnosis of lung abscess with empyema thoracis, right pleuropneumonectomy was performed. The general condition improved postoperatively until day 10 when he showed sudden change in mental status to stuporous and developed focal seizure. Brain CT showed multiple abscesses in right frontal and left frontotemporal lobes and he expired on postoperative day 14.