本科艾滋病英文版__培训课件.pptVIP

Gastrointestinal manifestations Thrush hairy leukoplakia Thrush Hairy leukoplakia Other  Kaposi sarcoma Lymphoma Shingles Kaposi’s sarcoma Shingles laboratory examinations  Serology plasma HIV viral load Immunologic laboratory tests Plasma laboratory marker diagnosis  two criteria must be met. 1、Positive test for HIV infection by confirmatory test 2、 one of the following criteria Weight loss of 10% body weight within 6 months. Chronic diarrhea of more than 1 month duration. Unknown persistent fever Opportunistic infection Kaposi sarcoma/Lymphoma. Neurological impairment restricting daily activities treatment HAART: highly active anti-retroviral therapy Treatment goals Eradication of HIV infection cannot be achieved with available antiretroviral regimens So the primary goals of them are to: reduce HIV-related morbidity, mortality, improve the quality of life，restore and preserve immunologic function，and maximally and durably suppress viral load Preparation before treatment Each patient initially entering care should have complete medical history，physical exam，and laboratory tests。 When to treat Clinical category CD4 COUNT (cells/mm3) recommendation Primary HIV infection regardless of Treat. Asymptomatic infection ≥350, ＜500 ＜350 Should be consideration. Recommended. AIDS regardless of Treat. Main point: treating patients earlier. The reason for starting medications earlier Some studies suggest those with lower CD4 cell counts at greater risk of heart disease, cancers and dementia No study shows more harm with early start of HIV medications Bad things are generally rarer among those with more normal CD4 cell counts Therapy is easier and better tolerated Treatment can also reduce infectiousness Selection of combination regimen EFV/TDF/3TC is recommended for initial therapy. Pretty easy to be an HIV doctor Long-term side effects Kidneys/bones (tenofovir) Liver (NNTRIs, PIs) Anemia (AZT) Nerves (ddI, d4T) Prophylaxis At the present