艾滋病的防治(研究生).ppt

* * How ZDV decreases vertical transmission is fully determined, but at least part of its benefit is likely due to a post-exposure prophylaxis effect. Data for AZT in pregnancy is very reassuring No increased incidence of congenital abnormalities, preterm delivery, low birthweight No differences in immunological, neurodevelopmental and growth variables at 6 years follow up No increase in neoplastic disease at 6 year follow up -Some nucleoside analogue agents are carcinogenic in rodents and can induce mitochondrial dysfunction in vitro -Reversible mitochondrial dysfunction has been reported in long term use of antiretroviral agents but genetic susceptibility probably plays a role 职业暴露的处理原则 立即处理暴露部位 皮肤暴露：挤压出血，用大量清水和肥皂清洗 粘膜暴露：用大量清水或生理盐水冲洗 使用消毒剂：尚无证据说明消毒剂可以减少HIV传染的危险，但不排除其可能的益处 72%酒精、0.2%次氯酸钠、0.2-0.5过氧乙酸、0.5%碘伏等 迅速评估状况，决定是否采取PEP 如果采取，最好在数小时内尽快开始 24－36小时后开始则疗效不佳 应该持续治疗4周 使用ART类药物 Prevention of the susceptible: Milestones of Vaccine  1981, AIDS first identified1984, HIV established as the cause of Aids1987, First human HIV vaccine trials begin 1997, US President Bill Clinton seeks commitment to develop an Aids vaccine within the next decade1999, First Africa HIV vaccine trial begins in Uganda 2003, VaxGen’s Aidsvax vaccine trials in North America, Netherlands, Puerto Rico and Thailand conclude, reporting no efficacy2007, Merck’s Step trial in Australia, the Americas and South Africa stopped early after some indications those vaccinated had a greater rate of HIV infection2009, RV 144 Sanofi/VaxGen trial reports first reduction in HIV infections Prevention of the susceptible: Vaccine /scienceinsider/2009/09/massive-aids-va.html AIDS对社会的影响 对社会的影响 AIDS带来的过早死亡，造成劳动力减少和生产力下降 造成贫富差距和贫困人口增加 造成心理恐慌和社会不稳定 国内的相关调查显示： 感染HIV后： -失去工作 -收入下降 -孤儿孤老问题 医疗费用上升 AIDS流行对我国部分地区的社会经济影响已经显现 AIDS研究中的几点启示 关于AIDS疾病的发现和病因的确定 关于抗病毒治疗预防AIDS的疾病传播 关于AIDS的功能性治愈 关于AIDS相关的社会行为问题 历史回顾 1981年 在美国发现首例。 1983年 法国巴斯德研究所发现相关病毒。