Homosexual Transmission of HIV - Dartmouth CollegeHIV同性传播达特茅斯学院.pptVIP

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2018-04-16 发布于江西
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Homosexual Transmission of HIV - Dartmouth CollegeHIV同性传播达特茅斯学院.ppt

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Homosexual Transmission of HIV - Dartmouth CollegeHIV同性传播达特茅斯学院.ppt

The global epidemic of HIV infection Ford von Reyn Infectious Disease Section Dartmouth-Hitchcock Medical Center AIDS at DHMC 7/15/81 33 yo gay man, IDU Admitted with bilateral pulmonary infiltrates Dx: Pneumocystis carinii pneumonia (PCP) Rx: Died after 16 days CDC: 30-35 cases reported Global estimates for adults and childrenend 2003 People living with HIV/AIDS New HIV infections Deaths due to HIV/AIDS Adults and children estimated to be living with HIV/AIDS as of end 2001 Modes of transmission of HIV Sexual Parenteral Perinatal Global transmission patterns Pattern I: developed countries (e.g. US, Australia, W Europe) Sexual: homosexualheterosexual Parenteral: injecting drug use Perinatal: perinatal/postnatalprenatal Seroprevalence: 1% (MF) Global transmission patterns Pattern II: developing countries (e.g. sub-Saharan Africa) Sexual: heterosexual (M=F) Parenteral: unsterile needles, transfusion Perinatal: perinatal/postnatalprenatal Seroprevalence: 1-25%(M=F) Modes of transmission of HIV Sexual Parenteral Perinatal Heterosexual Transmission: Uganda 415 couples with HIV pos and HIV neg partner Up to 30 month follow with counseling Seroconversion in 90 couples (12/100 py) No difference in M to F vs F to M transmission Role of circumcision seroconversion 16.7/100 py in uncircumcised males seroconversion 0/100 py in circumcised males Role of viral load: seroconversion 0/100 py in 51 patients with viral load 1500 Sexual transmission of HIV Transmission is bidirectional M F = F M Rate of transmission per episode intercourse: 1/1000 long term partner: 15-25% Risk factors: viral load lack of circumcision genital ulcers Modes of transmission of HIV Sexual Parenteral Perinatal Modes of transmission of HIV Sexual Parenteral Perinatal Perinatal Transmission of Human Immunodeficiency Virus (HIV) Prenatal(7%) -Transplacental Intrapartum(13%) -During delivery Postpartum (14%) -Breast feeding T