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专家：艾滋病早治疗能多活30年以上“隐形”感染者进入晚期才被确诊
www.jfdaily.com 2009-02-25 13:28 稿件来源：新闻晚报
□晚报记者 贺天宝 报道
上海市艾滋病治疗专家组组长、上海市（复旦大学附属）公共卫生临床中心教授卢洪洲指出，目前国内艾滋病诊治工作中面临的最大问题在于HIV感染者未能及早被发现；如果及早开展抗病毒治疗，患者寿命可延长30年以上。
昨天，上海市艾滋病治疗专家组今年首次全体会议在上海市公共卫生临床中心召开。与会专家分析了当前国内艾滋病诊治的现状、面临的困难与挑战，最终达成共识并提出艾滋病防治应注重早发现、早治疗。
HIV感染者很少早期确诊治疗
市公共卫生临床中心作为上海市惟一艾滋病定点收治单位，从1992年至今收治来自全国各地的艾滋病患者中，在HIV感染早期被确诊并进行随访和治疗的很少，绝大多数患者是因各种严重的机会感染和机会肿瘤在外院就诊过程中发现其HIV抗体检测阳性才转诊来。
卢洪洲教授曾收治过一名患者，诊治过程中先后出现12种机会感染和机会肿瘤，发病涉及中枢神经系统、肺部、腹腔脏器、眼部等全身多系统器官，病原包括细菌、病毒、真菌、寄生虫等，为临床诊治带来巨大的挑战。
晚期确诊时免疫力消失殆尽
上海市艾滋病治疗专家组组长卢洪洲教授指出，目前国内艾滋病诊治工作中面临的最大问题在于HIV感染者未能及早被发现，从而使得这些“隐形”感染者在进入艾滋病晚期时才被确诊，而此时他们体内中重要的免疫细胞CD4+ T淋巴细胞数每微升血液中已降至几十个甚至是几个（正常值为750±250/微升），人体免疫功能已几乎消失殆尽，因此他们中的大多数都合并有严重的机会感染和肿瘤。
专家表示，在目前没有疫苗的情况下控制传染源最有效的办法就是对感染者的治疗，而在适当的时机开始抗病毒治疗（“鸡尾酒”疗法）患者寿命可再延长30年以上。
综合医院也应加强抗艾检测
上海市艾滋病治疗专家组顾问、上海市疾病预防控制中心康来仪教授分析指出， CD4+T淋巴细胞计数目前仍是判断艾滋病分期、何时开始抗反转录病毒治疗以及治疗效果的重要依据。根据最新的临床研究数据，国际专家已达成共识，建议当患者每微升血液中该细胞计数降至350个时就应该启动抗反转录病毒治疗，而对该细胞计数在351到500个之间的HIV感染者启动抗反转录病毒治疗，其预后以及生活质量等也均有改善。
据此，上海市艾滋病治疗专家组呼吁，应重视加强艾滋病的早期发现和治疗工作。建议在充分发挥定点医院专业核心作用的同时，综合医院也应积极参与艾滋病的检测、治疗工作。为此应对综合医院感染科、皮肤性病科医师就艾滋病相关知识、诊断方法、最新治疗进展进行培训，并通过网络建设加强艾滋病的监测和防治。
Experts: AIDS, early treatment can live more than 30 years many "invisible" to enter the late infection was diagnosed
manuscript www.jfdaily.com 2009-02-25 13:28 Source: Evening News
□ Evening News reporter Tianbao He reported
AIDS treatment team leader, Shanghai, Shanghai (Fudan University), Professor of Public Health Clinical Center, Hong-Zhou Lu pointed out that the current AIDS diagnosis and treatment of domestic work is the biggest problem facing HIV-infected persons could not be found as early as possible; if carried out as soon as possible antiviral therapy , Life expectancy may be extended in patients with more than 30 years.
Yesterday, the Shanghai Municipal AIDS treatment expert group meeting the first time this year in Shanghai Public Health Clinical Center. The experts analyzed the current status quo of the domestic AIDS treatment, the difficulties and challenges, and ultimately reach a consensus and to make AIDS prevention should focus on early detection, early treatment.
HIV-infected people rarely diagnosed early treatment
City of Shanghai Public Health Clinical Center as the only fixed-point hospital AIDS units in 1992 from the hospital so far from across the country with AIDS, in HIV infection was diagnosed early and very little follow-up and treatment, the vast majority of patients are due to the kinds of serious opportunistic infections and opportunities tumor outside the course of hospital treatment and found positive for HIV antibody testing before referral to.
Professor Lu Hongzhou had been treated a patient, the diagnosis and treatment have occurred during the 12 kinds of opportunistic infections and the opportunity Cancer incidence involving the central nervous system, lungs, abdominal viscera, eye, such as many body system, organ, pathogens, including bacteria, viruses, fungi , parasites, etc., for clinical diagnosis and treatment of enormous challenges.
The time of diagnosis of advanced immune disappear
Shanghai AIDS treatment team leader Professor Lu Hongzhou pointed out that the current AIDS diagnosis and treatment of domestic work is the biggest problem facing HIV-infected persons could not be found so that these "stealth" infected when entering the last stages of AIDS was diagnosed, and At this point their bodies in important immune cells in CD4 + T lymphocytes increased slightly every few blood has been reduced to a few dozen or even several (normal to 750 ± 250 / increased slightly), the body's immune function has almost disappeared, So most of them are combined with serious opportunistic infections and tumors.
Experts said that in the present circumstances there is no vaccine控制传染源the most effective way is for the treatment of infected persons, and at an appropriate time to start anti-retroviral therapy ( "cocktail" therapy) in patients with life expectancy may be extended for more than 30 years.
General Hospital should also step up anti-Ai Detected
AIDS treatment expert group of consultants in Shanghai, the Shanghai Municipal Center for Disease Control and Prevention, Culture and Sport to Professor Miriam analysis, CD4 + T lymphocyte count is still the judge of AIDS stage, when anti-retroviral treatment, as well as an important basis for therapeutic effects. According to the latest clinical research data, have reached a consensus of international experts, it is recommended when the patients increased slightly each of the blood cell count fell to 350 when they should start antiretroviral therapy, and the cell count in between 351-500 HIV-infected people to start anti-retroviral treatment, their prognosis and quality of life also showed some improvements.
Accordingly, the Shanghai group of experts called for AIDS treatment, attention should be paid to strengthen the AIDS early detection and treatment. Recommended that hospitals give full play to the role of the professional core, a general hospital should also be actively involved in AIDS testing, treatment. To this end the integrated hospital infection Branch, Dermatology Physicians on AIDS-related knowledge, diagnostic methods, the latest progress in the treatment of training, and through network-building to strengthen surveillance and control of AIDS.
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