What are the principles of treatment for people infected with HIV and AIDS patients?
So far no effective drugs for complete cure of AIDS and vaccine for prevention have been found. The administration of drugs that inhibit HIV reverse transcriptase treatment also only inhibits the replication of the virus, prolongs the incubation period and extends the life of the patient. The principles of treatment for HIV-infected and AIDS patients by the Department of Disease Control of our Ministry of Health are.
1.Rest
HIV patients can work and study as usual, but AIDS patients must pay attention to rest when they have symptoms such as low fever and diarrhea, or when they are combined with various infections.
2.Strengthen nutrition
AIDS patients often cannot eat well due to fever, oral candidiasis or herpes virus infection to malnutrition, already immunocompromised, plus malnutrition is more likely to cause complications such as tuberculosis, so a high protein diet is recommended.
3.Treatment of pathogenesis
At present, the most common are AZT (azidothymidine), DDI (dideoxyinosine) and DDC (dideoxycytidine) all of which are used to inhibit reverse transcriptase to block the replication of HIV in cells and can be applied in combination.
4.Immunomodulatory drugs
(1)Interferon
There are antiviral and immunomodulatory effects, the dose is 3Miu intramuscular injection, three times a week, 3 to 6 months / course.
(2) Interleukin-II (IL-II)
IL-II can increase the number of lymphocytes and improve the immune function of patients. Currently, recombinant IL-II is mostly used (interferon, interleukin both have side effects such as fever).
(3) Gammaglobulin
Patients with AIDS are prone to bacterial infections because their humoral immune function is also affected. Regular use of gammaglobulin can reduce the occurrence of bacterial infections.
(4) Chinese medicine
Chinese herbal medicines, such as mushroom polysaccharide, salvia, astragalus and glycyrrhizin, also have the effect of regulating immune function. Some research work has found that certain Chinese medicines or their components can inhibit HIV in in vitro experiments, which has a good prospect.
5, various comorbidities treatment
(1) Oral Candida infection
AIDS patients often recurrent oral candidiasis infection sometimes extended to the tonsils and the back wall of the pharynx, can be locally coated with mycophenolate plus glycerin, or mixed into a thick paste slowly swallowed, or oral itraconazole, or fluconazole.
(2) Pneumocystis carinii pneumonia
Clinical manifestations: dyspnea, apparently low partial pressure of oxygen (about 70mmHg), but when the chest X-ray shows that its lesions are not too heavy, combined with the medical history and anti-HIV (+) to consider the disease can be taken orally TMPco recovery still need to intermittently take to prevent relapse. Long-term use should pay attention to the blood picture and urine and kidney function. Oral or aerosol inhalation.
(3) Bacterial infections
With recurrent Salmonella infections, such as blood culture (+), oral quinolones can be given. The United States recently reported a high incidence of tuberculosis and atypical mycobacterial infection in AIDS patients, and rapid progress, available triple or quadruple anti-tuberculosis drugs, the use of drugs must also pay attention to liver and kidney function.
(4) Cryptococcal meningitis
Treatment focus is to lower intracranial pressure, available 20% mannitol, or for ventricular drainage, antibiotics available diphenhydramine B or fluconazole, after the condition is stable can be changed to oral fluconazole.
(5) Herpes virus infection
Oral acyclic guanosine can be given for cutaneous herpes zoster, and oral acyclic guanosine or interferon can be given for mucosal herpes simplex or cytomegalovirus infection.
(6) Toxoplasma gondii
S.D. and ethidium are given orally. Spiramycin can also be given orally, but the effect is less certain.
(7) Cryptosporidiosis
The main manifestation is diarrhea. There is no specific treatment yet. Isospora and Microsporidia can cause diarrhea and small intestine malabsorption, and the diagnosis can only be made by special staining of stool smear and electrophotographic examination.
(8) Tumor
For Kaposi’s sarcoma which is developing fast, the combination of vincristine (or vincristine), bleomycin or adriamycin, or interferon can be used for six months to a year, which is more effective.
Who is prone to get AIDS?
People who are prone to get AIDS are called high-risk groups for AIDS. They are
1. Male homosexuals. Because male homosexuals have anal sex, it is easy to damage the anus and rectum and cause HIV infection.
2. Intravenous drug users. Intravenous drug users share HIV-contaminated needles and syringes, allowing the virus to spread through the blood.
3. Blood transfusion and frequent use of blood products, especially hemophiliac patients often input VIII clotting factor, because the clotting factor for transfusion is concentrated from the mixed plasma of many blood donors, as long as one of them has HIV, all the products will be contaminated and cause transmission. Virus antibodies were positive. In 1984, we also found four cases of hemophiliacs infected with HIV as a result of VIII clotting factor transfusion.
4.Prostitutes, bisexuals, heterosexuals, the more sexual partners, the greater the chance of infection.
5.Spouse or sexual partner of AIDS patients.
6.Children whose parents are AIDS patients.
Why are people who use drugs prone to HIV infection?
Because drug addicts share syringes and needles contaminated with HIV and cause infection. Drug addicts often gather together and use syringes together, and the more times they inject, the greater the chance of infection. In addition, drug users are often inseparable from prostitutes, and often take high-risk behaviors such as prostitution and anal sex in order to obtain drugs. The number of new cases of AIDS caused by drug addiction in Europe from 1985 to 1989 has been similar to the number caused by homosexuality, with a ratio of 0.91. China’s Yunnan AIDS testing center in 1986-1990 testing identified as HIV-positive people infected in the country, with intravenous drug users accounted for 87.44%. This shows that intravenous drug use plays an important role in the transmission of HIV.
Why are homosexuals vulnerable to AIDS?
Gay men have anal sex, because anal sex can easily cause anal and rectal mucosal trauma and increase the chances of HIV entering the body, and gay men often exchange sexual partners, in addition, allogeneic sperm entering the body through the wound can cause immunosuppression, which increases the chances of HIV infection. In the Americas and Europe, the number of AIDS patients is higher among men who have sex with men. About 94% of the AIDS patients found in the United States come from sexual contact, 90% of whom are men, and 66% of whom are gay men.
How can I stop having AIDS?
There is no complete cure for AIDS, but it is completely preventable. If you pay attention to the following aspects, you will not get AIDS.
1.No sexual promiscuity, no prostitution, no prostitution. The more sexual partners you have, the greater the chance of infection and the higher the risk of getting AIDS.
2.Do not have sex with AIDS patients, HIV-infected people and people at high risk of AIDS.
3. Do not take drugs or inject drugs intravenously. Do not share needles and syringes if you need to inject.
4. Do not use untested blood or blood products.
What should I do if I am infected with HIV?
If you are a carrier of the virus and have not yet developed into an AIDS patient, you are generally not infectious in your daily life. You can continue to participate in daily work and life, and try to maintain interaction with others, but take precautions to avoid spreading the virus to others and also to prevent yourself from contracting other diseases.
1.Do not share toothbrushes, razors, needles, syringes and other instruments that may contaminate blood and medical devices that can pierce the skin.
2. Don’t donate blood, semen or other tissues and organs.
3. Strengthen nutrition and combine work and rest. Do not smoke and do not drink alcohol.
4.Get regular medical checkups to prevent and treat infections in a timely manner.
5.To tell all your sexual partners and any partners who may share needles, encourage them to go to the hospital for consultation and for HIV antibody test
6.To see a doctor is to tell the doctor so that appropriate precautions can be taken to protect you and others.
7. Either avoid sex or tell your partner about the antibody test results, adopt safe behaviors, use condoms properly, and prevent exposure to your body fluids (including blood, semen, urine and feces, saliva, and female vulvar secretions) during sex. But despite the use of condoms success rate of about only 85%, there are still 15% can be sexually infected, so you should still avoid sex.
8, the blood and other body fluids spilled in the room or on other objects should be cleaned with 10% bleach clarifying solution.
9.If the infected person or his wife is a woman of childbearing age, she should use contraception.
What diseases should be distinguished from AIDS?
1.Primary immunodeficiency disease
2.Secondary immunodeficiency diseases. Such as corticosteroids, chemotherapy, radiotherapy or secondary immunodeficiency diseases caused by pre-existing primary malignancies and severe protein-thermal malnutrition.
3. Hematologic diseases. Since AIDS patients have fever, hepatosplenomegaly, enlarged lymph nodes, reduced white blood cells and few lymphocytes in individuals, they need to be differentiated from hematologic diseases.
4. Infectious mononucleosis. The manifestation of acute HIV infection period is very similar to infectious mononucleosis, so when the symptoms of infectious mononucleosis appear in people at high risk of AIDS, HIV antibody or virus antigen should be tested immediately.
5. Central nervous system disease. Brain damage can be caused by AIDS or by other causes and needs to be identified.
Should a pregnant woman with AIDS have an abortion?
A pregnant mother who has AIDS or HIV infection can transmit HIV to her fetus or baby through the placenta or birth canal, or through breast milk. There is no effective drug to cure AIDS, so HIV-infected and AIDS patients should have an abortion if they become pregnant.