Chủ đề: Mong mọi người giúp đỡ!

Xin chào cả nhà! mình đang làm luận văn tốt nghiệp cử nhân điều dưỡng, đề tài mình làm là về đồng nhiễm viêm gan virus B, C trên bệnh nhân HIV .mình đã làm xong bước nhập và xử lý số liệu, bây giờ bắt đầu tiến hành viết bài. Nhưng mình đang gặp khó khăn trong việc tìm tài liệu tham khảo để viết bài nên kính mong mọi người giúp đỡ. Cụ thể ai có hay biết những tài liệu liên quan đến viêm gan virus B, C ; HIV đặc biệt là những nghiên cứu liên quan đến chúng trước đây thì cho mình xin với! rất cám ơn mọi người.!

Gửi bởi powerful [Bạn không thể nhìn thấy link cho đến khi đăng ký, nhấn vào đây để đăng ký]

Xin chào cả nhà! mình đang làm luận văn tốt nghiệp cử nhân điều dưỡng, đề tài mình làm là về đồng nhiễm viêm gan virus B, C trên bệnh nhân HIV .mình đã làm xong bước nhập và xử lý số liệu, bây giờ bắt đầu tiến hành viết bài. Nhưng mình đang gặp khó khăn trong việc tìm tài liệu tham khảo để viết bài nên kính mong mọi người giúp đỡ. Cụ thể ai có hay biết những tài liệu liên quan đến viêm gan virus B, C ; HIV đặc biệt là những nghiên cứu liên quan đến chúng trước đây thì cho mình xin với! rất cám ơn mọi người.!

Có tài liệu liên quan đến kiến thức và kỹ năng triển khai tiêm viêm gan B sơ sinh. Bạn có thể tham khảo thêm để viết phần phương hướng, đánh giá và kiến nghị.

1.
Survival in patients with HIV infection and viral hepatitis B or C: a cohort study.

Bonacini M, Louie S, Bzowej N, Wohl AR.

Department of Medicine, University of Southern California School of Medicine, Los Angeles, California, USA. [Bạn không thể nhìn thấy link cho đến khi đăng ký, nhấn vào đây để đăng ký]

Abstract

AIM: To assess survival in patients with HIV and viral hepatitis co-infection. METHODS: A prospective university clinic cohort of 472 patients with HIV infection who were followed for 8343 patient-months. The outcome measures were the survival from HIV or liver disease assessed by the Kaplan-Meier method. Multivariable analysis using a Cox regression model identified variables associated with mortality. RESULTS: Patients were divided into four subgroups: HIV/hepatitis B virus (HBV) (n = 72), HIV/hepatitis C virus (HCV) (n = 256), multiple hepatitides (n = 18) and HIV alone (n = 126). One hundred and thirty-four patients (28.4%) died during follow-up. Liver mortality was noted in 55 patients, representing 12% of the cohort and 41% of the total mortality. Survival curves were similar in patients with HIV alone and those with any viral hepatitis co-infection. Liver deaths were more common in patients with multiple hepatitides (28%) HIV/HBV (15%), HIV/HCV co-infection (13%) versus HIV alone (6%). Liver mortality was comparable in HIV/HBV as in HIV/HCV co-infected patients and was not associated with gender, ethnicity, age, or mode of infection. HIV deaths were similar in patients co-infected with viral hepatitis compared with those with HIV alone. In patients with viral hepatitis co-infection, initial CD4 cell count > 200 x 10(6) cells/l and use of highly active antiretroviral therapy (HAART) were associated with significantly reduced liver mortality. CONCLUSIONS: Patients with HIV and viral hepatitis had greater liver mortality than patients with HIV alone, but had comparable HIV mortality. Co-infection with hepatitis B is associated with hepatic outcomes similar to hepatitis C. Control of immunosuppression with HAART and CD4 counts > 200 x 10(6) cells/l are associated with better hepatic outcomes and should be the first priority in patients with HIV and viral hepatitis.

sr:AIDS. 2004 Oct 21;18(15):2039-45.

2.
Influence of viral hepatitis on HIV infection.

Rockstroh JK.

Department of Medicine I, University of Bonn, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany. [Bạn không thể nhìn thấy link cho đến khi đăng ký, nhấn vào đây để đăng ký]

Abstract

The natural history of HBV is known to be complicated by HIV-co-infection. In contrast, the effect of HBV on the outcome of patients infected with HIV-1 is controversial. Some cohort studies from the pre-HAART era described a more rapid progression to AIDS in patients carrying antibodies to the core-antigen or having chronic HBV infection, but post-HAART studies did not detect any impact of HBV co-infection on HIV-disease progression. Similarly, studies assessing the impact of HCV on progression of HIV-disease delivered conflicting results. In the Swiss cohort study, the presence of HCV was independently associated with an increased risk of progression to AIDS and death. Subsequent studies, however, did not find any difference in survival. Most interestingly, the EuroSIDA cohort analysis found no difference between HCV-positive and HCV-negative HIV-patients starting HAART in the time needed to decrease viral loads to less than 400 copies as well as in the time needed to increase CD4-counts by 50%. In summary, there are no major differences in HIV-related mortality between hepatitis B or C co-infected individuals and patients infected with HIV alone, particularly if antiretroviral treatment is given. There is, however, an increased risk of liver disease related morbidity and mortality as well as more hepatoxicity under antiretroviral treatment regimens.

sr:J Hepatol. 2006;44(1 Suppl):S25-7. Epub 2005 Nov 21.

3.
Hepatitis B and hepatitis C co-infection in patients with HIV.

Herrero Martínez E.

Department of Virology and Haemophilia Centre, Royal Free and University College Medical School, London NW3 2PF, UK. [Bạn không thể nhìn thấy link cho đến khi đăng ký, nhấn vào đây để đăng ký]


Abstract

HAART has increased the life expectancy of patients with HIV. However, as their life expectancy increases, it becomes increasingly important to focus on the management of concurrent illnesses such as chronic HBV and HCV infections which have the potential to increase mid to long term morbidity and mortality. Shared epidemiological risks have resulted in the HIV infected population having a higher incidence of both HBV and HCV than those uninfected with HIV. Co-infection with HIV modifies the natural history of HBV infection, increasing the rate of viral replication, risk of carriage and chronic hepatitis but without increasing liver necroinflammatory processes. In chronic HCV infection, the presence of HIV enhances the risk of severe liver disease. There is no evidence as yet that HBV directly impacts on HIV disease progression but HCV infection increases the risk of death or an AIDS defining illness and impairs CD4+ T cell recovery during antiretroviral therapy. Treatment of either hepatitis virus is complex because of pharmacokinetic interactions with components of HAART regimens. Copyright 2001 John Wiley & Sons, Ltd.

sr:* Rev Med Virol 2001 Sep-Oct;11(5):343.


4.
Hepatitis C in the HIV-Infected Person

MS Sulkowski, DL Thomas

Because of shared routes of transmission, hepatitis C virus (HCV) infection is common in HIV-infected persons, who have been experiencing increasing HCV-related morbidity and mortality since the advent of effective antiretroviral therapy. Infection with HIV appears to adversely affect the outcome of hepatitis C, leading to increased viral persistence after acute infection, higher levels of viremia, and accelerated progression of HCV-related liver disease. In addition, hepatitis C may affect the course and management of HIV infection. The medical management of hepatitis C in HIV-infected persons is complicated by immune suppression, potential drug interactions and toxicities, and other forms of liver disease. In addition, there is little published experience with the safety and efficacy of the best available anti-HCV medications in HIV-infected persons. Thus, current efforts must be directed at preventing HCV and HIV infections and applying the principles learned in treating persons with either infection to manage those with both. Future efforts should include studies of the pathogenesis of HCV infection in HIV-infected persons and large, prospective studies that demonstrate the optimal management of persons co-infected with HIV and HCV. Such efforts will help to eliminate HCV-related liver disease as an emerging threat to HIV-infected persons.

sr:Ann Intern Med (2003) 138: 197-207.

5.Prevalence of hepatitis B and C seropositivity in a Nigerian cohort of HIV-infected patients.

JA Otegbayo, BO Taiwo, TS Akingbola, GN Odaibo, KS Adedapo, S Penugonda, IF Adewole, DO Olaleye, R Murphy, P Kanki

Introduction: The clinical and public health implications of the convergence of the human immunodeficiency virus (HIV) epidemic and chronic viral hepatitis in sub-Saharan Africa are poorly understood. This study was designed to determine the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV), and the impact of co-infection on baseline serum alanine transaminase (ALT), CD4+ T lymphocyte (CD4) count, and plasma HIV-RNA (viral load) in a cohort of HIV-infected Nigerians. Methods: A retrospective study was conducted, on eligible treatment-naive patients who presented between August 2004 and February 2007 to the University College Hospital (UCH), Ibadan, Nigeria. Demographic data and pre-treatment laboratory results (hepatitis B surface antigen (HBsAg), HCV antibodies (anti-HCV), ALT, CD4 count and viral load) were retrieved from the medical records. Fisher's exact, two sample t-tests, and the Wilcoxon rank sum tests were used to compare groups. A logistic regression model was fitted to explore characteristics associated with co-infection status. Results: A total of 1779 HIV-infected patients (male: female ratio, 1:2) met inclusion criteria. HBsAg was present in 11.9%, anti-HCV in 4.8% and both markers in 1%. HBsAg was more common among males than females (15.4% vs 10.1%, respectively p = 0.001) while anti-HCV was detected in a similar proportion of males and females (5.3% versus 4.6%, respectively p = 0.559). HIV-infected patients with anti-HCV alone had a lower mean baseline CD4 count compared to those without anti-HCV or HBsAg (197 cells/mm3 vs 247 cells/mm3, respectively p = 0.008). Serum ALT was higher among patients with HBsAg compared to those without HBsAg or anti-HCV (43 International Units (IU) vs. 39 IU, respectively p = 0.015). Male gender was associated with HBV co-infection on logistic regression (OR1.786; 95% CI, 1.306-2.443; p < 0.005). Conclusion: More HIV-infected females than males presented for care in this cohort. We identified a relatively high prevalence of HBV and HCV co-infection in general, and a higher rate of HBV co-infection among males than females. Pre-treatment CD4 count was significantly lower among those with HCV co-infection, while ALT was slightly higher among those with HBV co-infection. Triple infection with HIV, HBV and HCV was present in a small but significant proportion of patients. These findings underscore the importance of testing for HBV and HCV in all HIV-infected persons in our setting.
sr:Ann Hepatol (0) 7: 152-6.

6.Prevalence of occult hepatitis B & C in HIV patients infected through sexual transmission.

RR Rai, A Mathur, D Mathur, HP Udawat, S Nepalia, S Nijhawan,

BACKGROUND: Prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) markers including active and occult infection has not been described in diverse cohorts among HIV-infected patients in India. Earlier studies have explained the role of HBV/HCV co-infection in cohorts of injection drug users (IDUs) but the sexual co-transmission of HBV/ HCV is not completely understood. OBJECTIVE: The objective of this study was to assess the prevalence of occult HBV & HCV infection in HIV positive sexually acquired transmission risk group. MATERIALS AND METHODS: 58 sexually acquired HIV positive patients were taken up for the study of occult HBV/HCV co-infection. Data on demographics, sexual behaviour, sexually transmitted diseases (STD), medical history, laboratory tests viz., serum ALT and CD4 count were recorded. HBV serology included HBsAg, anti HBs, IgG anti HBc and HBV DNA (PCR). HCV serology included anti HCV & HCV RNA (RT-PCR). RESULTS: Occult HBV infection (HBV DNA) was observed in 12.2% (7/58 with HBsAg -ve and IgG anti HBc +ve subjects) while an overall prevalence of HBV DNA was 13.7% (12% occult & 1.7% in HBsAg+ve patients). Out of 58 HIV positive patients 29.3% demonstrated reactivity for any marker of past or current HBV infection. (HBsAg 1.7%, anti HBs 10.3% anti HBc IgG 17.2%). 4/58 (6.8%) revealed anti HCV positivity along with HCV RNA positivity by RT-PCR while 6/58 (10.3%) individuals revealed an occult HCV infection (anti HCV negative). The overall HCV RNA prevalence was 17.2%. 2 out of 58 (3.4%) individuals were positive for occult infection of both HBV DNA & HCV RNA (Triple infection HIV/HBV/ HCV). The HBV/HCV co-infected group (n = 18) showed a significantly high ALT (114.3 + 12.3 U/I) & low CD4 count (202.5 + 33.7 cells/mm3). The percent prevalence of HBV/ HCV co-infection was higher in the illiterate group, in men less than 30 years of age, and in those who were married and exhibited polygamous activity. CONCLUSIONS: The study demonstrated that in HIV infected patients testing only serological viral markers like HBsAg, antiHBcIgG & anti HCV, fails to identify the true prevalence of co-infection with HBV & HCV. Qualitative PCR for HBV DNA & HCV RNA detects co-infection in patients who are negative for serological markers. Also, in subjects who had only a sexual risk factor for parenterally transmitted infections, HIV may enhance the sexual transmission of HBV and HCV
sr:Trop Gastroenterol (0) 28: 19-23.

mình đang lam nghien cứu về đề tài " tình hình sử dụng thuốc của người dân " mà chưa có tài liệu tham khảo,các bạn hãy giúp mình với..mail của mình:
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