Overview of the epidemiological characteristics of AIDS, HIV features, infection diagnosis, and cocktail therapy.

The epidemic is widespread, with a significant increase in cases, and both low prevalence nationwide and high prevalence in some areas coexist; it is facing a peak in AIDS incidence and mortality; the epidemic is spreading from high-risk groups to the general population; and risk factors for the epidemic are widespread.

HIV can survive in the external environment of the human body and is generally less resistant than hepatitis viruses. HIV is very sensitive to heat and can be killed at temperatures above 60°C. Therefore, medical equipment such as syringes can be completely sterilized by high-temperature sterilization, boiling, or steam sterilization. HIV is also sensitive to chemicals. Commonly used bleaching powder, fresh 2% glutaraldehyde solution, 4% formaldehyde solution, 2% chloramine, and 6% hydrogen peroxide can all kill HIV. However, it has recently been found that 70% ethanol solution and carbonated solution are unstable in their effect on HIV. HIV is not sensitive to ultraviolet light.

The diagnosis is mainly based on relevant medical history, clinical manifestations, and HIV antibody testing. If the initial HIV antibody screening test is positive, a confirmatory test is then performed. If the confirmatory test is positive, HIV infection is confirmed.

Detection of HIV-specific antibodies is currently the primary laboratory basis for diagnosing HIV infection. Antibodies are generally detectable 8-12 weeks after infection, and 95% of infected individuals show detectable antibodies within 5 months. Patients in the window period, although already infected with HIV and without detectable antibodies, are still infectious. Therefore, testing patients in this period is crucial for preventing HIV spread and treating early-stage patients. The HIV p24 antigen test is suitable for detecting individuals in the window period who have not yet developed HIV antibodies.

A person who is HIV antibody positive and meets any of the following criteria can be diagnosed as an AIDS patient: A. Weight loss of more than 10% in the past 3-6 months, and persistent fever of 38°C or higher for more than one month. B. Weight loss of more than 10% in the past 3-6 months, and persistent diarrhea (3-5 times per day) for more than one month. C. Pneumocystis carinii pneumonia. D. Kaposi's sarcoma. E. Obvious fungal or other opportunistic pathogen infection; If a person who is HIV antibody positive has weight loss, fever, and diarrhea symptoms close to the first criterion above and meets any of the following criteria, they can be diagnosed as an AIDS patient: A. CD4/CD8 lymphocyte ratio less than 1, decreased CD4 cell count; B. Generalized lymphadenopathy; C. Obvious symptoms and signs of central nervous system space-occupying lesions, including dementia, loss of discrimination, or motor nerve dysfunction.

On the one hand, it can cause opportunistic infections, including protozoan infections such as Pneumocystis pneumonia (Pneumocystis carinii pneumonia) and enteritis (Cryptosporidium). Bacterial infections include Mycobacterium tuberculosis, Salmonella, Campylobacter jejuni, etc. (diarrhea and dysentery); fungal infections (Candida albicans: stomatitis, esophagitis), Cryptococcus (meningitis), and disseminated infections (Polymycosis avium); viral infections include cytomegalovirus (cytomegalovirus: progressive dementia, pneumonia retinitis, etc.), and herpesvirus (herpes simplex or herpes zoster). On the other hand, it primarily causes Kaposi's sarcoma, primary lymphoma, and primary brain lymphoma.

In AIDS patients, Kaposi's sarcoma initially presents as papules or nodules, which later merge and enlarge, but are generally a few millimeters to about 1 cm in size. The shape is mostly band-like, and it is more common in the chest and back, and less common in the lower limbs. In most cases, the tumor can invade the gastrointestinal tract, lungs, pleura and lymph nodes. It is highly invasive, malignant and has a poor prognosis.

The three main categories are: reverse transcriptase inhibitors, such as zidovudine, didanoxin, zalcitabine, stavudine, and lamivudine; non-nucleoside reverse transcriptase inhibitors, such as nevirapine, delavedine, and rovirat; and protease inhibitors, such as saquinavir, ritonavir, and nelfinavir.

The treatment of HIV using two or more reverse transcriptase inhibitors and protease inhibitors in combination is called cocktail therapy. This therapy has a strong antiviral effect, and the combination of drugs can enhance the synergistic effect of antiviral agents, inhibit viral replication, reduce drug dosage and toxic side effects, delay the chance of drug resistance due to mutations, improve clinical symptoms, and enhance quality of life.

Homosexuals, those with promiscuous sexual relationships, those with multiple sexual partners, intravenous drug addicts, those who receive blood transfusions or blood products, hemophiliacs, and children whose parents are HIV-positive are all high-risk groups. Additionally, individuals with sexually transmitted infections, especially genital ulcers such as syphilis, chancroid, and genital herpes, should also be considered high-risk for HIV.

For HIV/AIDS, prevention is better than any medicine. First, promiscuous sexual behavior should be prohibited, and the use of condoms should be encouraged to avoid contact with the secretions, blood, and excrement of HIV-positive individuals. Second, unsterilized needles and syringes should not be used; HIV testing is mandatory before any clinical use of blood or blood products; and intravenous drug users should not share syringes. Homosexuality and intravenous drug addiction should also be strictly prohibited. Women with HIV/AIDS or at high risk of HIV infection should avoid pregnancy, and their newborns should not be breastfed.

After HIV infection, the acute HIV infection phase begins within 1-2 weeks, with symptoms usually disappearing within a month. This is followed by asymptomatic HIV infection, which can last from a few months to more than 20 years, with an average of 8-10 years. After that, the AIDS phase (AIDS-related syndrome phase, complete AIDS phase) begins.