AIDS환자 및 HIV감염자의 간호관리

김주희,유은광 한양대학교 의과대학 1997 한양의대 학술지 Vol.17 No.2

The purpose of this paper is to describe the direction of nursing care for HIV/AIDS patients. AIDS is a clinical syndrome that involves progressive immune deficiency and consequent development of opportunistic infections, tumors, neurologic disease, and systemic wasting with chronic trends. Many of those diagnosed with HIB/AIDS has devastating impact from various aspects including physiological and psycho-socio-cultural. The continuity of emphathetic, compationate, and patient care is crucial. Partnering in care is important. Partnership is defined as a relationship in which two or more people have a joint interest. If the care providers do not enter into a partnership with the patient and his/her family or loved ones, then no system or organizational structure can be effective. For the successful partnering in care, it is essential that all related interdisciplinary members be aware of the patient's specific goals as identified during plan development with multiprofessional collaborative efforts. The care of HIV/AIDS patient includes preventing from HIV/AIDS infection by Infection Control Strategy in public and hospital through education and counseling; providing effective nursing therapy according to the physio-psycho socio-cultural and spiritual responses appeared in relation to health problem during the process of living with disease by nursing process, and finally helping them achieve high quality of life even in the painful experiences of illness. In specific, the frequent responses to deal with are the changes of nutrition requirement, elimination, body temperature, O₂ exchange, thinking process, self care ability, tissue integrity, meaning for being, knowledge; and comfort altered related to pain, and etc.The purpose of this paper is to describe the direction of nursing care for HIV/AIDS patients. AIDS is a clinical syndrome that involves progressive immune deficiency and consequent development of opportunistic infections, tumors, neurologic disease, and systemic wasting with chronic trends. Many of those diagnosed with HIB/AIDS has devastating impact from various aspects including physiological and psycho-socio-cultural. The continuity of emphathetic, compationate, and patient care is crucial. Partnering in care is important. Partnership is defined as a relationship in which two or more people have a joint interest. If the care providers do not enter into a partnership with the patient and his/her family or loved ones, then no system or organizational structure can be effective. For the successful partnering in care, it is essential that all related interdisciplinary members be aware of the patient's specific goals as identified during plan development with multiprofessional collaborative efforts. The care of HIV/AIDS patient includes preventing from HIV/AIDS infection by Infection Control Strategy in public and hospital through education and counseling; providing effective nursing therapy according to the physio-psycho socio-cultural and spiritual responses appeared in relation to health problem during the process of living with disease by nursing process, and finally helping them achieve high quality of life even in the painful experiences of illness. In specific, the frequent responses to deal with are the changes of nutrition requirement, elimination, body temperature, O₂ exchange, thinking process, self care ability, tissue integrity, meaning for being, knowledge; and comfort altered related to pain, and etc.

우리나라 약물남용자와 만성음주자에서의 C형 , B 형 간염 바이러스 및 HIV 의 유병률

김효석(Hyo Sock Kim),추동호(Dong Ho Choo) 대한내과학회 1997 대한내과학회지 Vol.52 No.6

N/A Objectives: After introduction of anti-HCV assay as screening test of blood donors, the proportion of trasfusion-associated hepatitis C declined, but the proportion of hepatitis C patients with a history of parenteral drug use increased, HCV, HRV, and H1V share similiar modes of transmission and prevalent among intravenous drug users in America. Recently the number of drug users in Korea has been increasing. Therefore we investigated the prevalence of HCV, HBV, and HIV among drug users in our country. In addition several recent reports showed that anti-HCV were freguently positive in the chronic alcoholics and HCV might play a role in the development of severe liver disease in these patients. We assessed the prevalence of anti-HCV and its re1ationship to the severity of liver disease in chronic alcoholic patients. Methods: The prevalence of anti-HCV, HHsAg, and anti-HIV among 185 drug users who were admitted at Taegu Medical Center from January 1994 to December 1995 has been studied using ELISA and the history of drug use including sort, route, and duration investigated. In addition, We studied the prevalence of anti-HCV and its relationship to the severity of liver disease in 73 chronic alcoholics. Results: 1) Among 176 methamphetamine intravenous users, the prevalence of anti-HCV was 80%, that of HBsAg was 4%, and there was none with anti-HIV positive in 131 cases tested. Of the 9 marihuana smokers, all of them were negative in anti-HCV or anti-HIV, and only 1 caese(11%) was HBsAg positive. 2) Longer duration of intravenous drug use was significantly associated with anti-HCV seropositivity, Elevated ALT level was found in 80 cases(57%) of the anti-HCV seropositive 140 cases and their mean was 971U/L. 3) The group with higher optical density of anti-HCV showed inclination of elevated ALT level; however there was no significant correlation between anti-HCV optical density and ALT level. 4) The prevalence of anti-HCV was 11% in 73 chronic alcoholic patients, and that of HBsAg was 4%. The seropositivity of anti-HCV correlated with the severity of liver disease: none in patients with no liver problem or fatty liver, 12.5% in patients with chronic liver disease, 1996 in patients with cirrhosis classified by clinical, biochemical, and ultrasonographic findings, However the presence of anti-HCV was not associated with impaired liver function tests in chronic liver disease and cirrhosis groups. Conclusion: The prevalence of anti-HCV among intravenous drug users in Korea was 80%, similiar to that in America, By contrast the prevalence of HBsAg was only 4%, lower than that of general population. And there was no HIV-infected cases among intravenous drug users in our study. The seropositivity of anti-HCV among chronic alcoholic patients was 11%. And increased prevalence of anti-HCV in alcoholic patients with severe liver disease might suggest that hepatitis C virus is involved in liver damage in these patients.

에이즈 환자군과 건강 감염자군 사이의 유전자 발현양상 변화

최장훈,최병선,김성순,이주실 대한혈액학회 2007 Blood Research Vol.42 No.1

배경: 장기 무증상 생존자와 같은 건강한 HIV 감 염자에 대한 HIV 감염으로 인한 숙주 세포 유전자 발현 양상 변화는 아직까지 잘 밝혀져 있지 않다. 본 연구에서는 in vivo상에서 건강한 HIV 감염자와 AIDS환자를 대상으로 숙주 유전자 발현 양상을 조사하여 HIV 감염과 질병 진전에 관여하는 숙주 유전자를 규명하고자 하였다.방법: HIV 비감염자 10명, 건강한 HIV 감염자 5명, AIDS 환자 5명을 대상으로 Magic-oligo 10K Chip을 사용하여 숙주 세포 유전자 발현 양상을 비교 분석하였다. 결과: HIV 비감염자와 감염자 간의 숙주 유전자 발현 양상을 분석한 결과 전체 유전자의 10.8%에 해당되는 1,097 숙주 유전자가 두 배 이상의 발현 차이를 보였으며, 이들 중 331개 유전자는 HIV 감염으로 인하여 발현이 증가한 반면 나머지 766개 유전자는 발현이 억제되었다. 건강 HIV 감염자와 AIDS 환자 모두에서 HIV 비감염자에 비해 두 배 이상의 발현량 차이를 보이는 유전자 수는 97개였다. 건강 HIV 감염자와 AIDS 환자 간 숙주 세포 유전자 발현 양상을 비교 분석한 결과 187개 유전자가 발현 차이를 보였으며, 이들 중 28개 유전자는 P값이 0.01 이하로 두 군 간 매우 유의한 발현 차이를 나타내었다. 대표적으로 tripartite motif (TRIM) 14와 interferon gamma receptor 2는 건강 HIV 감염자에서 유전자 발현이 증가한 반면, death-associated protein, DNA directed RNA polymerase II polypeptide A, STAT 등은 AIDS 환자에서 현저하게 과 발현되었다.

Incidence and risk factors for tenofovir-associated nephrotoxicity among human immunodeficiency virus-infected patients in Korea

( Jeong Eun Lee ),( Shinwon Lee ),( Sang Heon Song ),( Ihm Soo Kwak ),( Sun Hee Lee ) 대한내과학회 2019 The Korean Journal of Internal Medicine Vol.34 No.2

Background/Aims: Little is known about tenofovir disoproxil fumarate (TDF)-induced nephrotoxicity in human immunodeficiency virus (HIV)-infected patients in Korea. The objective of this study was to evaluate the incidence and risk factors of TDF-associated nephrotoxicity among HIV-infected patients in Korea. Methods: A single-center retrospective cohort study was conducted on HIV-infected patients in Korea. We included patients who had started TDF or abacavir (ABC)-based antiretroviral therapy (ART) between October 2006 and December 2014. Estimated glomerular filtration rate (eGFR) was estimated using the Chronic Kidney Disease-Epidemiology Collaboration equation. Renal dysfunction was defined as > 25% decrease of baseline eGFR. A propensity matched case-control study was conducted to compare renal dysfunction rates between the two groups. The risk factors of nephrotoxicity were analyzed by Cox regression analysis. Results: A total of 210 HIV-infected patients were included in the study, of which, 108 were TDF-based ART group and 102 were ABC-based ART group. Renal dysfunction occurred in 16 patients (14.8%) in the TDF group and 11 (10.8%) in the ABC group. Incidence of renal dysfunction of TDF and ABC group was 9.66 per 100 person-years (PYs) and 5.14 per 100 PYs, respectively (p = 0.176). In propensity-score-matched analysis, renal dysfunction rates were TDF 13.3% versus ABC 13.3% (p > 0.999). In multivariable analysis, Centers for Disease Control and Prevention clinical category C was a significant risk factor for renal dysfunction. Conclusions: Approximately, 13% of HIV-infected patients treated with TDF had renal dysfunction. Advanced stage of HIV infection was a significant risk factor for renal dysfunction.

뇌경색 및 B형 간염을 동반한 후천성 면역 결핍증 환자의 전신 마취 하 치과치료

지상은,김종수,김철환,김승오,Ji, Sang-Eun,Kim, Jong-Soo,Kim, Chul-Hwan,Kim, Seung-Oh 대한치과마취과학회 2014 Journal of Dental Anesthesia and Pain Medicine Vol.14 No.4

Acquired Immune Deficiency Syndrome is the state which develops after complications with the infection from HIV. Irrespective of their state, all HIV infections have infectivity. According to a 2013 U.N. AIDS global report, the number of reported newly infected with HIV is constantly falling, while that of Korea has been increasing over recent years and it surpassed 10,000 in 2013. This phenomenon might be attributed to the unusualness of the blood test for early detection of HIV infection. From this fact, we can assume that we have strong possibilities for encounters with infections in the office. But many misconceptions about the disease makes patients try to hide their medical history, which can lead to a nationwide spread of the infection without proper management. Even though it may be difficult to take care of HIV patients in smaller dental offices, large scale hospitals have the means to arrange protocols to treat them. We present a case about dental treatment of a patient with AIDS that has a history of cerebral infarction and hepatitis type B under general anesthesia. The purpose of this case report was to discuss the special considerations of dental care for patients with HIV.

A case of syphilis in a HIV positive patient mimicking chicken pox

( Bokwon Park ),( Junyeong Park ),( Eunbyul Cho ),( Eunjoo Park ),( Kwangho Kim ),( Kwangjoong Kim ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1

A 31-year-old HIV-positive male presented with a 1-month history of skin lesion on the entire body. Generalized scattered erythematous variable sized vesiculopapules were observed on the face and trunk. Although the skin lesions were similar with chicken pox, the clinical course was not corresponded with it. Biopsy was performed. Histologic findings revealed hyperkeratosis, parakeratosis, papillary dermal edema and dense dermal inflammatory cells infiltration including plasma cells. There were no intranuclear inclusion bodies which can be seen in the varicella. Varicella zoster virus PCR from the vesicle was negative. Serologic test revealed positive VDRL with a titer 1:32, and positivity for Treponema pallidum haemagglutination (TPHA) test. Based on the findings, he was finally diagnosed with secondary syphilis instead of chinken pox. Cutaneous manifestation of syphilis varies from maculopapules to ulcers, and can mimic many other dermatologic conditions. Especially in HIV positive individuals, unusual clinical features are known to be more frequently observed. Therefore, it is essential to include syphilis in the differential diagnosis when cutaneous lesions are noticed in HIV positive patients. Herein, we present an atypical case of syphilis that mimicked chicken pox clinically in HIV-positive patient.

인체면역결핍바이러스 음성 환자의 아래 눈꺼풀에서 발생한 단발성 카포시 육종

정혜진,나태윤.Hye Jin Chung. M.D.. Tae Yoon La. M.D. 대한안과학회 2008 대한안과학회지 Vol.49 No.10

Purpose: To report a case of solitary Kaposi’s sarcoma (KS) of eyelid in an HIV-negative patient, which has not yet been reported in domestics. Case summary: A 76-year-old woman was seen at our clinic with a purplish nodular mass on her left lower lid that had grown up for 4 months prior. There were no abnormal findings in the body except eyelid. In the routine laboratory examinations, the result of HIV test was negative. The lesion was completely excised and the eyelid was reconstructed by semicircular rotational flap procedure. The histopathologic examination showed spindle cells of mild atypism, intermixed with slit-like vascular spaces and red blood cell extravastaion. These findings coincided with KS and polymerase chain reaction was positive for human herpes virus-8. During 10 months follow up, there was no evidence of tumor recurrence and systemic abnormalities. Conclusions: We experienced that Kaposi’s sarcoma can occur solitarily in the eyelid of HIV-negative patient and favorable prognosis can be obtained by only surgical resection. J Korean Ophthalmol Soc 2008;49(10):1671-1675

Prediagnostic Utterances in the HIV-consultation : Constituting and Modifying Asymmetries

Alexandra Gross 행정언어와 질적연구학회 2013 행정언어와 질적연구 Vol.4 No.1

Development of Scenario for Simulation Program on HIV Patient Rights using Integrated Decision Making Model for Nurse Students

Ki Kyong Kim,Geun Sook Lee,Hyeran Jeong 한국간호과학회 2011 한국간호과학회 학술대회 Vol.2011 No.10

Seroprevalence of Toxoplasma gondii among HIV Patients in Jahrom, Southern Iran

Hassan Rezanezhad,Fateme Sayadi,Enayatollah Shadmand,Seyed Dawood Mousavi Nasab,Hadi Rezaei Yazdi,Kavous Solhjoo,Akbar Kazemi,Monireh Maleki,Abbas Ahmadi Vasmehjani 대한기생충학열대의학회 2017 The Korean Journal of Parasitology Vol.55 No.1