ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The role of mathematical models in the study of human immunodeficiency virus (HIV) transmission, the epidemiology and demographic impact of acquired immune deficiency syndrome (AIDS), and the course of infection within an individual is reviewed. Attention is focused on the part models can play in short-term prediction, parameter estimation, the interpretation of observed patterns, and the identification of areas in which knowledge is inadequate. Methods for short-term predictions, over 1–3 years, have proved reliable and can take account of distributed delays in the interval between reporting and diagnosis. Parametric and nonparametric methods have been developed for estimating summary statistics (e.g., means) for the distributed incubation period of AIDS. Current estimates, based on cohort or transfusion-associated AIDS cases, lie in the range of 7–10 years. Transmission models for longer-term prediction are less reliable at present given the many uncertainties concerning key epidemiological parameters. Theoretical studies highlight the need for quantitative data on temporal changes in the distribution of rates of sexual partner change and fluctuations in viral abundance in serum, secretions, and excretions (i.e., infectiousness) throughout the long and variable incubation period of the disease.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The complicated machinery used by HIV for multiplication offers several targets for therapy and the viral enzymes appear to be particularly appropriate targets. For the HIV reverse transcriptase, this has been demonstrated by the clinical effect of zidovudine, but less toxic drugs are needed. The HIV protease is another viral enzyme against which inhibitors are likely to be developed. As the function and structure of HIV proteins are understood in more detail, it will become possible to construct more selective inhibitors. It is necessary to evaluate new HIV inhibitors in animal models to facilitate the rapid selection of suitable compounds and combinations for further clinical evaluation. It appears likely that several drugs preventing HIV replication will be required, and that these will appear during the next few years, but it is also apparent that the elimination of HIV from a patient remains a remote possibility.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Intravenous drug use continues as the second most common risk behavior associated with acquired immune deficiency syndrome (AIDS) in the United States and Europe. Recently there has been increased public and research attention to this problem. Five areas of public health concern for AIDS among i.v. drug users are identified and discussed: (a) the potential spread of human immunodeficiency virus (HIV) to drug users in developing countries; (b) the emergence of cocaine use associated with HIV infection; (c) ethnic differences in seroprevalence rates among i.v. drug users, with ethnic minorities tending to have higher rates; (d) difficulties in changing the sexual behavior of i.v. drug users; and (e) an increased frequency of fatal infections among HIV seropositive drug users that are not counted with the current surveillance definition of AIDS. There have been numerous studies of AIDS risk reduction among i.v. drug users, but the ultimate effect of the behavior change on spread of the virus is not yet clear. Preliminary studies from New York City, San Francisco, and Stockholm indicate a relative stabilization of seroprevalence in those cities, suggesting that the behavior changes reported in those cities may be significantly slowing the rate of viral spread.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

To meet the needs of human immunodeficiency virus (HIV) infected individuals, innovative approaches to health care delivery have been developed that could affect the entire worldwide medical care system. Innovations include dedicated inpatient and outpatient AIDS treatment and research units, extensive community service organizations, active volunteers, hospices, visiting nurses, AIDS information hot lines, confidential testing sites, outpatient infusion centers, integration of research and clinical care, and new roles for health professionals including AIDS as an unofficial medical subspecialty. Patient care has replaced medical care, and nurture and technology must coexist when a cure cannot be assured. Physicians expecting choice in patients they care for must accept HIV; staggering health care costs, a sorely taxed public care system, fear of infection or medical inadequacy, declining nursing school enrollment, decreased interest in primary care medical specialties, a dwindling supply of community volunteers, and sparse extended care facilities hamper our efforts to provide for AIDS patients. However, the abundance of vacant hospital beds, the social and scientific challenge of AIDS care and research, employment opportunities, and a new generation of health care professionals accepting AIDS as part of the challenge of medicine all offer hope for change. In AIDS, we have the opportunity to strike an alliance between the art of healing and the advanced technology of modern medicine. In doing so, we will all face our own mortality.

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0894-9255    

出版商:OVID    

年代:1988

数据来源: OVID