基层医疗环境中人类免疫缺陷病毒/获得性免疫缺陷综合征管理中的姑息治疗

Palliative Care in the Management of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in the Primary Care Setting.

作者信息

Mitchell Linda R, Shah Nidhi, Selwyn Peter A

机构信息

Palliative Medicine Program, Department of Family and Social Medicine, Montefiore Medical Center, The University Hospital for the Albert Einstein College of Medicine, 3347 Steuben Avenue, Bronx, NY 10467, USA.

出版信息

Prim Care. 2019 Sep;46(3):433-445. doi: 10.1016/j.pop.2019.05.009. Epub 2019 Jun 12.

DOI:10.1016/j.pop.2019.05.009

PMID:31375191

Abstract

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has metamorphosed in the past 40 years since the first cases were diagnosed. The advent of highly active antiretroviral treatment (HAART) transformed the disease trajectory for many patients with HIV/AIDS and transitioned the course from a terminal disease to a chronic disease model. This article reviews the epidemiology of HIV/AIDS, prognostic indicators, frailty, opportunistic infections, specific AIDS-defining malignancies and non-AIDS-defining malignancies, role of palliative care, advance care planning, and the role of HAART in patients dying of late-stage AIDS.

摘要

自首例人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）病例被诊断以来的40年里，这种疾病已经发生了变化。高效抗逆转录病毒治疗（HAART）的出现改变了许多HIV/AIDS患者的疾病轨迹，并使病程从绝症转变为慢性病模式。本文综述了HIV/AIDS的流行病学、预后指标、虚弱、机会性感染、特定的AIDS定义恶性肿瘤和非AIDS定义恶性肿瘤、姑息治疗的作用、预先护理计划以及HAART在晚期AIDS患者死亡中的作用。