防治艾滋病研究的新成果使青少年受益

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图中这位印度母亲是艾滋病病毒携带者,但她已保护自己的孩子免受感染。据研究报告说,她应该注意孩子是否有语言障碍。
美国国务院国际信息局(IIP)«美国参考» Charlene Porter 从华盛顿报道,美国国家卫生院(NIH)正在陆续发布一些研究结果,它们有可能对感染上艾滋病病毒或已患上艾滋病的数百万儿童、青少年和年轻成年人的健康产生直接的影响。
大剂量服用维生素D有助于抵消使用泰诺福韦(tenofovir)造成的骨质疏松的副作用,这种药被用在一些病人身上来治疗艾滋病病毒感染。1月10日,美国国家卫生院发布关于维生素D可能有益于这些病人的报告。
在另一项研究中,美国国家卫生院的研究人员及其合作伙伴发现曾在母体内接触过艾滋病病毒的儿童面临另一项健康危险。他们可能会有语言障碍——也就是说,学会说话的过程迟缓、难以理解口头语言、难以进行口头表述。
从全世界范围内已感染艾滋病病毒的青年人人数以及艾滋病病毒在这个群体中扩大感染的潜在危险中可以看出这项研究的意义所在。世界卫生组织(World Health Organization)和世界银行(World Bank)共同发布的一份报告估计有500万青少年和年轻成年人携带艾滋病病毒,而且大多数人对自己的感染状况并不知情。据这份报告说,这一年龄段还包含40%以上的新感染病例,所占比例过高。联合国儿童基金会(U.N. Children’s Fund)所作的另一项估算得出在2009年约有370,000名儿童出生时携带艾滋病病毒。
但这项新研究确实提供了证据,表明治疗与受感染的不利方面可以得到克服与解决。
据美国国家儿童健康和人类发育研究所(National Institute of Child Health and Human Development)——资助这项研究的美国国家卫生院所属的8个研究所之一——的一个研究小组说,出生之前接触过艾滋病病毒的儿童出现语言障碍的可能性为一般人群的两倍。研究小组建议,出生前在母体内接触过艾滋病病毒的儿童——即使他们自己不携带病毒——应该接受语言障碍的检测和评估。
对于那些确实携带病毒的儿童,治疗显然会有帮助。接受少量或没有获得治疗的儿童出现语言障碍的可能性约为接受治疗的青少年艾滋病病毒感染者的三倍。
根据美国国家卫生院发布的新闻简报中关于艾滋病药物与骨质疏松的内容,泰诺福韦被广泛用于治疗艾滋病病毒感染,但它导致激素不断增加并造成骨质疏松。同样的症状在缺乏维生素D时也可能发生。这一点启发研究小组试用维生素D补充物来抵消这种副作用。每月服用50,000单位剂量的维生素D来配合泰诺福韦药物治疗的结果使激素水平降低。目前正在展开一项较为长期的研究,以确定持续服用维生素D能否消除因服用泰诺福韦引起的骨质疏松。
国家儿童健康和人类发育研究所的罗恩·黑兹拉(Rohan Hazra)博士说:“年龄段为十几岁、 二十几岁的人有可能要在今后几十年内接受抗艾滋病病毒治疗,因此找出一种既安全又价廉的保护其长期骨骼健康的方法将会是一项重要的进展。”
美国国家卫生院设有27个研究所和研究中心,是全世界医学研究经费最大的单一来源。欧巴马总统于12月1日世界艾滋病日重申美国对研究提供资助的承诺,旨在遏制这一全球性流行病并减轻它造成的苦难。在2011年,美国向近4百万艾滋病病毒感染者提供了治疗并向1300万受艾滋病病毒/艾滋病影响的人提供照顾和资助,其中包括超过410万名孤儿和易受感染的儿童。
美国国务院国际信息局 http://iipdigital.usembassy.gov/iipdigital-mgck/index.html
New Research Findings on HIV/AIDS Focus on Youth
By Charlene Porter | Staff Writer | 10 January 2012
This Indian mother is HIV-positive, but she was able to protect her baby from infection. She should monitor the baby for speech impairment, according to research.
Washington — The U.S. National Institutes of Health (NIH) is releasing research findings that could have a direct effect on the well-being of the millions of children, adolescents and young adults infected with HIV or with fully developed AIDS.
Megadoses of vitamin D can help to counteract the bone loss that occurs as a side effect of tenofovir, a drug administered to some patients to treat HIV infection. NIH reported on the potential benefit of vitamin D for these patients on January 10.
In another study, NIH researchers and their partners found another health risk for children exposed to HIV in the womb. They can have language impairment — that is, slowness in developing speech and difficulty understanding spoken words and expressing themselves with words.
The significance of the finding is conveyed by the numbers of youth worldwide who are HIV infected, and the potential for expanded infection in this group. A publication released jointly by the World Health Organization and the World Bank estimated that 5 million adolescents and young adults are living with HIV, and most do not know their status. This age group also comprises a disproportionate share of new infections, more than 40 percent, according to the report. Another estimate made by the U.N. Children’s Fund calculated that approximately 370,000 children were born with HIV in 2009.
But the new research does provide evidence that adverse effects of treatment and exposure can be countered and treated.
Language impairment in children exposed to HIV before birth was twice as likely to occur as it does in the general population, according to the research group at the National Institute of Child Health and Human Development, one of the eight NIH institutes that supported this work. The research group suggests that children with prenatal exposure to HIV — even if they do not carry the virus themselves — should be screened and evaluated for language difficulty.
Among those who do carry the virus, treatment apparently helps. The HIV-infected children receiving little or no treatment were about three times more likely to have language impairment than HIV-infected youngsters receiving treatment.
Regarding the AIDS medication and the bone loss, tenofovir is widely used to treat HIV infection, according to the NIH news release, but it causes increased levels of a hormone that leads to bone loss. The same symptom is seen in vitamin D deficiency, which led the research team to try the vitamin D supplements to counteract that side effect. Monthly 50,000-unit doses of Vitamin D accompanying tenofovir treatment resulted in reduced levels of the hormone. A longer-term study is being launched to determine if continued doses would eliminate bone loss due to tenofovir.
“People in their teens and 20s may be on anti-HIV treatment for decades to come, so finding a safe and inexpensive way to protect their long-term bone health would be a major advance,” said Dr. Rohan Hazra at the National Institute of Child Health and Human Development.
With 27 institutes and centers, NIH is the single largest source of funding for medical research in the world. On World AIDS Day December 1, President Obama renewed the U.S. commitment to funding research to curtail the global pandemic and the suffering it causes. In 2011, the United States provided treatment to almost 4 million HIV-infected people and provided care and support to 13 million people affected by HIV/AIDS, including more than 4.1 million orphans and vulnerable children.
(This is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://iipdigital.usembassy.gov/iipdigital-en/index.html)