hiv相关的贫血 ppt课件

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1、Anemiainhumanimmunodeficiencyvirus(HIV)–infectedpatients贫血定义：血红蛋白Hb：男性低于120g/l，成年女性低于110g/l，孕妇低于100g/l。AccordingtoTheAnemiaHIVWorkingGroup(hemoglobinlevelof<12g/dLinmenand<11g/dLinwomen)(Volberding2000).分类：★急性、慢性★红细胞形态（大细胞性、正常细胞性、小细胞低色素性）★骨髓增生情况：增生性贫血（溶血性

2、、缺铁性、巨幼贫）增生低下贫血（再生障碍性贫血）★病因分类一、红细胞生成减少（一）造血干祖细胞异常※再生障碍性贫血※纯红再障先天性：Diamond-Blackfan综合征后天性：原发---部分患者血清中有自身EPO或幼红细胞的抗体继发---药物相关型、感染相关型、自身免疫病相关型、淋巴细胞增殖性疾病相关型※先天性细胞生成异常性贫血※造血系统恶性克隆性疾病（二）造血微环境异常※骨髓基质、基质细胞受损※造血调节因子水平异常：SCF、IL、GM-CSF、G-CSF、EPO、TPO、TGF、TNF、IFN※造血原料

3、不足或利用障碍二、溶血性贫血三、失血性贫血Background---2000Despiteimportantadvancesinantiretroviraltherapy,anemiaremainsaprobleminmanyHIV-infectedpatientsAnemiahasadeleteriouseffectonbothfunctionalcapacityandqualityoflife,andhasbeenassociatedwithshortenedsurvival.InFebruaryand

4、Juneof1998,TheAnemiainHIVWorkingGroup,anexpertpanelofAIDScliniciansfromtheUnitedStates,convenedtodiscussthat：theimpactofanemiainpatientswithHIVinfectiontheavailabletreatmentoptionsthepracticestrategiesandfutureresearchdirectionsAnemiaisacommoncomplicationo

5、fHIVinfection﹡HIV-infectedpatientstreatedfromJanuary1990throughAugust1996,thel-yearincidenceofanemia(definedasahemoglobinlevel<10g/dL)was3.2%inthe6094cohortmemberswithHIVbutnotAIDS,12.1%inthe2579memberswithimmunologicAIDS(CD4+cellcount<200/mm3),and36.9%int

6、he4624memberswithclinicalAIDS.﹡78%wereregardedasnotdrugrelatedAnemiainHIVInfection:ClinicalImpactandEvidence-BasedManagementStrategiesIn2002,16membersoftheAnemiainHIVWorkingGroup,anexpertpanelofphysiciansinvolvedinthecareofHIV-infectedpatientsthatmetfirst

7、in1998,reconvenedtoassessnewdataandtotranslatethesedataintoevidence-basedtreatmentguidelinestheprevalenceofanemiainthehighlyactiveantiretroviraltherapyeratheriskfactorsthatareindependentlyassociatedwiththedevelopmentofanemiatheimpactofanemiaonqualityoflife

8、,physicalfunctioning,andsurvivalevidence-basedguidelinesfortreatmentofanemiainHIV-infectedpatientsAnemiaassociationwithdiseaseprogressionanddecreasedsurvivalWHATCAUSESANEMIAINHIVINFECTEDPERSONSBloodloss---neo