重庆医科大学：《传染病学》课程教学资源（教案讲稿）艾滋病（AIDS）

置庆医科大学脑床学院款未讲满 重庆医科大学临床学院教案及讲稿 课程名称传染病学年级2004级授课专业 留学生 教师袁詰职称副教授授课方式大课示教学时4 题目章节Part2 Chapter3 Acquired Immunodeficiency Syndrome(ADS) 教材名称Lemology 作者Chief Editor::Liu Zhengwen 曲版tC8n2sg9 ifice o Xian Jiaotong 版次 2004.11 数 1.Definition 3.Epidemiology 目的要 6.Diagnosis of HIV and AIDS 1.Epidemic Process and The effect Factors. 难 2.Pathogenesis of AIDS. 1.Epidemic Process and The effect Factors 点 4.Treatment of AIDS 外语 English Language 方 Classroom lectures and multimedia 手段 115th Edition Mandell,Douglas and Bennett's Principales and Practice of Infectious Diseasea.Vol-2.2001 edited by Gerald L.Mandell.Jone E.Bennett,Raphael Dolin,publishing by Harcourt Ansia and Churchill Livingstone. Medicine 2004 elited by H.David Humes 见 教学组长 教研室主任： 年 月 日 制表时间：2004年8月

重庆医科大学临床学院教案讲稿 制表时间：2004 年 8 月 1 重庆医科大学临床学院教案及讲稿 课程名称 传染病学 年级 2004 级 授课专业 留学生 教 师 袁 喆 职称 副教授 授课方式 √大课 示教 学时 4 题目章节 Part 2 Chapter3 Acquired Immunodeficiency Syndrome (AIDS) 教材名称 Lemology 作者 Chief Editor :Liu Zhengwen 出 版 社 Dean’s Office of Xi’an Jiaotong University 版次 2004 .11 教 学 目 的 要 求 1. Definition 2. History 3. Epidemiology 4. Pathollogy 5. clinical manifestations 6. Diagnosis of HIV and AIDS 7. Treatment of AIDS 8. Preventl of AIDS 教 学 难 点 1．Epidemic Process and The effect Factors. 2．Pathogenesis of AIDS. 教 学 重 点 1.Epidemic Process and The effect Factors 2.Features of AIDS 3.Diagnosis of AIDS 4.Treatment of AIDS 外语 要求 English Language 教学 方法 手段 Classroom lectures and multimedia 参考 资料 1、15th Edition Mandell,Douglas and Bennett’s Principales and Practice of Infectious Diseasea.Vol-2, 2001 edited by Gerald L.Mandell,Jone E.Bennett,Raphael Dolin, publishing by Harcourt Ansia and Churchill Livingstone. 2、4th Edition Kelley’s Textbook of Internal Medicine 2004 edited by H.David Humes, publishing by Lippincott Williams & Wilkins Inc. 教研 室意 见 教学组长： 教研室主任： 年 月 日

君庆医科大学脑床半院表来讲满 Time arrangement Definition 10min H=Human msoaeiengy A=Acquired tside agent(source).it is not inherited? I=Immune D=Deficency S=Synd ome Asyndrome is a set of symptoms. The symptoms of AIDS may be different in different people 二、History 20Min mong gay men started to be seen in heterosexuals.drug addicts.and people who received blood 轴助手段 TepSoRHlsbeginin9 同步播放 AIDS in the USA. 多媒体课件 1982-“A1DS-Ac0 ne Deficiency Syndrome-is created.AIDS is the Pasteur Institute in France firstly mittee of scientists name the virus Human 1985:HIV test kit(antibody)is approved by FDAto screen blood donors. 1986:Another strain of Human Immunodeficiency Virus(HIV-2)was discovered on the west coast of Africa. 1987:A Treatment Arrives:The drug Zidovudine(AZT)is FDAapproved and begins to be used in high doses to treat people infected with HIV. 1990:People living with HIV and AIDS rises to 1 million 1992:Combination Therapy Arrives. snglegiaoiayraesoiADSsamedoecnetueoteRtoaueaonotnew 2001:Making drugs affordable. Mn2o2aeat.ga2pmedastpo3nmionhiteaedndvauas 三、Epidemiology 20Min Source of transmission: 制表时间：2004年8月

重庆医科大学临床学院教案讲稿 制表时间：2004 年 8 月 2 Time arrangement 一、 Definition 10min H= Human I = Immunodeficiency V= Virus A = Acquired AIDS is caused by HIV . AIDS comes from an outside agent (source), it is not inherited? I = Immune Our immune system fights disease. HIV attacks the immune system. D = Deficiency Deficiency means “a lack of”. HIV weakens the immune system so that it cannot fight off diseases. S = Syndrome A syndrome is a set of symptoms. The symptoms of AIDS may be different in different people. 二、History 20Min 1981: The emergence of Kaposi's Sarcoma and Pneumocystis among gay men in New York and California; "GRID" (gay-related immune deficiency); However, cases started to be seen in heterosexuals, drug addicts, and people who received blood transfusions. In June 1981, the CDC published a report about the occurrence of PCP in five men in Los Angeles. This report is beginning of the general awareness of AIDS in the USA. 1982:“AIDS”-Acquired Immune Deficiency Syndrome – is created. AIDS is reported in USA and European Country. 1983: Luc Montagnier’s group at the Pasteur Institute in France firstly isolated a retrovirus , that is responsible for AIDS. 1984: An international committee of scientists name the virus Human Immunodeficiency Virus 1 (HIV-1). 1985: HIV test kit (antibody) is approved by FDA to screen blood donors. 1986: Another strain of Human Immunodeficiency Virus (HIV-2) was discovered on the west coast of Africa. 1987: A Treatment Arrives; The drug Zidovudine (AZT) is FDA approved and begins to be used in high doses to treat people infected with HIV. 1990: People living with HIV and AIDS rises to 1 million. 1992: Combination Therapy Arrives. 1997: Mortality rates of AIDS started to decline due to the introduction of new drug cocktails. 2001: Making drugs affordable. 2008: World Health Organization predicts up to 33 million infected individuals. More than 2 million have died in 2007. 三、Epidemiology 20Min Source of transmission: 辅助手段： 同步播放 多媒体课件 时间分配： 见教学内容

置庆医科大半脑床半院戴未计满 .blod rgassRareions 3 Can You get AIDS from.? 4.Injecting with sterile needles 5.Protected sex High risk Populations 2nomosexual or bis exual men 3.infants born to mothers with HIV 4.persons who received blood transfusions or clotting products before 1985(?) The first case of AIDS was reported in Beijing in 1985. Case:Male.34y.Argentine-American.He had a gay history.He traveled to china in Mng8a5yoeneeeengUeeMeae98h9geee8iaretresuendana rescue invand 四、Pathology 20Min HIV and AIDs Virion structure. s tak on9gmeoprae2aareeeeanalng9oe.shep horses cattle and monkeys. 2.Astrong immune response 五、clinical manifesta 30Min 2~10 years in adults. several months to 2 years in infants and young children. Stage 1:Primary HIV Infection 1Lasting for days to symptoms are serious enough to consult a doctor ently m 6.There is a large amount of HIV in the peripheral blood; 7.The immune system begins to respond to the virus by producing HIV 制表时间：2004年8月

重庆医科大学临床学院教案讲稿 制表时间：2004 年 8 月 3 1.blood 2.semen 3.vaginal secretions 4.breast milk 5.saliva 6.tear 7.nervous system tissue Can You get AIDS from. . . ? 1.Kissing 2.Sneezing, coughing, sharing cups, etc 3.Insects bite 4.Injecting with sterile needles 5.Protected sex High risk Populations 1.homosexual or bisexual men 2.intravenous drug users 3.infants born to mothers with HIV 4.persons who received blood transfusions or clotting products before 1985(?) The first case of AIDS was reported in Beijing in 1985. Case: Male，34y，Argentine-American, He had a gay history. He traveled to china in May 1985 . Due to continuous fever, cough, shortness of breath, was send to the emergency room of Beijing Union Medical College Hospital. But rescue invalid and died in the same day. He was confirmed as AIDS patients. 四、Pathollogy 20Min HIV and AIDS Virion Structure： 1．Lentiviruses are part of a larger group of viruses known as retroviruses. 2.Lentivirus literally means 'slow virus‘. 3.Lentivirus take a long time to produce any adverse effects in the body. 4.They have been found in a number of different animals, including cats, sheep, horses cattle and monkeys. The course of the disease： 1. Acute Infection 2. A strong immune response 3. A latent state 4. The beginning of disease 5. Advanced disease - AIDS 五、clinical manifestations 30Min Incubation period: 2~10 years in adults, several months to 2 years in infants and young children. Stage 1: Primary HIV Infection 1.Lasting for days to weeks; 2.Accompanied by a flu like illness; 3.In up to about 20% of people,the symptoms are serious enough to consult a doctor; 4.The diagnosis is frequently missed. 5.HIV antibody test may not yet be positive; 6.There is a large amount of HIV in the peripheral blood; 7.The immune system begins to respond to the virus by producing HIV

君庆医科大学临床半院表来讲满 Asymptod is freeo c Stage any symptoms 2hv/eneeimabanpstbutpeopeemamnecs dles are positive in the blood STAGE 3:PGL enteogegtegSbs8epiamagedbecauseofteyeasd 2.The lymph activity: 3.HIV mutates and becomes more pathogenic.in other words stronger and the symptoms are mild,but as the immune system eriorates the symptoms worsen STAGE 4:AIDS, drfaspeice 2.opportunisticinfections 3.cancers occur 六、 25Min qnpoeipogyferes Clinical manifestations Lab examinations HIV antigen p24 postive (Western blotting) 七、Treatment 25Min Antiretroviral chemotherapy dovudine(A)ddc.ddi,lamivudine(3TC) 2.Protease inhibitors:ritonair,indnavir 3.Combination therapy nucleoside reverse transcriptase(RT)inhibitors upts an early stage of the virus making copies of itself.called nucleoside ddl ne bCaciabinel, cavir (zlagen),an (tavudine).TC enorovir (vire 制表时间.2004年8月

重庆医科大学临床学院教案讲稿 制表时间：2004 年 8 月 4 antibody and cytotoxic lymphocytes. STAGE 2 : Clinically Asymptomatic Stage 1.Lasts for 2-10 years and is free from any symptoms; 2.The level of HIV in the peripheral blood drops but people remain infectious and HIV antibodies are positive in the blood. 3.Large amounts of T helper cells are infected and die and a large amount of virus is produced. STAGE 3: PGL 1.Persistent generalized lymphadenopathy; 2.The lymph nodes and tissues become damaged because of the years of activity; 3.HIV mutates and becomes more pathogenic, in other words stronger and more varied, leading to more T helper cell destruction; 4.As the immune system fails, so symptoms develop; 5.Initially many of the symptoms are mild, but as the immune system deteriorates the symptoms worsen. STAGE 4: AIDS, 1.An AIDS diagnosis is confirmed if a person with HIV develops one or more of a specific number of severe opportunistic infections or cancers. 2.opportunistic infections 3.cancers occur 六、Diagnosis 25Min Clinical diagnosis： Epidemiology features + Clinical manifestations + Lab examinations Pathogen diagnosis ： HIV antibody positive (ELISA); HIV antigen p24 postive (Western blotting) 七、Treatment 25Min Antiretroviral chemotherapy 1.Reverse transcriptase inhibitors: Zidovudine(AZT), ddc, ddi, lamivudine(3TC) 2.Protease inhibitors: ritonair,indnavir 3.Combination therapy nucleoside reverse transcriptase (RT) inhibitors 1.interrupts an early stage of the virus making copies of itself. called nucleoside analogs. 2.AZT, ddC (zalcitabine), ddI (dideoxyinosine), d4T (stavudine), 3TC (lamivudine), abacavir (ziagen), and tenofovir (viread)

重庆医科大半脑床半院载未讲满 2.in combination with other antiretroviral drugs. protease inhibitors 3.interrupt virus replication at a later step in its life cycle se),Indinavir(Crixivan),Amprenivi 八、Prevention Aa8a8RepreYH2CeareonpshesnemywaS 2.Treat HIV infection as an illness,not as a social stigma bu38p8nmesyetvynsoceyhdleaonceasodshougntng ea时nm23eehienauswhhdescbehowh Zm8ebarerpecaionsnonghgrakanmerodsexwaas 8.Provide clean needles for injection drug users 制表时间：2004年8月

重庆医科大学临床学院教案讲稿 制表时间：2004 年 8 月 5 non-nucleoside reverse transcriptase inhibitors (NNRTIs), 1.nevirapine (Viramune), and efravirenz (Sustiva), 2.in combination with other antiretroviral drugs. protease inhibitors 3.interrupt virus replication at a later step in its life cycle. 4.include :Ritonavir (Norvir) ,Saquinivir (Invirase), Indinavir (Crixivan), Amprenivir (Agenerase), Nelfinavir (Viracept),Lopinavir (Kaletra) 八、Prevention 10Min 1.no vaccine to prevent HIV infection!!!. Reduction in the spread of HIV can be accomplished in many ways: 2.Treat HIV infection as an illness, not as a social stigma 3.Reduce levels of poverty in society that lead to increased risks through drug abuse and promiscuity. 4.Give HIV-infected pregnant women antiretroviral therapy to reduce perinatal HIV transmission 5.Provide HIV testing and counselling to identify infected persons who can reduce their risk to others 6.Provide educational programs for children and adults which describe how to avoid sexually transmitted diseases 7.Promote sexual barrier precautions among high risk commercial sex workers and clients 8.Provide clean needles for injection drug users 9.Create health care programs providing antiretroviral therapy to extend life and reduce HIV transmission rates