探秘艾滋病病毒检验最后一关(组图)
2010-12-29 11:49:08 来源: 北方新报(呼和浩特)
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| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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【新闻进行时】
●阴影逼近（1982～1985年）
1981年，人类首次发现了艾滋病……
1982年，艾滋病病毒随血液制品传入中国；
1983年～1985年，带有艾滋病病毒的血液制品感染4例中国血友病病人。
●中国首例输入艾滋病(1985年)
1985年，一名美籍阿根廷艾滋病人来华旅游，死于北京，后被确诊为艾滋病。
1987年，当时认为，艾滋病在中国是可以控制的，因为同性恋和乱交在中国是被禁止的。
●从国外输入到在国内散播（1989～1994年）
1989年8月19日，负责云南省艾滋病监测工作的病毒科科长马瑛利用同学关系，到瑞丽市戒毒所采得吸毒人员血清50份，检测发现HIV阳性者26份。此后，在云南吸毒人群中共发现HIV感染者146例，这标志着艾滋病已由从国外输入发展到在国内的散播。
●感染者高速增长（1995～2000年）
1995年，中国艾滋病感染人数的示意图上，一直上扬的曲线呈现45度角跳高而升：我国中部一些地区发现了不少感染者；监测人员起初的习惯是，哪一个地区出现感染者，就在地图上那一部分打红点；2000年，这项工作停止了：中国地图上已经没有被艾滋病遗漏的省份。
●遏制艾滋迫在眉睫（2001年以来）
2001年起，中央财政艾滋病防治专项经费增加到1亿元，并投资12.5亿元国债、地方配套10亿元用于加强中西部地区的血站基础建设和设备投入，对控制经采供血途径传播艾滋病发挥了重要作用。
2009年新公布的数据显示，当年新增感染者就达4.8万例。
江苏一共检出艾滋病感染者近5000人
12月1日，又一个艾滋病防治日。艾滋病离我们很远？其实未必。记者了解到，江苏的艾滋病患者正以每年20%的速度递增，截至今年9月已累计检出艾滋病感染者近5000人。
江苏省疾控中心副主任羊海涛告诉记者，今年1～9月，江苏新增艾滋病感染者600多人。从全国的情况来看，七八成感染者是农民，这与早年边境上一些农民吸毒情况比较严重以及90年代时农村农民存在卖血的情况有关。
而在江苏，男同性恋者感染艾滋病人数增加较快，将占到去年检出人数的1/3。“男同性恋之间性行为传播艾滋病病毒的几率比男女性行为要多10倍！”
男同性恋者成高危人群
为什么同性恋者成为高危人群？一位多年从事防艾工作的专家告诉记者，同性恋者多活动于地下，他们很多人寻找和结识伴侣多从网络、酒吧等处，发展一夜情，一些人彼此不暴露真实的姓名、住址和工作地点；在情感上，由于无法和异性恋享受同样的尊重，造成了很多同性恋者感情关系上的脆弱，很多人不止一个性伴，一旦一人感染，就会造成HIV病毒的传播。另外，直肠黏膜本身的结构造成其抵抗力较脆弱，直肠肛门容易受到创伤，病毒容易侵入，直肠内环境也适合HIV病毒存活较长时间，这就是男同性恋者之间的性行为更易传播HIV的重要原因。由于受社会舆论的制约，不少男同性恋者还要结婚生子，这也将导致艾滋病向一般人群蔓延。
在男同性恋群体中，既有高级知识分子、青年大学生、工薪阶层，也有普通民工。由于很多人本身都是高知群体，他们对应该戴安全套等防护知识很熟悉，但实际上，很多男同性恋者在性行为中仍没有使用安全套的习惯。所以也曾有专家提出，现有市面上流通的安全套都是针对普通人群使用的，建议有关厂家能针对这一群体专门开发一种安全套。
由于同志人群圈子比较封闭，所以疾控部门在对这一群体进行干预上也比较困难。在外地，曾有防艾组织发展男同性恋者做志愿者,进入到他们隐蔽的集会场所,向其他男同性恋者发放安全套的工作方法，称为“男同干预男同”。
一家最安静的门诊
江苏省疾病预防控制中心皮肤病性病艾滋病门诊部，在普通人眼里具有一定神秘感，而这里开展艾滋病自愿免费检测咨询也有多年。26日，记者来到门诊时发现，这里很安静，而且对咨询者的隐私保护得非常好。不需要留下真实姓名，就可以得到医生专业的风险评估，是否接受检测也是自愿。
这大概是南京最安静的门诊部，在门口挂的牌子上，只写了性病皮肤病门诊，并未提到“艾滋病”3个敏感的字眼。在与其他医院门诊部门庭若市的热闹相比，这里空空荡荡。几个挂着咨询观察室牌子的房间，都是房门紧闭。
这才15时多就下班了？一名护士告诉记者，没有下班，里面的医生正在一对一的咨询。在咨询室门外，几名20多岁，穿着时尚的年轻男子正在安静地排队等候，整个门诊一点声音都没有。
10多分钟后，咨询室的门开了，一名医生送一名年轻男子出门，边走还边叮嘱一番。记者看见，咨询室里还有一层屏风，即便门开着也看不到里面的人，保证了咨询者的绝对隐私。
据了解，艾滋病自愿咨询检测是目前控制艾滋病流行的最有效措施之一，市民都可以在此接受艾滋病免费咨询和检测。
门诊部管文辉主任告诉记者，只要在挂号窗口领一张咨询服务表，不需要留下自己的名字。医生会仔细地询问咨询者，为其评估风险，以确定咨询者是否需要进行检测，以及是否处于艾滋病感染的窗口期。在知情同意的基础上，咨询者自愿选择是否接受HIV检测。很多情况下，尽管检测是阴性，但是有的人不放心，还会一遍又一遍地来检测，这时候医生还要为恐艾症提供心理疏导。
一个最谨慎的实验室
现在，江苏各级疾控、多个二级以上医院和采供血机构都可以进行艾滋病的筛查检测。但是否感染艾滋病的“终审判决”，需要经过艾滋病确证实验室的确认。目前，江苏共有1个省级确证中心实验室、11个确证实验室，承担着最终的确证实验。26日，记者来到了江苏省艾滋病确证中心实验室。
这个江苏唯一省级艾滋病确证中心实验室，位于江苏省疾控中心5楼。经过长长的走廊，记者来到实验室的第一个区域清洁区。在清洁区，工作人员必须从头到脚全副武装，换鞋，穿上专用的防护服，戴上口罩、工作帽和手套。随后，全副武装的工作人员经过半污染区，进入的是实验室最核心的区域污染区。进入实验室的工作人员必须摘除首饰，修剪手上的长指甲，以免刺破防护手套，实验工作人员皮肤表面如果有破损，必须经过特殊处理。
“这个实验室，它强调的是生物安全防护。”工作人员徐晓琴告诉记者，其实这样的实验室并不少见，目前所有的医疗机构的实验室都是按这个要求建的，“因为你不知道哪一份血样标本中含有潜在的危险因子，艾滋病、肝炎病毒等，都可以通过血液途径传播，所以做好防护是很重要的。”徐晓琴说，这里的工作人员，也必须通过专业培训，并从事病毒、血清学检验工作3年以上。
要做4次实验过三关
所谓的确证实验室，主要是对筛查阳性的血液样本进行确证。当医院、疾控或是采供血中心等机构将筛查出阳性的样本送到这里后，确证实验室的工作人员还会再进行一次复检，复检仍为阳性的进入确证程序。专家表示，运用国际通用的蛋白印迹的方法，通过近20个小时的实验，如果显现特异性条带达到规定的数量以上则判为阳性。
是否感染了艾滋病，从初筛到确证，一共过三关，进行4次实验方能确定。徐晓琴告诉记者，仅仅初筛呈阳性的，不可以发阳性报告，也不会告知个人检查结果。经过确证中心实验室最终确证为阳性的，要告知个人检测结果，同时进行相应的随访和流行病学调查。
会不会两次检测都是阳性，最后确证为阴性的？工作人员告诉记者，也有这样的可能，有时会出现初筛假阳性，但确证实验是可以排除的。
整天和这些艾滋病标本打交道的实验人员如何保护自己，这引起了记者的好奇。
记者观察到，全副武装的工作人员在一个特制的操作台上进行操作。工作人员胡海洋告诉记者，这叫Ⅱ级生物安全实验柜，这种实验柜有宽大的保护罩可以让实验人员的面部和操作台隔离，相当于戴上手套的手接触到操作台区域，这样的操作台还能产生气流使空气向实验人员相反的方向流动，从而保证污染的空气不进入实验人员的鼻腔。
徐晓琴告诉记者，一般来说，他们会用含氯的消毒剂对地面、台面等经常接触的地方进行反复消毒，她解释说这是因为HIV病毒对含氯的消毒剂比较敏感。
记者还观察到，在整个实验室中，没有一个玻璃容器，量杯等都是塑料的，这也是为了保护操作人员，防止被玻璃划破。
最后，工作人员告诉记者，所有医疗废物都要经过高压消毒后再由专业的机构回收。
揭秘志愿者的“艾滋生活”
同一个单元，同一间厨房，
同一只暖瓶，同一张餐桌，
他吃艾滋病人做的饭，
他吸艾滋病人递的烟……
他是一个志愿者。
事实上，在我们这座城市里，有这么一些人，每天都在与艾滋亲密接触他们不是艾滋病人，而是志愿者。为了让更多人解除对艾滋病的不必要的恐惧，懂得如何预防以及对感染者进行必要的干预和关爱，这些志愿者们每天都在做着努力。
小新(化名)，34岁，中等瘦削的身材，娃娃脸，显得比实际年龄小很多。接触之后，最大的感触是他外表的稚嫩与内心强大形成的强烈反差。
作为一个事业有成的生意人，他做志愿者已经4年了。4年里，他经常与感染者亲密接触，不分吃喝，也没有被感染。
小新的二手车生意做了十几年了，比较熟练，也有人帮忙打理。因此，一年中，他基本上有七八个月和艾滋病患者李虎他们在一起。
为了节约开支，大家不喝桶装水，都是用自来水烧开后灌在暖瓶里，每个人根据需求自己倒来喝。
杯子都是自己的杯子。来了客人，就用一次性纸杯招待。和我们想象的不一样，这些感染者们做饭吃饭与普通人家无异。他们和志愿者的餐具是共用的，并没有饭馆里提倡的公筷。
“有时，哪个人感冒了，我们也会拿出一双公筷来，不是因为艾滋，是因为害怕传播感冒病毒。”
卫生间也是人们敏感的地方。经常跟感染者共用卫生间会不会被感染？“不会。但是要注意不要共用洗漱用品和剃须刀就可以了。”小新接着说，“现在共用这些工具的情况也不多了。”
“其实他们都很善良。”小新说，这是他和感染者们亲密接触后的真实体验。“他们在做饭的时候特别小心，哪怕手上有一点小伤口，都会及时用创可贴贴上，害怕传染给我。同时，提醒我也这样。”
作为一个男人，以前，小新是不在乎一点小伤口的，现在，他们的创可贴使用率很高。
小新的存在：让感染者家属心里有底
在这里，小新是唯一的非感染者。“我常和他们开玩笑，在这里，不是我歧视你们，是你们不许歧视我。”他的乐观给感染者莫大的安慰。“一个感染者知道HIV阳性之后，每天夜里两点用公用电话和我们交流。直到两三个月后，他才现身。整个吃饭过程中都在瞄我，见我大大方方地夹菜，他才放心。饭后，他递给我一支烟，我接过来吸了。他当即就哭了，说知道自己感染以来，总躲着人，还是第一次给别人递烟。”
小新做的更多的是感染者家属的心理干预。“感染者家属其实很脆弱。他们既害怕亲人死掉，又害怕自己被感染。我整天和感染者吃住在一起也没事，这个事实本身，胜过任何说教。”
小新的顾虑：让父母完全理解很难
小新是河北省人。在老家有过一次婚姻，离了。对于他从事志愿者工作，二老是知道的，但是，他们并不知道小新每天与感染者吃住在一起。因此，小新告诉记者要用化名，照片也不要太清晰。“我的父母都是农民，想给他们讲清楚艾滋病没有这么可怕很难。所以，我不愿意让他们知道我现在的处境。”
（据《扬子晚报》） (本文来源： 北方新报 )
Quest HIV test last pass (Photo)
2010-12-29 11:49:08 Source: Northern Daily News (Hohhot)
Camera, the small block face new requirements
Doctors operate in the security cabinet
Disinfection is important
The core of HIV testing machine
The time】 【News
● Shadow Approximation (1982 ~ 1985)
In 1981, the first man discovered the AIDS ... ...
In 1982, the AIDS virus was introduced into China with the blood products;
1983 to 1985, blood products with HIV infection in 4 cases of Chinese hemophilia patients.
● China's first input AIDS (1985)
In 1985, an American tourist in China AIDS patients in Argentina, died in Beijing, after being diagnosed with AIDS.
In 1987, at that time that AIDS can be controlled in China, because homosexuality and promiscuity is banned in China.
● input from abroad to spread in China (1989 ~ 1994)
August 19, 1989, is responsible for monitoring the work of the AIDS virus in Yunnan Province Chief, Ma Yingli relationship with the students to be picked in Ruili City drug users in drug addiction treatment serum 50, detected 26 HIV positive persons. Since then, were found among drug users in Yunnan were 146 cases of HIV infection, which marked the development of AIDS has been the input from abroad to spread in the country.
● HIV rapid growth (from 1995 to 2000)
In 1995, the number of HIV infections in China diagram, has been rising curve was 45 degrees high jump and rise: some parts of central China discovered a lot of infection; monitors the habit of at first is the emergence of infections which, in playing the part of the map the red dot; 2000, the work stopped: the map of China has not been left out of the provinces of AIDS.
● Stop AIDS around the corner (since 2001)
In 2001, the central government special funds AIDS prevention increased to 1 billion and 1.25 billion investment in treasury bonds, 10 billion for the strengthening of local matching of blood banks in central and western areas of infrastructure and equipment investment, to control the transmission of blood collection and supply by AIDS has played an important role.
2009 New data released, when new infections to 4.8 million cases annually.
Jiangsu detected a total of nearly 5,000 people living with HIV
December 1, another AIDS day. AIDS is far away from us? Not necessarily. This reporter learned that Jiangsu AIDS at an annual rate of increase of 20%, as of September this year, has accumulated detected nearly 5,000 people living with HIV.
Jiangsu Province, Yang Haitao, deputy director of CDC, told reporters this year 1 to 9 months, Jiangsu, more than 600 new HIV infections. Judging from the country, seven or eight into the infected farmers, which some farmers on the border with the earlier more serious drug use and 90's there when rural farmers selling blood status.
In Jiangsu, the number of gay men infected with AIDS increased rapidly, the number of detected last year, will account for 1 / 3. "Sexual behavior among gay men more likely to spread HIV to more than 10 times between men and women having sex!"
Gay men into high-risk groups
Why is gay as high-risk groups? AIDS prevention work in a multi-year expert told reporters that homosexuals more activities on the ground, many of them to find and get to know your partner more from the network, bars, etc., the development of one-night stands, some people are not exposed to each other, real name, address and work location; in emotion, since they can not enjoy the same respect straight, causing a lot of the fragile relationship between homosexual feelings, a lot of people more than one sex partner, if a person infected, the virus will cause the spread of HIV. In addition, the rectal mucosa caused by the resistance of the structure itself is more fragile and susceptible to anorectal trauma, the virus easily penetrated, the environment is also suitable for rectal HIV virus live longer, which is sex between gay men more likely to spread HIV, important reasons. Due to the constraints of public opinion, many gay men still marry and have children, which will also lead to the spread of AIDS to the general population.
In the male gay community, both intellectuals, young students, working-class, but also ordinary workers. Since many people themselves are the Kochi group, they should wear condoms and other protection of knowledge is very familiar with, but in fact, a lot of gay sex is still not in the habit of using condoms. Therefore, some experts have suggested that the existing circulation are for the general population to use condoms, and propose that the manufacturers can focus on this group specifically to develop a condom.
Relatively closed circle of the gay population, so disease control departments to intervene in this group are also more difficult. In the field, the development of gay men had AIDS prevention organizations to volunteer to enter into their hidden meeting place gay men condom distribution to other methods of work, known as the "intervention with gay men."
One of the most quiet, out-patient
Jiangsu Provincial Center for Disease Control and Prevention sexually transmitted diseases, AIDS, skin diseases clinic, in the eyes of ordinary people have a certain mystique, but here free voluntary testing and counseling of AIDS has for many years. 26, the reporter went to the clinic found that, where it is quiet and privacy on the consultant was very good. Do not leave a real name, you can get the risk assessment of the medical profession, whether to accept the test is voluntary.
This is probably the most quiet, out-patient department in Nanjing, the sign hanging in the doorway, just write a venereal disease skin clinic, did not mention "AIDS" 3 a sensitive word. Hospital outpatient departments with other than the excitement of crowds, where empty. Observation room hung several brand consulting room, the door is closed.
This 15:00 to work out more? A nurse told reporters that there is no work, which the doctor is one to one consultation. In the consulting room door, a few more than 20 years old, wearing a fashionable young man who is quietly waiting in line, the patient is almost silent.
10 minutes later, consulting room door opened, and a doctor sent out a young man, while walking also told some edge. The reporter saw, consulting room, a layer of screen, even if the door was open not see the people inside, to ensure the absolute privacy of consultants.
It is understood that HIV voluntary counseling and testing is currently the most effective control measures to the AIDS epidemic, one of the public can be tested for HIV in this free counseling and testing.
Director of outpatient department management Wenhui told reporters, as long as the registration window to receive a consulting service table, do not leave their names. The doctor will carefully ask consultants, their risk assessment to determine the need for testing consultants, and is in the window period of HIV infection. On the basis of informed consent, consultants, voluntary choice whether to accept HIV testing. In many cases, even though testing is negative, but some people do not trust, but also to detect again and again, this time for the fear of AIDS patients but also doctors provide psychological counseling.
One of the most careful laboratory
Now, Jiangsu levels of disease control, more than two or more hospitals and blood banks can be screened for HIV testing. But is infected with HIV, "final judgments" and must be confirmed by laboratory confirmation of HIV. At present, the Jiangsu provincial total of a central laboratory confirmed, 11 laboratory confirmed, are responsible for the final confirmatory test. 26, the reporter went to the Central Laboratory of Jiangsu Province, confirmed AIDS.
Jiangsu confirmed that the only provincial AIDS Center Laboratory, located in Jiangsu Province, 5th Floor, CDC. After a long corridor, the reporters came to the laboratory area clean area first. In the clean area, the staff must be fully armed from head to toe, changing his shoes, wear special protective clothing, wearing masks, hats and work gloves. Subsequently, the heavily armed personnel through the semi-polluted area, the core of the laboratory into the contaminated area. Into the laboratory staff must be removed jewelry, hand cut long fingernails, so as not to pierce the protective gloves, laboratory staff in the skin surface if damaged, must be special treatment.
"The lab, which emphasizes the biological security." Xu Xiaoqin staff, told reporters, in fact, not uncommon in the laboratory, all current medical laboratories are built according to this requirement, "because you do not know containing blood samples which list potential risk factors, AIDS, hepatitis viruses, can be transmitted through blood, so good protection is very important. "Xu Xiaoqin said that the staff here must also be through professional training, and in the virus, serological tests for 3 years.
Do 4 experiments over three hurdles
Conclusive evidence of the so-called laboratory, mainly for screening of blood samples confirmed positive. When hospitals, disease control, or blood collection centers and other institutions will be screened positive samples to post here, confirmed the lab staff will then conduct a re-examination, re-examination remained positive into the confirmation process. Experts said that the use of internationally accepted method of Western blot, by nearly 20 hours of experiment, if the apparent specific bands is more than the required number of sub-positive.
Is infected with HIV, from screening to confirmation, had a total of three tests conducted 4 experiments confirmation. Xu Xiaoqin told reporters that only positive screening can not send positive reports, it will not inform the individual test results. After the final confirmation for the central laboratory confirmed positive, to inform the individual test results, while the corresponding follow-up and epidemiological investigations.
Will the two tests were positive, and finally confirmed as negative? Staff told reporters, but also the possibility that sometimes false positive screening, but confirmatory test can be excluded.
All day dealing with these experimental specimens of AIDS on how to protect themselves, which caused a reporter's curiosity.
Reporter observed that the staff of heavily armed special operations platform in an operation. Hu told reporters the marine staff, called biosafety level Ⅱ experimental cabinet, such experiments have large cabinets can shield the experimenter's face and console isolation, the equivalent of hand gloves console access to the area, so The console also generates the air flow in the opposite direction to the flow of laboratory personnel to ensure polluted air does not enter the nasal cavity of laboratory personnel.
Xu Xiaoqin told reporters that, in general, they will use chlorine disinfectants on the ground, where the table and so often repeated exposure to disinfection, and she explained that this is because the HIV virus more sensitive to the chlorine disinfectant.
Reporter also observed that in the laboratory, not a glass container, measuring cup, etc. are all plastic, which is to protect the operator against the glass shattered.
Finally, the staff told reporters to go through all the high-pressure sterilization of medical waste after recycling by the professional bodies.
Secret volunteers "HIV life"
The same unit, same kitchen,
The same only thermos flask, at the same table,
AIDS made him eat rice,
He handed the cigarette smoke AIDS ... ...
He is a volunteer.
In fact, in our city, there are some people so every day they are in close contact with HIV is not AIDS, but the volunteers. To enable more people to lift the unnecessary fear of AIDS, as well as know how to prevent infection and care interventions necessary, these volunteers are doing the work every day.
Little new (a pseudonym), 34-year-old, middle-thin body, baby face, looked much smaller than their actual age. After exposure, the greatest feeling of his strong appearance of the immature form with the strong contrast between the heart.
Successful career as a businessman, he did volunteer for 4 years. 4 years, he often close contact with an infected person, regardless of eating and drinking and has not been infected.
Little new used car business for over ten years, more skilled, it was also to help take care of. Therefore, the year he basically had seven or eight months and Li Hu AIDS with them.
To save money, we do not drink bottled water, are boiled with water filling the thermos bottle, each person needs their own down under drink.
Cup is their own cup. To the guests to entertain with a disposable paper cups. And not the same as we imagine, these infections are no different from ordinary people to cook a meal with. Their utensils are shared and volunteers, and there is no restaurant in the promotion of public chopsticks.
"Sometimes, which were cold, and we will come up with a pair of chopsticks to, not because of AIDS, because of fear of spread of flu virus."
Is also a place where people are sensitive to the bathroom. Often share the bathroom with the infected person will not be infected? "No. But be careful not to share toiletries and razors on it." Little New continued, "Now the situation is not common these tools and more."
"In fact, they are very good." Little new said it was he and his close contact with infected persons after their real-life experience. "They are very careful when cooking, even if a small hand wound with a Band-Aid will be pasted in a timely manner, fear spread to me. At the same time, remind me the same way."
As a man, before the new do not care about a little small wounds, and now, their use is high Band-Aid.
Little new there: the families of infected hearts to bottom
Here is the only non-small new infections. "I often joke with them, where I did not discriminate against you, that you must not discriminate against me." Infected his optimism to the great comfort. "A known HIV-positive after infection, two points every night, and we communicate with the public telephone. Until two or three months before he appeared. The whole process all aim to eat me, see me openly and take their food He was at ease. After dinner, he handed me a cigarette, I took to smoking. He immediately started to cry, saying that since they are infected, the total dodging people, is the first time to someone else Diyan. "
Little new to do more family members is infected with the psychological intervention. "HIV is very fragile families. They both fear their loved ones die, and fear they are infected. I live and eat together all day and have nothing to infection, this fact alone, more than any preaching."
Little new concerns: parents fully understand the difficult
Little new is in Hebei Province. Have been married in the home, away from. He engaged in volunteer work for, the old couple are known, but they do not know that a small new infections every day and room and board together. Thus, small to use his real name, told reporters the new, photos, and do not be too clear. "My parents were farmers, want to make it clear they are not so terrible AIDS is difficult. So, I do not want to let them know of my situation."
(According to "Yangzi Evening News") (This article Source: Northern Daily News)
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