医学英语—HIV的传播与预防.docx

医学英语—HIV的传播与预防Transmission　　HIV transmission requires contact with body fluids containing infected cells or plasma. HIV may be present in any fluid or exudate that contains plasma or lymphocytes, specifically blood, semen, vaginal secretions, breast milk, saliva, or wound exudates. Although theoretically possible, transmission by saliva or droplet nuclei produced by coughing or sneezing is extremely rare, if it occurs. HIV is not transmitted by casual contact or even by the close nonsexual contact that occurs at work, school, or home. The most common means of transmission is direct transfer of bodily fluids either through sharing contaminated needles or sexual relations.　　传播　　HIV的传播必须要有与含感染细胞或血浆体液的干脆接触。

HIV可存在于任何含血浆或淋巴细胞的液体或渗出液中，特殊是血液、精液、阴道分泌液、母乳、唾液或伤口渗出液虽然从理论上讲有这种可能性，但在实际中，通过咳嗽或喷嚏唾液或飞沫传播的情形极其罕见在工作场所、学校或家里的平常接触甚或亲密的非性接触都不会传播HIV最觉见的传播途径是共用注射器或性关系所带来的干脆的全液沟通　　Sexual practices involving no exposure to bodily fluids are safe. Other practices, such as fellatio and cunnilingus appear to be relatively, but not absolutely, safe. The greatest risk is through genital intercourse, especially anal-receptive intercourse. Sexual practices producing mucosal trauma before or during intercourse increase the risk. Use of latex condoms or vaginal barriers decreases but does not eliminate risk. Oil-based lubricants decrease the protection provided by latex condoms because they dissolve them.　　无体液接触的性生活是平安的。

其他如口*或舐阴等性方式则相对而非肯定平安最危急的是生殖器性交，尤其是的接受方性交前或性交中的粘膜破损会增加危急性运用乳胶避孕套或子宫帽可降低但不能消退这种危急因为润滑油会溶解乳胶，所以，也会降低避孕套的爱护作用　　Infected cells or free virions can reach target cells in a new host via blood transfusion, accidental injection, or mucous membrane exposure. The role of mucous membrane inflammation is illustrated by the effect of other sexually transmitted diseases (STDs) on susceptibility to HIV infection. HIV transmission is definitely increased by chancroid and may be more likely in the presence of herpes, syphilis, trichomoniasis, and possibly other STDs.　　感染细胞或游离病毒体可经由输血、意外注射或粘膜暴露到达新宿主的靶细胞。

粘膜炎症所起的作用与其他性传病（STD）医学教.育网搜集和HIV感染易感性的作用相同软下疳确定会增加HIV的传播性，单纯疱疹、梅毒、滴虫病和其他STD感染更可能引发HIV传播　　Transmission of HIV by needle-stick injury, estimated at about 1/300 incidents, is much less frequent than transmission of hepatitis B, presumably because of the relatively lower number of HIV virions in the blood of most infected patients. Risk of HIV transmission appears to be increased by deep wounds or injection of blood, such as when hollow-bore needles containing blood penetrate the skin.　　由针刺损伤导致的HIV传播发生率估计为1/300，远低于乙型肝炎，这可能是由于大多数感染者血液中的HIV病毒数量相对较少的原故。

深部创口或注入血液，如含有血液的中空针头刺入皮肤，都可增加HIV的传播危急　　Use of enzyme-linked immunosorbent assay (ELISA) to screen blood donors has vastly reduced the risk of acquiring HIV by transfusion. However, persons in the early stages of HIV infection, who have not yet mounted an antibody response, may have transiently negative ELISA and Western blot results while yielding positive results for HIV p24 antigen in plasma. These persons may account for the very low, but continuing, risk of transfusion-associated HIV infection (estimated at between 1/10,000 and 1/101,000 per unit transfused). Currently mandated screening for both antibody and p24 antigen may further reduce this risk.　　用酶联免疫吸附试验（ELISA）方法对供血者进行筛检，已大大降低了输血引起的HIV感染危急。

不过，HIV感染早期的供血者，在尚未产生抗体应答时，他们的ELISA和Westernblot结果短暂均为阴性，而血浆HIVp24抗原检查则为阳性这些供血者可能造成特别低、但依旧存在的输血相关性HIV感染危急（估计介于1/1万～1/10万之间）近来采纳同时进行抗体和p24抗原筛检的方法可进一步降低危急性　　Prevention　　Multiple strategies are being developed to induce protective immunity in persons not infected with HIV. Immunogens include attenuated live and whole killed HIV, genetically engineered HIV proteins and peptides (e.g., from the viral envelope), and vaccinia virus genetically modified to express HIV viral proteins. These efforts are hampered by the lack of a measurable marker of protective immunity, such as the neutralizing antibody engendered by polio vaccine, or of a convenient animal model. Nevertheless, vaccines continue to be developed and tested for safety and immunogenicity.　　传播的预防　　正在研制多种方法来诱导未感染HIV者的免疫爱护功能。

免疫原包括减毒HIV活病毒或完全灭活HIV病毒，因工程HIV蛋白和肽（如取自病毒包膜的），和基因修饰后表达HIV蛋白质的牛痘病毒这些工作都因缺少可计量的免疫爱护标记物而受阻，如灰髓炎疫苗能产生中和抗体；另外也没有合适的动物模型尽管如此，疫苗探讨仍在进行并在作平安性和免疫遗传学试验　　All pregnant women should be offered a test for antibody to HIV. HIV-infected women should be advised to consider deferring pregnancy at least until management of HIV in pregnancy is better studied. The risk of transmission in utero, intrapartum, or postpartum transmission to the fetus is estimated to be 30 to 50%, but zidovudine (ZDV or AZT) alone reduces intrapartum infection by 2/3, and combinations of drugs may be more effective. Given the low, but real, risk of transmission even with treatment and the uncertainty of the effects on the fetus of drugs needed for their own health, termination of pregnancy may be an alternative for many HIV-infected pregnant women.　　全部妊娠妇女都应进行HIV抗体试验。

应劝说HIV感染女性推迟怀孕，至少要等到妊娠期HIV处理已有了更好的探讨结果后据估计，胎儿在宫内、产程中或。