Initiatives to Improve the Quality of Life of HIV Positive Diagnosed Subjects: A Review of Diagnosis, Prognosis and Therapeutics under the Light of Science and Ethics

M. Molina, Jeremías Abou Medelej, Jorgelina Zucchi, C. Manassero
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Abstract

The first cases of AIDS occurred about 1981. There are not fully appropriate therapeutic interventions for treating this medical condition. People who are diagnosed HIV-positive or with AIDS suffer a poor quality of life and receive medication that produces severe adverse reactions. We have analyzed a significant number of papers published in several countries on these topics, and we have found various inconsistencies: - HIV risk behaviors: According to the Centers for Disease Control and Prevention, in the United States, the Estimated Per-Act Probability of Acquiring HIV from an Infected Source, by Exposure Act (heterosexual) is about one in one thousand for women and about one in two thousand for men. Nevertheless, in an investigation conducted through the University of San Francisco, California, on 442 discordant heterosexual couples no seroconversions were observed throughout the ten years the research lasted. (1985-1995). No other study of similar characteristics has been conducted ever since. - Diagnostics methods: In Argentina, we employ the ELISA screening method, subsequently confirmed by a Western Blot test, but in the United Stated this last is discouraged since 2014. - Medication: Many of the drugs that are used to treat HIV are DNA chain terminators which interfere with the normal functioning and replication of normal cells. As a result, damage in the immune system and the mitochondrial DNA are reported very frequently. We ask the scientific community what we should inform the patients about all these. We urge the experts´ opinion on the ethical management aspects. Since the diagnostic tests employed may result in false positives and the fact that the medication is highly toxic, we recommend that patients with HIV positive diagnosis fully re-test their condition at least once a year to minimize eventual diagnostic errors, suspending specific medications in case of discrepancies on the testing results.
提高HIV阳性患者生活质量的举措:科学与伦理视野下的诊断、预后和治疗学综述
第一例艾滋病发生在1981年左右。目前还没有完全适当的治疗干预措施来治疗这种疾病。被诊断为艾滋病毒阳性或艾滋病患者的生活质量很差,接受的药物会产生严重的不良反应。我们分析了几个国家发表的关于这些主题的大量论文,我们发现了各种不一致之处:-艾滋病毒风险行为:根据疾病控制和预防中心的数据,在美国,通过暴露法(异性恋)从感染源感染艾滋病毒的估计每次行为概率约为女性的千分之一,男性的千分之一。然而,在加州旧金山大学进行的一项调查中,对442对不和谐的异性恋夫妇进行了调查,在研究持续的十年中,没有观察到任何性关系转变。(1985 - 1995)。从那以后,再没有其他类似特征的研究。-诊断方法:在阿根廷,我们采用ELISA筛选方法,随后通过Western Blot测试确认,但在美国,自2014年以来,最后一种方法不被鼓励。-药物治疗:许多用于治疗HIV的药物是DNA链终止剂,会干扰正常细胞的正常功能和复制。因此,免疫系统和线粒体DNA的损伤被报道得非常频繁。我们询问科学界关于这些我们应该告诉病人什么。我们敦促专家就道德管理方面发表意见。由于所采用的诊断测试可能导致假阳性,而且药物具有高毒性,因此我们建议诊断为艾滋病毒阳性的患者每年至少对其病情进行一次全面重新测试,以尽量减少最终的诊断错误,如果测试结果不一致,则暂停使用特定药物。
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