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同性恋相关免疫缺陷,此为媒体所创造的词语。此词既不准确,又有侵犯人权之虞,毕竟同性性行为与该疾病并无直接关联。1982年,美国疾控中心首创了后天免疫缺陷一词,也就是AIDS。整件事的细节详见:“What to call the AIDS virus?” Nature 321(1986).
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关于人类白细胞抗原及其在免疫系统中所扮演的角色,详见:Immunobiology ,5th edition,The Immune System in Health and Disease ,by Charles A Janeway Jr,Paul Travers,Mark Walport,and Mark J Shlomchik(Garland,2001).
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沃克的个人经历援引自个人访谈。
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沃克的第一篇论文为:“HIV-specific cytotoxic T lymphocytes in seropositive individuals,” Nature 328(1987).
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8 来自百分之一
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1993年国际艾滋病大会的附注可参见:“We are all Berliners:notes from the Ninth International Conference on AIDS,” American Journal of Public Health 83(1993).
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关于细胞及其在免疫系统中扮演的角色,可参见一篇相当卓越的回顾:“CD4 T cells:fates,functions,and faults,” Blood 112(2008).
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对“协和”临床试验的评判,详见:“After Concorde,” British Medical Journal 306(1993).
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“罗氏制药付你们多少钱?”是玛格丽特·费舍尔所言,撷取自:“Once We Were Warriors:Activist Corpses Borne in Protest,Furtive Legislative Coups and the Devastation That Was Berlin,” Treatment Action Group (2002).该篇文章也陈述了1993年国际艾滋病大会乃为“最让人沮丧的艾滋病会议”。
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1993年于柏林举办的第九届国际艾滋病大会的摘要与数据,可在艾滋教育全球信息系统网站中查询(http://www.aegis.org/DisaplayConf/directory.aspx?Conf=The%20International%20 AIDS%20Society-IAS)。
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沙奎那韦首度由罗氏制药发表:“Antiviral properties of Ro 31-8959,an inhibitor of human immunodeficiency virus(HIV)proteinase,” Antiviral Research 16(1991).
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关于罗氏制药开发沙奎那韦的细节,详见:Ethics and the Business of Bioscience by Margaret L. Eaton(Stanford University Press,2004).
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默克集团早期公布的(不正确的)蛋白结构,刊载于:“Three-dimensional structure of aspartyl protease from human immunodeficiency virus HIV-1,” Nature 337(1989).
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关于鸡尾酒疗法的效率,详见:“Long term effectiveness of potent antiretroviral therapy in preventing AIDS and death:A prospective cohort study,” Lancet 366(2005).
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有两篇论文指出鸡尾酒疗法可减少60%~80%的死亡:“A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less,” New England Journal of Medicine 337(1997),and “Treatment with indinavir,zidovudine,and lamivudine in adults with human immunodeficiency virus infection and prior antiretroviral therapy,” New England Journal of Medicine 337(1997).
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9 但是,医生,我不觉得自己生病了
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圣克莱医院中HIV阳性患者的相关描述,来自笔者的观察。
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关于哪个时间点进行抗病毒治疗才正确的争辩,详见:“When to start antiretroviral therapy—ready when you are?” New England Journal of Medicine 360(2009).
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HIV的感染起始为一种单一的“创始病毒”所引发,此发现震惊了整个医学界。部分人士相信此创始病毒的特性,将导向新型疫苗的开发。此事首度刊载于:“Identification and characterization of transmitted and early founder virus envelopes in primary HIV-1 infection,” Proceedings of the National Academy of Sciences 105(2008).
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T细胞如何被HIV感染,并通过何种机制遭到破坏,详见:“HIV preferentially infects HIV-specific CD4+ T cells,” Nature 417(2002).
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大部分HIV在肠道中进行复制,详见:“Getting to the guts of HIV pathogenesis,” Journal of Experimental Medicine 200(2004).
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大量研究都已在肠道及其他黏膜组织中检测出淋巴细胞的密集网络,例如:“Overview of the mucosal immune system,” Current Topics in Microbiology and Immunology 146(1989).
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关于黏膜中的淋巴细胞在H IV感染上的重要性的讨论,详见:“HIV pathogenesis:the first cut is the deepest,” Nature Immunology 6(2005).
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让人惊讶的是,不管是通过黏膜路径(直肠或阴道)感染,还是通过静脉,其细胞的减少趋势相同。详见:“Gastrointestinal tract as a major site of CD4+ T cell depletion and viral replication in SIV infection,” Science 280(1998).
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许多论文已指出感染后,肠道内的T淋巴细胞的破坏。早期发表的其中一篇:“Severe CD4+ T-cell depletion in gut lymphoid tissue during primary human immunodeficiency virus type 1 infection and substantial delay in restoration following highly active antiretroviral therapy,” Journal of Virology 77(2003).
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