Ultra Rapid Real-Time PCR에 의한 Human Immunodeficiency Virus (HIV)의 신속진단법

이동우,김을환,유미선,한상훈,윤병수,Lee, Dong-Woo,Kim, Eul-Hwan,Yoo, Mi-Sun,Han, Sang-Hoon,Yoon, Byoung-Su 한국미생물학회 2007 미생물학회지 Vol.43 No.2

인간면역결핍바이러스(Human immunodeficiency virus; HIV) 진단을 위한 다중, 초고속실시간 PCR법을 개발하였다. 검출대상의 DNA 염기서열은 env 유전자를 기반으로 설계되었으며, 각기 HIV-1 특이 495염기(gi_1184090) 및 HIV-2 특이 294염기(gi_1332355)의 DNA를 안정상의 이유로 PCR을 이용한 유전자합성법으로 제작하여 사용하였다. 초고속 실시간 PCR은, PCR의 회전 중 각 단계별 설정시간을 극단적으로 축소하여, $1\;{\mu}l$의 PCR 용액용 microchip을 탑재할 수 있는 $Genspector^{TM}$을 사용하여 수행하였다. DNA 증폭과 융점분석을 포함한 총 PCR 검색 시간은 HIV_1 및 HIV-2 모두에서 15분 이내로 완료되었으며, 각기 최소 2.3개의 합성 env 유전자로부터도 HIV-1 특이 117염기와 HIV-2 특이 119염기의 PCR산물을 성공적으로 증폭시킬 수 있는 민감성을 보여주었다. 이런 형식의 실시간 PCR법을 본 연구에서 초고속실시간 PCR (Ultra-rapid real-time PCR)이라 명명하였다. 이는 본 연구의 대상인 HIV에 대한 보조적 진단방법일 뿐 아니라 PCR 검색법이 사용되고 있는 다른 병원체에 대하여도 적용될 수 있을 것이나, 우선 HIV 임상시료에 대한 본 검색법의 효용성 실험 등 추가 연구가 필요할 것으로 사료된다. For the detection of Human Immunodeficiency Virus (HIV), multiple and ultra-rapid real-time PCR methods were developed. The target DNA sequences were deduced from HIV-1 specific 495bp partial env gene (gi_1184090) and from HIV-2 specific 294 bp partial env gene (gi_1332355), and were synthesized by using PCR-based gene synthesis on the reason of safety. Ultra-rapid real-time PCR was performed by $Genspector^{TM}$ using microchip-based, $1\;{\mu}l$ of reaction volume with extremely short time in each 3 step in PCR. The detection including DNA-amplification and melting temperature analysis was completed inner 15 minutes. The HIV-1 specific 117 bp-long and HIV-2 specific 119 bp-long PCR products were successfully amplified from minimum of template,2.3 molecules of each env gene. This kind of real-time PCR was designated as ultra-rapid real-time PCR in this study and it could be applied not only an alternative detection method against HIV, but also other pathogens using PCR-based detection.

국내 HIV/AIDS 발견이후 HIV 유행주의 분자역학적 변이 분석

이주실,김성순,남정구,전수경,변승옥,최병선,박미선,김옥진,서순덕 국립보건연구원 2000 국립보건원보 Vol.37 No.-

Markov Chain Modelling Analysis of HIV/AIDS Progression: A Race-based Forecast in the United States

Lee, S.,Ko, J.,Tan, Xi,Patel, Isha,Balkrishnan, R.,Chang, J. Medknow PublicationsMedia Pvt Ltd 2014 Indian journal of pharmaceutical sciences Vol.76 No.2

<P>HIV/AIDS has reached a pandemic level across the world with more than 33 million people who are living with HIV. In the United States, more than half a million people have been victims of AIDS. This study investigates the most vulnerable racial minority population (the African Americans) in the United States and the second least affected (the Caucasians) in order to predict the trends of the epidemic. A Markov chain analysis was used to model the progression of the disease among vulnerable people, infective people and AIDS cases for the two races separately, based on the 2009 Centers of Disease Control and Prevention HIV/AIDS Surveillance Report. Based on the Markov model, our study predicts that the number of African American people living with AIDS diagnosis and HIV infection and dead due to HIV/AIDS will be 662.2, 1225.3 and 62.9 in 2015 and 794.9, 1566.5 and 79.2 in 2030, respectively. The number of Caucasian people living with AIDS diagnosis and HIV infection and dead due to HIV/AIDS will be 96.4, 160 and 6.5 in 2015 and 118.6, 206.9 and 8.3 in 2030, respectively. The numbers of deaths due to HIV/AIDS are quite stable over the years in both the races. There is an increasing trend in the number of people living with HIV infection and AIDS diagnosis in Caucasians compared with African Americans. The absolute number of Caucasians living with AIDS diagnosis and HIV infection is quite smaller compared with African Americans. The results reveal discrepancy in HIV infection, AIDS diagnosis and deaths due to HIV/AIDS among the African Americans and the Caucasians races. There is a need for interventions focusing on HIV/AIDS prevention and management, optimum resource allocation and development of antiAIDS campaigns to reduce the infection rate.</P>

Comparison of Three Cardiovascular Risk Scores among HIV-Infected Patients in Korea: The Korea HIV/AIDS Cohort Study

배지윤,김수민,최윤수,Choi Jun Yong,김상일,김신우,박보영,최보율,최희정 대한감염학회 2022 Infection and Chemotherapy Vol.54 No.3

Background We investigated cardiovascular disease (CVD), risk factors for CVD, and applicability of the three known CVD risk equations in the Korean human immunodeficiency virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) cohort. Materials and Methods The study parcitipants were HIV-infected patients in a Korean HIV/AIDS cohort enrolled from 19 hospitals between 2006 and 2017. Data collected at entry to the cohort were analyzed. The 5-year CVD risk in each participant was calculated using three CVD risk equations: reduced CVD prediction model of HIV-specific data collection on adverse effects of anti-HIV drugs (R-DAD), Framingham general CVD risk score (FRS), and Korean Coronary Heart Disease Risk Score (KRS). Results CVD events were observed in 11 of 586 HIV-infected patients during a 5-year (median) follow-up period. The incidence of CVD was 4.11 per 1,000 person-years. Older age (64 vs. 41 years, P = 0.005) and diabetes mellitus (45.5% vs. 6.4%, P <0.001) were more frequent in patients with CVD. Using R-DAD, FRS, and KRS, 1.9%, 2.4%, and 0.7% of patients, respectively, were considered to have a very high risk (≥10%) of 5-year CVD. The discriminatory capacities of the three prediction models were good, with c-statistic values of 0.829 (P <0.001) for R-DAD, 0.824 (P <0.001) for FRS, and 0.850 (P = 0.001) for KRS. Conclusion The FRS, R-DAD, and KRS performed well in the Korean HIV/AIDS cohort. A larger cohort and a longer period of follow-up may be necessary to demonstrate the risk factors and develop an independent CVD risk prediction model specific to Korean patients with HIV. Background We investigated cardiovascular disease (CVD), risk factors for CVD, and applicability of the three known CVD risk equations in the Korean human immunodeficiency virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) cohort. Materials and Methods The study parcitipants were HIV-infected patients in a Korean HIV/AIDS cohort enrolled from 19 hospitals between 2006 and 2017. Data collected at entry to the cohort were analyzed. The 5-year CVD risk in each participant was calculated using three CVD risk equations: reduced CVD prediction model of HIV-specific data collection on adverse effects of anti-HIV drugs (R-DAD), Framingham general CVD risk score (FRS), and Korean Coronary Heart Disease Risk Score (KRS). Results CVD events were observed in 11 of 586 HIV-infected patients during a 5-year (median) follow-up period. The incidence of CVD was 4.11 per 1,000 person-years. Older age (64 vs. 41 years, P = 0.005) and diabetes mellitus (45.5% vs. 6.4%, P <0.001) were more frequent in patients with CVD. Using R-DAD, FRS, and KRS, 1.9%, 2.4%, and 0.7% of patients, respectively, were considered to have a very high risk (≥10%) of 5-year CVD. The discriminatory capacities of the three prediction models were good, with c-statistic values of 0.829 (P <0.001) for R-DAD, 0.824 (P <0.001) for FRS, and 0.850 (P = 0.001) for KRS. Conclusion The FRS, R-DAD, and KRS performed well in the Korean HIV/AIDS cohort. A larger cohort and a longer period of follow-up may be necessary to demonstrate the risk factors and develop an independent CVD risk prediction model specific to Korean patients with HIV.

국내 감염성 질환 병원체의 성상 분석을 통한 표준 실험실 체계 구축 : 우리나라의 AIDS reagent 프로그램 개발 및 국내 HIV/AIDS 물질 자원화

강춘,남정구,김성순,최병선,김옥진,김재인,이성래,구본기,서순덕,이주실,조해월 국립보건연구원 1999 국립보건원보 Vol.36 No.-

HIV/AIDS 감염인의 자존감 향상과 신체 기능 증진에 대한 개입 연구

김경하 한국정신건강사회복지학회 2008 정신보건과 사회사업 Vol.30 No.-

본 연구는 HIV/AIDS 감염인의 자존감 향상과 신체 기능 증진을 목적으로 인지행동치료를 통하여 프로그램 개입을 하였으며, 개입의 효과성을 평가하기 위하여 AB설계를 사용하였다. 본 연구에 참가 동의를 한 3명의 클라이언트는 모두 5주간의 기초선 단계와 5주간의 개입 단계에 참가하였다. 평가 결과의 타당도를 높이고자 다각적 측정원칙을 적용하였다. 기초선 및 개입 단계 동안 수집된 자료는 시각적인 방법과 통계적 방석으로 분석하였다. 시각적 분석에는 추세선과 추세지수를 활용하여 분석한 결과 클라이언트 3명 모두 자존감과 신체 기능이 개입단계에서 나아진 것으로 나타났다. 이러한 개입의 효과는 통계적 분석인 3표준편차 띠 접근을 사용한 분석에서도 3명의 클라이언트 모두 통계적으로도 아주 높게 유의미하게 나타났다. 이는 인지행동치료로 자존감 향상과 HIV/AIDS 감염인의 신체적 욕구인 신체 기능 증진 프로그램이 시너지 효과로 서로 동반 상승하여 더욱 큰 효과를 나타냈다고 할 수 있다. 본 연구는 아직 국내에 HIV/AIDS 감염인을 대상으로 하는 연구 특히 실험설계가 부족한 가운데 HIV/AIDS 감염인의 자존감 향상과 신체 기능 증진에 대한 연구가 재가 HIV/AIDS 감염인들에게는 생활의 안내가 될 수 있는 탐색적 연구의 의의를 가질 수 있다. 그리고 본 연구를 통하여 이 땅의 편견과 차별 속에 있는 HIV/AIDS 감염인들에 대한 사회복지의 제 서비스가 필요하고, HIV/AIDS 감염인들에게 효과적인 서비스가 제공될수록 그들의 삶의 질이 보다 향상되어짐을 보여주고 있다. This study has attempted to make a program intervention through the cognitive behavioral therapy in order to obtain an elevation of the self-esteem and of the infected with HIV/AIDS, and used AB Plan to evaluate the effectiveness of the intervention. All of the three clients who had agreed to participate in this study completed the 5 week basic-line course and the 5 week intervention course. The multiple- measurement principle was utilized to elevate the validity of the results. The collected data throughout the two courses were analyzed with both visual and statistical methods. The visual analysis, using a tendency line and a tendency index, shows that all of the three clients had come to increase their self-esteem and physical function. The effectiveness of the intervention was also significantly revealed from the three clients for whom the analysis by the 3 standard deviation band approach, which is statistical analysis, was utilized. It means that the cognitive behavioral therapy has contributed to the synergy between the elevation of the self-esteem and the increase of the physical function of the infected with HIV/AIDS together, causing much better results. This exploratory study may take a special place as it is providing the infected with HIV/AIDS with a guide for life while studies on the infected with HIV/AIDS or experimentation plans are lacking in Korea. This study also shows that a variety of social services for the infected with HIV/AIDS, who suffer from bias and discrimination in this country, are needed, and that the more effective the services for the infected with HIV/AIDS, the better the quality of their lives.

사람면역결핍바이러스 감염 및 후천면역결핍증후군의 예방 및 감염관리

진범식 대한의사협회 2024 대한의사협회지 Vol.67 No.3

Background: Although the global incidence of human immunodeficiency virus (HIV) has decreased significantly since modern antiretroviral therapy (ART), new HIV infections steadily occur, in the Republic of Korea. Based on the understanding of the risk factors for HIV infection, combined strategic behavioral and biomedical interventions should be implemented to reduce HIV infection. This paper reviews the strategies for the prevention of HIV infection. Current Concepts: While the consistent use of latex condoms is effective for the prevention of HIV transmission, consistent use of condoms is low among sexually active individuals. ART can be initiated, after exposure, to prevent HIV infection (post-exposure prophylaxis) after occupational or sexual exposure, injection drug use, and other nonoccupational exposures to HIV. There is a negligible risk of sexual transmission of HIV when the HIV-infected sexual partner has durably suppressed viral replication with ART. Antiretroviral agents have been shown to be highly effective when administered prophylactically to HIV-uninfected but at-risk individuals (preexposure prophylaxis). A high-risk group, such as men who have sex with men, is required to be included in health insurance care benefits for pre-exposure prophylaxis, in addition to the current partners of HIV-infected individuals, to ensure its efficacy. Discussion and Conclusion: HIV-related deaths are rapidly decreasing, but new HIV infections continue to occur. In an environment where a cure or the development of vaccines is unlikely, a multifaceted and proactive approach is required to minimize new HIV infections.

Human Immunodeficiency Virus (HIV) and Hepatitis Virus Coinfection among HIV-Infected Korean Patients: The Korea HIV/AIDS Cohort Study

김용찬,안진영,김준명,김윤정,박대원,윤영경,송준영,김신우,이진수,최보율,최윤수,최주연,한명국,강춘,최준용 대한감염학회 2017 Infection and Chemotherapy Vol.49 No.4

Background: Despite declines in mortality and morbidity rates of patients with human immunodeficiency virus (HIV) infection as the result of highly active antiretroviral therapy, liver diseases due to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are a leading cause of death among HIV-infected patients. However, HIV and HBV or HCV coinfection is still poorly documented, and more information is needed to better understand the characteristics of HIV-infected patients in Korea. Materials and Methods: A cross-sectional study was performed to investigate clinical characteristics and prevalence of HBV and HCV infection in HIV patients enrolled in the Korea HIV/acquired immune deficiency syndrome (AIDS) cohort study from 17 institutions between December 2006 and July 2013. Results: Among the 1,218 HIV-infected participants, 541 were included in this study. The prevalence of HBV-HIV and HCV-HIV coinfection was 5.0% (27/541) and 1.7% (9/541), respectively. There was no patient who was positive for both HBs antigen and HCV antibody. In multivariate logistic regression analysis, HBV unvaccinated status was a significant risk factor for HBV-HIV coinfection (odds ratio = 4.95, 95% confidence interval = 1.43–17.13). Conclusion: HBV and HCV infection was more common in HIV-infected persons enrolled in the Korean HIV/AIDS cohort, than in the general population in Korea.

일도시의 보건복지직 공무원과 일반인의 HIV/AIDS에 대한 태도와 지식에 관한 연구

김화선,최은정,양정남 한국보건사회학회 2010 보건과 사회과학 Vol.0 No.28

HIV/AIDS is recognised to be one of the most serious public health problems in recent times. It is having a profound impact on society and particularly on the lives of infected people and their families. This study explores the level of knowledge and attitude towards HIV/AIDS and the relationship between knowledge and attitude among adults from the general public, including health care officers working in the public sector in G. city, S. Korea. Data for the present analysis was obtained from a purposive sampling of health care officers who work in the public sector in G. city, S. Korea to determine their knowledge and attitude towards HIV/AIDS. The sample was composed of 240 health care officers including nurses and social workers and 204 adults from the general public. The study relied on a self-administered questionnaire. The data was collected between December 2008 and January 2009. All data was analyzed using SPSS WIN version 12.0 for technical statistics. t-Test, ANOVA and multiple regression analysis was used. The result of this study is outlined in the following:First, the result of this research showed that the average level of participants knowledge on HIV/AIDS was 84.4%. The health care officer'sscore was 87%, adults from the general public was 81% which showed that health care officer's score was higher than that of adults from the general public. Second, the outcome also showed that health care officers generally had a more positive attitude about HIV/AIDS patients than adults from the general public but it was not significant. Third, the result of this study showed that there is a positive corelation between participant's attitudes towards HIV/AIDS and their level of knowledge. Fourth, the results also showed that knowledge on HIV/AIDS is the most important influential factor towards participant's attitude. This result has important implications for future education programs designed for health care officers in the public sector including nurses and social workers. 최근 HIV/AIDS는 가장 심각한 공중 보건 문제들 중 하나로 인식되고 있으며, 감염인과 그 가족들은 물론 사회전반에 심각한 영향을 주는 보건복지의 문제이다. 본 연구는 G광역시의 보건복지직 공무원과 일반인들의 HIV/AIDS에 대한 지식과 태도 수준, 그리고 지식과 태도 사이의 관계에대해 연구하였다. HIV/AIDS에 대한 지식과 태도를 측정하기 위해 분석에 사용된 자료는 G광역시의 보건복지직 공무원과 일반인을 대상으로 편의표집되었다. 표본은 보건직과 사회복지직을 포함하여 보건복지직 공무원 240명, 일반인 204명으로 구성되었고, 구조화된 질문지에 자기기입 하도록 하였으며, 자료수집 시기는 2009년 1월이었다. 전체 자료는 SPSS Win 12.0을 사용하여 기술통계, t-Test, ANOVA, 다중회귀분석을 통해 분석되었다. 본 연구의 결과를 정리하면 다음과 같다: 첫째, HIV/AIDS에 대한 대상자들의 지식의 평균 정답률은 84.4%였다. 보건복지직 공무원은87%, 일반인은 81%로 보건복지직 공무원이 일반인보다 지식에 대한 평균 정답률이 더 높은 것으로 나타났다. 둘째, 보건복지직 공무원이 일반인보다 HIV/AIDS 감염인에 대해 더 긍정적인 태도를 가지는 것으로 나타났으나, 통계적으로 유의미하지는 않았다. 셋째, HIV/AIDS에 대한 대상자들의 태도와 지식 수준 사이에는 긍정적인 상관관계가 있는 것으로 나타났다. 넷째, HIV/AIDS에대한 지식이 대상자들의 태도에 가장 중요한 영향 요인인 것으로 나타났다. 이러한 연구결과는 보건복지직 공무원에 대한 향후 교육 프로그램 개발과 체계구축에 중요한 함의를 가지고 있고 본다.

Cost-Effectiveness of Voluntary HIV Testing Strategies in a Very Low-Prevalence Country, the Republic of Korea

Lee, Young Hwa,Bang, Ji Hwan,Park, Sang Min,Kang, Cho Ryok,Cho, Sung-Il,Oh, Myoung-don,Lee, Jong-Koo KOREAN ACADEMY OF MEDICAL SCIENCE 2018 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.33 No.46

<P><B>Background</B></P><P>The Republic of Korea has a very low prevalence of human immunodeficiency virus (HIV) infection, but the number of new HIV diagnoses has steadily risen, strongly indicating a large number of undetected HIV infections. Thus, it is important for Korean public health authorities to adopt and encourage cost-effective HIV detection tools, such as rapid HIV screening tests. In this study, we aimed to evaluate the cost-effectiveness of enzyme-linked immunosorbent assays (ELISA) and rapid tests in a public health center (PHC) setting.</P><P><B>Methods</B></P><P>We developed a decision analytic model to assess the per-examinee cost and the cost-effectiveness of identifying HIV patients in a PHC setting using two HIV testing strategies: conventional HIV screening by ELISA versus rapid HIV testing. Analysis was performed in two scenarios: HIV testing in an average-risk population and in a high-risk population.</P><P><B>Results</B></P><P>Compared to the ELISA, the rapid test was cost-saving and cost-effective. The per-examinee cost was USD 1.61 with rapid testing versus USD 3.38 with ELISA in an average-risk population, and USD 4.77 with rapid testing versus USD 7.62 with ELISA in a high-risk population. The cost of identifying a previously undiagnosed HIV case was USD 26,974 with rapid testing versus USD 42,237 with ELISA in an average-risk population, and USD 153 with rapid testing versus USD 183 with ELISA in a high-risk population.</P><P><B>Conclusion</B></P><P>Rapid testing would be more cost-effective than using conventional ELISA testing for identifying previously undiagnosed HIV-infected cases in Korea, a country with extremely low HIV prevalence.</P>