请问艾滋病感染者可能会被第二次感染不同类型的hiv病毒吗？

舞茸β-葡聚糖对HIV（艾滋病）病人的效果

Effects of Maitake (Grifola frondosa) gulcan in HIV-infected patients

摘要翻译

    为评估一种从舞茸中提取的β-葡聚糖MD-Fraction（舞茸D-fraction）对艾滋病（HIV）感染病人的效果，进行了长期的实验。参与实验的HIV感染者被跟踪监测CD4+ 细胞计数，病毒载量，艾滋病感染症状，继发病状况，以及健康状态。20位患者的CD4+细胞计数增加到原来的14-18倍，8位患者降低到原来的08-05倍。9位病人的病毒载量增加，10位降低。尽管如此，85%的受试者对于HIV引起的症状和继发病的感觉变好，这表明舞茸D-fraction对于艾滋病HIV患者具有积极的影响。

关键词： 抗HIV活性，CD4+细胞，舞茸，IL-2，MD-Fraction

注：CD4+细胞是人体免疫系统中的一种重要免疫细胞，由于艾滋病病毒攻击对象是CD4+细胞，所以其检测结果对艾滋病治疗效果的判断和对患者免疫功能的判断有重要作用。

论文原文

        Effects of Maitake (Grifola frondosa) gulcan in HIV-infected patients

Hiroaki Nanba1), Noriko Kodama1), Douglas Schar 2) and Denise Turner 2)

1)Department of Microbial Chemistry, Kobe Pharmaceutical University, 4-19-1,

Motoyamakita-machi, Higashinada-ku, kobe 658-8558, Japan

2)Herbal Clinical Research, 140 Columbia Road, London E2 7RG, UK

The effects of MD-Fraction, a β-glucan extracted from Maitake mushroom (Grifola frondosa)， on the health status of individuals suffering from HIV infection were evaluated in a long-term trial The HIV status of the 35 respondents who participated in the study was followed by monitoring CD4+ cell counts, viral load measure, sympotoms of HIV infection, status of secondary disease, and sense of well-being Twenty patients reported to increase in CD4+ cell counts to 14-18 times, and 8 patients reported a decrease to 08-05 times Viral load was reported to increase in 9 patients and decrease in 10 patients However, 85% of respondents reported an increased sense of well-being with regard to various symptoms and secondary diseases caused by HIV These results suggest that Maitake D-Fraction had a positive impact in HIV patients

Key Words : anti-HIV activity; CD4+ cell; Grifola frondosa (Maitake); IL-2; MD-Fraction

Acquired immune deficiency syndrome (AIDS) is caused by HIV infection, which attacks helper T cells (CD4+ cells) and decreases the body’s immunity In 1991, we studied the effect of a Grifola frondosa SF Gray (Maitake) extract, named MD-Fraction on HIV, which is believed to be a cause of AIDS Sulfated MD-Fraction was found to prevent HIV from killing helper T (CD4+) cells: almost 100% of CD4+ cells survived challenge by HIV at concentrations of sulfated MD-Fraction of around 1 pg/ml, and the results were presented in an abstract paper at the 8th International AIDS conference in Amsterdam in July 1992 National Institute of Health and National Cancer Institute in USA also confirmed the anti-HIV activity of the sulfated form of MD-Fraction NCI doctors have recognized that the sulfated MD-Fraction is the most effective among all anti-HIV polysaccharides known to date and is as powerful as the drug azidothymidine (AZT) However, the sulfated MD-Fraction has the strong side-effect of toxicity to cells in vivo On the other hand, we have reported that a β1,6-glucan having a β 1,3-branched chain (named MD-Fraction) can enhance immunocompent cell activities (Hishida et al, 1988; Nanba et al, 1987; Nanba et al, 1993)In this paper, we report that Maitake appears to work on several levels in HIV conditions, by (a) direct inhibition of the human immunodeficiency virus (HIV), (b) stimulation of the body’s own natural defense system against HIV, and (c) making the body less vulnerable to opportunistic disease

Materials and Methods：

Preparation of Maitake tablets  Tablets containing 250 mg of dried Maitake powder(φ200 μm) and 5 mg of vitamin C were prepared with a tabloid machinePreparation of MD-Fraction  Dried Maitake powder (500 g) was autclaved with 3,000 ml of distilled water at 120℃ for 60 min, and the water-soluble layer obtained was saturated with the same volume of ethanol at 4℃ for 12 h After removal of floating material, this ethanol solution was saturated to 80% with ethanol and stored at 4℃ for 10 h The pellet obtained by centrifugation at 5,000×g for 20 min was suspended in a small volume of distilled water and protein was removed by passage through a DEAE-cellulofine column (4×80cm) Finally 1 g of purified MD-Fraction was prepared

Detection of virions  The HIV genome is known to have nine genes, three expressing structural protein and six expressing regulating protein Anti-HIV-Env antibody was produced in blood from 10 wk to 12 yr after HIV infection The coagulation test of antigen was performed with HIV-Env antibody collected from blood Viral loads were counted in 50-μl portions of patients’ serumDetection of interleukin-2 (IL-2)  Production of IL-2 in blood was detected with IL-2 ELISA Kit Intertest-2X (Genzyme Co USA)Counting of CD4+ cells and CD8+ cells  CD4+ cells were counted by flow cytometric analysis after treatment of 10 μl of blood with CD4+- monoclonal antibody (Cytovax Biotechologies Inc) The count of CD8+ cells was obtained by subtracting the CD4+ cell count from the total count of T cells determined by flow cytometric analysis

Administration of Maitake  A supply of Maitake was given to each HIV carrier at a dose level of 6 g of tablets or 20mg of purified MD-Fraction together with 4 g of tablets per day for 360d

Results：

The main focus in monitoring the progress of HIV disease is CD4+ cells (helper T cells) The normal range of CD4+ cell count is 500-1,200 cells/10μl of blood A level of 200-500 cells indicates that some damage has occured Below 200 cells, the individual is highly susceptible to secondary diseases An elevated viral load indicates an increased risk of damage to CD4+ cells The significance of these activities in regard to HIV infection relates to the immune system Both IL-2 and interferon are activated by the immune system response to infection by viral disease After administration of Maitake tablets for 12 mo to 35 respondents (24 in England and 11 in USA), 20 responders reported an increase in CD4+ cell counts and 8 reported a decrease , as shown in Table 1 Nine respondents reported an increase in viral load, 10 reported a decrease and 2 patients reported static, Typical individual results were as follows

Patient A  The initial CD4+ count of 90 cells rose as high as 460 cells (average CD4+ count: 355) in the study period, but viral load was undetected throughout Previous symptoms were Kaposi’s sarcoma, pneumocystis carinii pneumonia, and allergic conjunctivitis, all of which resolved and remained controlled during study period The patient consistently reported feeling very well and energy levels much improvedPatient B  The initial CD4+ count of 400 cells rose to 620 cells after the treatment The viral load of 15,200 copies/ml in CD4+ cells decreased to 5,000 copies/ml IL-2 production was also increased 31 times by Maitake treatment Previous symptoms were Kaposi’s sarcoma, verrucae, anal warts, anal herpes, diarrhea, chest infections, and fatigue Following the study period, when the patient received 6 g of Maitake tablets together with 20mg of MD-Fraction per day, Kaposi’s sarcoma became static, verrucae and anal warts were resolved, and other symptoms became intermittent

Patient C  The initial CD4+ count of 510 cells showed little change at 500 cells after the study, but the viral load of 60,000 copies/ml in CD4+ cell decreased to 1,000 copies/ml The patient had day and night sweats, bouts of colds, mucous membrane irritation and fatigue as previous symptoms, but after the course of Maitake all symptoms were resolved In particular, a direct effect on the sweats was observedPatient D  The initial CD4+ count of 425 rose to 680 counts (average 5133) during the study The viral load of 20,000 copies/ml increased to 93,000 copies/ml, but skin, oral, and gastric Candida, catarrh, irritable bowel, and aching muscles as previous symptoms were all improved by MaitakePatient E  The initial CD4+ count of 17 cells decreased to 7 cells during the study, while the viral load of 55,000 copies/ml increased to 62,000 copies/ml AIDS, oral Candida, and wasting disease as previous symptoms persisted despite the treatment with Maitake The CD4+ cell counts and HIV viral loads of other patients who received Maitake for 1 yr are shown in Tables 2 and 3 It is known that long infection period of HIV makes seriously symptoms and secondary disease Therefore, as shown in Tables 4 and 5, we examined that these symptoms and diseases were improved by Maitake treatment Symptoms depends on HIV infection, such as weight loss, hair loss, night sweat, fever, dry cough and leg pain, were improved by Maitake almost in 50% of patients (as Table 4), also secondary diseases, such as toxoplasmosis, cryptococcosis, herps, kaposi’s sarcoma and mycopathy, were cured in 40-50% of patients Table 6 indicates that the percentage of patients reporting changes in symptoms and sense of well-being following treatment

Discussion ：

The MD-Fraction exhibited an enhancing effect on CD4+ cells, the target cells of HIV, upon oral administration in animals (Hishida et al, 1988) Even though it was a non-controlled trial, this clinical study indicated that MD-Fraction and Maitake powder were effective in patients with breast cancer, lung cancer, or liver cancer These human tests suggest that the active ingredients of Maitake have significant healing and preventative potential in HIV-responders by stimulating the immune system The present study indicates that when MD-Fraction and Maitake enhanced the activities of immuno-competent cells such as macrophages, cytotoxic T cells (CD8+) or helper T cell (CD4+), the HIV in CD4+ cells was directly killed or its multiplication was suppressed However, even if these cellular activities were increased by MD-Fraction, HIV in CD4+ cells of AIDS patients did not decrease All of the results shown here indicate that there is evidence to support a more structured investigation in to the potential benefits of Maitake and MD-Fraction in the treatment of HIV infection The results also indicate that this trial study needs to be done on a larger scales, as many questions remain unanswered

Literature cited：

Hishida I, Nanba H And Kuroda H 1988 Anti-tumor activity exhibited by oral administered extract from fruit body of Grifola frondosa (Maitake) Chem Pharm Bull 36:1819-1827

Nanba H, Hamaguchi A and Kuroda H 1987 The chemical structure of an anti-tumorpolysaccharide in fruit bodies of Grifola frondosa (Maitake) Chem Pharm Bull 35: 1162-1168

Nanba H and George S R 1993 Effects of Maitake (Grifola frondosa) for HIV-positive or fibroid tumor patients 113th Congr Pharmaceutical Society of Japan, Osaka, Japan, March 29-31, p212

Nanba H1993 Anti-tumor activity of orally administered D-Fraction from Maitake mushroom Grifola frondosa J Naturopath Med 4: 10-15

艾滋病传播模型的研究

摘 要：艾滋病是人体的免疫系统被艾滋病病毒破坏，使人体对威胁生命的各种病原体丧失

了抵抗能力，从而发生多种感染或肿瘤，最后导致死亡的一种严重传染病。国际医学界至今

尚无防治艾滋病的有效药物和疗法。因此，做好艾滋病的有效预防和控制应是我们抗击艾滋

病最有效的手段。本文通过建立参数规划数学模型以Matlab 软件包为工具平台研究艾滋病

的传播过程及流行趁向，期望能为政府做好新时期艾滋病预防控制工作提供理论参考。

关键词：艾滋病；传播模型；参数规划；MATLAB

中图分类号： O2218 文献标识码： A

0 引言

艾滋病在世界范围内的传播越来越迅猛，严重威胁着人类的健康和社会的发展，已成

为威胁人们健康的第四大杀手。联合国艾滋病规划署2006 年5 月30 日宣布自1981 年6 月

首次确认艾滋病以来，25 年间全球累计有6500 万人感染艾滋病毒，其中250 万人死亡。尤

其忧虑的是，全世界约95%的艾滋病患者来自防治能力薄弱的发展中国家，如非洲、南亚、

东南亚、中美洲等地。在我国，《中国艾滋病防治联合评估报告（2007）》显示，截至2007

年底，现存艾滋病毒感染者和病人约70 万。疫情处于总体低流行、特定人群和局部地区高

流行态势，性传播逐渐成为HIV 主要传播途径，意味着艾滋病防控形势更加严峻。未来我

国艾滋病的流行是趁向平稳还是快速增长，取决于能否大面积地积极开展艾滋病预防活动以

及提供有效的治疗。

建立数学模型研究流行病的发展机理和传播过程，已有一个多世纪的历史，艾滋病出现

以后，更引起了生物数学家们的注意，且在这方面做了较多的研究。本文就是在前人的研究

基础上，通过建立参数规划数学模型借助Matlab 软件包为工具对一个艾滋病传播模型的探

讨，期望能为政府做好我国新时期艾滋病预防和控制工作提供理论参考。

1 艾滋病简介

艾滋病的医学中文全名为“获得性免疫缺损综合症”，英文全名为“Acquired Immuno

Deficieney Syndrome”，简称AIDS，它是由艾滋病（中英文全名为“人体免疫缺损病毒”、

“Human Immunodeficiency Virus”，简称HIV）引起的。这种病毒终身传染，破坏人的免疫系

统，使人体丧失抵抗各种疾病的能力，从而严重危害人的生命[1]。

HIV 进入人体后，它就把人体免疫系统中最重要的CD4+T 淋巴细胞作为攻击目标，大

量吞噬、破坏CD4+T 淋巴细胞，从而破坏人的免疫系统，最终使人体免疫系统崩溃，使人

体因丧失对各种疾病的抵抗能力而发病并死亡。AIDS 从感染到发作的进程大致可分3 个阶

段：感染初期、潜伏期、发作期。在感染初期，HIV 进入人体的感染巨噬细胞，将病毒带到

局部淋巴结，引起各种急性症状，接着，CD8+T 淋巴细胞、抗体做出反应，从而控制疾病

的发展，血液中的HIV 持续在一个较稳定的水平，疾病进入潜伏期。随着HIV 对巨噬细胞、

CD4+T 细胞等的感染，免疫系统逐步被破坏，被感染的CD4+T 细胞由裂解而大量产生HIV。

1本课题获广西教育科研立项项目“离散空间的模糊多属性决策理论与方法研究”（No200707LX037）的资助。

- 2 -

当正常的CD4+T 细胞急剧减少、HIV 迅速增加时，病情发作，随时出现的各种病原体都可

能引起感染，病人最后因各种机能衰竭而死亡。

一般在未治疗情况下，AIDS 从感染到发作的平均时间约为10 年，但是不同的病人的

差异较大，临床上可观察到2 到18 年的潜伏期，这主要取决于CD4+T 细胞浓度下降和HIV

浓度上升的速度。通常健康人每1mm3 血液中平均有1000 个CD4+T 细胞，当HIV 的携带者

的CD4+T 细胞降至200 个/mm3 时，疾病发作。

2 艾滋病传播模型

艾滋病传播途径主要有性传播、血液传播、共用针具的传播和母婴传播等四种，其中性

传播已成为当今艾滋病传播的主要途径。故下面的模型主要研究通过性活动引起AISD 的传

播 ，通过其他因素引起的传播可以建立类似的模型。

21 模型建立

将目标人群（具有性活动者）分为3 类，x(t)为t 年易感染的人数，y(t)为被HIV 感染

的人数，z(t)为已患AIDS 的人数，在没有特定目标的情况下，假定x,y,z 的初始值分别为

15×106,3×106,005×106。参照其它传染病的传播模型及参数规划模型案例得到模型为[2]，[3]

( ) , 1 s c x

dt

dx = − λ + μ (1)

( ) , 2 c x y

dt

dy = λ − γ + μ (2)

( ) , 3 y z

dt

dz = γ − μ +δ (3)

其中各个参数的定义及其定值如下：s ～易感染者加入目标人群的速率（106/年）；c ～

获得新的性伴侣的平均速率（2/年）；λ ～性伴侣被HIV 感染者的概率（02）； 1

μ ～易感染

者退出目标人群的比例（0025/年）；γ ～HIV 感染者进入AIDS 的比例（01/年）； 2 μ ～HIV

感染者退出目标人群的比例（0025/年）； 3 μ ～AIDS 退出目标人群的比例（0025/年）；δ ～

AIDS 死亡的比例（095/年）。

虽然线性常系数微分方程（1）～（3）有解析解，可是我们只想了解数值结果和观察直

观的变化趁势，于是在上面的参数和初值下运用Matlab75 软件包[4]求数值解便得到了图1。

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可以看出，人们最关心的被HIV 感染的人数y 在约5 年时达到最大值约1200 万，20

年后趁向稳定值约750 万。

22 模型分析

由劳斯-霍尔维茨（Routh-Hurwitz）判据，容易得到方程（1）～（3）的唯一平衡点是

,

1

λ + μ

=

c

x s ,

2

y c x

γ μ

λ

+

=

3

z y

μ δ

γ

+

= 。 （4）

因为方程（1）～（3）的3 个特征根均为负值，所以平衡点是全局稳定的，与初始值无关。

稳态下HIV 感染者在目标人群中的比例为

λ

γ μ

μ δ

γ

β

c

x y z

y

2

3

1

1

+

+

+

+

=

+ +

= (5)

当一个参数值增加时引起平衡点3 个坐标及β 值的变化见下表1（如γ 增加时，x 不变，y

减少， z 增加，β 减少）。

表1 一个参数值增加时引起3 个坐标及β 值的变化情况

参数 x y z β

s ↑ ↑ ↑ ￣

λ ↓ ↑ ↑ ↑

c ↓ ↑ ↑ ↑

γ ￣ ↓ ↑ ↓

图1 方程（1）～（3）的数值解

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1 μ

↓ ↓ ↓ ￣

2 μ ￣ ↓ ↓ ↓

3 μ ￣ ￣ ↓ ↑

δ ￣ ￣ ↓ ↑

由于平衡点的全局稳定性，所以只要采取适当措施使各个参数向正确的方向（增加或减

少）改变，长期说来就可以使HIV 感染者和AISD 的人数减少，而不管目前情况如何。

23 接种疫苗模型

用弱化的HIV 作疫苗帮助人体建立对病毒的免疫性，是一种人为的干预措施，为了建

立这种情况

模型，需要增加两个函数：目标人群中接种疫苗的人数( ) 1 y t ，接种疫苗后又被病毒感染的

人数( ) 2 y t ，假定1 y ， 2 y 的初始值分别为1000 和0。模型为

(1 ) ( ) , 1 1 p s c c x

dt

dx = − − λ + λ + μ （6）

( ) , 2 c x y

dt

dy = λ − γ + μ （7）

(1 ) ( ) , 1 1 1 4 1

1 ps c x c y y

dt

dy = + λ − −ϕ λ − γ + μ （8）

(1 ) ( ) , 1 2 5 2

2 c y y

dt

dy = −ϕ λ − γ + μ （9）

( ) , 1 1 2 2 3 y y y z

dt

dz = γ +γ +γ − μ +δ （10）

其中新增加的参数及其设定值如下： p ～目标人群接种疫苗的比例（04）； 1

λ ～性伴

侣接种疫苗的概率（05）；ϕ ～接种疫苗后起到预防作用的概率（093）； 1 γ ～接种疫苗者

进入AIDS 的比例（0005/年）； 4 μ ～接种疫苗人群退出目标人群的比例（0025/年）； 2 γ ～

接种疫苗者被病毒感染进入AIDS 的比例（095/年）； 5 μ ～接种者被病毒感染退出目标人群

的比例（0025/年）。

虽然接种疫苗还不能预防HIV 的初期感染，但是我们可以作简单的计算来预测如果疫

苗取得进展后的效果[4]。 比如在p =04，ϕ =093 的情况下利用Matlab75 软件包求（6）～

（10）的数值解即得到图2，从图2 可以看出，被HIV 感染的人数y 在约3 年时达到最大值

约600 万，比模型（1）～（3）的结果

减少了一半，20 年后趁向稳定值约200 万，比模型（1）～（3）的结果减少得更多。

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24 结论分析

上面这个艾滋病传播模型概念上虽然较简单，但涉及到的参数很多，对于这些模型来说，

关键在于如何确定其中的参数。应用它的主要困难是确定用于特定国家或地区的一组参数，

虽然乌干达等非洲国家已经在这方面做了大量的统计研究，但是目前还不能得到确定这些参

数的较有效方法，另外，在临床上较精确地得到被HIV 感染的和已患AIDS 的人数也是困

难的。

3 结束语

尽管目前我国艾滋病的疫情上升速度有所减缓，还没有出现艾滋病大规模流行之势，

但是我们要清醒地看到，疫情存在潜在的流行趁势，HIV 的传播途径已演变成以性传播途径

为主，已经与国际上的流行趁势一样，艾滋病疫情地区分布差异大，艾滋病流行因素广泛存

在，局势越来越严峻，一触即发，并可能出现灾难性后果。因此，从现在到本世纪末将是我

国预防控制艾滋病的关键时期，如果我们现在不积极采取预防控制措施，将错失良机。

当务之急是要全面了解我国艾滋病传播途径的变化、流行趁势、受影响人群有关的危险

行为等情况，建立一个有效的监测系统，为决策者提供有关艾滋病传播的准确数据，预测艾

滋病流行疫情和趁势，为全国艾滋病规划策略的制定提供依据。随着艾滋病在我国不同地区

不断蔓延扩大，其流行模式将变得越来越复杂。因此，我们的监测系统不仅仅是数据的收集，

而应当注重数据的分析以帮助对策的制定。

图2 方程（6）～（10）的数值解

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参考文献

[1]曹毅警惕艾滋病[M] 北京:清华大学出版社,2005

[2]谭永基,蔡志杰 数学模型[M]上海:复旦大学出版社,2005 310～320

[3] Christelle,Christian Prins, Marc Sevaux运筹学案例[M] 北京:北京林森科技发展有限公司,2007

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Model of the spread of AIDS on the basis of estimation

programming

Zhu Jiarong

Nanning Teacher’s College,Department of Mathematics & Computer Science, P RChina

Guangxi Province, CongZuo（532200）

Abstract

AIDS is a serious infectious disease,it’s caused by HIV infection, which damage the body’s immune

system and make the body losing their resistance to various life-threatening pathogens International

medical profession has no effective drugs and treatments of preventing or healing AIDS Therefore, do

a good job in AIDS prevention and control should the most effective means to fight AIDS Our paper

discussed the process of AIDS’ spreading by establishing math model about estimation programming

based on Matlab, and except the government can take it as a reference for AIDS prevention in the new

era

如果是不同种类的HIV型，是有可能第二次感染的，但其危险性尚未有定论。

有不少患者是同时感染了两种HIV亚型的，可能是一次性感染的两种，也可能是先感染了一种，后来又感染了另外一种。

因此美国的专家建议，即便是HIV感染者寻求同样也是感染者的性伴侣，也要使用安全套，否则的话有可能被不同的亚型再次感染。混合感染有可能加大治疗的难度。

但是根据你的情况，KJ感染HIV的几率很小，不用过于担心。

参考：

Choosingpartners with like HIV status, such as infected person choosing partners known

to also have HIV, is called “serosorting” The safety of serosorting with

respect to HIV isn’t really known There are different strains of HIV and it

may be possible to catch a second HIV infection, perhaps one that is

drug-resistant and might not respond well to standard treatment of HIV/ADIS

Equally important, even with serosorting, unprotected sex still carries the

risk of passing STDs, such as gonorrhea, chlamydia, syphilis, and herpes In

fact, at present there is a massive epidemic of syphilis occurring in

HIV-infected gay men in the US and other industrialized countries, probably

caused in part by serosorting according to HIV status

以上就是关于浙江中医院违规 *** 作致5名患者被感染艾滋，你怎么看全部的内容，包括:浙江中医院违规 *** 作致5名患者被感染艾滋，你怎么看、数学建模-艾滋病传播问题、请问艾滋病感染者可能会被第二次感染不同类型的hiv病毒吗等相关内容解答，如果想了解更多相关内容，可以关注我们，你们的支持是我们更新的动力！