• RED RIBBON
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• s.83
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• pp.24-25
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• 2009

RNA 정량검사는 혈중 바이러스 농도를 측정하는 검사로, 감염인의 투약과 치료에 필수적인 검사로써 감염인이라면 $3{\sim}6$개월 간격으로 정기적으로 받는 검사이다. 그동안 국가에서 시행해 왔던 RNA 정량검사가 2009년 7월 1일자로 민간 의료기관에서 시행된다. RNA 정량검사를 민간 의료기관에서 실시하게 됨에 따라 감염인의 진료비 부담이 증가하게 된다. 병원에 따라서는 감염인의 비급여 본인부담금을 고려하여 특진료를 가산하지 않는 병원도 있으나 이는 극히 일부 병원에 불과한 실정이다.

• RED RIBBON
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• s.64
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• pp.14-15
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• 2005

지난해 5월 영국 로이터 통신을 통해 공개된 1장의 사진이 전세계를 경악시켰다. 태어난지 4개월밖에 안 된 여자 아기인 소피아. 천사같이 천진난만한 눈을 가진 소피아는 에이즈를 일으키는 바이러스인 HIV 보균자다. 소피아는 러시아 제 2의 도시 상트페테르부르크의 한 보호시설에 격리 수용돼 있다. 이 시설에는 소피아 말고도 HIV에 감염된 수십여 명의 아기들이 있다. 이 사진이 공개될 당시 22명의 어린이가 있었으나 현재는 40여 명으로 늘어났다는 최근 소식이다. 이 시설은 한번 다녀간 사람들의 마음을 무겁게 한다.

• Microbiology and Biotechnology Letters
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• v.46 no.4
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• pp.320-325
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• 2018

Hepatitis E virus (HEV) infection accounts for 20 million annual infections worldwide. HEV can be fatal in approximately 20-30% of pregnant women. HEV infections are normally self-limiting and mostly asymptomatic. However, in patients with insufficient immunity, such as acquired immunodeficiency syndrome patients, chronic and often fatal infections may ensue. Therefore, it is likely that host immune responses, especially interferon responses, play a critical role in HEV infection control. Here, we report that an HEV-encoded non-structural protein down-regulates type I interferon response. In addition, some other immune genes involved in the induction of type I interferon may be regulated as well. Detailed molecular mechanisms are currently being studied.

• RED RIBBON
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• s.82
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• pp.20-21
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• 2009

강력한 항레트로바이러스 치로(highly active antiretroviral therapy, HAART)의 도입으로 HIV 감영인의 기대여명(life expectancy)이 비감염인과 큰 차이가 나지 않을 정도로 향상된 것은 널리 알려진 사실이다. 하지만 평생 동안 약물을 복용해야 하며, 이에 따른 약물 부작용, 약제 내성, 경제적 손실, 불편함 등이 문제가 되고 있으며, 이를 극복하기 위한 다양한 치료법에 대한 연구가 진행 중이다. 이 글에서는 최근 발표되거나 진행 중인 새로운 치료 방법에 대해 간단히 알아보고자 한다.

• RED RIBBON
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• s.72
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• pp.9-11
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• 2006

후천성 면역 결핍 증후군(AIDS, Aquired Immune Deficiency Syndrome)과 사람 면역결핍 바이러스 (HIV, Human Immunodeficiency Virus)관련 질환은 1981년 처음 AIDS가 보고된 이래 전 세계적으로 인류의 건강을 위협하고 있는 공중보건학적 문제이다. 그동안 HIV/AIDS 관련 질환에 대한 치료들은 주로 감염 경로 차단 및 관련된 내과적 질환의 치료에 초점이 맞추어져 왔다. 그러나 AIDS 환자 본인뿐만 아니라 가족, 치료진들은 흔히 HIV 감염으로 인한 심리적인 어려움에서부터 HIV 전파 위험을 높이는 물질 오남용 문제, 우울증, 치매 같은 전형적인 정신과 질환 및 자살에 이르기 까지 다양한 종류의 정신건강 상의 문제들에 자주 직면한다. 이와 같은 신경정신과적 문제들은 치료 결과나 예후, 삶의 질 등에 영향을 미칠 수 있기 때문에 환자의 가족들은 AIDS로 인한 정신과적 질환이나 현상들에 대해 잘 이해하고 적절하게 대처할 필요가 있다.

• Journal of Hospice and Palliative Care
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• v.20 no.3
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• pp.159-166
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• 2017

According to the advance of antiretroviral regimen and the early treatment strategy, people living with human immunodeficiency virus (PLWH) are achieving the goal of virologic suppression and immune restoration. Most of them no more die of acquired immunodeficiency syndrome (AIDS) defining illnesses, and become older with chronic comorbidities such as cardiovascular, metabolic, hepatic, renal and neurological diseases. However some PLWH still visit hospitals as late presenters with very low CD4+ T cell counts, so that they suffer AIDS defining illnesses to die or experience severe neurological complications resulting in disabilities. Early palliative interventions are needed on the various symptoms of PLWH. Thus far chronic pains such as distal symmetric sensory polyneuropathies have been underevaluated. Active pain-relieving interventions are important to them. Recently we define end of life condition of human immunodeficiency virus (HIV) or eligibility to hospice care after adjusting current status of HIV treatment. Hospice teams should pay attention to the specific medical conditions, psychological needs, and social circumstances of PLWH. With just standard precautions as common infection control measures, general hospice cares can be provided to them like to other hospices subjects. For giving PLWH opportunities to have the end of life with value and dignity, hospice multidisciplinary team should intervene them early and aggressively. Now we need more clinical experiences and institutional improvements.

• The Korean Society of Law and Medicine
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• v.15 no.2
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• pp.367-397
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• 2014

Dans le contentieux m$\acute{e}$dical, il est difficile de prouver l'existence d'un lien de causalit$\acute{e}$ entre la faute m$\acute{e}$dicale et les pr$\acute{e}$judices subis par la victime. R$\acute{e}$partir bien de façon raisonnable la charge de la preuve du lien causal est alors une des questions pr$\acute{e}$occup$\acute{e}$es par la doctrine cor$\acute{e}$enne. La Cour supr$\hat{e}$me cor$\acute{e}$enne semble toutefois facilliter l'indemnisation des victimes dans les cas o$\grave{u}$ la responsabilit$\acute{e}$ du m$\acute{e}$decin a ${\acute{e}}t{\acute{e}}$ mise en cause, et cela en admettant des fois une solution op$\acute{e}$rant un renversement de la charge de la preuve du lien causal. Une telle attitude a ${\acute{e}}t{\acute{e}}$ m$\hat{e}$me affirm$\acute{e}$e dans un arr$\hat{e}$t rendu r$\acute{e}$cemment en cas de dommage caus$\acute{e}$ par le fait du produit de sant$\acute{e}$, notamment pour le cas de contamination virale par voie de transfusion. La Cour a $\acute{e}$galement reconnu que l'action se pr$\acute{e}$scrit $\grave{a}$ partir du moment de la consolidation du pr$\acute{e}$judice. Aux termes de cette $\acute{e}$tude, on pourra constater que le juge français reconna$\hat{i}$t aussi l'assouplissement de la charge de la preuve du lien de causalit$\acute{e}$ en mati$\acute{e}$re d'action m$\acute{e}$dicale. Il faudra toutefois souligner que le ph$\acute{e}$nom$\acute{e}$ne ne soit pas g$\acute{e}$n$\acute{e}$ralis$\acute{e}$ en droit français, d'autant plus que la pr$\acute{e}$somption de l'existence de la causalit$\acute{e}$ en la mati$\grave{e}$re a $\acute{e}$t$\acute{e}$ admise de mani$\grave{e}$re restrictive par la l$\acute{e}$gislation sp$\acute{e}$cifique. Tel $\acute{e}$tait notamment le cas pour les accidents de la contamination par le virus du sida ou de l'h$\acute{e}$patite C survenus apr$\grave{e}$s la transfusion. En d$\acute{e}$finitive, on peut dire qu'en droit français, le principe est maintenu en cas de manquement $\grave{a}$ une obligation de r$\acute{e}$sultat n$\acute{e}$e du contrat m$\acute{e}$dical, tandis que la Cour de cassation admet parfois en mati$\grave{e}$re de droit commun de la responsabilit$\acute{e}$ contractuelle la pr$\acute{e}$somption de causalit$\acute{e}$ en cas d'inex$\acute{e}$cution des obligations de r$\acute{e}$sultat. En fait, la pr$\acute{e}$somption de causalit$\acute{e}$ dans le contentieux m$\acute{e}$dical pourra mener les m$\acute{e}$decins $\grave{a}$ se diriger vers les traitements d$\acute{e}$fensifs. Cette situation peut m$\hat{e}$me conduire $\grave{a}$ emp$\hat{e}$cher le d$\acute{e}$veloppement de la science m$\acute{e}$dicale, enfin $\grave{a}$ une situation d$\acute{e}$savantageuse aux patients. Il y a alors lieu de se m$\acute{e}$fier des int$\acute{e}$r$\hat{e}$ts d$\acute{e}$s$\acute{e}$quilibr$\acute{e}$s entre le m$\acute{e}$decin et le patient. De ce point de vue, on peut estimer que le droit français donne des suggestions aux juristes cor$\acute{e}$ens dans la recherche des solutions plus ad$\acute{e}$quates en ce qui concerne la charge de la preuve du lien causal en mati$\acute{e}$re de responsabilit$\acute{e}$ m$\acute{e}$dicale.

• Journal of Hospice and Palliative Care
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• v.4 no.2
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• pp.122-129
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• 2001

Purpose : After Acquired Immunodeficiency Syndrome (AIDS) is known to be a fatal disease, efforts and studies are made to determine the cause, treatment method and method of preventing infection. However, no treatment method is present and vaccine development has not been made. Therefore, the most effective treatment method is prevention, and almost 100% prevention is possible when correct preventive measures are taken. We suggest effective prevention education by comparing knowledge and attitude of those unmarried men who had sexual encounters with prostitutes (high risk group) and those with no sexual encounters with prostitutes (low risk group). Methods : From January 1, 2000 to June 30, 2000, a survey was done in 516 unmarried soldiers and college students. With the collected data, chi-square test was used to compare and analyze the demographic characteristic, knowledge on AIDS, and attitude on AIDS between the high risk group and low risk group. One-way ANOVA test was used to compare and analyze the scores on knowledge between these two groups. Results : Among 516 unmarried men, 256 men (49.6%) fell into the high risk group and 260 men (50.4%) into the low risk group. Both groups showed that they heard of AIDS during their middle school years. The main route of obtaining knowledge on AIDS was through TV programs with 124 men(48.4%) in the high risk group and 167 men (64.2%) in the low risk group (P=0.002). Among 20 items, the average score on knowledge was $13.9{\pm}1.9$ in the high risk group and $14.1{\pm}1.8$ in the low risk group with no statistical difference between these two groups (P=0.191). Two items showed statistical significance in the low risk group compared with the high risk group; these were the item of AIDS being transmitted through transfusion (P=0.014) and through mosquitoes (P=0.009). As for attitude, statistical significance was present in the item stating that AIDS patients should be isolated in the high risk group compared with the low risk group (P=0.029). Conclusions : The present study showed that both the high risk group and low risk group obtained knowledge on AIDS through TV. No statistical difference was present between the two groups other than the high risk group showed statistically high results in two items on knowledge and one item on attitude. Thus, these results showed that exposure to AIDS can be lowered with better knowledge and the attitude of those with a low risk of infection was more positive.