:

1 : 2549

: 800

: ()

. 09/08/49

/
/
/
/

/

1
2
3
3
4
5
8

13
17
18
20
20
21
22
23
26

29
33
33
34
35

4 /

CD4

38
41
44
45
49
52

/
/

55
55
56
62
64

6 /

(..2549)

67
68
71
73
75
77
78
81
82
83

84
85

(HIV CARE)

Standard HIV/AIDS care package in Thailand.

11
12
27
28
48
57
70

1.1 Protease inhibitor Non-nucleoside reverse

trancriptase inhibitor Rifampicin
3.1 (Pretest HIV counseling)
3.2 (Posttest HIV counseling)
4.1
5.1 /

5.2 /

5.3 /

5.4 /

6.1
CD4
6.2 CD4 Count
6.3 :
6.4

5
34
35
50
58
58
59
60

70
70
77
78

HIV

(Dissemination)


70-90%
40-80% (Dissemination)

20-40%

(cavitation) (lower-lobe
infiltration) (miliary infiltrates)
(pleural effusion)
(upper lobe fibrocavitary infiltrates) reactivation
TB

localized alveolar infiltration
bacterial pneumonia
100%


(Disseminated TB)

Disseminated mycobacterium avium complex
|


low-density
necrosis

primary
complex hilar adenopathy, pleural effusion,
lower zone miliary infiltration cavity


tissue damage cavity (
) cell
monocytes
Bronchoscopy tissue Biopsy, Blood culture

/

nocardia
pneumococci, PCP, salmonella, lymphoma, kaposis sarcoma, lymphocytic, interstitial
pneumonitis

caseous necrosis

mediastinum

2 |

Miliary tuberculosis
miliary tuberculosis



miliary noduies

5-10%


tuberculoma

10 1
5 6

10

5 - 10%
1 60

1.
1 7-10%
/ 10% / CD4
PPD
2. TB (Active TB)

|

16

CD4

1.
2.

3. (PPD TST)
5 . CD4

4. CD4
200 5 - 10%

5 .
INH 300 . 9

PPD skin test (Mantoux method)
tuberculin protein
T-lymphocyte PPD skin test
4 |

t-lymphocyte lymphokines
PPD

PPD skin test
10%
5% 2 5%
10%

1. /
2.
Rifabutin Rifampicin
CYP 450 Protease
inhibitor (PI) Non - nucleoside reverse transcriptase inhibitor (NNRTI)
3.
4.

5.
/

Immune recovery syndrome MAC ()

1.1 Protease inhibitor Non - nucleoside reverse transcriptase

inhibitor Rifampicin

Protease inhibitors (PI)s

Pls
Saquinavir (SQV)
Ritonavir (RTV)
Indinavir (IDV)
Nelfinavir (NFV)
NNRTI
Nevitapine (NVP)
Efavirenz (EFV)

Rifampicin (RIF)
RIF PIs
PIs RIF
80%
35%
92%
82%
RIF NNRITs
37%
13%

NNRTIs RIF

(
/)

1.
(AIDS-de-fining illness)
CD4 250 cell/cu.mm
2. CD4 250 cell/cu.mm
3. CD4 200 cell cu.mm

1. 12

1.1
1.2 CD4 < 25%
2. 12

2.1 clinical staging B C

2.2 CD4 < 20%

DOT

HAART

6 |

1. CD4 > 250 cells/cu.mm

CD4
3-6 /
CD4 < 250 cells/
cu.mm
2. CD4 < 250 cells/cu.mm
2
- 2
CD4 <100 cells/ cu.mm

AZT + 3TC + EFV
d4T + 3TC + EFV

(1) GPO - VIRZ (AZT + 3TC + NVP)
(2) GPO - VIR (d4T + 3TC + NVP)
(3) AZT + 3TC + SQV / RTV
(4) d4T + 3TC + SQV / RTV

1. EFV containing regimens

2. NVP containing regimens

NVP EFV
3. PI containing regimens
EFV boosted PI
SQV/RTV (400 : 400 bid)
IDV/RTV (800 : 200 bid)
PI boosted
RTV 200 mg bid
RTV 100 mg bid

Rifampicin NNRTI EFV

EFV 600 mg OD
EFV 800 mg OD
Rifampicin NVP
EFV GPO - VIRZ
GPO - VIR NVP
GPO - VIRZ (AZT + 3TC + NVP) AZT + 3TC + EFV
GPO - VIRZ
EFV EFV

(IRIS)
/ National Tuberculosis
Program
|

(Directly Observed Treatment,
Short - course : DOTS) /

1.

1.1 /
2

1.2
/
2.





2.1 (Voluntary
Counselling and Testing VCT)

2.2

8 |

2.3 TB/HIV CD4 250 cell/cu.mm

2 - 4 Refer

2.4 TB/HIV CD4>250 cell/cu.mm

CD4 3-6 /
CD4<250 cell/cu.mm Refer
2.5 DOT TB/HIV

1.

2.

3.
4.
5.

6.
7.
8.

9.
30
10.

11.

12.
13.

/

2

1.
2

2. /

3.

4.

5.

6.
7.

8.

9. /
/
30
10.

10 |

11. /

12.

11

12 |

37 9 2501
1 2502

1.
2.
3.
4.

13


(...)
2539-2543
1.


2

2.

3.





4.





5.



8-18

14 |

6.


5

(Addiction)


(Pavlov)


Pavlov

4
1. (Introductory stage)

15

2. (Maintenance stage)

3. (Disenchantment phase)








(Limbic system)

4. (Disaster phase)

16 |


1.
1.1

1.2



1.3


2.
2.1


2.2

2.3

3.
3.1

3.2


4. 2







|

17

1.

2.












2.1



18 |

 (Abandonment)
(Enmeshment)

2.2

2.3

3.



80

19

1.
2.

1.
2.
3.
3.1
3.2
3.3
3.4
Clorox (Sod Hypochlorite)

20 |

1.

2. (/)
3.



4.

5.

1.
1.1
1.2
1.3

1.4
|

21

2.
2.1
2.2

2.3
2.4

1.



2.

1.
1

(
)
2.
30
2
3.
30
2
4.
30
2

22 |


1.

2.

3.

1.
1.

2.
2.

(/)

23

3.
3.

4. (
4.
)

( )

5.
5.

6.
6.

24 |

7.
7.

8.
8.

9.
9.

10.
10.

25


1.

2.
3.

4.

5.

6.

7.

1.

2.

3.
4.
5.
6. (Water - based Lubricants)
(Oil - based Lubricants)

7.

26 |

27

28 |

(Acquired Immune Deficiency Syndrome, AIDS)

Human Immunodeficiency Viruses (HIV)
HIV (
) (Secretion)

(neuropsychiatric disorders)

(Psychosocial Reactions in Patients With HIV Infection)

(impending death)
1 (Shock and Denial)
2 (Anger)
3 (Withdrawal)
4 (Honeymoon)
5 (Bargaining)
6 (Depression)
7 (Acceptance)
8 (Termination)

29

 1

(denial)

(decompensation) (projection)

2


(guilt) (shame)

(acting out)



(low self-esteem) (suicidal
ideation)

3

(recognition of stigma)

30 |

 5
5 . (Coming Out
to Significant Others)
(model) Kubler-Ross
Cass (1979)
(stages of homosexual identity
formation)



(bargaining)
(stress displacement)

(rejection)
(confrontation)
5 . (Looking for Others)






(loss of autonomy)
5 . (Special Status)

(reaction formation)
(a sense of guilt or self-blame)

(us and
them dichotomy)
|

31

 5 . (Altruistic Behavior)
5 5

(overreaction) (overcompensation)
(burn out)

6

(preparatory grief) (final grief)

7

(self-identity)
(altruism) (self)
(unfinished business)

(resuscitation method)

32 |


(Voluntary Counseling and Testing : VCT)



(Voluntary Counseling and Testing : VCT)
(motivation)

1. (Compassionate)
(nonjudgmental)
2.
3.

(Pre-test Counseling)
(prevalence)
Mood Disorders Substance-Use
Disorders
1.
2.
3.

4.

3.1

33

 3.1 (Pretest HIV counseling)

1. (Positive)
(
)
2. (negative)

)
3. (fears and concerns)
4.
5. (
)
6. (severe stresses)
7. ( )

8. (social status)
(positive) ( )
9. (high-risk behaviors)
10.
11.

(Post-test HIV Counseling)

(positive)

(shock) (denial) (anger) (bargaining)

(depression) (anxiety)

(stress)

3.2
34 |

 3.2 (Posttest HIV counseling)

1. (interpretation of test result)
1.1 (
)
1.2
2.
3.
4. (positive)
( )
5.
( )

(Neuropsychiatric Disorders in HIV Patients)

(fear) (hopelessness)



1. (disease-related factors)

2. (factors related to the person)

3. (interpersonal and social factors)
(social
support)

HIV-Associate Cognitive/Motor Complex

T4 lymphocyte
(symptoms of dementia)
HIV-associated cognitive/motor complex
|

35

 (impairment in cognitive functioning)

(concrete thinking)

subcortical dementia
(incoordination) (ataxia)

Delirium
Delirium (cognitive functions)
(consciousness) (orientation)
(attention) (learning) (memory) Delirium
(physical diseases) (neurological
disorders)

Adjustment Disorders Anxiety Disorders

(distress)
Adjustment Disorders
Adjustment Disorder with Depressed, Anxious Mixed Mood
Adjustment Disorders Anxiety Disorders

Panic Disorder, Obsessive-Compulsive Disorder Generalized Anxiety

Disorder

Depressive Disorders
(mild depression)
(Depressive Disorders)
2


(suicide behavior)

Psychotic Disorders, Including Mania

(psychotic and mania symptoms)
(delusions)
(hallucinations) (thought form disorders)

36 |

(Human immunodeficiency virus, HIV)

2-3

1-2 (viremia) (antigenemia)
2-6 (anti-HIV)
1-2


3-12 ( 8 6 )
window period

37


2
1. Indirect method

2. Direct method

p24

3-12 6
IgM IgG
2
1. (Screening test)
2. (Confirmatory test)
ELISA
paticla agglutination (rapid/simple test)
western blot

1. (Screening test)

1.1 (ELISA)
ELISA 99
0.3-0.5%



IgM IgG window period
1.2 (Simple Test)
(Gelatin particle agglutination ; GPA)
1.3 (Rapid Test)

1.4
38 |

(technical error)
(clerical error)
(reactive)

(false-negative)
(false-positive)

(biological false-positive)
anti-HIV
1. Auto antibodies SLE (systemic lupus erythematosus)
2. HIV Vaccine

3.
4.

anti-HIV
1. Window period anti-HIV
3 - 3
10-14
2. anti-HIV (Seroreversion)
3.
4. gamma
globulin (Agammaglobulinemia)
5. HIV-1 type (type N
type O) HIV-2
anti-HIV-1
(Screening
Test)

39

2. (confirmatory tests)
anti-HIV-1/2
2.1 (Western blot, WB)

gold standard

WB
(profile)
2.2 (Immunofluorescent
assay, IFA)
licensed US FDA
fix slide
anti-human lgG conjugate
Fluorescein

1.
2.

3.
2.3
(Line immunoasay)

envelope / gag

40 |

HIV Viral Load

HIV Viral Load HIV Viral burden
HIV-1 RNA
HIV Viral load copies/ml
HIV Viral load log10 1log10 10
viral load 20,000 copies/ml 1 log
10 viral load 200,000 copies/ml
viral load 1 log viral load 2,000
copies/ml viral load log

HIV Viral Load

HIV Viral Load

1. HIV-1 RNA
HIV-1 RNA


HIV-1 RNA
100,000 copies/ml
HIV-1
RNA 10,000 copies/ml 10
HIV-1 RNA
CD4+ T cells HIV RNA

HIV
viral load

41

2.
/


HIV-1 RNA

HIV viral load 5
HIV viral load 5

viral load

(caesarean section)
viral load

HIV Viral Load

1. viral load
1-2 (baseline) viral load


baseline viral load 3-4

2. viral load

10
1
3. viral load 20,000 copies/
ml


42 |

.
.
CD4+ T cells
. viral load
.

4. viral load 20,000 copies/ml

viral load (<50 copies/ml)


viral load 60,000 copies/ml (
32.6%) 3 viral load
18,000 copies/ml ( 5.9%) 3
5. viral load 2-8

6. viral load 3-4

7. viral load
3-4
8.

viral load
5
viral load
500 copies/ml 4-6
50 copies/ml 6-8
viral load

CD4+ T cells

43




1. HIV antigen HIV
p24
HIV-1 HIV-2
p24 HIV antigen ELISA
p24 antigen
2-4 HIV
antigen
15
anti-HIV

HIV antigen

2.
probe HIV RNA proviral DNA

Anti-HIV Anti-HIV
18

1. (Viral Load Viral burden)

2. (Window Period)
3.
subtype
4.
6
5. HIV-1 HIV-2
6.

7.
8.

44 |

 HIV Viral Load

( RT-PCR)
5 ml. EDTA ACD
( heparin)
6
800-1,600 X g 20
-20 C
(stability
1 2-8 C
5 -80 C)

CD4

CD4


(Flow cytometer)


CD 4 cell (CD4+
T-lymphocyte) CD4 cell



anti-HIV CD4 cell
CD4 <
200 cell/ml
CD4 cells
CD4 cell
monoclonal Ab CD4 marker
%
lymphocyte
complete blood count (CBS) CD4
cell cells/ml
|

45


CD4
EDTA
(ethylenediamine tetraacetic acid) K3EDTA
EDTA 0.15 1
3 ( ()
EDTA )
EDTA

( 1 )

1.
2. colt

3. 24

46 |

 anti-HIV
1.


anti-HIV
(unit)
2. (epidemiological surveillance)
(Unlinked anonymous)

3. anti-HIV (screening assay) anti-HIV negative (non reactive)
(reactive)
western
blot (immunoblot)

(indeterminate)
.. 2537 .. 2540

( .. 2540
.. 2545) 2
/

3
anti-HIV positive

3

(indeterminate)
1-6 1

( 1)

47

48 |



3 ( 4.1)
1. (primary infection) 2-6
anti-HIV window period (pre-serocoversion) CD4+ T
lymphocytes HIV-RNA (viral load)
105-106 copies/ml HIV-1 DNA HIV
p24 Ag 89 HIV RNA HIV p24 Ag
10-12 16-17
20-25 HIV RNA HIV p24 Ag 10
5
2. (clinical latency) 3-10

anti-HIV HIV-1 DNA
HIV-1 p24 Ag HIV RNA
(viral load)
antiretroviral
viral load CD4+ T lymphocyte
viral load 105 copies/ml 3
5 3-10 5
CD4+ > 500 cells/ml 10-15 (long term
survivor) CD4+ < 200 cells/ml
3. (advanced disease)
CD4+ <
200 cells/ml

49

 4.1
CD4+ T cells
(Cells/ul)

99.3-99.7

200-500
<200
200-500
<200

10-20
37-95
30-70
75-85

p24 immune
complex
(acid treatment)
(heat denature)

PBMC/
(co culture)

<500

95-100

DNA PCR PBMC (PCR)

97-98

proviral DNA



(indeterminate)

Quantitative HIV RNA

(RT PCR, RNA amplification target amplification)

>200
<200

90
98-100

RNA
(viral load)
reall time PCR

()
Anti-HIV /
(immunoassay)

HIV p24 antigen

/ (ELISA)
Immune complex
Dissociation p24 (ICD p24)
/ (ELISA)

50 |

 HIV
HIV
(clotted blood) EDTA (sterile EDTA
blood) (Peripheral blood mononuclear cell, PBMC)
(whole blood) EDTA blood

Anti-HIV

HIV Ag
Viral load
HIV DNA
HIV RNA
HIV culture
CD4+ T lymphocyte

: , 5
(whole blood )
: , 5
: ( EDTA 5 )
: PBMC
: ( EDTA 5 )
: PBMC,
: EDTA blood 3-5

serology anti-HIV, HIV Ag clotted blood

(2-8 C) 7

molecular viral load, HIV DNA, HIV RNA,
CD4+ T lymphocytes count sterile EDTA blood 1

(p24 antigen)
p24 antigen (Core
protein)


p24 antigen
p24
(fluctuation)

51

RNA
proviral DNA
proviral DNA
(polymerase chain reaction, PCR)
PCR 1993



p24
18
PCR 2-3
100% 6

Universal Precautions


pathogenic organisms

1.

2.

52 |

3.


4.

5.


6.


7.

8.
( 110%)
9.

10.

53

1.

2.

3.

4.

1. 3 4

2.

3.

0.5% 2% 30
54 |

/
/
/

1. /

2. /
3. /

4. /

/
1.

2. /
/
/
/

55

3.

4.
/


/

1.
/
/
2.

3.

4.

56 |

57

 5.1 /

67

8
-
-

5.2 /
66 9

1
2

(/)

- /

-

1
- /

- /

- /

-
67

-
-

- -
9

58 |

 5.3 /

1
1.1
1.2
1.3
1.4

1.

.
2.

3. 25

-
-

1.
.
2.

3.

-
-

1.

.
2.

5
2 . 0 2246 0359
|

59

 5.4 /

1.

1.

2.

2.

(


)

1,000

3,000

1

2,000 /
1
3,000 /
1

1.
(

)
2.

3.
4.
5.

2,000

3 /
/

1.

2.

3.

(
)

()
1 . 10100
0-2282-5869, 0-2659-6170-71

* .. 2539 0514/227
5 2537
60 |

3.

1. - - - 500 /

6,000 /

2.

1.
2.
3.

4.



5.
( 3x5

2
60 . . 10400
0-2247-9480, 0-2246-8651, 0-2247-9484

4.

1.
...

.. 5,000
2539

2.

3.

4.

5.

5,000

. 0526.7/
3/140 29
2539

1.

2.

3.

8
( 118)
|

61

/
67

1.

1.1

(..3)

1.2

(..3)

(..3)

62 |

2.

(..3)

()
(Zoning)
()

/
/
/

63

( )

.. 2533

CD4 200 cell/cu.mm
CD4 250 cell/cu.mm

14

15% 3

64 |


1
2

d4T + 3TC + Nevirapine (NVP) GPO-VIR

2.1 d4T + 3TC + Efavirenz (EFV)
2.2 AZT + 3TC + NVP
2.3 AZT + 3TC + EFV
2.4 d4T + 3TC + IDV/RTV AZT + 3TC + IDV/RTV

2 2

NVP 1
2 2.1

d4T 1
2 2.2

NVP d4T 1
2 2.3

NVP EFV 1
2 2.4

HIV/AIDS
1 2

1 2

5,000

1.

2.

3.

65


1.

2. 1 2
2 HIV/AIDS
3.
4.

66 |

/
/




/ 2

(Comprehensive care)

/
(1) (Medical care)





(2) (Psychological care)
(Counselling) (Emotional support)
/ (Self-help group)
/

67

(3) - (Socio-economical care

and human right)
/


(Child adoption) (Foster home)
(Legal and ethical service)

(Human right protection)
/
(Health and life insurance)

/

(Continum care)
/

/
2
(1) (Place)
/



/

(Health care provider)

68 |

(2) (Time)
/




/
(Bio-medical care) (Psychological care)
(Socio-economical care)




(Evidence based)
/


/

69

 6.1
CD4
CD4 (/..)
CD4 200
CD4 200-350
CD4 350
CD4 < 200

OI/ARV
3
6

6.2 CD4 count

CD4
count
< 200
< 100
< 50

PCP
Toxoplasmosis

Cryptococosis

Mycobacterium Avium
Complex

70 |

Cotrimoxazole
2
Fluconazole
(200) 2
Azithromycin
(250) 4-5


: 3

(Viral load < 50 copies)

(Life long treatment)

95% adherence

(adherence)

( )

(collective financing)
(third party payer principle)

.



|

71




/
30 /
1 2548

()
2549

2549

2,796.2

82,000
2550

72 |



MAC CMV

/
4 250

4 200

:

1. (CD4)
4 6

( )

(
)

d4T+3TC+NVP
AZT+3TC+NVP

d4T+3TC+EFV
ddl NFV
AZT+3TC+EFV
d4T+3TC+IDV/r
AZT+3TC+IDV/r

NRTI : AZT 3TC d4T ddl
PI : IDV/r, SQV/r LPV/r


|

73

2.

CD4 6

() 6
() 1
CD4 30 %

1,000

(adherence)

1,000

3.
/
(CD4)

...

74 |


(..2549)

CD4
3

(.. 2549)
1.

2.

3.
3.1 AZT 28 300

3.2 NVP 200 1 AZT 300

1 AZT 300 3
3.3 AZT 100 1 - 3TC 150 .
1 - 7 NVP

75

4. CD4
CD4<200
3
4.1 14 AZT
100 + 3TC 150 .+ NVP
200 . 2 -
4.2 AZT 100
+3TC 150 . + NVP 200 .
2 -
5.
5.1 6 1 (
2,500 2 1 )
5.2 AZT 2
1 6 1
4
5.3 AZT 2
1 6 6
4
6.
12
7.
12

18
8. (
)

9.

76 |


1.

2.
3.
/
4.

5.

6.


7.

6.3 :

< 60 kg
> 60 kg

30 mg GPO-VIR S30 1 tab

40 mg
12
30 mg 30 mg 12
40 mg

GPO-VIR S40 1 tab

12

40 mg 12

3. 3TC

150 mg 150 mg 12 150 mg 12

4. NVP

200 mg

1.GPO-VIR
2. d4T

200 mg 1 200 mg 1 x 14
x 14 days
200 mg 12

600 mg
600 mg 600 mg

IDV 800 mg 12 IDV 800 mg 12

400 mg
RTV 100 mg 12 RTV 100 mg 12

5. EFV
6. IDV+RTV
(Boosted PI)

300 mg 250-300 mg 12 250-300 mg 12

7. AZT
100 mg

77

 6.4

1.
(NRTI)

(AZT)

(d4T)

( )

( )
()

Steven-Johnson Syndrome



()

()

(3TC)

(ddI)
2.

(NVP)
(NNRTI)
(EFV)
3. (PI)
-

-
-

(IDV)

(SQV)

(RTV)
/
(LPV/RTV)

(NFV)

( )

()

.. 2527
1 6

78 |

1.
1 d4T + 3TC+NVP (GPO-VIR)
2 2.1 d4T+3TC+EFV NVP
2.2 AZT+3TC+NVP d4T
d4T
<50 copies/ml
d4T GPO-VIR S40 GPO-VIR S30 d4T, 3TC
NVP d4T 15 20 mg. 12
2.3 AZT + 3TC + EFV NVP d4T
3 3.1 d4T + 3TC + IDV/RTV
3.2 AZT + 3TC + IDV/RTV

2.
1 d4T + 3TC ( AZT + 3TC) + NVP >20
GPO-VIR ()
2 d4T + 3TC ( AZT + 3TC) + EFV
3 d4T + 3TC + IDV/RTV AZT + 3TC + IDV/RTV NVP
EFV
NVP, EFV IDV/RTV CD4 > 15%
d4T + 3TC AZT + 3TC

NEW

1
2.1
2.2
2.3
3.1
3.2
4
5
6
7
8
9
10

d4T + 3TC + NVP (GPO Vir)

d4T + 3TC + EFV
AZT + 3TC + NVP
AZT + 3TC + EFV
d4T + 3TC + IDV/RTV
AZT + 3TC + SQV/RTV
AZT + ddl
d4T + ddl
AZT + ddl + NVP
d4T + ddl + EFV
AZT + 3TC + SQV/RTV
d4T + ddl + IDV/RTV
d4T + ddl + SQV/RTV

..

..
..
..

..
..
( ..)

79

1.

1.1 CD4 250 cells/cu.mm

CD4 3-6
CD4 250 cells/cu.mm

1.2 CD4 250 cells/cu.mm

2-4 2

d4T + 3TC + EFV AZT + 3TC + EFV
(1) GPO-Vir
(2) d4T + 3TC + SQV/RTV AZT + 3TC + SQV/RTV
:
() Rifampicin NNRTI EFV
EFV 800 mg OD
() Rifampicin NVP
NVP Fifampicin EFV NVP
(GPO-Vir) NVP
() Boosted PI Rifampicin SQV/RTV (400:400 BID)
RTV booted PI

2.

1. EFV containing regimens
2. NVP containing regimens EFV
3. unboosted PI regimen EFV boosted PI
IDV / RTV ( 800:200 BID ) PI booted
RTV 200 mg BID RTV 100 mg BID

80 |

( )

0.3%
0.09 %
0.09%

81

2
1
2
3
3
3

(less sevsere) (solid needle) (superficeal injury)
(more severe) (lasge bore hollow needle)
(deep injury) (visvble blood in device)
(needle in patient artery or vein )

12
3

82 |

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13. .
4.
14.
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8.
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9.
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83


, . .. 2540
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, . / 1 :
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3. : , 2549.
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, 2547.
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, 2548.
, . /. 1.
: , 2547.
, . . 1.
: , 2547.
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1. : , 2547.
, , , 2542.
Atkinson JH, Grant l. Natural history of neuropsychiatric manifestations of HIV disease. Psychiatr Clin North Am
1994 : 17 : 17-33.
Cass VC. Homosexual identity formation : a theoretical model. J Homosex 1979:4:219-35
Catalan J. Psychological interventions in infection with the human immunodeficiency virus. Br J Psychiatry
1995:167:104-11.
Fernandez F,Levy JK. Psychopharmaology in HIV spectrum disorders. Psychiatr Clin North Am 1994:17:135-47.
Grant I, Atkinson Jr. JH. Psychiatric aspects of acquirde immune deficiency syndrome. In:Kaplan HI, Sadock BJ,
editors. Comprehensive textbook of psychiatry/VI. 6th ed. Baltimore (MD) : Williams & Wikins : 1994.
p.1644-69.
Hinkin CH, van Gorp WG, Satz P. Neuropsychological and neuropsychiatric sapects of HIV infection in Adults.
In : Kaplan HI, Sadock BJ, editors. Comprehensive textbook of psychiatry/VI.6th ed. Baltimore (MD) :
Williams & Wilkins : 1994.p. 1669-80.
Kelly JA. Behavior and acquired immunodeficiency syndrome. In : Wedding D, editor. Behavior and medicine.2nd
ed. St. Louis (MO) : Mosby : 1995. p. 367-75.
Oakley A, Fullerton D, Holland J. Behavioural interventions for HIV/AIDS prevention. AIDS 1995:9:479-86.
Rosse RB, Giese AA, Deutsch SE, Morihisa JM. Laboratory and diagnostic testing in psychiatry. Washington (DC)
: American Psychiatric Press; 1989.
www.aisdthai.org,

84 |

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0-2211-0860
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108
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