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Syphilis testing in antenatal care: Policies and practices among laboratories in the Americas

International Journal of Gynecology and Obstetrics 2015年第S1期130卷 S37-S42页

作者： Luu, Minh Ham, Cal Kamb, Mary L. Caffe, Sonja Hoover, Karen W. Perez, Freddy Division of STD Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention (CDC) Atlanta GA United States Communicable Diseases and Health Analysis Department HIV Hepatitis Tuberculosis and Sexually Transmitted Infections Unit - CHA//HT Pan American Health Organization 525 23rd St NW Washington D.C. 20037 United States

Abstract Objective To asses laboratory syphilis testing policies and practices among laboratories in the Americas. Methods Laboratory directors or designees from PAHO member countries were invited to participate in a structured, electronically-delivered survey between March and August, 2014. Data on syphilis tests, algorithms, and quality control (QC) practices were analyzed, focusing on laboratories receiving specimens from antenatal clinics (ANCs). Results Surveys were completed by 69 laboratories representing 30 (86%) countries. Participating laboratories included 36 (52%) national or regional reference labs and 33 (48%) lower-level laboratories. Most (94%) were public sector facilities and 71% reported existence of a national algorithm for syphilis testing in pregnancy, usually involving both treponemal and non-treponemal testing (72%). Less than half (41%) used rapid syphilis tests (RSTs);and only seven laboratories representing five countries reported RSTs were included in the national algorithm for pregnant women. Most (83%) laboratories serving ANCs reported using some type of QC system;68% of laboratories reported participation in external QC. Only 36% of laboratories reported data to national/local surveillance. Half of all laboratories serving ANC settings reported a stockout of one or more essential supplies during the previous year (median duration, 30 days). Conclusion Updating laboratory algorithms, improving testing standards, integrating data into existing surveillance, and improved procurement and distribution of commodities may be needed to ensure elimination of MTCT of syphilis in the Americas. © 2015 Pan American Health Organization.

关键词： Americas region Antenatal care Congenital syphilis Rapid testing Syphilis testing

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HIV Cure and HIV Reservoirs

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Biomedical and Environmental Sciences 2014年第6期27卷 478-480页

作者： YIN Qian Qian Shao Yi Ming MA Li Ying State Key Laboratory for Infection Disease Prevention and Control National Center for AIDS/STD Control and Prevention (NCAIDS) Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseas Chinese Center for Disease Control and Prevention (China-CDC)

The success of combined antiretroviral therapy （cART） has dramatically improved the clinical outcomes of HIV infection and made HIV infection a chronic disease. Nonetheless, cART alone cannot eliminate viral reservoirs and fully recover patients＇ health, so the patients have to receive this treatment for lifetime. Therefore, researchers have focused their efforts on the cure for HIV infection. In recent years, some intriguing and inspiring cases indicated that the cure of HIV infection （HIV cure） or durable alleviation of HIV infection may not be a dream any more. ＇Berlin Patient＇＇Mississippi Baby＇, and probably ＇Long Beach Baby＇ have brought great hope to the HIV cure. Many scientists believe that the HIV cure is just a question of time.

关键词： HIV Cure and HIV Reservoirs ZFN

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Global, regional, and national sex-specific burden and control of the HIV epidemic, 1990–2019, for 204 countries and territories: the Global Burden of Diseases Study 2019

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The Lancet HIV 2021年第10期8卷 e633-e651页

作者： Jahagirdar, Deepa Walters, Magdalene K. Novotney, Amanda Brewer, Edmond D. Frank, Tahvi D. Carter, Austin Biehl, Molly H. Abbastabar, Hedayat Abhilash, E.S. Abu-Gharbieh, Eman Abu-Raddad, Laith Jamal Adekanmbi, Victor Adeyinka, Daniel Adedayo Adnani, Qorinah Estiningtyas Sakilah Afzal, Saira Aghababaei, Soodabeh Ahinkorah, Bright Opoku Ahmad, Sajjad Ahmadi, Keivan Ahmadi, Sepideh Ahmadpour, Ehsan Ahmed, Muktar Beshir Rashid, Tarik Ahmed Salih, Yusra Ahmed Aklilu, Addis Akram, Tayyaba Akunna, Chisom Joyqueenet Al Hamad, Hanadi Alahdab, Fares Alanezi, Fahad Mashhour Aleksandrova, Ekaterina A. Alene, Kefyalew Addis Ali, Liaqat Alipour, Vahid Almustanyir, Sami Alvis-Guzman, Nelson Ameyaw, Edward Kwabena Amu, Hubert Andrei, Catalina Liliana Andrei, Tudorel Anvari, Davood Arabloo, Jalal Aremu, Olatunde Arulappan, Judie Atnafu, Desta Debalkie Quintanilla, Beatriz Paulina Ayala Ayza, Muluken Altaye Azari, Samad Darshan, B.B. Banach, Maciej Bärnighausen, Till Winfried Barra, Fabio Barrow, Amadou Basu, Sanjay Bazargan-Hejazi, Shahrzad Belay, Habtamu Gebrehana Berheto, Tezera Moshago Bezabhe, Woldesellassie Mequanint Bezabih, Yihienew Mequanint Bhagavathula, Akshaya Srikanth Bhardwaj, Nikha Bhardwaj, Pankaj Bhattacharyya, Krittika Bibi, Sadia Bijani, Ali Bisignano, Catherine Bolarinwa, Obasanjo Afolabi Boloor, Archith Boltaev, Azizbek A. Briko, Nikolay Ivanovich Buonsenso, Danilo Burkart, Katrin Butt, Zahid A. Cao, Chao Charan, Jaykaran Chatterjee, Souranshu Chattu, Soosanna Kumary Chattu, Vijay Kumar Choudhari, Sonali Gajanan Chu, Dinh-Toi Couto, Rosa A.S. Cowden, Richard G. Dachew, Berihun Assefa Dadras, Omid Dagnew, Amare Belachew Dahlawi, Saad M.A. Dai, Xiaochen Dandona, Lalit Dandona, Rakhi das Neves, José Degenhardt, Louisa Demeke, Feleke Mekonnen Desta, Abebaw Alemayehu Deuba, Keshab Dhamnetiya, Deepak Dhungana, Govinda Prasad Dianatinasab, Mostafa Diaz, Daniel Djalalinia, Shirin Doan, Linh Phuong Dorostkar, Fariba Edinur, Hisham Atan Effiong, Andem Eftekharzadeh, Sahar El Sayed Zaki, Maysaa Elayedath, Rajesh Elhadi, Institute for Health Metrics and Evaluation University of Washington Seattle WA United States Department of Health Metrics Sciences School of Medicine University of Washington Seattle WA United States Division of Allergy and Infectious Diseases University of Washington Seattle WA United States Department of Global Health University of Washington Seattle WA United States School of Social Work University of Washington Seattle WA United States Department of Medicine University of Washington Seattle WA United States Vagelos College of Physicians and Surgeones Columbia University Medical Center New York NY United States Division of Data Analytics and Delivery for Impact WHO Geneva Switzerland Advanced Diagnostic and Interventional Radiology Research Centre Tehran University of Medical Sciences Tehran Iran Multiple Sclerosis Research Centre Tehran University of Medical Sciences Tehran Iran School of Public Health Tehran University of Medical Sciences Tehran Iran Department of Epidemiology and Biostatistics Tehran University of Medical Sciences Tehran Iran Paediatric Chronic Kidney Disease Research Centre Tehran University of Medical Sciences Tehran Iran Department of Psychiatry Tehran University of Medical Sciences Tehran Iran Metabolomics and Genomics Research Centre Tehran University of Medical Sciences Tehran Iran Sina Trauma and Surgery Research Centre Tehran University of Medical Sciences Tehran Iran Research Centre for Immunodeficiencies Tehran University of Medical Sciences Tehran Iran Non-Communicable Diseases Research Centre Tehran University of Medical Sciences Tehran Iran Department of Botany Sree Narayana Guru College Chelannur Kozhikode India Clinical Sciences Department University of Sharjah Sharjah United Arab Emirates Mass Communication Department University of Sharjah Sharjah United Arab Emirates Department of Health-Care Policy and Research Weill Cornell Medical College in Qatar Doha Qatar Department of Population Medicine Ca

Background: The sustainable development goals (SDGs) aim to end HIV/aids as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold <0·03), and the ratio of incident cases to deaths (incidence-to-mortality ratio threshold <1·0). Findings: In 2019, there were 36·8 million (95% uncertainty interval [UI] 35·1–38·9) people living with HIV worldwide. There were 0·84 males (95% UI 0·78–0·91) per female living with HIV in 2019, 0·99 male infections (0·91–1·10) for every female infection, and 1·02 male deaths (0·95–1·10) per female death. Global progress in incident cases and deaths between 2010 and 2019 was driven by sub-Saharan Africa (with a 28·52% decrease in incident cases, 95% UI 19·58–35·43, and a 39·66% decrease in deaths, 36·49–42·36). Elsewhere, the incidence remained stable or increased, whereas deaths generally decreased. In 2019, the global incidence-to-prevalence ratio was 0·05 (95% UI 0·05–0·06) and the global incidence-to-mortality ratio was

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Reductions in virological failure and drug resistance to antiretroviral therapy in Chinese patients associated with lamivudine-based regimens, 2003–12: a cross-sectional study

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The Lancet 2015年 386卷 S60-S60页

作者： Hui Xing Yuhua Ruan Jenny H Hsi Wei Kan Lingjie Liao Xuebing Leng Jing Wang Cui He Yiming Shao State Key Laboratory of Infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases Beijing China

Background China's National Free Antiretroviral Treatment Program has substantially scaled up and standardised antiretroviral treatment (ART) since 2008. Meanwhile, no study worldwide has examined the effects of rapid ART programme scale-up on treatment outcomes in resource-limited settings on a large scale. Methods The national HIV drug resistance surveillance database included annual cross-sectional surveys HIV drug resistance from 2003–12. We used China's national HIV drug resistance surveillance database to determine virological failure, acquired drug resistance, and poor adherence after 12–15 months of first-line ART. The probability proportional to proxy size (PPPS) sampling recommended by WHO was used in this study. χ tests and logistic regression were used for categorical variables. The institutional review board of the National center on HIV/std control and prevention (NCaids), China CDC, approved this study. Findings Of the 2252 patients included in this study, 1180 (52%) were aged less than 40 years; 2100 (93%) belonged to the Han ethnic group; 1331 (59%) were male; 963 (43%) had primary school (1–6 years of education) or less; 1665 (74%) were married; 968 (43%) were farmers; 929 (41%), 947 (42%), and 322 (14%) were infected through blood or plasma transmission, sexual intercourse, and intravenous drug use, respectively. 1431 (64%) patients had initiated ART before 2008, and 821 (36%) initiated ART after 2008. The incidence of virological failure after 12–15 months of treatment was lower in the group of patients who had initiated ART after 2008 than in the group of patients who initiated ART before 2008 (12·1% vs 26·6%). The incidence of HIV drug resistance to ART was also significantly reduced in patients who initiated ART after 2008 compared to patients who intiated treatment before 2008 (5·4% vs 15·4%). However, these improvements are strongly associated with the standardised use of lamivudine-based regimens instead of didanosine-based regimens. Patien

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Prevalence and patterns of drug-resistance mutations among HIV-1 patients infected with CRF07_BC strains in Sichuan province,China

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Virologica Sinica 2014年第4期29卷 237-241页

作者： Ling Su Xia Zhou Dan Yuan Hong Yang Dongbing Wei Guangmin Qin Shu Liang Sichuan Provincial Center for Disease Control and Prevention Center for AIDS/STD Control and Prevention University of Kansas Medical Center Department of Internal Medicine Kansas City

Little information is available on the prevalence of drug-resistance mutations in patients harboring the human immunodeficiency virus type 1(HIV-1) circulating recombinant form(CRF)07_BC variant in Sichuan, China. This study examined 375 plasma samples from patients with HIV-1 who were infected with the CRF07_BC strain, including 104 drug-naive participants and 271 in whom antiretroviral therapy(ART) had failed. Only one participant in the drug-naive group had a drug-resistance mutation(M46L), compared with 31.73% of those in whom ART had failed. Further analysis showed that 19.56% of strains contained mutations conferring resistance to non-nucleoside reverse transcriptase inhibitors(NNRTIs) alone, 0.74% were resistant to nucleoside reverse transcriptase inhibitors(NRTIs) alone, and 11.44% were dual-resistant to both NRTIs and NNRTIs. The most common mutation in the ART-failure group was M184V(35.88%), K103N(45.01%), Y181C(17.33%), and G190S/A(15.88%). The percentages of HIV-1 strains resistant to lamivudine, emtricitabine, efavirenz, etravirine, and nevirapine were 10.70%, 10.70%, 28.04%, 7.75%, and 26.20%, respectively. To explore site variants possibly related to drug resistance, variations in the ancestor/consensus CRF07_BC sequences from the therapy-naive and ART-failure groups were compared, and seven mutations at six positions were identified as being significantly differently distributed between the two groups(p<0.05). Detailed sequence data will provide information on CRF07_BC genetic characterizations, and improve our understanding of antiretroviral susceptibility and the evolution of drug-resistance mutations. This will be valuable in developing and implementing local public-health approaches for HIV drug-resistance prevention and treatment.

关键词： HIV-1 CRF07_BC drug resistance Sichuan China

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Using Reduced Inoculum Densities of Mycobacterium tuberculosis in MGIT Pyrazinamide Susceptibility Testing to Prevent False-Resistant Results and Improve Accuracy: A Multicenter Evaluation

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Tuberculosis research and treatment 2017年第1期2017卷 3748163页

作者： Glenn P Morlock Frances C Tyrrell Dorothy Baynham Vincent E Escuyer Nicole Green Youngmi Kim Patricia A Longley-Olson Nicole Parrish Courtney Pennington Desmond Tan Brett Austin James E Posey Division of Tuberculosis Elimination Laboratory Branch National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention 1600 Clifton Road NE Atlanta GA 30329 USA. Tennessee Department of Health Division of Laboratory Services 630 Hart Lane Nashville TN 37216 USA. Mycobacteriology Laboratory Wadsworth Center New York State Department of Health 120 New Scotland Avenue Albany NY 12208 USA. Public Health Laboratory Los Angeles County Department of Public Health 12750 Erickson Avenue Los Angeles CA 90242 USA. Mycobacteriology Laboratory Wisconsin State Laboratory of Hygiene 465 Henry Mall Madison WI 53706 USA. Missouri State Public Health Laboratory 101 North Chestnut Street Jefferson City MO 65102 USA. Department of Pathology Johns Hopkins School of Medicine 600 North Wolfe Street Baltimore MD 21287 USA. Bureau of Clinical Laboratories Alabama Department of Public Health 8140 AUM Drive Montgomery AL 36117 USA. Massachusetts State Public Health Laboratory 305 South Street Jamaica Plain MA 02130 USA. County of San Diego Public Health Laboratory 3851 Rosecrans Street San Diego CA 92110 USA.

The primary platform used for pyrazinamide (PZA) susceptibility testing of is the MGIT culture system (Becton Dickinson). Since false-resistant results have been associated with the use of this system, we conducted a multicenter evaluation to determine the effect of using a reduced cell density inoculum on the rate of false resistance. Two reduced inoculum densities were compared with that prescribed by the manufacturer (designated as "BD" method). The reduced inoculum methods (designated as "A" and "C") were identical to the manufacturer's protocol in all aspects with the exception of the cell density of the inoculum. Twenty genetically and phenotypically characterized isolates were tested in duplicate by ten independent laboratories using the three inoculum methods. False-resistant results declined from 21.1% using the standard "BD" method to 5.7% using the intermediate ("A") inoculum and further declined to 2.8% using the most dilute ("C") inoculum method. The percentages of the resistant results that were false-resistant declined from 55.2% for the "BD" test to 28.8% and 16.0% for the "A" and "C" tests, respectively. These results represent compelling evidence that the occurrence of false-resistant MGIT PZA susceptibility test results can be mitigated through the use of reduced inoculum densities.

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Survival of people living with HIV after treatment with Traditional Chinese Medicine in Henan province of China: a retrospective cohortstudy

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Journal of Traditional Chinese Medicine 2014年第4期34卷 430-436页

作者： Yantao Jin Zhibin Liu Xiumin Chen Xin Wang Dan Wang Ziqiang Jiang Ying Liu Jian Wang Wen Zou Huijun Guo Liran Xu Department of Acquired Immune Deficiency Syndrome Treatment and Research Center the First Affiliated Hospital of Henan University of Traditional Chinese Medicine National Center for AIDS/STD Control and Prevention Chinese Center for Disease ControlandPrevention Key Laboratory of Viral Diseases Prevention and Treatment of Traditional Chinese Medicine of Henan Province School of International Education Zhengzhou Railway Vocational and Technical College Traditional Chinese Medicine Center for Acquired Immune Deficiency Syndrome Prevention and Treatment China Academy of Traditional Chinese Medicine National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Traditional Chinese Medicine Center for Acquired Immune Deficiency Syndrome Prevention and Treatment China Academy of Traditional Chinese Medicine

OBJECTIVE: To provide survival estimates of people living with human immunodeficiency virus(PLHIV) after treatment with Traditional Chinese Medicine(TCM) in rural China, to identify the prognostic factors at enrollment, and to explore the effectiveness of TCM intreating ***: PLHIV who enrolled in national TCM HIV treatment trial program in October 2004 were analyzed in this study and followed up to October 2010. Survival time was estimated by the Kaplan-Meier curve and hazard ratios, and identifying prognostic factors were computed through Cox proportional hazard ***:A total of 1666 PLHIV were included with 102 591 person-months of follow-up. Overall, 312(18.7%) patients died. The total mortality rate over the study period was 3.6 per 100 person-years,which was lower than the worldwide rate. The cumulative survival rate was 95.9% at 1 year[95% confidence interval(CI)(94.8-96.8)] and 80.4% at 6years [95% CI(78.4-82.3)]. Elevated death risks emerged among males, older individuals, and thosewithlowerCD4+***: TCM could increase survival and lengthen the life span of PLHIV in Henan province of China, as shown by our retrospective cohort study. Factors such as sex, age, education, and CD4+ T-cell counts correlated to survival. However,retrospective cohorts bias the data, so more prospective studies should be performed to confirm our primary results.

关键词： Retrospective studies HIV Acquired immunodeficiency syndrome Survival Medicine Chinese traditional

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Development of HIV-1 vaccines based on replication competent Tiantan vaccinia vector in China

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Lancet, The 2015年 386卷 S10-S10页

作者： Liu, Ying, PhD Li, Taisheng, MD Liu, Yong, PhD Hao, Yanling, PhD Wang, Jiansheng, PhD Wu, Yingqi, MD Liang, Hua, PhD Ren, Li, PhD Hong, Kunxue, PhD Xu, Jing, MS Zhao, Kai, BS Shao, Yiming, Dr State Key Laboratory of Infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases Hangzhou China Peking Union Medical College Hospital Beijing China Division of Health Statistics China Center for Disease Control and Prevention Beijing China National Vaccine and Serum Institute Beijing China

Abstract Background A vaccine is the best solution to stop the aids pandemic, but how to develop a vaccine is an unprecedented challenge to the global scientific community. The HIV vaccine programme of the China center for Disease control and prevention (CDC) is being developed through careful selection of the representative circulating HIV-1 strain CRF07 in China, through a nationwide molecular epidemiology survey involving all provinces. The replication competent Tiantan vaccinia (VTT, smallpox vaccine in China) was used as an aids vaccine vector. A DNA/rTV HIV-1 vaccine containing gag, pol, and env genes has been developed. In preclinical tests in monkeys, this vaccine gives high protection (more than 80%) against homologous SHIV (SHIV97001) challenge and partial protection (50%) against heterologous SHIV (SHIV SF162 P3) challenge when boosted with HIV-1 envelop protein. The aim of this study was to test the safety and immunological effect of the HIV-1 vaccine in healthy human volunteers. Methods A double-blind, placebo-controlled phase 1 trial was done at the Peking Union Medical College Hospital, Beijing, China. We enrolled HIV-1 uninfected healthy adults with or without history of smallpox vaccination. The subjects were randomly assigned to receive DNA alone (DNA 4 mg, DNA-H/rTV (DNA 4 mg), DNA-L/rTV (DNA 2 mg), or placebo. Randomisation was done by the Division of Health Statistics, China CDC, using SAS version 9.1.2. Participants, site staff, laboratory personnel responsible for endpoint assays, and investigators were blinded as to treatment assignments during the trial. Participants were primed with DNA vaccine (4 mg, intramuscular) three times at 1 month intervals and boosted once with rTV (5×104 plaque-forming units, skin scratches). The participants were monitored for safety and immunological outcomes. Vaccine-induced immunogenicity were measured by the enzyme-linked immunospot assay, intracellular cytokine staining, and antibody assays. All available da

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An unbalanced PD-L1/CD86 ratio in CD14^＋＋CD16^＋ monocytes is correlated with HCV viremia during chronic HCV infection

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Cellular & Molecular Immunology 2014年第3期11卷 294-304页

作者： Jiajia Zheng Hua Liang Chunhui Xu Qiang Xu Ting Zhang Tao Shen Fengmin LU Department of Microbiology Peking University Health Science Center Beijing China Department of Laboratory Medicine Peking University Third Hospital Beijing China State Key Laboratory for infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention China CDC Beijing China Center of Infectious Diseases Peking University Beijing China These authors contributed equally to this work

Circulating monocyte subsets with distinct functions play important roles in hepatitis C virus （HCV） infection. However, the mechanisms have not been well studied. In this study, we analyzed the distributions and phenotypic characteristics of three circulating monocyte subsets--CD14^＋＋CD16^-, CD14^＋＋CD16^＋ and CD14^＋＋mCD16^——in chronic HCV-infected patients, HCV spontaneous resolvers and healthy controls, and we evaluated the possible link between HCV viremia and disease progression. Our results indicated that the frequency of the CD 14^＋＋CD 16^＋ monocyte subset was decreased, and negatively correlated with HCV RNA and core antigen levels during chronic HCV infection. PD-L1 expression and the PD-L1/CD86 ratio in CD14^＋＋CD16^＋ monocytes were higher during chronic HCV infection than in spontaneous HCV resolvers and healthy controls. The PD-L1/CD86 ratio positively correlated with HCV viral load and core antigen levels. Finally, PD-L1 was significantly increased, while cytokine secretions were dramatically decreased upon Toll-like receptor （TLR） ligand binding and HCV JFH-lstimulation. These findings indicates the compromised immune status of the CD14^＋＋CD16^＋ monocytes during chronic HCV infection and provides new insights into the specific role of the CD14^＋＋CD16^＋ monocytes and their significance in chronic HCV infection.

关键词： core antigen hepatitis C virus monocytes PD-L1/CD86 viral load

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Consensus is needed at a global level concerning dual-use research

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REVIEWS IN MEDICAL VIROLOGY 2013年第1期23卷 1-2页

作者： Shao, Yiming State Key Laboratory for Infection Disease Prevention and Control National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China [*] Yiming Shao State Key Laboratory for Infection Disease Prevention and Control National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 102206 China.Email: yshao08@***

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