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A new approach for sequencing virion genome of Chinese HIV-1 strains subtype B and BC from plasma

Chinese Medical Journal 2011年第2期000卷 304-308页

作者： MENG Zhe-feng ZHANG Xiao-yan XIN Ruo-lei XING Hui HE Xiang XU Jian-qing SHAO Yi-ming Shanghai Public Health Clinical Center Key Laboratory of Medical Molecular Virology of Ministry of Health Shanghai Medical College Institutes of Biomedical Sciences Fudan University Shanghai 200433 China Key Laboratory of Infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 100050 China

Background Although it was widely accepted that full-length HIV genome sequences is important in studying virus genetic evolution and variation as well as developing vaccine candidate,to directly sequencing HIV-1 genome of virion RNA remains as a challenge *** to date,no published genomic sequences from virion RNA are available for Chinese prevalent HIV-1 strains due to the absence of specialized protocol and appropriate lab *** this study we developed a straightforward approach for amplifying and sequencing HIV virion RNA from plasma by modifying published protocols and further confirmed it is suitable to process Chinese *** The methods for viral RNA extraction and gene amplification was modified and optimized as could be widely used in most Chinese *** alignment of Chinese HIV-1 strains was employed for designing specialized primer sets for Thai-B and BC recombinant *** on comprehensively consideration of high variable gene region and recombinant breakpoints in BC recombinant strains,a three-amplicon strategy （including 4.3-kb gag-pol,2.9-kb pol-env and 2.7-kb env-ne） was *** addition,one amplicon （9 kb near full-length genome） was also used in 32 samples with varied viral *** amplicons were directly sequenced by DNA automated *** Twenty-five percent（8/32） amplification efficiency was achieved by the one-amplicon strategy and 65.6%（21/32） by three-amplicon *** one amplicon strategy,none of complete near full-length genome sequences was obtained by DNA *** three-amplicon strategy,75% sequences were achieved in DNA *** efficiency but not sequencing efficiency was closely associated with viral *** Three-amplicon strategy covering all encoding regions of HIV-1 is suitable for Thai-B and BC recombinant strains and could be potentially employed in less-well equipped Chinese labs.

关键词： human immunodeficiency virus 1 RNA full-genome amplification

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HIV,HCV,and HBV Co-Infections in a Rural Area of Shanxi Province with a History of Commercial Blood Donation

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Biomedical and Environmental Sciences 2011年第3期24卷 207-213页

作者： DONG RuiLing QIAO Xiao Chun JIA WangQian WONG Michelle QIAN HanZhu ZHENG XiWen XING WenGe LAI ShengHan WU ZhengLai JIANG Yan WANG Ning Shenzhen International Travel Health Care Center Shenzhen 518033 Guangdong China National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 102206 China Shanxi Provincial Center for Disease Control and Prevention Taiyuan 030012 Shanxi China Wenxi County Center for Disease Control and Prevention Wenxi 043800 Shanxi China School of Medicine Vanderbilt University Nashville TN USA Johns Hopkins Medical School New York USA Peking Union Medical College Beijing 100005 China

Background： Unhygienic blood collection in the early 1990s led to blood-borne infections in Central China. This study aimed to estimate human immunodeficiency virus （HIV） co-infection with hepatitis C and B viruses （HCV and HBV） and their risk factors in a rural area of Shanxi Province with a history of commercial blood donation. Methods： A cross-sectional study was conducted in 2004. All adult residents in the target area were invited to participate in the study. Face-to-face interviews were completed and blood specimens were tested for HIV, HCV, and HBV surface antigen （HBsAg）. Results： Prevalence rates of HIV, HCV, and HBsAg were 1.3% （40/3 062）, 12.7% （389/3 062）, and 3.5% （103/2982）, respectively. Of the 40 HIV-positive specimens, 85% were HCV positive and 2.5% were HBsAg positive. The history of commercial blood donation was positively associated with HIV, HCV, and HIV/HCV co-infections, but was negatively associated with HBsAg seropositivity. Migration for employment in the last 5 years was positively related to HIV, HBsAg, and HIV/HCV co-infections. Univariate logistic analysis showed that illegal drug use, number of sex partners, extramarital sex behavior, commercial sex behavior, and condom use rate were not related to anti-HIV, anti-HCV, HBsAg seropositivity or their co-infections. Conclusion： The history of commercial blood donation was the main risk factor for HIV, HCV, and HIV/HCV co-infections in this former commercial blood donation area. HIV and HCV prevention and treatment interventions are important in this area.

关键词： Human immunodeficiency Virus Co-infections Hepatitis C Virus Hepatitis B Virus SurfaceAntigen Commercial Blood Donation

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Heterosexual risk of HIV infection in China： systematic review and meta-analysis

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Chinese Medical Journal 2011年第12期124卷 1890-1896页

作者： ZANG Chun-peng JIA Zhong-wei Katherine Brown Kathleen Heather Reilly WANG Jun-jie WANG Ning National Center for AIDS/STD Control and Prevention ChineseCenter for Disease Control and Prevention 155 Changbai RoadChangping District Beijing 102206 China National Institute of Drug Dependence 38 Xueyuan Road HaidianDistrict Beijing 100083 China Tulane University Health Sciences Center School of Public Healthand Tropical Medicine New Orleans LA USA

Background Heterosexual sex has become the dominant transmission route in China. Recently studies reported high heterogeneity in heterosexual transmission risk in resource-limited countries. The aim of this study was to summarize the risk of HIV transmission among Chinese serodiscordant couples. Methods A systematic review and meta-analysis of observational studies of heterosexual HIV transmission among serodiscordant couples in China was conducted. Two reviewers conducted a literature search using the China National Knowledge Infrastructure （CNKI）, Chinese Medical Current Contents （CMCC）, and Medline databases. Pooled transmission estimates per 100 person-years （PY） were calculated using a random-effects model. Meta-regression analysis and subgroup analysis stratified by study design, transmission direction and period of antiretroviral therapy （ART） availability were conducted to assess the factors associated with transmission. Results Eleven eligible studies were identified reporting on 11 984 couples and 405 HIV transmission events. HIV transmission risk from HIV-positive individuals to heterosexual partners was 1.68 （95% Cl 0.74-2.62） per 100 PY. Study design did not reach statistical significance in meta-regression analysis. The pooled female-to-male transmission estimate was 1.11 （95% CI 0.09-2.14） per 100 PY and male-to-female transmission estimate was 1.43 （95% Cl 0.19-2.68） per 100 PY. The pooled estimate for those before the availability of the Chinese National Free Antiretroviral Therapy Program （2.13 （95% Cl 0.00-4.63） per 100 PY） was higher than that for those after the implementation of this program （1.44 （95% CI 0.62-2.26） per 100 PY）. Conclusions Transmission estimates in China were lower than other developing countries, but higher than developed countries. Research that better defines HIV secondary transmission rates and the associated behavioral, treatment adherence, and health-related risk factors among heterosexual serodiscordant couples in China

关键词： human immunodeficiency virus heterosexual transmission

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Engaging HIV-infected patients in antiretroviral therapy services： CD4 cell count testing after HIV diagnosis from 2005 to 2009 in Yunnan and Guangxi, China

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Chinese Medical Journal 2011年第10期124卷 1488-1492页

作者： ZHANG Yao LU Lin LI Hui-qin LIU Wei TANG Zhi-rong FANG Hua Jennifer Y. Chen MA Ye ZHAO Yan Ray Y. Chen ZHANG Fu-jie Division of Treatment and Care National Center for AIDS/STD Control and Prevention Chinese Center for Diseases Control and Prevention Beijing 100050 China Yunnan Center for Diseases Control and Prevention Kunrning Yunnan 650022 China Yunnan AIDS Care Center Ktmming Yunnan 650118 China Division of HIV and Sexually Transmitted Disease Guangxi Center of Diseases Control and Prevention Nanning Guangxi 530012 China Outpatient Clinic Provincial Center of Diseases Control and Prevention Nanning Guangxi 530000 China Harvard Medical School Boston USA The Office of Global Research National Institute of Allergy and Infectious Diseases US National Institutes of Health Beijing 100600 China Beijing Ditan Hospital Affiliated to Capital Medical University Beijing 100015 China

Background The initiation and expansion of China＇s national free antiretroviral therapy program has led to significant improvement of survival among its participants. Success of further scaling up treatment coverage rests upon intensifying HIV screening and efficient linkage of care. Timely CD4 cell count testing after HIV diagnosis is necessary to determine whether a patient meets criteria for antiretroviral treatment, and represents a crucial link to engage HIV-infected patients in appropriate care, which has not been evaluated in *** We evaluated all patients ≥16 years who tested HIV positive from 2005 to 2009 in Yunnan and *** Logistic regression models were applied to identify factors associated with lack of CD4 cell count testing within 6 months after HIV *** A total of 83 556 patients were included. Over the study period, 30 635 （37%） of subjects received a CD4 cell count within 6 months of receiving the HIV diagnosis. The rate of CD4 cell count testing within 6 months of HIV diagnosis increased significantly from 7% in 2005 to 62% in 2009. Besides the earlier years of HIV diagnosis, negative predictors for CD4 cell count testing in multivariate analyses included older age, not married or unclear marriage status,incarceration, diagnosis at sexual transmitted disease clinics, mode of HIV transmission classified as men who have sex with men, intravenous drug users or transmission route unclear, while minority ethnicity, receipt of high school or higher education, diagnosis at voluntary counseling and testing clinics, and having HIV positive parents were *** Significant progress has been made in increasing CD4 testing among newly diagnosed HIV positive patients in Yunnan and Guangxi from 2005-2009. However, a sizable proportion of HIV positive patients still lack CD4testing within 6 months of diagnosis. Improving CD4 testing, particularly among patients with identified risk factors, is essential to link

关键词： human immunodeficiency virus CD4 cell count testing care linkage risk factors

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The characteristics and risk factors for HIV infection among Beijing drug users in different settings

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Drug and Alcohol Dependence 2011年第1期113卷 37-45页

作者： Wang, Haibo Li, Guiying Brown, Katherine Smith, Kumi Jin, Xia Dong, Ruiling Wang, Ning Chinese Center for Disease Control and Prevention 27 Nanwei Rd Beijing 100050 PR China Department of AIDS/STD Control and Prevention Beijing Center for Disease Control and Prevention 16 Hepingli ZhongJie Beijing 100013 PR China National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention 155 Changbai Road Changping District Beijing 102206 PR China University of North Carolina Chapel Hill Gillings School of Global Public Health Department of Epidemiology Chapel Hill NC 27599-7435 United States Shenzhen International Travel Health Care Center Shenzhen Port Hospital Shenghuo District HuangGang Port Shenzhen 518033 PR China

Abstract Background Treatment for drug addiction in China can take place in mandatory detoxification centers (MDC), voluntary detoxification centers (VDC), or at outreach programs located in the community. To date little is known about HIV prevalence or associated risk factors among the current and past drug users (DU) in each setting. Methods Cross-sectional surveys were conducted at three different settings in Beijing, China; 795 subjects were enrolled at MDC, 824 at VDC, and 520 within the community. Subjects who provided informed consent took part in face-to-face interviews and provided blood samples for HIV and syphilis testing. Results Significant differences were found across enrollment sites in terms of demographic, drug use and sexual behavior characteristics. Overall HIV sero-prevalence was 2.9%, and was particularly high in MDC (5.2% versus 1.0% in VDC and 2.3% among community drug users). Adjusted odds ratios (OR) for HIV infection were 50.5 (95% CI: 19.07–133.85) for being of Yi ethnicity, 29.4 (95% CI: 15.10–57.24) for Uyghur ethnicity, 3.4 (95% CI: 1.57–7.52) for injection drug users who did not share equipment, and 18.8 (95% CI: 8.31–42.75) among injection drug users who shared injection equipment. Conclusions The vast differences among DU in various enrollment sites in terms of demographic characteristics, socioeconomic status, and HIV related risk profiles underscore the importance of familiarity with population characteristics and drug user environment to better inform targeted prevention programs. prevention programs targeting DU in Chinese settings must also consider differences in ethnicities, culture, and residential status.

关键词： Drug use Detoxification centers HIV China

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Correlation Analysis on Total Lymphocyte Count and CD4 Count in HIV-infected Patients: A Retrospective Evaluation

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2011年第5期31卷 712-716页

作者：王宇明梁淑英于二曼郭金玲李自钊王哲杜玉开 Henan Provincial Medical Academy Department of Epidemiology and Biostatistics College of Public Health Zhengzhou University Center for AIDS/STD Control and Prevention Department of Health of Henan Province Institute for Infection Disease Control and Prevention Henan Provincial Center for Disease Control and Prevention Department of Maternal and Child Health Care and Adolescent Hygiene School of Public Health Tongji Medical College Huazhong University of Science and Technology

CD4 count is the standard method for determining eligibility for highly active antiretroviral therapy （HAART） and monitoring HIV/aids disease progression, but it is not widely available in resource-limited settings. This study examined the correlation between total lymphocyte count （TLC） and CD4 count of HIV-infected patients before and after HAART, and assessed the thresholds of TLC for making decisions about the initiation and for monitoring HAART. A retrospective study was performed, and 665 HIV-infected patients with TLC and CD4 count from four counties （Shangcai, Queshan, Shenqiu and Weishi） were included in the study. Pearson correlation and receiver operating characteristic （ROC） were used. TLC and CD4 count after HAART was significantly increased as compared with pre-HAART （P〈0.01）. An overall positive correlation was noted between TLC and CD4 count （pre-HAART, r=0.73, P=0.0001; follow-up HAART, r=0.56, P=0.0001）. The ROC curve between TLC and CD4 count showed that TLC ≤ 1200 cells/mm3 could predict CD4 〈 200 cells/mm3 with a sensitivity of 71.12%, specificity of 66.35% at pre-HAART. After 12-month HAART, the optimum prediction for CD4 count 〈 200 cells/mm3 was a TLC ≤ 1300 cells/mm3, with a sensitivity of 63.27%, and a specificity of 74.84%. Further finding indicated that TLC change was positively correlated to CD4 change （r=0.77, P=0.0001） at the time point of 12-month treatment, and the best prediction point of TLC change for CD4 increasing was 135 cells/mm3. TLC and its change can be used as a surrogate marker for CD4 count and its change of HIV-infected individuals for making decisions about the initiation and for monitoring HAART in resource-limited settings.

关键词： HIV/aids CD4 count total lymphocyte count highly active antiretroviral therapy

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Reply to Hsue et al

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Clinical Infectious Diseases 2011年第1期53卷 96-97页

作者： Mondy, Kristin E. Gottdiener, John Brooks, John T. Washington University School of Medicine St Louis Missouri University of Texas Southwestern Austin Program Central Texas Veterans Healthcare System Austin Texas University of Maryland Baltimore Maryland Centers for Disease Control and Prevention National Center for HIV Hepatitis STD and TB Prevention Division of HIV/AIDS Prevention Atlanta Georgia

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HLA-DR expression on regulatory T cells is closely associated with the global immune activation in HIV-1 infected subjects naive to antiretroviral therapy

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Chinese Medical Journal 2011年第15期124卷 2340-2346页

作者： XIAO Jian QIAN Ke-lei CAO Qing-hua QIU Chen-li QIU Cao XUE Yi-le ZHANG Xiao-yan ZHONG Ping XU Jian-qing LI Ming-yuan WANG Ying Department of Microbiology West China School of preclimcal and Forensic Medicine Sichuan University Chengdu Sichuan 610041 China Department of AIDS/STD Shanghai Municipal Center for Disease Control and Prevention Shanghai 200336 China Shanghai Public Health Clinical Center Institutes of Biomedical Sciences Key Laboratory of Medical Molecular Virology of Ministry of Education/Health Shanghai Medical College Fudan University Shanghai 201508 China

Background The frequencies of regulatory T cells （Tregs） increased over the HIV infection but its counts actually decreased. We proposed that the decrease of Treg counts may cause the reduction of inhibitory effect and thereby account for the over-activation of Tregs during HIV infection. However, it remains unknown whether Tregs are also over-activated and thereafter the activation induced death may lead to the decrease of Tregs. Methods Tregs were defined as CD4＋CD25＋CD127lo/-T cells. Eighty-one HIV-1 infected patients were enrolled in our study, and twenty-two HIV-1 seronegative donors were recruited as the control. The levels of HLA-DR on Tregs were determined by FACSAria flow cytometer. Results Compared to HIV-1 seronegative donors, the levels of HLA-DR on CD4＋CD25＋CD127lo/- Tregs were significantly increased in HIV-1 infected patients, and its increase was positively associated with viral loads （r=0.3163, P=-0.004） and negatively with CD4 T-cell counts （r=-0.4153, P 〈0.0001）. In addition, significant associations between HLA-DR expression on CD4＋CD25＋CD127lo/- Tregs and the percentages of HLA-DR, CD38, Ki67 expressing CD4＋ and CD8＋ T cells were also identified. Conclusion HLA-DR on Tregs is a good marker for viral replication and disease progression. The over-activation of Tregs might result in the decrease of Tregs.

关键词： human immunodeficiency virus type 1 T-lymphocytes, regulatory HLA-DR antigens immune activation

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The clinical significance of CD4 counts in asian and caucasian HIV-infected populations: Results from TAHOD and AHOD

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Journal of the International Association of Physicians in aids Care 2011年第3期10卷 160-170页

作者： Achhra, Amit C. Zhou, Jialun Choi, Jun Yong Hoy, Jennifer Zhang, Fujie Templeton, David J. Merati, Tuti Woolley, Ian Petoumenos, Kathy Amin, Janaki National Centre in HIV Epidemiology and Clinical Research Faculty of Medicine UNSW Sydney Australia Division of Infectious Diseases Department of Internal Medicine Yonsei University College of Medicine Seoul South Korea Infectious Diseases Unit Alfred Hospital Monash University Melbourne VIC Australia National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Yunnan China RPA Sexual Health Royal Prince Alfred Hospital Sydney Australia Faculty of Medicine Udayana University Sanglah Hospital Bali Indonesia Infectious Diseases Department Monash Medical Centre Monash University Clayton VIC Australia National Centre in HIV Epidemiology and Clinical Research University of New South Wales Sydney NSW 2052 Australia

The significance of interethnic variation in CD4 counts between Asian and Caucasian populations is not known. Patients on combination antiretroviral therapy from Treat Asia and Australian HIV Observational Databases (TAHOD, predominantly Asian, n = 3356;and AHOD, predominantly Caucasian, n = 2312, respectively) were followed for 23 144 person-years for aids/death and all-cause mortality endpoints. We calculated incidence-rates and used adjusted Cox regression to test for the interaction between cohort (TAHOD/AHOD) and time-updated CD4 count category (lagged by 3 months) for each of the endpoints. There were 382 aids/death events in TAHOD (rate: 4.06, 95%CI: 3.68-4.50) and 305 in AHOD (rate: 2.39, 95%CI: 2.13-2.67), per 100 person-years. At any given CD4 count category, the incidence-rates of endpoints were found to be similar between TAHOD and AHOD (in the adjusted models, P >.05 for the interaction term between cohort type and latest CD4 counts). At any given CD4 count, risk of aids or death was not found to vary by ethnicity, suggesting that the CD4 count thresholds for predicting outcomes defined in Caucasian populations may be equally valid in Asian populations. © The Author(s) 2011.

关键词： Asians Caucasian race CD4 counts cohort analysis ethnicity

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Study on factors affecting TB/HIV co-infection in four counties of China

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Frontiers of Medicine 2010年第2期4卷 185-191页

作者： Shi-Ming CHENG Yu-Ji LAI Er-Yong LIU Lin ZHOU Xue-Jing WANG Qiu-Lan CHEN Dong-Ming LI Ning WANG National Center for TB Control and Prevention Chinese Center for Disease Control and PreventionBeijing 102206China National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and PreventionBeijing 102206China

The factors affecting case detection of tuber-culosis(TB)/human immunodeﬁciency virus(HIV)co-infection cases were explored in order to provide evidence-based formulation of a TB/HIV co-infection control strategy in *** counties with different modes of HIV transmission and varying cooperation mechanisms between TB and HIV institutions were *** test among TB patients and TB examination among people living with HIV/acquired immunodeﬁciency syndrome(aids)were *** also completed ques-tionnaires on potential factors affecting TB/HIV *** results showed that 19(1.7%)were HIV-positive among 1089 cases of people living with active TB who received HIV ***,there were 126(10%)cases of active TB among 1255 cases of people living with HIV/*** the newly discovered 145 cases of TB/HIV co-infection,aids institutions found 86.9%of these co-infections and 14.1%came from TB *** different registration categories,there were 31(21.4%)cases of smear positive TB,104(71.7%)cases of smear negative TB,and extrapulmonary cases accounted for 10(6.9%).Gender,occupation,marital status,ethnic group,education,HIV transmission route,CD4 level,and type of TB susceptible symptoms had signiﬁcant effects on whether HIV/aids patients were co-infected with TB disease(P<0.01).Sex,age,ethnic group,occupation,and type of tuberculosis had no signiﬁcant inﬂuence on whether TB patients had HIV *** institutions couldﬁnd more TB/HIV co-infection patients in compar-ison with TB institutions,particularly in patients with smear negative pulmonary tuberculosis and extrapulmon-ary ***,a cooperation mechanism should be built up between TB and HIV control systems,and routine TB checks should be conducted for HIV/aids *** areas where sex or drug use is the major transmission mode of HIV infection,antiretroviral therapy should be expanded,treatment adherence should be improved and patients’immunity level should

关键词： tuberculosis/acquired immunodeﬁciency syn-drome dual infection prevention and control case detection impact factors

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