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Development and Challenge of HIV/aids Testing Laboratory Network and Quality Assurance System in China

Virologica Sinica 2007年第6期22卷 434-442页

作者： Yan JIANG National AIDS Reference Laboratory of National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 100050 China

This paper describes the development and challenge of HIV/aids testing laboratory network and quality assurance system in China. At present,the HIV/aids testing laboratories includes three classes,the National aids Reference Laboratory,HIV/aids confirmatory laboratories and HIV/aids screening laboratories. All of them are accredited by the health authorities,and each class of laboratories take charge of their function strictly according to the "National Management of HIV/aids Detection (2006)". A complete quality assurance and quality control system for HIV/aids testing has been developed,which includes technical training,strict laboratory monitoring and approval,examination or proficiency testing on HIV/aids detection,and quality evaluation and supervision of HIV/aids diagnostic kits. Besides conduct the routine anti-HIV antibody test,more and more laboratories began to conduct other tests,such as CD4+ T lymphocyte cell counting,HIV viral load,HIV DNA PCR,genotyping,drug resistance,and HIV-1 recent infection test. The primary challenges faced by the HIV/aids testing laboratory network are in the areas of laboratory management and quality control. For example,the provincial PT program is inefficient,the internal quality control is conducted perfunctorily,personnel training can not met the needs of the workplace,which need to be improved.

关键词： Human immunodeficiency virus （HIV） Laboratory Detection Quality assurance Quality control

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aids Research and Its Role in China's aids prevention and control Policies

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Virologica Sinica 2007年第6期22卷 421-425页

作者： Yi-ming SHAO State Key Laboratory for Infectious Diseases Prevention and Control National Center for AIDS / STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 100050 China

By the end of 2005,the estimated number of HIV infected people in China was 650,000. The seriousness of the epidemic calls for effective control measures to tackle the problems in order to avoid the tragedy in Africa from happening in China. "prevention First" is the cornerstone of the country's health policy. On 2003 World aids Day,Premier Jiabao Wen announced a new national aids control policy,"Four Frees and One Care". This policy clearly shows that the Chinese government has once again taken full responsibility to solve public health problems and has profound impact far beyond the aids field. In early 2006,the central government put scientific and technology innovation as a national priority and set the target to build an innovative China by year 2020. Since then,the government has been increasing investment in science and technology with major emphasis on both infectious diseases control and new drug research and development. For the first time,development of 100 new drugs and control of major infectious diseases (aids,HBV,TB and other emerging infectious diseases) have been selected as national key scientific projects. China's best minds in related fields will be pooled to work together in order to remove the technical barriers blocking efficient control of the major infectious disease in China. Knowledge on molecular epidemiology,immunology,pathogenesis,HAART,as well as HIVDR strains will certainly provide urgently needed scientific information for China's aids control program. Only evidence-based strategy from good research will provide long-term effective control of aids.

关键词： aids prevention control

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Continued spread of HIV among injecting drug users in southern Sichuan Province, China

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Harm Reduction Journal 2007年第1期4卷 1-7页

作者： Yin, Lu Qin, Guangming Qian, Han-Zhu Zhu, Yu Hu, Wei Zhang, Li Chen, Kanglin Wang, Yunxia Liu, Shizhu Zhou, Feng Xing, Hui Ruan, Yuhua Wang, Ning Shao, Yiming State Key Laboratory for Infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Xuanwu District Beijing 100050 27 Nanwei Road China Sichuan Provincial Center for Disease Control and Prevention Chengdu Sichuan Province 610031 6 Zhongxue Road China Department of Medicine Division of Preventive Medicine University of Alabama at Birmingham Birmingham AL 35205 1717 11th Ave. S. Med. Towers Bld. United States Xichang Center for STD and Leprosy Control Sichuan Province 615000 5 Chang'an Road China

Objective: To estimate HIV prevalence among injecting drug users (IDUs) in a drug trafficking city in southwest Sichuan Province, China. Methods: A total of 314 IDUs was invited to participate in the cross-sectional survey in 2004 through community outreach recruitment and peer referrals. Blood sample was taken for HIV antibody testing and a structured questionnaire was administered to collect information on socio-demographics, drug using and sexual behaviors. Results: HIV prevalence among IDUs was 17.8% (56/314), about one half higher than that in previous survey in 2002 (11.3%, 43/379). Yi and other minority ethnicity (Odds ratio [OR], 3.1;95% confidence interval [CI], 1.7-5.8;P < 0.001), and total times of sharing injecting equipments 1-9 times versus none, OR, 2.7;95% CI 1.2-6.2;P = 0.02;and ≥10 times versus none, OR, 7.5;95% CI, 3.2-17.7;P < 0.001) were independent risk factors for HIV infection. Conclusion: IDUs with high prevalence rates of HIV and equipment sharing behavior in the drug trafficking city may serve a source for further spread of HIV to other areas in China. The increasing trend of HIV epidemic among IDUs underscores the urgency of scaling up interventions. © 2007 Yin et al;licensee BioMed Central Ltd.

关键词： Drug Trafficking Methadone Maintenance Therapy Needle Exchange Program Leprosy control Ethnic Minority People

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HIV incidence, retention, and changes of high-risk behaviors among rural injection drug users in Guangxi, China

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Substance Abuse 2007年第4期27卷 53-61页

作者： Wei, Liu Chen, Jie Rodolph, Michelle Beauchamp, Geetha Mâsse, Ben Li, Rongjian Wang, Shaoping Ruan, Yuhua Liu, Shizhu Zhang, Li Zhou, Feng Rose, Scott M. Perdue, Thomas Lai, Shenghan Shao, Yiming Jackson, J. Brooks Guangxi Centers for Disease Control and Prevention Nanning China Department of Pathology Johns Hopkins University School of Medicine Baltimore MD United States Statistical Center for HIV/AIDS Research and Prevention Fred Hutchinson Cancer Research Center Seattle WA United States Heng County Anti-Epidemic Station Hengzhou China State Key Laboratory for Infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China Family Health International Durham NC United States Johns Hopkins University Carnegie 415 Baltimore MD 21287 600 North Wolfe Street United States

Background: A prospective observational study of HIV seroincidence among high-risk injection drug users (IDU) was carried out in Guangxi, China. The primary objectives of this study were (1) to estimate HIV seroincidence (2) to estimate participant retention rate and (3) to evaluate changes in drug use and sexual behavior over a one year period. Methods: Five hundred HIV seronegative IDU were enrolled. HIV-1 incidence and retention rates were analyzed as a function of sociodemographic, behavioral, and recruitment variables. Changes in drug use and sexual behavior were analyzed at the baseline, 6-month and 12-month follow- up visits. Results: At 12 months of follow-up, the HIV-1 incidence rate was 3.1 per 100 person years, [95% CI: (1.6%;5.2%)] and participant retention rate was 87%. Reported changes in high-risk behaviors over 12-months included significant decreases in the frequency of heroin injection, in direct or indirect sharing of injection equipment, and in the number of sexual partners. Conclusions: HIV incidence is high among IDU in Guangxi, China despite a self-reported decrease in some high risk behaviors over the course of the study. Copyright © by The Haworth Press, Inc. All rights reserved.

关键词： China Guangxi HIV incidence IDU Retention

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Adverse events in HIV-infected persons receiving antiretroviral drug regimens in a large urban slum in Nairobi, Kenya, 2003-2005

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Journal of the International Association of Physicians in aids Care 2007年第3期6卷 206-209页

作者： Kim, Andrea A. Wanjiku, Lucy MacHaria, Doris K. Wangai, Mary Isavwa, Anthony Abdi, Hussein Marston, Barbara J. Ilako, Festus Kjaer, Mette Chebet, Kenneth De Cock, Kevin M. Weidle, Paul J. Global AIDS Program National Center for HIV Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA 30333 1600 Clifton Rd. United States Global AIDS Program CDC-Kenya Nairobi Kenya Republic of Kenya Ministry of Health Nairobi Kenya African Medical Research Foundation-Kenya Nairobi Kenya Division of HIV/AIDS Prevention CDC Atlanta GA United States

Objective: This article describes toxicities to antiretroviral therapy (ART) among HIV-infected patients receiving care at a clinic in a large urban slum in Nairobi, Kenya. Methods: Patients were treated with nonnucleoside reverse transcriptase inhibitor-based ART and followed at scheduled intervals. Frequencies and cumulative probabilities of toxicities were calculated. Results: Among 283 patients starting ART, any and severe clinical toxicity were recorded as 65% and 6%, respectively. Cumulative probabilities for remaining free of any and severe clinical toxicities at 6, 12, and 18 months, were 0.47, 0.26, and 0.17, respectively and 0.98, 0.95, and 0.89, respectively. The probability of remaining free from elevated and grade 3 or 4 serum aminotransferase (AST) at 6, 12, and 18 months were 0.62, 0.42, and 0.21, respectively, and 0.99 at 6, 12, and 18 months. Conclusions: ART toxicities were frequent, but severe toxicities were less common. In resource-limited settings, ART toxicity should not represent a barrier to care. © 2007 Sage Publications.

关键词： Africa antiretroviral therapy HIV nonnucleoside reverse transcriptase inhibitor toxicity

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P008 A National Multicenter Study for definition of a Reference Range for Peripheral Blood CD4+ T Lymphocyte in Healthy Adult Han Chinese

P008 A National Multicenter Study for definition of a Refere...

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第一届世界华人免疫学大会(International Conference on Immunology 2007)

作者： Yao Xiao Hui Zhang Shibei Yu Cuiying Li Yan Jiang National AIDS Reference Laboratory National Center for STD/AIDS Prevention and ControlChinese Center for Disease Prevention And Control27 Nanwei RoadXuan Wu Dist.BeijingChina

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Relationship of HLA-A,-Cw Polymorphisms with HIV/aids in Chinese Yi Ethnic Group of Sichuan Province

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中国病毒学 2007年第4期22卷 301-306页

作者： Kun-xue HONG Xiao-zhi LU Guang-ming QIN Jian-ping CHEN Yu-hua RUAN Hui XING Jia-hong ZHU Yi-ming SHAO National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and PreventionBeijing 100050 China 2. Wuhan Institute of Biological Products Wuhan 430060 China Wuhan Institute of Biological Products Wuhan 430060 China Sichuan Center for Disease Control and Prevention Chendu 610000 China

The relationship of HLA-A, -Cw alleles on HIV infection and aids disease progression in the Chinese Yi ethnic group of Sichuan province were investigated. The genetic polymorphisms of HLA-A, -Cw alleles of 102 unrelated healthy Chinese Yi ethnic individuals, 68 HIV-1 infected and 21 HIV positive long-time survivors were typed by PCR-SSP assay. Statistic signifiance was determined by the χ2 test with the SPSS software. No significant differences were observed between the HLA-A, -Cw alleles of the 68 HIV-1 infected and 102 non-infected Chinese Yi control individuals. Whereas the prevalence of A*3601,Cw*14(01-03)and Cw*0304 was significantly higher in 21 long time survivors compared with 102 healthy controls with P values of 0.016, 0.016 and 0.000 by χ2 or the Fisher exact test respectively. The result implies that A*3601,Cw*14(01-03) and Cw*0304 may be associated with slow aids disease progression in the Chinese Yi ethnic group, further studies on this association may yield insight on the pathogenesis of HIV-1 infection.

关键词：艾滋病病毒艾滋病彝族 HLA-A HLA-Cw 多态性相关性四川

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Measuring sexual risk using audio computer-assisted self-interviewing (ACASI) versus computer-assisted personal interview (CAPI) in China

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International Journal of Sexual Health 2007年第1期19卷 25-30页

作者： Li, Li Wu, Zunyou Rotheram-Borus, Mary Jane Detels, Roger Guan, Jihui Batterham, Philip Lin, Ying-Ying National Institute of Mental Health (NIMH) Collaborative HIV Prevention Trial Group United States Department of Psychiatry and Behavioral Sciences Neuropsychiatric Institute University of California Los Angeles CA United States National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China School of Public Health University of California Los Angeles CA United States Fujian Institute of Health Education Fuznou China Research Management UCLA Center for Community Health Los Angeles CA 90024 1100 Glendon Avenue United States

The reliability of self-reports of sexual acts and sexually transmitted disease symptoms was compared among 199 food market workers in an eastern coastal city in China using audio computer-assisted self-interviewing (ACASI) and computer-assisted personal interview (CAPI). Two assessments (ACASI and CAPI) were evaluated with each participant;100 participants were interviewed with ACASI first, followed by CAPI, and 99 participants were interviewed by CAPI first, followed by ACASI. McNemar tests showed that participants were significantly more likely to report that they had engaged in lifetime sexual intercourse when using a CAPI interview than an ACASI interview. There was no significant difference between CAPI and ACASI in reports of the number of lifetime sexual partners and two measures of sexually transmitted disease. Participants with less education were more likely to give inconsistent responses than participants with more education and older participants were more likely to have discrepancies in their sexual behavior responses than younger participants. ACASI is not necessarily a better mode of data collection than CAPI for sensitive behavioral measures among urban market workers in China. © 2007 by The Haworth Press, Inc. All rights reserved.

关键词： Assessment China HIV Interview std

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Study of HIV-1 Drug Resistance in Patients Receiving Free Antiretroviral Therapy in China

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中国病毒学 2007年第3期22卷 233-240页

作者： Xin-ping LIP　 Hui XING　 Zhe WANG　 Xue-feng SI Lian-en WANG　 Hua CHENG　 Wei-guo CUI　 Shu-lin JIANG　 Ling-jie LIAO　 Hai-wei ZHOU　 Jiang-hong HUANG　 Hong PENG　 Peng-fei MA　 Yi-ming SHAO State key laboratory of virology Wuhan Institute of Virology Chinese Academy of Science Wuhan 430071 China State key laboratory for Infectious disease prevention and control Division of Research on Virology and Immunology National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 100050 China Henan Center for Disease Control and Prevention Zhengzhou 450003 China Queshan Center for Disease Control and Prevention Henan 463200 China Graduate University of Chinese Academy of Sciences Beijing 100080 China

To investigate the prevalence of drug-resistance mutations,resistance to antiretroviral drugs,and the subsequent virological response to therapy in treatment-naive and antiretroviral-treated patients infected with HIV/aids in Henan,China,a total of 431 plasma samples were collected in Queshan county between 2003 and 2004,from patients undergoing the antiretroviral regimen Zidovudine + Didanosine + Nevirapine(Azt+Ddi+Nvp).Personal information was collected by face to face *** load and genotypic drug resistance were *** resistance mutation data were obtained by analyzing patient-derived sequences through the HIVdb Program(http://***).Overall,38.5% of treatment-naive patients had undetectable plasma viral load(VL),the rate significantly increased to 61.9% in 0 to 6 months treatment patients(mean 3 months)(P<0.005)but again significantly decrease to 38.6% in 6 to 12 months treatment patients(mean 9 months)(P<0.001)and 40.0% in patients receiving more than 12 months treatment(mean 16 months)(P<0.005).The prevalence of drug resistance in patients who had a detectable VL and available sequences were 7.0%,48.6%,70.8%,72.3% in treatment-na?ve,0 to 6 months treatment,6 to 12 months treatment,and treatment for greater than 12 months patients,*** mutation associated with resistance to Protease inhibitor(PI)was detected in this *** RT inhibitor(NRTI)mutations always emerged after non-nucleoside RT inhibitor(NNRTI)mutations,and were only found in patients treated for more than 6 months,with a frequency less than 5%,with the exception of mutation T215Y(12.8%,6/47)which occurred in patients treated for more than 12 *** mutations emerged quickly after therapy begun,and increased significantly in patients treated for more than 6 months(P<0.005),and the most frequent mutations were K103N,V106A,Y181C,*** had been optimal viral suppression in patients undergoing treatment for less than 6 months in Queshan,Henan

关键词：艾滋病病毒艾滋病治疗抗药性逆转录酶

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Detection of two amino acid deletions in HIV-1 Nef protein from Chinese former paid blood donors

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Chinese Medical Journal 2007年第18期120卷 1635-1638页

作者： SONG Yan-hui WEI Min MA Peng-fei XING Hui SI Xue-feng TANG Hai-li LI Hui-guang SHAO Yi-ming Wuhan Institute of Virology Chinese Academy of SciencesWuhan 430071 China Graduate School of the Chinese Academy of Sciences Beijing100039 China State Key Laboratory for Infectious Disease Control andPrevention National Center for AIDS/STD Control andPrevention Chinese Center for Disease Control and PreventionBeijing 100050 China

HIV-1 Nef protein plays an important role in HIV-1 pathogenesis, including downregulation of the cell surface CD4 and class I major histocompatibility complex （MHC）, enhancement of virion infectivity and alteration of a variety of cellular signal transduction pathways.1.2 A recent report demonstrated that Nef down-regulates dendritic cell surface expression of MHC class I and up-regulates molecules known to be critical for apoptosis induction, such as TNF-α and FasL^3 It is also very interesting that Nef expression alone may be sufficient to cause an aids-like disease in transgenic mice.2 In many human cohort studies it has been reported that long-term nonprogressors （LTNPs）, who remain asymptomatic for more than one decade without antiretroviral therapy, harbored nef-deleted viruses.4-7 Intense studies on nef genes from LTNPs have been done in Europe and United States but none of such studies have been done in China.

关键词： human immunodeficiency virus nef disease progression

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