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Human immunodeficiency virus and hepatitis C virus co-infection： epidemiology, natural history and the situation in China

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Chinese Medical Journal 2009年第1期122卷 93-97页

作者： LU Ying Matthew Robinson ZHANG Fu-jie Department of Public Health Lanzhou University Lanzhou Gansu 730000 China School of Medicine University of North Carolina Chapel Hill 27599 USA National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 100050 China

Worldwide, the hepatitis C vires （HCV） and human immunodeficiency virus （HIV） pandemics poseserious threats to global health, currently infecting 130 million and 40 million people respectively. Of those infected with HW, an estimated 4-12 million are co-infected with HCV. Due to shared risk factors for transmission, co-infection with HIV and HCV is common in China. Liver disease was the second leading cause of death behind acquired imunodeficiency syndrome （aids） in co-infected patients. Several studies have confirmed that HIV co-infection accelerates the clinical course of chronic HCV infection and leads to an increased risk of cirrhosis, hepatocellular carcinoma, and decompensated liver disease.

关键词： human immunodeficiency virus hepatitis C virus co-infection

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A public health approach to rapid scale-up of free antiretroviral treatment in China： an ounce of prevention is worth a pound of cure

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Chinese Medical Journal 2009年第11期122卷 1352-1355页

作者： Marc Bulterys Sten H. Vermund Ray Y. Chen Chin-Yih Ou Global AIDS Program - China Office US Centers for Disease Control and Prevention Beijing 100600 China Division of Global AIDS National Center for HIV Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta Georgia USA Institute for Global Health and Department of Pediatrics Vanderbilt University School of Medicine Nashville Tennessee USA National Institute of Allergy and Infectious Diseases US Embassy Beijing/National Institutes of Health Beijing 100600 China

China＇s rapidly evolving HIV/aids epidemic calls for a dramatic expansion of both prevention and treatment services. Official state media recently reported that for the first time, in 2008, HIV/aids became China＇s leading cause of death among infectious diseases. Estimates from the Ministry of Health indicate that around 700 000 people were living with HIV and 85 000 people had aids in 2007. Initially, HIV-1 infection was confined primarily to certain high-risk populations such as injection drug users （IDU） along drug-trafficking routes, and former plasma donors （FPD） in rural communities in east-central China. Now, however, HIV prevalence is increasing among female sex workers （FSW） and men who have sex with men （MSM）.

关键词： antiretroviral therapy China human immunodeficiency virus drug resistance universal access

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Emergence and control of infectious diseases in China

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The Lancet 2008年第9649期372卷 1598-1605页

作者： Wang, Longde Wang, Yu Jin, Shuigao Wu, Zunyou Chin, Daniel P Koplan, Jeffrey P Wilson, Mary Elizabeth Ministry of Health Beijing China Chinese Centre for Disease Control and Prevention Beijing China National Centre for Public Health Surveillance Information Service Chinese Centre for Disease Control and Prevention Beijing China National Centre for AIDS/STD Control and Prevention Chinese Centre for Disease Control and Prevention Beijing China Bill and Melinda Gates Foundation China Office Beijing China Emory Global Health Institute Emory University Atlanta GA United States Department of Global Health and Population Harvard School of Public Health Boston MA United States

Infectious diseases remain the major causes of morbidity and mortality in China despite substantial progress in their control. China is a major contributor to the worldwide infectious disease burden because of its population size. The association of China with the rest of the world through travel and trade means that events in the country can affect distant populations. The ecological interaction of people with animals in China favours the emergence of new microbial threats. The public-health system has to be prepared to deal with the challenges of newly emerging infectious diseases and at the same time try to control existing diseases. To address the microbial threats, such as severe acute respiratory syndrome, the government has committed substantial resources to the implementation of new strategies, including the development of a real-time monitoring system as part of the infectious-disease surveillance. This strategy can serve as a model for worldwide surveillance and response to threats from infectious diseases. © 2008 Elsevier Ltd. All rights reserved.

关键词： China/epidemiology Communicable Diseases/*classification/diagnosis/transmission Communicable Diseases Emerging/*epidemiology/mortality/*prevention & control Disease Notification Disease Outbreaks/*prevention & control Health Services Accessibility/*economics Humans Incidence Public Health

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An HIV, std, and hepatitis prevention program for young men leaving prison: Project START

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Journal of Correctional Health Care 2008年第3期14卷 183-196页

作者： Grinstead, Olga Eldridge, Gloria MacGowan, Robin Morrow, Kathleen M. Seal, David W. Sosman, James M. Zack, Barry Belcher, Lisa Dey, Achintya Iqbal, Kashif Margolis, Andrew Moss, Susan Williamson, John Wolitski, Richard Fitterling, Jim Askew, John Fortenberry, Marty Griebler, Joe Kennedy, Stephen McGregor, Scott Vardaman, Jerry McAuliffe, Tim Reed, Barbara Simms, Rodney Berzowski, Jessica Bourque, Don Buckles, Jeff Charles, Mark Krapf, Melanie Malen, Kelly Reed, Ricardo Rosado, Noel Morrow, Kathleen Flanigan, Timothy Fitzgerald, Christine Nealey-Moore, Jill Lugo, Ricky Strother, Daniel Hecht, Jacki Green, Kellie Best, Gina Woods, Meghan Paton, Stephanie Binson, Diane Faigeles, Bonnie Kramer, Katie Lerma, Annette McCartney, Kathleen McKee-Shapter, Jax Woods, William King, Anthony King, Carolyn Gregorich, Steve Center for AIDS Prevention Studies University of California San Francisco San Francisco CA 94105 50 Beale Street United States University of Alaska Anchorage Anchorage AK United States Division of HIV/AIDS Prevention National Center for HIV STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA United States Miriam Hospital Alpert Medical School Brown University Providence RI United States Center for AIDS Intervention Research Department of Psychiatry and Behavioral Medicine Medical College of Wisconsin Milwaukee WI United States University of Wisconsin School of Medicine and Public Health Madison WI United States Centerforce San Rafael CA United States Centers for Disease Control and Prevention Jackson State University Jackson MS United States Medical College of Wisconsin University of Wisconsin Medical School Madison WI United States University of Wisconsin School of Medicine and Public Health Madison WI United States Brown Medical School The Miriam Hospital United States University of California San Francisco CA United States

The rates of HIV, std, and hepatitis infection are high among persons entering prisons, and many of these persons engage in high-risk behaviors after release. Therefore, innovative programs that reduce risk behaviors after release are urgently needed. Project START developed and evaluated two interventions designed for young men leaving prison. This article describes both interventions: the single-session intervention and the enhanced intervention. The single-session intervention focused on HIV/std/hepatitis prevention only. The enhanced intervention consisted of two prerelease and four postrelease sessions that focused on HIV/std/hepatitis prevention and more broadly on health and reintegration into the community. Specific procedures used to implement the interventions in correctional settings are described. Process data describing intervention attendance and fidelity to the intervention protocols are presented. Implications for future intervention studies are discussed. © 2008 NCCHC.

关键词： Correctional health care HIV Intervention Prisons Risk reduction

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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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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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Subtype and sequence analysis of HIV-1 strains in Heilongjiang Province

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Chinese Medical Journal 2007年第22期120卷 2006-2010页

作者： WANG Fu-xiang ZHOU Hui LING Hong ZHOU Hai-zhou LIU Wei-hua SHAO Yi-ming ZHOU Jin Department of Infectious Diseases First Clinical College of Harbin Medical University Harbin 150001 China Department of Hematology First Clinical College of Harbin Medical University Harbin 150001 China Department of Microbiology Harbin Medical University Harbin 150081 China Agriculture General Hospital Harbin 150001 China National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 100050 China

Background Human immunodeficiency virus （HIV-1） is divided into two types, HIV-1 （groups M, N and O） and HIV-2. Heilongjiang Province located in the northeast of China, and the feature of the subtype distribution and sequence characteristics of HIV-1 strains prevalent in Heilongjiang Province is still uncertain. The aim of this study was to investigate the subtype distribution and genetic characteristics of HIV-1 strains in one hospital in Heilongjiang Province. Methods HIV-1 env gene was amplified by nested-PCR from peripheral blood mononuclear cells （PBMCs） obtained from 19 HIV-1 seropositive individuals in Heilongjiang Province. The C2-V3 region was sequenced. Aligned the nucleotide sequence of 19 samples with CLUSTAL W （BioEdit） software, results were acquired and used for phylogenetic tree analysis after artificial adjustment. Reference sequence, downloaded from Los Alamos HIV Sequence Database, was used to identify the subtype of obtained sequence. Genetic distance between sequences was assessed using the software MEGA 3.1 Kimura 2-parameter, and the Phylogenetic tree was reestablished with Neighbor-Joining method. Results Phylogenetic tree analysis showed that 19 Heilongjiang strains clustered closely to subtype B strain from Thailand and were far from other international subtype reference strains. Statistical test showed no significant discrepancy between the genetic distance of interclass and intra-class （P〉0.05）. The analysis of V3 loop amino sequence of 19 Heilongjiang B strains revealed that V3 tip motif of 10 samples （52.63%） was GPGQ, and of 4 samples （21.53%） was GPGR. Conclusions The subtype of 19 HIV-1 seropositive individuals in Heilongjiang Province is B′, and it is introduced from He＇nan Province. V3 tip motifs of the HIV-1 isolates are mainly GPGQ and GPGR.

关键词： human immunodeficiency virus type 1 sequence analysis

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Injection drug use and HIV/aids in China: Review of current situation, prevention and policy implications

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Harm Reduction Journal 2006年第1期3卷 1-8页

作者： Qian, Han-Zhu Schumacher, Joseph E. Chen, Huey T. Ruan, Yu-Hua Division of Preventive Medicine School of Medicine University of Alabama Birmingham AL United States Department of Health Behavior School of Public Health University of Alabama Birmingham AL United States National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing China

Ilicit drug abuse and HIV/aids have increased rapidly in the past 10 to 20 years in China. This paper reviews drug abuse in China, the HIV/aids epidemic and its association with injection drug use (IDU), and Chinese policies on illicit drug abuse and prevention of HIV/aids based on published literature and unpublished official data. As a major drug trans-shipment country with source drugs from the "Golden Triangle" and "Gold Crescent" areas in Asia, China has also become an increasingly important drug consuming market. About half of China's 1.14 million documented drug users inject, and many share needles. IDU has contributed to 42% of cumulatively reported HIV/aids cases thus far. Drug trafficking is illegal in China and can lead to the death penalty. The public security departments adopt "zero tolerance" approach to drug use, which conflict with harm reduction policies of the public health departments. Past experience in China suggests that cracking down on drug smuggling and prohibiting drug use alone can not prevent or solve all illicit drug related problems in the era of globalization. In recent years, the central government has outlined a series of pragmatic policies to encourage harm reduction programs;meanwhile, some local governments have not fully mobilized to deal with drug abuse and HIV/aids problems seriously. Strengthening government leadership at both central and local levels;scaling up methadone substitution and needle exchange programs;making HIV voluntary counseling and testing available and affordable to both urban and rural drug users;and increasing utilization of outreach and nongovernmental organizations are offered as additional strategies to help cope with China's HIV and drug abuse problem. © 2006 Qian et al;licensee BioMed Central Ltd.

关键词： Human Immunodeficiency Virus Drug User Harm Reduction Human Immunodeficiency Virus prevention Human Immunodeficiency Virus Risk

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Reply to Cook

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Clinical Infectious Diseases 2006年第6期42卷 892-893页

作者： McElroy, Peter D. Ijaz, Kashef Navin, Thomas R. Divisions of HIV/AIDS Prevention Atlanta Georgia Tuberculosis Elimination National Center for HIV/STD and TB Prevention Centers for Disease Control and Prevention US Public Health Service Department of Health and Human Services Atlanta Georgia

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