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Azithromycin susceptibility of Neisseria gonorrhoeae in the USA in 2017: a genomic analysis of surveillance data

The Lancet Microbe 2020年第4期1卷 e154-e164页

作者： Gernert, Kim M Seby, Sandra Schmerer, Matthew W Thomas, Jesse C Pham, Cau D St Cyr, Sancta Schlanger, Karen Weinstock, Hillard Shafer, William M Raphael, Brian H Kersh, Ellen N Hun, Sopheay Hua, Chi Ruiz, Ryan Soge, Olusegun O Dominguez, Catherine Patel, Ami Loomis, Jillian Leavitt, John Zhang, Jenny Baldwin, Tamara Wang, Chun Moore, Christina Whelen, Christian Harvey, Alesia Laboratory Reference and Research Branch Division of STD Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA United States Surveillance and Data Management Branch Division of STD Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA United States Epidemiology and Statistics Branch Division of STD Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA United States Oak Ridge Institute for Science and Education Research Participation and Fellowship Program Oak Ridge TN United States Department of Microbiology and Immunology and Emory Antibiotic Resistance Center Emory University School of Medicine Atlanta GA United States Laboratories of Bacterial Pathogenesis Veterans Affairs Medical Center Decatur GA United States

Background: The number of cases of gonorrhoea in the USA and worldwide caused by Neisseria gonorrhoeae is increasing (555 608 reported US cases in 2017, and 87 million cases worldwide in 2016). Many countries report declining in vitro susceptibility of azithromycin, which is a concern because azithromycin and ceftriaxone are the recommended dual treatment in many countries. We aimed to identify strain types associated with decreased susceptibility to azithromycin. Methods: We did a genomic analysis of N gonorrhoeae isolates obtained by the US Gonococcal Isolate Surveillance Project. Isolates were whole-genome sequenced based on decreased susceptibility to azithromycin (minimal inhibitory concentration [MIC] ≥2 μg/mL, using agar dilution antibiotic susceptibility testing) and geographical representation. Bioinformatic analyses established genomic diversity, strain population dynamics, and antimicrobial resistance profiles. Findings: 410 isolates were sorted into more than 20 unique phylogenetic clades. One predominant persistent clade (consisting of 97 isolates) included the most isolates with azithromycin MICs of 2 μg/mL or higher (61 of 97 [63%] vs 59 of 311 [19%];p<0·0001) and carried a mosaic mtr (multiple transferable resistance) locus (68 of 97 [70%] vs two of 313 [1%];p<0·0001). Of the remaining 313 isolates, 57 (18%) had decreased susceptibility to azithromycin (MIC ≥4 μg/mL), which was attributed to 23S rRNA variants (56 of 57 [98%]) and formed phylogenetically diverse clades, showing various levels of clonal expansion. Interpretation: Reduced azithromycin susceptibility was associated with expanding and persistent clades harbouring two well described resistance mechanisms, mosaic mtr locus and 23S rRNA variants. Understanding the role of recombination, particularly within the mtr locus, on the fitness and expansion of strains with decreased susceptibility has important implications for the public health response to minimise gonorrhoea transmission. Funding:

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Open letter from Chinese HIV professionals on human genome editing (vol 393, pg 26, 2018)

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LANCET 2019年第10166期393卷 30-30页

作者： Zhang, L. Zhong, P. Zhai, X. [a]Comprehensive AIDS Research Center Global Health and Infectious Diseases School of Medicine Tsinghua University Beijing 100084 China [b]Shanghai Municipal Institutes for Preventive Medicine Shanghai China [c]Center for Bioethics Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China [d]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 [e]Department of Medicine University of Massachusetts Medical School Worcester MA USA

See Online for a full list of signatories in the appendix

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Benefits of early ART initiation on mortality among people with HIV

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The lancet. HIV 2022年第6期9卷 e377页

作者： Yihong Xie Jinhui Zhu Guanghua Lan Yuhua Ruan Department of Epidemiology and Biostatistics Guangxi Medical University Nanning Guangxi China. Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response Guangxi Center for Disease Control and Prevention Nanning Guangxi China. Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response Guangxi Center for Disease Control and Prevention Nanning Guangxi China 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. Electronic address: ruanyuhua92@***.

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Real-time digital intervention on oral pre-exposure prophylaxis adherence among MSM: randomized controlled trial

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npj Digital Medicine 2025年第1期8卷 1-8页

作者： Zhen-Xing Chu Yan-Yan Zhu Yu-Jing An Zhen-Hao Wu Yong-Jun Jiang Qing-Hai Hu Hong Shang Xia Jin Ze-Hao Ye Xiao-Jie Huang Hui Wang Yao-Kai Chen State Key Laboratory for Diagnosis and Treatment of Infectious Diseases NHC Key Laboratory of AIDS Prevention and Treatment National Clinical Research Centre for Laboratory Medicine The First Hospital of China Medical University China Medical University Shenyang 110001 China Key Laboratory of AIDS Immunology Chinese Academy of Medical Sciences Shenyang 110001 China Key Laboratory of AIDS Immunology of Liaoning Province Shenyang 110001 China Collaborative Innovation Centre for Diagnosis and Treatment of Infectious Diseases 79 Qingchun Street Hangzhou 310003 China Parexel International Real World Research 100020 Beijing China Department of STD and HIV/AIDS Control and Prevention Ningbo Municipal Centre for Disease Control and Prevention Ningbo 315010 China Centre for Infectious Diseases Beijing Youan Hospital Capital Medical University 100069 Beijing China Department of Infectious Diseases National Clinical Centre for Infectious Diseases Third People’s Hospital of Shenzhen (Second Affiliated Hospital of Southern University of Science and Technology) Shenzhen 518112 China Department of Infectious Diseases Chongqing Public Health Medical Center Chongqing 400036 China

Oral pre-exposure prophylaxis (PrEP) effectively prevents HIV among men who have sex with men, but its adherence faces significant hindrances. We evaluated the effectiveness of real-time digital intervention in promoting oral PrEP adherence through a randomized controlled trial using electronic medication monitors. The trial was registered on the Chinese Clinical Trial Registry (ChiCTR1900025604) and randomized 442 MSM to intervention (247) or control group (195). At the 6-month follow-up, the intervention group exhibited significantly higher oral PrEP adherence than the control (83.1% vs. 59.8%; adjusted net difference: 21.0%, 95% confidence interval: 12.9–29.2%,p< 0.001), while no differences were detected in the number of male sexual partners, condomless anal intercourse prevalence, or substance use disorder, with consistent results across both daily and event-driven oral PrEP regimens. Therefore, digital intervention significantly increased oral PrEP adherence over 6 months in the daily and event-driven subgroups but demonstrated no effect on high-risk behaviors.

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Time from HIV diagnosis to viral suppression: Survival analysis of statewide surveillance data in Alabama, 2012 to 2014

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JMIR Public Health and Surveillance 2020年第2期6卷 e17217页

作者： Scott Batey, D. Dong, Xueyuan Rogers, Richard P. Merriweather, Anthony Elopre, Latesha Rana, Aadia I. Irene Hall, H. Mugavero, Michael J. Department of Social Work University of Alabama at Birmingham Birmingham AL United States ICF International Fairfax VA United States Division of STD Prevention and Control Alabama Department of Public Health Montgomery AL United States Department of Medicine University of Alabama at Birmingham Birmingham AL United States Division of HIV/AIDS Prevention Centers for Disease Control and Prevention Atlanta GA United States

Background: Evaluation of the time from HIV diagnosis to viral suppression (VS) captures the collective effectiveness of HIV prevention and treatment activities in a given locale and provides a more global estimate of how effectively the larger HIV care system is working in a given geographic area or jurisdiction. Objective: This study aimed to evaluate temporal and geographic variability in VS among persons with newly diagnosed HIV infection in Alabama between 2012 and 2014. Methods: With data from the National HIV Surveillance System, we evaluated median time from HIV diagnosis to VS (<200 c/mL) overall and stratified by Alabama public health area (PHA) among persons with HIV diagnosed during 2012 to 2014 using the Kaplan-Meier approach. Results: Among 1979 newly diagnosed persons, 1181 (59.67%) achieved VS within 12 months of diagnosis;52.6% (353/671) in 2012, 59.5% (377/634) in 2013, and 66.9% (451/674) in 2014. Median time from HIV diagnosis to VS was 8 months: 10 months in 2012, 8 months in 2013, and 6 months in 2014. Across 11 PHAs in Alabama, 12-month VS ranged from 45.8% (130/284) to 84% (26/31), and median time from diagnosis to VS ranged from 5 to 13 months. Conclusions: Temporal improvement in persons achieving VS following HIV diagnosis statewide in Alabama is encouraging. However, considerable geographic variability warrants further evaluation to inform public health action. Time from HIV diagnosis to VS represents a meaningful indicator that can be incorporated into public health surveillance and programming. © D Scott Batey, Xueyuan Dong.

关键词： HIV Public health surveillance Sustained viral suppression

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Author Correction: Ultra-long-acting in-situ forming implants with cabotegravir protect female macaques against rectal SHIV infection

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Nature communications 2024年第1期15卷 1054页

作者： Isabella C Young Ivana Massud Mackenzie L Cottrell Roopali Shrivastava Panita Maturavongsadit Alka Prasher Andres Wong-Sam Chuong Dinh Tiancheng Edwards Victoria Mrotz James Mitchell Josilene Nascimento Seixas Aryani Pallerla Allison Thorson Amanda Schauer Craig Sykes Gabriela De la Cruz Stephanie A Montgomery Angela D M Kashuba Walid Heneine Charles W Dobard Martina Kovarova J Victor Garcia J Gerardo Garcίa-Lerma S Rahima Benhabbour Division of Pharmacoengineering and Molecular Pharmaceutics Eshelman School of Pharmacy University of North Carolina at Chapel Hill Chapel Hill NC USA. Laboratory Branch Division of HIV Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA USA. Division of Pharmacotherapy and Experimental Therapeutics Eshelman School of Pharmacy University of North Carolina at Chapel Hill Chapel Hill NC USA. Joint Department of Biomedical Engineering North Carolina State University and The University of North Carolina at Chapel Hill Chapel Hill NC USA. Comparative Medicine Branch Division of Scientific Resources National Center for Emerging and Zoonotic Infection Diseases Centers for Disease Control and Prevention Atlanta GA USA. Infectious Diseases Pathology Branch Division of High-Consequence Pathogens and Pathology National Center for Emerging and Zoonotic Infection Diseases Centers for Disease Control and Prevention Atlanta GA USA. Department of Psychology and Neuroscience University of North Carolina at Chapel Hill Chapel Hill NC USA. Pathology Services Core Lineberger Comprehensive Cancer Center University of North Carolina School of Medicine Chapel Hill NC USA. International Center for the Advancement of Translational Science Division of Infectious Diseases Center for AIDS Research University of North Carolina at Chapel Hill Chapel Hill NC USA. Laboratory Branch Division of HIV Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA USA. jng5@cdc.gov. Division of Pharmacoengineering and Molecular Pharmaceutics Eshelman School of Pharmacy University of North Carolina at Chapel Hill Chapel Hill NC USA. benhabs@email.unc.edu. Joint Department of Biomedical Engineering North Carolina State University and The University of North Carolina at Chapel Hill Chapel Hill NC USA. benhabs@email.unc.edu.

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2007-17年美国儿童和青少年结核病流行病学:国家监测数据分析

2007-17年美国儿童和青少年结核病流行病学:国家监测数据分析

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作者： Tori L Cowger Jonathan M Wortham Deron C Burton 许磊 Division of Tuberculosis Elimination National Center for HIV/AIDSViral HepatitisSTDand TB PreventionUS Centers for Disease Control and Prevention Department of Epidemiology Harvard T H Chan School of Public Health

背景:在2018年期间,全球15岁以下的儿童中约有100万例结核病病例和233000例与结核相关的死亡。儿童和青少年的结核病在临床和流行病学上存在差异,给护理和预防带来了挑战。对儿童和青少年结核病流行病学的了解有助于治疗和预防工作,以... 详细信息

背景:在2018年期间,全球15岁以下的儿童中约有100万例结核病病例和233000例与结核相关的死亡。儿童和青少年的结核病在临床和流行病学上存在差异,给护理和预防带来了挑战。对儿童和青少年结核病流行病学的了解有助于治疗和预防工作,以及消除结核病发病率和死亡率差异。目的:我们试图描述美国患有结核病的儿童和青少年的流行病学,包括按父母出生国和美国领土及自由联系的州分列的结核病发病率,这些情况以前没有描述过。方法:我们分析了2007-17年期间向国家结核病监测系统报告的15岁以下儿童和15-17岁青少年的数据,并使用美国人口普查局的人口估计数计算了结核病发病率。结果:在2010至2017年间,有6072例肺结核病例发生在儿童和青少年中,其中5175例(85%)发生在美国50个州或哥伦比亚特区,6072例中有897例(15%)发生在美国附属岛屿。在美国各州,5175例中有3520例(68%)发生在美国出生的人群中,包括3896名儿童中的2977名(76%)和1279名青少年中的543名(42%)。2007-2017年儿童和青少年发病率为1.0/10万人,同期下降47.8%(95%CI-51.4～44.1)。我们观察到,在所有非白人种族或族裔群体的儿童和青少年中,生活在美国附属岛屿的人,以及出生在结核病流行国家或与其父母一起出生的儿童中,结核病发病率过高。讨论:在对国家监测数据的审查中,我们观察到所有非白种人种族或族裔群体的儿童和青少年、生活在美国附属岛屿的儿童和青少年、出生在结核病流行国家或其父母来自于结核病流行国家的儿童和青少年中结核病发病率过高。此外,我们观察到,与美国各州相比,美国附属岛屿的儿童和青少年患结核病的死亡率高得不成比例。这些广泛和普遍的差距可能反映了结构性的不平等,造成了不成比例的接触、感染和疾病的脆弱性以及不平等的迅速诊断和治疗机会。我们的研究结果表明,美国的结核病护理和预防策略正在成功地降低儿童和青少年的总体结核病负担,但需要更多的关注和可能的新方法来解决这些年龄组结核病发病率和死亡率的差异。我们观察到儿童和青少年的结核病发病率和死亡率存在普遍的种族或民族和地理差异。与非西班牙裔白人儿童和青少年相比,每一个被调查的种族或族裔群体的结核病发病率都显著增加,这表明健康的结构性和社会决定因素可能具有广泛的影响,导致历史上边缘化的儿童和青少年接触结核病、感染或疾病进展的风险增加。尽管我们强调了结核病的差异可能会被种族,民族,地理位置和出生地等影响,但我们注意到这种异质性可能归因于基本的社会,政策和环境条件。此外,通过对各种健康结果的研究确定了有助于人口水平的其他因素健康差距,这些因素可能包括粮食安全和营养,获得经济和营养物质资源,住宅隔离,接触二手烟,室内外空气质量,持久历史创伤的影响(例如奴隶制,殖民,流离失所),医疗政策,获取和基础设施。所以除了努力预防和治疗高危儿童和青少年中的结核病外,还应努力阐明和改善风险增加的潜在社会和结构驱动因素。结论:总体而言,美国儿童和青少年中的结核病发病率较低,而且稳步下降,但仍需作出更多努力,以消除发病率和死亡率方面的差异。

关键词：肺结核儿童青少年流行病学

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Consensus statement on human immunodeficiency virus pre-exposure prophylaxis in China

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Chinese Medical Journal 2020年第23期133卷 2840-2846页

作者： Jun-Jie Xu Xiao-Jie Huang Xin-Chao Liu Li-Ming Wang Yao-Kai Chen Hui Wang Fu-Jie Zhang Hao Wu Tai-Sheng Li Meng-Jie Han Fang Zhao Hai-Bo Ding Jun-Yi Duan Gen-Shen Sheng Hong Shang National Health Commission(NHC)Key Laboratory of AIDS Immunology(China Medical University) National Clinical Research Center for Laboratory MedicineThe First Affiliated Hospital of China Medical UniversityShenyangLiaoning 110001China Key Laboratory of AIDS Immunology Chinese Academy of Medical SciencesShenyangLiaoning 110001China Key Laboratory of AIDS Immunology of Liaoning Province ShenyangLiaoning 110001China Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases HangzhouZhejiang 310003China Center for Infectious Diseases Beijing Youan HospitalCapital Medical UniversityBeijing 100069China Department of Infection Peking Union Medical College HospitalBeijing 100730China Beijing Ditan Hospital Capital Medical UniversityBeijing 100015China Chongqing Public Health Medical Center Chongqing 400036China Department of Infectious Diseases National Clinical Center for Infectious DiseasesThird People’s Hospital of Shenzhen(Second Affiliated Hospital of Southern University of Science and Technology)ShenzhenGuangdong 518112China National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and PreventionBeijing 102206China Shenzhen Rainbow 258 Centre For Men ShenzhenGuangdong 518001China

Introduction Although the global human immunodeficiency virus(HIV)epidemic has been effectively curbed,preventing and managing HIV infection in high-risk populations remains challenging.[1]In China,HIV is primarily transmitted through sexual contact.[1,2]Pre-exposure prophylaxis(PrEP)is a new and effective method for preventing HIV infection using antiretroviral drugs[3];data from multiple clinical trials worldwide have shown that using antiretroviral drugs for PrEP can limit HIV transmission.[4,5,6,7]The World Health Organization(WHO)issued guidelines in 2015 recommending PrEP in populations with an HIV incidence above 3/100 person-years(PY)and in individuals engaging in high-risk behaviors.[3]According to existing studies,the HIV incidence among key populations in China was 5.6/100 PY for men who have sex with men(MSM),[8]1.6/100 PY for intravenous drug users(IDUs),[9]and 1.4/100 PY for female sex workers.[10,11]As of July 2020,54 countries and regions have issued PrEP guidelines for adults to prevent HIV infection,and 36 of these have also published guidelines for children and ***,there are no PrEP guidelines or related consensus statement in *** such,there is a strong need for standardized guidance on the implementation of PrEP pertaining to medical selection criteria,PrEP timing,drug safety,and consultation and testing *** we present the consensus statement on the implementation of PrEP in China based on the opinions and suggestions of health policy-makers,scientists,clinical experts,community-based organizations of key populations,and the latest reports in PrEP researches.

关键词： drugs statement exposure

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Correction: A Peer-to-Peer Collaborative Learning Approach for the Implementation of Evidence-Informed Interventions to Improve HIV-Related Health Outcomes

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aids and behavior 2024年 2024 Mar 4页

作者： Alex S Keuroghlian Linda Marc Hilary Goldhammer Massah Massaquoi Alicia Downes Joseph Stango Hannah Bryant Sean Cahill Jessica Yen Antonia C Perez Jennifer M Head Kenneth H Mayer Janet Myers Gregory M Rebchook Beth Bourdeau Demetrios Psihopaidas Nicole S Chavis Stacy M Cohen The Fenway Institute Fenway Health 1340 Boylston Street Boston MA 02215 USA. akeuroghlian@***. Department of Psychiatry Massachusetts General Hospital Boston MA USA. akeuroghlian@***. Department of Psychiatry Harvard Medical School Boston MA USA. akeuroghlian@***. The Fenway Institute Fenway Health 1340 Boylston Street Boston MA 02215 USA. Department of Biostatistics The Harvard T.H. Chan School of Public Health Boston MA USA. AIDS United Washington DC USA. Department of Health Sciences Bouvé College of Health Northeastern University Boston MA USA. Kansas City Free Health Clinic Kansas City MO USA. Synergy Scientifics LLC Port Orford OR USA. Harvard T.H. Chan School of Public Health Boston MA USA. Harvard Medical School Beth Israel Deaconess Medical Center Boston MA USA. Division of Prevention Science University of California San Francisco San Francisco CA USA. US Department of Health and Human Services Health Resources and Services Administration HIV/AIDS Bureau Rockville MD USA. Division of HIV Prevention National Center for HIV Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA USA.

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Duration of Human Immunodeficiency Virus Infection at Diagnosis among New Human Immunodeficiency Virus Cases in Dehong, Yunnan, China, 2008-2015

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Chinese Medical Journal 2018年第16期131卷 1936-1943页

作者： Ai-Hua Li Zun-You Wu Zhen Jiang Jennifer M. McGoogan Yan Zhao Song Duan National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 102206 China Department of Epidemiology University of California Los Angeles California USA Dehong Prefecture Center for Disease Control and Prevention Mangshi Yunnan 678400 China

Background： On diagnosis of human immunodeficiency virus （HIV） infection, a person may have been infected already for many years. This study aimed to estimate the duration of HIV infection at the time of diagnosis. Methods： Newly diagnosed HIV cases in Dehong, China, from 2008 to 2015 were studied. Duration of infection at the time of diagnosis was calculated using the first CD4 cell count result after diagnosis and a CD4 depletion model of disease progression. Multiple linear regression analysis was used to investigate the associated risk factors. Results： A total of 5867 new HIV cases were enrolled. Overall, mean duration of infection was 6.3 years （95% confidence interval [CI]： 6.2, 6.5）. After adjusting for confounding, significantly shorter durations of infection were observed among participants who were female （beta： -0.37, 95% CI： -0.64, -0.09）, Dai ethnicity （beta： -0.28, 95% CI： -0.57, 0.01 ）, and infected through injecting drug use （beta： -1.82, 95% CI： -2.25, -1.39）. Compared to the hospital setting, durations were shorter for those diagnosed in any other settings, and compared to 2008, durations were shorter for those diagnosed all years after 2010. Conclusion： Although the reduction in duration of infection at the time of diagnosis observed in Dehong was significant, it may not have had a meaningful impact.

关键词： China Delayed Diagnosis Human lmmunodeficiency Virus Infection

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