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Evaluation of PIMA Point-of-care CD4 Analyzer in Yunnan, China

Chinese Medical Journal 2015年第7期128卷 890-895页

作者： Jun Liang Song Duan Yan-Ling Ma Ji-Bao Wang Ying-Zhen Su Hui Zhang Chin-Yih Ou Ling Hao Ming-Shan Qi Marc Bulterys Larry Westerman Yan Jiang Yao Xiao Department of AIDS/STD Prevention National HIV/HCV Reference Laboratory National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 102206 China Department of Laboratory Tongzhou Blood Center Beijing 101100 China Department of AIDS/STD Prevention Dehong Prefecture Center for Disease Control and Prevention Dehong Yunnan 678400 China Department of AIDS/STD Prevention Yunnan Provincial Center for Disease Control and Prevention Kunming Yunnan 650022 China Global AIDS Program-China Office US Center for Disease Control and Prevention Beijing 100600 China International Laboratory Branch Division of Global HIV/AIDS Center for Global Health U.S. Centers for Disease Control and Prevention Atlanta GA 30329 USA

Background： CD4 count is used to determine antiretroviral therapy （ART） eligibility. In China, flow cytometers are mostly located in urban areas with limited access by patients residing in remote areas. In an attempt to address this issue, we conducted a study to validate the performance ofAlere PIMA point-of-care CD4 analyzer. Methods： Venous and finger-prick blood specimens were collected from HIV-positive participants from two voluntary counseling and testing sites in Yunnan Province. Both venous and finger-prick blood specimens were tested with the PIMA analyzer. Venous blood specimens tested with the Becton Dickinson FACSCalibur were used as a reference. Results： Venous specimens from 396 and finger-prick specimens from 387 persons were available for analysis. CD4 counts by PIMA correlated well with those from FACSCalibur with an R2 of 0.91 for venous blood and 0.81 for finger-prick blood. Compared to FACSCalibur, the PIMA analyzer yielded lower counts with a mean bias of- 47.0 cells/μl （limit of agreement, [LOA]： -204-110 cells/μl） for venous blood and -71.0 cells/μl （LOA： -295-153 cells/μl） for finger-prick blood. For a CD4 threshold of 350 cells/μl, the positive predictive value （PPV） of PIMA was 84.2% and 75.7% and the negative predictive value （NPV） was 97.6% and 95.8% for venous and finger-prick blood, respectively. For an ART threshold of 500 cells/μl, the corresponding PPV was 90.3% and 84.0% and NPV was 94.3% and 93.4%, respectively. Conclusions： CD4 counting using venous blood with PIMA analyzers is a feasible alternative to a large flow cytometer to determine ART eligibility.

关键词： CD4 Counts Finger-prick HIV Point-of-care Venous Blood

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Clinician perspectives on delaying initiation of antiretroviral therapy for clinically eligible HIV-infected patients

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Journal of the International Association of Providers of aids Care 2015年第3期14卷 245-254页

作者： Beer, Linda Valverde, Eduardo E. Raiford, Jerris L. Weiser, John White, Becky L. Skarbinski, Jacek Division of HIV/AIDS Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA United States Division of Global HIV/AIDS Center for Global Health Centers for Disease Control and Prevention Atlanta GA United States Division of Infectious Diseases Department of Medicine University of North Carolina Chapel Hill NC United States

Objectives: Guidelines for antiretroviral therapy (ART) initiation have evolved, but consistently note that adherence problems should be considered and addressed. Little is known regarding the reasons providers delay ART initiation in clinically eligible patients. Methods: In 2009, we surveyed a probability sample of HIV care providers in 582 outpatient facilities in the United States and Puerto Rico with an open-ended question about nonclinical reasons for delaying ART initiation in otherwise clinically eligible patients. Results: Very few providers (2%) reported never delaying ART. Reasons for delaying ART were concerns about patient adherence (68%), patient acceptance (60%), and structural barriers (33%). Provider and practice characteristics were associated with reasons for delaying ART. Conclusion: Reasons for delaying ART were consistent with clinical guidelines and were both patient level and structural. Providers may benefit from training and access to referrals for ancillary services to enhance their ability to monitor and address these issues with their patients.

关键词： adherence antiretroviral therapy clinical practice

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Efficacy and Safety of Tenofovir and Lamivudine in Combination with Efavirenz in Patients Co-infected with Human Immunodeficiency Virus and Hepatitis B Virus in China

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Chinese Medical Journal 2016年第3期129卷 304-308页

作者： Ya-Song Wu Wei-Wei Zhang Xue-Mei Ling Lian Yang Shao-Biao Huang Xi-Cheng Wang Hao Wu Wei-Ping Cai Min Wang Hui Wang Yan-Fen Liu Hao-Lan He Fei-Li Wei Zun-You Wu Fu-Jie Zhang National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 100050 China Department of Infectious Diseases The Third People's Hospital of Hengyang City Hengyang Hunan 421005 China Department of Infectious Diseases The Fourth People's Hospital of Nanning City Nanning Guangxi 530023 China Department of Infectious Diseases Yunnan Provincial Infectious Disease Hospital Kunming Yunnan 650301 China Center for Infectious Diseases Beijing You'an Hospital Capital Medical University Beijing 100069 China Department of Infectious Diseases Guangzhou No. 8 People's Hospital Guangzhou Guangdong 510060 China The Institute of HIV/AIDS The First Hospital of Changsha Changsha Hunan 410005 China Department of Infectious Diseases Shenzhen Third People's Hospital Shenzhen Guangdong 518112 China Department of Infectious Diseases Beijing Ditan Hospital Capital Medical University Beijing 100015 China

Background： The prevalence of hepatitis B virus （HBV） infection is high among individuals infected with human immunodeficiency virus （HIV） in *** HIV and HBV can be treated with tenofovir disoproxil fumarate （TDF） and lamivudine （3TC）, so we evaluated the safety and efficacy of combination antiretroviral therapy （ART） that included TDF, 3TC, and efavirenz （EFV） among ART-naive individuals who were co-infected with HIV and ***： One hundred HIV/HBV co-infected ARV-naive individuals were started on the regimen ofTDF, 3TC, and EFV, and the levels of plasma HBV DNA, HIV RNA, and biochemical evaluation related to the function of liver and kidney were ***： Concerning efficacy, this study found that by week 48, the vast majority co-infected participants receiving this ART regimen had undetectable HBV DNA levels （71%） and/or HIV RNA levels （90%）.Concerning safety, this study found that the median estimated glomerular filtration rate of participants decreased from baseline （109 ml＆#183;min-1＆#183; 1.73 m-2） to week 12 （104 ml＆#183;min-1＆#183; 1.73 m-2） but was almost back to baseline at week 48 （1 1 1 ml＆#183;min-1＆#183; 1.73 m-2）.Conclusion： This combination ART regimen is safe and effective for patients with HIV/HBV *** Registration： ***, NCT01751555;https：//***/ct2/show/NCT01751555.

关键词： Antiretroviral Therapy Co-infection Hepatitis B Virus Human lmmunodeficiency Virus Tenofovir Disoproxil Fumarate

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Higher levels of circulating monocyte-platelet aggregates are correlated with viremia and increased sCD 163 levels in HIV- 1 infection

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Cellular & Molecular Immunology 2015年第4期12卷 435-443页

作者： Hua Liang Zhaojun Duan Dan Li Dongliang Li ZhengWang Li Ren Tao Shen Yiming Shao State Key Laboratory for Infectious Disease Prevention and Control National Center for AIDS/STD Control and Prevention China CDC CollaborativeInnovation Center for Diagnosis and Treatment of Infectious Diseases Beijing China Department of Microbiology School of Basic Medical SciencesPekin8 University Beijing China and 3Beijing Chaoyang District Center for Disease Control and Prevention Beijing China Correspondence: Dr T Shen Department of Microbiology Peking University Health Science Center Beijing 100191 China.

Increased levels of monocyte-platelet aggregates （MPAs） are reported to be highly correlated with cardiovascular events. In this study, the MPA levels in different monocyte subsets and the associations between MPA levels, HIV-1 viremia and monocyte activation were evaluated during HIV-1 infection. The results showed that the percentages of MPAs in all three monocyte subsets were higher in HIV-l-infected subjects than in healthy controls, and were associated with the plasma viral load in the non-classical and intermediate monocyte subsets. The plasma levels of sCD14 and sCD163 were upregulated in HIV-1 infection and were positively associated with viral loads and negatively associated with CD4 counts. P-selectin glycoprotein ligand-1 （PSGL-1） was shown to be expressed at significantly lower levels on all three monocyte subsets and was negatively correlated with the sCD163 level. The MPA level was correlated with the levels of plasma sCD163 but negatively correlated with CD163 and PSGL-1 on all three monocyte subsets. An elevated immune activation status was correlated with increased MPA formation, underlying the potential interaction between monocyte activation and MPA formation. This interaction may be related to a higher thromboembolic risk in patients infected with HIV-I.

关键词： HIV-1 immune activation monocytes platelets sCD163

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Meningococcal disease in patients with human immunodeficiency virus infection: A review of cases reported through active surveillance in the United States, 2000-2008

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Open Forum Infectious Diseases 2016年第4期3卷 ofw226页

作者： Harris, Christine M. Wu, Henry M. Li, Jianmin Hall, H. Irene Lee, Adria Zell, Elizabeth Harrison, Lee H. Petit, Susan Farley, Monica M. Lynfield, Ruth Miller, Lisa Nichols, Megin Reingold, Arthur Schaffner, William Thomas, Ann MacNeil, Jessica R. Clark, Thomas A. Cohn, Amanda C. Division of Bacterial Diseases National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention Atlanta GA United States Logistics Health Inc. La Crosse WI United States Emory University 550 Peachtree Street NE MOT 7 Atlanta 30308 GA United States Division of HIV/AIDS Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA United States Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MD United States Connecticut Department of Public Health Hartford United States Department of Medicine Emory University School of Medicine Atlanta VA Medical Center GA United States Minnesota Department of Health St. Paul MN United States Colorado Department of Public Health and Environment Denver CO United States New Mexico Department of Health Sante Fe NM United States School of Public Health University of California Berkeley CA United States Vanderbilt University School of Medicine Nashville TN United States Oregon Department of Human Services Portland OR United States

Background. Although human immunodeficiency virus (HIV) infection is an established risk factor for several bacterial infections, the association between HIV infection and meningococcal disease remains unclear. Methods. Expanded chart reviews were completed on persons with meningococcal disease and HIV infection reported from 2000 through 2008 from 9 US sites participating in an active population-based surveillance system for meningococcal disease. The incidence of meningococcal disease among patients meeting Centers for Disease control and prevention acquired immune deficiency syndrome (aids) surveillance criteria was estimated using data from the National HIV Surveillance System for the participating sites. Results. Thirty-three cases of meningococcal disease in individuals with HIV infection were reported from participating sites, representing 2.0% of all reported meningococcal disease cases. Most (75.8%) persons with HIV infection were adult males aged 25 to 64 years old. Among all meningococcal disease cases aged 25 to 64 years old, case fatality ratios were similar among HIV-infected and HIV-uninfected persons (13.3% vs 10.6%;P = .6). The cumulative, mean incidence of meningococcal disease among patients aged 25 to 64 years old with HIV infection ever classified as aids was 3.5 cases per 100 000 person years (95% confidence interval [CI], 2.1-5.6), compared with 0.3 cases per 100 000 person years (95% CI, 0.3-0.3) for persons of the same age group not reported to have aids (relative risk = 12.9;95% CI, 7.9-20.9). Conclusions. Individuals with HIV infection meeting the aids surveillance case definition have a higher incidence of meningococcal disease compared with the general adult population. Copyright © 2018 Oxford University Press.

关键词： Disease surveillance HIV Meningitis Meningococcal disease

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Dysfunctional Characteristics of antibody-dependent cellular cytotoxicity mediated by CD56+Natural Killer cells in chronic HCV infection

Dysfunctional Characteristics of antibody-dependent cellular...

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第十一届全国病毒学学术研讨会暨第六届武汉现代病毒学国际研讨会

作者： Xueying Fan Lu Long Manxue Jia Hua Liang Xiangbo Huang Liyan Zhu Fengmin Lu State Key Laboratory of Infectious Disease Prevention and Control Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesNational Center for AIDS/STD Control and PreventionChina CDCBeijing 10026China Department of Microbiology and Infectious Disease Center Peking University Health Science CenterBeijing 100191China

Objective:As an important cooperated immune response of innate and adaptive immunity,CD56+ NK cell-mediated antibody-dependent cellular cytotoxicity(NK-ADCC)is of considerable interest in viral ***,limited knowledge w... 详细信息

关键词： NK cells ADCC HCV epitope neutralizing antibodies

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Effects of patient load and travel distance on HIV transmission in a cohort of serodiscordant couples in rural China: a longitudinal analysis

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The Lancet 2016年 388卷 S65-S65页

作者： M Kumi Smith William C Miller Huixin Liu Chuanyi Ning Wensheng He Myron S Cohen Ning Wang University of North Carolina Chapel Hill Chapel Hill NC USA Ohio State University College of Public Health Columbus OH USA Department of Clinical Epidemiology Peking University People's Hospital Beijing China University of North Carolina Institute for Global Health and Infectious Diseases University of North Carolina Chapel Hill NC USA Zhumadian City Center for Disease Control Prevention Zhumadian China National Centre for AIDS/STD Control and Prevention China Centers for Disease Control and Prevention Changping District Beijing China

Background Sustained viral suppression through antiretroviral therapy (ART) reduces the risk of sexual HIV transmission. However, it can require routine access to reliable and effective medical care, which can be difficult to obtain in resource-constrained areas. We investigated the effects of patient load and travel distance to an HIV care clinic on transmission risk in HIV serodiscordant couples in the Henan Province, China. Methods The study cohort arises from a population of HIV-infected individuals in central rural China where regional blood selling scandals in the 1990s led to mass HIV transmission of up to 30 000 people though unsanitary blood collection practices. Local disease control centres in our study prefecture followed up patients with HIV and their uninfected spouses to monitor transmission events since 2006. Eligible couples had to be registered residents living in the study prefecture, older than 16 years (the age of legal consent in China), in a stable marriage (no separation or divorce), one partner confirmed to be HIV seropositive and the other seronegative, and be willing to provide written or verbal informed consent. Cox proportional hazard models were used to compare events of HIV transmission between couples living near (<50 km), medium (≥50 km), or far (>100 km) distances from their assigned HIV care clinics, as well as between those attending clinics with high (>100 patients per clinician) versus low (≤100 patients per clinician) patient loads. Ethics approval for the analysis of these data for research purposes was provided by the Institutional Review Board of the National Center for aids/std control and prevention (NCaids) at the Chinese Centers for Disease control and prevention. This analysis relied on an agreement between the Institutional Review Boards of NCaids and the University of North Carolina, Chapel Hill. Findings 3611 HIV-serodiscordant couples contributed a total of 21 231 person-years. Index partners received HIV care at 15

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CD160 plays as a co-stimulatory molecule to promote CD8+ T-cell mediated cytotoxicity and correlates with viral suppression and slow disease progress during persistent viral infection

CD160 plays as a co-stimulatory molecule to promote CD8+ T-c...

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第十届全国免疫学学术大会

作者： Jianqing Xu Shanghai Public Health Clinical Center & Institutes of Biomedical Sciences Key Laboratory of Medical Molecular Virology of Ministry of Education/Health Fudan University Yuncheng CDC Department of AIDS/STD Shanghai Municipal Center for Disease Control and Prevention Department of Pathology The University of Chicago

It remains elusive on the role of CD8 T cells in persistent viral infection. Here we employed HIV and LCMV infection models and identified that the up-regulation of CD8 T-cell mediated cytotoxicity but not cytokines, which could be regulated by CD160-mediated pathway, correlates with viral suppression and slow disease progress during persistent viral infection. During chronic HIV infection, CD160 phenotyped CD8 T cell population is enriched in HIV+ subjects with elevated CD4 T-cell counts and culminated in long-term nonprogressors/slow progressor. Increased frequency of CD160CD8 T cells in HIV+ subjects predicts a benign clinical course in a three-year longitudinal observation. CD160HIV-specific CD8 T cells are polyfunctional and proliferative upon HIV antigen stimulation and resistant to HVEM mediated inhibition whereas CD160- HIV-specific CD8 T cells are unable to do so. Cross-linking of CD160 with anti-CD160 antibodies significantly enhances the capacity of CD8 T cells to produce granzyme B and to degranulate their cytotoxic molecules but resulted in slightly decreased production of IFN-gamma and TNF-alpha in response to cognate antigen stimulation. Knocking out CD160 in mice significantly damages CD8 T-cell functionalities and attenuates their capacity to suppress LCMV replication. These results demonstrated for the first time that CD160 plays as a costimulatory role on CD8 T cells and defines a proliferative and cytotoxic T-cell population. The triggering of CD160 with anti-CD160 antibodies may provide a useful tool for clinical immune intervention during persistent viral infection.

关键词： Persistent infection Immune Protection CD8+ T cells CD160 Cytotoxicity

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Association between Macroscopic-factors and Identified HIV/aids Cases among Injecting Drug Users: An Analysis Using Geographically Weighted Regression Model

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Biomedical and Environmental Sciences 2014年第4期27卷 311-318页

作者： XING Jian Nan GUO Wei QIAN Sha Sha DING Zheng Wei CHEN Fang Fang PENG Zhi Hang QIN Qian Qian WANG Lu National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Department of Epidemiology and Biostatistics School of Public Health Nanjing Medical University

Drug use （DU）, particularly injecting drug use （IDU） has been the main route of transmission and spread of Human Immunodeficiency Virus （HIV）/Acquired Immune Deficiency Syndrome （aidsJ among injecting drug users （IDUs）[1]. Previous studies have proven that needles or cottons sharing during drug injection were major risk factors for HIV/aids transmission at the personal level[z4]. Being a social behavioral issue, HIV/aids related risk factors should be far beyond the personal level. Therefore, studies on HIV/aids related risk factors should focus not only on the individual factors, but also on the association between HIV/aids cases and macroscopic-factors, such as economic status, transportation, health care services, etc[1]. The impact of the macroscopic-factors on HIV/aids status might be either positive or negative, which are potentially reflected in promoting, delaying or detecting HIV/aids epidemics.

关键词： aids HIV An Analysis Using Geographically Weighted Regression Model

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Introduction of rapid syphilis testing in antenatal care: A systematic review of the impact on HIV and syphilis testing uptake and coverage

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International Journal of Gynecology and Obstetrics 2015年第S1期130卷 S15-S21页

作者： Swartzendruber, Andrea Steiner, Riley J. Adler, Michelle R. Kamb, Mary L. Newman, Lori M. Rollins School of Public Health Emory University 1518 Clifton Road Atlanta 30322 GA United States Global AIDS Program Centers for Disease Control Prevention Atlanta GA United States Division of STD Prevention International Activities Unit Centers for Disease Control and Prevention Atlanta GA United States Department of Reproductive Health and Research World Health Organization Geneva Switzerland

Abstract Background Global guidelines recommend universal syphilis and HIV screening for pregnant women. Rapid syphilis testing (RST) may contribute toward achievement of universal screening. Objectives To examine the impact of RST on syphilis and HIV screening among pregnant women. Search strategy We searched MEDLINE for English- and non-English language articles published through November, 2014. Selection criteria We included studies that used a comparative design and reported on syphilis and HIV test uptake among pregnant women in low- and middle-income countries (LMICs) following introduction of RST. Data collection and analysis Data were extracted from six eligible articles presenting findings from Asia, Africa, and Latin America. Main results All studies reported substantial increases in antenatal syphilis testing following introduction of RST;the latter did not appear to adversely impact antenatal HIV screening levels at sites already offering rapid HIV testing and may increase HIV screening among pregnant women in some settings. Qualitative data revealed that women were highly satisfied with RST. Nevertheless, ensuring adequate training for healthcare workers and supplies of commodities were cited as key implementation barriers. Conclusions RST may increase antenatal syphilis and HIV screening and contribute to the improvement of antenatal care in LMICs. © 2015 World Health Organization;licensee Elsevier.

关键词： HIV Point-of-care test Pregnancy Screening Syphilis

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