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Commentary: Socio-economic determinants of tuberculosis in Recife, Brazil

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY 2009年第5期38卷 1295-1296页

作者： Marks, Suzanne Clinical and Health Systems Research Branch Division of Tuberculosis Elimination National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention US Centers for Disease Control and Prevention. smarks@cdc.gov

The article examines the study 'Is it better to be rich in a poor area or poor in a rich area? A multilevel analysis of a case-control study of social determinants of tuberculosis,' by X. Ricardo Arraes de Alencar, V. S. Wayner and colleagues, published in the 2009 issue. It notes the model used by the authors to identify least ownership of goods or little personal wealth as being most linked tuberculosis (TB) in Recife, Brazil. The limitations of the study such as selection bias are also discussed.

关键词： TUBERCULOSIS POOR people SOCIAL status WEALTH PERSONAL property

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Complete Human Immunodeficiency Virus-1 Specific T Lymphocyte Response to Chinese Human Immunodeficiency Virus-1 B/C Chronic Infectors

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Biomedical and Environmental Sciences 2009年第6期22卷 522-528页

作者： ZHE WANG HONG-WEI LIU KUN-XUE HONG ZU-JIANG YU JIAN -PING CHEN YU-HUA RUAN QUAN-CHENG KAN YI-MING SHAO The First Affiliated Hospital of Zhengzhou University Zhengzhou 450052 Henan China Center for AIDS/STD Control and Prevention Henan Center for Disease Control and Prevention Zhengzhou 450016 Henan China Division of Virology and Immunology National Center for Disease Control and Prevention Chinese Center for Disease Control and Prevention Beijing 100052 China

Objective To characterize the human immunodeficiency virus （HIV） -specific T lymphocyte responses and identify the immunodominant regions in Chinese HIV-1 recombinant subtype B/C chronic infectors at complete genome level. Methods Twenty-five HIV-I B/C recombinant chronic infectors were screened for their specific T lymphocyte responses to a panel of peptides corresponding to the complete HIV-1 subtype B genome by gamma interferon ELISPOT assay. Kruskal-Wallis nonparametric analysis of variance was used to test significant differences across gene regions, and Tukey pairwise analysis was used to identify differences between gene regions. Spearman rank correlation was used to assess the relation between responses. Results The order of recognized frequencies of specific T lymphocyte responses to HIV proteins was Nef〉Vpr〉Gag〉Pol〉Vpu〉Env〉Rev〉Vif〉Tat. When adjusted for protein length, Nef, Vpr, Gag, and Pol were the most intensely targeted proteins and the central region of Nef, Gag p24, Pol RT, and Vpr was most frequently recognized. No significant correlation was observed between the magnitude of IFN-γ production of HIV-l-specific T lymphocyte responses and plasma viremia, breadth of response and CD4 counts. Conclusion The central region of Nef, Gag p24, Pol RT, and Vpr is most frequently targeted in HIV-1 B/C recombinants chronic infectors. HIV-1-specific T lymphocyte responses and plasma viremia or CD4 counts play no protective role at complete genome level in these infectors.

关键词： Human immunodeficiency virus （HIV） Specific T lymphocyte response Elispot IFN-γ

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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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Erratum

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Public Health Reports 2009年第5期124卷 624页

作者： Elin B. Begley Division of HIV/AIDS Prevention National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention Centers for Disease Control and Prevention Atlanta GA

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P16-14. Loss of balance between CD4+ regulatory T cell and Th17 population in chronic HIV infection

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Retrovirology 2009年第3期6卷 1-1页

作者： D Li J Chen M Jia K Hong S Liu X Zhang H Zhao H Peng Q Zhao P Ma C Wu Y Shao Division of Virology and Immunology National Center for AIDS/STD Control and Prevention China CDC Beijing PR China

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P16-12. Relative dominance of Gag-specific cytotoxic T lymphocytes is associated with viral load inversely in HIV-1 clade B' infected Chinese

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Retrovirology 2009年第3期6卷 1-1页

作者： M Jia J Chen K Hong S Liu X Zhang H Zhao Y Shao M Altfeld B Walker X Yu Division of Virology and Immunology National Center for AIDS/STD Control and Prevention China CDC Beijing PR China Ragon Institute of MGH MIT and Harvard Boston MA USA

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Factors influencing the natural history of HIV-1 infection

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Chinese Medical Journal 2008年第24期121卷 2613-2621页

作者： QU Wei Matthew Robinson ZHANG Fu-jie Division Treatment and Care National Center for AIDS/STD Control and Prevention Chinese Center for Disease Control and Prevention Beijing 100050 China University of North Carolina Chapel Hill 27599 USA

The natural history of HIV is defined as the untreated progression from the time of HIV transmission to death. The typical course of infection is characterized by three phases： acute or primary infection phase, the asymptomatic phase, and aids. Primary infection is often accompanied by a symptomatic acute retroviral syndrome starting 2-3 weeks after transmission and lasting an additional 2-4 weeks. The asymptomatic phase, in contrast, is long with a duration that varies widely. While there is little consensus on how to divide patients based on their duration of asymptomatic phase, multiple clinical groups have been described in the literature including rapid progressors, typical progressors, long-term nonprogressors, and elite controllers. Approximately 5% to 15% of asymptomatic subjects considered as rapid progressors experience a sharp decline in CD4^＋ T cell counts progressing to aids within 2 to 5 years.

关键词： HIV infections natural history influencing factors

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Formulas for estimating the costs averted by sexually transmitted infection (STI) prevention programs in the United States

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Cost Effectiveness and Resource Allocation 2008年第1期6卷 10-10页

作者： Chesson, Harrell W. Collins, Dayne Koski, Kathryn 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

Background: Sexually transmitted infection (STI) prevention programs can mitigate the health and economic burden of STIs. A tool to estimate the economic benefits of STI programs could prove useful to STI program personnel. Methods: We developed formulas that can be applied to estimate the direct medical costs and indirect costs (lost productivity) averted by STI programs in the United States. Costs and probabilities for these formulas were based primarily on published studies. Results: We present a series of formulas that can be used to estimate the economic benefits of STI prevention (in 2006 US dollars), using data routinely collected by STI programs. For example, the averted sequelae costs associated with treating women for chlamydia is given as (Cw)(0.16)(0.925)(0.70)($1,995), where Cw is the number of infected women treated for chlamydia, 0.16 is the absolute reduction in the probability of pelvic inflammatory disease (PID) as a result of treatment, 0.925 is an adjustment factor to prevent double-counting of PID averted in women with both chlamydia and gonorrhea, 0.70 is an adjustment factor to account for the possibility of re-infection, and $1,995 is the average cost per case of PID, based on published sources. Conclusion: The formulas developed in this study can be a useful tool for STI program personnel to generate evidence-based estimates of the economic impact of their program and can facilitate the assessment of the cost-effectiveness of their activities. © 2008 Chesson et al;licensee BioMed Central Ltd.

关键词： Indirect Cost Syphilis Sexually Transmitted Infection Direct Medical Cost Pelvic Inflammatory Disease

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Study of HIV-1 drug resistance in patients receiving free antiretroviral therapy in China

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Virologica Sinica 2008年第3期22卷 233-240页

作者： Xin-ping, Li 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 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 China Graduate University of Chinese Academy of Sciences Beijing China Henan Center for Disease Control and Prevention Zhengzhou China Queshan Center for Disease Control and Prevention Henan 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 interview. Viral load and genotypic drug resistance were tested. Drug 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-naïve, 0 to 6 months treatment, 6 to 12 months treatment, and treatment for greater than 12 months patients, respectively. No mutation associated with resistance to Protease inhibitor (PI) was detected in this study. Nucleoside 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 months. NNRTI 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, G190A. There had been optimal viral suppression in pat

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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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