中华疾病控制杂志

Review for progress of vaccination for patients with HIV infection

LIU Yuan-bao, LI Jing-xin, ZHU Yuan-yuan, JIA Si-yue, FU Geng-feng, XU Jin-shui, TANG Fen-yang, ZHU Feng-cai

2017, 21(12): 1187-1190. doi: 10.16462/j.cnki.zhjbkz.2017.12.001

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Abstract:
The prevalence of acquired immune deficiency syndrome (AIDS) in the world especially in China is still high. While vaccination strategies for human immunodeficiency virus (HIV) infected people are well developed in developed countries, it remains unknown in China. In this paper, vaccination strategies for HIV infected persons including physical conditions, vaccination times, vaccine types, administration methods, doses, schedules, and priority to vaccinate inactivated or attenuated live vaccines were reviewed. Together with the progress of new published researches, we provided some suggestions which may be benefit for further research in China.

Risk factors associated with HIV drug resistance among ART virological failure patients taking first-line antiviral treatment from Jiangsu Province

ZHOU Ying, LU Jing, ZHANG Zhi, FU Geng-feng

2017, 21(12): 1191-1194,1199. doi: 10.16462/j.cnki.zhjbkz.2017.12.002

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Objective To investigate drug resistance characters and risk factors among patients with virological failure taking first-line antiviral treatment with drug resistance. Monitoring drug resistance (DR) and providing strategies for ART effects. Methods In-house DR was tested to determine the subtype of HIV-1 in patients with virological failure. The study was a cohort study and subjects were patients with virological failure who emerged drug resistance for first time in 2013-2014. Patients' information was collected from the sub platform of China's legal information management system. The ratios of DR in different factors groups were analyzed using χ² test, and binary Logistic regression was used to analyze the influencing factors of drug resistance mutation. Results The number of patients in this study was 404. The prevalence of DR among virological failure patients taking first-line antiretroviral therapy (ART) was 53.96% (218/404). Patients with treated duration of 2-4 years were at higher DR risk (OR=1.96,95%CI:1.18-3.25). The main DR class was nucleoside reverse transcriptase inhibitor with non-nucleoside reverse transcriptase inhibitor(NRTI+NNRTI)combination, 73.39%. DR mutations distributed in NRTI associated mutations, mainly 184V(79.27%)and NNRTI associated mutations, mainly 103N(35.21%), 181C (32.39%)and 190A(26.29%). Conclusions It is important to maintain success of ART through strengthening early following up on patients after ART initiation, improving adherence to drug, delaying and controlling DR emergence in virological failure patients taking first-line antiviral treatment.

Analysis of epidemiology characteristics among HIV/AIDS who joined the antiviral treatment in Shandong Province from 2008 to 2015

ZHU Xiao-yan, YANG Xing-guang, LIAO Mei-zhen, HUANG Peng-xiang, HAO Lian-zheng, LIN Bin, LI Jin-hai, WANG Guo-yong, QIAN Yue-sheng, TAO Xiao-run, KANG Dian-min, HUANG Tao

2017, 21(12): 1195-1199. doi: 10.16462/j.cnki.zhjbkz.2017.12.003

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Objective To understand the epidemiological characteristics of HIV/AIDS who joined the highly active antiretroviral therapy in Shandong Province from 2008 to 2015. Methods The basic information of HIV/AIDS who joined the antiviral treatment in Shandong Province from 2008 to 2015 were collected, and the database was established by Excel 2010. Data were analyzed using SPSS 23.0. Results Of the 5 330 cases, 86.1% were male and 42.8% were married,the average age was 34.8±10.6 years old. The proportion of the HIV/AIDS patients that were being male, unmarried, under 35 years older showed a trend of increase. 93.6% of them were infected through sexual contacts, and the homosexual transmission increased during 2008-2015. 80.7% were in clinical phase I. The average baseline CD4⁺T lymphocyte count was 272.4(139.0,370.0). 86.1% of them were without any symptoms when joined treatment. Median of the interval between HIV confirmation and HAART initiation was 3 months. Proportion of the HIV/AIDS patients that were WHO Ⅰ, with higher baseline CD4⁺T lymphocyte count, without any symptoms showed a trend of increase from 2008 to 2015. Conclusions In Shandong province, the timing of HIV/AIDS receiving antiretroviral therapy was earlier than before, the detection and treatment on HIV should be earlier.

Dropout and its related factors among non-repeated clients of methadone maintenance treatment clinic in Zhaojue County

ZHUO Ma-lacuo, NAN Lei, YUAN Xin-hao, LUO Shao-hui, DA Zheng-ciji, LUAN Rong-sheng

2017, 21(12): 1200-1203,1213. doi: 10.16462/j.cnki.zhjbkz.2017.12.004

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Objective To explore the the situation of dropout of the drug users receiving methadone maintenance treatment (MMT) and its related factors in Zhaojue County, Liangshan Prefecture. Methods A retrospective cohort study was conducted on drug users enrolled from MMT clinics in Zhaojue County and who had only one treatment stage from January 1st, 2013 to December 31th, 2015. Descriptive method was used to describe demographic characteristics, drug use behaviors, etc. Factors affecting the situation of dropout were analyzed by survival analysis. Results A total of 301 drug users were included in this study, the average duration of the drug users receiving MMT was 14.5±10.7 months, and the median was 15.1 months. By the end of observation period, the rate of patients who withdrew from MMT was 85.38% and the rate of patients whose retention time was more than 1 year (including 1 year) was 56.48%. Cox proportional hazard regression modeling determined that the situation of dropout was associated with education level, the period of drug use, the history of injecting drug use and daily dosage (all P<0.05). Conclusions There were more than half of maintenance treatment patients adhered to the period that MMT had an effect. In the later process, corresponding measures, such as increasing daily dosage, enhancement of education, psychological counseling and behavior intervention, should be taken to prolong retention time.

Study on influencial factors of adherence to anti-retroviral treatment among people who co-infected with HIV/HCV in Fuyang City, Anhui Province

FAN Yin-guang, ZHU Zhi-wei, MA Wei-xiang, DING Zhi-qiang, CHENG Guo-jin, DAI Se-ying, YE Dong-qing

2017, 21(12): 1204-1208. doi: 10.16462/j.cnki.zhjbkz.2017.12.005

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Objective To investigate the adherence to anti-retroviral treatment and related factors among human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infectors. Methods In this cross-sectional study, 256 HIV and HCV co-infectors were recruited by convenience sampling method, and information about demography, taking medicine and therapy were collected and analyzed. Results A total of 256 HIV/HCV co-infectors were investigated, 34.0% of them missed dose in the last month. Multiple Logistic regression analysis showed that HIV/HCV co-infectors with long marriage (OR=3.049, 95% CI:1.435-6.481, P=0.004), longer time of treatment with antiretroviral therapy (ART) (OR=1.803, 95% CI:1.251-2.599, P=0.002), frequent alcohol consumption (OR=2.512, 95% CI:1.152-5.478, P=0.021) were risk factors of missed dose, while female (OR=0.180, 95% CI:0.089-0.366, P<0.001) and co-infectors who take a reminder method (OR=0.315, 95% CI:0.159-0.626, P=0.001) were protective factors for missed dose. Conclusions The ART adherence rate of HIV/HCV co-infectors was lower in Anhui Province, comprehensive intervention measures should be taken to promote the ART adherence.

Impact of high risk behavioral change on MSMs infected with HIV/AIDS patients under antiretroviral treatment in Yantai City

CHENG Xiao-song, LIN Rong, JIANG Ju-jun, XUE Jian, FENG Jing, WANG Mao-bo, YANG Shan

2017, 21(12): 1209-1213. doi: 10.16462/j.cnki.zhjbkz.2017.12.006

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Objective To evaluate the impact of sexual behaviors among HIV-infected men who have sex with men (MSM) after one year of antiretroviral treatment. Methods A face-to-face questionnaire interview was administrated to collect the information about high-risk behaviors of survey objects before and after one year antiretroviral treatment. Differences in sexual behavior were assessed by using the McNemar χ² text. Qualitative research with individual interviews was conducted to explore the factors of continuing high-risk behaviors after antiretroviral treatment. Results A total of 132 cases were investigated, with a high rate of condom use in the anal intercourse among respondents and the regular partners, 91.4% and 87.1% before and after treatment, with no statistical difference (χ²=1.500, P=0.682), anal intercourse with casual partners the condom use rate was 22.2% and 28.3% respectively before and after treatment, and the difference was statistically significant (χ²=11.257, P=0.010). Treatment success rate of patients with unprotected anal intercourse was lower than no unprotected anal intercourse behavior, 82.4% and 95.7% respectively, and the difference was statistically significant (χ²=4.601, P=0.032). Conclusions Among MSMs HIV-infected patients/AIDS patients after antiviral treatment a year later, there were still some of the subjects had unprotected anal intercourse with accidental sexual partners, increased the risk of HIV-resistant strains of transmission and sexually transmitted diseases risk, promotion of education and behavioral intervention for the target population should be further strengthened.

A cross-sectional study on the mental health among non-starting ART people living with HIV/AIDS under the ART expansion era

DU Xuan, ZHOU Kai, GU Jing, HAO Yuan-tao

2017, 21(12): 1214-1218. doi: 10.16462/j.cnki.zhjbkz.2017.12.007

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Objective To investigate the mental health status among PLWH (people living with HIV/AIDS) who had not started ART before in Guangzhou under the ART expansion era and to analyze the association between social support, social stigma and self-stigma with depression and anxiety in different time since confirmation of HIV infection, respectively. Methods A cross-sectional survey was conducted in 6 districts of Guangzhou. Data were collected on demographic characteristics, HIV-related health status, depression status, anxiety status, perceived social support, perceived social stigma and self-stigma of HIV positive participants. To investigate the influencing factors of depression and anxiety, respectively, Logistic regression analysis were applied to identify their associations. Results Of the 452 participants, the depression detection rate was 66.2%(299/452) and the anxiety detection rate was 52.9%(239/452). Multivariate logistic regression analysis revealed that, among PLWH with less than 1 month since confirmation of HIV infection, family support(OR=0.80, 95% CI:0.63-1.00, P=0.049) and self-stigma(OR=2.15, 95% CI:1.36-2.44, P=0.001) were significantly associated with depression, significant others support(OR=0.68, 95% CI:0.53-0.87, P=0.003) and self-stigma(OR=2.31, 95% CI:1.55-3.43, P<0.001) were significantly associated with anxiety; among PLWH with 1 month or more since confirmation of HIV infection, self-stigma(OR=2.72, 95% CI:1.74-4.25, P<0.001) was significantly associated with anxiety. Conclusions Depression and anxiety are common among people living with HIV/AIDS who had not started ART in Guangzhou. Self-stigma is an important influencing factor of anxiety and depression. Different source of supports have different effect toward depression and anxiety among PLWH in different time since confirmation of HIV infection, so the social support should be targeted to provide for PLWH.

Analysis of mental health status and related factors in 298 AIDS patients receiving antiretroviral therapy

YANG Yu-wei, SUN Hong-min, HU Ming-jun, HE Qian, ZHANG Qian, HE Yi-xin, HUANG Fen

2017, 21(12): 1219-1222. doi: 10.16462/j.cnki.zhjbkz.2017.12.008

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Objective To explore the mental health status and related factors of acquired immunodeficiency syndrome (AIDS) individuals receiving antiviral therapy (ART) in Anhui Province, and to provide appropriate measures for improving their physical and mental health. Methods Quantitative questionnaire survey was conducted among AIDS patients with positive CD4⁺T cell who have received treatment in 3 cities of Anhui Province to collect the general demographic characteristics and mental health status of patients from January 2013 to June 2014. Results 63 (21.1%) patients were equipped with anxiety syndrome and 126 (42.3%) with depression. Multivariate Logistic regression analysis showed that holding religious belief was related to anxiety (OR=2.221,95% CI:1.094-4.509), good ART adherence, marital status was married or cohabitation, educational level was junior high school or college and above, area in Huaibei and knowing antiviral treatment was a lifelong process on medication were influencing factors of depression (all P<0.05). Conclusions Anxiety and depression were common syndrome among AIDS patients in 3 cities of Anhui Province and were related to multiple factors. It was important to increase ART adherence and the awareness of lifelong medication to reduce anxiety and depression incidence.

Prevalence of anxiety disorders in 360 cases of HIV/AIDS outpatients

JIANG Yan, HE Li-ping, HE Jian-mei, WEI Xiu-qing, WANG Min, GUO Tian-sheng, CHEN Xi

2017, 21(12): 1223-1226,1231. doi: 10.16462/j.cnki.zhjbkz.2017.12.009

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Objective To investigate and analyze the prevalence of anxiety disorders and its influencing factors in HIV/AIDS patients. Methods This was a cross-sectional study of a total of 360 HIV/AIDS outpatients recruited in the first hospital of Changsha from June to December 2015. SAS questionnaire (SAS score greater than or equal to 50 points) was used to screen candidates and psychological CT was used to confirm the patients with anxiety disorders. The influencing factors were analyzed by using multivariate logistic regression analysis. Results 72 candidates (20.0%) were screened by SAS questionnaire and 34 cases (9.4%) were confirmed with anxiety disorders by using psychological CT. Multivariate logistic regression analysis revealed that great than or equal to 1 and less than 3 years after final diagnosis(OR=3.388, 95% CI:1.335-8.599), HIV related diseases diagnosed within nearly three months(OR=3.623, 95% CI:1.561-8.409), and the higher scores of HIV/AIDS related stigma and discrimination performance scale(scoring great than or equal to 40 points and less than 60 points, OR=4.595, 95% CI:1.666-12.674;scoring great than or equal to 60 points, OR=12.278, 95% CI:3.376-44.656)were independent risk factors of anxiety disorders. Conclusions The anxiety disorders in HIV/AIDS patients with highly active antiretroviral therapy should be paid more attention. The psychological care should be improved in clinic work.

Prevalence of HIV and syphilis infection and their associated factors among men who have sex with men in Jiangsu Province

CHEN Li-ping, CHEN Yu-heng, HUAN Xi-ping, ZHANG Zhi, SHI Ling-en, LU Jing, FU Geng-feng, HU Hai-yang

2017, 21(12): 1227-1231. doi: 10.16462/j.cnki.zhjbkz.2017.12.010

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Objective To understand the prevalence of human immunodeficiency virus (HIV) and syphilis infection and their associated factors among men who have sex with men (MSM) in Jiangsu Province. Methods MSM from eight cities in Jiangsu Province were recruited for questionnaire interview and laboratory test in 2015. Multivariate Logistic regression model was used to analyze associated factors of HIV and syphilis infection. Results The prevalence of HIV and syphilis were 10.3% and 8.3% among 2 451 MSM, respectively. MSM who were older than 40 years were recruited via internet, engaged in unprotected anal intercourse (UAI) in the past 6 months, did not have an HIV test in the past year and were currently infected with syphilis were susceptible to HIV infection (all P<0.05). MSM who were older than 24 years, had an education level of junior high school or less were recruited in venues and engaged in UAI in the past 6 months were susceptible to syphilis infection(all P<0.05). Conclusions Continuous high HIV prevalence and controlled syphilis epidemic were shown among MSM in Jiangsu Province. Condom usage and HIV/syphilis testing promotion should be prioritized when attempting to reduce HIV/syphilis transmission among MSM in Jiangsu Province.

Cohort study on the influential factors of HIV infection among men who have sex with men in Liuzhou City

LIU Xue-mei, LI Ming-qiang, WEI Dong-xu, FAN Yin-guang, JIANG Zhi-yu, FENG Xian-xiang

2017, 21(12): 1232-1235. doi: 10.16462/j.cnki.zhjbkz.2017.12.011

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Objective To understand the prevalence and influential factors of human immune deficiency virus(HIV)infection among men who have sex with men(MSM) in Liuzhou City, so as to provide the evidence for HIV prevention and control. Methods Snowball sampling method was used to set up MSM cohort in the urban area of Liuzhou from June 2014, and they were followed up each six months. Blood samples were taken from these MSM to detect antibodies of HIV. Results Baseline and three followers were recruited for 1 369 MSM. We successively completed the first follow-up (158 cases), the second follow-up (126 cases), and the third follow-up (74 cases). MSMs' knowledge of HIV/AIDS increaseed with the rise as the number of follow-up(χ²=7.698,P=0.006).Condom usage in the latest commercial anal sex (χ²=7.510,P=0.006) and anal same-sex sexual behavior (χ²=5.005,P=0.025) were in rising trend. Multifactorial Cox regression analysis showed that higher scores of HIV/AIDS related knowledge(OR=0.119,95% CI:0.021-0.686,P=0.017)and less drug use in the last 6 months (OR=0.036,95% CI:0.006-0.212,P<0.001), the risk of HIV infections was lower. Conclusions It is important to strengthen AIDS knowledge propaganda among MSM, raise the rate of AIDS related knowledge and the frequency of using comdom, reduce the drug use in order to curb the spread of AIDS in the MSM.

Analysis of anal human papillomavirus infection and influencing factors among different sex role of men who have sex with men

HUANG Bing-xue, ABIDAN·Ainiwaer, TIAN Tian, CAI Ai-jie, YE·Yekejiergeli, DAI Jiang-hong

2017, 21(12): 1236-1240. doi: 10.16462/j.cnki.zhjbkz.2017.12.012

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Objective To understand the Human Papillomavirus(HPV) infection status among different sex role of men who have sex with men(MSM) and to analyze relevant risk factors. Methods A total of 704 MSM were recruited by using the"snowballing"sampling method from March 2016 to April 2017 in Urumqi. Data on the demographic and sexual behavioral characteristics of MSM were collected by questionnaires. The cells in anal canal were collected and the 37-type HPV test kits were used for identification and classification. Results The previous anal HPV infection rate of MSM was 50.4%, of which the overall and low-risk HPV infection rate in "0" sex role group and "1" sex role group was different, namely, 54.6%,18.8% and 45.6%, 11.9% respectively, and the difference was statistically significant (all P<0.05). Multiple Logistic regression analysis showed that sometimes using condoms when having anal sex and homosexual commercial sex in nearly six months was the risk factor for HPV infection in "0" sex role group(all P<0.05), while having homosexual commercial sex in nearly six months was the risk factor for HPV infection in "1" sex role group(OR=3.04,95% CI:1.21-7.62, P=0.018). Conclusions The anal HPV infection rate between "0" sex role group and "1" sex role group was different. In view of risk factors, MSM should urge sexual partners adhere to using condoms and avoid commercial sex.

Self-control and risky behaviors among male students who have sex with men

YANG Yin-mei, XIAO Chen-chang, WANG Tang, LI Shi-yue, YAN Hong

2017, 21(12): 1241-1244. doi: 10.16462/j.cnki.zhjbkz.2017.12.013

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Objective To investigate the relationship between self-control ability and AIDS(acquired immune deficiency syndrome)-related risky behaviors of male students who have sex with men in Wuhan. Methods A total of 180 students MSM(men who have sex with men)were recruited from May to November, 2013. Anonymous questionnaire survey was carried out. Results The self-control score was 27.00-89.00 (median=55.00). The scores of impulse control 17.00(13.00-19.75) and overall self-control 53.00(47.00-61.75) among the students MSM aged 20-25 were lower than those aged 16-19 years old 18.00(16.00-21.75),57.50(51.25-65.00); those with a disposable monthly income of over 1 000 RMB Yuan 17.00(12.75-19.00) were lower than among those with less than 1 000 Yuan 18.00(15.00-21.00) in the scores of impulse control; The scores of impulse control 18.00(15.00-22.00), temperance entertainment 9.00(7.00-11.00) and overall self-control 58.00(48.00-66.50)among those with homosexual behaviors before the age of 18 years were higher than those aged 18-24 years old 17.00(13.75-20.00),8.00(6.00-10.00),54.00(48.00-60.00). The students MSM with histories of multiple sexual partners in the past six months had higher scores for resisting the temptation 13.00(11.00-14.00),12.00(10.00-14.00); drinkers were poorer in temperance entertainment 8.50(7.00-10.00),7.50(5.75-10.00); those with sexual behaviors after drinking had higher scores for impulse control 19.00(16.00-23.00), 17.00(14.00-20.00). The students MSM who had one night sex, engaged in group sex activities or had drug abuse in the past 6 years had higher scores for self-control. Conclusions The prevalence of risky behaviors is high. MSM with low self-control are more likely to engage in AIDS-related risky behaviors.

Analysis on the influencing factors of late diagnosis of newly identified HIV/AIDS cases in Nanjing from 2011 to 2015

LIU Li, ZHU Zheng-ping, XU Yuan-yuan, WU Su-shu

2017, 21(12): 1245-1249. doi: 10.16462/j.cnki.zhjbkz.2017.12.014

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Objective To analyze the late diagnosis (LD) status and its influencing factors of newly reported HIV/AIDS cases in Nanjing from 2011 to 2015. Methods Newly identified HIV/AIDS in Nanjing from 2011 to 2015 were selected from the National HIV/AIDS comprehensive information system. Chi-square test was used for trend analysis on LD rate and multivariate Logistic regression was conducted to test the factors associated with LD. Results From 2011 to 2015, the prevalence of LD were 32.0%, 30.5%, 32.5%, 29.6% and 30.9%, without a decreasing trend(χ²=0.255, P=0.614). The LD rate among cases found by voluntary counseling and testing increased significantly from 14.0% in 2011 to 21.4% in 2015 and the LD rate among cases found from medical institution decreased significantly from 53.4% to 47.4% in the same period. Multiple Logistic regression analysis indicated that those who were married (aOR=1.628,95% CI:1.306-2.028), aged over 64 (aOR=4.563,95% CI:2.502-8.320), didn't live in Nanjing(aOR=2.041,95% CI:1.683-2.475), infected via heterosexual transmission(aOR=1.279,95% CI:1.040-1.572), found from medical institutions (aOR=2.791,95% CI:2.280-3.416) were more likely to be diagnosed lately. Conclusions Given a high prevalence of LD among newly reported HIV/AIDS in Nanjing from 2011 to 2015, more efforts are urgently needed to promote medical institutions to carry out PITC, as well as expand HIV counseling and testing targeted key populations, so as to promote the early detection of HIV.

Prevalence and associated factors with late HIV diagnosis among HIV/AIDS patients detected via different pathways in Liuzhou City

DAI Se-ying, SHEN Zhang-wei, FAN Yin-guang, LI Ming-qiang, CHENG Xiao-li, YE Dong-qing

2017, 21(12): 1250-1253,1258. doi: 10.16462/j.cnki.zhjbkz.2017.12.015

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Objective To understand the status and associated factors with late human immunodeficiency virus (HIV) diagnosis among HIV/acquired immune deficiency syndrome (AIDS) patients detected via HIV testing for persons seeking medical care for illness (HTPSMCI) and HIV testing for other types of person (HTOTP) in Liuzhou City. Methods A cross-sectional survey was conducted to eligible subjects who were newly diagnosed with HIV infection between January 2009 and June 2010 in Liuzhou City. Multivariate Logistic regression analysis was used to identify risk factors associated with late HIV diagnosis among HIV/AIDS patients detected via HTPSMCI and HTOTP respectively. Results The prevalence of late HIV diagnosis among 839 HIV/AIDS patients detected via HTPSMCI and HTOTP were 83.8% and 62.7% respectively and the difference was statistically significant (χ²=48.765, P<0.001). Among HIV/AIDS patients detected via HTPSMCI, the participants at age of 16-39 years, female, unmarried, and injection drug transmission route accounted for 37.3%, 22.8%, 15.3% and 5.0%, which were lower than HIV/AIDS patients detected via HTOTP (all P<0.05). The results of multivariate Logistic regression analysis showed that risk factors of late HIV diagnosis among HIV/AIDS patients detected via HTPSMCI included heterosexual contact, regular heterosexual partner and casual heterosexual partner prior to HIV diagnosis, and annual household income ≥ 15 000 Yuan was a protective factor. The results also showed that risk factors associated with late HIV diagnosis among HIV/AIDS patients detected via HTOTP was older age. Conclusions The prevalence of late HIV diagnosis among HIV/AIDS patients detected via HTPSMCI and HTOTP are both high. Moreover, there are some differences in demographic characteristics and risk factors of late HIV/AIDS diagnosis patients detected via HTPSMCI and HTOTP, which suggested that it is essential to promote appropriate interventions to detect HIV infections earlier targeting the demographic characteristics of HIV/AIDS patients detected via HTPSMCI and HTOTP.

Sexual behavior and its risk factors of new reported 988 HIV/AIDS cases with extra-marital heterosexual transmission in Yunnan Province in 2015

SONG Li-jun, LI Cai-xia, FU Li-ru, MEI Jing-yuan, NIU Jin, XIAO Min-yang, LI Xue-hua, LU Ji-yun, LUO Hong-bing

2017, 21(12): 1254-1258. doi: 10.16462/j.cnki.zhjbkz.2017.12.016

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Objective To explore the high-risk sexual behavior features and its influencing factors of the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) cases with extra-marital heterosexual transmission, and to provide basic data for controlling HIV heterosexual transmission. Methods New reported HIV/AIDS cases with extra-marital heterosexual transmission in Yunnan Province in 2015 were recruited. Face to face questionnaire was used to get the information as risk behaviors before and after inform HIV infection. Results A total of 498 males and 490 females were recruited; 39.88% (male 68.67%, female 10.61%) of the cases had business sexual behaviors before informing HIV infection in the near one year, there was significant difference between genders (χ²=352.797,P<0.001).The site centralized in the street sides. Persistent condom using rate was only 8.38%;71.36% (male 64.46%,female 78.37%)had temporary sexual behavior, there was significant difference between genders (χ²=23.379,P<0.001). 82.52% were among the friends/acquaintances. The multiple and cross sexual behavior existed. 12.96% of those informed infected cases still insisted unprotected high risk sexual behaviors. Only 31.86% of them were willing to tell the sexual partners their infection status. Conclusions Heterosexual HIV/AIDS transmission population is enlarging. The strategy should transfer into strengthen high-risk population intervention, and advocate universal condom use. Sexual responsibilities, sexual health and sexual safety propaganda should be added as well. The spread risk assessment of the HIV/AIDs in the follow-up management should be included and steps should be taken accordingly.

Analysis on occupational exposure to HIV between 2010 to 2015 in Dehong Prefecture, Yunnan Province

GAO Jie, YU Qiu-yan, YANG Yue-cheng, LI Lin, YE Run-hua, GONG Yu-rong, DU Ben-li, DUAN Song

2017, 21(12): 1259-1262,1288. doi: 10.16462/j.cnki.zhjbkz.2017.12.017

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Objective To acquaint the occurrence, post-exposure prophylaxis (PEP) and prognostic follow-up of occupational exposure to HIV from 2010 to 2015 in Dehong Prefecture in Yunnan Province, so as to provide reference for carrying out and tightening the protection work of occupational exposure to HIV. Methods The CDC of Dehong Prefecture collected total occupational HIV exposure cases from 2004 to 2015, which then were put into pooling and statistical analysis. Results From 2010 to 2015, a total of 323 cases of occupational HIV exposure occurred and none suffered HIV infection, of whom 220 (68.11%) were females, of whom 229 (70.90%) were less than 35 years old, and of whom 209 (64.71%) were health care workers. needle or other sharp instrument sticking occupied the most proportion of 72.14% (233/323). Medical facilities were the main areas where the occupational HIV exposure occurred (82.66%, 267/323). After exposure to HIV, total 323 immediately washed or disinfected skin or mucous membranes whereas 279 had received post-exposure prophylaxis(PEP), 156 of 279 completed the 28-day course. The cases of occupational HIV exposure differed largely. Conclusions Insisting on the principle of universal protection, employing timely and emergent treatment and PEP after exposure assessment are helpful for avoiding and reducing HIV infection due to occupational exposure.

Study on the infection status of HIV-positive population from Shanghai Xuhui voluntary counseling and testing from 2008 to 2015

CAI Xiao-feng, TAO Dong-yi, HE Xiao-wen, ZHANG Tie-jun

2017, 21(12): 1263-1266. doi: 10.16462/j.cnki.zhjbkz.2017.12.018

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Objective To analyze the social demographic characteristics and the risk factors of HIV-positive population from Xuhui voluntary counseling and testing (VCT) from 2008 to 2015, and compare the differences of infectious routes, CD4 counts and progression of disease between two groups of patients who were detected from VCT and general hospitals. Methods Cross-sectional study was conducted to describe the relative information of HIV-positive population from VCT. The VCT group and the hospital group were established and the relative data of two groups was collected for retrospective study and comparison. Results Among VCT-positive population, the ratio between male and female was 21.09:1. 48. 97% of the patients were among the age of 20 to 29. 71.60% were unmarried, and 67.49% had the college degree or higher education level. The groups, who were men who have sex with men (MSM), or with the age <20 or ≥ 50, or divorced and widowed, or with lower education level, had higher positive rates. The percentage of homosexual transmission in VCT group was higher than that of hospital group. The median values of the first CD4 test were 360 cells/μl and 293 cells/μl. The median values of incubation period were 2 115 days and 942 days. Conclusions Most of the positive patients from Xuhui VCT are young, unmarried MSM population with higher education level. Those high-risk subgroups, such as young students, elderly population, lower education level groups, divorced or widowed population, should be paid close attention. The advantage of early discovery of HIV patients from VCT is obviously higher than that of general hospital.

Analysis on incidence and risk factors for HIV infection among drug users in Yunnan Province from 2013 to 2015

DONG Li-juan, XIAO Min-yang, MA Yan-ling, LUO Hong-bing, CHEN Min, YANG Chao-jun, DAI Jie, YANG Li, Song Li-jun, FU Li-ru, NIU Jin, JIN Xiao-mei, CHEN Hui-chao

2017, 21(12): 1267-1270. doi: 10.16462/j.cnki.zhjbkz.2017.12.019

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Objective To determine the related risk factors influencing incidence of human immunodeficiency virus (HIV) infection among drug users(DUs) in Yunnan Province and to provide scientific reference for the prevention and control of acquired immune deficiency syndrome(AIDS). Methods HIV-1 antibody positive serum samples of DUs from drug abuse sentinel sites in Yunnan Province during 2013 to 2015 were collected and tested by BED-capture enzyme immunoassay (BED-CEIA). Questionnaires including demographic and behavioral characteristics were performed among DUs to analyze HIV infection risk factors. Results In 31 503 samples, 3 424 were HIV-1 antibody positive(including 2 793 previous infections) and the positive rate was 10.9%(3 424/31 503).Male and female DUs accounted for 87.3% (2 989/3 424) and 12.7% (435/3 424) respectively. Of total 598 new reported HIV cases, 101 new infections were detected by BED-CEIA, among which 90 (89.1%) were male and 11(10.9%) were female with an average age of 31.54 years old (16-54). HIV-1 incident rate among DUs was 0.53% from 2013 to 2015. The result of multivariate Logistic regression analyses showed that new infection risk among participants with the foreign nationality(Myanmar), non-Han nationality and injection drug use was significantly higher than that among participants with registered permanent residence in or not in Yunnan Province,Han nationality and oral drug use (all P<0.05). Conclusions More attention should be paid to DUs with foreign nationality(Myanmar),non-Han nationality and injection drug use. Comprehensive intervention measures including community maintenance treatment, peer education and HIV testing and counseling should be taken to reduce HIV-1 new infection rate.

HIV and HCV infection situation and associated risk factors among injecting drug users: a Meta-analysis

ZHENG Er-da, GAO Liang-min, PENG Xia, XIE Tian-sheng, LIU Hong-yan, SUN Yue-qi, HUANG Jin, LI Hong

2017, 21(12): 1271-1276. doi: 10.16462/j.cnki.zhjbkz.2017.12.020

Abstract(325)

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Objective To obtain the infection prevalence of human immunodeficiency virus(HIV)and hepatitis C virus(HCV) among Chinese injecting drug users (IDUs), and to estimate the associated risk factors of HIV/HCV(hepatitis C virus) infection. Methods Literatures on HIV and HCV infection among Chinese IDUs were collected with search strategies, data were abstracted to create the database and the meta-analysis were conducted. Results Prevalence of HIV among IDUs was 7.00% (95% CI:6.10%-8.00%), and the prevalence of HCV was 67.10% (95% CI:61.00%-73.20%). Subgroup analysis indicated that both of HIV and HCV prevalence were different among different groups of regions, types of population and periods. Single factor meta-regression indicated HCV infection was the major associated factors of HIV prevalence, and HIV prevalence in high HCV infection group was higher than it in low HCV infection group. Conclusions The prevalence of HIV and HCV were high among Chinese IDUs, and HIV prevalence was closely related to HCV prevalence. HCV prevalence could be used as a predictor of HIV prevalence among IDUs.

Changes in gene expression profiles and bioinformatics analysis in brain tissue of HIV-related neurological cognitive impairment patients

SUN Na, FAN Song, GUO Ya-shou, LIU Qi-ling, LI Xing-hui, ZHANG Rong-qiang

2017, 21(12): 1277-1281. doi: 10.16462/j.cnki.zhjbkz.2017.12.021

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Objective To analyze the biological regulation and key proteins of brain tissue gene expression gene data in HIV-related neurocognitive disorder (HAND) patients, and to provide a new theoretical basis for HAND prevention and intervention. Methods Microarray gene chip data of brain tissue were downloaded from gene expression omnibus (GEO) public database including New York HAND patients (14 cases) and non-patients (7 cases), and the differential expression genes were imported into the analysis software gene-cloud of biotechnology informs (GCBI) experimental platform, GenClip 2.0 and Sytoscape 3.5.1. Exploring expression of protein interaction network, biological pathway, and the molecular mechanism of the development of HAND from the perspective of transcriptions. Results Compared with the control group, there were 780 (1.43%) differentially expressed genes between the two groups. The difference gene was mainly associated with immune response regulation, anti-infective, antiviral, cell signaling and synaptic transmission. LYN and RPS4Y1 genes are the key nodes of the protein-protein interaction network. DNM1, FLT1, NOTCH3, LYN, ISG15 and RPS4Y1 were the key expression genes. The DNM1, FLT1 and NOTCH3 genes were lower in the HAND group, while LYN, ISG15 and RPS4Y1 gene was highly expressed, and the difference was statistically significant (all P<0.05). Conclusions There were 780 differentially expressed genes in HAND patients and non-patients. LYN and RPS4Y1 genes are the core nodes of protein network and are highly expressed in brain tissue of HAND patients. The function mainly includes immune response, immune regulation, anti-infection, anti-virus and other biological functions.

A systematic review of phase Ⅱ/Ⅲ trials of preventive HIV vaccine

WANG Ke-ran, HE Na

2017, 21(12): 1282-1288. doi: 10.16462/j.cnki.zhjbkz.2017.12.022

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This systematic review aims to provide with information for the future clinical trials of human immunodeficiency virus(HIV) preventive vaccine in China on the phaseⅡ/Ⅲ clinical trials of HIV preventive vaccines worldwide. Related literatures were collected by the joint use of medical subject headings (Mesh) and free terms from Medline. The types of vaccination, research subjects, immunogenicity and the efficacy of the clinical trials were sorted out and analyzed. According to the inclusive and exclusive criteria, total twenty five literatures were selected. There were more and more various types and the strategies of the vaccination with stronger immunogenicity, yet RV144 was the only clinical trial with significant efficacy. Based on the previous worldwide researches' findings, while many types of HIV preventive vaccines have been developed, there is still the need to explore potential candidates for HIV has various mutation, and there are confusions about protective immune response to HIV and pre-immune response to viral vectors effecting the vaccine efficacy. According to the previous experiences, it is necessary to target the local epidemic HIV genotypes, to apply the regimens of multiple vaccines and to investigate the HIV incidence rate, follow-up rate and willing-to-participate rate of high-risk populations in advance if large clinical trials of HIV preventive vaccines will be conducted in China.

HIV-1 molecular epidemiological investigation and drug resistance in Jiangxi Province in 2015

ZHANG Na, DING Chen, LIU Li-ping, YI Zhi-qiang, JIN Ting-li, TANG Yi-long, HU Guo-liang

2017, 21(12): 1289-1291. doi: 10.16462/j.cnki.zhjbkz.2017.12.023

Abstract(279)

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Study on association between CD4⁺T lymphocyte and life quality of MSM with HIV

ZHANG Peng, SUN Xiao-ming, LOU Ji-quan, ZHANG Yi-min, LI Hua-zhang, SUN Qiao

2017, 21(12): 1292-1294. doi: 10.16462/j.cnki.zhjbkz.2017.12.024

Abstract(314)

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Study on medication compliance in antiviral therapy among people with HIV/AIDS in Enshi City

WANG Ke-kun, YANG Yin-mei, HUANG Xiao-lin, LI Shi-yue

2017, 21(12): 1295-1297. doi: 10.16462/j.cnki.zhjbkz.2017.12.025

Abstract(209)

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Analysis on the situation of the AIDS follow-up management of HIV/AIDS in Jiangxi Province

HUANG Ling, YANG Qing, HU Qiang, HUANG Qing, JIANG Xiao-qing, ZHU Hui, XIE Fei, LIU Rong, WEN Xiao-tong, YUAN Zhao-kang

2017, 21(12): 1298-1300. doi: 10.16462/j.cnki.zhjbkz.2017.12.026

Abstract(284)

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Editor

Editor-in-Chief Ye Dongqing M.D.

Assistant editor Fan Yinguang M.D.

Assistant editor Pan Haifeng M.D.

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