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Objective To investigate the prevalence and risk factors of highly active antiretroviral therapy (HAART)-associated lipodystrophy syndrome (LD) in patients with acquired immunodeficiency syndrome (AIDS) treated with HAART in China.Methods A total of 137 AIDS patients treated with HAART for more than 2 years were analyzed.Sixteen clinical parameters (including gender,age,baseline body mass index,baseline human immunodeficiency virus [HIV] viral load,stage of disease,routes of HIV transmission,baseline CD4+ T lymphocyte count,white blood cell count,fasting plasma glucose level,serum triglycerides level,serum cholesterol level and other laboratory results,and HAART regimens) that might be associated with HAART-LD occurrence were evaluated using Cox proportional hazards models.Results HAART regimens were significantly correlated with HAART-LD (P=0.031),while the remaining 15 factors were not associated with the risk of HAART-LD (all P＞0.05).Patients who received stavudine d4T)-containing regimen was 2.684 times more likely to develop HAART-LD than patients who received zidovudine (AZT)-containing regimen (95 ％ CI:1.302-5.531,P=0.007) ; HAART-LD prevalence rates were gradually increased with treatment duration in both groups.First HAART-LD was seen at 24 weeks in both d4T group and AZT group,and the prevalence rates were 2.7％,1.6％ at 24 weeks,27.0％,7.9％ at 48 weeks and 37.8％,15.9％ at 96 weeks respectively.The prevalence of HAART-LD in d4T group was much higher than that in AZT group and the difference was statistically significant (x2 =8.285,P=0.004).Conclusions HAART regimen is an independent predictor of HAART-LD.HAART-LD tend to occur more frequently in patients treated with d4T or AZT,especially d4T.Our study recommends to avoid the use of d4T-contained HAART regimen.
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Objective To explore whether the mitochondrial toxicity markers of peripheral blood mononuclear cells (PBMC)are of significance in monitoring mitochondrial toxicity during highly active antiretroviral therapy (HAART)in patients with acquired immune deficiency syndrome (AIDS).Methods Mitochondrial DNA (mtDNA),mitochondrial thymidine kinase (TK2 )and p53-inducible ribonucleotide reductase small subunit 2 (p53R2 )were selected as mitochondrial toxicity markers.The expression changes of theses markers of PBMC in 22 AIDS patients were detected by real time quantitative polymerase chain reaction (q-PCR)at baseline,48 weeks and 96 weeks after initiation of the treatment. All the patients received stavudine/zidovudine and lamivudine as the mainstay of the HAART regimen. Independent-samples t test was used.Results The relative expression level of mtDNA in patients before HAART was 3.27 ± 0.94,and decreased to 2.16±0.85 at week 48 and 1 .66±0.66 at week 96, respectively.The differences were both significant compared with the level prior to the treatment (t =-3.90,P <0.01 and t =-6.29,P <0.01 ,respectively).The relative expression level of TK2 before HAART was 0.37 ±0.13,and increased to 1 .01 ±0.25 at week 48 and 2.13 ±0.61 at week 96 of the treatment.After pairwise comparisons of the three pairs of data (pre-HAART vs week 48 of the treatment,pre-HAART vs week 96 of the treatment and week 48 vs week 96 of the treatment),the differences were all significant (t = 10.77,8.00 and 3.56,respectively;all P < 0.01 ).The relative expression level of p53R2 was 0.86±0.39 before HAART,but gradually increased to 2.36 ±1 .14 and 7.73±0.65 ,respectively,at week 48 and week 96 of the treatment.The differences in p53R2 levels among three groups after pairwise comparison were all significant (t=3.27,12.26 and 13.25,respectively;all P < 0.01 ).Conclusions The expression levels of mtDNA,TK2 and p53R2 in PBMC could change significantly during HAART in AIDS patients,which might be used as indexes for monitoring mitochondrial toxicity.
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Objective To know the changing characteristics of residents' iodine nutritional status after eating salt with different iodine concentrations in Hubei Province,according to the assessment standard of iodine nutrition recommended by WHO/UNICEF/ICCIDD provide a scientific standard for appropriate iodine concentration in edible salt.Methods According to inhabitants' salt and urine surveillance of Hubei in 2010,Xinzhou District,Tianmen City and Changyang County were selected for trial.Salt with two kinds of iodine content was used in 3 trial areas in 4 months for the study of community intervention.Before the intervention,3 months and 4 months after the intervention,urine samples of observed participants(40 from 8-10 old children,40 from pregnant women or lactating women and 40 from adults aged older than 18) were collected and tested.The urinary medians of different groups of people and at different times were calculated and compared.Results Three months and 4 months after the intervention,in those towns using iodized salt of (15 ± 3) mg/kg,the urinary medians of children,declined from 294.2 μg/L to 185.6,195.7 μg/L,respectively.The urinary medians of pregnant women or lactating women dropped from 269.0 μg/L to 141.7,176.1 μg/L.For adults aged 18 and older,the urinary medians changed from 304.9 μg/L to 199.7,202.2 μg/L.In those trial towns of using (25 ± 3)mg/kg iodized salt,the urinary medians of children,pregnant women or lactating women and adults older than 18 all went down from 301.1 μg/L to 229.7,253.8 μg/L,from 261.4.0 μg/L to 196.6 and 206.5 μg/L and from 379.7 μg/L to 244.3,237.4 μg/L,respectively.Conclusions According to the assessment standard of iodine nutrition recommended by WHO/UNICEF/ICCIDD and the decreasing of urinary iodine median and per capita daily salt intake,salt with 25 mg/kg iodine is suitable as the average level of salt iodine concentration after the adjustment in Hubei Province.