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To characterize long-term nonprogressors (LTNPs) and viremia controllers (VCs), infected with HIV-1 through contaminated blood donation or transfusion between 1992 and 1996 in Henan, China. LTNPs and VCs were defined by CD4+T lymphocyte (CD4) count and viral load (VL). Of 29,294 patients infected with HIV-1 via contaminated blood donation or transfusion that had conducted for more than 20 years, 92 were LTNPs/VCs. There were 70 LTNPs (0.24%), 43 VCs (0.15%), and 48 LTNPs+VCs- (0.16%). VCs had a significantly lower CD4 nadir, compared to LTNPs and LTNPs+VCs-, and no significant differences for the highest VL and HIV-1 DNA. Cases P4 and P5 were LTNPs, while their VL reached approximately 4.3 log copies/mL. P6 was a VC, but with CD4 < 500 cells/μL constantly. Data from the LTNPs/VCs cohort provided valuable information, future research is needed.
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Objective To examine the malnutrition status of infants exposed to HIV in rural areas of Henan province and related risk factors.Methods Z scores of weight for age,height for age and weight for height of infants exposed to HIV in rural areas of Henan province born in 2010-2012 were calculated at 1,3,6,9,12 and 18 months of age.Z scores were used to evaluate the nutrition status of infants under study.Data regarding the pregnant women and infants were collected and analyzed by non-conditional logistic regression model.Results One hundred fifty-seven infants were surveyed in which 125 were HIV negative and 32 were HIV positive.The incidence rates of underweight,athrepsia and growth retardation of HIV-negative infants were 8.8％,16.8％ and 30.4％,respectively.The incidence rates of underweight,athrepsia and growth retardation among the HIV-positive infants were 15.0％,30.0％ and 41.7％,respectively.Anemia in pregnancy (RR=2.05,95％ CI:1.15-3.66),low count of CD4 + T leukomonocyte (RR=1.43,95％ CI:1.18-1.74),status of complementary feeding before 4 months old (RR=1.96,95％CI:1.40-2.74) might serve as the risk factors related to the situation.Infants received antiviral treatment (RR=0.14,95％ CI:0.02-1.04),normal birth weight (RR=0.08,95％CI:0.04-0.15) might serve as the protective factors.Conclusion The malnutrition incidence was high among those infants younger than 18 months exposed to HIV in rural area of Henan province.Essential health services such as antenatal care,artificial feeding and growth monitoring for infants and pregnant infants should be provided to prevent malnutrition among these sub-populations.
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<p><b>OBJECTIVE</b>To understand the epidemiological characteristics of hepatitis C in Henan province.</p><p><b>METHODS</b>Multistage sampling was used to investigate a group of 1-75 year-old general population, living in 30 districts of 18 cities, Henan province. Blood samples were collected and tested for anti-HCV and hepatitis C virus(HCV), from April to July 2012.</p><p><b>RESULTS</b>32 203 persons were investigated. Among the general population aged 1 to 75 years old, the overall prevalence rates of anti-HCV and HCV RNA were 0.64% and 0.35% respectively. The prevalence rates of anti-HCV among males and females were 0.60%, and 0.68% respectively, with the rates of HCV RNA as 0.37%, and 0.33% respectively. The prevalence rates of anti-HCV and HCV RNA were increasing with age. The prevalence rates of anti-HCV and HCV RNA in urban area were 0.58% and 0.32%, and in rural area as 0.41%, and 0.19% respectively.</p><p><b>CONCLUSION</b>After the implementation of comprehensive measures for HCV control and prevention, Henan province became low prevalent for HCV infection. Our data revealed that the overall prevalence remained low, but the epidemic was severe in some geographical regions in Henan province.</p>
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Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , China , Epidemiology , Hepatitis C , Epidemiology , Risk Factors , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To investigate the prevalence and distribution of hepatitis C virus (HCV) genotypes in Henan province in 2012.</p><p><b>METHODS</b>A total of 32 203 permanent residents (1 to 74 years old) in Henan were recruited using multi-stage random samping method from March to June 2012. All participants were asked to complete a questionnaire to collect demographic information, past medical history and the exposure history of risk factors. A blood sample of 5 ml was collected at the same time. The condition of anti-HCV and HCV RNA was determined through the ELISA test and nested RT-PCR. HCV RNA positive samples were further subject to the nonstructural protein 5 region (NS5B) gene amplification and sequencing. The sequence was amplified for the phylogenetic tree and genetic analysis. The differences of the positive rate of anti-HCV and HCV RNA and the HCV genetic subtype distribution in different respondents'characteristics were analyzed.</p><p><b>RESULTS</b>Among 32 203 subjects, the overall positive rate of anti-HCV and HCV RNA were 0.48% (153/32 203) and 0.24% (78/32 203), in which men were 0.42% (65/15 634), and 0.23% (36/15 634), and women were 0.53% (88/16 569) and 0.25% (42/16 596). The differences between men and women were not statistically significant (χ(2) values were 2.26, 0.18, respectively, both P values > 0.05). The results of NS5B genotyping and molecular evolution analysis showed that there were six subtypes in the 71 HCV RNA positive samples.In those six subtypes, the proportion of genotypes 1b, 6a, 3a, 2a, 3b and 1a were 56.3% (40/71), 19.7% (14/71), 11.3% (8/71), 8.5% (6/71), 2.8% (2/71) and 1.4% (1/71), respectively. The HCV genetic subtypes of infestor were mainly present with two branches of 1b and 6a, and the two subtypes Bootstrap values were 0.95.</p><p><b>CONCLUSION</b>The prevalence of HCV infection was high in Henan. The major HCV genotypes in patients with HCV infection were 1b and 6a.</p>
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Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , China , Epidemiology , Genotype , Hepacivirus , Classification , Genetics , Hepatitis C , Epidemiology , Virology , Phylogeny , RNA, Viral , Genetics , Sequence Analysis, DNAABSTRACT
Objective To study the management status of HIV-discordant family in Henan province from 2006 to 2010.Methods Data on AIDS infected family from “AIDS Infected Family Follow-up Management and Analysis System” was collected and analized to uderstand the management status of HIV-discordant situation.Results The sero-conversion rates of HIV-discordant spouse were 1.94/100 person-years in 2006,1.79/100 person-years in 2007,0.59/100 person- years in 2008 and 0.41/100 person-years in 2009,showing the yearly decrease.Regarding the number of sero-conversion in the same year,male was significantly higher than female in 2007,but not in the other years.The ratio on the course of sero-conversion which was ＞2.5 years was increasing.Frequency of most HIV-discordant couples' sexual activities was 1-4 times/month with consistent use of condoms.Conclusion The population of HIV-discordant spouse in Henan province was stable.Regarding management of those HIV-discordant spouse,the acceptance on the rate of test rate was increasing.The course of sero-conversion was also increasing,with most HIV-discordant couples insist on condom use while the sero-conversion rate of HIV-discordant spouse appeared to be low.
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Objective To study the effect of a government-provided-free highly activeantiretroviral treatment (HAART) program,on the reduction of mortality and relevant risk factorsamong adult (AIDS) patients in Henan province.Methods Data on the survival and deaths of AIDSpatients were collected from the National HAART reporting system between 2003 and 2009.Coxproportional hazards model was applied to analyze those factors that affecting the survival time of thepatients.Results 24 669 cases were enrolled to this study in Henan province,from 2003 to 2009.The overall mortality declined from 20.1/100 person-years in 2003 to 5.1/100 person-years in 2009.There was significant difference between the survival curves of different CD4 + T counts and differentnumbers of opportunistic infection syndromes.Results from the Multivariate Cox proportional hazardsregression analysis indicated that CD4+T cell counts ( ＞200 cells/μl,50-199 cells/μ l) was a riskfactor to death,with hazard ratio as 4.4 and 2.0 respectively.Hb of the patients that lower than 90,was a risk factor to death with the HR=1.8.Number of opportunistic infection (OIs) episodes was arisk factor to the mortality (HR=1.7).In addition,other risk factors would include age ( ≥60 years,old),being male,unmarried or divorced,ALT＞100 μl,and other routes of infection,other thanFormer Plasma Donors (FPDs),with HR as 2.2,1.6,1.5,1.3 and 1.2.However,the protectivefactors would include:(1)the earlier the HAART began,the longer the survival time would last(HR =0.8 ) ; (2) when one spouse had already had the infection of HIV,it seemed helpful for the otherspouse to live longer (HR=0.8).Conclusion The National Free Treatment Program hadsignificantly reduced the AIDS mortality rate.Some effective measures should be further taken tomonitor the CD4 + T and the opportunistic infection of the AIDS patients.Patients who were in need totake the HARRT should be adopted into the ART timely,At the same time,the occurrence ofopportunistic infections should be actively prevented.
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Objective To describe the prevalence and risk factors of hepatitis C virus (HCV) occurred in Henan province,at the end of 2011.Methods Five villages round Maqiao township,including 5187 residents,were selected for the study.Five-milliliter-blood was drawn from every one of the interviewee.Clinical data including age,gender and anti-HCV antibody was recorded.Patients with positive antibodies against HCV were tested for HCV RNA.Results A total number of 5187 people from five villages were studied,with age span from 1 to 97.The average age was 48 years and the sex ratio was 1 ∶ 1.34.The anti-HCV result showed that the prevalence was 2.27％,with 1-9 age group the lowest ( 1.55％ ) and the ≥50 year-olds the highest (4.93％).Different villages seemed to have significant differences on the prevalence of HCV,with the highest as 8.68％ and the lowest as 0.55％.Under risk factors analysis and distance-infection rates linear regression analysis,data showed that the prevalence might have correlated to the behavior of a certain family-run clinic.Results from multivariate analysis indicated that factors as intravenous dropping,intravenous injection and the use of surgery/endoscope were associated with the HCV infection in this village.Conclusion Although the public health care system had been developed for more than ten years,iatrogenic infection was yet responsible for the infection of HCV patients in the rural areas of China that called for further attention paid to the system.
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<p><b>OBJECTIVE</b>To explore the situation and cause of new reported HIV/AIDS cases and death of HIV cases in Henan province from 2008 to 2009.</p><p><b>METHODS</b>The data of HIV/AIDS cases in Henan province before the end of 2009 was downloaded from "the history card downloading site" of the national online case reporting system on Jan. 5(th), 2010. There were 6990 HIV/AIDS new cases reported from 2008 to 2009, and 1214 cases died. Descriptive study was implemented including population characteristics of new reported HIV/AIDS cases and dead cases from 2008 to 2009. Survival time and cause of death were analyzed.</p><p><b>RESULTS</b>Among all the dead cases, the Han nationality accounted for 99.0% (1202 cases), and males were more than females (62.0% (753 cases) vs 38.0% (461 cases)), 64.7% (786 cases) were married, those under junior high school education level accounted for 93.7% (1137 cases), AIDS patients accounted for 93.2% (1131 cases) and 6.8% (83 cases) were HIV carriers; 65.5% (795 cases) were former plasma donors and transfusion blood/blood produces. The main cause of death were AIDS-related diseases, the proportion was 71.9% (873 cases). The median survival time after confirmed HIV positive was 62 days (Q(L) = 14 d, Q(U) = 151 d), 35.9% (436 cases) cases died in one month and 79.0% (959 cases) cases died in six months after confirmed HIV positive.</p><p><b>CONCLUSION</b>The newly reported dead cases of HIV/AIDS were mainly infected through former plasma donation and transfusion blood/blood produces in 2008 and 2009. The main cause of death was AIDS-related diseases.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Acquired Immunodeficiency Syndrome , Epidemiology , Mortality , Cause of Death , China , Epidemiology , HIV Infections , Epidemiology , MortalityABSTRACT
Objective To analyze the CD4 +T cells and virus load in HIV/AIDS affected population and to evaluate the HIV/AIDS antiretroviral therapy programs in Henan province.Methods "Henan HIV/AIDS Testing Laboratory Network Database" was used to collect the data on CD4+ T cells and virus load (VL) value and corresponding information in HIV/AIDS population of Henan in 2009. Cross-sectional studies was used to study the constituent ratio of CD4 + T cells and virus load value in individuals who had not received antiretroviral-treated (ART) and had joined first-line ART between the year of 2005 to 2008 among HIV/AIDS population of Henan. Results As to these people living with HIV/AIDS that had not received ART in the first half and the second half year of 2009, the constituent ratio of individuals whose CD4+T cells were less than 200 cells/μl both accounted for more than 20% (χ2=2.059, P=0.151). The constituent ratio of individuals whose CD4+T cells were in 200-350 cells/μl and more than 350 cells/μl increased from 27.61% to 29.41%(χ2=4.636, P=0.031 ) and decreased from 51.49% to 48.60% (χ2=9.767, P=0.002), respectively.Meanwhile, we saw 34.53% and 19.65% of the patients whose virus load was ＞10 000 copy/mland ＞30 000 copy/ml in this population. Patients that joined first-line ART during 2005-2008 showed the following results: the longer of the therapy time, the higher constituent ratio of individuals whose CD4+ T cells were more than 350 cells/μl (χ2= 148.689, P＜0.001) and the lower constituent ratio of individuals of whose CD4+T cells were less than 200 cells/μl (χ2=46.686,P＜0.001).Simultaneously, the lower constituent ratio of individuals whose viral load was less than 500 copy/ml (χ2=9.066, P=0.003) and the higher constituent ratio of individuals whose virus load was more than 10 000 copy/ml (χ2=6.597, P=0.010). Conclusion Significant curative effect had been achieved in AIDS first-line ART of Henan, but along with the increasing treatment time, the risk of treatment failure also increased. Drug resistance test and changing of treatment protocols were needed. To reach better and more efficient effects on therapy, factors as more detections and investments on ART, expanding the scope of treatment etc. were needed on those people living with HIV/AIDS that had not received ART.
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<p><b>OBJECTIVE</b>To survey the prevalence of HIV-1 drug resistance after five years antiretroviral treatment in Henan province.</p><p><b>METHODS</b>Through the cross-sectional study, serum specimens of 69 HIV infected individuals that were 2 to 25 years old who were newly diagnosed according the WHO standard from November 2007 to August 2008 and did not receive antiretroviral treatment (ART) were collected. HIV-1 pol genetic mutations associated with drug resistance were identified with RT-PCR and interpreted.</p><p><b>RESULTS</b>Out of 69 samples, 50 samples were successfully amplified and sequenced. Seven drug resistant mutation in reverse transcriptase region were detected and three mutations in protein region. In one specimen, a mutation (K103N) in reverse transcriptase was identified which caused high level resistance to NNRTIs, but no proteinase inhibitor mutation was found in protein region. According to the sampling and threshold surveillance criteria, the prevalence of drug resistant HIV-1 in Henan was less than 5%.</p><p><b>CONCLUSION</b>The prevalence of drug resistant HIV-1 was still at low level in Henan. However, the proportion of resistant strains would be higher with the antiretroviral treatment. We should pay more attention to the transmission of resistant strains and continue the drug resistance surveillance.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Humans , Young Adult , Acquired Immunodeficiency Syndrome , Virology , Anti-HIV Agents , Pharmacology , China , Cross-Sectional Studies , Drug Resistance, Viral , Genetics , HIV-1 , Genetics , MutationABSTRACT
<p><b>OBJECTIVE</b>To explore the change trend of mother-to-child-transmission (MTCT) of HIV-1 in some areas in China.</p><p><b>METHODS</b>The investigation was conducted in 15 counties or districts of 4 provinces in China with relatively high HIV prevalence from January 2005 to June 2009. The data on the death and HIV-status of the babies born to HIV-positive mothers from January 2005-December 2007 in research sites were collected through 18-month following up after they were born.</p><p><b>RESULTS</b>During the time that the research was conducted, there were 644 babies born to HIV-positive mothers who were followed up for 18 months. At the end of 18 months, full data were collected from 550 babies, 44 babies were lost to follow-up and 50 babies died. Among 550 babies who were followed up for 18 months, 53 babies were confirmed as HIV positive. The rate of MTCT of HIV-1 was 13.19% (24/182), 8.90% (17/191) and 6.78% (12/177) in 2005, 2006, 2007 respectively, which showed a descending trend yearly (chi(2) = 4.23, P < 0.05). Adjusted by the death data of the HIV-exposed children, it was found that during 2005-2007 the rate of MTCT of HIV-1 was 16.74%, 12.98%, 9.52% respectively, which was also descending year by year (chi(2) = 4.69, P < 0.05).</p><p><b>CONCLUSION</b>Long-term, effective prevention of mother-to-child-transmission of HIV (PMTCT) could reduce the level of MTCT of HIV-1 year-by-year. In addition, using death data of HIV-exposed children to adjust the level of MTCT of HIV-1 is valuable to grade the effect of PMTCT.</p>
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Female , Humans , Infant , Infant, Newborn , Pregnancy , Acquired Immunodeficiency Syndrome , Mortality , China , Epidemiology , HIV-1 , Infant Mortality , Infectious Disease Transmission, Vertical , MothersABSTRACT
<p><b>OBJECTIVE</b>To understand the influencing factors on the death of infants born to HIV infected mothers in areas with high prevalence of HIV/AIDS in China.</p><p><b>METHODS</b>Based on the follow-up cohort study targeting at HIV/AIDS infected pregnant women and their babies initiated in 2004, a survey on the death status and influencing factors on the infants born to HIV/AIDS infected mothers enrolled in this cohort from Jan.2004 to Nov.2007 was carried out during Aug.to Nov.2008 in seven counties of four provinces in China. A total of 498 pairs of HIV-infected mothers and their infants were enrolled and their related information was collected. Single factor and multiple factors Cox model methods were adopted for data analysis.</p><p><b>RESULTS</b>The total observed person-years of 498 infants was 406.22, among which, 45 infants died, and the mortality density was 110.78 per 1000 child-year. A single factor Cox model showed, the pregnancy in pre-period of HIV/AIDS and HIV/AIDS period (RR = 1.971, 95%CI: 1.143 - 3.396), living status of the pregnancy (RR = 3.062, 95%CI: 1.097 - 8.550), multipara women (RR = 0.517, 95%CI: 0.278 - 0.961), natural childbirth (RR = 0.561, 95%CI: 0.345 - 0.910), premature labor (RR = 5.302, 95%CI: 2.944 - 9.547), low birth weight (RR = 4.920, 95%CI: 2.691 - 8.994), mother-child pairs taking antiretroviral drugs (RR = 0.227, 95%CI: 0.121 - 0.428) and infants infected HIV (RR = 5.870, 95%CI: 3.232 - 10.660) could affect the infants death. The death of HIV-exposed infants was influenced by various factors. The death risk of infants born to HIV infected mothers who were in the danger of pre-period of HIV/AIDS and HIV/AIDS period was greater than the infants delivered by HIV infected mothers who were in preclinical period of HIV/AIDS (RR = 6.99, 95%CI: 1.92 - 25.64). The death risks were greater in the group that the women whose CD4(+)TLC count number lower than 200 cells/microl (RR = 2.05, 95%CI: 1.01 - 4.15). The infants whose mothers had no ARV treatment had higher possibility to die than the others (RR = 6.17, 95%CI: 1.62 - 23.26). The death risk of premature delivered infants was 2.87 times of mature delivered infants (95%CI: 1.12 - 7.35). The death risk of HIV/AIDS infected infants was 9.87 times of the HIV/AIDS uninfected infants (95%CI: 3.81 - 25.62).</p><p><b>CONCLUSION</b>Some measurements including improving HIV-infected pregnant women's immunity, reducing mother to child transmission of HIV and premature birth, low birth weight are beneficial to reducing infant mortality.</p>