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Objective To understand the sources and characteristics of newly reported HIV/AIDS cases in Yiwu,Zhejiang province,from 2015 to 2016.Methods From January 1,2015 to December 31,2016,newly reported HIV/AIDS cases in Yiwu were recruited in the study and they were asked to complete an in-depth field epidemiology questionnaire.Information related to their previous sexual behaviors and infection sources or routes were collected in the survey.The data were processed and analyzed with EpiData 3.0 and SPSS 19.0 software.Results A total of 320 participants from 393 newly reported HIV/AIDS cases in Yiwu during this period were surveyed and recruited in the study.Most of them were males (268,83.8％),unmarried (141,44.1％),aged between 25-44 years (166,51.9％),had census register in other provinces (217,67.8％) and educational level of junior high school (128,40.0％).Among 305 cases whose infection times could be determined,107 (35.1％) were newly infected within one year,and among 267 cases whose infection location could be determined,200 (74.9％) were infected in Yiwu.New infections were mainly detected in those who had homosexual behaviors or causal sex partners (during the past year) and through active detection approach.Local infections were mainly among those who had local residence and commercial heterosexual behavior in Yiwu.Conclusions Most newly reported HIV/AIDS cases in Yiwu from 2015-2016 were infected for more than one year and locally infected.Census registration of other provinces,homosexual sexual behavior,and casual sexual behavior give major contribution to HIV/AIDS epidemic in Yiwu.
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Objective To understand the sources and characteristics of newly reported HIV/AIDS cases in Yiwu,Zhejiang province,from 2015 to 2016.Methods From January 1,2015 to December 31,2016,newly reported HIV/AIDS cases in Yiwu were recruited in the study and they were asked to complete an in-depth field epidemiology questionnaire.Information related to their previous sexual behaviors and infection sources or routes were collected in the survey.The data were processed and analyzed with EpiData 3.0 and SPSS 19.0 software.Results A total of 320 participants from 393 newly reported HIV/AIDS cases in Yiwu during this period were surveyed and recruited in the study.Most of them were males (268,83.8％),unmarried (141,44.1％),aged between 25-44 years (166,51.9％),had census register in other provinces (217,67.8％) and educational level of junior high school (128,40.0％).Among 305 cases whose infection times could be determined,107 (35.1％) were newly infected within one year,and among 267 cases whose infection location could be determined,200 (74.9％) were infected in Yiwu.New infections were mainly detected in those who had homosexual behaviors or causal sex partners (during the past year) and through active detection approach.Local infections were mainly among those who had local residence and commercial heterosexual behavior in Yiwu.Conclusions Most newly reported HIV/AIDS cases in Yiwu from 2015-2016 were infected for more than one year and locally infected.Census registration of other provinces,homosexual sexual behavior,and casual sexual behavior give major contribution to HIV/AIDS epidemic in Yiwu.
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Objective@#To understand the molecular subtypes and recombinant structure of HIV-1 infection in Zhejiang Province.@*Methods@#According to the method of stratified random sampling method, a total of 302 newly HIV infected people (excluding AIDS patients) were selected as the subjects of the investigation from April to June, 2015, who were all newly HIV positive patients reported in Zhejiang Province and were diagnosed as HIV positive and had not received antiretroviral treatment. Questionnaires were used to collect information such as gender, residency, marital status, route of transmission and case reporting area. At least 8 ml of venous blood was collected from HIV infected people, reverse transcription-polymerase chain reaction (RT-PCR) and nested PCR were used to amplify the pol gene sequence of HIV-1 strains and circulating recombination forms (CRF) and unique recombinant form (URF) strains were screened using phylogenetic tree, and molecular subtype analysis and recombinant analysis were performed.@*Results@#Of the 302 HIV infected people, 18 cases were infected with new CRFs or URFs, among which 15 were male (83.3%), 3 were heterosexual transmission (17.7%); 8 cases (44.4%) were infected with new CRFs, which included CRF55_01B 5(27.8%), CRF67_01B 2 (11.1%), CRF69_01B 1 (5.6%); 10 cases (55.6%) were infected with URFs, in which 6 cases were infected with two groups of recombinant strains composed of CRF01_AE subtype and CRF07_BC subtypes in pol region, 3 cases were infected with three groups of recombinant strains of the two subtypes in pol region, and 1 case could not be accurately determined of the recombinant structure. The results of recombinant source analysis showed that the newly recombinant strains found from Zhejiang province were highly homologous to the strains from Guangdong, Anhui, Hebei, Yunnan, Liaoning province, and the sequence similarity was 94.4%-98.0%.@*Conclusion@#The new recombinant strains of Zhejiang province included CRFs strains and URFs strains with CRF01_AE and CRF07_BC as the main recombinant structure mode, and all of them were introduced from other places and formed a trans-regional chain of HIV transmission.
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Objective To understand the characteristics of distribution on HIV-1 subtypes and the transmission clusters in Yiwu in Zhejiang province.Methods A cross-sectional study of molecular epidemiology was carried out on newly reported H1V/AIDS cases in Yiwu.RNA was extracted from 168 plasma samples,followed by RT-PCR and nest-PCR for pol gene amplification,sequencing,phylogenetic tree construction used for analyzing the subtypes and transmission clusters.Mutations on drug resistance was analyzed by CPR 6.0 online tool.Results Subjects were mainly males (86.3％,145/168),with average age as (39.1 ± 13.4) years old and most of them were migrants (66.7％,112/168).The major routes of transmission included homosexual (51.2％,86/168) and heterosexual (48.8％,82/168) contacts.The rate of success for sequence acquisition was 89.9％ (151/168).The dominant subtypes showed as CRF01_AE (74,49.0％) and CRF07_BC (64,42.4％),followed by CRF08_BC (5,3.3％),CRF55_01B (3,2.0％),each case of subtype B,CRF45_cpx,CRF59_01B,CRF85_BC and URF (B/C).CRF45_cpx and CRF85_BC were discovered the first time in Zhejiang province.Twenty-six transmission clusters involving 65 cases were found,with the total clustered rate as 43.0％ (65/151),in which the CRF01_AE clustered rate appeared as 54.1％ (40/74),higher than that of CRF07_BC (21/64,32.8％).The average size of cluster was 2.5 cases/cluster,with average size of cluster in CRF01_AE patients infected through heterosexual transmission as the largest (3.5 cases/cluster).The prevalence of transmitted drug resistance was 4.6％ (7/151).Seven cases with surveillance drug resistant mutations (SDRM) were found,including 5 cases of M46L (3.3％),and one case of F77L or Y181C.Conclusion HIV genetic diversity and a variety of transmission clusters had been noticed in this study area (Yiwu).Programs on monitoring the subtypes and transmission clusters should be continued and strengthened.
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Objective To understand the distribution of HIV-1 subtype diversity and its transmission characteristics in Zhejiang province. Methods A total of 302 newly diagnosed HIV-1 positive patients were selected through stratified random sampling in Zhejiang in 2015. HIV-1 pol genes were sequenced successfully with reverse transcription PCR/nested PCR and phylogenetic analysis was conducted for 276 patients. Then a molecular epidemiologic study was performed combined with field epidemiological investigation. Results Of 276 sequence samples analyzed, 122 CRF07_BC strains (44.2%), 103 CRF01_AE strains (37.3%), 17 CRF08_BC strains (6.1%), 9 B strains (3.2%), 6 CRF55_01B strains (2.2%), 5 C strains (1.8%), 1 CRF59_01B strain (0.4%), 1 CRF67_01B strain (0.4%), 1 A1 strain (0.4%), and 11 URFs strains (4.0%) were identified. Phylogenetic analysis revealed 16 clusters with only 15.1% (34/225) sequences involved among CRF07_BC and CRF01_AE strains. The clustered cases in MSM were higher than that in populations with other transmission routes. And clusters existed between the populations with different transmission routes. Conclusion The major strains of HIV-1 in Zhejiang are CRF07_BC and CRF01_AE. The HIV subtypes showed more complexity in Zhejiang. It is necessary to strengthen the surveillance for HIV subtypes, carry out classified management and conduct effective prevention and control in the population at high risk.
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Objective To understand the characteristics of distribution on HIV-1 subtypes and the transmission clusters in Yiwu in Zhejiang province.Methods A cross-sectional study of molecular epidemiology was carried out on newly reported H1V/AIDS cases in Yiwu.RNA was extracted from 168 plasma samples,followed by RT-PCR and nest-PCR for pol gene amplification,sequencing,phylogenetic tree construction used for analyzing the subtypes and transmission clusters.Mutations on drug resistance was analyzed by CPR 6.0 online tool.Results Subjects were mainly males (86.3％,145/168),with average age as (39.1 ± 13.4) years old and most of them were migrants (66.7％,112/168).The major routes of transmission included homosexual (51.2％,86/168) and heterosexual (48.8％,82/168) contacts.The rate of success for sequence acquisition was 89.9％ (151/168).The dominant subtypes showed as CRF01_AE (74,49.0％) and CRF07_BC (64,42.4％),followed by CRF08_BC (5,3.3％),CRF55_01B (3,2.0％),each case of subtype B,CRF45_cpx,CRF59_01B,CRF85_BC and URF (B/C).CRF45_cpx and CRF85_BC were discovered the first time in Zhejiang province.Twenty-six transmission clusters involving 65 cases were found,with the total clustered rate as 43.0％ (65/151),in which the CRF01_AE clustered rate appeared as 54.1％ (40/74),higher than that of CRF07_BC (21/64,32.8％).The average size of cluster was 2.5 cases/cluster,with average size of cluster in CRF01_AE patients infected through heterosexual transmission as the largest (3.5 cases/cluster).The prevalence of transmitted drug resistance was 4.6％ (7/151).Seven cases with surveillance drug resistant mutations (SDRM) were found,including 5 cases of M46L (3.3％),and one case of F77L or Y181C.Conclusion HIV genetic diversity and a variety of transmission clusters had been noticed in this study area (Yiwu).Programs on monitoring the subtypes and transmission clusters should be continued and strengthened.
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Objective To understand the distribution of HIV-1 subtype diversity and its transmission characteristics in Zhejiang province. Methods A total of 302 newly diagnosed HIV-1 positive patients were selected through stratified random sampling in Zhejiang in 2015. HIV-1 pol genes were sequenced successfully with reverse transcription PCR/nested PCR and phylogenetic analysis was conducted for 276 patients. Then a molecular epidemiologic study was performed combined with field epidemiological investigation. Results Of 276 sequence samples analyzed, 122 CRF07_BC strains (44.2%), 103 CRF01_AE strains (37.3%), 17 CRF08_BC strains (6.1%), 9 B strains (3.2%), 6 CRF55_01B strains (2.2%), 5 C strains (1.8%), 1 CRF59_01B strain (0.4%), 1 CRF67_01B strain (0.4%), 1 A1 strain (0.4%), and 11 URFs strains (4.0%) were identified. Phylogenetic analysis revealed 16 clusters with only 15.1% (34/225) sequences involved among CRF07_BC and CRF01_AE strains. The clustered cases in MSM were higher than that in populations with other transmission routes. And clusters existed between the populations with different transmission routes. Conclusion The major strains of HIV-1 in Zhejiang are CRF07_BC and CRF01_AE. The HIV subtypes showed more complexity in Zhejiang. It is necessary to strengthen the surveillance for HIV subtypes, carry out classified management and conduct effective prevention and control in the population at high risk.
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<p><b>OBJECTIVE</b>To identify the status and risk factors of transmission in couples which males was HIV-positive in Zhejiang province.</p><p><b>METHODS</b>A cross-sectional study was conducted among HIV-serodiscordant couple (male positive) and HIV-seroconcordant couple (male first infected). A self-designed questionnaire was complimented containing basic information, the awareness of infection and HIV-testing, sexual relationship power, self-efficacy of condom use, sex. The univariated and multivariate logistic regression methods were used to analyze the influence factors.</p><p><b>RESULTS</b>A total of 263 couples were enrolled in this study, including 210 HIV HIV-serodiscordant couples and 53 HIV-seroconcordant couples. HIV-positive males aged 30-50 accounted for 57.8% (152 cases) and females under junior high school accounted for 79.1% (208 cases). HIV/AIDS accounted for 41.1% (217 cases). The proportion of man who were diagnosed as HIV, MSM and ever heard HIV were 61.9% (130 cases), 38.3% (80 cases) and 81.9% (172 cases), which were higher than that in HIV positive 47.2% (25 cases), 7.5% (4 cases), 64.2% (34 cases); χ(2)=3.80, 18.33, 7.86;P=0.051, 0.001, 0.005. The results revealed that AIDS patients had high risk to infect their spouse than HIV patients (OR=2.93, 95% CI: 1.05-8.21). Male patients who had ever heard " HIV" before were less likely pass virus to their wives than those who had never heard " HIV" (OR=0.13, 95% CI: 0.04-0.41). Compared with heterosexuality man, homosexuality man' wives had high risk to get virus from their husbands (OR=0.14, 95% CI: 0.03-0.73). Female infected with STIs was the independent factors for HIV infection (OR=4.86, 95% CI: 1.23-19.11).</p><p><b>CONCLUSION</b>Among the couples of male HIV-positive in Zhejiang Province, the risk of spouses infected with HIV virus has relationship with male disease progression, sexual orientation and awareness of AIDS knowledge. For females who infected with sexual diseases in last 6 months might be infected by their spouses.</p>
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Adult , Female , Humans , Male , Middle Aged , Cross-Sectional Studies , HIV Antibodies , Blood , HIV Infections , Health Knowledge, Attitudes, Practice , Mass Screening , Risk Factors , Sexual Behavior , Sexually Transmitted Diseases , SpousesABSTRACT
Objective To identify the HIV transmission in discordant couples and the epidemic characteristics of concordant couples related to HIV infection.Methods HIV/AIDS database was down-loaded from AIDS information reported system for analysis.Patients with HIV-negative couples between 2009 and 2013 in Zhejiang province were enrolled in this study.Information included demography characteristics,highly active antiretroviral therapy (HAART),HIV incidence rate and risk factors,characteristics on HIV concordant couples.Results The HIV incidence rate on HIV-negative couples of 2 575 HIV/AIDS was 3.56 per 1 000 person-year,reducing from 5.49 per 1 000 person-year in 2009 to 3.20 per 1 000 person-year in 2013.There was a slight increase on HIV incidence rate among couples in those HIV-positive men who were heterosexual,while it decreased among couples of HIV-positive women.Initiation of HAART over 1 years (OR=0.063,95％ CI:0.019-0.204) seemed to be a preventive factor for HIV transmission between the couples under study.Factors as history of infection longer than 3 years (OR=3.564,95％ CI:1.296-9.804) and beingnon-local resident (OR=2.626,95％ CI:1.098-6.230) were risky factors.Conclusion The incidence rate of HIV transmission between HIV discordant couples was low but imbalance in different areas.People who were non-local residents under HIV discordant status,would need more attention.HAART,time of infection,status of residency appeared risk factors for HIV transmission within the couples.
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Objective To understand the prevalence of HIV infection,syphilis and hepatitis C infection and related risk behaviors among club drug users in Zhejiang province.Methods The drug users were interviewed with questionnaires in 2011 to collect the information about their demographic characteristics,sexual behaviors,drug use behaviors and the utilization of intervention services.Blood samples were collected from them to detect HIV,syphilis and HCV antibodies.Results A total of 3 253 drug users were surveyed,in which 1 298 were club drug users,accounted for 39.9％.The proportion of club drug users was high in northern and central Zhejiang,in females,in age group ≤25 years,in local residents and in those having commercial sexual behaviors during previous 12 months.Of the 1 298 club drug users,91.2％ were methamphetamine users,0.1％ were infected with HIV(95％CI:0.0％-0.2％),8.1％ suffered from syphilis (95％CI:6.6％-9.6％),17.3％ were infected with HCV(95％CI:15.2％-19.4％).Among the interviewed club drug users,12.7％ were aware of AIDS,9.2％ had injecting drug use histories,29.6％ reported having commercial sex during the previous 12 months,only 33.4％ received free condom and counsel,14.0％ received HIV test.Multivariate logistic regression analysis indicated that living in central and southern Zhejiang was associated with syphilis prevalence,HCV infection and injecting drug use behavior,being female was associated with syphilis prevalence.Injecting drug use and commercial sex during the previous 12 months were associated with HCV infection,and injecting drug use and commercial sex during the previous 12 months were associated with each other.Among the 1 285 club drug users,males,local residents in Zhejiang and those who never received free condom or counsel were more likely to have commercial sex.Conclusion The prevalence of syphilis and HCV infection are high and unprotected sexual behaviors are common among the club drug users in Zhejiang,but less intervention services were received by them,suggesting that more attention should be paid to the prevention and control of HIV,HCV infections and syphilis in club drug users by taking effective intervention measures and increasing intervention coverage.
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<p><b>OBJECTIVE</b>To understand the HIV-1 subtype diversity and transmission characteristics in men having sex with men (MSM) in Zhejiang province.</p><p><b>METHODS</b>A total of 233 newly diagnosed as HIV-1 positive patients in 2011 were screened out by BED capture enzyme immunoassay (BED-CEIA). Among them, 107 eligible subjects were enrolled for further molecular epidemiological study. Viral RNA was extracted from plasma samples and followed by reverse transcription PCR and nested PCR for amplification of pol gene fragments, sequencing, and bioinformatics analysis.</p><p><b>RESULTS</b>There were no statistically significant differences regarding the social demographic distribution between the subjects under study and those recently infected MSM population. The rate of success for sequence acquisition was 94.4% (101/107). The highest proportion of subtype was CRF01_AE (62.4%), followed by CRF07_BC (31.7%) and with three cases of subtype B, one case of CRF55_01B and two cases of unique recombinant form (CRF01_AE/B and CRF01_AE/CRF07_BC). The phylogenetic trees were mainly divided into CRF01_AE cluster 1, cluster 2 and CRF07_BC cluster 3. The strains located in Hangzhou were diffused in the branches of phylogenetic tree. 10 transmission clusters were found, in which 80% involved two or more regions and 90% was associated with patients residing in Hangzhou. Three surveillance drug resistance mutations (M46I, T215S and G190A) were found in three samples (each sample harbored only one resistance mutation). The overall rate of transmitted drug resistance (TDR) was 2.97%.</p><p><b>CONCLUSION</b>The increasing complexity of HIV was noticed in MSM in Zhejiang province. However, the prevalence of TDR was low. Cross-regional HIV transmission in MSM was common, which inferred from the study. Hangzhou might play a central regional role in the intra-provincial spread of HIV, to form an interwoven complex network in the MSM population.</p>
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Humans , Male , China , Epidemiology , Demography , Drug Resistance, Viral , Genes, pol , HIV Infections , Genetics , HIV-1 , Classification , Homosexuality , Immunoenzyme Techniques , Phylogeny , Prevalence , RNA, ViralABSTRACT
<p><b>OBJECTIVE</b>To assess the characteristics and influencing factors of HIV detection among HIV/AIDS patients in Zhejiang province.</p><p><b>METHODS</b>HIV/AIDS cases information were selected from the case reporting database of HIV/AIDS Comprehensive Response Information Management System in Zhejiang province in 2012. HIV late diagnosed patients and early diagnosed patients were classified by first CD4(+) T cell counts (less than 200 cells/µl) and positive BED HIV-1 capture enzyme immunoassay (BED-CEIA) tests result. A total of 1 894 patients were enrolled and 1 383 patients were served by BED-CEIA tests. Information including social demographics, transmission routes, test history were collected for analysis. The univariate and multivariate logistic regression methods was used to analyze the characteristics of HIV detection and related influence factors.</p><p><b>RESULTS</b>Among 1 894 cases, 26.4% (500/1 894) were late diagnosed and 19.2% (361/1 883) were early diagnosed. The highest rate of late diagnose (36.5%, 27/74) and lowest rate of early diagnose(3.9%, 14/74) were both in Lishui city. Age, transmission routes, HIV testing style, permanent residence were independent reasons for late diagnosed. Compared with patients < 20 years old, participants over 50 years old had higher risk of late diagnosed (OR = 2.885, P < 0.05); patients with homosexual behaviors had lower risk of late diagnosed than patients with heterosexual behaviors and other high risk behaviors(OR = 1.471 or 2.416, P < 0.05). Age, marriage status, HIV testing style, transmission routes, the detection unit, permanent residence were independent reasons for early diagnosed. The risky of early diagnosed among patients ≥ 50 years old were 0.432 times than that among patients < 20 years old (OR = 0.432, P < 0.05). Compared with unmarried participants, married patients had lower risk of early diagnosed (OR = 0.603, P < 0.05). Compared with homosexual behaviors, high risk heterosexual behaviors and other risk behavior significantly reduced the chance of early diagnosis(OR = 0.719 or 0.763, P < 0.05).</p><p><b>CONCLUSION</b>Late diagnoses and early diagnosis coexist among reported HIV/AIDS in Zhejiang province in 2012. The main reasons for late diagnosis of HIV infection are older age, heterosexual behaviors and other risk behavior, testing in hospital, living in other province. The main reasons for early diagnosis of HIV infection are young age, unmarried, homosexual behaviors, testing in CDC, living in Zhejiang province.</p>