ABSTRACT
@#Abstract: Objective To understand the difference of DNA sequence and RNA sequence of paired pol region in HIV patients in constructing HIV genetic transmission network, and to provide scientific data for constructing molecular transmission networks using DNA sequences. Methods The whole blood and plasma samples of HIV patients living in 2014 and newly reported in 2015-2018 in Liuzhou, Guangxi, were collected, DNA and RNA sequences were extracted, amplified, sequenced, spliced and aligned, and then genetic transmission networks were constructed, and the connectivity consistency of genetic transmission networks constructed by DNA and RNA sequences was compared. Results In this study, a total 2 983 participants were investigated, which were 2014 baseline and 2015-2018 newly reported HIV patients, of which 2 590 participants were only DNA sequences in 2014 baseline, 196 HIV patients were both DNA and RNA sequences of paired pol region in 2014 baseline, and 197 newly reported HIV patients were both DNA and RNA sequences of paired pol region in 2015-2018. In 393 DNA and RNA sequences of paired pol region, the genotype of DNA sequence and RNA sequence were consistent, and there was no statistically significant difference in genetic distance between paired DNA sequences and RNA sequences (Z=-2.72, P=1.00). The connection consistency rate of genetic transmission networks constructed by DNA and RNA sequences of paired pol region of 2015-2018 newly reported with the baseline DNA sequences was 91.4% (108/197). And the connection consistency rate of genetic transmission networks constructed by DNA and RNA sequences of paired pol region of 2015-2018 newly reported with the baseline RNA sequences was 97.0% (191/197). There was no statistical difference in antiretroviral therapy to reduce the risk of HIV secondary transmission between genetic transmission networks constructed by DNA and RNA sequences of paired of pol gene newly reported from 2015 to 2018 with baseline DNA sequence. Conclusion DNA sequence and RNA sequence of paired pol region of HIV patients have good consistency in genotype, genetic distance, and genetic transmission network construction, and both DNA and RNA sequences can be used for genetic transmission network analysis.
ABSTRACT
@#Abstract: Objective To investigate the growth and development of HIV-infected children initiating antiretroviral therapy (ART) and its influencing factors. Methods This retrospective cohort study was conducted in Guangxi. HIV-infected children initiating free antiretroviral therapy (ART) from 2004 to 2019 were included. Z-score was calculated according to the Chinese Child Growth and Development Standard, the Cox-Stuart test was used for trend analysis, and the generalized estimating equation was used to analyze HAZ (Height-for-age Z-score)≥-2 and WAZ (Weight-for-age Z-score)≥-2 influencing factors. Results A total of 943 children with HIV infection were enrolled in the cohort. The median HAZ at baseline and 1, 2, 5, and 10 years after treatment was -2.47, -2.14, -1.94, -1.55, -1.23, respectively, and the median WAZ was -1.85, -1.40, -1.30, -1.21, -1.09, respectively. By Cox-Stuart trend test, HAZ and WAZ showed an upward trend with the treatment time (P<0.05). The proportions of HAZ≥-2 at baseline and at 1, 2, 5, and 10 years after treatment were 38.1%, 46.5%, 51.6%, 66.8%, and 74.6%, respectively, and the proportions of WAZ≥-2 were 57.1%, 76.9%, 81.1%, 85.8% and 89.2%, respectively. According to Cox-Stuart trend test, the proportions of HAZ≥-2 and WAZ≥-2 increased with the treatment time (P<0.05). The results of multivariate generalized estimating equation analysis showed that the associated factors with HAZ≥-2 were that age at ART initiation was 3-7 years old (aOR=0.71, 95%CI: 0.53-0.94), age at ART initiation was >7 years old (aOR=0.66, 95%CI: 0.47-0.93), CD4 cell counts before ART was <200/μL (aOR=0.64, 95%CI: 0.47-0.87), WHO clinical stage before ART was Stage Ⅲ/Ⅳ (aOR=0.74, 95%CI: 0.56-0.97) and time on ART (aOR=1.01, 95%CI: 1.01-1.01); the associated factors with WAZ≥-2 were male (aOR=0.72, 95%CI: 0.53-0.97), WHO clinical stage before ART was Stage Ⅲ/Ⅳ (aOR=0.63, 95%CI: 0.45-0.86) and time on ART (aOR=1.01, 95%CI: 1.01-1.01). Conclusion Antiretroviral therapy can effectively improve the growth and development status of children with HIV infection, but a large proportion of children still have stunted growth and development in the 10th year after treatment. It is necessary to strengthen the training of antiretroviral treatment staff and the publicity and education of parents of children infected with HIV. Improve the effect of antiviral treatment and guide children's nutrition reasonably.