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Objective To investigate the gene mutations of human immunodeficiency virus (HIV)‐1 drug resistance among anti‐retrovirus (ARV ) treated‐naive men who have sex with men (MSM ) in Shanghai to provide evidence‐based data for optimized treatment .Methods All 669 treatment‐nave cases of HIV‐1 infection identified among MSM in 2013 were recruited and their plasma was collected .RNA was extracted and amplified by nest reverse transcription‐polymerase chain reaction ,and DNA was sequenced and then phylogenetically analyzed .Finally ,subtypes were identified and drug resistance was analyzed in comparison with International HIV Drug Resistance Database .Results The pol gene fragments of 645 cases were obtained .Primary drug‐resistance rate was 2 .48% (16/645) ,including mutations conferring resistance to protease inhibitor (PI) (0 .31% ,2/645) ,nucleoside reverse transcriptase inhibitors (NRTI) (0 .16% ,1/645) ,non‐nucleoside reverse transcriptase inhibitors (NNRTI) (1 .70% ,11/645) and both NRTI and NNRTI (0 .31% ,2/645) ,respectively .Mutations conferring resistance to CRF01_AE were 12 cases (2 .99% ) ,while mutations conferring resistance to CRF07_BC and CRF_01B were 0 .61%(1/163) and 4 .65% (2/43 ) including 1 case of CRF52_01B and unidentified CRF_01B , respectively . Resistance to NNRTI in B subtype were 2 .70% (1/37) .Conclusion The prevalence of HIV‐1 drug resistance‐associated mutations among MSM in Shanghai ,2013 is still low ,but resistance to NNRTI is relatively high .CRF01_AE is the major subtype of drug resistance .It is necessary to strengthen the HIV drug resistance surveillance in MSM group in Shanghai .
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Currently the highly active anti-retroviral therapy (HAART) is the most effective and practical approach for AIDS treatment. However, as the public health strategy for HIV/AIDS prevention and control, governmental involvement is highly needed. Since 2004 Chinese govemment actively responded to the United Nations' proposition and promised, "Four Free and One Care" policy, to promote HAART for AIDS patients in whole country, which was free of charge for all the AIDS patients. HIV related testing technologies are important assurance for effective implementation of HAART and replacement of anti-HIV drugs, including screening and confirmation of HIV/AIDS patients, screening of patients for HAART, evaluation of treatment effcacy and side effects, monitoring HIV-1 drug resistance and molecular evolution. In this issue, there are 6 papers describing the research on HAABT and relevant HIV testing technologies. The studies clearly demonstrated that great development was made in HIV testing technologies, which played significant supportive roles for HAART implementation in China.
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Laboratory testing for HIV infection is the most basic diagnosis evidence for HIV infection and case with AIDS.However,HIV testing is not only professional issue but also quite psychologically different from other tests for infectious diseases.It requires that the HIV test need reach up nearly both 100% of the sensitivity and specificity.If false positivity occurs,it may cause personal,familial and social problems,even result in extremist behavior such as action of suicide.If false negativity occur,it may lead not to receive medical intervention prompdy and to increase infection for society due to blood and sexual transmission modes.As of December 2007,there were 6 918 HIV screening labs and 202 HIV confirmatory labs,which has been approved in China.Therefore,the purpose of"the regulation on national management of HIV laboratory testing"(Management)is to require the management of HIV laboratory testing work legally and to ensure the testing as a technical protection measure for priority prevention and control of AIDS in the country.This paper presents the development and formulation of the Management,and also describes people's concern and understand some key points to carry out the Management in hospital laboratory departments currently.
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Objective To investigate the molecular epidemiology of human immunodefieiency viruses (HIV)-1 infected individuals in Honghe district,Yunnan Province and provide the evidence of molecular biology features of HIV-1 infection.Methods HIV-1 pol gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR).Then sequencing and phylogenetic tree analysis were employed tO determine HIV-I subgenotype.The sequence alignment was performed in the database of international drug resistance tO identify resistance-associated mutations.Results The samples from 60 HIV-1 infected individuals were investigated:39 were male,21 were female,with average age 35.5 years old.Thirty-four cases were infected with HIV-I through intravenous drug abuse,12 by sexual contacts,2 were contaminated blood/blood products transfusion and 12 with unknown transmission routes.Phylogenetic analysis revealed that 53 cases (88.3%) were subtype 08-BC,6 (10.0%) were subtype 07-BC and 1 (1.7%) was subtype 01_AE.The total rate of drug resistance associated mutations was 33.3%.The major mutations in protease (PR) and reverse transcriptase (RT) regions accounted for 5.0% and 3 1.7%,respectively.The major mutations in PR region were I541M,V82VFIL,M46MI,which were found in 1 case,respectively.The mutations in RT region were as follows:4 cases were T69D,6 were A62V,1 was D67DE,1 was E44D,3 were V179D,1 was V179E.1 was K238KN,1 was L234T+P236S and 1 was V106E.Conclusions The major transmission route of HIV-I infection in Honghe district,Yunnan Province is through drug injection.The major HIV-1 subtype of HIV-infeeted individuals is 08_BC.PR inhibitor and RT inhibitor drug resistance associated mutations in HlV-1 gene have already existed.
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Objective To investigate the clinical epidemiologic characteristics of patients with hepatitis C virus(HCV)infection post blood transfusion.Methods The polymerase chain reaction (PCR)and enzyme linked immunosorbent assay(ELlSA)were used to detect HCV RNA and antiHCV,respectively.Analysis was performed for patients' age distribution,cause of primary diseases,exposure years,ingredient and amount of transfusion,incubation period and liver function damage.The statistical processing were performed with chi-square test,t-test and correlation analysis.Results HCV RNA levels were higher than 3.0 log10 copy/mL in 85.3%infected patients with a median of 5.99log10 copy/mL,among which 19.7%patients showed viral load 3.0 to 4.0 log10 copy/mL and 69.9%showed 5.0 to 6.0 log10 copy/mL.Eighty-one point six percent(40/49)of infected persons were confirmed as HCV RNA positive by HCV RNA qualitative analysis,while 99.7%(383/384)patientswere detected as anti-HCV positive by serological test.The sensitivity of serological test was higher than both HCV RNA quantitative and qualitative assays(F=57.138,P=0.000;F=63.149,P=0.000,respectively).HCV infection post blood transfusion was more common in people of 30 to 60years old.Most cases(84.4%)got the first time exposure during 1990 to 1994.More than 10%cases had primary disease as obstetrics, orthopedics or gastrointestinal tract hemorrhage. Eighty percent received whole blood product transfusion.The mean interval between transfusion and clinical diagnosis was (86.0±54.6 ) months. Eighty nine percent of infected patients had liver function damage, while most of them showed elevated alanine aminotransferase (ALT) with no more than 5 upper limits of normal (ULN). Conclusions Post transfusion HCV infection mainly happened in adulthood. Infected patients usually have liver function damage with elevated ALT with no more than 5 ULN and medium HCV RNA levels.
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Objective:To investigate the impact of the CD4+CD25nt/hiCD127lo regulatory T cell subset frequency on the immune status and disease progression of Chinese HIV-1 infected individuals.Methods:83 untreated HIV-infected individuals and 312 healthy control individuals of four distinct age groups were enrolled in the research. The CD4+ T cell absolute counts, phenotypes and frequency determination of CD4+CD25nt/hiCD127lo Regulatory T cell subsets was performed on freshly obtained whole blood samples by 3-color immune staining flow cytometry. The HIV-1 specific cellular immune function was test at single cell level by ELISpot. The corresponding plasma viral load was determined by NASBA.Results:The frequency of peripheral CD4+CD25nt/hiCD127lo regulatory T cells of HIV infected individuals in distinct disease progression status was dissimilar in China , and significantly increased in contrast to the healthy controls(P
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Objective To measure normal range of CD4 from Chinese adults in Shanghai area by flow cytometry. Methods CD4 and CD8 value were measured through flow cytometry in adult blood specimens from various age and gender group. Results There were no difference in CD4 value among different sex and age groups, with the mean value being 726.99?255.21. However, CD8 and CD4/CD8 ratio vary significantly among different groups. The mean value of CD8 was 539.58?134.07, while the mean value of CD4/CD8 1.49?0.57. Conclusions The mean value of CD4 in Shanghai adults is about 100/mm 3 lower than that in American.