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Objective:To construct the molecular transmission network of human immunodeficiency virus type 1 (HIV-1) epidemic strains in northern Zhejiang Province (Jiaxing City and Huzhou City) and to explore the HIV-1 transmission characteristics in this region.Methods:A total of 371 newly diagnosed human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients in Jiaxing City and Huzhou City in 2017 were included as study subjects, and the blood samples were collected and the basic demographic and epidemiological information were obtained. RNA in plasma was extracted, and the pol region gene sequence was amplified by reverse transcriptase polymerase chain reaction (RT-PCR) and nested polymerase chain reaction (PCR) to construct phylogenetic tree for identifying subtypes. The pairwise genetic distances were calculated, and the optimal threshold of genetic distance was selected, and finally the molecular transmission network was constructed. Chi-square test was used for statistical analysis. Results:The pol region gene sequences of 336 samples were successfully obtained, and 11 subtypes were detected, mainly including circulating recombinant form (CRF)07_BC (40.8%, 137/336) and CRF01_AE (31.2%, 105/336). Based on the 1.0% genetic distance threshold, the molecular transmission network of HIV-1 was plotted. A total of 38 transmission clusters (cluster sizes ranging from two to 28) including 119 patients were found, with males predominantly (82.4%, 98/119) and most of the patients aged over 40 (include 40) years old (52.9%, 63/119), mainly infected with CRF07_BC subtype (57.1%, 68/119) and CRF01_AE (24.4%, 29/119). The clustering rate of CRF07_BC (49.6%, 68/137) was significantly higher than that of CRF01_AE (27.6%, 29/105), the difference was statistically significant ( χ2=5.27, P=0.022). Two large clusters C1 (28 cases) and C2 (11 cases) were identified, the majority of which were men who have sex with men (17 cases and seven cases, respectively). High-risk cases generally sought sexual partners in local or nearby cities through mobile phone dating software, of which the infected sequences mostly had high homology with other economic developed regions (Guangdong Province, Beijing City and Hangzhou City, etc.). Conclusions:The HIV-1 subtypes are diverse in Jiaxing City and Huzhou City, mainly CRF07_BC and CRF01_AE. The HIV-1 transmission networks are complex, among which high-risk cases may be the key factor leading to the HIV-1 epidemic in the region. Therefore, it is urgent to deepen the transmission network monitoring and formulate timely precise intervention and prevention strategies.
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Objective@#To study oral sexual behavior and related factors among male students.@*Methods@#The male students from college graduation in Hangzhou were selected as the study objects, and the inclusion criteria were having had sex and informed the type of behavior. A total of 490 subjects were finally included.@*Results@#Among 490 male students, the 20-22 years old, 23 years old and 24-27 years old age groups accounted for 38.8% (n=190), 37.8% (n=185) and 23.3% (n=114), respectively. A total of 99 (20.2%) cases had oral sexual behavior, of which only 14 (2.9%) cases used condom. After adjusting for unplanned pregnancy, stage of sexual behavior, sexually transmitted diseases infection possibility, sexual orientation factors, normal/unnormal family relationship, more than 2 sexual partners, casual sexual partners, sexual partners from other college, sexual partners from society, sexual behavior in past 1 year were positively associated with oral sexual behavior. The corresponding OR (95%CI) values were 2.77 (1.40-5.50), 2.29 (1.27-4.15), 2.68 (1.23-5.88), 2.45 (1.34-4.48), 2.47 (1.15-5.33) and 2.04 (1.05-3.96), respectively. Use of condoms was negatively associated with oral sexual behavior, the OR (95%CI) value was 0.20 (0.09-0.42).@*Conclusion@#Normal/unnormal family relationship, more than two sexual partners, casual sexual partners, sexual partners from other college, sexual partners from society, sexual behavior in last one year and condom use in each vaginal sexual behavior were associated with oral sexual behavior.
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Objective@#To understand HIV infection status and characteristics of non-remunerated blood donors in Hangzhou.@*Methods@#HIV antibody test were conducted for non-remunerated blood donors in Hangzhou and their demographic and epidemiological information were collected from 2008-2017. χ2 test for trend (liner by liner association chi square test) was used for the comparison of the HIV infection trends in each year.@*Results@#A total of 1 461 129 non-remunerated blood donors were surveyed in Hangzhou during 2008-2017, and 260 blood donors were HIV positive. Most HIV infected blood donors were males (96.5%, 251/260) and aged 18-34 years (72.7%, 189/260). Among 260 HIV positive blood donors, those reporting repeated non-remunerated blood donation accounted for 36.9% (96/260), those reporting homosexual transmission accounted for 53.5% (139/260) and those reporting heterosexual transmission accounted for 44.6% (116/260). The HIV infected persons reporting homosexual behaviors were mainly aged 18-34 years (82.0%, 114/139) and unmarried (71.2%, 99/139). Most HIV infected students reported homosexual transmission (88.4%, 23/26). The crude HIV positive rate was 0.8/10 000-2.5/10 000, the differences in annual HIV positive rate had no significance (trend χ2=2.355, P=0.125). The crude HIV positive rate in male blood donors aged 18-24 years increased from 1.1/10 000 in 2008 to 3.7/10 000 in 2017, the difference was significant (trend χ2=5.175, P=0.023). Standardized HIV positive rate was 0.9/10 000-2.4/10 000.@*Conclusions@#HIV infection rate was low in non-remunerated blood donors in Hangzhou during 2008-2017. Most HIV infected persons were males and aged 18-34 years. Heterosexual and homosexual contacts were the major transmission routes. The HIV positive rate in males aged 18-24 years showed an increase trend.
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Objective@#Using field epidemiological investigation and molecular analysis to construct the molecular transmission network of human immunodeficiency virus/acquired immunodeficiency syndrome cases (HIV/AIDS) newly diagnosed in Huzhou in 2017, Zhejiang Province.@*Methods@#A total of 160 participants were obtained through a web-based system from Chinese Center for Disease Control and Prevention (CCDC) with the features of diagnosed in Huzhou in 2017 who also had been collected samples for the first follow-up. The basic information of demographic characteristics and risk factors was extracted from the website. RNA was extracted from plasma samples of untreated cases, followed by RT-PCR and nest-PCR for pol gene amplification, sequencing. Phylogenetic tree was constructed by MEGA software for HIV gene subtyping. TN93 model was used for calculating the distance between two sequences. Cytoscape software was used for drawing molecular transmission network. And then an epidemiological survey was conducted to cases in the primary cluster.@*Results@#A total of 138 sequenced individuals (86.3%) were acquired from 160 individuals. Among which, 123 (89.1%) were male. The highest proportion of subtype was CRF07_BC (60, 43.5%), followed by CRF01_AE (46, 33.3%), and with four cases of Unique Recombinant Form (URF, CRF01_AE and CRF07_BC) and one case of URF (subtype B and C). A total of 18 molecular clusters included 56 individuals (40.6%) were found in the transmission network under the optimal genetic distance threshold (1.0%). The clustering proportion of CRF07_BC (66.1%, 37 cases) was higher than that of CRF01_AE. There were 9 clusters formed among CRF07_BC, including 37 cases (accounting for 61.7%, 37/60). The primary transmission cluster contained 11 cases, among which 9 cases were transmitted by homosexual sex. The first time of the cases to have homosexual behavior is range from 2010 to 2016, whose media number (P25, P75) of partners was 6 (3.5, 8.5). Most of the cases come from Anhui Province and engaged in garment industry (5 cases), between which there were 8 cases used Blued software to seek for casual partners, 1 case seeking for casual partners in garden.@*Conclusion@#With CRF07_BC and CRF01_AE predominantly circulating, HIV genetic diversity had been noticed in this area. The primary cluster was consisted of high proportion of locally new infections, and a specific population aggregation in limited place existed.
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Objective@#To understand the situation and influencing factors related to the promotion of HIV testing program among sex partners in newly diagnosed HIV positive MSM in Zhejiang province during 2015 to 2017.@*Methods@#Newly diagnosed HIV positive MSM in Zhejiang province from 2015 to 2017 were collected and provided four rounds of testing services to their sexual partners so as to study the consequences. Chi-square test was conducted to compare the difference between groups while multivariate logistic regression was conducted to analyze the related influencing factors.@*Results@#A total of 6 269 HIV positive MSM were provided with four rounds of testing services to their sexual partners. 1 925 HIV positive MSM (30.7%, 1 925/6 269) were successfully persuaded in mobilizing their sexual partners to participate in the HIV testing services. However, 4 344 HIV positive MSM (69.3%, 4 344/6 269) refused to do so. A total of 2 126 sexual partners received HIV testing and the HIV positive rates of those sexual partners appeared as 13.0% (277/2 126, 95%CI:11.6%-14.5%) and 78.7% (218/277, 95%CI: 73.8%-83.6%). Results from the multivariate logistic regression analysis indicated that factors as: HIV positive MSM that participated in the study in 2016 (compared with participated in the study in 2015, OR=1.581, 95%CI: 1.370-1.823), in 2017 (compared with participated in the study in 2015, OR=1.394, 95%CI: 1.208-1.608), living in the reporting city (compared with lived outside the reporting city, OR=1.518, 95%CI: 1.320-1.745), being married (compared with unmarried/divorced/widowed, OR=4.449, 95%CI: 3.837-5.160), having education level of junior high school or below (compared with education level of senior high school or above, OR=1.203, 95%CI: 1.058-1.367), numbers of homosexual partners >5, (compared with numbers of homosexual partner from past between 1-5, OR=1.236, 95%CI: 1.095-1.395), active detection (compared with passive detection, OR=1.340, 95%CI: 1.193-1.506) were more likely to relate to the successful persuasion on their sexual partners to receive the HIV testing. There was no statistical difference noticed between HIV-infected homosexual partners and their corresponding HIV positive MSM, in terms of socio-demographic situations.@*Conclusions@#HIV positive MSM should promote their sexual partners to receive HIV testing. This seemed an important role in expanding the HIV testing in this population. However, the program needs to be further improved and included in daily work, focusing on those partners with similar social and demographic characteristics with those infected MSM.
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Objective@#To identify the status and risky factors of anal sexual intention in casual sex behavior in Zhejiang province.@*Methods@#Stratified cluster sampling was conducted among college students in 13 colleges in 11 cities between October to November, 2018. 482 students were enrolled who self-reported "heterosexuality "and" ever had casual sex behavior". A self-designed network questionnaire was complimented containing basic information, knowledge of HIV, sexual behavior. Chi-square test was used to compared the difference of anal sex intention between different characteristic. The multivariate logistic regression methods was used to analyze the influence factors.@*Results@#Among 482 students, the age was (20±1.442) years old. And 87.3% (421) were male and 29.0% (140) were from other province. The rate of anal sex intention were 19.4% (94/482) in total, with the rates of 38.1% (24/63) and 14.4% (53/367) in students with sexual number more than 5 and less than 5 (P<0.001), separately. Compared with students searching casual sexual partner with non-internet access (17.0%, 16/201), students searching sexual partner with internet access had higher risk of anal sex practice (27.8%, 78/281) (P<0.001). The rate of anal sex practice among students reporting "ever had casual sex after drinking "and" never had casual sex after drinking" were 30.5% (64/210) and 9.4% (25/266) (P<0.001). The multivariate logistic regression results revealed that compared with students searching casual sexual partner with non-internet access and reporting "never had casual sex after drinking", subjects searching sexual partner with internet access(OR (95%CI)=2.65 (1.34-5.23)) and "ever had casual sex after drinking" OR (95%CI)=3.02 (1.65-5.33) were more likely had higher risk of anal sex practice.@*Conclusion@#Heterosexual college students in Zhejiang Province tend to have anal intercourse with causal sexual partners. Searching for causal sexual partners on internet or mobile phone dating software and having temporary sexual behavior after drinking were correlated factors.
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Objective To understand the epidemiological characteristics of one large HIV molecular transmission cluster in Jiaxing city,Zhejiang province,2017 in order to select those people under high-risk and providing basis for programs on prevention.Methods During 2017,newly diagnosed HIV/AIDS cases in this city were recruited.Plasma samples were collected from subjects,followed by RNA extraction,RT-PCR and nest-PCR for pol gene amplification,before being sequenced and aligned.Mega 6.0 software was used to construct phylogenetic tree,and Cytoscape 3.6.0 software was used to identify HIV molecular transmission clusters.Cases within the large transmission clusters were investigated,using a field-epidemiology-questionnaire.Data related to socio-demographics and previous sexual behaviors were collected and EpiData 3.0 and SPSS 20.0 software were used.Results In the large transmission cluster with subtype identified as CRF07_BC,in Jiaxing,2017,26 cases of the total 30 cases were investigated.A total of 80.8％ (21/26) could be identified as newly infected within the last two years and 30.8％(8/26) could be identified as newly infected within the last one year,including 22 cases infected locally.Among several infected cases who were at age 45 years or older,they admitted that they had experienced unprotected sexual contacts in local city for long time and having had more than 10 disclosed sexual contacts within the last two years at the local venues.Conclusions This molecular cluster had been formed and scaled up quickly in recent two years,it has played an important role in promoting and scaling up the HIV transmission.Three cases identificed as high risk played an importantrde role in scaling up this cluster.
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Objective To understand the epidemiological characteristics of one large HIV molecular transmission cluster in Jiaxing city,Zhejiang province,2017 in order to select those people under high-risk and providing basis for programs on prevention.Methods During 2017,newly diagnosed HIV/AIDS cases in this city were recruited.Plasma samples were collected from subjects,followed by RNA extraction,RT-PCR and nest-PCR for pol gene amplification,before being sequenced and aligned.Mega 6.0 software was used to construct phylogenetic tree,and Cytoscape 3.6.0 software was used to identify HIV molecular transmission clusters.Cases within the large transmission clusters were investigated,using a field-epidemiology-questionnaire.Data related to socio-demographics and previous sexual behaviors were collected and EpiData 3.0 and SPSS 20.0 software were used.Results In the large transmission cluster with subtype identified as CRF07_BC,in Jiaxing,2017,26 cases of the total 30 cases were investigated.A total of 80.8％ (21/26) could be identified as newly infected within the last two years and 30.8％(8/26) could be identified as newly infected within the last one year,including 22 cases infected locally.Among several infected cases who were at age 45 years or older,they admitted that they had experienced unprotected sexual contacts in local city for long time and having had more than 10 disclosed sexual contacts within the last two years at the local venues.Conclusions This molecular cluster had been formed and scaled up quickly in recent two years,it has played an important role in promoting and scaling up the HIV transmission.Three cases identificed as high risk played an importantrde role in scaling up this cluster.
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Objective To evaluate the effects of enteral immunonutrition on cell immunity level and clinical efficacy in patients with severe tuberculosis. Methods Sixty patients with severe tuberculosis were admitted to the department of tuberculosis intensive care unit of Hangzhou Red Cross Hospital from June 2015 to June 2017, and they were randomly divided into a conventional enteral nutrition group (EN group) and a enteral immunonutrition group (EIN group), each group 30 cases. Based on the patients' gastrointestinal tolerance condition, the EN group was treated with therapies of normal nutrition support, anti-tuberculosis, anti-infection, etc.; the EIN group was treated with enteral immunonutrition (TPF-T), and simultaneously with anti-tuberculosis, anti-infection, etc. therapies according to the disease situation. The target energy maintained at 104.6 kJ·d-1·kg-1and the therapeutic course was 14 days in the two groups. The levels of interleukins (IL-6, IL-10) and interferon-γ (IFN-γ), white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT), cell immune indexes (T cell subgroup CD4+, CD8+) were observed before treatment and on day 14 after treatment in the patients of two groups; the changes of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score before treatment and after treatment and 28-day mortality rate were recorded in the two groups. Results After treatment, the levels of WBC, CRP, PCT were obviously lower than those before treatment, while the levels of IL-6, IFN-γ, CD4+in the two groups were significantly higher than those before treatment, and the changes of the EIN group were more significant than those in the EN group [WBC (×109/L): 8.0±3.1 vs. 10.0±2.4, CRP (mg/L): 30.3±9.1 vs. 45.8±6.6, PCT (μg/L): 2.2±1.8 vs. 4.3±2.2, IL-6 (mg/L): 182.53±8.52 vs. 168.42±7.62, IFN-γ (mg/L): 32.52±3.5 vs. 25.41±2.6, CD4+: 0.56±0.06 vs. 0.45±0.08, all P < 0.05]. The level of CD8+after treatment in the two groups was higher than that before treatment (the EN group: 0.28±0.06 vs. 0.27±0.07, the EIN group: 0.27±0.08 vs. 0.26±0.09), the APACHE Ⅱ scores in the two groups were lower than those before treatment (the EN group: 11±6 vs. 18±4, the EIN group: 10±3 vs. 17±6), the 28-day mortality in the EIN group was lower than that in the EN group [13.3% (4/30) vs. 16.7% (5/30)], no statistical significant difference in CD8+, APACHE Ⅱscore, 28-day mortality between the two groups being found (all P > 0.05). Conclusion Enteral immunonutrition can improve the level of cell immunity and decrease the degree of inflammatory response, and increase the clinical curative effect in patients with severe tuberculosis.
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Objective To investigate the application value of MR SWI and DWI in the diagnosis of liver lesions.Methods 1 300 patients underwent 1.5T MRI scan of liver,no pathology or follow-up examination results of patients with focal liver lesions were excluded,147 patients were included and underwent conventional magnetic resonance(MRI),DWI and SWI.By 2 senior radiologists with double blind method of conventional MRI and MRI combined with DWI and SWI image reading,the feature and enhancement pattern of signal intensity were evaluated.Kappa test was used to evaluate the consistency of the diagnosis of 2 physicians.The pathological examination and comprehensive follow-up results were used as the gold standard.The diagnostic accuracy of the two groups was compared.Results 2 doctors had good consistency in the image diagnosis of the two groups.The Kappa values of conventional MRI and conventional MRI combined with DWI and SWI images were 0.912 and 0.936,respectively.The conventional MRI diagnosed primary hepatocellular carcinoma(HCC) in 40 cases,bile duct cancer cells (ICC) in 13 cases,liver metastasis (HMs) in 14 cases,cavernous hemangioma of the liver (CHL) in 17 cases.The conventional MRI combined with DWI and SWI diagnosed HCC in 50 cases,ICC in 20 cases,HMs in 20 cases,CHL in 24 cases,the differences were statistically significant (x2 =5.660,5.250,5.560,6.640,all P ＜ 0.05).Conclusion Conventional MRI combined with DWI and SWI can provide additional valuable information and improve diagnostic performance for liver lesions.
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Objective To investigate dynamic changes of serum Tau proteins and their correlation with cognitive dysfunction in patients with acute traumatic brain injury (TBI).Methods A total of 95 patients with acute TBI were retrospectively studied by case-control study.There were 61 males and 34 females,with age of 16-65 years [(40.7 ± 13.6)years].The Glasgow coma scale (GCS) was 3-8 points in 9 patients,9-12 points in 11,and 13-15 points in 75.A total of 30 healthy physical examinees were recruited as control group.The levels of Tau proteins were measured at days 1,3,5,7 and 14 after TBI.The cognitive dysfunction was evaluated by the Montreal Cognitive Assessment (MoCA) score at 6 months after injury.The correlation between Tau protein levels at different time points and MoCA was determined.Results The serum Tau proteins of TBI group was significantly higher than that of control group at all time points (P ＜ 0.05).In TBI group,39 (41％) out of 95 patients developed cognitive dysfunction assessed by MoCA scale.The main manifestations of cognitive dysfunction were the defects in visual spatial and acting function,delayed memory,language,abstract,attention and calculation,with statistical significance compared with control group (allP ＜ 0.05).The serum Tau proteins of patients with cognitive dysfunction were significantly higher than those without cognitive dysfunction at all time points after TBI (P ＜ 0.05).Tau proteins at days 1,3,5 after TBI was significantly correlated with cognitive dysfunction at 6 months after TBI (P ＜ 0.05).Conclusions The levels of serum Tau proteins show a significant increase after TBI,the early changes of which are statistically related to cognitive dysfunction.The early changes of serum Tau protein after TBI can be used as a reliable biomarker for early prediction of cognitive function prognosis.
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Objective To assess the prevalence of HIV infection and related factors in men who have sex with men (MSM) living for ≤5 years in Wenzhou of Zhejiang province.Methods MSM who were aged ≥ 16 years,had lived in Wenzhou for ≥3 months and had anal sex and/or oral sex with men in the last 12 months were recruited through respondent-driven sampling (RDS) from February to October in 2015.The MSM recruited completed a questionnaire for the information collection on socio-demographic characteristics,sexual behavior,awareness of HIV and related intervention,mental health status.Blood samples were collected from them for serological detection of HIV and syphilis antibodies.Software SPSS 18.0 was used to analyze HIV infection and related factors.Results A total of 454 MSM were investigated,108 of them (23.7％) were HIV positive.There were 267 MSM who lived in Wenzhou for ≤5 years,and 73 of them (27.3％) were HIV positive.Most of them were workers and commercial servants aged ≥ 25 years with personal monthly income ＜4 000 yuan and educational level of junior high school or below.According to multiple logistics regression analysis,age of 25-68 years old (OR=12.19,95％CI:2.29-65.02),heterosexual behavior in recent 6 months (OR=0.42,95％CI:0.18-0.96),believing it was possible to be infected with HIV (OR=0.06,95％CI:0.01-0.95),believing it was impossible to be infected with HIV (OR=0.03,95％CI:0.01-0.35) and syphilis status (OR=3.32,95％CI:1.05-10.52) were the risk factors associated with HIV infection.Conclusion Compared with MSM who lived in Wenzhou for ＞ 5 years,MSM who lived in Wenzhou for ≤ 5 years had higher HIV infection rate and higher prevalence of risk behavior.It is necessary to conduct targeted intervention among them.
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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 assess the prevalence of HIV infection and related factors in men who have sex with men (MSM) living for ≤5 years in Wenzhou of Zhejiang province.Methods MSM who were aged ≥ 16 years,had lived in Wenzhou for ≥3 months and had anal sex and/or oral sex with men in the last 12 months were recruited through respondent-driven sampling (RDS) from February to October in 2015.The MSM recruited completed a questionnaire for the information collection on socio-demographic characteristics,sexual behavior,awareness of HIV and related intervention,mental health status.Blood samples were collected from them for serological detection of HIV and syphilis antibodies.Software SPSS 18.0 was used to analyze HIV infection and related factors.Results A total of 454 MSM were investigated,108 of them (23.7％) were HIV positive.There were 267 MSM who lived in Wenzhou for ≤5 years,and 73 of them (27.3％) were HIV positive.Most of them were workers and commercial servants aged ≥ 25 years with personal monthly income ＜4 000 yuan and educational level of junior high school or below.According to multiple logistics regression analysis,age of 25-68 years old (OR=12.19,95％CI:2.29-65.02),heterosexual behavior in recent 6 months (OR=0.42,95％CI:0.18-0.96),believing it was possible to be infected with HIV (OR=0.06,95％CI:0.01-0.95),believing it was impossible to be infected with HIV (OR=0.03,95％CI:0.01-0.35) and syphilis status (OR=3.32,95％CI:1.05-10.52) were the risk factors associated with HIV infection.Conclusion Compared with MSM who lived in Wenzhou for ＞ 5 years,MSM who lived in Wenzhou for ≤ 5 years had higher HIV infection rate and higher prevalence of risk behavior.It is necessary to conduct targeted intervention among them.
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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 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 related factors on previous HIV testing behavior among MSM who visit gay bathroom in Hangzhou, Zhejiang province. Methods Through time-location sampling (TLS) survey, men who had oral sex or anal sex with men in past 6 months were interviewed in the gay bathroom in Hangzhou from October 2015 to January 2016. Software SPSS 22.0 was used to analyze the HIV testing acceptance, sexual behaviors and condom usage of MSM during past 6 months, and χ2 test and logistic regression model were used for univariate and multivariate analyses. Results Our study planned to recruit 480 gay bathroom MSM, due to the unwilling or other factors, 465 MSM were surveyed. A total of 47.3%(220/465) gay bathroom MSM received HIV testing during past 6 months. Multivariate analysis indicated that being married (OR=0.35, 95%CI:0.18-0.69), peer education (OR=4.31, 95%CI:1.32-14.09), homosexual behavior during past 6 months (OR=1.85, 95%CI: 1.08-3.14), extramarital heterosexual behavior during past 6 months (OR=4.12, 95%CI: 2.45-6.91) might be positive factors related with HIV testing acceptation in MSM. Conclusion Being married, homosexual behavior during past 6 months, extramarital heterosexual behavior, partner education might be the positive factors related with acceptance of HIV testing among gay bathroom MSM. Therefore, peer education needs to be strengthened. HIV testing after high risk sexual behavior needs to be promoted in MSM.
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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.
ABSTRACT
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.