Birth weight of infants born to pregnant women living with human immunodeficiency virus and its associated factors / 中华传染病杂志

Objective:To investigate the birth weight (BW) of infants born to pregnant women living with human immunodeficiency virus (HIV) and its associated factors, and to provide more evidence for the prevention of mother-to-child transmission (PMTCT) in China.Methods:This study was a retrospective cohort study. Between January 2004 and December 2021, pregnant women living with HIV and their infants in Hubei Province were recruited and followed up, and clinical data were collected through hospital medical records and HIV/acquired immunodeficiency syndrome comprehensive response information management system. The multivariable linear regression was performed on the collected data to investigate associated influencing factors of BW.Results:In total, 531 pregnant women living with HIV (581 pregnancies) and 581 infants were enrolled. Of the 581 infants, 36 were HIV-positive, with a PMTCT rate of 6.2%. The mean BW of the infants was (3 075.0±470.2) gram. Protease inhibitor (PI) based-anti-retroviral therapy (ART) ( β=-0.1, 95% confidence interval ( CI)-188.2 to -37.1, P=0.004), ART in the first trimester( β=-0.1, 95% CI -201.9 to -65.5, P<0.001), infant HIV infection ( β=-0.1, 95% CI -310.4 to -68.2, P=0.002), hepatitis C virus infection ( β=0.1, 95% CI 71.2 to 410.4, P=0.005) and gestational age ( β=0.6, 95% CI 155.9 to 191.5, P<0.001) were associated with decreased BW. Conclusions:While improving the effectiveness of PMTCT for HIV, more attention should be paid to pregnant women who received ART in the first trimester and PI-based ART for preventing lower BW and improving maternal and infantile health.

Retrospective analysis of the effect of CD4 + T lymphocyte level on hepatitis B surface antibody in human immunodeficiency virus infected patients / 中华传染病杂志

Objective:To investigate the relationship between positive rate and titer of hepatitis B surface antibody (anti-HBs) and CD4 + T lymphocyte count level in human immunodeficiency virus (HIV) infected patients after hepatitis B virus (HBV) exposure. Methods:A total of 4 893 HIV-infected patients were admitted to Zhongnan Hospital of Wuhan University from January 2010 to December 2018. The demographic data, HIV-related diagnosis, treatment information, CD4 + T lymphocyte count and serum markers of HBV infection of HIV infected patients were retrospectively analyzed. The patients were grouped according to the CD4 + T lymphocyte count and serum markers of HBV infection, and the differences of anti-HBs positive rate and HBV exposure rate in patients with different CD4 + T lymphocyte counts were compared.The differences of CD4 + T lymphocyte count in patients with different titer of anti-HBs were compared. Statistical analysis was performed using chi-square test, analysis of variance or t test. Results:Patients with HIV infection were divided into CD4 + T lymphocyte count<200/μL group (3 293 cases), 200-500/μL group (1 200 cases) and CD4 + T lymphocyte count>500/μL group (400 cases). The HBV exposure rates in the three groups were 78.0%(2 569/3 293), 77.0%(924/1 200) and 76.2%(305/400), respectively. The anti-HBs positive rates were 38.2%(1 258/3 293), 53.8%(645/1 200) and 62.5%(250/400), respectively. The anti-HBs titers were (120.00±36.45) IU/L, (148.00±26.40) IU/L and (212.00±92.08) IU/L, respectively. The exposure rates of HBV in the three groups were similar ( χ2=0.992, P=0.609), but the positive rates and titers of anti-HBs were significantly different ( χ2=146.779 and F=45.362, respectively, both P<0.01). When the patients were grouped by anti-HBs titer, 2 740 cases were divided into anti-HBs negative group (<10 IU/L), 1 220 cases in low anti-HBs group (10-99 IU/L), 693 cases in medium anti-HBs group (100-499 IU/L) and 240 cases in high anti-HBs group (≥500 IU/L). The CD4 + T lymphocyte count levels of the four groups were (150.00±8.42)/μL, (185.00±7.08)/μL, (243.00±12.07)/μL and (308.00±22.60)/μL, respectively. The overall CD4 + T lymphocyte count levels among the four groups were significantly different ( F=68.479, P<0.01). Among the 90 HIV infected patients who received anti-retroviral therapy (ART), the anti-HBs titer increased from (91.96±21.87) IU/L to (200.76±56.43) IU/L after treatment, and the anti-HBs level before and after treatment was significantly different ( t=-2.542, P=0.035). Among 208 patients with negative HBV markers, no patients had hepatitis B surface antigen switched to positive when monitored for an interval time of (26.2±5.3) months. Conclusions:The risk of HBV exposure in patients with HIV infection is not significantly related to the disease stage, but the positive rate and titer of anti-HBs are significantly positively correlated with CD4 + T lymphocyte count level. The monitoring of anti-HBs and the serum markers of HBV infection in the same individual is conducive to the in-depth understanding of the protective effect of anti-HBs and the scientific evaluation of the risk of infection after HBV exposure.

The situation of sexual transmitted diseases among acquired immune deficiency syndrome patients and its influence on the risk of human immunodeficiency virus transmission between couples / 中华传染病杂志

Objective To investigate the situation of sexual transmitted diseases (STD) prevalence among human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS ) patients and to analyze its impact on HIV transmission between couples .Methods Under voluntary counseling and testing ,1871 clinically confirmed HIV/AIDS patients underwent common STD testing , with synchronous test of HIV infection on their couples .Continuous variables were compared using t-test , and categorical variables were compared using variance analysis .Chi-square test was used for comparison between groups .Results Among 1871 HIV/AIDS patients ,571 patients (30 .5％ ) were co-infected with STD .The HIV transmission rates between couples in STD co-infection group and non-STD co-infection group were 49 .2％ (281/571) and 23 .6％ (307/1300) ,respectively ,which was statistically different (χ2 =120 .6 ,P<0 .01) .Among the 571 HIV/STD co-infection patients ,HIV transmission rates between couples with genital herpes ,condyloma acuminatum ,gonorrhoea or nongonococcal urethritis and syphilis were 84 .2％ (80/95) ,72 .2％ (78/108) ,45 .0％ (27/60) and 31 .2％ (96/308) ,respectively .There was statistically significant among multiple groups comparisons (χ2 =110 .0 , P<0 .01) .Among the comparison between two groups , there were statistically significant differences between genital herpes group and condyloma acuminatum group (χ2 =4 .210 ,P=0 .040) ,between pointed condyloma group and gonorrhoea or nongonococcal urethritis group (χ2 =12 .196 , P< 0 .01) ,between gonorrhoea or nongonococcal urethritis group and syphilis group (χ2 = 4 .317 , P=0 .038) .Conclusions STD co-infection rate is high among HIV/AIDS patients .STD can facilitate the HIV transmission between couples ,and different STD has different impact on the transmission .

Association of CD4 + T lymphocyte count with HBV replication and progression of liver diseases in patients infected with HIV and HBV / 中华全科医师杂志

The clinical data of 459 patients,who were first diagnosed as HIV/HBV co-infection from January 2007 to December 2013,were retrospectively analyzed.Among all patients,there were 89 cases with CD4 ＜ 50/μl,134 cases with CD4 50-200/μl and 236 cases with CD4 ＞ 200/μl,when HIV infection was diagnosed.In these three groups with different CD4 levels,the HBV DNA positive rates were 49.3％ (37/75),50.5％ (54/107) and 33.7％ (66/196);the HBV viral load were (6.37 ± 1.71) log10 copies/ml,(5.82 ± 1.86) log10 copies/ml and (4.36 ± 1.64) log10 copies/ml;the rates of abnormal liver function were 29.2％ (26/89),29.1％ (39/134) and 10.6％ (25/236);the occurrence rates of end-stage-liver-diseases were 16.9％ (15/89),14.9％ (20/134) and 5.1％ (12/236);the mortality rates were 10.1％ (9/89),9.7％ (13/134) and 3.8％ (9/236),respectively.The HBV DNA positive rates,HBV viral load,the rates of abnormal liver function,the occurrence rates of end-stage-liver-diseases and the mortality rates in CD4 ＞ 200/μl group were lower than that in CD4 ＜ 50/μl group and 50-200/μl group.The results suggest that for HIV and HBV co-infection patients,HBV replication level and prognosis of liver diseases are associated with CD4 + T lymphocyte count.

Analysis on sero-conversion status of human immunodeficiency virus-discordant spouse during 5-year follow-up period / 中华传染病杂志

Objective To investigate the influence of safe sex education and antiretroviral therapy (ART) on human immunodeficiency virus (HIV) antibody sero-conversion status among HIV-discordant spouses.Methods Totally 1 258 HIV/acquired immunodeficiency syndrome (AIDS) cases and their spouses were enrolled and the related information was collected during 2005 to 2007.The HIV negative spouses were tested for HIV antibody once every 6 months.The effects of safe sex education and ART on sero-conversion status of HIV-discordant spouses were analyzed.The date were analyzed by x2 test.Results Without any intervention,505 out of 1 258 HIV/AIDS spouses were positive for HIV test,with the HIV natural spousal transmission rate of 40.1％.Among 442 blood source and 816 sexual source index HIV cases,HIV was positive in 103 and 402 of their spouses,respectively,with the HIV transmission rates between couples of 23.3％ and 49.3 ％,respectively.HIV transmission rate in sexual source group was higher than that in blood source group (x2 =80.421,P＜0.01).Among 608 male and 650 female index HIV cases,HIV was positive in 333 and 172 of their spouses,respectively,with the HIV transmission rates between couples of 54.8％ and 26.5％,respectively.Rate of HIV transmission from men to women was higher than that from women to men (x2 =104.770,P＜0.01).Among 753 HIV discordant couples,only 5 spouses had HIV sero-conversion (0.7％) after comprehensive intervention measures during 5 years of follow-up period.Among 31 HIV/AIDS patients who were only accepted safe sex education,3 of their spouses were HIV positive (9.7％).The transmission rate was lower than that in patients without any intervention (40.1％) (x2 =11.760,P＜0.01).Among 722 HIV/AIDS patients received ART,2 of their spouses were HIV positive (0.3 ％),which was lower than the transmission rate (9.7％) in ART-na(i)ve group (x2=39.821,P＜0.01).Conclusion Safe sex education should be implemented throughout the health management of HIV/AIDS patients and their spouses.If possible,early ART should be carried out to reduce the risk of HIV transmission between married couples.

Impact of hepatitis B virus infection on efficacy of combined antiretroviral therapy in patients with acquired immunodeficiency syndrome / 中华传染病杂志

Objective To investigate the influence of hepatitis B virus (HBV) infection on efficacy of combined antiretroviral therapy (cART) in patients with acquired immunodeficiency syndrome (AIDS).Methods Seventy-eight subjects with human immunodeficiency virus (HIV)/HBV co-infection and 156 subjects with HIV mono-infection were included.CD4+ T cell count,HIV viral load,HBV-markers and liver functions were routinely tested.The differences in survival rate,as well as immunological and virological responses between the two groups (HIV/HBV co-infection group and HIV mono-infection group) during cART were compared.Categorical data were compared by Chisquare test,measurement data were compared by t test,and measurement data with abnormal distribution were compared by Mann-Whitney test.Results At month 42 of cART,HIV RNA levels and CD4+ T cell counts of the two groups were comparable.However,at month 48,54 and 60 of cART,the immunological and virological responses of HIV/HBV co-infection group were less favorable than those of HIV mono-infection group.At each time point of month 12,24,36,48 and 60 of cART,3 out of 13 subjects with HIV/HBV co-infection maintained hepatitis B e antigen (HBeAg)loss; the HBeAg seroconversion rates were 32.1％ (9/28),50.0％ (14/28),53.6％ (15/28),64.3％ (18/28) and 71.4％ (20/28),respectively (x2 =10.189,P=0.037) ; HBV DNA negative rates were 95.1％ (39/41),82.9％ (34/41),68.3％ (28/41),43.9％ (18/41) and 43.9％ (18/41),respectively (x2 =29.982,P=0.000); liver dysfunction rate was 32.1 ％ (25/78),51.4％ (38/74),33.8％ (22/65),47.9％ (23/48) and 6.7％ (3/45),respectively (x2 =28.053,P=0.000).Mortalities in HIV/HBV co-infected and HIV mono-infected individuals were 24.4％ (19/78) and 5.1 ％ (8/156),respectively (x2 =18.841,P＜0.01).Sixteen out of the 19 deaths (84.2 ％) in HIV/ HBV co-infected subjects died of end stage liver diseases.Conclusions HBV co-infection diminishes the long term efficacy of cART.End stage liver diseases are the primary cause of death in HIV/HBV co-infected subjects during cART.

Studies of interleukin-28B gene polymorphisms in human immunodeficiency virus/hepatitis C virus infected Han patients in Hubei Province / 中华传染病杂志

ObjectiveTo understand the distribution of interleukin(IL)-28B gene polymorphisms in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected Han patients in Hubei Province.MethodsOne hundred Han patients with anti-HIV and anti-HCV double positive in Hubei Province were enrolled.HCV RNA level was detected by fluorescence quantitative polymerase chain reaction (PCR) and genotyping of IL-28B gene was pcrformed by sequencing.The data were analyzed by chi square test.ResultsThe proportion of IL-28B C/C genotype was 95.0 ％ in target population,arnong which 21.1％ (20/95) were HCV RNA negative.While there were no HCV RNA negative cases in C/T and T/T genotypes (0/5;x2 =1.043,P=0.588).ConclusionAmong HIV/HCV coinfccted Han patients in Hubei Province,the proportion of IL-28B C/C genotype is high.

Epidemiological characteristics of patients acquiring human immunodeflciency virus infection through sexual contact or blood transfusion / 中华传染病杂志

Objective To compare the epidemiological characteristics of patients acquiring human immunodeficiency virus (HIV) infection through sexual contact or blood transfusion. Methods A total of 679 HIV/AIDS patients were recruited. The informed consents were obtained from all participants. CD4+T lymphocyte count, anti-syphilis and HIV-1 subtype of recruited cases were tested, and anti-HIV of their spouses was tested.Human papillomavirus (HPV) genotyping was performed in female patients. The data were analyzed by t test and chi square test. ResultsThere were 348 cases in heterosexual transmission group (STG) and 331 in blood transfusion group (BTG). HIV-1 genotyping was performed in 120 STG cases and 90％ (108/120) were mixed genotypes; HIV1 genotypes in 107 BTG cases were all subtype B'. Curable sexual transmitted diseases (STDs) in STG and BTG were identified in 293 and 156 cases, respectively. The incidence of cSTDs were 34.1％ (100/293) in STG and 5.8％ (9/156) in BTG (x2 =44. 541, P＜0.01). Forty-three females in STG and 138 females in BTG were tested for HPV, and the HPV infection rates ware 67.4％ (29/43) and 26.8％ (37/138), respectively (x2 =23. 361, P＜0.01). Among 348 cases in STG and 331 cases in BTG, the rate of HIV transmission between couples was 48.9％ (170/348) and 23.3％ (77/331),respectively (x2 =47. 991, P＜0. 05). ConclusionsThe diagnosis of HIV infection acquired through sexual contact is usually late, which results in a relatively high risk for viral transmission. Furthermore, the co-infection of HIV and HPV or other sex transmission disease is common.

Spectrum and survival of cancer in cohort of HIV-infected population / 肿瘤研究与临床

Objection To investigate the spectrum and survival status of HIV positive cancer in HuBei province, China. Methods HIV positive cancer patients were added up and followed up who had registered in Zhongnan Hospital between January 2004 and June 2009. The prognostic features were determined for HIV patients with cancer. Results The average age of HIV positive and HIV negative group who suffered with malignant neoplasm were 42.5±8.8 years and 55.1±13.7 years respectively (P ＜0.05), mean CD4 counts were (220.9±142.3)/μl and (554.4±174.3)/μl, respectively (P ＜0.05), the types of common cancer were NHL, cervical cancer, liver cancer and lung cancer, colon cancer, breast cancer, respectively. Anticancer and/or ART treatment were the important positive prognostic factors. Additional factors such as age and CD4 count were associated with survival of cancer patients with HIV infection. Conclusion Mean age of HIV positive cancer patients is about 42 years old. NHL, cervical cancer and liver cancer are HIV associated malignant tumor. ART and anticancer can effectively prolong the survival of HIV infected patients with cancer.

Analysis on diagnostic occasion for HIV positive pregnant women / 中华疾病控制杂志

Objective To understand the existing deficiency in the work of preventing HIV transmission from mother to child.Methods The diagnostic occasions of 179 HIV positive pregnant women(189 pregnant times)in some counties in Hubei,Shanxi,and Hebei were collected,including measures for prevention.The reasons for the missing prevention for HIV positive pregnant women were analyzed.Results The HIV positive rate in pregnant women in the counties enrolled in this study was 0.26‰.Percentage of HIV pregnant women who were found in antepartum,intrapartum,and postpartum were 66.7%,7.4%,and 25.9% respectively.Some HIV positive pregnant women missed the prevention in all of three periods.In HIV positive pregnant women found antepartum,some rejected prevention.The missing reason for HIV positive pregnant women found intrapartum failed to get ARV drug.HIV positive pregnant women found postpartum missed the prevention.Conclusions There is some progress in the work of preventing HIV transmission from mother to child in China,but some HIV positive pregnant women can not be detected in time,and the percentage of HIV pregnant women who have received comprehensive measures is low.The work of PMTCT therefore needs to be improved.