An ambispective cohort study of the natural history of HIV infection among former unsafe commercial blood and plasma donors / 中华流行病学杂志

<p><b>OBJECTIVE</b>Discussing the natural history and the influencing factors of HIV infection among former commercial blood and plasma donors engaged in unsafe blood donation practices in China.</p><p><b>METHODS</b>Using ambispective cohort study, with data obtained from ten counties (districts) from six provinces in the National AIDS Control Demonstration Area. HIV/AIDS cases were found and confirmed prior to July 24, 2006 being former commercial blood. Plasma donors were selected and data regarding infection, incidence, death, and influencing factors was collected. Analysis was performed using SPSS 12.0 statistical analysis software.</p><p><b>RESULTS</b>(1) In 7551 cases of HIV infection, there were 6533 typical progressors (86.52%, 4757 cases of AIDS), 108 rapid progressors (1.43%), 910 long-term non-progressors (12.05%) with 4865 cases progressed to AIDS (64.43%). The median incubation period for HIV progression to AIDS was nine years (95% CI:8.96-9.04). (2) According to data, from a total of 1157 AIDS cases without ARV therapy (23.78% of total AIDS cases), there were 283 confirmed AIDS-related deaths, of which the median survival time was 6 months (95% CI:4-7) and the two and three year fatality rates were 95% and 99%, respectively. (3) The duration of HIV incubation period was irrespective to gender and age at the time of HIV infection (P > 0.05). Length of survival for untreated AIDS showed correlation to gender (P < 0.05) but no correlation with culture, marital status or age at the time of diagnosis of AIDS (P > 0.05).</p><p><b>CONCLUSION</b>Compared with the UNAIDS theory regarding slow disease progressors among adults, our study showed a longer AIDS incubation period and shorter outlook for untreated survival, but a similar incubation period for other routes of HIV infection.</p>

Study on the seropositive prevalence of human immunodeficiency virus in a village residents living in rural region of central China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the human immunodeficiency virus (HIV) prevalence of residents living in a village located in rural region of central China where the paid blood donors used to be popular.</p><p><b>METHODS</b>All residents of one village "ZY" were asked to participate in HIV serologic screening test. Those over the age of 16 and participated in HIV serologic test was followed to undergo an indoor interview a week later, to finish a questionnaire, which including information on demography, marital status, smoking and drinking habits, history of blood donation, sexual behavior and history of drug use. Names on those either died from AIDS or having HIV serologic testing before were collected from local hospitals and the Center of Disease Control and Prevention.</p><p><b>RESULTS</b>There were in total 2364 residents in 527 households in "ZY" village including 1551 residents participated in the HIV serologic screening test, and 926 completed questionnaires. A total of 115 HIV seropositive residents were found in the HIV screening. 5 had been undergone HIV screening tests before, and 24 died of AIDS. The HIV prevalence of the whole population was 9.1% (CI: 7.7% - 10.6%). There were 19.6% households had at least one member living with HIV, out of which 25% had over two HIV seropositive members. No significant difference was found between genders with respect to HIV prevalence. 40 - 50 years old group had the highest HIV prevalence, significantly differed from other age groups. The HIV prevalence among former paid blood donors was 22.4%. The proportions of getting HIV infection through routes of blood transfusion, sex and mother-to-child, were 0.9%, 9.6% and 5.2% respectively among 115 HIV seropositive residents.</p><p><b>CONCLUSION</b>Some villages in the rural regions of central China showed high HIV prevalence. Former paid blood donation was responsible for the main transmission route in these villages. However, sexual transmission and mother-to-child transmission were becoming dominant routes in general population which called for effective action be taken to contain the spread of HIV.</p>