ABSTRACT
Objective: To analyze the dynamic changes and influencing factors of HIV-1 DNA load in HIV-1 infected individuals under antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture, Yunnan province, and provide information support for the clinical use of HIV-1 DNA quantitative detection. Methods: The HIV infection cases in recent infection cohort from Dehong Center for Disease Control and Prevention during 2009-2018 were selected as study subjects. The dynamic curve of HIV-1 DNA load varrying with time was generated and logistic regression analysis was conducted to identify the risk factors for HIV-1 load in the recent follow up after ART and statistical analysis was performed by using SPSS 17.0. Results: Among the 113 HIV infection cases detected from the recent infection cohort, the recent HIV infection rate were 49.6%(56/113) males, sexual transmission cases and drug injection transmission cases accounted for 53.1% (60/113), 80.5% (91/113) and 19.5% (22/113), respectively. The dynamic changes curve showed that HIV-1 DNA load was relatively high (>800 copies /106 PBMCs) before ART, and droped rapidly (<400 copies /106 PBMCs) after ART for 1 year. However, HIV-1 DNA load decreased insignificantly from the second year of ART, and remained to be 269 copies/106 PBMCs after ART for 6 years. Univariable logistic regression analysis indicated that OR (95%CI) of CD8, CD4/CD8 and HIV-1 DNA load were 1.00 (1.00-1.00), 0.30 (0.09-1.05) and 1.01 (1.00-1.01), respectively. Multivariable logistic regression analysis showed that OR value of HIV-1 DNA load base was 1.00 (1.00-1.01). Conclusions: HIV-1 DNA load decreased significantly in the first year of ART, then remained stable for years. HIV-1 DNA load base was the key factor associated with the decrease of HIV-1 DNA load, the lower the HIV-1 DNA load base, the lower HIV-1 DNA load. Therefore, earlier ART can contribute to the decrease of HIV-1 DNA load.
Subject(s)
Humans , Male , China/epidemiology , DNA/therapeutic use , HIV Infections/drug therapy , HIV Seropositivity , HIV-1/genetics , Viral LoadABSTRACT
ObjectiveTo understand the infection of AIDS， syphilis， and gonorrhea in men who have sex with men （MSM）， and the factors influencing the acceptance of gonorrhea testing in Dehong Dai Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunnan Province. MethodsAcross-sectional survey was conducted to describe and analyze the acceptance of AIDS， syphilis， and gonorrhea testing among MSM tracked in Dehong Prefecture in 2018. ResultsA total of 385 MSM were included in the analysis， with a 100.0% HIV and syphilis testing rate. The HIV antibody positivity rate was 10.6% （41/385） and the positivity rate of syphilis antibody was 14.8%（57/385）. Only 30.4% of the subjects were willing to test for gonorrhea， and 13.7%（16/117）of them were test positive. Further multifactorial analysis revealed that local MSM and syphilis co-infected individuals were more likely to be tested for gonorrhea （aOR=2.48， 95%CI=1.33-4.65， P=0.004； aOR=2.59， 95%CI=1.43-4.71， P=0.002）. ConclusionThe positive rates of AIDS， syphilis and gonorrhea in MSM population in Dehong Prefecture are relatively high. Integrated interventions of STD/AIDS and gonorrhoea detection should be strengthened.
ABSTRACT
ObjectiveTo understand the infection of AIDS， syphilis， and gonorrhea in men who have sex with men （MSM）， and the factors influencing the acceptance of gonorrhea testing in Dehong Dai Jingpo Autonomous Prefecture （Dehong Prefecture）， Yunnan Province. MethodsAcross-sectional survey was conducted to describe and analyze the acceptance of AIDS， syphilis， and gonorrhea testing among MSM tracked in Dehong Prefecture in 2018. ResultsA total of 385 MSM were included in the analysis， with a 100.0% HIV and syphilis testing rate. The HIV antibody positivity rate was 10.6% （41/385） and the positivity rate of syphilis antibody was 14.8%（57/385）. Only 30.4% of the subjects were willing to test for gonorrhea， and 13.7%（16/117）of them were test positive. Further multifactorial analysis revealed that local MSM and syphilis co-infected individuals were more likely to be tested for gonorrhea （aOR=2.48， 95%CI=1.33-4.65， P=0.004； aOR=2.59， 95%CI=1.43-4.71， P=0.002）. ConclusionThe positive rates of AIDS， syphilis and gonorrhea in MSM population in Dehong Prefecture are relatively high. Integrated interventions of STD/AIDS and gonorrhoea detection should be strengthened.
ABSTRACT
The liver is the most important digestive organ in the body. Several studies have explored liver biology and diseases related to the liver. However, most of these studies have only explored liver development, mechanism of liver regeneration and pathophysiology of liver diseases mainly based on two-dimensional (2D) cell lines and animal models.Traditional 2D cell lines do not represent the complex three-dimensional tissue architecture whereas animal models are limited by inter-species differences. These shortcomings limit understanding of liver biology and diseases. Liver organoid technology is effective in elucidating structural and physiological characteristics and basic tissue-level functions of liver tissue. In this review, formation strategies and a wide range of applications in biomedicine of liver organoid are summarized. Liver organoids are derived from single type cell culture, such as induced pluripotent stem cells (iPSCs), adult stem cells, primary hepatocytes, and primary cholangiocytes and multi-type cells co-culture, such as iPSC-derived hepatic endoderm cells co-cultured with mesenchymal stem cells and umbilical cord-derived endothelial cells. In vitro studies report that liver organoids are a promising model for regenerative medicine, organogenesis, liver regeneration, disease modelling, drug screening and personalized treatment. Liver organoids are a promising in vitro model for basic research and for development of clinical therapeutic interventions for hepatopathy.
ABSTRACT
The liver is the most important digestive organ in the body. Several studies have explored liver biology and diseases related to the liver. However, most of these studies have only explored liver development, mechanism of liver regeneration and pathophysiology of liver diseases mainly based on two-dimensional (2D) cell lines and animal models.Traditional 2D cell lines do not represent the complex three-dimensional tissue architecture whereas animal models are limited by inter-species differences. These shortcomings limit understanding of liver biology and diseases. Liver organoid technology is effective in elucidating structural and physiological characteristics and basic tissue-level functions of liver tissue. In this review, formation strategies and a wide range of applications in biomedicine of liver organoid are summarized. Liver organoids are derived from single type cell culture, such as induced pluripotent stem cells (iPSCs), adult stem cells, primary hepatocytes, and primary cholangiocytes and multi-type cells co-culture, such as iPSC-derived hepatic endoderm cells co-cultured with mesenchymal stem cells and umbilical cord-derived endothelial cells. In vitro studies report that liver organoids are a promising model for regenerative medicine, organogenesis, liver regeneration, disease modelling, drug screening and personalized treatment. Liver organoids are a promising in vitro model for basic research and for development of clinical therapeutic interventions for hepatopathy.
ABSTRACT
The emergence of regular short repetitive palindromic sequence clusters (CRISPR) and CRISPR- associated proteins 9 (Cas9) gene editing technology has greatly promoted the wide application of genetically modified pigs. Efficient single guide RNA (sgRNA) is the key to the success of gene editing using CRISPR/Cas9 technology. For large animals with a long reproductive cycle, such as pigs, it is necessary to screen out efficient sgRNA
Subject(s)
Animals , CRISPR-Cas Systems/genetics , Clustered Regularly Interspaced Short Palindromic Repeats/genetics , Gene Editing , /genetics , SwineABSTRACT
Objective To investigate the accessibility of HIV-related public health services among cross-border couples living in Dehong Prefecture and age differences. Methods A cross-sectional survey was conducted among cross-border couples in Dehong Prefecture from January 2017 to July 2019. Results In total, 32 182 participants were included. The proportion of people who had received HIV testing services, HIV-related intervention services in past year, care and help in the past year, and participated in new rural cooperative medical services (NCMS) were 57.8%, 92.7%, 6.5% and 94.5%, respectively; and the latter three services were significantly different across age groups (P<0.001). In multivariable Logistic regression model, variables significantly associated with having ever received HIV testing services older age (51-85 years: OR=0.71, 95% CI: 0.63-0.81), women (OR=1.14, 95% CI:1.03-1.25), county/city (Longchuan: OR=6.30, 95% CI: 5.72-6.93; Lianghe: OR=1.27, 95% CI: 1.11-1.44; Yingjiang: OR=0.88, 95% CI: 0.82-0.94), Dai ethnic minority (OR=1.60, 95% CI: 1.50-1.72), marriage registration (marriage registration for border inhabitants: OR=0.60, 95% CI: 0.56-0.65; non-registration: OR=0.66, 95% CI: 0.62-0.70), years of marriage (4-5 years: OR=1.21, 95% CI: 1.12-1.31; 6-60 years: OR=1.30, 95%CI:1.22-1.39), having not received care and help in the past year (OR=0.64, 95% CI: 0.58-0.71) and having not participated in NCMS (OR=0.58, 95% CI: 0.52-0.65). Conclusions The accessibility to HIV-related public health services are relatively high among cross-border couples in Dehong Prefecture. However, the relatively low proportion of receiving AIDS testing services, particularly among certain groups and counties/cities, need to be strengthened.
ABSTRACT
Objective To understand the prevalence and epidemiological characteristics of hepatitis C virus (HCV) co-infection among newly reported HIV-infected patients from 2016 to 2017 in Dehong Prefecture of Yunnan Province. Methods A cross-sectional survey was conducted to detect HCV antibodies in 2 196 newly reported HIV-infected persons in Dehong Prefecture, Yunnan Province, from 2016 to 2017. Results A total of 694 cases(31.6%) were detected antibodies against HCV during HIV-infected persents. The prevalence of HCV co-infection among newly reported HIV-infected patients in Chinese and Burmese was 14.4% (112/780) and 41.1% (582/1 416), respectively. Moreover, the prevalence of HCV co-infection was higher in male, ethnic minorities such as Dai and Jingpo minority, primary school and below and farmers in both Chinese and Burmese. Multivariate Logistic regression model showed that HCV infection was associated with male, Dai minority, HIV infection by injecting drug and famers among Chinese and Burmese reported HIV-infected patients. Conclusions The prevalence of HCV co-infection was high among newly reported in Dehong Prefecture of Yunnan Province. Meanwhile, the epidemiological characteristics of HIV/HCV co-infections in Chinese and Burmese are different, thus different prevention and control measures are needed for patients of different nationalities.
ABSTRACT
Objective To understand the prevalence of HIV infection and its influencing factors in the premarital physical examination population in Dehong Prefecture, Yunnan Province, 2017. Methods The data of people receiving premarital medical examination was collected, the demographic characteristics was described and the related factors was analyzed by Logistic regression. Results There were 21 875 participants receiving premarital medical examination in Dehong. 98(0.45%) participants were confirmed positive for HIV and male infection rate was 0.47% (52/10 955) and female was 0.42% (46/10 920). Among the 98 patients, 20 patients were infected in the first time, and main route was sexual transmission accounting for 81.63% (80/98). Logistic multivariate regression analysis showed that age, ethnicity and drug use were the influencing factors for premarital couples infecting HIV. The risk of HIV infection in 31-40 and 41-50 years old group was higher than the people under 25 years old group(OR=3.78, 95% CI：1.81-7.89, P<0.001；OR=3.95, 95% CI：1.72-9.08, P=0.001). The infection risk of Dai and Jingpo ethnic group was higher than that of the Han ethnic(OR=1.86, 95% CI：1.06-3.29, P=0.031；OR=3.25, 95% CI：1.81-5.84, P<0.001). The risk of infection among drug users was much higher than non-drug users (OR=926.76, 95% CI：271.65-3 161.71, P<0.001). Conclusion Age, ethnicity, and drug use are influencing factors of HIV infection among premarital couples. Targeted measures need to be taken against risk factors. HIV infection is mainly transmitted by sexual transmission. It can be effectively detected and controlled through premarital medical examination.
ABSTRACT
As pigs are similar to humans in anatomy, physiology and pathology, nutrition metabolism and disease characteristics, genetically modified pigs are already used for the studies of disease mechanism, pathology and toxicology and the evaluation of drugs. But the production of large modified animals is difficult, cumbersome, time-consuming and costly. With the breakthrough of gene editing technology, clustered regularly interspersed short palindromic repeat (CRISPR)/CRISPR-associated 9( Cas9)(CRISPR/Cas9) technology has greatly improved the mutation efficiency, reduced the cost and simplified the steps, and promoted the widespread application of genetically modified pigs. In this paper, the production methods of genetically modified pigs and the research progress of genetically modified pigs by CRISPR/Cas9 in the medical field were reviewed.
ABSTRACT
<p><b>BACKGROUND</b>Nonlinguistic cognitive impairment has become an important issue for aphasic patients, but currently there are few neuropsychological cognitive assessment tests for it. To get more information on cognitive impairment of aphasic patients, this study aimed to develop a new cognitive assessment test battery for aphasic patients, the Non-language-based Cognitive Assessment (NLCA), and evaluate its utility in Chinese-speaking patients with aphasia.</p><p><b>METHODS</b>The NLCA consists of five nonverbal tests, which could assess five nonlinguistic cognitive domains such as visuospatial functions, attention test, memory, reasoning, and executive functions of aphasic patients. All tests are modified from the nonverbal items of the current existed tests with some changes to the characteristics of Chinese culture. The NLCA was tested in 157 participants (including 57 aphasic patients, 50 mild cognitive impairment (MCI) patients, and 50 normal controls), and was compared with other well-established relative neuropsychological tests on the reliability, validity, and utility.</p><p><b>RESULTS</b>The NLCA was fully applicable in the MCI patients and the normal controls, almost working in the aphasic patients (57/62 patients, 91.9%). The NLCA scores were 66.70 ± 6.30, 48.67 ± 15.04, and 77.58 ± 2.56 for the MCI group, the aphasic group, and the control group, respectively , and a significant difference was found among three groups (F = 118.446, P < 0.001). The Cronbach's alpha of the NLCA as an index of internal consistency was 0.805, and the test-retest and interrater reliability was adequate (r=0.977 and r= 0.970, respectively). The correlations of the cognitive subtests and their validation instruments were between 0.540 and 0.670 (all P < 0.05). Spearman's correlation analysis indicated that the coefficient of internal consistency of each subtest itself was higher than other subtests. When choosing the Montreal Cognitive Assessment score of <26 as the diagnostic criteria of cognitive impairment, the area under the curve for all participants in the control and MCI groups was 0.942 (95% confidence interval: 0.895-0.989), and an optimal cutoff point of 75.00 seemed to provide the best balance between sensitivity and specificity. Age (r = -0.406, P < 0.001) was the main influence factor for the NLCA.</p><p><b>CONCLUSIONS</b>The NLCA could efficiently differentiate the cognitive impairment patients from the normal controls and is a reliable and valid cognitive assessment test battery to specially find nonlinguistic cognitive function for aphasic patients.</p>
ABSTRACT
In order to enhance the anticoagulant properties of decellularized biological materials as scaffolds for tissue engineering research via heparinized process, the decellularized porcine liver scaffolds were respectively immobilized with heparin through layer-by-layer self-assembly technique (LBL), multi-point attachment (MPA) or end-point attachment (EPA). The effects of heparinization and anticoagulant ability were tested. The results showed that the three different scaffolds had different contents of heparin. All the three kinds of heparinized scaffolds gained better performance of anticoagulant than that of the control scaffold. The thrombin time (TT), prothrombin time (PT) and activated partial thromboplastin time (APTT) of EPA scaffold group were longest in all the groups, and all the three times exceeded the measurement limit of the instrument. In addition, EPA scaffolds group showed the shortest prepared time, the slowest speed for heparin release and the longest recalcification time among all the groups. The decellularized biological materials for tissue engineering acquire the best effect of anticoagulant ability in vitro via EPA heparinized technique.
Subject(s)
Animals , Anticoagulants , Chemistry , Biocompatible Materials , Chemistry , Heparin , Chemistry , Liver , Swine , Tissue Engineering , Tissue ScaffoldsABSTRACT
<p><b>BACKGROUND</b>CD4 count is used to determine antiretroviral therapy (ART) eligibility. In China, flow cytometers are mostly located in urban areas with limited access by patients residing in remote areas. In an attempt to address this issue, we conducted a study to validate the performance of Alere PIMA point-of-care CD4 analyzer.</p><p><b>METHODS</b>Venous and finger-prick blood specimens were collected from HIV-positive participants from two voluntary counseling and testing sites in Yunnan Province. Both venous and finger-prick blood specimens were tested with the PIMA analyzer. Venous blood specimens tested with the Becton Dickinson FACSCalibur were used as a reference.</p><p><b>RESULTS</b>Venous specimens from 396 and finger-prick specimens from 387 persons were available for analysis. CD4 counts by PIMA correlated well with those from FACSCalibur with an R2 of 0.91 for venous blood and 0.81 for finger-prick blood. Compared to FACSCalibur, the PIMA analyzer yielded lower counts with a mean bias of - 47.0 cells/μl (limit of agreement, [LOA]: -204-110 cells/μl) for venous blood and -71.0 cells/μl (LOA: -295-153 cells/μl) for finger-prick blood. For a CD4 threshold of 350 cells/μl, the positive predictive value (PPV) of PIMA was 84.2% and 75.7% and the negative predictive value (NPV) was 97.6% and 95.8% for venous and finger-prick blood, respectively. For an ART threshold of 500 cells/μl, the corresponding PPV was 90.3% and 84.0% and NPV was 94.3% and 93.4%, respectively.</p><p><b>CONCLUSIONS</b>CD4 counting using venous blood with PIMA analyzers is a feasible alternative to a large flow cytometer to determine ART eligibility.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Biological Assay , Methods , Blood Specimen Collection , CD4 Lymphocyte Count , Methods , China , HIV Infections , Diagnosis , Sensitivity and SpecificityABSTRACT
<p><b>OBJECTIVE</b>To obtain information on HIV disease progression through western blot (WB) band profile.</p><p><b>METHODS</b>1466 available serum samples of newly reported HIV/AIDS cases, confirmed by WB from Dehong prefecture of Yunnan province in 2011, were tested, using the BED HIV Incidence Capture Enzyme Immunoassay (BED-CEIA) and Limiting Antigen Avidity Enzyme Immunoassay (LAg-Avidity EIA), respectively. Differences of WB band profiled between recent infections and established infections were then compared.</p><p><b>RESULTS</b>Infections defined as 'recent' showed lower mean antibody intensities to p17, p24, p31, gp41, p51, p55, p66, gp120 and gp160 in WB when compared to those established infections with statistical difference(P < 0.05).</p><p><b>CONCLUSION</b>These WB band profiles which were considered as 'recent' infections would include factors as:lack of antibody reactivity to gp41 antigen, with intensity scores of all bands lower than 13, and those intensity scores of antibody to env protein lower than 5 or to pol protein lower than 4.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Acquired Immunodeficiency Syndrome , Blood , Diagnosis , Epidemiology , Blotting, Western , China , HIV Seropositivity , HIV-1 , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To study the early diagnosis, treatment and Prognosis of pyriform sinus perforation.</p><p><b>METHODS</b>To study the clinical feature about 15 cases of pyriform sinus perforation, Most of the 15 cases with pyriform sinus perforation were associated with pharyngeal pain or fever. contrast x-ray studies and CT scan were used to confirm the perforation. conservative treatment in 9 cases and surgical intervention in 6 cases. and review relevant literature.</p><p><b>RESULTS</b>Of all 15 cases, 9 cases with wild symptoms for conservative treatment, 6 cases with severe symptoms and complications were treated surgically. All achieved better clinical efficacy, By relevant examination, the perforation were healed within 2 - 4 weeks and none had re-perforation for 1 - 30 months follow-up.</p><p><b>CONCLUSIONS</b>Pyriform sinus perforation with wild symptoms and within 12 hours can be treated conservatively. Large perforation (> 2 cm) last more than 12 hours or any complications require exploration, operation repair if possible and adequate drainage. early diagnosis and effective treatment can reduce the incidence of complications and improve the survival rate of patients.</p>
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Early Diagnosis , Pharyngeal Diseases , Diagnosis , Therapeutics , Pyriform Sinus , PathologyABSTRACT
Objective To investigate the distribution of HIV-1 subtypes in Dehong prefecture,Ymnan province,in 2011.Methods 300 HIV-1 positive plasma samples were collected from Jan.2011 to May 2011 in Dehong prefecture.HIV-1 gag genes and env genes were amplified by nestedpolymerase chain reaction (PCR) from viral RNA,After sequencing,the HIV-1 subtypes were determined by phylogenetic analysis.Results Based on the phylogenetic trees of gag gene and env gene fragments,a total of 222 samples were genotyped.Subtype C was the predominant strain in Dehong (43.2％,96/222),followed by unique recombinant forms (URFs,27.0％,60/222),CRF01 _AE ( 21.2％,47/222 ),C R F08_BC ( 5.0％,11/222 ),B,( 2.3％,5/222 ) and CRF07 BC ( 1.4％,3/222).Subtype C strains were predominant in both heterosexually transmitted population and intravenous drug users (IDUs),but different subtype distribution patterns were found in these two populations.All 6 genotypes including subtype C (40.7％,70/172),CRF01_AE (25.0％,43/172),and URFs (25.0％,43/172 ) found in this area among hcterosexually transmitted population,which showed the diversity of genotypes in this population.Except subtype B' and CRF07_BC,the other 3 subtypes and URFs were detected among IDUs,mainly including subtype C (54.8％,23/42) and U R Fs (38.1％,16/42),vhich shoved the concentration trend of genotypes distribution among IDUs.The proportion of URFs increased significantly in this area,including the new BC recombinants (41.7％,25/60) and CRF01_AE relative URFs (58.3％,35/60).However,the distributions of these two URFs among heterosexually transmitted population and IDUs showed no statistical significance.Conclusion The distribution of HIV-1 strains prevailing in Dehong prefecture was diversity,including 5 subtypes and a variety of URFs,of which subtype C was the predominant strain.The distribution patterns of subtype were different among different populations.
ABSTRACT
Objective To explore the determinants and changes ofCD4+ T cell counts among antiretroviral treatnent-naive HIV/AIDS patients in Dchong prefecture, Yunnan province. Methods A retrospective cohort analysis was conducted on HIV-infected local residents, being reported during 1989 through May 2010, in Dehong prefecture. The patients had received at least two CD4 + T cell counting tests before receiving the antiretroviral treatment (ART). Difference between the first and the last CD4 + T cell counts was calculated and described. Logistic regression analysis was conducted to examine the determinants of significant depletion of CD4 + T cell counts among them. Results A total of 4487 HIV/AIDS patients were included in the study. The change of CD4 +T cell counts between the first and the last CD4 + T cell count tests had a median of-2.0 cells/μ l in month (IQR: -8.2-3.6) and was significantly associated with socio-demographic characteristics, HIV transmission mode,the first or baseline CD4+ T cell counts and the time interval between the first and the last CD4 + T cell counting tests etc. About 60.0％ (2693/4487) of the HIV/AIDS patients had deletions of CD4 + T cell counts, and 31.2％ (1400/4487) had significant ( ≥ 30％ ) deletions of CD4 + T cell counts. Results from the multiple logistic regression analysis indicated that age, ethnicity,marital status, HIV transmission mode, the first CD4+ T cell counts and the interval between the first and the last CD4+ T cell counting tests were significantly associated with the significant depletion of CD4 + T cell counts. Conclusion The changing rate of CD4 + T cell count among ART-naive local HIV-infected patients in Dehong prefecture, Yunnan province was relatively slow. However,substantial proportion of them showed significant decreases of CD4 + T cell counts, which was determined by many factors. More efforts were needed to systematically and consistently follow-up those HIV-infected patients and measure their CD4+ T cell counts in China, in order to instantaneously monitor the disease progression,and the initiation of ART, if necessary.
ABSTRACT
Objective To determine the adherence to and its determinants of methadone maintenance treatment (MMT) among heroin addicts in Dehong prefecture in Yunnan province from 2005 to 2009. Methods A dynamic cohort analysis was conducted with the time of treatment initiation as the time of cohort entry, to calculate the proportion of adhering to the treatment at different time points after initiation of the treatment, and to study the determinants of adherence.Results A total of 3758 had been treated. Among them, 95.8% were males, 75.8% aged between 20-39 years, 90.4% were peasants or unemployed, 57.0% were ethnic minorities, 35.0% were single and 55.5% were married with spouses, 43.9% were illiterate or educated at most primary school. The age of first using drugs averaged at 23.93 years. About 96.3% of the study subjects had used heroin and 21.7% were HIV-infected. The minimum time under MMT was less than 1 month and the maximum 61 months. The median methadone dose at first delivery was 25 ml, with the minimum 1 ml and the maximum 330 ml. By the end of the study or observation period, a total of 1798 patients had withdrawn from treatment and 1960 were still under treatment. The proportions of adherence to or still being under the treatment after 1,3,6,9, 12,24, 36,48 and 60 months treatment were 0.919,0.847,0.756, 0.690, 0.637, 0.519, 0.417, 0.360 and 0.321, respectively. Multiple regression analysis using Cox proportional hazard model indicated that withdraw from the methadone maintenance treatment was significantly associated with location of the treatment clinics, year of treatment initiation, marital status, HIV infection status, methadone dose of first delivery and the result of last urine test for heroin use. Conclusion MMT attendants in Dehong prefecture had a relatively high withdraw rate and low adherence rate. More efforts are needed to provide tailored counseling and education to MMT attendants, to provide family and community support, appropriate methadone dose at first delivery, and to better coordinate with local police department.
ABSTRACT
<p><b>OBJECTIVE</b>To explore a new method for finding more HIV/AIDS.</p><p><b>METHODS</b>In September 2009, newly reported HIV-infected individuals from May to August, 2009 in Dehong prefecture were asked to participate in a survey which requested demographic characteristics, history of high-risk behaviors and contact information of individuals with whom they had high risky contacts. People with risky contacts with HIV-infected cases (index cases) were also approached to participate in this survey and HIV testing was provided.</p><p><b>RESULTS</b>A total of 342 HIV-infected individuals were newly reported and served as index cases from May to August, 2009. Among them, 47.1% (161/342) were transmitted by regular sexual partners. Through three-round surveys, 218 contacts were traced and among them, 84.9% (185/218) were traced by regular heterosexual partners. HIV positive rate of the tested was 34.7% (60/173) in the first-round tracing and 12.5% (1/8) in the second one. Among the 560 individuals (index cases and their high-risk contacts), the proportions of having regular heterosexual partners, non-regular and non-commercial sexual partners, commercial sexual heterosexual partners and men having sex men were 87.9% (492/560), 18.9% (106/560), 22.3% (125/560) and 0.3% (1/318), respectively, while the proportion of having never used condoms when having sex with the above four types sexual partners were 73.8% (363/492), 72.6% (77/106), 63.2% (79/125) and 0.0% (0/1), respectively.</p><p><b>CONCLUSION</b>As an epidemiological method for HIV/AIDS finding, contact tracing identified a large number of HIV infectors who were traced by newly reported HIV-infected individuals.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Young Adult , Acquired Immunodeficiency Syndrome , Epidemiology , China , Epidemiology , Contact Tracing , Methods , HIV Infections , Epidemiology , Risk Factors , Surveys and QuestionnairesABSTRACT
Objective To study the HIV incidence and risk factors among sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province. Methods A cohort of sero-negative spouses of the HIV patients had been developed and followed up since November, 2005.HIV new infections and related behaviors had been investigated every six months. Results By the end of June, 2008, 790 sero-negative spouses of HIV patients had been recruited, of whom 702 were followed-up for at least one time. During the total 1202.35 person-years, 31 new HIV infections were identified, with an overall incidence of 2.58/100 preson-years. The HIV incidence rates were 2.22/100person-years in 2006, 2.95/100 person-years in 2007 and 2.74/100 person-years in 2008. Data from the Cox proportional hazard regression model indicated that those who resided in Yingjiang county [hazard ratio (HR) =4.37, 95% CI: 1.48-12.90, P=0.008] , ever using drugs (HR=3.49, 95% CI:1.09-11.18, P=0.035) , or having an HIV-infected spouse who never exposed to antiretroviraltreatment (HR=3.60, 95% CI: 1.41-9.16, P=0.007) were at higher risk for HIV infection.Conclusion Sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province had a relatively high incidence of HIV new infection during 2006-2008. More efforts should put on those people living in these areas, having a history of drug use or having an HIV-infected spouse who had never been exposed to antiretroviral treatment.