ABSTRACT
Objective To evaluate the HIV/AIDS epidemic in Zhejiang Province through Estimation and Projection Package (EPP)-Spectrum model and to provide scientific evidence for the control practice of AIDS. Methods Consecutive behavior surveillance data, HIV prevalence, the number of HIV/AIDS patients under highly active anti-retroviral therapy (HAART) and social-demographic data from population census in Zhejiang Province were collected and input into the optimized EPP-Spectrum model. HIV epidemic curves of different sub-population were generated for comprehensive estimation of HIV/AIDS prevalence, people living with HIV/AIDS (PLWHA), the number of new HIV infection and the death toll in Zhejiang Province. Results It was estimated that by the end of 2016, the HIV infection rate in the whole population was 0.05% (95%CI: 0.04%-0.06%) . There were a total of 27 542 (95%CI: 24 564-31 187) PLWHA in Zhejiang Province, with 47.55% of which by homosexual transmission, 24.43% by commercial heterosexual transmission and 25.29% by non-commercial heterosexual (including spouses) transmission. There were 1 714 (95%CI: 1 340-2 194) new infections in 2016 and this number fluctuated slightly from 2014 to 2016. Most of the new HIV/AIDS were infected by sexual transmission, with homosexual transmission accounted for 46.94%; the proportion of non-commercial sex transmission (including spouses) increased year by year. A total of 642 (95%CI: 476-896) PLWHA died in 2016, and the number of death increased slowly and remained stable each year. A total of The proportion of PLWHA being diagnosed and under HAART increased during 2012-2016. It was estimated that 57.70% of PLWHA had been controlled. Conclusion The HIV/AIDS epidemic in Zhejiang Province from 1995 to 2016 increased steadily and was at low prevalence. The main transmission routes were homosexual behaviors, commercialand non-commercial heterosexual behaviors.
ABSTRACT
Objective To analyze the association between baseline level of CD4+T and the therapeutic effects of highly active antiretroviral therapy (HAART) for MSM HIV/AIDS in Hangzhou City. Methods We recruited MSM HIV/AIDS who initiated HAART from July 1st 2014 to June 30th 2016 into the study in Hangzhou City. MSM HAART patients whose baseline CD4+T≥500 copies/μL was set as observation group, and baseline CD4+T<500 copies/μL was set as control group. Patients were tested CD4 count and viral load regularly. We compared HAART effects of observation group and control group. Results We recruited 1206 MSM patients with access to HAART in our study in Hangzhou City. And 1026 patients were set in control group, and 180 patients were set in observation group. In the 12th month, the rates of two groups' patients with CD4 successfully recovered (reached 719 cells/μL) were 12.50% and 39.13%. In the 18th month, the rates were 13.75% and 38.71%. The median time of patients with CD4 first successfully recovered to 719 cells/μL was 7.2 month s in observation group, while the median time of control group was 20.4 months, which was longer than observation group (P<0.05) . A total of 375 patients were tested viral load, and the successful suppression rate of viral load was 97.33%. The rates of observation and control group were 96.34% and 97.50% (P>0.05) . Conclusion The rates of viral successful suppression were similar between baseline CD4 counts ≥500 cells/μL group and<500 cells/μL group among MSM HAART patients. Recovery time in baseline CD4 counts ≥500 cells/μL group was shorter than baseline CD4 counts<500 cells/μL group.
ABSTRACT
<p><b>OBJECTIVE</b>To survey the prevalence of drug resistant HIV in Zhejiang province in 2009-2011.</p><p><b>METHODS</b>WHO truncated sequential sampling technique was adopted annually by using 63, 62 and 57 samples of newly diagnosed as HIV positive and aged 16-25 years in Hangzhou, Ningbo and Wenzhou from 2009 to 2011, respectively. RNA was prepared and HIV pol region was amplified by RT-PCR and nested PCR. Pol genetic mutation associated with drug resistance was analyzed.</p><p><b>RESULTS</b>The success rates for sequence acquisition of the survey were 82.5% (52/63), 95.2% (59/62) and 94.7% (54/57) from year 2009 to 2011, respectively, and the main subtype was CRF01_AE (68.5% (37/54)-71.2% (37/52)). A total of 4 surveillance drug-resistance mutation (SDRMs), 2 SDRMs and 2 SDRMs were found by analyzing the 47 sequences each year, sampled from year 2009 to 2010, respectively, indicating that the prevalence of drug resistant HIV stains was moderate in 2009, and low for the next two years (2010-2011). A total of 8 individuals with drug resistant HIV stains found in this study were all infected by sexual transmission, especially in homosexual transmission (6 cases), and the main subtype was CRF01_AE (7 cases). SDRMs for protease inhibitor (PI), nucleotide HIV-reverse transcriptase inhibitor (NRTI) and non-NRTI (NNRTI) (L90M, T215S and Y188L) were all found in one case.</p><p><b>CONCLUSION</b>The prevalence of drug resistant HIV stains in major areas with AIDS epidemic in Zhejiang province was low in 2009-2011.</p>