ABSTRACT
Objective:To explore the feasibility of applying plasma with same blood group as kidney donor to ABO incompatible kidney transplantation(ABOi-KT)preconditioning of blood group O recipients with high-titer anti-A/B preformed antibody(IgM/IgG titer ≥1∶256).Methods:A total of 15 cases of blood group O ABOi-KT recipients with high-titer anti-A/B were recruited and divided into two groups of AB( n=8)and kidney donor's blood(KD, n=7)according to plasma type for plasma exchange during preconditioning phase. Clinical data of preconditioning and post-KT were recorded. Results:They received plasmapheresis(PP)(8.1±2.5)sessions in preconditioning phase, including double plasma filtration(DFPP)(4.0±1.4)sessions and plasma exchange(PE)(4.1±2.0)sessions, PP frequency was(0.8±0.1)sessions per day. No hemolysis reaction occurred during preconditioning phase. Anti-A/B titers declined as expected and fulfilled the ABOi-KT criteria(IgM/IgG titers ≤1∶8). KT was performed successfully without antibody-mediated rejection. All of them survived with normal renal function within 90 days post-KT. Levels of serum creatinine at Day 7/30/90 post-KT were(92.9±30.4), (96.2±25.9)and(103.1±28.4)μmol/L; anti-A/B IgM titers at Day 7/30/90 post-KT 1∶1-1∶32, 1∶1-1∶64 and 1∶1-1∶32; anti-A/B IgG titers at Day 7/30/90 post-KT 1∶1-1∶64, 1∶1-1∶64 and 1∶1-1∶32 respectively. No significant differences existed in count/frequency of PP sessions, levels of serum creatinine or anti-A/B titers at each observation point between AB and KD groups( P>0.05). Conclusions:Plasma with the same blood group as kidney donor is feasible for maximizing the intensity of ABOi-KT preconditioning. Favorable outcomes may be achieved through an intensified desensitization strategy on blood group O recipients with high-titer anti-A/B preformed antibody. The potential risks and long-term outcomes should be further explored.
ABSTRACT
Objective@#To evaluate the effect of the "Interner Plus-based AIDS Comprehensive Prevention Service System" among MSM in Guangzhou, during 2010-2017, using a dynamic compartmental model.@*Methods@#A dynamic compartmental model was developed to describe the HIV situation among MSM in Guangzhou. This model was parameterized on data from published literature or surveillance programs from the Guangzhou CDC. The Matlab 7.0 software was used for coding and analysis on collected data. HIV prevalence was analyzed among MSM under the status quo data and estimated the impact by the "Internet Plus" AIDS prevention services project.@*Results@#HIV prevalence would have increased to 22.75% in 2017, and the total number of new HIV infections would have been 11 038, from 2010 to 2017, using the data status quo. Under the Guangzhou "Internet Plus" AIDS prevention services project, the prevalence of HIV among MSM from 2010 to 2017 was estimated to be 8.44%, 9.68%, 10.65%, 11.34%, 11.73%, 11.83%, 11.71% and 11.43% in Guangzhou, which were similar to the surveillance data. The total number of new infections in the past 8 years under the "Internet Plus" scenario was estimated to be 4 009. The "Internet Plus" program would have prevented 7 029 (63.68%) new infections during 2010-2017 as compared to the number, status quo.@*Conclusions@#The fitting result of dynamic compartmental model seemed more reasonable, which was applicable to predict HIV epidemic among MSM in Guangzhou, suggesting that the increase of HIV prevalence had been curbed since the "Internet Plus" project which was launched in 2010, and the "Interner Plus-based AIDS Comprehensive Prevention Service System" had achieved the purpose as planned, epidemiologically.
ABSTRACT
Objective To establish a dynamic compartmental model to predict the impact of HIV testing and treatment and pre-exposure prophylaxis (PrEP) on the annual incidence of HIV infection in men who have sex with men (MSM) in China from 2018 to 2037.Methods A dynamic compartmental model was developed to describe the HIV epidemic in MSM in China.The model was parameterized using data from the literature available.We used MATLAB 7.0 software for data simulation and graphics rendering.We analyzed HIV transmission among MSM and estimated the impact of expanded HIV testing and treatment and PrEP on HIV elimination in MSM.Results Under the current policy,the number of new HIV infections would reach 770 000,the infection rate would reach 11.1％ and the incidence rate would reach 0.72/100 person years in MSM in the next 20 years.Under the 90％-90％-90％ goal,440 000 new infections (57.7％) would be reduced,the HIV infection rate would decline to 5.7％ and the incidence rate would decline to 0.24/100 person years in the next 20 years,but it is still unlikely to achieve the goal of HIV elimination.With 100％ PrEP compliance,the required PrEP coverage rates for achieving HIV elimination in the next 10,15 and 20 years would be 65％,32％ and 19％,respectively.Conclusion It is necessary to strengthen the comprehensive intervention in MSM,continue to expand HIV testing and treatment,and improve PrEP adherence and coverage to further control and eliminate the epidemic of HIV/AIDS in MSM.
ABSTRACT
Objective To establish a dynamic compartmental model to predict the impact of HIV testing and treatment and pre-exposure prophylaxis (PrEP) on the annual incidence of HIV infection in men who have sex with men (MSM) in China from 2018 to 2037.Methods A dynamic compartmental model was developed to describe the HIV epidemic in MSM in China.The model was parameterized using data from the literature available.We used MATLAB 7.0 software for data simulation and graphics rendering.We analyzed HIV transmission among MSM and estimated the impact of expanded HIV testing and treatment and PrEP on HIV elimination in MSM.Results Under the current policy,the number of new HIV infections would reach 770 000,the infection rate would reach 11.1％ and the incidence rate would reach 0.72/100 person years in MSM in the next 20 years.Under the 90％-90％-90％ goal,440 000 new infections (57.7％) would be reduced,the HIV infection rate would decline to 5.7％ and the incidence rate would decline to 0.24/100 person years in the next 20 years,but it is still unlikely to achieve the goal of HIV elimination.With 100％ PrEP compliance,the required PrEP coverage rates for achieving HIV elimination in the next 10,15 and 20 years would be 65％,32％ and 19％,respectively.Conclusion It is necessary to strengthen the comprehensive intervention in MSM,continue to expand HIV testing and treatment,and improve PrEP adherence and coverage to further control and eliminate the epidemic of HIV/AIDS in MSM.