Analysis of factors associated with the structure of the gut microbial community in HIV/AIDS patients in some areas of Henan province / 中华流行病学杂志

Objective: To investigate the related factors associated with the structure of the gut microbial community in HIV infection/AIDS cases (HIV/AIDS) in Henan province. Methods: The convenience sampling method was used to select 122 cases who were receiving Antiviral Treatment (ART) or ART-naive in Henan. Whole blood and stool specimens were collected. Genomic DNA of stool samples was extracted, and the V3-V4 hypervariable regions of the 16S rRNA gene were sequenced using Illumina NovaSeq 6000 high-throughput sequencing system. The analysis was performed mainly at the genus level, and the 30 genera with the highest abundance were selected as a measure of the gut microbial community structure. The correlation between community structure and related factors was analyzed using redundancy analysis and Envfit function. Results: 122 cases were finally completed sequencing and analysis, the average BMI was (23.62±2.78) kg/m2 and the average age was (47±13) years. Among them, male accounted for 66.39% (81/122), and heterosexual transmission route constituted the largest ratio, accounting for 51.64% (63/122). 36 cases were treatment naive (29.51%, 36/122). The top five dominant genera of the total population (122 cases) were Prevotella, Roseburia, Megamonas, Bacteroides and Faecalibacterium and the top five dominant genera of the ART population (86 cases) were Prevotella, Megamonas, Bacteroides, Roseburia and Faecalibacterium. The top five dominant genera of the ART-naive population (36 cases) appeared as Prevotella, Faecalibacterium, Roseburia, Bacteroides and Megamonas. In the total population, ART (P<0.001) was the most significant factors of community structure. Other significant factors were: duration of diagnosis (P=0.009), viral load (P=0.022) and anti-HCV (P=0.018). ART was positively correlated with Megamonas and negatively correlated with Prevotella, Roseburia and Faecalibacterium, while the other three factors of duration of diagnosis, viral load and anti-HCV were positively correlated with Prevotella, Roseburia and Faecalibacterium and negatively correlated with Megamonas. In the ART-naive population, duration of diagnosis (P=0.003) were the factors significantly associated with community structure. Duration of diagnosis was positively correlated with Roseburia, Faecalibacterium, Megamonas and Prevotella and negatively correlated with Bacteroides. Conclusion: ART and duration of diagnosis were factors significantly associated with gut microbial community structure and had a significant impact on multiple high-abundance genera.

Characteristics of Long-term Nonprogressors and Viremia Controllers Infected with HIV-1 via Contaminated Blood Donations or Transfusions Conducted 20 Years Earlier / 生物医学与环境科学（英文）

To characterize long-term nonprogressors (LTNPs) and viremia controllers (VCs), infected with HIV-1 through contaminated blood donation or transfusion between 1992 and 1996 in Henan, China. LTNPs and VCs were defined by CD4+T lymphocyte (CD4) count and viral load (VL). Of 29,294 patients infected with HIV-1 via contaminated blood donation or transfusion that had conducted for more than 20 years, 92 were LTNPs/VCs. There were 70 LTNPs (0.24%), 43 VCs (0.15%), and 48 LTNPs+VCs- (0.16%). VCs had a significantly lower CD4 nadir, compared to LTNPs and LTNPs+VCs-, and no significant differences for the highest VL and HIV-1 DNA. Cases P4 and P5 were LTNPs, while their VL reached approximately 4.3 log copies/mL. P6 was a VC, but with CD4 < 500 cells/μL constantly. Data from the LTNPs/VCs cohort provided valuable information, future research is needed.

Epidemiological survey on the hepatitis C virus and its genotyping analysis in Henan province in 2012 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and distribution of hepatitis C virus (HCV) genotypes in Henan province in 2012.</p><p><b>METHODS</b>A total of 32 203 permanent residents (1 to 74 years old) in Henan were recruited using multi-stage random samping method from March to June 2012. All participants were asked to complete a questionnaire to collect demographic information, past medical history and the exposure history of risk factors. A blood sample of 5 ml was collected at the same time. The condition of anti-HCV and HCV RNA was determined through the ELISA test and nested RT-PCR. HCV RNA positive samples were further subject to the nonstructural protein 5 region (NS5B) gene amplification and sequencing. The sequence was amplified for the phylogenetic tree and genetic analysis. The differences of the positive rate of anti-HCV and HCV RNA and the HCV genetic subtype distribution in different respondents'characteristics were analyzed.</p><p><b>RESULTS</b>Among 32 203 subjects, the overall positive rate of anti-HCV and HCV RNA were 0.48% (153/32 203) and 0.24% (78/32 203), in which men were 0.42% (65/15 634), and 0.23% (36/15 634), and women were 0.53% (88/16 569) and 0.25% (42/16 596). The differences between men and women were not statistically significant (χ(2) values were 2.26, 0.18, respectively, both P values > 0.05). The results of NS5B genotyping and molecular evolution analysis showed that there were six subtypes in the 71 HCV RNA positive samples.In those six subtypes, the proportion of genotypes 1b, 6a, 3a, 2a, 3b and 1a were 56.3% (40/71), 19.7% (14/71), 11.3% (8/71), 8.5% (6/71), 2.8% (2/71) and 1.4% (1/71), respectively. The HCV genetic subtypes of infestor were mainly present with two branches of 1b and 6a, and the two subtypes Bootstrap values were 0.95.</p><p><b>CONCLUSION</b>The prevalence of HCV infection was high in Henan. The major HCV genotypes in patients with HCV infection were 1b and 6a.</p>

A cross-sectional study on the prevalence of HIV drug resistance in patients receiving antiretroviral treatment in Shenqiu county, Henan province / 中华流行病学杂志

Objective To understand the prevalence of drug resistance in AIDS patients who had been receiving HAART in a long run,in Shenqiu county,Henan province.Methods This crosssectional study included 120 HIV infected patients who began receiving ART (antiretroviral therapy) in 2003.Viral loads and CD4 +T cells counts were measured,and In-house drug resistance test was performed in VL ＞ 1000 copies/ml patients.Results 114 cases out of 120 patients had complete viral load data.Among them,33 cases having viral loads less than 50 copies/ml,and the remaining viral loads showed an average of lg (4.09 ± 1.10) copies/ml.The average of CD4+ T cell counts was (377 ±2 1 8) cells/ml,with 64 (53.3％) cases showing their CD4+ T cell counts higher than 350 cells/ml.In 67 patients,58 of them showed genotypic resistance,and 40 cases showed reverse transcriptase inhibitors (RTIs) resistance.The ratios of nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) resistance were 53.4％ (31/58) and 67.2％ (39/58),respectively.There were no differences of drug resistance ratio in the three treatment programs.The highest drug resistance rates in NRTIs and NNRTIs were zidovudine,lamivudin,nevirapine.However,protease inhibitors (PIs) resistance variants were not found.Conclusion The prevalence of drug-resistant strains seemed to be high in Shenqiu country,Henan province.Long-term follow-up monitoring strategy should be developed to optimize the timely treatment programs.

The primary HIV drug resistance in partial region of Henan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the prevalence of primary HIV drug resistance in antiretroviral therapy (ART) areas of Henan province.</p><p><b>METHODS</b>A total of 121 drug-naive long-term infected individuals and 154 patients with newly diagnosed from January 2011 to March 2012 were recruited, the questionnaires were surveyed and whole blood were collected to analyze the CD4(+)T cell counts and viral load. In-house method for genotypic resistance test was determined in those with viral load > 1000 copies/ml samples, the differences of demographic characteristics, immunological parameters and primary drug resistance were compared between the two groups.</p><p><b>RESULTS</b>A total of 121 cases of long-term individuals who had infected (12.50 ± 3.21) years were mainly previous paid blood donors, and the age was (46.61 ± 9.32) years old. The infection route of the newly diagnosed were diversity, including blood, sexual transmission and others, the cases were 73, 73, 8, respectively, the confirmatory year was (0.91 ± 0.28) years, and average age was (22.21 ± 3.11) years old. The difference were statistically significant in the route of transmission, age and infection time from demographic analysis of the two groups (P < 0.05). The absolute M(P(25)-P(75)) counts of CD4(+)T lymphocytes of long-term group was 322 (217 - 422) cell/µl, which was lower than the newly diagnosed was 434(308 - 578) cell/µl (P < 0.05), and viral load was 4.0 (2.96 - 4.64) copies/ml, 3.77 (2.94 - 4.53) copies/ml, the difference was not significant (P > 0.05). The prevalence of primary drug resistance in long-term group and newly diagnosed was 5.79% (7/121), 9.09% (14/154), respectively, and the difference was statistically different (P < 0.05), and one PI-resistant strain was found in the newly diagnosed group.</p><p><b>CONCLUSION</b>The primary drug resistant strains in untreated patients were found in Henan province of ART areas, and there was difference in degree of resistance between long-term infected individuals and newly diagnosed.</p>

Men who have sex with men and its relationship with HIV-1 strains prevailing in the paid blood donors from Zhengzhou city, Henan / 中华流行病学杂志

Objective To clarify the genetic characteristics of human immunodeficiency virus (HIV) circulated in the population of men who have sex with men (MSM) in Zhengzhou,Henan and to analyze its relationship with HIV-1 prevailing in the paid blood donors (PBDs).Methods Thirty-one MSM who were confirmed as HIV positive individuals in 2010 together with 41 HIV-positive former PBDs were enrolled in the study.Information on related epidemiological characteristics and their plasma were collected.RT-PCR was used to amplify HIV-1 full length gag (1584 bp),pol (3147 bp) genes and partial env gene (C2V3 segment,558 bp) followed by sequencing on those subjects.Online software available at LosAlamos HIV Database was used to identify the HIV subtypes based on the findings of the sequences.Phylogenetic tree was used to identify thc possible relationship of transmission.Results Fifty-three full length gag,38 full length pol and 48 partial env (C2V3) genes were collected from 72 participants.Among the 31 HIV ( + )MSM individuals,14 CRF01_AE strains,5 CRF07BC_ strains and 12 subiype B ( 1 subtype B and 11B' ) strains were identified respectively.All of the 41 strains identified from former PBDs were infected by B' strains.The CRF01_AE strains identified in MSM showed a close relationship to those identified from both Hebei and Liaoning provinces.The CRF07 BC strains showed a close relationship with those from Shijiazhuang and Beijing cities.Among the 12 subtype B strains,8 sequences grouped into 1 cluster with 1 sequence from the former PBDs.Two sequences grouped with 02HNseq4 suggested that B' had been prevailed in the MSM population might come from the former PBDs and were closely related to the strains identified in the MSM population.Conclusion Complicated genetic background and multiple introductions of HIV in the MS population in Zhengzhou,were found.This was also the first report which noticed that the subtype B epidemic among Zhengzhou MSM was mainly originated from the B' among the former PBDs.

Follow-up study on 84 AIDS patients having received the replaced therapy program for six months in one county of Henan, China / 中华流行病学杂志

Objective To analyze the situation of AIDS patients who had received replaced therapy program in Henan province.Methods 84 AIDS patients had been enrolled into the national free first-line antiretroviral treatment for more than 5 years and would soon be replaced with another antiretroviral treatment program,were selected to a follow-up program to be carried out six months later Data on CD4+ tlymphocyte count,viral load and genotypic resistance were included in the study.Results The DDI + AZT + NVP treatment program was used by all the 84 patients at baseline.A replacement by 3TC + AZT + NVP (post first-line) in 31 patients and 3TC + TDF + LPV/r (second-line) in another 53 patients were taken place within a week.All the patients were followed for six months.Results showed that:all of the 84 patients appeared an amelioration of CD4 1 tlymphocyte count median from the baseline of 374.00 cell/μl to 406.50 cell/μl(P=0.005).Those patients who had changed to second-line treatment program also showed an improvement of CD4 + tlymphocyte count median from the baseline of 267.00 cell/μl to 365.00 cell/μl (P=0.015),while patients who were on the post first-line program with their CD4 + tlymphocyte count mean did not show significant change as compared to the baseline (P=0.158) data.All the 84 patients showed a decrease of virus load median from the baseline of 3.61 Iog10copies/ml to 0.00 log10 copies/ml (P=0.000).Both of the two types of patients who had been changed to different programs,had a lower virus load median in the end of the tollow-up period (for post first-line:P=0.007 ；for second-line:P=0.000).13 patients kept their viral load more than 1000 copies/ml,including 5 cases bore more than three thymidine analogue mutations (TAMs) a the end of the follow-up program.Another 4 patients had no resistance mutations detected and no significant variation of viral load (less than 3 times) in the pre-or post- surveys.Conclusion AIDS patients who had received long-term first-line antiretroviral treatment program,showed an amelioration six months after changing of the treatment program.Timely and effective testing on drug resistance as well as the strengthening of the follow-up program still seemed to be the link to those patients who were receiving first-line treatment that should not be ignored.