Clinical evaluation of platelet-rich plasma in the treatment of early and middle stage knee osteoarthritis under 3.0T MRI T2 mapping sequence / 中华外科杂志

Objective: To quantitatively evaluate the clinical effect of platelet-rich plasma(PRP) intra-articular injection for early and middle stage knee osteoarthritis(KOA) treatment by 3.0T MRI T2 mapping sequence. Methods: Clinical data of 26 patients with early or middle stage KOA who received treatment from April to December 2021 at Department of Orthopaedic Surgery,the Second Affiliated Hospital,Zhengzhou University were retrospectively analyzed. In total, 8 patients were male and 18 were female,with age of (66.4±12.0)years(range:51 to 94 years). Four patients were bilateral KOA and 22 patients were unilateral KOA.All patients received PRP intra-articular injection. Patients underwent 3.0T MRI T2 mapping sequence scanning pre-treatment,3-month-after and 6-month-after treatment respectively. Those were used to measure and compare T2 values of medial and lateral femoral articular surface and patellofemoral articular surface. Visual analogue scale(VAS) and Western Ontario and McMaster Osteoarthritis Index (WOMAC) score were recorded and evaluated. The results were analyzed using repeated measure ANOVA followed by Bonferroni multiple comparison test.The correlation between WOMAC scores and T2 values at pre-treatment and 6 months post-treatment was analyzed using Pearson correlation test. Results: After treatment, the patients' International Cartilage Regeneration＆Joint Preservation Society(ICRS) classification were partly improved(one case improved from grade Ⅲ to grade Ⅱ, one case improved from grade Ⅱ to grade Ⅰ),and all patients generally improved after treatment in clinical symptoms. Compared with pre-treatment,VAS and WOMAC scores of grade Ⅰ,Ⅱ,and Ⅲ of 6-month after treatment were declined significantly(all P<0.05).The T2 values of articular cartilage declined to varying degrees(the decrease in T2 values was about 2.06 ms in grade Ⅰ, 2.66 ms in grade Ⅱ, and 3.72 ms in grade Ⅲ).Three-month (VAS:4.8±1.3,WOMAC:21.5±4.0) and 6-month (VAS:4.2±1.4,WOMAC:17.2±2.9) after treatment, the VAS and WOMAC score were significantly higher than those before treatment (VAS:6.0±1.2, WOMAC:29.0±2.3) (F=48.846, F=346.746;both P<0.01). Multiple comparisons showed a statistically significant difference between pre-treatment and post-treatment VAS (P<0.01) and it also was significantly different between 3-month and 6-month post-treatment (P<0.01).At 3- and 6-month after treatment,WOMAC scores were significantly different from before treatment.And it also was significantly different between 3-month and 6-month post-treatment (P<0.01).There was a statistically significant improvement in T2 values of patellofemoral articular surface, medial and lateral femoral articular surface at pre-treatment((44.64±4.02)ms,(44.17±3.64)ms and(43.53±3.91)ms) and 3-month ((43.19±3.91)ms,(43.24±3.34)ms and (42.47±3.80)ms), 6-month ((41.49±3.64)ms,(41.83±3.15)ms and (41.10±3.42)ms) after treatment(F=148.845,F=73.657,F=86.268;all P<0.01).The results of the multiple comparisons showed a statistically significant difference in the T2 values of medial and lateral femoral articular surface and patellofemoral articular surface at each time point(all P<0.01).The Pearson correlation analysis suggested that the WOMAC score at pre-treatment was positively correlated with the medial condyle (r=0.856,P<0.01) and the patellofemoral joint surface T2 values (r=0.840,P<0.01);The WOMAC score at 6-month post-treatment was positively correlated with the medial condyle (r=0.731,P<0.01) and the patellofemoral joint surface T2 values (r=0.691,P<0.01). Conclusions: In the treatment of early and mid-stage KOA,MRI T2 mapping sequences are able to indicate the integrity of cartilage morphology and quantitatively evaluate cartilage repair. PRP has a good therapeutic effect on cartilage repair and reconstruction.

Progress in research of HIV transmission network analysis methods and metrics / 中华流行病学杂志

HIV transmission network analysis plays a significant role in the precise prevention and control of AIDS. The current studies inferred the HIV transmission networks mainly based on the social network methods and molecular network methods and interpret the structural characteristics using individual-level and network-level metrics. To provide references for further researches, we summarized the principles, advantages or disadvantages, and application of HIV transmission network analysis methods and metrics in this paper.

Efficacy and safety of the long-acting fusion inhibitor albuvirtide in antiretroviral-experienced adults with human immunodeficiency virus-1: interim analysis of the randomized, controlled, phase 3, non-inferiority TALENT study / 中华医学杂志(英文版)

BACKGROUND@#Albuvirtide is a once-weekly injectable human immunodeficiency virus (HIV)-1 fusion inhibitor. We present interim data for a phase 3 trial assessing the safety and efficacy of albuvirtide plus lopinavir-ritonavir in HIV-1-infected adults already treated with antiretroviral drugs.@*METHODS@#We carried out a 48-week, randomized, controlled, open-label non-inferiority trial at 12 sites in China. Adults on the World Health Organization (WHO)-recommended first-line treatment for >6 months with a plasma viral load >1000 copies/mL were enrolled and randomly assigned (1:1) to receive albuvirtide (once weekly) plus ritonavir-boosted lopinavir (ABT group) or the WHO-recommended second-line treatment (NRTI group). The primary endpoint was the proportion of patients with a plasma viral load below 50 copies/mL at 48 weeks. Non-inferiority was prespecified with a margin of 12%.@*RESULTS@#At the time of analysis, week 24 data were available for 83 and 92 patients, and week 48 data were available for 46 and 50 patients in the albuvirtide and NRTI groups, respectively. At 48 weeks, 80.4% of patients in the ABT group and 66.0% of those in the NRTI group had HIV-1 RNA levels below 50 copies/mL, meeting the criteria for non-inferiority. For the per-protocol population, the superiority of albuvirtide over NRTI was demonstrated. The frequency of grade 3 to 4 adverse events was similar in the two groups; the most common adverse events were diarrhea, upper respiratory tract infections, and grade 3 to 4 increases in triglyceride concentration. Renal function was significantly more impaired at 12 weeks in the patients of the NRTI group who received tenofovir disoproxil fumarate than in those of the ABT group.@*CONCLUSIONS@#The TALENT study is the first phase 3 trial of an injectable long-acting HIV drug. This interim analysis indicates that once-weekly albuvirtide in combination with ritonavir-boosted lopinavir is well tolerated and non-inferior to the WHO-recommended second-line regimen in patients with first-line treatment failure.@*TRIAL REGISTRATION@#ClinicalTrials.gov Identifier: NCT02369965; https://www.clinicaltrials.gov.Chinese Clinical Trial Registry No. ChiCTR-TRC-14004276; http://www.chictr.org.cn/enindex.aspx.

Antiviral Activity of Dual-acting Hydrocarbon-stapled Peptides against HIV-1 Predominantly Circulating in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>New rationally designed i,i+7-hydrocarbon-stapled peptides that target both HIV-1 assembly and entry have been shown to have antiviral activity against HIV-1 subtypes circulating in Europe and North America. Here, we aimed to evaluate the antiviral activity of these peptides against HIV-1 subtypes predominantly circulating in China.</p><p><b>METHODS</b>The antiviral activity of three i,i+7-hydrocarbon-stapled peptides, NYAD-36, NYAD-67, and NYAD-66, against primary HIV-1 CRF07_BC and CRF01_AE isolates was evaluated in peripheral blood mononuclear cells (PBMCs). The activity against the CRF07_BC and CRF01_AE Env-pseudotyped viruses was analyzed in TZM-bl cells.</p><p><b>RESULTS</b>We found that all the stapled peptides were effective in inhibiting infection by all the primary HIV-1 isolates tested, with 50% inhibitory concentration toward viral replication (IC50) in the low micromolar range. NYAD-36 and NYAD-67 showed better antiviral activity than NYAD-66 did. We further evaluated the sensitivity of CRF01_AE and CRF07_BC Env-pseudotyped viruses to these stapled peptides in a single-cycle virus infectivity assay. As observed with the primary isolates, the IC50s were in the low micromolar range, and NYAD-66 was less effective than NYAD-36 and NYAD-67.</p><p><b>CONCLUSION</b>Hydrocarbon-stapled peptides appear to have broad antiviral activity against the predominant HIV-1 viruses in China. This finding may provide the impetus to the rational design of peptides for future antiviral therapy.</p>

Distinctive Drug-resistant Mutation Profiles and Interpretations of HIV-1 Proviral DNA Revealed by Deep Sequencing in Reverse Transcriptase / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate distinctive features in drug-resistant mutations (DRMs) and interpretations for reverse transcriptase inhibitors (RTIs) between proviral DNA and paired viral RNA in HIV-1-infected patients.</p><p><b>METHODS</b>Forty-three HIV-1-infected individuals receiving first-line antiretroviral therapy were recruited to participate in a multicenter AIDS Cohort Study in Anhui and Henan Provinces in China in 2004. Drug resistance genotyping was performed by bulk sequencing and deep sequencing on the plasma and whole blood of 77 samples, respectively. Drug-resistance interpretation was compared between viral RNA and paired proviral DNA.</p><p><b>RESULTS</b>Compared with bulk sequencing, deep sequencing could detect more DRMs and samples with DRMs in both viral RNA and proviral DNA. The mutations M184I and M230I were more prevalent in proviral DNA than in viral RNA (Fisher's exact test, P<0.05). Considering 'majority resistant variants', 15 samples (19.48%) showed differences in drug resistance interpretation between viral RNA and proviral DNA, and 5 of these samples with different DRMs between proviral DNA and paired viral RNA showed a higher level of drug resistance to the first-line drugs. Considering 'minority resistant variants', 22 samples (28.57%) were associated with a higher level of drug resistance to the tested RTIs for proviral DNA when compared with paired viral RNA.</p><p><b>CONCLUSION</b>Compared with viral RNA, the distinctive information of DRMs and drug resistance interpretations for proviral DNA could be obtained by deep sequencing, which could provide more detailed and precise information for drug resistance monitoring and the rational design of optimal antiretroviral therapy regimens.</p>

Genetic characteristics of viral quasispecies of HIV-1 CRF07_BC among intravenous drug users / 病毒学报

To explore the genetic characteristics of viral quasispecies in HIV-1 CRF07_BC infections among intravenous drug users (IDU), the gp120 fragments of HIV-1 env gene were amplified from plasma samples collected from 6 CRF07_BC infected persons using single genome amplification and sequencing (SGA/ SGS) method, and 11 to 28 sequences were obtained from these samples, respectively, A neighbor-joining phylogenetic tree was reconstructed to describe the genetic characteristics of viral quasispecies. The Simplot, segments' phylogenetic trees and diversity plots based on average pairwise distance (APD) were used to identify the recombination events between quasispecies. The SGA sequences derived from single specimen formed a large monophyletic cluster in the neighbor-joining phylogenetic tree and showed the complex topologic structures of viral quasispecies. Of the 6 CRF07_BC infected patients, only one possessed the high genetic homogeneity, whereas the other five individuals showed high heterogeneity, with two to four subclusters inside the monophyletic cluster for each specimen. In addition, the recombinant events were identified among viral quasispecies from 3 cases. The results show SGA technique and phylogenetic analyses are useful tool to investigate the intrahost CRF07_BC gp120 complex quasispecies variation and high genetic diversity.

HIV infection among new synthetic drug abusers: a pilot study in Beijing / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Following the increased human immunodeficiency virus (HIV) notification (infection) rates via sexual transmission and increased abuse of new synthetic drugs instead of heroin in China, a study on HIV infections and risk factors among synthetic drugs and heroin users in Beijing was conducted to provide a cue for further development of targets and strategies of HIV/AIDS control and prevention for different drug populations.</p><p><b>METHODS</b>A total of 428 subjects including 224 heroin users and 204 new synthetic drug users was recruited from communities in Beijing by convenience sampling. A χ(2) test was used to compare HIV and syphilis infections between the two subpopulations. Logistic regression models were used to evaluate factors related to HIV, syphilis infections and abuse of synthetic drugs.</p><p><b>RESULTS</b>Unbalanced distributions of demographics were detected between the two subpopulations. Compared with heroin users, most users of synthetic drugs were migrants, single and of younger age (age ≤ 30 years). Ten HIV infections and twenty-four syphilis infections were confirmed among 428 subjects. No significant difference in HIV infection was found between the two subpopulations (crude odds ratio (OR) = 0.46, 95% confidence interval (CI): 0.07 - 15.80 and adjusted odds ratio (AOR) = 1.26, 95%CI: 0.09 - 18.28) while four times as many syphilis infections were identified among users of synthetics drugs (AOR = 3.92, 95%CI: 1.06 - 14.56). HIV and syphilis infections appeared to work synergistically. The migrants who were of Han ethnicity, single and who had stayed in Beijing for more than six months were more likely to abuse synthetics drugs.</p><p><b>CONCLUSIONS</b>The new synthetic drug users and heroin users are different subpopulations. We optimistically speculate that HIV has not yet been introduced into the former in Beijing, but considering higher syphilis infections in synthetic drug users and the role of syphilis in HIV infection, synthetic drug users, as a possible and important driver of the HIV/AIDS epidemic in Beijing, should be paid more attention in HIV prevention and control strategies.</p>

Research progress in the structure and fuction of Orthopoxvirus host range genes / 病毒学报

Orthopoxvirus vector has a broad prospect in recombinant vaccine research, but the rarely severe side-effect impedes its development. Vaccinia virus and Cowpox virus of Orthopoxvirus have broad host range, and they have typical host range genes as K1L, CP77 and C7L. These three genes affect host range of Vaccinia virus, disturb the cell signaling pathways, suppress immune response and are related to virulence.

Comparison between different gene and near full-length genome on the phylogenetic analyses of HIV-1 subtype B' in China / 病毒学报

This study aims to compare the influence of different genes to the results of HIV-1 subtype B' phylogenetic analyses. We first split 47 near full-length genome sequences of subtype B' into different regions (gag, pol, vif, vpr, vpu, env, nef), which derived from various risk populations and geographic regions from Thailand, Myanmar and China from published studies. Phylogenetic analyses were performed to each region obtained. The phylogenetic results of different regions were compared to that of the near full-length genome sequences. The pol gene was found to have the lowest diversity and evolutionary rate, and could repeat the phylogenetic results by using near full-length genome sequences. Although the env gene has the highest diversity and evolutionary rate, it could not achieve the similar results. This study compared the influence to the results of HIV-1 subtype B' phylogenetic analyses by using different genes and laid foundation for further molecular survey and analyses of the transmission of subtype B' in China.

Study on the incidence of HIV and associated risk factors through a prospective cohort among men who have sex with men in Beijing, China / 中华流行病学杂志

Objective To investigate the dynamic change and associated risk factors of HIV sero-conversion rate in Beijing.Methods 809 sero-negative men who have sex with men (MSM) were recruited in the cohort from August to December in 2009.HIV sero-antibody,medicinal examination and behavior questionnaire interview were carried out every six months.Results 962 MSM with overall baseline prevalence of HIV infection as 6.34％ (61/962) together with 809 seronegative MSM,were enrolled in the cohort.Of the 809 sero-negative participants,95.1％ (769/809),85.5％ ( 692/809 ) and 71.0％ ( 574/809 ) of them were retained in the 6-month,12-month and 18- month follow-up visits,with 19,29 and 17 of them became HIV sero-conversion at 6-month,12-month,and 18-month follow-up visits and the HIV incidence rates appeared to be 5.47,12.37 and 6.86 per 100 person-years respectively.The HIV incidence was 7.59 per 100 person-years in the 18 months follow-up visit.Factors including:younger than 25-years old (HR =2.32,95％CI:1.39-3.87),having more than 8 MSM partners (HR=2.50,95％CI:1.49-4.20),less than RMB 2000 Yuan every month income (HR=1.76,95％CI:1.06-2.95 ),having more than 4 homosexual partners in the last six months (HR=3.50,95％ CI:2.11 -5.81 ),showing phimosis and redundant prepuce (HR=2.47,95％ CI:1.50-4.07 ) as well as positive syphilis test (HR=2.62,95％CI:1.53-4.49) etc.,were significantly associated with HIV incidence.Conclusion High HIV incidence was shown among MSM in Beijing and had spread fast in this population,calling for more favorable prevention measures to be taken.

The study of an in-house method for drug resistance genotyping testing on HIV-1 strains prevailing in China / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the amplification rate and the lowestlower detection limit of an in-house HIV-1 Drug resistant (HIVDR) genotyping test.</p><p><b>METHODS</b>A total of 30 plasma samples were selected, which covered all major HIV-1 subtypes predominating prevailing in China (B', CRF07_BC, CRF01 _AE). The viral loads of the 30 selected samples were detected in triplicate by Easy Q method and the average values were taken as the viral loads of the samples. Each sample was diluted to the concentration of > 1000 copies/ml, 401-1000 copies/ml, 101-400 copies/ml, 50-100 copies/ml and < 50 copies/ml with HIV-negative plasma. After extraction of nucleic acids, RT-PCR and nested PCR amplification were performed, the efficiency of amplification of each subtype and the minimum detection limit were determined statistically based on the PCR results.</p><p><b>RESULTS</b>The viral loads of the selected samples ranged from 2.03 x 10(2)-5.92 x 10(4) copies/ml. The sample of 50-1000 copies/ml have a high amplification rate (86%).</p><p><b>CONCLUSION</b>The In-house method for HIV-1 drug resistance genotyping has a high sensitivity with a high successful amplification rate, especially in the samples with low viral load. This method can be used to the detection of drug-resistant virus and to provide scientific data to treatment options for patients.</p>

Incidence and risk factors of HIV and syphilis seroconversion among men who have sex with men in Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the incidence and risk factors of HIV and syphilis seroconversion among men who have sex with men (MSM) in Beijing.</p><p><b>METHODS</b>A total of 550 MSM were recruited on the basis of community and followed up after 6 and 12 months in Beijing. Each subject was investigated by only one investigator at one time to collect information on demographics and behaviors. Blood samples were collected to test HIV and syphilis seroconversion. ELISA was used for screening test, west blotting (WB) and Particle agglutination were used for confirmatory test.</p><p><b>RESULTS</b>A total of 550 MSM investigated, among which 4.5% (25/550) were HIV-positive and 29.3% (161/550) were syphilis-positive. For 525 HIV-negative MSM, 87.0% (457/525) retained during the 12-month investigation. Seroincidence for HIV and syphilis were 3.37/100 person-years (95%CI = 1.66 - 5.08) and 9.32/100 person-years (95%CI = 5.87 - 12.77) respectively. HIV seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 7.11/100 and 0.76/100 person-years respectively. Multivariate Cox regression analysis revealed that rectal douching after homosexual anal intercourse in the past 3 months (HR = 9.23, 95%CI = 2.08 - 40.88) was significantly associated with HIV seroconversion. Syphilis seroconversions for those who met male sex partners in parks, public washrooms or bathhouses in the past 3 months were 41.77/100 and 7.97/100 person-years respectively. Syphilis seroconversions for those who performed and did not perform rectal douching after homosexual anal intercourse in the past 3 months were 16.17/100 and 4.92/100 person-years respectively. In the past 3 months, meeting male sex partners in parks, public washrooms or bathhouses (HR = 4.67, 95%CI = 1.77 - 12.34) and performing rectal douching after homosexual anal intercourse (HR = 3.09, 95%CI = 1.40 - 6.83) were significantly associated with syphilis seroconversion.</p><p><b>CONCLUSION</b>The seroconversions of HIV and syphilis during the follow-up visits in this MSM cohort study in Beijing were very serious, and that the associated factors for seroconversions were rectal douching after homosexual anal intercourse and meeting male sex partners in parks, public washrooms or bathhouses.</p>

A new approach for sequencing virion genome of Chinese HIV-1 strains subtype B and BC from plasma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although it was widely accepted that full-length HIV genome sequences is important in studying virus genetic evolution and variation as well as developing vaccine candidate, to directly sequencing HIV-1 genome of virion RNA remains as a challenge worldwide. Up to date, no published genomic sequences from virion RNA are available for Chinese prevalent HIV-1 strains due to the absence of specialized protocol and appropriate lab equipments. In this study we developed a straightforward approach for amplifying and sequencing HIV virion RNA from plasma by modifying published protocols and further confirmed it is suitable to process Chinese samples.</p><p><b>METHODS</b>The methods for viral RNA extraction and gene amplification was modified and optimized as could be widely used in most Chinese labs. Gene alignment of Chinese HIV-1 strains was employed for designing specialized primer sets for Thai-B and BC recombinant strains. Based on comprehensively consideration of high variable gene region and recombinant breakpoints in BC recombinant strains, a three-amplicon strategy (including 4.3-kb gag-pol, 2.9-kb pol-env and 2.7-kb env-nef) was developed. In addition, one amplicon (9 kb near full-length genome) was also used in 32 samples with varied viral loads. All amplicons were directly sequenced by DNA automated sequencer.</p><p><b>RESULTS</b>Twenty-five percent (8/32) amplification efficiency was achieved by the one-amplicon strategy and 65.6% (21/32) by three-amplicon strategy. For one amplicon strategy, none of complete near full-length genome sequences was obtained by DNA sequencing. For three-amplicon strategy, 75% sequences were achieved in DNA sequencing. Amplification efficiency but not sequencing efficiency was closely associated with viral loads.</p><p><b>CONCLUSION</b>Three-amplicon strategy covering all encoding regions of HIV-1 is suitable for Thai-B and BC recombinant strains and could be potentially employed in less-well equipped Chinese labs.</p>

The prevalence of HIV-1 drug resistance and associated factors in AIDS patients receiving HAART in Zhecheng county, Henan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the prevalence of HIV-1 drug resistance and its main factors in AIDS patients receiving to HAART in Zhecheng county, Henan province.</p><p><b>METHODS</b>By cross-sectional survey, 378 AIDS patients who had received the national free antiretroviral therapy from July 2003 to March 2009 in Zhecheng county of Henan were selected. All recruits were interviewed and blood samples were collected. HIV-1 viral loads were measured by real-time polymerase chain reaction, HIV genotypic resistance was determined by an in-house polymerase chain reaction to amplify the HIV-1 pol gene region.</p><p><b>RESULTS</b>Among 378 subjects receiving antiretroviral therapy, the prevalence of successful viral suppression was 42.9% (162/378), and HIV-1 drug resistance was detected in 47.1% (178/378) patients. The rate of resistance-associated mutations to non-nucleotide reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs) and protease inhibitors (PIs) was 46.6% (176/378), 37.8% (143/378) and 1.9% (7/378), respectively. Multivariate logistic regression analysis showed that the main risk factors associated with the prevalence of drug resistance included drug non-adherence (ratio of on-time drug intake in the past month < 90%:≥ 90% = 64.5% (40/62):43.7% (138/316), OR = 2.3, 95%CI: 1.3 - 4.1), and initiation of anti-retroviral therapy (ART) with didanosine (DDI) (ART with DDI:ART with lamivudine (3TC) = 53.3% (137/257):33.9% (41/121), OR = 2.3, 95%CI = 1.1 - 4.5).</p><p><b>CONCLUSION</b>The prevalence of HIV-1 drug resistance among ART patients in Zhecheng county of Henan was high. Drug non-adherence and initiation of ART with DDI were the main factors of drug resistance.</p>

Drug resistance and associated factors on HIV in Liangshan prefecture, Sichuan province / 中华流行病学杂志

Objective To investigate the HIV drug resistance among HIV/AIDS patients who had received highly active antiretroviral treatment (HAATR) in Liangshan prefecture and related factors.Methods This investigation was conducted from August to October 2010.Data on epidemiology,treatment,CD4 + T cell,viral load and drug resistance tests were collected.Results 233 (73.50％) had a viral load of ＜ 1000 copy/ml,with the median CD4+T cell count as 329 cell/μl.26 samples appeared to be drug resistant,with the rate as 8.20％.Among 84 patients with antiviral therapy failure,the overall drug resistance rate was 30.95％(26/84).While 24 (28.57％) were resistant to non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs.Among nucleoside reverse transcriptase inhibitors (NRTI),7 (8.33％) were resistant.1 (1.19％) had protease inhibitor (PI)resistance mutations identified.Factors that significantly associated with drug resistance would include:being injecting drug users (A OR =3.37,95 ％ CI:1.06-10.66,P =0.0390),having had chronic diarrhea ＞1 month (AOR=8.38,95％ CI:1.87-37.69,P=0.0055),having had CD4+T cell＜200(AOR=3.48,95％CI:1.29-9.39,P=0.0139),being residents from Butuo area (AOR=17.68,95％ CI:4.97-62.86,P＜0.0001 ).When comparing with other areas,data from Butuo showed that people who carried Yi ethnicity (AOR=17.35,95％ CI:2.01-149.73,P=0.0095) and were literate (having had primary or higher levels of education) (AOR=0.18,95％ CI:0.08-0.42,P＜0.0001 ),being married or having cohabited relations (AOR=8.17,95％ CI:2.35-28.39,P=0.001 ) were found to be less adherent (AOR=0.05,95％ CI:0.02-0.13,P＜0.0001) to the treatment.Conclusion Successful antiviral outcomes were seen among those AIDS patients under treatment,in Liangshan prefecture.Resistance rates were significantly different in regions.For IDUs,enforcement on subjects including prevention on drug resistance,adherence to HAART and treatment for drug addiction should be strengthened and programs being integrated.

Analysis of gag-specific IFN-gamma secretion responses in HIV-1 B/C recombinant infectors / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To characterize the Gag-Specific T lymphocyte responses and identify immunodominant region recognized in Chinese HIV-1 recombinant subtype B/C infectors.</p><p><b>METHODS</b>10 antiretroviral treatment (ART) naive HIV-1 recombinant subtype B/C infectors with infected time in 1 year, 25 ART-naive infectors with infected time > 3 years and 10 HIV-1-seronegative healthy individuals were enrolled. HIV-1-specific T lymphocyte responses were analyzed by an IFN-gamma Elispot assay against 123 overlapping peptides spanning HIV-1 Gag protein in the present study.</p><p><b>RESULTS</b>Gag-specific T lymphocyte responses of interferon-gamma secretion were identified in 8(8/10) Chinese HIV-1 recombinant subtype B/ C infectors with infected time in 1 year, the specific T lymphocytes are mainly targeted at five seperated peptides. Responses were identified in 17(68%) infectors with infected time more than 3 years, the specific T lymphocytes are mainly targeted at one peptide in p17 and six in p24. There was obviously positive correlation (P = 0.0318, r = 0.519) between the magnitude of responses and viremia in infectors infected time > 3 years. The magnitude of response in infectors infected in 1 year was significantly higher than group infected time > 3 years (P = 0.021). None of healthy individuals produced positive responses.</p><p><b>CONCLUSIONS</b>HIV-1 recombinant subtype B/C Infectors at different stages of diseases recognize different region of gag.</p>

Analysis on the relationship between condom social norms and unprotected anal intercourse among men who have sex with men in Beijing / 中华流行病学杂志

Objective To understand the prevalence of and factors associated with unprotected anal intercourse(UAI)among men who have sex with men(MSM)in Beijing.Methods Five hundred MSM were recruited for a survey using Respondent Driven Sampling (RDS)method, from September to October in 2009. A computer-assisted, interviewer-administered questionnaire was used to gather information including demographics, sexual behaviors and condom use social norms(a scaled number). Variables were evaluated by using RDSAT and SAS software.Results Mean age of the participants was 30.6 years, with 96.0% of them as Han ethnicity and68.5% having had at least high school or higher education level. 72.8% of them were unmarried, with 61.7% of them identified themselves as homosexual, 61.2% had ＞ 1 male partners in the past six months, and the prevalence of UAI was 42.0%. Significant bivariate predictors of UAI would include condom use social norms score, role for anal sex with male sex partner, number of male sexual partners in the past 6 months and amount of alcohol consumed. In multivariable analysis, UAI was associated with a higher condom use social norms score(AOR= 1.2, 95%CI: 1.1-1.3), receptive anal intercourse(AOR=2.0, 95%CI: 1.3-3.2)and drinking alcohol more than 3 times per month in the past 12 months(AOR=1.6, 95%CI: 1.1-2.5). Conclusion The prevalence of UAI was high in the MSM community in Beijing, suggesting that efforts should be targeting on how to make the condom use a social norm and being promoted.

HIV-1 co-receptor usage of patients experienced anti-retroviral therapy / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate HIV-1 co-receptor usage in patients experienced anti-retroviral therapy (ART) in Anhui and Henan province of China.</p><p><b>METHODS</b>A total of 45 HIV-1 infected individuals who have experienced ART and 109 un-experienced ART patients from Anhui and Henan province, which were called as treatment group and treatment-negative group, were selected as study subjects. HIV-1 strains were isolated from peripheral blood mononuclear cells of whole blood from patients. HIV-1 p24 in the culture supernatant was measured using a commercial enzyme-linked immunosorbent assay (ELISA) kit. HIV-1 co-receptor usage was identified using Ghost cell lines expressing CD4 and the chemokine receptor CCR5 or CXCR4.</p><p><b>RESULTS</b>Among 45 HIV strains from the treatment group, 22 (48.9%) strains used CCR5 as a co-receptor (R5 tropic strain), 21 (46.7%) strains used CXCR4/CCR5 as a co-receptor (X4/R5 duel tropic strain), and 2 (4.4%) used only CXCR4 as a co-receptor (X4 tropic strain). In 109 strains from treatment-negative group, 96 (88.1%) strains used CCR5 as a co-receptor (R5 tropic strain), 13 (11.9%) strains used CCR5/CXCR4 as a co-receptor use (X4/R5 strain). A significant difference was found between two groups in X4 co-receptor usages (χ(2) = 27.30, P < 0.05). Furthermore, after treated with AZT + DDI + NVP, the HIV-1 CXC4/CCR5 utilization was 59.09% (13/22), meanwhile after treated with D4T + DDI + NVP, the HIV-1 CXC4/CCR5 utilization was 43.48% (10/23), which the difference was not statistical significant (χ(2) = 1.10, P = 0.30).</p><p><b>CONCLUSION</b>HIV-1 CXCR4/CCR5 co-receptor utilization was higher in ART patients than treatment-negative patients.</p>

Feasibility of using dried blood spots to detect HIV drug resistance genotyping / 中华预防医学杂志

<p><b>OBJECTIVE</b>This study aimed at exploring the feasibility of using dried blood spots (DBS) to detect HIV drug resistance genotyping in China by comparing the results of drug resistance from DBS, plasma and whole blood samples.</p><p><b>METHODS</b>Blood samples were collected from 39 AIDS patients from Anhui (10), Yunnan (13), Hunan (6) and Xinjiang (10) provinces and autonomous regions. The HIV strains that infected these patients covered all the major HIV-1 subtypes prevailing in China (B, CRF01_AE, CRF07_BC). HIV drug resistance genotyping assay was performed on DBS as well as on the whole blood and plasma samples from the same patients simultaneously by using an in-house nest RT-PCR method. Drug resistance levels were determined based on Stanford University HIV drug resistance database, and the results from these three types of samples were compared.</p><p><b>RESULTS</b>The percentages of successful amplification of protease and reverse transcriptase regions in the pol gene were 95% (37/39) from DBS, 92% (36/39) from whole blood and 100% (39/39) from plasma samples. The sequences from the three types of samples showed more than 99% identity.86% (31/36) of the DBS samples had the same set of drug resistance mutations as those which were detected from plasma samples. The differences probably resulted from mixed bases.</p><p><b>CONCLUSIONS</b>There was no major difference in detecting HIV drug resistance genotyping among DBS, plasma and whole blood samples. Therefore, DBS is useful for detection of HIV drug resistance genotyping and is particularly valuable in developing countries like China, especially in remote rural regions.</p>

Study on the relationship between behavioral factors,psychological status and HIV infection among men who have sex with men in Beijing / 中华流行病学杂志

Objective To study the prevalence and risk factors of human immunodeficiency virus (HIV) among men who have sex with men (MSM) in Beijing. Methods A sample of 550 MSM was recruited between March and June in 2008 in Beijing. Interviewer-administered interviews were conducted to collect information on demographics and behaviors. Blood samples were collected to test for HIV,syphilis,HBsAg and HCV infections. Chi-square test and logistic regression model were used to identify risk factors associated with HIV infection. Results Of the 550 eligible MSM surveyed,HIV prevalence appeared to be 4.5% (25/550). Data from multivariate logistic regression analysis demonstrated that factors as reporting unprotected anal intercourse with causal male sexual partners in the last month (X~2=11.381,P=0.001),rectal douching after homosexual anal intercourse in the past three months (X~2=5.326,P=0.021),feeling sad in the last month (X~2=8.809,P=0.003) were significantly associated with HIV infection. Conclusion Health education on safer sex behavior and mental health care should be taken to hinder the speed of HIV transmission among MSM.