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Objective To understand the characteristics of HIV infected persons without long term disease progress [also known as long term non-progressors (LTNPs)],and related factors in Guangxi Zhuang Autonomous Region (Guangxi).Methods Data of persons living with HIV and receiving no antiretroviral therapy in Guangxi by the end of 2016 were collected from the national HIV/AIDS comprehensive control and prevention information system of China.Results By the end of 2016,there were 313 LTNPs in Guangxi,accounting for 2.3 ％ of those being reported for more than 10 years,5.4％ of those being reported for more than 10 years and surviving,and 26.6％ of those being reported for more than 10 years,surviving and receiving no antiretroviral therapy.Among the LTNPs,87.2％(273) were men,94.9％ (297) were aged ≤ 40 years,32.3％ (101) were farmers,55.6％ (174) were single,divorced or widowed,69.3％ (217) were of Han ethnic group,68.1％ (213) were injecting drug users,and 52.1％ (163) were from custody facilities.Multiple logistic regression analysis indicated that factors associated with delayed disease progression included age ≤40 years (compared with age ＞40 years,aOR=1.55,95％ CI:1.31-3.12) and injection drug use (compared with sexual transmission,aOR=1.23,95％ CI:1.10-1.74).Conclusions A number of LTNPs existed in HIV-infected individuals in Guangxi.Further research are needed to identify the related factors,and it is necessary to conduct large sample size studies on host immunology,genetics and the virology of HIV to explore the related mechanism.
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Objective To understand the characteristics of HIV infected persons without long term disease progress [also known as long term non-progressors (LTNPs)],and related factors in Guangxi Zhuang Autonomous Region (Guangxi).Methods Data of persons living with HIV and receiving no antiretroviral therapy in Guangxi by the end of 2016 were collected from the national HIV/AIDS comprehensive control and prevention information system of China.Results By the end of 2016,there were 313 LTNPs in Guangxi,accounting for 2.3 ％ of those being reported for more than 10 years,5.4％ of those being reported for more than 10 years and surviving,and 26.6％ of those being reported for more than 10 years,surviving and receiving no antiretroviral therapy.Among the LTNPs,87.2％(273) were men,94.9％ (297) were aged ≤ 40 years,32.3％ (101) were farmers,55.6％ (174) were single,divorced or widowed,69.3％ (217) were of Han ethnic group,68.1％ (213) were injecting drug users,and 52.1％ (163) were from custody facilities.Multiple logistic regression analysis indicated that factors associated with delayed disease progression included age ≤40 years (compared with age ＞40 years,aOR=1.55,95％ CI:1.31-3.12) and injection drug use (compared with sexual transmission,aOR=1.23,95％ CI:1.10-1.74).Conclusions A number of LTNPs existed in HIV-infected individuals in Guangxi.Further research are needed to identify the related factors,and it is necessary to conduct large sample size studies on host immunology,genetics and the virology of HIV to explore the related mechanism.
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Objective@#To analyze the change trend of HIV genetic subtypes and compare the first CD4+T cell counts of newly diagnosed HIV infected patients in Liuzhou from 1998 to 2012, and provide a reference for AIDS prevention and control.@*Methods@#Newly diagnosed HIV-infected patients from 1998 to 2012 in Liuzhou were selected through national HIV/ADIS comprehensive response information management system. Their plasma samples were used for RNA gene extraction, amplification, sequencing and genotyping. Coharan-Armitage trend test was used to analyze the ratio trend of genetic subtypes and phylogenetic clusters of HIV and Wilcoxon Rank Sum Test was used to compare the first CD4+T cell counts (CD4) of the different subtype HIV infected patients.@*Results@#A total of 1 877 newly diagnosed HIV infected patients were included in the study. From 1998 to 2012, the proportions of CRF01_AE and CRF01_AE (Cluster 1) increased from 78.4% (76/97) to 91.5% (1 441/1 574), from 63.9% (62/97) to 74.0% (1 164/1 574), and the proportion of CRF07_BC decreased from 17.5% (17/97) to 4.6% (72/1 574), respectively (Z=4.632, P<0.001; Z=2.455, P=0.014; Z=-5.943, P<0.001). The median and interquartile range of the first CD4 of the patients infected with subtype CRF01_AE (Cluster 1), CRF01_AE (Cluster 2), CRF07_BC and CRF08_BC were 230 (83-375), 215 (48-351), 365 (254-503) and 334 (206-479) cell/μl, respectively. The first CD4 levels of the patients infected with subtype CRF01_AE (Cluster 1) or CRF01_AE (Cluster 2) were significantly lower than those of CRF07_BC (Z=-4.795, P<0.001; Z=-4.238, P<0.001).@*Conclusion@#The genetic subtypes of HIV were mainly CRF01_AE in newly diagnosed HIV-infected patients and this subtype proportion was in increase and the first CD4 levels of the patients were low in Liuzhou during 1998 to 2012.
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Objective@#To understand the characteristics of HIV/AIDS epidemic in Guangxi Zhuang Autonomous Region (Guangxi) with a purpose to accurately provide scientific basis for prevention and control measures, 2010-2017.@*Methods@#Data were retrieved from case reporting cards of Guangxi during 2010 to 2017 through National HIV/AIDS Comprehensive Response Information Management System. Data was analyzed using epidemiological methods such number of cases, proportion and rate. χ2 test was used for statistical analysis.@*Results@#The HIV positive rate was 12.53 per ten thousand (85 182/67 959 000) in Guangxi during 2010 to 2017. The number of newly diagnosed HIV/AIDS cases and the number of death yearly respectively increased by 22.34%(2 602/11 648) and 32.83% (952/2 900) in 2011 compared with 2010, and both showed a six-year continuous downward trend (the number of newly diagnosed cases respectively 12 229 cases, 10 877 cases, 9 460 cases, 9 190 cases, 8 848 cases, 8 680 cases, and the number of death respectively 3 888 cases, 3 316 cases, 2 914 cases, 2 717 cases, 2 595 cases, 2 600 cases) from 2012 to 2017. But proportion of late discovery remained above 50.00% (50.53%-57.06%) for eight-years continuously. The ratio of male and female was 2.47 ∶ 1 (60 639/24 543). The ratio of males and females aged 50 and over was 2.71∶1 (28 654/10 557). Proportion of the cases in 25-49 years old group and 50 years old group accounting for 47.40%(40 377/85 182) and 46.03% (39 211/85 182) respectively. The occupation was farmers accounting for 68.40% (58 262/85 182), housekeeping, housework and unemployment accounting for 11.21% (9 546/85 182), student accounting for 0.86% (729/85 182). Heterosexual transmission accounted for 90.60% (77 171/85 182, homosexual transmission accounted for 3.13% (2 669/85 182), injection drug use transmission accounted for 4.60%(3 924/85 182) and mother-to-child transmission accounted for 0.73% (619/85 182).@*Conclusions@#The number of newly diagnosed cases and the number of death yearly showed a continuous downtrend for six-years from 2012 to 2017. However, proportion of late discovery remained above 50.00% for eight-years. The major route of infection was heterosexual transmission. With the change of HIV/AIDS newly epidemic mode in Guangxi, there are many new challenges for HIV/AIDS prevention and control work. Strategy of targeted intervention modes should be innovated for a new breakthrough.
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Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95％CI:1.053-1.171,P＜0.001),1.391 (95％CI:1.278-1.514,P＜0.001) and 1.695 (95％CI:1.497-1.918,P＜ 0.001),respectively,in risk for drop-out compared with those with baseline CD4 ＜200 cells/μ 1.Among the HIV infected persons,56.0％ (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.
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Objective To understand the dynamic variation of BMI and influencing factors among HIV/AIDS patients receiving highly active anti-retroviral therapy (HAART) in Liuzhou,Guangxi Zhuang Autonomous Region (Guangxi).Methods HIV/AIDS patients receiving HAART for the first time since 1 January 2013 were selected.Data on BMI was analyzed among patients receiving HAART at baseline,6 months and 12 months after treatment.By using the general linear model repeated measures of analysis of variance,BMI dynamic variations and influencing factors were described and analyzed.Results The average BMI of 2 871 patients at baseline,6th months and 12th months appeared as (20.65 ±3.32),(20.87 ± 3.22) and (21.18 ± 3.20),respectively,with differences all statistically significant (F=18.86,P＜0.001).BMI were increasing over time with treatments (F=37.25,P＜0.001).Main influencing factors were noticed as:age,sex,marital status,baseline data of CD4+T cells and the WHO classification on clinical stages.Conclusions Higher proportion of BMI malnutrition counts was seen among patients before receiving HAART in Liuzhou.BMI of the patients that were on HAART seemed being influenced by many factors.It is necessary to select appropriate treatment protocols on different patients so as to improve the nutritional status of the patients.
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Objective To investigate the effect of baseline CD4+T cell count (CD4) on drop-out of antiretroviral therapy (ART) in HIV infected persons.Methods Retrospective cohort was conducted in this study.HIV infected persons aged≥ 18 years and receiving free ART for the first time in Guangxi Zhuang Autonomous Region (Guangxi) from 2008 to 2015 were selected from the antiretroviral treatment database of National Comprehensive HIV/AIDS Information System,with follow-up conducted till May 30,2016.Cause-specific Cox proportional hazard models were used to evaluate effect of different CD4 on the drop-out of ART in the HIV infected persons.Results A total of 58 502 eligible study participants were included in this retrospective cohort study.The average drop-out ratio was 4.8/100 person-years.After controlling the following baseline covariates:age,sex,marital status,route of HIV infection,WHO clinical stage before ART,initial/current ART regiment,ART regiment adjustment,and year of initiating ART for potential confounding,the adjusted HR of drop-out for HIV infected persons with 200-cells/μl,351-cells/μl and ≥500 cells/μl were 1.110 (95％CI:1.053-1.171,P＜0.001),1.391 (95％CI:1.278-1.514,P＜0.001) and 1.695 (95％CI:1.497-1.918,P＜ 0.001),respectively,in risk for drop-out compared with those with baseline CD4 ＜200 cells/μ 1.Among the HIV infected persons,56.0％ (1 601/2 861) of drug withdrawal was due to poor compliance with medication.Conclusions With the increase of baseline CD4 when initiating ART,the risk for the drop-out in HIV infected persons increased significantly.To further reduce the drop-out of ART,it is important to take CD4 into account in initiating ART and to strengthen the health education on treatment compliancy and training for healthcare providers.
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Objective To understand the dynamic variation of BMI and influencing factors among HIV/AIDS patients receiving highly active anti-retroviral therapy (HAART) in Liuzhou,Guangxi Zhuang Autonomous Region (Guangxi).Methods HIV/AIDS patients receiving HAART for the first time since 1 January 2013 were selected.Data on BMI was analyzed among patients receiving HAART at baseline,6 months and 12 months after treatment.By using the general linear model repeated measures of analysis of variance,BMI dynamic variations and influencing factors were described and analyzed.Results The average BMI of 2 871 patients at baseline,6th months and 12th months appeared as (20.65 ±3.32),(20.87 ± 3.22) and (21.18 ± 3.20),respectively,with differences all statistically significant (F=18.86,P＜0.001).BMI were increasing over time with treatments (F=37.25,P＜0.001).Main influencing factors were noticed as:age,sex,marital status,baseline data of CD4+T cells and the WHO classification on clinical stages.Conclusions Higher proportion of BMI malnutrition counts was seen among patients before receiving HAART in Liuzhou.BMI of the patients that were on HAART seemed being influenced by many factors.It is necessary to select appropriate treatment protocols on different patients so as to improve the nutritional status of the patients.
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Objective To explore the influencing factors of late diagnosis for newly diagnosed HIV/AIDS positive patients in Guangxi in 2015.Methods The CD4 + T lymphocytes count which was first detection for newly diagnosed HIV/AIDS positive patients in Guangxi during 2015 was collected.Data were statistically analyzed.Results We collected 8 586 newly diagnosed HIV/AIDS whose median CD4+ T lymphocytes counts was 237.5 cells/μl,and 43.12％ of them had less than 200 cells/μl.Gender,age,occupation,marriage,nation,education,route of transmission,types of testing and region had effects on late HIV diagnosis(all P ＜ 0.05).Logistic analysis found that risk factors associated with the late diagnosis of HIV were male(OR =1.851,95％ CI:1.673-2.048),migrant worker (OR =1.387,95％ CI:1.242-1.549),education below middle and secondary school(OR =1.619,95％ CI:1.400-1.873),currently married(OR =1.207,95％ CI:1.075-1.354),divorced or widowed(OR =1.508,95％ CI:1.309-1.738).Voluntary testing was a protective factor.Conclusions The prevalence the late diagnosis of HIV was high in Guangxi in 2015,it is crucial for related departments to enhance the testing and screening effort for HIV/AIDS.
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Objective To understand dynamic variation of CD4-Positive T-Lymphocytes counts and influencing factors among patients receiving highly active anti-retroviral therapy (HAART) in Guangxi.Methods Adult patients who received antiviral treatment for the first time after 1 January 2013 were selected.Their CD4-Positive T-Lymphocytes counts at baseline,6 months and 12 months after treatment were analyzed.By using the general linear model repeated measures ANOVA,CD4-Positive T-Lymphocytes dynamic variations and influencing factors were described and analyzed.Results The average CD4 cell counts of 4 082 patients at baseline,6th months and 12th months were (195.3 ± 155.7) cells/mm3,(331.9 ± 202.6) cells/mm3 and (380.9 ± 221.3) cells/mm3,respectively.The time specific differences in CD4-Positive T-Lymphocytes count among them were statistically significant (F=3 161.124,P=0.000).CD4-Positive T-Lymphocytes counts increased over time after treatment.The main influencing factors were sex,age,baseline CD4 cell count,medication,discontinuation of treatment or dose miss.Influenced by sex,age,medication,discontinuation of treatment or dose miss,the increased CD4-Positive T-Lymphocytes count showed a linear trend.Influenced by baseline CD4-Positive T-Lymphocytes counts and dose miss,the increase of CD4-Positive T-Lymphocytes count showed a trend which was conformed to quadratic curvilinear equation.Conclusion CD4-Positive T-Lymphocytes counts among patients receiving HAART in Guangxi were influenced by many factors.It is necessary to select the time to start treatment according to patient' s characteristics to get good outcome.
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<p><b>OBJECTIVE</b>To understand the efficacy of antiviral therapy on prevention of HIV transmission and to assess the feasibility of treatment-as-prevention strategy in public health practice, among sero-discordant couples in Guangxi Zhuang autonomous region (Guangxi).</p><p><b>METHODS</b>Data was gathered through the AIDS prevention and control information system in Guangxi from January 1, 2008 to December 31, 2014, on HIV sero-discordant couples. Time-dependent Cox Model was used to analyze the efficacy of antiviral treatment.</p><p><b>RESULTS</b>A total of 7 694 sero-discordant couples were followed and 394 appeared positive from those negative spouses. The overall HIV positive seroconversion rate was 2.5 (2.2-2.7) /100 person-year. The HIV positive sero-conversion rates were 4.3 (3.7-4.8) /100 person-year in the untreated cohort and 1.6 (1.4-1.9) per 100 person-year in the treated cohort. Rate of HIV transmission declined by 51% in the treated cohort (HR=0.49, 95%CI: 0.40-0.60) but appeared as 45% (AHR=0.55, 95%CI:0.43-0.69) after adjusting for factors as sex, age, education, marital status, occupation, transmission route and baseline CD4(+)T lymphocyte cell count. The rate of reduction in transmission was significant among couples in which the HIV-positive spouses showing the following features as: aged ≥25 years, married, farmers, with educational level of junior high school or below, baseline CD4(+)T lymphocyte cell count <500 cells/mm(3) and infection was through heterosexual intercourse.</p><p><b>CONCLUSION</b>Antiviral therapy as a prevention strategy among sero-discordant couples seemed feasible and effective in Guangxi. Expansion of the coverage on antiviral therapy would reduce the spread of HIV in married couples.</p>
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Adulto , Humanos , Antivirales , Usos Terapéuticos , Recuento de Linfocito CD4 , China , Estudios de Factibilidad , Infecciones por VIH , Seronegatividad para VIH , Seropositividad para VIH , Heterosexualidad , Factores Socioeconómicos , Esposos , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>To understand the illegal sidenafil use among middle-aged and elderly male clients of female sex workers (FSWs) in central region of Guangxi as well as on related risk factors. Initial evaluation regarding the effect of illegal sidenafil use on HIV infection among the middle-aged and elderly men was also conducted.</p><p><b>METHODS</b>A survey was conducted among the over 50-year-olds male clients of low-grade prostitutions in central areas of Guangxi. Information on demographics, related behavior, and illegal sidenafil use was collected. 5 ml blood sample were taken to test antibodies of HIV and syphilis. PASW Statistics 18.0 was used for data analysis.</p><p><b>RESULTS</b>2 056 questionnaires were completed. 23.1% of the participants said they had ever used illegal sidenafil. The risk of sildenafil use was low among the male clients who were not over 60 years old (OR = 0.586, 95% CI:0.459-0.749). The risks of sildenafil use among the male clients with frequencies(in the past 30 days) of having commercial sex behavior were:only once (OR = 0.184, 95%CI:0.090- 0.378), twice (OR = 0.187, 95%CI:0.089-0.378) or three times (OR = 0.181, 95%CI: 0.085-0.384) lower than those with more than five times. Being single (OR = 0.608, 95% CI: 0.396-0.933), married/cohabiting (OR = 0.533, 95% CI:0.391-0.727), having unstable partners (OR = 0.558, 95%CI:0.393-0.792) seemed to be protective on those who used sildenafil, among the study population. Factors as 'never use the condom (OR = 1.642, 95%CI:1.125-2.397) or 'seldom use as condom (OR = 1.840, 95%CI:1.278-2.648) when having commercial sex, were under high risk among the sildenafil users. Forty-seven subjects were HIV positive, with the prevalence as 2.29% in this study population. Male clients of the FSWs who used sidenafil were under 60 years of age and with higher risk of HIV infection.</p><p><b>CONCLUSION</b>people who were ≥60 years old, divorced/widowed/ separated, with frequencies (in the past 30 days) of having commercial sex more than 5 times, never or occasionally using a condom when having commercial sex etc., appeared at high risk. Middle-aged and elderly male clients who used sildenafil or sildenafil-like drugs were under high risk of contracting HIV infection.</p>
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Distribución por Edad , China , Epidemiología , Condones , Infecciones por VIH , Epidemiología , Piperazinas , Mal Uso de Medicamentos de Venta con Receta , Prevalencia , Purinas , Factores de Riesgo , Trabajo Sexual , Trabajadores Sexuales , Parejas Sexuales , Citrato de Sildenafil , Sulfonamidas , Sífilis , EpidemiologíaRESUMEN
Objective To explore the knowledge about HIV/AIDS and related factors associated among farmer workers with private corporations in Guangxi and to inform intervention programs.Methods Questionnaire survey was conducted among workers working with 10 private corporations,and data were analyzed using logistic regression.Results Correct answers to questions about HIV/AIDS transmission route accounted for over 85%,yet much less regarding knowledge about non-transmission routes and prevention methods.The factors associated with knowledge about HIV/AIDS included gender,age,nationality,registered living place and years of schooling.Conclusions HIV/AIDS-related education should be strengthened for farmer workers working for private corporations.