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Objective:To investigate the efficiency of the Montreal cognitive assessment (MoCA) and international human immunodeficiency virus dementia scale (IHDS) in asymptomatic neurocognitive impairment (ANI) and human immunodeficiency virus-associated dementia (HAD) screening among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM).Methods:According to the exclusion criteria, 210 HIV-infected MSM and 84 HIV-negative MSM were recruited from the First Hospital of China Medical University in Shenyang from December 2016 to December 2018. In this cross-sectional study, the MoCA and IHDS were performed among all HIV-positive and HIV-negative MSM, and their efficiency in ANI and HAD screening were analyzed. Student t-test, one-way analysis of variance and chi-square test were used for statistical analysis. Results:HIV-positive MSM had lower total scores of MoCA and IHDS [(26.04±3.41) and (11.15±1.44)] than HIV-negative controls [(27.58±1.85) and (11.67±0.52)] ( t =-4.970 and -4.542, respectively, both P<0.01). The differences of MoCA and IHDS total scores of HIV-infected patients with different cognitive functions were statistically significant ( F=117.982 and 49.291, respectively, both P<0.05). The proportions of patients with MoCA<26 points and IHDS≤10 points were statistically significant ( χ2=115.917 and 70.155, respectively, both P<0.05). In ANI screening, the cut-off of MoCA<26 points showed a sensitivity of 79% and a specificity of 91%, Youden index was 0.70; and the cut-off of IHDS≤11 points showed a sensitivity of 74% and a specificity of 75% Youden index was 0.49. In HAD screening, the cut-off of MoCA<24 points showed a sensitivity of 88% and a specificity of 87%, Youden index was 0.75; and the cut-off of IHDS≤10 points showed a sensitivity of 68% and a specificity of 87%, Youden index was 0.55. Conclusion:The MoCA is prefered to the IHDS in HIV-associated neurocognitive disorders screening among MSM population, and its cut-off score should be set for the purpose to screen different degrees of cognitive impairment.
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Objective To investigate the relationship between the CD 8 +T cells results of clinical automatic analysis platform and the CD8lowT and CD8highT cell subsets.Methods A total of 1316 cases of lymphocyte and flow cytometry data were collected from the First Affiliated Hospital of China Medical University from December 2015 to September 2016 by cross-sectional study. There were 287 cases of malignant tumor , 389 cases of autoimmune disease , 320 healthy people and 320 cases of HIV infection , then to get automatic analysis platform returns result of CD 8+T cell.FlowJo software was used to analyze the CD8low T and CD8high T lymphocyte subsets in the patients , and the results were compared with the results of CD8 +T cells returned by the clinical automatic analysis platform .Results The results of clinical returns CD8 +T cells were consistent with the results of CD 8high T cells in patients with different diseases , and were not exactly the same as the results of CD8lowT cells, and the difference was as follows:the results of CD8low T cells in HIV-infected patients were significantly lower than those of healthy people (56.2 ±42.0, 68.8 ± 45.9, cells/μl P<0.001), which were different from the clinical results of CD 8 +T cells.The results of clinical report of CD8 +T cells were statistically correlated with CD8high T cells and CD8low T cells, and the correlation between CD8 +T cells and CD8highT were higher than that of CD8lowT cells.There was a positive correlation between CD8low T cell count and CD4 +T cell count ( r=0.204, P<0.001) .CD8low T was significantly higher in patients on antiviral treatment than that in untreated group (58.3 ±43.9, 42.9 ± 26.5, cells/μl, P<0.001).After treatment for more than 2 years, the CD8lowT cells in patients with CD4<500 cells/μl were significantly lower than those in patients with CD 4>500 cells/μl (50.1 ±47.0, 66.3 ±46.6, cells/μl, P<0.001).Conclusions The clinical report of CD8 +T cells was consistent with the results of CD8highT cells, and there was a great difference between the results of CD 8lowT cells and the results of CD8 +T cells.CD8low T cells were significantly reduced in HIV infected patients , and CD8low T cells could be effectively reconstructed by antiviral therapy .
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Objective To evaluate the clinical outcomes and prognosis of older human immunodeficiency virus (HIV )-infected patients under antiretroviral therapy (ART ) in China .Methods This study was carried out in a retrospective cohort of HIV-infected patients initiated ART between January 2004 and December 2012 at The First Affiliated Hospital ,China Medical University .The patients were enrolled and divided into two groups ,including <50 years group (young and middle-aged group) and≥50 years group (older group) .Immunological and virological responses and mortality were analyzed . Data were analyzed by t test ,chi-square test ,two-way analysis of variance and log-rank test .Results Totally 291 subjects were included ,among whom 97 subjects were older patients and 194 subjects were young and middle-aged patients .Male was predominate in both groups ,which accounted for 91 .8％ and 87 .6％ ,respectively .The CD4+ T lymphocyte count in the older group before treatment was (151 .9 ±96 .2) cells /μL ,which was significantly lower than that in the young and middle-aged group (183 .4 ± 93 . 5) cells/μL (t= 2 .657 , P=0 .009) .At month 12 of treatment ,the CD4+ T lymphocyte count in the older group was significantly lower than that in the young and middle-aged groups (t= 2 .120 , P=0 .035) ,while there was no statistically significant difference between the two groups at month 24 (t=1 .025 ,P=0 .299) .The percentage of CD4+ T lymphocyte count increasing to 500 cells/μL in the older and youth groups during follow-up were 11 .3％ and 16 .0％ ,respectively (χ2=1 .127 ,P =0 .376) .Log-rank analysis showed that the mean times of virus inhibition in older group and young and middle-aged group were 7 .9 (95％ CI:6 .8-8 .5) and 7 .6 (95％ CI:6 .5 -9 .3) ,respectively ,with no statistically significant difference (χ2 =0 .002 , P=0 .961) .Virological failure was reported in 4 patients (4 .1％ ) in older group and 11 patients (5 .7％ ) in young and middle-aged group . Chi-square test showed no statistically significant difference between the two groups (χ2 = 0 .15 , P= 0 .78) .During follow-up , 19 .6％ (19/97) in older group and 3 .6％ (7/194) in young and middle-aged group died .The former was significantly higher than the latter (χ2 = 21 .113 , P< 0 .01 ) .Conclusions Older patients show a poor immunologic response ,similar viral suppression and higher risk of mortality compared with young and middle-aged patients . Future research should be aimed at the feasible and specific strategy for early diagnosis and timely treatment for older patients to improve treatment efficacy and reduce mortality .
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Objective To analyze and reveal the distribution,research hotspots and study trend of worldwide published articles correlated with HIV/AIDS post-exposure prophylaxis (PEP),and provide information for related studies in China.Methods CiteSpace software 5.1 was used to visualize all related papers in the web of science database published during 2000-2017.Results The average growth rate of international PEP-related papers was 10.78％,and number of published papers in 2016 was highest (n=34),relevant research hotspots have shifted from the prevention of occupational HIV exposure to the prevention of non-occupational HIV exposure in group at high risk,such as MSM,in recent years.Clustering analysis classified research hotspots into three categories,including risk reduction through enhanced intervention,current status of global HIV PEP and German-Austrian Recommendation.Conclusions Non-occupational HIV PEP in groups at high-risk,especially MSM,has received increasing attention in recent years,the research of PEP mainly focus on improving the awareness and use of PEP in MSM and compliance in the course of medication.In the context of severe HIV epidemic in MSM without effective control in China,PEP should be strengthened to assess and explore the risk of HIV infection in MSM to provide reference for medical personnel and related departments to implement HIV non-occupation exposure blockade and formulate PEP medication.
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Objective To analyze and reveal the distribution,research hotspots and study trend of worldwide published articles correlated with HIV/AIDS post-exposure prophylaxis (PEP),and provide information for related studies in China.Methods CiteSpace software 5.1 was used to visualize all related papers in the web of science database published during 2000-2017.Results The average growth rate of international PEP-related papers was 10.78％,and number of published papers in 2016 was highest (n=34),relevant research hotspots have shifted from the prevention of occupational HIV exposure to the prevention of non-occupational HIV exposure in group at high risk,such as MSM,in recent years.Clustering analysis classified research hotspots into three categories,including risk reduction through enhanced intervention,current status of global HIV PEP and German-Austrian Recommendation.Conclusions Non-occupational HIV PEP in groups at high-risk,especially MSM,has received increasing attention in recent years,the research of PEP mainly focus on improving the awareness and use of PEP in MSM and compliance in the course of medication.In the context of severe HIV epidemic in MSM without effective control in China,PEP should be strengthened to assess and explore the risk of HIV infection in MSM to provide reference for medical personnel and related departments to implement HIV non-occupation exposure blockade and formulate PEP medication.
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Objective To investigate the acceptability and related factors of an "on-demand"pre-exposure prophylaxis (PrEP) to prevent HIV transmission among MSM in Shenyang.Methods MSM recruited by non-probability sampling method and questionnaire survey conducted by investigators to collect information on social and behavioral characteristics,awareness of PrEP,Truvada and the acceptability of two different PrEP-based trials.Multivariate logistic regression was employed for statistical analysis.Results Among the 292 respondents,34.2％ had heard of PrEP and 58.2％ (170/292) reported were interested in participating a PrEP trial-"on-demand" use or 48.3％ (141/292) interested on "daily" use (x2=5.785,P=0.02).Factors independently associated with those "on-demand" would include:having more than 2 male sexual partners during the past 6 month (aOR=1.7,95％CI:1.1-2.7),concerning on the positive effect of PrEP (vs.side effects) (aOR=6.4,95％CI:2.2-18.9),having an HIV-infected sexual partners (aOR=8.1,95％ CI:1.0-63.3) and self-reported high risk for HIV (aOR=2.6,95％CI:1.2-6.0).The last two factors were only associated with the "on-demand" group.Conclusions "On-demand" PrEP (as opposed to daily) seemed a more feasible prevention strategy on HIV and particularly in those having high risk behavior of HIV.For those who could not follow the daily medication or having HIV risk perception,"On-demand" basis PrEP trial should be recommended for them to follow.
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Objective To investigate the acceptability and related factors of an "on-demand"pre-exposure prophylaxis (PrEP) to prevent HIV transmission among MSM in Shenyang.Methods MSM recruited by non-probability sampling method and questionnaire survey conducted by investigators to collect information on social and behavioral characteristics,awareness of PrEP,Truvada and the acceptability of two different PrEP-based trials.Multivariate logistic regression was employed for statistical analysis.Results Among the 292 respondents,34.2％ had heard of PrEP and 58.2％ (170/292) reported were interested in participating a PrEP trial-"on-demand" use or 48.3％ (141/292) interested on "daily" use (x2=5.785,P=0.02).Factors independently associated with those "on-demand" would include:having more than 2 male sexual partners during the past 6 month (aOR=1.7,95％CI:1.1-2.7),concerning on the positive effect of PrEP (vs.side effects) (aOR=6.4,95％CI:2.2-18.9),having an HIV-infected sexual partners (aOR=8.1,95％ CI:1.0-63.3) and self-reported high risk for HIV (aOR=2.6,95％CI:1.2-6.0).The last two factors were only associated with the "on-demand" group.Conclusions "On-demand" PrEP (as opposed to daily) seemed a more feasible prevention strategy on HIV and particularly in those having high risk behavior of HIV.For those who could not follow the daily medication or having HIV risk perception,"On-demand" basis PrEP trial should be recommended for them to follow.
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Objective To study the B lymphocytes counts and the expression of TLR9 mRNA on B lymphocytes in peripheral blood from Chinese HIV-infected patients.Methods The cells from peripheral blood were stained with antibodies labeled with fluorescence and B lymphocytes were counted with flow cytometry.Using the method of magnetic activated cell sorting and real-time PCR,the expression of TLR9 mRNA was measured.Results The B lymphocytes counts in HIV/AIDS patients was significantly lower than that of healthy controls(P ＜0.01).The B lymphocytes counts in HIV/AIDS patients positively correlated with the CD4 +T cells counts(r =0.534,P = 0.006).The expression of TLR9 mRNA on B lymphocytes in HIV/AIDS patients was significantly lower than that of healthy controls(P =0.023),and positively correlated with the CD4 + T cells counts(r = 0.390,P = 0.040).Conclusion The B lymphocytes counts and the expression of TLR9 mRNA on B lymphocytes in Chinese HIV/AIDS patients were decreased due to HIV infection,which may correlate with disease progression.
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Objective To investigate the change of CD8+T lymphocyte non-cytotoxic antivirus response(CNAR)in slow progressors infected by HIV.Methods Applying with density gradient and immunomagnetic beads methods to purify the CD4+T lymphocyte from the healthy person and CD8+T lymphocyte from HIV-infected individuals.The CD4+T cell was infected by HIV(SF-33)virus and cocuhured with CD8+T cell.The culture supernatant was collected and the p24 value was detected by ELISA method.Results Our study showed that the CNAR function decreased by turns of slow progressors(SP),typical progressors(TP),health control group and AIDS group.There was significant difference between groups(P<0.01).We found a significant positive correlation between the CIM+T cell ture count and the CNAR function.The virus load didn't statistically correlate with the CNAR function.Conclusion The CNAR function possibly protected the HIV-infected individuals from progression.
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Objective To study the relationships between neutralizing antibody response against heterologous virus and disease progression in Chinese HIV-1 B'/C infected individuals. Methods Plasmas from HIV-1-infected individuals, grouped as HIV chronically infected or AIDS according to CD4+ count and clinical symptom, were tested for neutralizing activity against the three HIV-1 isolates with very low homology in vitro. Six two-fold dilutions of each plasma sample (from 1/10 to 1/320) were tested against each virus from the panel. Giving a 50% reduction in p24Ag compared with normal human plasma control wells was defined as positive. The breadth of the cross-neutralizing response was defined based on the number of viruses that were effectively neutralized by any given patient-derived plasma sample. The magnitude of the crossneutralizing response was defined based on the average neutralizing titer against all heterologous viruses. Resuits We found that there revealed a significant difference between HIV chronically infected and AIDS group in the breaths and magnitudes of neutralizing heterologous virus. There was higher prevalence for the frequency of neutralizing heterologous virus in HIV chronically infected than AIDS. The results showed that there was positive correlation between the breadths and magnitudes of neutralizing response against heterologous virus and the plasma HIV RNA level in HIV chronically infected group, while not in AIDS group. There was no association between the breadth of the neutralizing responses against heterologous virus and CD4 T cell counts. Conclusion The capacity of neutralizing antibodies against heterologous virus varied among different disease stage. There were higher titers of neutralizing antibodies in HIV chronically infected than AIDS group. The loss of neutralizing antibodies in plasma from AIDS group appears to be associated with a narrowing of the antibody response during disease progression. These suggest that the presence of neutralizing antibodies against hetreologous virus was associated with disease progression.
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Objective To examine the expression of TLR7/8 in monocytes purified from HIV-1 infected individuals and to study its association with disease progression. Methods Sixty-three HIV-1 infected individuals and 18 normal controls were enrolled. Monocytes were purified by MACS system and RNA of them was extracted by RNA mini kit of QIAGEN company. TLR7/8 expression was tested by real-time RT-PCR with ABI7500. Results It was found that the expression of TLR7 was strongly correlated with absolute CD4 count (r =0.614, P＜0.01) , so was TLR8 (r =0.419, P＜0.01). The expression of TLR7 in slow progressor (SP) group was higher than that in HIV-1 infected patients group, AIDS patients group and normal group (P ＜ 0. 05 ) . HIV group and normal group were strongly higher than AIDS group (P ＜ 0. 05). It was no significant differentiation of expression of TLR7 between HIV infection group and normal control group. The expression of TLR8 in SP group and normal group were significantly higher than that in AIDS group (P ＜ 0. 05). The expression of TLR8 was no singnificantly difference between SP group and HIV group or normal control group, so was it between HIV group or normal control group and AIDS group. Conclusion The expression of TLR7/8 in monocytes from HIV-1 infected patients significantly correlated with disease progression.
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Objective To investigate the association between APOBEC3G mRNA levels in peripheral blood mononuclear cells(PBMCs)of HIV/AIDS patients and disease progression in Henan province.Methods Real-time PCR was used to detect the mRNA levels of APOBEC3G in PBMCs of HIV/AIDS patients at difierent disease progression stage.Flow cytometry and automated viral load analyzer were used to count CD4+ T cells and plasma HIV viral loads.Results The mRNA levels of APOBEC3G in HIV/AIDS patients were lower than in HIV-negative controls(t=4.887,P＜0.01),and APOBEC3G levels were significantly higher in slow development group than those in HIV and AIDS groups(P＜0.05).The levels of APOBEC3G mRNA correlated positively with CD4+ T cell counts(R2=0.190,P=0.002)and negatively with HIV-1 viral loads(R2=0.094.P=0.038).Conclusions The APOBEC3G mRNA levels in PBMC of HIV infected individuals are associated with HIV disease pmgression. Higher mRNA expression levels of APOBEC3G may be one of the protective factors which can play important role in delaying disease progression.
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Objective To discuss the effect of different negative pressure to directional airflow in the main room of BSL-3 laboratory.Methods The author combined the experiment and numerical simulation in the study.Results Under the condition that the air supply volume in the main room of BSL-3 laboratory is ensured invariable,negative pressure is a critical factor to effect air distribution in the lab.Conclusion The simulation result shows that a good form of directional airflow under the condition of-50pa can come into being,which offers some reference to the engineering design.
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Objective:To study the relationships between neutralizing antibody response against autologous virus and disease progression of HIV-1 B'/C infected individuals in China.Methods:Twenty-four primary HIV-1 isolates were incubated with autologous plasma collected either freshly or at approximately six months intervals thereafter.Normal human peripheral blood mononuclear cells were incubated with the virus-serum mixtures for 7 days and then the production of p24 antigen was measured.The neutralizing titer of a particular plasma and virus was defined as the reciprocal of the highest dilution giving a 50% reduction in p24 Ag compared with NHP control wells.More than 1∶8 were considered significant and were scored as positive.Results:In neutralizing antibody(Nabs) response against contemporaneous virus,Nabs were produced in all slow progressors(SP) individuals,while only four in 21 of HIV group had.There was statistically significance of the neutralizing antibody titers between SP and HIV.When plasma samples of six months later were tested for their ability to neutralize autologous virus,all of SPs had higher neutralizing antibody titers and the titers of neutralizing antibody in HIV group had increased in different rate.Among the twenty-one individuals of HIV group,12 of these individuals had neutralizing antibody response against autologous virus and other 9 of these individuals had not.NAb titers of SP in six months later plasma were higher than those of HIV.There was a negative correlation between the generation of the neutralizing titer against autologous virus and the plasma HIV RNA level in HIV-1 B'/C infected individuals(including SP,HIV).Conclusion:Neutralizing antibody against autologous viruses in HIV-1 B'/C infected SP is higher than those of HIV group,suggesting that neutralizing antibodies play a vital role in delaying disease progression in these individuals.