HIV care continuum among newly diagnosed student and non-student youths between 2012 and 2016 in Hangzhou, China / 中华医学杂志(英文版)

Background@#Youths are disproportionally affected by the human immunodeficiency virus (HIV) infection. We aimed to assess antiretroviral therapy (ART) initiation and viral suppression rates among student and non-student youths in Hangzhou, China.@*Methods@#Data were taken from the Chinese HIV/acquired immune deficiency syndrome Comprehensive Response Information Management System. Youths aged 15 to 24 years who were newly diagnosed with HIV between 2012 and 2016 and were living in Hangzhou were included in the study. Comparisons between student and non-student youths were made for ART initiation within 30 days, 90 days, and 12 months of HIV diagnosis, and the viral suppression rate at 12 months of HIV diagnosis and at 12 months of ART initiation.@*Results@#A total of 707 cases met inclusion criteria, 29.6% of which were students and 70.4% were non-student youths. The student group had a higher proportion of ART initiation compared with the non-student group within 30 days of diagnosis (45.5% vs. 37.0%, P = 0.044), and a slightly higher but not statistically significant proportion at 90 days (67.0% vs. 62.7%), and 12 months (83.7% vs. 78.5%) of HIV diagnosis. ART initiation within 30 days improved from <15% in 2012 to over 65% in 2016 in both groups, and ART initiation within 90 days improved from <30% in 2012 to >90% in 2016. A smaller proportion of students experienced viral suppression compared with the non-student group (9.6% vs. 17.1%, P = 0.011) at 12 months after HIV diagnosis, but the suppression rate was similar at 12 months of ART initiation (69.9% vs. 71.1%, P = 0.743).@*Conclusions@#ART initiation in both student and non-student youths has significantly improved between 2012 and 2016. However, the viral suppression rate remained unacceptably low at 12 months of HIV diagnosis in both student and non-student groups. Specific intervention strategies must be taken to address this challenge.

Low Calf Circumference Predicts Nutritional Risks in Hospitalized Patients Aged More Than 80 Years / 生物医学与环境科学（英文）

OBJECTIVE@#The aim of this study was to determine whether low calf circumference (CC) could predict nutritional risk and the cutoff values of CC for predicting nutritional risk in hospitalized patients aged ⪖ 80 years.@*METHODS@#A total of 1,234 consecutive patients aged ⪖ 80 years were enrolled in this study. On admission, demographic data, CC, and laboratory parameters were obtained. Patients with Nutritional Risk Screening 2002 (NRS-2002) total score ⪖ 3 were considered as having nutritional risk.@*RESULTS@#CC values were significantly lower in patients with nutritional risk compared to those in patients without nutritional risk [27.00 (24.50-31.00) vs. 31.00 (29.00-33.50], P < 0.001]. CC was negatively correlated with age and nutritional risk scores. Logistic regression analysis of nutritional risk revealed that body mass index, albumin level, hemoglobin level, cerebral infarction, neoplasms, and CC (OR, 0.897; 95% confidence interval, 0.856-0.941; P < 0.001) were independent impact factors of nutritional risk. Nutritional risk scores increased with a decrease in CC. In men, the best CC cutoff value for predicting nutritional risk according to the NRS-2002 was 29.75 cm. In women, the cutoff value was 28.25 cm.@*CONCLUSION@#CC is a simple, noninvasive, and valid anthropometric measure to predict nutritional risk for hospitalized patients aged ⪖ 80 years.

HIV care continuum among newly diagnosed student and non-student youths between 2012 and 2016 in Hangzhou, China / 中华医学杂志(英文版)

BACKGROUND@#Youths are disproportionally affected by the human immunodeficiency virus (HIV) infection. We aimed to assess anti-retroviral therapy (ART) initiation and viral suppression rates among student and non-student youths in Hangzhou, China.@*METHODS@#Data were taken from the Chinese HIV/acquired immune deficiency syndrome Comprehensive Response Information Management System. Youths aged 15 to 24 years who were newly diagnosed with HIV between 2012 and 2016 and were living in Hangzhou were included in the study. Comparisons between student and non-student youths were made for ART initiation within 30 days, 90 days, and 12 months of HIV diagnosis, and the viral suppression rate at 12 months of HIV diagnosis and at 12 months of ART initiation.@*RESULTS@#A total of 707 cases met inclusion criteria, 29.6% of which were students and 70.4% were non-student youths. The student group had a higher proportion of ART initiation compared with the non-student group within 30 days of diagnosis (45.5% vs. 37.0%, P = 0.044), and a slightly higher but not statistically significant proportion at 90 days (67.0% vs. 62.7%), and 12 months (83.7% vs. 78.5%) of HIV diagnosis. ART initiation within 30 days improved from 90% in 2016. A smaller proportion of students experienced viral suppression compared with the non-student group (9.6% vs. 17.1%, P = 0.011) at 12 months after HIV diagnosis, but the suppression rate was similar at 12 months of ART initiation (69.9% vs. 71.1%, P = 0.743).@*CONCLUSIONS@#ART initiation in both student and non-student youths has significantly improved between 2012 and 2016. However, the viral suppression rate remained unacceptably low at 12 months of HIV diagnosis in both student and non-student groups. Specific intervention strategies must be taken to address this challenge.

Prevalence of HIV, syphilis and HCV and their risk factors among drug users in Hangzhou / 预防医学

Objective To learn the prevalence of HIV, syphilis and HCV and to identify the potential risk factors among drug users in Hangzhou. Methods A consecutive cross-sectional survey was conducted from 2012 to 2016. The drug users from compulsory rehabilitation center, community and methadone clinic were interviewed face to face with questionnaires to collect the information about their demographic characteristics, drug use behaviors and sexual behaviors. Blood specimens were collected for HIV, syphilis and HCV testing. Results Totally 4067 drug users were included during this 5-year study. The infection rates of HIV, syphilis and HCV were 0.64％, 7.25％ and 22.69％, respectively. Multivariate logistic regression analysis indicated that the risk factors for syphilis infection were female (OR=4.411, 95％ CI: 3.273-5.945) , single (married/cohabited:OR=0.664, 95％ CI: 0.482-0.915; divorced/widowed: OR=0.534, 95％ CI: 0.353-0.810) , club drug user (OR=5.064, 95％CI: 3.287-7.803) and mixed drug user (OR=2.663, 95％CI: 1.191-5.954); the risk factors for HCV infection were age (OR: 2.168-2.878), place of domicile (OR=1.747, 95％CI: 1.398-2.184), injecting drug use (OR=3.120, 95％CI: 2.534-3.840) and conventional drug use (club drug user: OR=0.348, 95％CI: 0.277-0.438; mixed drug user: OR=0.611, 95％CI: 0.390-0.959) . Conclusion The infection rate of syphilis and HIV is high among drug users in Hangzhou. Female, single, club drug use and mixed drug use may increase the risk of syphilis infection. high age, drug injection and migrant population are risk factors for HCV infection.

Epidemiological characteristics of students with HIV/AIDS in Hangzhou / 预防医学

Objective To explore the epidemiological characteristics of young students with HIV/AIDS in Hangzhou and to provide scientific basis for AIDS prevention and control in school settings. Methods Data on HIV/AIDS patients was collected from HIV Comprehensive Prevention and Control Information System, and retrospective survey was conducted to those who were students and whose current residential address was Hangzhou. Results A total of 132 HIV/AIDS student cases were surveyed. The average age was (21.42±2.65) years, and 98.48％ were male. The proportion of homosexual transmission was 83.33％. Before positive confirmation, 55.45％ had homosexual partners both from students and non-students, 90.91％ had temporary sexual behavior, five cases had heterosexually fixed partners and two cases had heterosexually temporary partners.The proportions of condom use in all types of sexual partners ranged from 0.00％-50.00％. Seventy-two (54.55％) HIV/AIDS student cases thought they were impossible to be infected by HIV. Only 23.48％ of cases did HIV antibody test before positive confirmation. The proportion of HARRT was 80.30％. The proportion of co-infected with syphilis was 18.03％. Conclusion Homosexual behavior is the main route of transmission for HIV infection among young students in Hangzhou. Dangerous behaviors are prevalent, and the situation of AIDS prevention and control among students is severe.

A study on the association of baseline CD4+T and early antiretroviral therapy effect among MSM HIV/AIDS patients / 预防医学

Objective To analyze the association between baseline level of CD4+T and the therapeutic effects of highly active antiretroviral therapy (HAART) for MSM HIV/AIDS in Hangzhou City. Methods We recruited MSM HIV/AIDS who initiated HAART from July 1st 2014 to June 30th 2016 into the study in Hangzhou City. MSM HAART patients whose baseline CD4+T≥500 copies/μL was set as observation group, and baseline CD4+T<500 copies/μL was set as control group. Patients were tested CD4 count and viral load regularly. We compared HAART effects of observation group and control group. Results We recruited 1206 MSM patients with access to HAART in our study in Hangzhou City. And 1026 patients were set in control group, and 180 patients were set in observation group. In the 12th month, the rates of two groups' patients with CD4 successfully recovered (reached 719 cells/μL) were 12.50% and 39.13%. In the 18th month, the rates were 13.75% and 38.71%. The median time of patients with CD4 first successfully recovered to 719 cells/μL was 7.2 month s in observation group, while the median time of control group was 20.4 months, which was longer than observation group (P<0.05) . A total of 375 patients were tested viral load, and the successful suppression rate of viral load was 97.33%. The rates of observation and control group were 96.34% and 97.50% (P>0.05) . Conclusion The rates of viral successful suppression were similar between baseline CD4 counts ≥500 cells/μL group and<500 cells/μL group among MSM HAART patients. Recovery time in baseline CD4 counts ≥500 cells/μL group was shorter than baseline CD4 counts<500 cells/μL group.