Genetic Subtypes and Pretreatment Drug Resistance in the Newly Reported Human Immunodeficiency Virus-Infected Men Aged≥50 Years Old in Guangxi / 中国医学科学院学报

Objective To analyze the genetic subtypes of human immunodeficiency virus (HIV) and the prevalence of pretreatment drug resistance in the newly reported HIV-infected men in Guangxi. Methods The stratified random sampling method was employed to select the newly reported HIV-infected men aged≥50 years old in 14 cities of Guangxi from January to June in 2020.The pol gene of HIV-1 was amplified by nested reverse transcription polymerase chain reaction and then sequenced.The mutation sites associated with drug resistance and the degree of drug resistance were then analyzed. Results A total of 615 HIV-infected men were included in the study.The genetic subtypes of CRF01_AE,CRF07_BC,and CRF08_BC accounted for 57.4% (353/615),17.1% (105/615),and 22.4% (138/615),respectively.The mutations associated with the resistance to nucleoside reverse transcriptase inhibitors (NRTI),non-nucleoside reverse transcriptase inhibitors (NNRTI),and protease inhibitors occurred in 8 (1.3%),18 (2.9%),and 0 patients,respectively.M184V (0.7%) and K103N (1.8%) were the mutations with the highest occurrence rates for the resistance to NRTIs and NNRTIs,respectively.Twenty-two (3.6%) patients were resistant to at least one type of inhibitors.Specifically,4 (0.7%),14 (2.3%),4 (0.7%),and 0 patients were resistant to NRTIs,NNRTIs,both NRTIs and NNRTIs,and protease inhibitors,respectively.The pretreatment resistance to NNRTIs had much higher frequency than that to NRTIs (2.9% vs.1.3%;χ2=3.929,P=0.047).The prevalence of pretreatment resistance to lamivudine,zidovudine,tenofovir,abacavir,rilpivirine,efavirenz,nevirapine,and lopinavir/ritonavir was 0.8%, 0.3%, 0.7%, 1.0%, 1.3%, 2.8%, 2.9%, and 0, respectively. Conclusions CRF01_AE,CRF07_BC,and CRF08_BC are the three major strains of HIV-infected men≥50 years old newly reported in Guangxi,2020,and the pretreatment drug resistance demonstrates low prevalence.

Effects of Human Immunodeficiency Virus-positive Mothers Receiving Antiretroviral Therapy to Prevent Mother-to-child Transmission on the Growth and Development of 18-month-old Children in Lingshan County of Guangxi / 中国医学科学院学报

Objective To evaluate the effects of antiretroviral therapy(ART)for the prevention of mother-to-child transmission(PMTCT)of acquired immune deficiency syndrome(AIDS)on the growth and development of 18-month-old children born by human immunodeficiency virus(HIV)-positive pregnant women in Lingshan County,Guangxi Zhuang Autonomous Region,and provide scientific evidence for improving the ART medication plan for PMTCT.Methods Lingshan County,ranking the first in the HIV-epidemic counties of Guangxi,was selected as the research site.According to the design of retrospective case-control study,we assigned all the subjects into the case group and the control group:(1)The case group included the HIV-positive pregnant women who had received ART for PMTCT and their HIV-negative infants in Lingshan County from 2010 to 2017.The historical cards and PMTCT data of them were collected from the national PMTCT database.(2)The control group included the healthy pregnant women and their healthy babies born in the Lingshan Maternity and Infant Hospital in 2017,and the children's growth and development data were collected.The stunted growth in children was defined as at least one of the three main indicators of body height,body weight,and head circumference below the normal range.Results The number of HIV-positive mothers and their infants in the case group was 391 and 368,respectively,and 87.21%(341/391)and 95.38%(351/368)of mothers and infants respectively received ART medication.The HIV positive rate,mortality rate,and mother-to-child transmission rate of 18-month-old children were 1.36%(5/368),4.35%(16/368),and 2.01%(5/249),respectively.The incidence of stunted growth of 18-month-old children in the case group and the control group was 42.12%(155/368)and 23.06%(101/438),respectively,with significant difference(

Investigation on the risk factors for HIV infection among elderly male clients of the commercial female sex-workers in Guangxi Zhuang Autonomous Region, in 2012 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To monitor the current HIV prevalence, related risk behaviors and factors for HIV infection among the elderly male clients of the commercial female sex-workers (CFSW)in Guangxi.</p><p><b>METHODS</b>Face to face interview on male clients aged ≥40 years old was carried out in April to July, 2012. Information on demography, awareness of HIV prevention, related risk behaviors, history on HIV testing etc. were collected, with 3-5 ml full blood collected for testing on HIV. Data was analyzed by SPSS 18.0 software.</p><p><b>RESULTS</b>4260 clients were surveyed at 14 surveillance sites in which 82.1% had received secondary or lower education, 72.0% experienced commercial sex in places with low-class sex trade. HIV awareness rate of clients was 74.2% in which the rate of clients who were HIV positive was 65.8%. Among all the clients, 73 were detected as HIV positive, with the HIV positive rate as 1.40% . Samples from voluntary counseling and testing sites showed higher risk to HIV infection than from other sources (OR = 23.672, 95%CI:4.984-112.434). Samples from middle class population showed lower risk to HIV infection than those at low class (OR = 0.410, 95%CI:0.190-0.885). Among those who were syphilis negative (OR = 0.255, 95%CI: 0.132-0.491) or hepatitis C virus (HCV)negative (OR = 0.154, 95% CI:0.059-0.401), the risk of getting HIV infected seemed to be low. Rate on condom use was low for clients among all of the sex-related behaviors regardless of the marriage status. In those lower-class sex trade places, lower rate on the condom use was seen. Rate for previous HIV testing for clients was only 4.6% . Among 41 clients who had received CD4 testing, 80.5% of them showed CD4 under 350 cell/µl, 61.0% were under 200 cell/µl.</p><p><b>CONCLUSION</b>The HIV positive rate for elderly male clients of the CFSWs was high in Guangxi. Unprotective sexual contact with low class sex workers was the most important risk factor for HIV infection.</p>

A qualitative exploration of the role of antiretroviral therapy on Chinese rural life / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore factors influencing the quality of life of people living with HIV/AIDS (PLHA) and receiving antiretroviral therapy (ART) in rural China.</p><p><b>METHODS</b>In-depth interviews with 20 PLHA were conducted in March 1999. Participants were recruited from the USAID-funded Longitudinal Enhanced Evaluation of ART Project, which tracks a cohort of eligible PLHA receiving treatment at five collaborating treatment centers in Guangxi Autonomous Region, China. An interview guide (semi-structured with open-ended questions) was developed to provide a qualitative examination of the quality of life of PLHA.</p><p><b>RESULTS</b>Participants identified that ART affects physical health, including the experience of pain, side effects, and opportunistic infections. ART imposes lifestyle constraints such as reduced mobility due to drug procurement, and social restrictions due to the daily drug regimen. Participants discussed the psychological burden of taking drugs, and the fear of accidental transmission to others, or having their disease status known by others, as well as optimistic feelings about their future due to ART. ART poses a significant drain on individual's economic resources due to related medical costs, and inability to seek seasonal migrant labor due to reduced mobility.</p><p><b>CONCLUSION</b>While China's national free ART program improved the physical health of those surveyed, their social and economic needs were left unaddressed. To improve life outcomes for PLHA, and by extension, the wider Chinese population, quality of life measures should be included when evaluating the success of the ART program.</p>