Health utility measurement for people living with HIV/AIDS under combined antiretroviral therapy: A comparison of EQ-5D-5L and SF-6D.

We compared the discriminative validity, agreement and sensitivity of EQ-5D-5L and SF-6D utility scores in people living with HIV/AIDS (PLWHIV). We conducted a cross-sectional survey among PLWHIV aged more than 18 years old in 9 municipalities in Yunnan Province, China. A convenience sample was enrolled. We administered the SF-12 and EQ-5D-5L to measure health-related quality of life. The utility index of the SF-6D was derived from the SF-12. We calculate correlation coefficients to evaluate the relationship and agreement of 2 instruments. To evaluate the homogeneity of the EQ-5D-5L and SF-6D, intraclass correlation coefficients, scatter plots, and Bland-Altman plots were computed and drawn. We also used receiver operating characteristic curves to compare the discriminative properties and sensitivity of the econometric index. A total of 1797 respondents, with a mean age of 45.6 ±â€…11.7 years, was interviewed. The distribution of EQ-5D-5L scores skewed towards full health with a skewness of -3.316. The overall correlation between EQ-5D-5L and SF-6D index scores was 0.46 (P < .001). The association of the 2 scales appeared stronger at the upper end. An intraclass correlation coefficient of 0.59 between the EQ-5D-5L and SF-6D meant a moderate correlation and indicated general agreement. The Bland-Altman plot displayed the same results as the scatter plot. The receiver operating characteristic curve showed that the AUC for the SF-6D was 0.776 (95% CI: 0.757, 0.796) and that for the EQ-5D-5L was 0.732 (95% CI: 0.712, 0.752) by the PCS-12, and it was 0.782 (95% CI: 0.763, 0.802) for the SF-6D and 0.690 (95% CI: 0.669, 0.711) for the EQ-5D-5L by the MCS-12. Our study demonstrated evidence of the performance of EQ-5D-5L and SF-6D index scores to measure health utility in people living with HIV/AIDS. There were significant differences in their performance. We preferred to apply the SF-6D to measure the health utility of PLWHIV during the combined antiretroviral therapy period. Our study has demonstrated evidence for instrument choice and preference measurements in PLWHIV under combined antiretroviral therapy.

Syphilis seroprevalence and seroconversion among people newly diagnosed with HIV during the pre-antiretroviral therapy period in rural China.

Syphilis has a high incidence among people living with HIV (PLHIV), which may be attributable to their similar sexual transmission route. A retrospective cohort study was conducted during the period 2009-2015 to investigate the syphilis seroprevalence and incidence of syphilis seroconversion among newly-diagnosed PLHIV in rural Yunnan, China. Recent HIV infection among PLHIV was identified by BED capture enzyme immunoassay. PLHIV were followed until they initiated antiretroviral therapy. Syphilis serology was conducted at baseline and each follow-up over the study period. Among 2162 participants, the syphilis seroprevalence at baseline was 2.7%, 95% confidence interval (CI) (2.4-3.1). Single and divorced (versus married) (aOR = 2.9, [1.1-7.4]; 5.9, [2.4-14.7], respectively), employed in the service industry (versus unemployed) (2.8, [1.4-5.6]), being diagnosed with HIV in hospitals (versus voluntary counselling and testing) (5.1, [2.0-12.9]), recent HIV infection (17.9, [8.5-37.9]) and inconsistent condom use in the previous three months (versus consistent condom use) (6.2, [2.8-13.4]) were associated with higher risk of syphilis infection at baseline. Participants contributed 1955.4 person-years (PYs) of follow-up, with a median follow-up period of 0.9 years (IQR: 0.5-1.9) and the incidence of syphilis seroconversion was 2.2 (95% CI 1.5-2.9) per 100 PYs. The syphilis seroprevalence at baseline (aHR 3.7, [1.8-7.9]), had a HIV-negative partner at baseline (3.9, [1.5-9.8]) and inconsistent condom use in the last three months at baseline (6.0, [1.4-25.4]) were associated with higher risk of syphilis seroconversion. Our findings indicate that the public health response should be escalated to minimise the spread of syphilis co-infection among PLHIV and reducing condomless sexual behaviours after HIV diagnosis.

Hypertensive disorders during pregnancy and elevated blood pressure in the offspring: A systematical review and meta-analysis protocol.

BACKGROUND: Hypertensive disorders during pregnancy (HDP), including gestational hypertension, preeclampsia (PE), and chronic hypertension, affect approximately 10% of pregnancies worldwide. PE was associated with elevated blood pressure (BP) in the offspring confirmed by previous literature. No previous systematic review has investigated the associations between the subtypes of HDP and BP in offspring. Therefore, from the published literature, the present systematic review and meta-analysis aims to reach to a clear consensus on this topic. METHODS: The Cochrane Handbook for Systematic Reviews of Interventions was used to structure our methodological approach, and the Preferred Reporting Items for Systematic Reviews and Meta Analyses Protocols guidelines to this protocol. We will include cohort, case-control, and cross-sectional studies, in which HDP or its subtypes were reported and BP in the offspring was the outcome of interest. A systematic search of PubMed, Embase, the Cochrane library, and Web of Science will be conducted according to a specific search strategy. The titles and abstracts of all literature will be reviewed independently by 2 authors. A standardized data collection form will be used for data extraction. The overall pooled estimates will be calculated by meta-analysis in Revman 5.3 based on an inverse variance method. According to the heterogeneity by the I, a random-effect model or a fixed-effect model will be chosen to pool data. Risk of bias and quality of the studies will be assessed by a suitable bias classification tool. RESULTS: This study will provide high-quality evidence of the effects in offspring BP, which were influenced by different subtypes of HDP. CONCLUSION: This systematic review will infer a conclusion on the associations between different subtypes of HDP and BP in offspring. ETHICS AND DISSEMINATION: Due to the data come from the published study, the present systematic review and meta-analysis does not require ethics approval. Findings will be published in a peer-reviewed journal. REGISTRATION: Supporting data can be found at the International Prospective Register of Systematic Reviews (PROSPERO) website, with registration number CRD 42018110872.

Expression and significance of aquaporin-2 in human ectocervical-vaginal epithelial cells.

AIM: To observe the expression of aquaporin-2 (AQP2) in human ectocervical-vaginal epithelial cells (hECEs). METHODS: The study included 75 females who underwent hysterectomy for benign pelvic lesions. They were divided into three groups according to menstrual states: 28 cases in the normal menstrual group, 24 cases in the perimenopausal group, and 23 cases in the postmenopausal group. Specimens were obtained from the posterior vaginal wall. AQP2 mRNA and protein expression were detected using quantitative real-time polymerase chain reaction and immunohistochemistry, respectively. Estrogen (E2), follicle-stimulating hormone (FSH) and plasma osmolality were assayed by blood routine test. Linear regression analysis was used for data analysis. RESULTS: AQP2 mRNA and protein expression were detected in all hECE tissues. AQP2 mRNA and protein expression in the normal menstrual group were significantly higher than those in the peri- and menopausal groups (p < 0.05). AQP2 mRNA was negatively correlated with FSH level (R = -0.537, p < 0.05), age (R = -0.508, p < 0.05) and plasma osmolality (R = -0.214, p < 0.05), but positively correlated with E2 (R = 0.511, p < 0.05). AQP2 protein expression was negatively correlated with FSH (R = -0.419, p < 0.05) and age (R = -0.034, p < 0.05), but positively correlated with E2 (R = 0.367, p < 0.05). CONCLUSIONS: The downregulation of AQP2 might be a causative factor for decreased vaginal secretions during the menopausal period.