Twenty-seven year surveillance of blood transfusion recipients infected with HIV-1 in Hebei Province, China.

We conducted an investigation of blood management in which blood transfusion recipients underwent molecular biological analysis, to trace the possible source of HIV infection. Epidemiological investigation was carried out among HIV-infected individuals. Blood transfusion recipients infected with HIV were tracked for the date of transfusion, reason for transfusion, hospital where transfusion was received, source of blood, components of transfusion, number of transfusions, and transfusion volume. A total of 285 blood transfusion recipients infected with HIV-1 were detected in Hebei over the study period, with 42.81% (122/285) detected through clinical diagnostic testing. These cases showed a concentrated distribution in southern Hebei, with local outbreak characteristics. A census of the population in Shahe County, which had a high concentration of cases, revealed that recipients of blood transfusions had an HIV infection rate of 15.54% (92/592). Post-transfusion infection frequently occurred among blood transfusion recipients at township medical institutions, with a peak in 1995. Owing to late detection of HIV infection among blood transfusion recipients, the rates of spousal transmission and mother-to-child transmission reached 20.87% and 28.05%, respectively. Around 1995, community medical institutions did not screen for HIV antibodies among paid blood donors, which was an important cause of the outbreak of HIV-1 infection among blood transfusion recipients. Our findings indicate that cases of blood transfusion-related infection decreased rapidly with gradual improvement in the HIV screening system for blood donors that began in 1995, particularly after full implementation of HIV nucleic acid testing of volunteer blood donors was begun in 2015.

Baseline Investigation of HIV-1 Primary Drug Resistance Among Newly Diagnosed Treatment-Naïve HIV-1 Individuals in Hebei, China.

Human immunodeficiency virus (HIV) primary drug resistance (PDR) has influenced the long-term therapeutic effects of antiretroviral drugs. However, for the overall PDR prevalence in China, no report was found in published articles. In our study, an extensive cross-sectional investigation based on all newly diagnosed treatment-naive HIV-infected individuals was conducted. The overall prevalence of HIV-1 PDR among newly diagnosed treatment-naive HIV-1 individuals was 8.3% (60/720), obviously beyond the warning line (5.0%) set by WHO. The prevalence of PDR to PIs, nucleoside reverse transcriptase inhibitors, and non-nucleoside reverse transcriptase inhibitors was 4.9% (35/720), 0.4% (3/720), and 2.5% (18/720), respectively. Moreover, the occurrence of HIV-1 PDR strains was random among different prefectures. HIV-1 PDR strains were extensively circulating among the sexual contact population inside and outside the Hebei province, especially between neighboring provinces and Hebei. Hebei province has become the moderate level PDR epidemic area. Enhanced surveillance for PDR is necessary among treatment-naïve individuals in Hebei, and we must take effective measures to cut off the spread of HIV PDR strains.

Effect of YHHJ on the expression of the hepatocellular bile acid transporters multidrug resistance-associated protein 2 and bile salt export pump in ethinylestradiol-induced cholestasis.

The herbal medicine Yin Huang Mixture (YHHJ; patent no. 200910031240.7) is an aqueous extract composed from various herbs, including Artemisia capillaries Thunb, Hypericum japonicum Thunb, Eucommia ulmoides Oliver, Rheum officinale Baill, Gardenia jasminoides Ellis, Poria cocos Wolf and Dictamnus dasycarpus Turcz. Previous studies have indicated that YHHJ treatment has a beneficial effect on ameliorating itching and reducing serum bile acid levels in patients with intrahepatic cholestasis of pregnancy (ICP). However, the molecular mechanisms of action of YHHJ in ICP have not been fully elucidated. Therefore, the present study investigated an experimental hepatocellular cholestasis model to explore the regulatory role of YHHJ on the expression of the bile acid carriers, multidrug resistance-associated protein 2 (MRP2) and the bile salt export pump (BSEP). Initially, 5 mg/kg/day 17-α ethinylestradiol (EE) was used to induce cholestasis in rats and primary isolated rat hepatocytes. Subsequently, 9 or 36 g/kg/day YHHJ water extract was administrated. Blood samples were collected and serum biochemical parameters of total bile acids (TBA), total bilirubin (TBil), alanine transaminase and aspartate aminotransferase levels were determined. Rat livers and primary isolated rat hepatocytes were obtained and the protein and mRNA expression levels of MRP2 and BSEP were analyzed by western blot analysis and reverse transcription-quantitative polymerase chain reaction, respectively. Results revealed that EE-induced hepatocellular cholestasis was associated with a significant increase in serum TBA and TBil levels, whereas, YHHJ treatment significantly reversed this effect (P<0.01). Further experiments on the molecular mechanism revealed that EE significantly decreased the expression of MRP2 and BSEP compared with the control group, whereas YHHJ treatment significantly upregulated MRP2 and BSEP expression in vivo and in vitro compared with no YHHJ treatment (P<0.01). In addition, to establish whether upregulation of MRP2 and BSEP protein expression levels resulted from increased expression of their respective mRNA, the mRNA expression levels were determined. Results indicated that YHHJ treatment significantly increased MRP2 and BSEP mRNA expression levels in EE-induced hepatocellular cholestasis compared with no YHHJ treatment (P<0.01). In conclusion, the present findings suggest that YHHJ effects EE-induced cholestasis and this process may be mediated through regulating hepatobiliary transporters, MRP2 and BSEP.

Regional Transmission Pattern of HIV-1 Non-CRF01_AE Strains Circulating in Hebei Province, China.

HIV-1 genetic diversity has recently been more and more complicated in Hebei province. To know about the transmission pattern of HIV-1 in Hebei, the phylogenetic analysis of non-CRF01_AE strains was performed using the maximum-likelihood (ML) method. Four clusters and two clusters were observed in the CRF07_BC and subtype B ML tree, respectively. Of these clusters, men who have sex with men (MSM) sequences were the most frequent, and no pure heterosexual cluster was found in this study. Our findings highlighted the close transmission relationship between the main HIV-1 non-CRF01_AE strains and the sexual exposure especially among MSM between neighboring provinces, such as Beijing and Liaoning, and Hebei. This provides new evidence that the main strains of HIV-1 were introduced into Hebei through sexual exposure especially among MSM from neighboring provinces, suggesting that it is urgent for us to take measures together with neighboring provinces to cut off HIV-1 dissemination chain through MSM.

HIV-1 molecular epidemiology among newly diagnosed HIV-1 individuals in Hebei, a low HIV prevalence province in China.

New human immunodeficiency virus type 1 (HIV-1) diagnoses are increasing rapidly in Hebei. The aim of this study presents the most extensive HIV-1 molecular epidemiology investigation in Hebei province in China thus far. We have carried out the most extensive systematic cross-sectional study based on newly diagnosed HIV-1 positive individuals in 2013, and characterized the molecular epidemiology of HIV-1 based on full length gag-partial pol gene sequences in the whole of Hebei. Nine HIV-1 genotypes based on full length gag-partial pol gene sequence were identified among 610 newly diagnosed naïve individuals. The four main genotypes were circulating recombinant form (CRF)01_AE (53.4%), CRF07_BC (23.4%), subtype B (15.9%), and unique recombinant forms URFs (4.9%). Within 1 year, three new genotypes (subtype A1, CRF55_01B, CRF65_cpx), unknown before in Hebei, were first found among men who have sex with men (MSM). All nine genotypes were identified in the sexually contracted HIV-1 population. Among 30 URFs, six recombinant patterns were revealed, including CRF01_AE/BC (40.0%), CRF01_AE/B (23.3%), B/C (16.7%), CRF01_AE/C (13.3%), CRF01_AE/B/A2 (3.3%) and CRF01_AE/BC/A2 (3.3%), plus two potential CRFs. This study elucidated the complicated characteristics of HIV-1 molecular epidemiology in a low HIV-1 prevalence northern province of China and revealed the high level of HIV-1 genetic diversity. All nine HIV-1 genotypes circulating in Hebei have spread out of their initial risk groups into the general population through sexual contact, especially through MSM. This highlights the urgency of HIV prevention and control in China.

HIV-1 drug-resistant mutations and related risk factors among HIV-1-positive individuals experiencing treatment failure in Hebei Province, China.

BACKGROUND: To understand HIV-1 drug resistance in 11 prefectures of Hebei Province, China, we implemented a cross-sectional HIV-1 molecular epidemiological survey. METHODS: Blood samples were collected from 122 newly diagnosed drug-naïve HIV-1-positive individuals and 229 antiretroviral therapy (ART)-failure individuals from 11 prefectures in Hebei Province, China. Patient demographic data were obtained via face-to-face interviews using a standardized questionnaire when blood samples were collected. Genotyping of HIV-1 drug resistance (DR) was implemented using an in-house assay. RESULTS: In this study, the overall prevalence of HIV-1 DR was 35.5%. The prevalence of HIV-1 DR in participants experiencing treatment failure and ART-naïve participants was 51.9 and 5.9%, respectively. Mutations in protease inhibitors, nucleoside reverse transcriptase inhibitors (NRTIs), and non-NRTI (NNRTIs), as well as dual and multiple mutations were extensively seen in participants experiencing treatment failure. The proportions of NNRTI mutations (χ2 = 9.689, p = 0.002) and dual mutations in NRTIs and NNRTIs (χ2 = 39.958, p < 0.001) in participants experiencing treatment failure were significantly higher than those in ART-naïve participants. The distributions of M184V/I and M41L mutations differed significantly among three main HIV-1 genotypes identified. Viral load, symptoms in the past 3 months, CD4 counts, transmission route, and the duration of ART were found to be associated with HIV-1 DR. CONCLUSIONS: Our results suggest that new prevention and control strategies should be formulated according to the epidemic characteristics of HIV-1-resistant strains in Hebei Province, where antiretroviral drugs are widely used.

Recombinant Patterns of Nine Novel HIV-1 Recombinant Strains Identified in Hebei Province, China.

We found cluster 1 and cluster 2 that were identified as two potential circulating recombinant forms (CRFs) by analyzing the recombinant breakpoints and phylogenetic tree. Three sequences composed of CRF01_AE, subtype C, and potential subtype B (N/A) in cluster 1 had nearly identical recombinant breakpoints, and four sequences composed of CRF01_AE and subtype B in cluster 2 possessed identical breakpoints. Demographic characteristics indicated that there were no epidemiological linkages among three subjects in cluster 1 and four subjects in cluster 2, respectively. Likewise, two unique recombinant forms (URFs) were found in this study: one URF was composed of subtype C and subtype B, and subtype B was inserted into a backbone of subtype C; another URF was composed of subtype C, subtype B, CRF01_AE, and subtype A2. It was inferred that the potential novel CRFs and URFs have spread into general populations, suggesting that the series research of novel recombinant strains will be a priority for our researches in the future.

HIV-1 genetic diversity and its distribution characteristics among newly diagnosed HIV-1 individuals in Hebei province, China.

BACKGROUND: Since the first HIV-1 case in 1989, Hebei province has presented a clearly rising trend of HIV-1 prevalence, and HIV-1 genetic diversity has become the vital barrier to HIV prevention and control in this area. To obtain detailed information of HIV-1 spread in different populations and in different areas of Hebei, a cross-sectional HIV-1 molecular epidemiological investigation was performed across the province. METHODS: Blood samples of 154 newly diagnosed HIV-1 individuals were collected from ten prefectures in Hebei using stratified sampling. Partial gag and env genes were amplified and sequenced. HIV-1 genotypes were identified by phylogenetic tree analyses. RESULTS: Among the 139 subjects genotyped, six HIV-1 subtypes were identified successfully, including subtype B (41.0 %), CRF01_AE (40.3 %), CRF07_BC (11.5 %), CRF08_BC (4.3 %), unique recombinant forms (URFs) (1.4 %) and subtype C (1.4 %). Subtype B was identified as the most frequent subtype. Two URF recombination patterns were the same as CRF01_AE/B. HIV-1 genotype distribution showed a significant statistical difference in different demographic characteristics, such as source (P < 0.05), occupation (P < 0.05) and ethnicity (P < 0.05). The distributions of subtype B (P < 0.05), CRF01_AE (P < 0.05), CRF07_BC (P < 0.05) and subtype C (P < 0.05) showed significant differences in all ten prefectures, and the distributions of all six subtypes were significantly different in Shijiazhuang (P < 0.05) and Xingtai (P < 0.05), but not in other prefectures (P > 0.05). The differences in HIV-1 genotype distribution were closely associated with transmission routes. Particularly, all six subtype strains were found in heterosexuals, showing that HIV-1 has spread from the high-risk populations to the general populations in Hebei, China. In addition, CRF01_AE instead of subtype B has become the major strain of HIV-1 infection among homosexuals. CONCLUSIONS: Our study revealed HIV-1 evolution and genotype distribution by investigating newly diagnosed HIV-1 individuals in Hebei, China. This study provides important information to enhance the strategic plan for HIV prevention and control in China.

Eighteen-year follow-up report of the surveillance and prevention of an HIV/AIDS outbreak amongst plasma donors in Hebei Province, China.

BACKGROUND: There has been a clear increase in HIV-1 infection cases in recent years in Hebei Province, China, and transmission via blood is one of the risk factors in the early. This article aimed to investigate the HIV infection rate and control efficiency among the paid blood donor population over a period of 18 years. METHODS: From 1995-2013, HIV/AIDS cases among former blood donors in Hebei Province were registered and closely monitored to collect data of all-cause mortality, intervention measures to prevent family transmission, disease transmission between couples as well as between mothers and infants, and HAART therapy outcomes. RESULTS: A total of 326 cases were identified as directly infected with HIV/AIDS during plasma donation in Hebei Province. Of these, 146 cases (44.8%) were identified in the same year as infection; 180 cases (55.2%) were identified 1-18 years after infection because they did not participate in the 1995 screening. The final case was identified in February 2012. By 2013, the mortality rate and survival rate of plasma donor-related HIV/AIDS was 54.9% and 45.1%, respectively. The identified transmission rate between couples was 11.3% (8/71); this rate during the same year as infection was 3.3% (1/30), and the rate 4-17 years after HIV infection was 17.1% (7/41). Approximately 91.2% (145/159) of married women of childbearing age did not have children after being informed of HIV infection. Only 8.8% (14/159) of these women had children after being informed of HIV infection. The mother-to-infant transmission rate was 38.5% (5/13). The HAART coverage rate has increased from 10.1% (16/159) in 2003 to 83.6% (127/152) in 2013. Since 1999, the HIV mortality rate has trended up; by 2013, the cumulative mortality rate reached 54.9% (179/326). After HAART was initiated in China, the death rate decreased to some extent. Second generation transmission (via couple or mother-to-infant transmission) among blood donor-related HIV cases accounted for approximately 4.0% (13/326). All first- or second-generation cases were infected with HIV-1 subtype B. CONCLUSIONS: In this accident of HIV-infection among plasma donors in Hebei Province, a total of 339 direct and second-generation cases have been identified over 18 years of monitoring. Favorable clinical results have been achieved using intervention measurements and antiviral therapy.

HIV-1 Genetic Diversity and Transmitted Drug Resistance Among Recently Infected Individuals at Men Who Have Sex with Men Sentinel Surveillance Points in Hebei Province, China.

For this study, 50 HIV-1 plasma samples of recently infected men who have sex with men (MSM) were amplified and sequenced. Multiple subtypes were identified by phylogenetic analyses of HIV-1 gag, env, and pol gene regions, including CRF01_AE (56.0%), CRF07_BC (30.0%), subtype B (12.0%), and unique recombinant forms (URFs, 6.0%). CRF01_AE was the most frequent genotype in the epidemic. Three recombination patterns of URFs were identified: 01BC, 01B, and 01C. The rate of HIV-1 transmitted drug resistance (TDR) mutation (M46L) was 2.08% (1/48). URFs and TDR first identified in this study suggest that HIV-1 prevalence is more and more complicated, and HIV-1 drug-resistant strains have begun to spread among at risk populations in Hebei. Our findings can provide vital information for an efficient surveillance system and strategic HIV prevention and control measures in China by revealing the evolutionary status and HIV-1 TDR of HIV-1 strains among recently infected MSM in Hebei Province.

[Effect of highly active anti-retroviral therapy on reducing HIV/AIDS related death in Hebei, 1989-2013].

OBJECTIVE: To investigate the effect of highly active anti-retroviral therapy (HAART) on reducing HIV/AIDS related death. METHODS: The analysis was conducted by using the data of 4,148 HIV/AIDS cases reported in Hebei province from 1989 to 2013. Regular follow-up, CD4 detection, registration of death were carried out for them. Free HAART has been provided to people living with HIV/AIDS who met the treatment requirement since 2003. RESULTS: Of 4,148 HIV/AIDS cases, 12,451.48 person years were observed, 968 cases died due to all registered death causes. The death density was 7.77/100 person years. The death density was 2.87/100 person years for the HIV/AIDS cases receiving HAART, and 16.58/100 for the HIV/AIDS cases receiving no HAART. In 1,894 AIDS cases, a total of 4,774.48 person years were observed from onset to death, 581 cases died due to all registered death causes, and the death density was 121.69/100 person years. The death density was 4.77/100 person years for the cases receiving HAART, and 125.92/100 person years for the cases receiving no HAART. In the cases with CD less than 200/mm3, the death density was 22.9/100 person years for those receiving no HAART and 5.3/100 person years for those receiving HAART. The annual analysis found that the death rate due to all registered death causes declined as the increase of HAART coverage in people living with HIV/AIDS. The expanding of HAART coverage in people infected with HIV can reduce death rate among them. CONCLUSION: Further expanding of HAART can effectively reduce the death among people living with HIV/AIDS.

A simple, rapid and eco-friendly approach for the analysis of aromatic amines in environmental water using single-drop microextraction-gas chromatography.

Single-drop microextraction (SDME) coupled with gas chromatography-flame ionization detector (GC-FID) was developed for the extraction and determination of aromatic amines (AAs) in environmental water samples. A silicon tube was introduced for the SDME procedure by inserting it into the needle of the micro-injector. In this manner, a large volume of extractant is allowed to be suspended for the extraction, leading to the enhancement of method sensitivity and reproducibility. Extraction parameters which control the performance of SDME such as the type of microextraction solvent and volume, sample pH, ionic strength and extraction time were investigated and optimized. Under the optimized conditions, the SDME-GC method exhibited good linearity from 0.5 to 50 µg mL(-1) for aniline and 4-methylaniline and 0.1 to 50 µg mL(-1) for N-methylaniline and N, N-diethylaniline. The enrichment factors were calculated to be 42-509. The SDME-GC method was performed for the determination of AAs in environmental water samples including drinking, lake and sea water, and excellent recoveries and relative standard deviations (RSD values) ranging from 79.5 to 122.7% and 3.2 to 13.3%, respectively, were obtained. The results demonstrated that SDME-GC is a rapid, simple and effective sample preparation method and could be successfully applied for the determination of AAs in environmental water samples.

Ordered mesoporous carbon/Nafion as a versatile and selective solid-phase microextraction coating.

In this study, ordered mesoporous carbon (OMC) with large surface area (1019m(2)g(-1)), uniform mesoporous structure (pore size distribution centering at 4.2nm) and large pore volume (1.46cm(3)g(-1)) was synthesized using 2D hexagonally mesoporous silica MSU-H as the hard template and sucrose as the carbon precursor. The as-synthesized OMC was immobilized onto a stainless steel wire using Nafion as a binder to prepare an OMC/Nafion solid-phase microextraction (SPME) coating. The extraction characteristics of the OMC/Nafion coating were extensively investigated using a wide range of analytes including non-polar (light petroleum and benzene homologues) and polar compounds (amines and phenols). The OMC/Nafion coating exhibited much better extraction efficiency towards all selected analytes than that of a multi-walled carbon nanotubes/Nafion coating with similar length and thickness, which is ascribed to its high surface area, well-ordered mesoporous structure and large pore volume. When the OMC/Nafion coating was used to extract a mixture containing various kinds of analytes, it possessed excellent extraction selectivity towards aromatic non-polar compounds. In addition, the feasibility of the OMC/Nafion coating for application in electrochemically enhanced SPME was demonstrated using protonated amines as model analytes.

A colorimetric agarose gel for formaldehyde measurement based on nanotechnology involving Tollens reaction.

Gold nanoparticles (Au NPs) coupled with Tollens reagent were used for measuring formaldehyde. Au@Ag core-shell NPs were formed along with distinct color changes from pink to deep yellow. This colorimetric system was further immobilized into an agarose gel, which was used for monitoring of gaseous formaldehyde.

Oriented ZnO nanorods grown on a porous polyaniline film as a novel coating for solid-phase microextraction.

In this work, oriented ZnO nanorods (ZNRs) were in situ hydrothermally grown on a porous polyaniline (PANI) film to function as a solid-phase microextraction (SPME) coating. Scanning electron microscopy (SEM) study revealed that the majority of oriented ZNRs grew from pores of PANI matrix, which protected the ZNRs from easily peeling off during operation. Furthermore, in this process, a thin layer of PANI was found to cover the ZNRs, which can enlarge the effective surface area of the composite coating. This ZNRs/PANI composite coating combined the merits of both ZNRs and PANI and, thus, has several advantages over that of sole PANI film and ZNRs coating such as improved extraction efficiency for benzene homologues, enhanced mechanical stability and longer service life (over 150 cycles of SPME-GC operation). Coupled with gas chromatography-flame ionization detector (GC-FID), the optimized SPME-GC-FID method was used for the analysis of six benzene homologues in water samples. The calibration curves were linear from 1 to 1000µgL(-1) for each analyte, and the limits of detection were between 0.001 and 0.024µgL(-1). Single fiber repeatability and fiber-to-fiber reproducibility were in the range of 1.3-6.8% and 5.3-11.2%, respectively. The spiked recoveries at 100 and 5µgL(-1) for three environmental water samples were in the range of 79.8-115.4% and 73.7-117.4%, respectively.

[Comparative study on the effect of highly active antiretroviral therapy (HAART) in patients with HIV infection acquired by blood transfusion and paid plasma donation].

OBJECTIVE: To study the effect of HAART in patients with AIDS acquire by blood transfusion and paid plasma donation. METHODS: All AIDS patients whose disease was caused by blood transfusion and commercial plasma donation came from the domicile of Hebei Province. In the group of cases of blood transfusion in whom the infection was caused by one-time blood transfusion before and after 1995, there were 189 cases, of whom 105 cases on HAART were designated as observation group, and 84 cases who were not on HAART were designated as control group. The group of AIDS patients who were former commercial plasma donors (FCPDs) had 120 patients who were identified in the survey of 1995, of whom 63 cases on HAART were designated as observation group and 57 cases who were not on HAART were as control group. Onset dates were defined as the dates into the queue. Death due to AIDS was regarded as an outcome event. Subjects who were enrolled into the observation group and control group were epidemiologically followed up regularly. Observation was ended on December 31, 2010. RESULTS: Mortality of patients after HAART from groups of FCPDs and blood recipients were 4.42/100 person-years and 6.13/100 person-years, respectively. The survival rates of HAART groups were 80% in FCPDs for 110 months and 72% in blood recipients for 90 months, respectively. Meanwhile the mortality of no HAART groups were 182.05/100 person-years and 250.66/100 person-years, respectively. Mean survival of patients whose disease was caused by plasma donation and blood transfusion were 4 months and 3 months, respectively. CONCLUSIONS: Whether the HIV infection was caused by plasmapheresis or blood transfusion, the effects of HAART did not show difference. HAART cold reduce the death intensity and prolong survival.

[A retrospective cohort study on the natural history of AIDS caused by blood transfusion].

OBJECTIVE: To study the natural history of AIDS, caused by blood transfusion. METHODS: All HIV infections and AIDS patients were from Hebei province, including those infected through blood transfusion around 1995, that were identified as through general census of former commercial plasma donors (FCPDs). Among those objects being observed during the incubation period, 354 had HIV infections (including 142 cases infected via plasmapheresis and 212 cases caused by transfusion) but had not been treated by HAART before the onset of disease. Objects being observed during the survival period, 141 were AIDS patients (including 57 cases infected via plasmapheresis and 84 cases causes by transfusion) but had not been treated by HAART before and after the onset of disease. All infectors and AIDS patients were under follow-up on the progress of illness or death, respectively. RESULTS: By December 31, 2010, the cumulative incidence among HIV infections was 88.70% (314/354), with the incidence density as 9.14/100 person-years (314/3435.75) and the median incubation period was 113 months. Of 142 HIV infections in the blood donation group and 212 infections in the blood transfusion group, the incubation periods were 112 months and 115 months, respectively. All of the 141 patients died 34 months after the onset, with the death-strength as 204.70/100 person-years (141/68.88) and the period of survival was 4 months. Among those 57 FCPDs infections, they were all died 24 months after the onset, with the death-strength as 250.66/100 person-years (57/22.74) and the survival was 3 months. The other 84 infections who were blood recipients, all died 34 months after the onset, with the death-strength as 182.05/100 person-years (84/ 46.14) and the survival was 4 months. CONCLUSION: Through this study, we noticed that the natural history of all the AIDS patients was caused by blood transmission. It was important to evaluate the natural history of HIV epidemics among both FCPDs and blood recipients, occurred before and after 1995.

[Retrospective cohort study on the rate of mother-to-child transmission among mothers infected with human immunodeficiency virus type 1 through blood transfusion].

OBJECTIVE: To study the rate of mother-to-child transmission (MTCT) on HIV-1. METHODS: All local residents from 8 townships in a region were screened for mothers who had a history of only one blood transfusion and 63 were found HIV-1 positive. A further study on these HIV-1 positive mothers and their children was conducted with the emphasis on the date of receiving blood transfusion, date and type of nationality, history regarding breastfeeding and so on. Sera specimens from 84 children born from 63 HIV-1 positive mothers were screened, using ELISA for HIV-1 antibody, and positive specimens were confirmed by Western-blot. RESULTS: The rate of MTCT was 32.1% (27/84) for children with all risk factors related to MTCT. Another 36.8% (7/19) were related to factors on intrauterine, intrapartum and breastfeeding, 35.7% (5/14) to intrapartum and breastfeeding factors, 14.3% (2/14) to intrauterine and intrapartum factors, 37.9% (11/29) to breastfeeding factor alone. By group combination analysis, the MTCT rate was 36.9% (24/65) with breastfeeding, 11.8% (2/17) with artificial feeding, and the former was significantly higher than the latter. CONCLUSION: HIV-1 MTCT rate among mothers caused by a single blood transfusion varied with different risk factors. Breastfeeding played an important role in MTCT, appeared in our study.

[Investigation on status of HIV-1 infection among blood recipients from 1994 to 1998 in certain areas of China].

OBJECTIVE: To study the infection status of HIV-1 among blood recipients from 1994 to 1998 in certain areas of Hebei province. METHODS: A general investigation was set up among all the people in 15 townships of certain areas from November 2003 to February 2005. An epidemiological investigation was conducted among people who had received blood from donors, during 1994 and 1998. Blood samples were collected. ELISA was used in preliminary screening and Western-blot (WB) was used among people who showed a positive result in the preliminary screening. RESULTS: The infection rate of HIV-1 after blood receipt was 15.54% (92/592), and the infected persons were all appeared in five medical centers of 6 townships which located at the west part of the area. HIV-1 infection happened over the years, and reaching the zenith in the year 1995. Most of the infected persons were young women. Procreation was the main cause of blood transfusion for women and trauma was for men. CONCLUSION: A typical HIV outbreak happened in certain areas after blood transfusion in Hebei.

[Following surveillance on HIV infection after blood transfusion].

OBJECTIVE: To study epidemiological features of HIV infection after blood transfusion and the situation of transmission among members of family. METHODS: The persons infected with HIV through blood transfusion and their intrafamilial transmission in some city were analyzed and testing methods of ELISA, Western-blot, RT-PCR and subtype analyzing were used. The whole surveillance data came from residents investigation around problem medical centres and HIV monitoring network around Hebei province. RESULTS: 173 people infected with HIV after blood transfusion in some city, including 89 cases found in hospital and 84 cases in CDC, accounted for 68.7% (173/252) of all of infected persons by blood transfusion in Hebei province. The rate of intrafamilial transmission, spousal transmission and mother-to-child transmission((MTCT) were 32.0% (49/153),17.0% (26/153) and 32.7% (32/98), respectively. Most of persons infected with HIV were youth among who the female were more than the male. Childbearing and women's ailments were the main cause of blood transfusion from 1990 to 1999, and traumatism surgery took second place. Infected persons by HIV blood, whose time to diagnostic were the year from 1999 to 2009, spread over Kangtai hospital and other hospital which accounted for 45.1% (78/173) and 42.2% (73/173), respectively. The genetype of all patients were B' subtype. CONCLUSION: The medical centers at the grass-roots level in some city resulted in outbreak of infected persons by HIV blood because of having no screening test antibody of HIV for liid blood donors.