Classification management of HIV reactive blood donors based on test results / 中国输血杂志

【Objective】 To explore the viability of classification management of HIV reactive blood donors based on test results in blood screening laboratory. 【Methods】 According to the HIV test results of blood donors (including twice ELISA and once NAT), the HIV reactive blood donors were divided into three groups. Group 1 was all-test reactive (both ELISA and NAT were reactive), group 2 serological reactive (only ELISA was reactive), and group 3 NAT reactive (only NAT was reactive). The HIV test results of 191 628 blood donors from May to December 2017 were analyzed. Samples with positive RIBA results and / or the repeated reactive NAT results were determined as HIV true positive. The yielding rates of HIV true positivity in each group were analyzed. Receiver operating characteristic curve (ROC curve) was used to elevate the S/CO limit under 99% specificity as the blood donor deferral limit for ELISA. 【Results】 A total of 180 HIV reactive samples were detected out of 191 628 blood donors, including 77 positive cases in group 1, 100 in group 2 and 3 in group 3. 1) The HIV reactive results were diverse. Among the 82 true positive blood donors, 4 were early HIV infection (3 HIV antibody+ antigen window period yield, 1 HIV antibody window period yield), 2 were suspected elite controllers, and 76 cases were both serology and NAT reactive. 2) The overall yielding rate of HIV was 47.67%, with group 1 (100%) = group 3 (100%) > group 2 (2.17%), showing statistically significant (P0.05). All true positive blood donors in group 1 and group 2 could be accurately screened by using the blood donor deferral limit for ELISA1 and ELISA2 simultaneously. 【Conclusion】 The composition of HIV results among blood donors is diverse and complex. It is necessary to continuously improve the awareness of HIV prevention and control. The classification of HIV reactive blood donors is conducive to conduct fine and scientific management. The blood donors in group 1 and group 3 should be permanently deferral, and the suspected HIV elite controllers in group 2 should be paid attention to and permanently deferral.

Aneurysmal vasculopathy in human-acquired immunodeficiency virus-infected adults: Imaging case series and review of the literature.

BACKGROUND: Intracranial vasculopathy in adult patients with human-acquired immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a rare but increasingly recognized disease entity. OBJECTIVE: We aimed to contribute to and summarize the adult literature describing patients with HIV/AIDS who have intracranial vasculopathy. METHODS: A retrospective review of adult patients with HIV/AIDS undergoing diagnostic cerebral angiography at our institution from 2007-2013 was performed. A literature review of relevant existing studies was performed. RESULTS: Five adult patients with HIV-related aneurysmal and occlusive vasculopathy were diagnosed and/or treated at our institution. A comprehensive review of the literature yielded data from 17 series describing 28 adult patients with HIV/AIDS and intracranial vasculopathy. Our review suggests that low CD4 count, motor weakness, and meningismus may be associated with the sequelae of intracranial vasculopathy/vasculitis in patients with HIV/AIDS. CONCLUSION: Patients with HIV/AIDS who have aneurysmal and stenotic vascular disease may benefit from earlier surveillance with the onset of neurological symptoms. The roles of medical, open surgical, and endovascular therapy in this unique entity will be further defined as the pathological basis of the disease is better understood.

Factors associated with HIV infection among men who have sex with men in Nanjing, Suzhou and Yangzhou: a 1:4 matched case-control study / 中华流行病学杂志

Objective This study assessed the main factors associated with HIV infection among men having sex with men(MSM),in order to provide evidence for future intervention. Methods A case-control study was conducted among HIV cases identified at the MSM survey in Nanjing, Suzhou and Yangzhou cities from May to July in 2008. Each HIV case was matched by 4 HIV negative MSM who participated consecutively right after the HIV case was identified at the same survey, same time and in the same city. A national core MSM survey questionnaire was used with addition of variables of local interest. Fitting conditional logistic regression model was applied for univariate and multivariate analysis. Results During the survey, 62 HIV positive cases were identified and 248 controls were matched. Data from univariate analysis showed that, inconsistent condom use, syphilis infection, self reported sexually transmitted infection (STI) symptoms and/or signs, unprotected anal sex (UAI) were risk factors, with OR values of 5.56(95%CI: 1.82-16.96), 2.19(95%CI: 1.18-4.05), 2.50(95%(CI: 1.13-5.50) and 3.13 (95%CI: 1.64-5.98) respectively. Online cruising and receptive anal sex were protective factors with OR values as 0.47(95%CI: 0.22-0.998) and 0.67(95% CI: 0.23-1.97). Through multivariate analysis, it was found that syphilis, age of having experienced first insertive sexual intercourse and UAI were risk factors to HIV transmission, with OR values of 2.28 (95%CI: 1.05-4.94), 4.16 (95%CI: 1.63-10.66) and 1.11 (95% CI: 1.04-1.18) respectively. Compared with non-anal sex, bisexual (OR=0.41,95%CI: 0.18-0.97) behavior seemed a protected factor. Conclusion Syphilis infection, UAI and self reported STI symptoms and/or signs were risk factors related to HIV transmission while bisexual seemed a protective factor.

Impact of micronutrients on immunocyte and microelements status among people living with HIV / 中华流行病学杂志

Objective To explore the impact of micronutrients supplement on immunocyte and microelements status in HIV positive people. Methods Volunteers aged 25-49 years old were randomly selected and distributed into two groups. Supplement and placebo were given to the two groups. At the beginning of the trial, data on physical examination, immunocyte and microelements level in serum of the two groups were collected and showed no significant difference (P>0.05). Results After 6 months, the amount of immunocyte(CD4+, CD8+,CD3+) were (2078±108) mm3, (582±75) mm3, (1287±97) mm3 in the study group while they were (1436±105) mm3, (472±61)mm3, (998±84) mm3 in the control group, with statistically significant difference (P<0.05). Amounts of serum Zn, Ca, Mg, Fe showed (144.89±9.78) μmol/L, (1.89±0.19) μmol/L, (1.68±0.12) μmol/L, (152.61±8.94) μmol/L in the study group and they were (102.67±5.45) μmol/L, (1.13±0.07) μmol/L, (0.85±0.05) μmol/L, (89.24±3.91) μmol/L in the control group, with statistically significant difference(P<0.05). Conclusion Supplementation of micronutrients could increase the levels of Zn, Ca, Mg, Fe so as to increase the immune function in people living with HIV.