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Dai Z, Wu Y, Liu X, Fu J, Si M, Chen X, Wang H, Xiao W, Huang Y, Yu F, Mi G, Su X. Characteristics and influencing factors of anticipated HIV stigma among HIV-negative/unknown MSM in China: A regression mixture model. Brain Behav 2024; 14:e3472. [PMID: 38549560 PMCID: PMC10979188 DOI: 10.1002/brb3.3472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 01/29/2024] [Accepted: 02/28/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Anticipated HIV stigma among men who have sex with men's (MSM) has a severe negative effect on their physical and mental health wellbeing and hence requires specific attention. The current study aims to identify the characteristics and the psychosocial influencing factors of anticipated HIV stigma in MSM using regression mixture model (RMM) and to determine the cut-off point of the seven-item Anticipated HIV Stigma Questionnaire (AHSQ) using the receiver operating characteristic (ROC) analysis. METHODS A cross-sectional study was conducted among HIV-negative/unknown MSM from Blued online platform in China from December 16th, 2020 to March 1st, 2021, enrolling 1394 participants. Data were collected on demographic characteristics, perceived social support, anticipated HIV stigma, depressive symptoms, and HIV knowledge. Latent profile analysis was performed to identify different profiles of anticipated HIV stigma level. Chi-square test, analysis of variance, and RMM analysis were conducted to explore the influencing factors in different profiles. ROC analyses were carried out to identify the cut-off value of anticipated stigma. RESULTS Among the participants, three profiles of anticipated stigma were identified: "low anticipated HIV stigma" (12.0%), "moderate anticipated HIV stigma" (52.1%), and "severe anticipated HIV stigma" (35.9%). RMM analysis showed that higher income and higher levels of knowledge were positively associated with moderate anticipated HIV stigma, whereas full-time job and social support were negatively associated with moderate anticipated HIV stigma; higher income, depressive symptoms, and knowledge were positively associated with severe anticipated HIV stigma, whereas minor ethnicity and social support were negatively associated with severe anticipated HIV stigma. ROC curve of the AHSQ showed that the optimal cut-off value of ≥16 could indicate positive anticipated HIV stigma. CONCLUSION The study focuses on the level of anticipated HIV stigma and its psycho-socio influencing factors among HIV-negative/unknown MSM. It provides evidence for implementing relevant psychological interventions to HIV-negative/unknown MSM.
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Affiliation(s)
- Zhenwei Dai
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Yijin Wu
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Xin Liu
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Jiaqi Fu
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Mingyu Si
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Xu Chen
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Hao Wang
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Weijun Xiao
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Yiman Huang
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Fei Yu
- Danlan Public WelfareBeijingChina
| | | | - Xiaoyou Su
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
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Yu Z, Zhang TT, Wang X, Chang Q, Huang H, Zhang H, Song D, Yu M, Yang J, Liu Y, Li C, Cui Z, Ma J. Sexual behaviour changes and HIV infection among men who have sex with men: evidence from an open cohort in China. BMJ Open 2022; 12:e055046. [PMID: 36171031 PMCID: PMC9528664 DOI: 10.1136/bmjopen-2021-055046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The HIV epidemic in key populations such as men who have sex with men (MSM) is a public health issue of worldwide concern. China has seen an increase in newly diagnosed HIV infections through male-male sexual contact in the past decade. In a long-term cohort, how the complex behaviour pattern of MSM changed and the association with the HIV risk are unclear at present. METHODS This study was conducted from October 2011 to December 2019 in Tianjin. MSM were recruited by snowball sampling through online and offline ways. Demographic and sexual behavioural data were collected for analysis. Three indicators (condom use in last anal sex, frequency of condom use during anal sex and the number of sexual partners) were used to define the behaviour change. Participants with zero, one, and two or three risk indicators were categorised into behaviour types of 'protective', 'moderate', and 'fragile', respectively. Change in behaviour type between baseline and each visit was considered. Time-varying Cox models were performed to evaluate HIV infection risk. RESULTS Of 2029 MSM included in the study, 127 were new HIV diagnoses. The overall incidence rate was 3.36 per 100 person-years. The percentage of 'protective' and 'moderate' behaviour types had a conspicuous growth trend as the follow-up. Furthermore, the HIV incidence rate in each visit among different behaviour transition types showed a general downward trend as the number of total follow-up times increased. Individuals who remained in 'fragile' (adjusted HR (aHR): 25.86, 95% CI: 6.92 to 96.57) or changed from 'protective' to 'moderate' (aHR: 4.79, 95% CI: 1.18 to 19.47), 'protective' to 'fragile' (aHR: 23.03, 95% CI: 6.02 to 88.13), and 'moderate' to 'fragile' (aHR: 25.48, 95% CI: 6.79 to 95.40) between baseline and the last follow-up had a higher HIV risk. Gained risk indicators were associated with the increase of HIV risk (gained one indicator, aHR: 2.67, 95% CI: 1.68 to 4.24; gained two or three indicators, aHR: 4.99, 95% CI: 3.00 to 8.31) while losing just one risk indicator could halve the risk (aHR: 0.43, 95% CI: 0.21 to 0.90). CONCLUSIONS Among MSM in Tianjin, it is necessary to get timely behaviour change for those with high-incidence behaviour patterns while sustaining for those with low-incidence patterns. TRIAL REGISTRATION NUMBER Chinese Clinical Trials Registry (ChiCTR2000039500).
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Affiliation(s)
- Zeyang Yu
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Tian-Tian Zhang
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Xiaomeng Wang
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Qinxue Chang
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Huijie Huang
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Honglu Zhang
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Desheng Song
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Maohe Yu
- STD & AIDS Control and Prevention Section, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
| | - Jie Yang
- Tianjin Shenlan Community-Based Organization, No. 43, Shuimu Tiancheng Tuanjie Ring Road, Hongqiao District, Tianjin, China
| | - Yuanyuan Liu
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Changping Li
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Zhuang Cui
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
| | - Jun Ma
- School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin, China
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Xu JJ, Han MJ, Jiang YJ, Ding HB, Li X, Han XX, Lv F, Chen QF, Zhang ZN, Cui HL, Geng WQ, Zhang J, Wang Q, Kang J, Li XL, Sun H, Fu YJ, An MH, Hu QH, Chu ZX, Liu YJ, Shang H. Prevention and control of HIV/AIDS in China: lessons from the past three decades. Chin Med J (Engl) 2021; 134:2799-2809. [PMID: 34759226 PMCID: PMC8667973 DOI: 10.1097/cm9.0000000000001842] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT In the past 37 years, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has undergone various major transmission routes in China, with the world most complex co-circulating HIV-1 subtypes, even the prevalence is still low. In response to the first epidemic outbreak of HIV in injecting drug users and the second one by illegal commercial blood collection, China issued the Anti-Drug Law and launched the Blood Donation Act and nationwide nucleic acid testing, which has avoided 98,232 to 211,200 estimated infections and almost ended the blood product-related infection. China has been providing free antiretroviral therapy (ART) since 2003, which covered >80% of the identified patients and achieved a viral suppression rate of 91%. To bend the curve of increasing the disease burden of HIV and finally end the epidemic, China should consider constraining HIV spread through sexual transmission, narrowing the gaps in identifying HIV cases, and the long-term effectiveness and safety of ART in the future.
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Affiliation(s)
- Jun-Jie Xu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Meng-Jie Han
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yong-Jun Jiang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hai-Bo Ding
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Xi Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiao-Xu Han
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Fan Lv
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Qing-Feng Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Zi-Ning Zhang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hua-Lu Cui
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Wen-Qing Geng
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Jing Zhang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Qi Wang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Jing Kang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Xiao-Lin Li
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hong Sun
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Ya-Jing Fu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Ming-Hui An
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Qing-Hai Hu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Zhen-Xing Chu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Ying-Jie Liu
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
| | - Hong Shang
- NHC Key Laboratory of AIDS Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology of Liaoning Province, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China
- Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning 110001, China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang 310003, China
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Wang JY, Zhang KG, Ruan JX, Chen W, Wang L. Shift in HIV/AIDS Epidemic and Factors Associated with False Positives for HIV Testing: A Retrospective Study from 2013 to 2018 in Xi'an, China. Curr HIV Res 2021; 18:219-226. [PMID: 32294041 PMCID: PMC7475938 DOI: 10.2174/1570162x18666200415123607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/16/2020] [Accepted: 03/28/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND In China, although quite a few bold programmes have been made for HIV/AIDS, the epidemic has still shown an increasing trend. OBJECTIVES The study was aimed to investigate the characteristics of new HIV/AIDS and the major factors of false positives (FP) for HIV testing. METHODS A retrospective review was performed in a teaching hospital in Xi'an between 2013 and 2018. The overall characteristics and trends of new HIV/AIDS were described. Moreover, the major factors of FP were determined by the Pareto analysis. RESULTS A total of 469 new HIV/AIDS were diagnosed, with an increasing prevalence of the new HIV/AIDS from 0.0626% (41/65503) in 2013 to 0.0827% (115/139046) in 2018. Of them, the majority occurred in the males (88.50%), people aged 21-50 years (76.97%), migrants (60.98%), and sexual contact route (88.70%). There was a rapid increase in the annual number of new HIV/AIDS and increasing trends in groups of young individuals, students, and homosexual mode; however, a downward trend in the percentage of injecting drug use was also observed. Over 50 years old and patients from oncology, obstetrics, hepatobiliary surgery, nephrology, cardiology, and infectious disease constituted the major factors of FP. CONCLUSION The HIV/AIDS epidemic in Xi'an is still evolving, therefore, effective strategies, appropriate education and scaling up HIV testing should be developed. In addition, old adults and specific departments were associated with FP.
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Affiliation(s)
- Jing-Yuan Wang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Kai-Ge Zhang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Jing-Xiong Ruan
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Wei Chen
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Linchuan Wang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
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Zhang Y, Gao Z, Wang S, Liu J, Paul N, He T, Liu C, Zhang H, Lv Y, Cao R, Mao W, Wan J, Ma H, Huang M, Liu Y, Wang J, Liao P, Zeng P, He M, Shan H. Hepatitis C virus genotype/subtype distribution and evolution among Chinese blood donors: Revealing recent viral expansion. PLoS One 2020; 15:e0235612. [PMID: 32649673 PMCID: PMC7351211 DOI: 10.1371/journal.pone.0235612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 06/19/2020] [Indexed: 01/30/2023] Open
Abstract
Hepatitis C virus (HCV) genotype (GT) distribution in China shows significant geographical and demographic difference. As a routinely tested virus in Chinese blood bank systems, rare molecular epidemiology research in blood donors is reported. Our purpose is to investigate the HCV GT/subtypes distribution, phylogenetic analysis and population genetics in Chinese blood donors. Anti-HCV screen positive samples and donor demographics were collected. HCV Core and E1 gene fragments were amplified by RT-PCR, followed by sequencing and phylogenetic analysis to determine HCV GTs/subtypes using MEGA 7.0. The population genetics were performed using Arlequin v3.0 and Beast v1.10.4. SPSS Statistics 17.0 software was used to analyze the correlation between HCV GTs/subtypes distribution and demographic characteristics. 419 and 293 samples based on Core and E1 gene respectively were successfully amplified. HCV la, lb, 2a, 3a, 3b, 6a, 6e and 6n were found, and the corresponding proportions were 0.66% (3/455), 58.68% (267/455), 17.80% (81/455) and 5.05% (23/455), 3.52% (16/455), 12.31% (56/455), 0.88% (4/455) and 0.66% (3/455). Samples from Guangxi showed the most abundant genetic diversity with 8 subtypes were found. The number of haplotypes in HCV-1b is higher than 2a and 6a. The negative Tajima's D and Fu's Fs values of HCV-1b, 2a and 6a suggested the population expansion of those HCV subtypes. The distribution of HCV GT showed significant statistical difference by age and ethnicity. Conclusion: An abundance of HCV genetic diversity was found in Chinese blood donors with mainly 1b and then 2a subtype. There were significant geographical and demographic differences in HCV GTs/subtypes among Chinese blood donors. HCV subtype 1b has stronger viability and HCV subtype 6a has experienced significant expansion.
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Affiliation(s)
- Yu Zhang
- The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, China
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
| | - Zhan Gao
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
- Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Shaoli Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
- Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Jing Liu
- The Johns Hopkins Medical Institutions, Baltimore, MD, United States of America
| | - Ness Paul
- The Johns Hopkins Medical Institutions, Baltimore, MD, United States of America
| | - Tao He
- Chongqing Blood Center, Chongqing, China
| | - Cunxu Liu
- Guangxi Blood Center, Liuzhou, Guangxi, China
| | | | - Yunlai Lv
- Luoyang Blood Center, Luoyang, Henan, China
| | - Ru’an Cao
- Mianyang Blood Center, Mianyang, Sichuan, China
| | - Wei Mao
- Chongqing Blood Center, Chongqing, China
| | - Jianhua Wan
- Urumqi Blood Center, Urumqi, Xinjiang, China
| | - Hongli Ma
- Luoyang Blood Center, Luoyang, Henan, China
| | - Mei Huang
- Mianyang Blood Center, Mianyang, Sichuan, China
| | - Yu Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
- Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Jingxing Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
- Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Pu Liao
- The People’s Hospital of Chongqing, Chongqing, China
| | - Peibin Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Miao He
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, China
- Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, China
| | - Hua Shan
- Stanford University, Stanford, CA, United States of America
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Wu Z, Wang Y, Detels R, Bulterys M, McGoogan JM. The US CDC Global AIDS Program in China. HIV/AIDS IN CHINA 2020. [PMCID: PMC7121485 DOI: 10.1007/978-981-13-8518-6_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The China-US Cooperation-Global AIDS Program (GAP) was a strategic technical collaboration program jointly implemented by the US Centers for Disease Control and Prevention and the Chinese Center for Disease Control and Prevention. This program developed, piloted, launched, and evaluated a broad range of projects supporting national and local HIV prevention and control programs; evidence-based decision-making; strengthening systems and capacity at national, provincial, and local levels; prioritizing high-risk geographic areas and populations; developing innovative approaches for scale-up; answering important scientific questions that can be most effectively answered in China but also with global implications for the HIV response; and increasing China’s engagement with the global public health community and sharing critical lessons learned. A productive working relationship with well-conceived models, a results-based activity implementation plan, and proper linkage to the domestic policy process has made a significant contribution to HIV control and prevention in China.
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Affiliation(s)
- Zunyou Wu
- National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Yu Wang
- Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Roger Detels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA USA
| | - Marc Bulterys
- U.S. Centers for Disease Control and Prevention, Global AIDS Program, China Office, Beijing, China
| | - Jennifer M. McGoogan
- National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
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Wu Z, Wang Y, Detels R, Bulterys M, McGoogan JM. Civil Society Involvement in National HIV/AIDS Programs. HIV/AIDS IN CHINA 2020. [PMCID: PMC7119907 DOI: 10.1007/978-981-13-8518-6_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Globally, the AIDS response relies on active participation of nongovernmental organizations (NGOs) and civil society. In China, the government is the main provider of health and social services, and the role of NGOs is more limited than in other countries. Despite this, China has opened the door for NGO participation in its AIDS response, initially because of donor pressure but increasingly due to official acknowledgment of the important role these groups play in controlling the epidemic. Since the first AIDS NGOs were established in China in the 1990s, Chinese AIDS NGOs have made unique contributions to China’s AIDS response in critical areas like access to drugs, support for treatment compliance, outreach to marginalized at-risk groups, and efforts to reduce stigma among marginalized populations. However, there has been a substantial drop-off in donor funding in recent years, and although the Chinese government has filled the funding gap, demonstrating its commitment to the sector, recent policy moves toward greater control over the work and funding of NGOs threatens their survival. Thus far, China’s AIDS response has been noteworthy, but these new NGO funding and regulatory developments pose significant challenges to the next phase of outreach, prevention, treatment, and care.
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Affiliation(s)
- Zunyou Wu
- National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Yu Wang
- Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Roger Detels
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA USA
| | - Marc Bulterys
- U.S. Centers for Disease Control and Prevention, Global AIDS Program, China Office, Beijing, China
| | - Jennifer M. McGoogan
- National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
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Wang L, Xiao Y, Tian XD, Ruan JX, Chen W, Yu Y. HIV infection in Xi'an, China: epidemic characterization, risk factors to false positives and potential utility of the sample-to-cutoff index to identify true positives using Architect HIV Ag/Ab combo. Antimicrob Resist Infect Control 2019; 8:9. [PMID: 30651975 PMCID: PMC6329139 DOI: 10.1186/s13756-019-0463-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 01/03/2019] [Indexed: 01/15/2023] Open
Abstract
Background In China, although tremendous efforts has been made, the HIV/AIDS is still not controlled. Objectives The study was carried out to determine the epidemic of HIV infection in Xi'an, analyse false positives (FP) risk factors and potential utility of sample-to-cutoff index to identify true positives using Architect HIV Ag/Ab Combo. Methods A retrospective review for HIV screening by Architect HIV Ag/Ab Combo was performed in a teaching hospital in Xi'an between 2015 and 2016. The prevalence of HIV, positive predictive value (PPV) at different cut-off indexices (COI) were calculated. The epidemic of infections and risk factors for FP results were investigated. Results In the study, the HIV prevalence and FP rate of Architect HIV Ag/Ab Combo were 0.076 and 46.08%, respectively. The Han Chinese, males and people aged < 40 years accounted for the majority of infections (98.29, 76.07 and 73.5%, respectively). 85.47% of the infections were transmitted through sexual contact (35.04% of male homosexual and 50.43% of heterosexual). COI at 1-10, 10-30 and ≥ 30, the PPVs were 0, 50 and 100%, respectively. The independent risk factors for FP, i.e., pregnancy and malignancy had a statistically significant association with FP (p < 0.05), and age had a very strong statistically significant association with FP (p < 0.001). Conclusions In Xi'an, sexual contact was the most important transmission mode for HIV, and the infections were predominantly identified in Han Chinese, males, young and middle-aged people. For Architect HIV Ag/Ab Combo, it can achieve 100% of PPV with COI ≥30, and the age was strongly statistically associated with FP.
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Affiliation(s)
- Linchuan Wang
- Clinical Laboratory of the First Affiliated Hospital of Xi’an Jiaotong University, Yan Ta Road No 277, Xi’an, Shaanxi Province China
| | - Yao Xiao
- Clinical Laboratory of the First Affiliated Hospital of Xi’an Jiaotong University, Yan Ta Road No 277, Xi’an, Shaanxi Province China
| | - Xu-Dong Tian
- Clinical Laboratory of the First Affiliated Hospital of Xi’an Jiaotong University, Yan Ta Road No 277, Xi’an, Shaanxi Province China
| | - Jin-xiong Ruan
- Clinical Laboratory of the First Affiliated Hospital of Xi’an Jiaotong University, Yan Ta Road No 277, Xi’an, Shaanxi Province China
| | - Wei Chen
- Clinical Laboratory of the First Affiliated Hospital of Xi’an Jiaotong University, Yan Ta Road No 277, Xi’an, Shaanxi Province China
| | - Yan Yu
- Inspection Department of Hong-Hui Hospital, Xi’an Jiaotong University College of Medicine, Nan Guo Road No 76, Xi’an, Shaanxi Province China
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9
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Yang JP, Simoni JM, Dorsey S, Lin Z, Sun M, Bao M, Lu H. Reducing distress and promoting resilience: a preliminary trial of a CBT skills intervention among recently HIV-diagnosed MSM in China. AIDS Care 2019; 30:S39-S48. [PMID: 30628480 DOI: 10.1080/09540121.2018.1497768] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
People living with HIV/AIDS (PLWHA) in China experience significant psychological distress, due to high rates of stigma and low availability of mental health resources. Recently diagnosed Chinese PLWHA who are men who have sex with men (MSM) are particularly vulnerable to distress, facing both HIV and sexual orientation stigma. Reducing distress and enhancing psychological resilience is critical in promoting wellbeing. However, no research to date has examined evidence-based interventions to reduce psychological symptoms and improve resilience in this population. Based on qualitative research on their mental health needs, we developed a culturally tailored, brief 3-session CBT skills-based intervention for integration into primary care [Yang, J. P., Simoni, J., Cheryan, S., Shiu, C., Chen, W., Zhao, H., & Lu, H. (2018). The development of a brief distress reduction intervention for individuals recently diagnosed with HIV in China. Cognitive Behavioral Practice, 25(2), 319-334. doi: 10.1016/j.cbpra.2017.08.002 ]. The intervention includes cognitive restructuring to address depressive thought patterns, behavioral activation to decrease isolation, and paced breathing to reduce anxiety. We conducted a pilot Type 1 hybrid effectiveness-implementation trial assessing pre-post mental health outcomes as well as feasibility, acceptability, and appropriateness information. Ten recently diagnosed MSM completed the research protocol of three individual weekly sessions. Paired-samples t tests demonstrated significant reduction in HIV-related distress, depression, problems with adjustment, as well as improvements in resilience, and perceived social support. Participants and community advisory board members found the intervention highly acceptable, appropriate, and feasible. Preliminary data from the first known study examining a psychological intervention with evidence-based components for recently diagnosed Chinese MSM suggests that this brief intervention may be useful for reducing distress and promoting resilience.
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Affiliation(s)
- Joyce P Yang
- a Department of Psychiatry and Behavioral Sciences , Stanford University , Stanford , CA , USA.,b National Center for PTSD , VA Palo Alto Health Care System , Palo Alto , CA , USA
| | - Jane M Simoni
- c Department of Psychology , University of Washington , Seattle , WA , USA
| | - Shannon Dorsey
- c Department of Psychology , University of Washington , Seattle , WA , USA
| | - Zhang Lin
- d Shanghai Public Health Clinical Center , Fudan University , Shanghai , People's Republic of China
| | - Meiyan Sun
- d Shanghai Public Health Clinical Center , Fudan University , Shanghai , People's Republic of China
| | - Meijuan Bao
- d Shanghai Public Health Clinical Center , Fudan University , Shanghai , People's Republic of China
| | - Hongzhou Lu
- d Shanghai Public Health Clinical Center , Fudan University , Shanghai , People's Republic of China
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10
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Wang L, Zhang Y, Xu K, Dong T, Rowland-Jones S, Yindom LM. Killer-cell immunoglobulin-like receptors associate with HIV-1 infection in a narrow-source Han Chinese cohort. PLoS One 2018; 13:e0195452. [PMID: 29664957 PMCID: PMC5903672 DOI: 10.1371/journal.pone.0195452] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 03/22/2018] [Indexed: 11/17/2022] Open
Abstract
Background The HIV pandemic remains the most serious challenge to public health worldwide. The hallmark characteristics of the disease is the eventual failure of the immune system to control opportunistic infections and death. However not everyone who has HIV develops the disease at the same rate and so we are studying how the immune system works to control the virus in those who have been infected for decades and remain relatively healthy without the need of anti-retroviral therapy (ART). Methods Genomic DNA samples from 513 Chinese Han individuals from Henan province were typed for 15 KIR and 3 HLA class I genes. Genotype frequencies were compared between a village cohort of 261 former plasma donors (SM cohort) infected with HIV-1 through an illegal plasma donor scheme who survived more than 10 years of infection without ART and 252 ethnically-matched healthy controls from a nearby village. KIR and HLA were molecularly typed using a combination of polymerase chain reaction (PCR) with sequence-specific primers (PCR-SSP) and sequence based techniques. Results All 15 KIR genes were observed in the study population at various frequencies. KIR2DL3 was significantly less common in the HIV-1 infected group (95.8% vs 99.2%, p = 0.021). The combination of KIR3DS1 with homozygosity for HLA-Bw4 alleles (the putative ligand for KIR3DS1) was significantly less frequent in the HIV-1 infected group than in the control group (6.0% vs 12.0% respectively, p = 0.023). Conclusion Specific KIR-HLA compound genotypes associate with differential outcomes to infection and disease progression following exposure to a narrow-source HIV-1.
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Affiliation(s)
- Linghang Wang
- Beijing Ditan Hospital, Capital Medical University, Beijing, People's Republic of China.,Nuffield Department of Medicine, Headington, Oxford, United Kingdom.,MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom
| | - Yonghong Zhang
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom.,Beijing You An Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Keyi Xu
- Beijing Ditan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Tao Dong
- Nuffield Department of Medicine, Headington, Oxford, United Kingdom.,MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, United Kingdom
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11
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Analysis of HIV-1 envelope evolution suggests antibody-mediated selection of common epitopes among Chinese former plasma donors from a narrow-source outbreak. Sci Rep 2018; 8:5743. [PMID: 29636501 PMCID: PMC5893620 DOI: 10.1038/s41598-018-23913-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/20/2018] [Indexed: 12/31/2022] Open
Abstract
The HIV-1 envelope mutates rapidly to evade recognition and killing, and is a major target of humoral immune responses and vaccine development. Identification of common epitopes for vaccine development have been complicated by genetic variation on both virus and host levels. We studied HIV-1 envelope gp120 evolution in 12 Chinese former plasma donors infected with a purportedly single founder virus, with the aim of identifying common antibody epitopes under immune selection. We found five amino acid sites under significant positive selection in ≥50% of the study participants, and 22 sites consistent with antibody-mediated selection. Despite strong selection pressure, some sites housed a limited repertoire of amino acids. Structural modelling revealed that most of the variable amino acid sites were located on the exposed distal edge of the Gp120 trimer, whilst invariant sites clustered within the centre of the protein complex. Two sites, flanking the V3 hypervariable loop, represent novel antibody sites. Analysis of HIV-1 evolution in hosts infected with a narrow-source virus may provide insight and novel understanding of common epitopes under antibody-mediated selection. If verified in functional studies, such epitopes could be suitable as targets in vaccine development.
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12
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Zhang Y, Souleymanov R. Impacts of HIV/AIDS on poor and socially marginalised former commercial plasma donors in rural central China: social work implications. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/17525098.2017.1413515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Yurong Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Rusty Souleymanov
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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Yu B, Chen X, Yan Y, Gong J, Li F, Robserson E. Migration Stress, Poor Mental Health, and Engagement in Sex with High-Risk Partners: A Mediation Modeling Analysis of Data from Rural-to-Urban Migrants in China. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2017; 14:467-477. [PMID: 29098041 PMCID: PMC5662130 DOI: 10.1007/s13178-016-0252-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND There is a growing need for better understanding of mechanisms underpinning the relationship between migration stress and HIV risk behaviors for the development of HIV prevention and control policy. METHODS Survey data from a random sample of 1,293 Chinese rural-to-urban migrants were analyzed. Stress was assessed using the Domestic Migration Stress Questionnaire (DMSQ), mental health status was assessed using the Brief Symptoms Inventory (BSI), and having sex with high risk partners was assessed as if ever have had sex with high risk partners (e.g., sex workers, intravenous injection drug users, blood donors, persons infected with HIV, persons with sexually transmitted infection, and same gender partners) in the past year. The proposed relationship was tested using mediation modeling method. RESULTS Among the sample, 5.5% reported having had sex with high-risk partners in the past year. Mediation analysis indicated that the relationship between DMSQ scores and having sex with high-risk partners was mediated by BSI (coefficient =0.41, 95% CI [0.21, 0.65]), including its components of somatization (0.32 [0.15, 0.53]), obsessive-compulsive disorder (0.31 [0.07, 0.55]), depression (0.45 [0.23, 0.72]), anxiety (0.41 [0.23, 0.63]), and hostility (0.35 [0.17, 0.56]). Furthermore, the effect was more pronounced in males than in females. CONCLUSION The study findings provide new data advancing our understanding of the mechanism of engagement in risky sex, underscoring the need for the HIV prevention policies in China to pay more attention to mental health of the rural-to-urban migrant population.
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Affiliation(s)
- Bin Yu
- Department of Epidemiology, University of Florida, USA
| | - Xinguang Chen
- Department of Epidemiology, University of Florida, USA
- Department of Chronic Disease, Wuhan Centers for Disease Prevention and Control, China
| | - Yaqiong Yan
- Department of Chronic Disease, Wuhan Centers for Disease Prevention and Control, China
| | - Jie Gong
- Department of Chronic Disease, Wuhan Centers for Disease Prevention and Control, China
| | - Fang Li
- Department of Chronic Disease, Wuhan Centers for Disease Prevention and Control, China
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14
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Zhang YH, Zhao Y, Rajapaksa US, Lawrence TM, Peng YC, Liu J, Xu K, Hu K, Qin L, Liu N, Sun H, Yan HP, Repapi E, Rowland-Jones S, Thimme R, McKeating JA, Dong T. A Comprehensive Analysis of the Impact of HIV on HCV Immune Responses and Its Association with Liver Disease Progression in a Unique Plasma Donor Cohort. PLoS One 2016; 11:e0158037. [PMID: 27455208 PMCID: PMC4959707 DOI: 10.1371/journal.pone.0158037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/09/2016] [Indexed: 01/28/2023] Open
Abstract
Objective Human Immunodeficiency Virus (HIV) and Hepatitis C virus (HCV) co-infection is recognized as a major cause of morbidity and mortality among HIV-1 infected patients. Our understanding of the impact of HIV infection on HCV specific immune responses and liver disease outcome is limited by the heterogeneous study populations with genetically diverse infecting viruses, varying duration of infection and anti-viral treatment. Methods Viral-specific immune responses in a cohort of 151 HCV mono- and HIV co-infected former plasma donors infected with a narrow source of virus were studied. HCV and HIV specific T cell responses were correlated with clinical data. Results HIV-1 accelerated liver disease progression and decreased HCV specific T cell immunity. The magnitude of HCV specific T cell responses inversely correlated with lower HCV RNA load and reduced liver injury as assessed by non-invasive markers of liver fibrosis. HIV co-infection reduced the frequency of HCV specific CD4+ T cells with no detectable effect on CD8+ T cells or neutralizing antibody levels. Conclusion Our study highlights the impact of HIV co-infection on HCV specific CD4+ T cell responses in a unique cohort of patients for both HCV and HIV and suggests a crucial role for these cells in controlling chronic HCV replication and liver disease progression.
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Affiliation(s)
- Yong-Hong Zhang
- You’an-Oxford Centre for Clinical Research, Beijing You’an Hospital, Capital Medical University, Beijing, China
- CAMS- Oxford University joint International Centre for Translational Immunology, Nuffield and Radcliffe departments of Medicine, University of Oxford, Oxford, United Kingdom
- Beijing Key Laboratory for Biomarkers in Infection Related Diseases (BZ0373), Beijing, China
- * E-mail: (YHZ); (TD)
| | - Yan Zhao
- You’an-Oxford Centre for Clinical Research, Beijing You’an Hospital, Capital Medical University, Beijing, China
- CAMS- Oxford University joint International Centre for Translational Immunology, Nuffield and Radcliffe departments of Medicine, University of Oxford, Oxford, United Kingdom
| | - Ushani S. Rajapaksa
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
- Department of Microbiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Tessa M. Lawrence
- Viral Hepatitis Laboratory, Centre for Human Virology, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
| | - Yan-Chun Peng
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Jinghua Liu
- You’an-Oxford Centre for Clinical Research, Beijing You’an Hospital, Capital Medical University, Beijing, China
| | - Keyi Xu
- Beijing Di’Tan Hospital, Capital Medical University, Beijing, China
| | - Ke Hu
- Viral Hepatitis Laboratory, Centre for Human Virology, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
| | - Ling Qin
- You’an-Oxford Centre for Clinical Research, Beijing You’an Hospital, Capital Medical University, Beijing, China
| | - Ning Liu
- You’an-Oxford Centre for Clinical Research, Beijing You’an Hospital, Capital Medical University, Beijing, China
| | - Huanqin Sun
- You’an-Oxford Centre for Clinical Research, Beijing You’an Hospital, Capital Medical University, Beijing, China
| | - Hui-Ping Yan
- You’an-Oxford Centre for Clinical Research, Beijing You’an Hospital, Capital Medical University, Beijing, China
| | - Emmanouela Repapi
- Computational Biology Research Group, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Sarah Rowland-Jones
- Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Robert Thimme
- University Hospital Freiburg, Department of Medicine II, Hugstetter Str 55, 79106, Freiburg, Germany
| | - Jane A. McKeating
- Viral Hepatitis Laboratory, Centre for Human Virology, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
| | - Tao Dong
- You’an-Oxford Centre for Clinical Research, Beijing You’an Hospital, Capital Medical University, Beijing, China
- CAMS- Oxford University joint International Centre for Translational Immunology, Nuffield and Radcliffe departments of Medicine, University of Oxford, Oxford, United Kingdom
- MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
- * E-mail: (YHZ); (TD)
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15
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Yin YH, Li CQ, Liu Z. Blood donation in China: sustaining efforts and challenges in achieving safety and availability. Transfusion 2015; 55:2523-30. [DOI: 10.1111/trf.13130] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 03/13/2015] [Accepted: 03/13/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Yong-Hua Yin
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences & Peking Union Medical College; National Reference Laboratory of Nucleic Acid Testing; National Health and Family Planning Commission of the People's Republic of China; Chengdu P.R. China
| | - Chang-Qing Li
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences & Peking Union Medical College; National Reference Laboratory of Nucleic Acid Testing; National Health and Family Planning Commission of the People's Republic of China; Chengdu P.R. China
| | - Zhong Liu
- Institute of Blood Transfusion; Chinese Academy of Medical Sciences & Peking Union Medical College; National Reference Laboratory of Nucleic Acid Testing; National Health and Family Planning Commission of the People's Republic of China; Chengdu P.R. China
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Seroprevalence of transfusion-transmissible infectious agents among volunteer blood donors between 2006 and 2012 in Zhejiang, China. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 13:401-10. [PMID: 26192780 DOI: 10.2450/2015.0271-14] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 02/25/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND The high prevalence of hepatitis B and C viruses (HBV and HCV), paralleling the growing epidemic of human immunodeficiency virus (HIV) and Treponema pallidum (TP) infections in the general population, poses a great threat to blood safety in China. This study investigated the prevalence of serological markers for causative agents of transfusion-transmissible infections (TTI), i.e. HBV, HCV, HIV and TP, among volunteer blood donors in five cities/regions of Zhejiang Province, China. MATERIAL AND METHODS We investigated whole blood and apheresis donations collected at the Blood Services in five cities/regions in Zhejiang Province between January 1, 2006 and December 31, 2012. Two rounds of serological testing were performed for HBsAg, anti-HCV, anti-HIV1/2 and anti-TP using different kits. The rates of serological positivity were calculated and further analysis was performed to examine the association between donors' characteristics and seroprevalence. RESULTS Of the 1,615,120 donations, approximately 40% came from first-time donors and 60% from repeat donors. The overall seroprevalence rates of HBV, HCV, HIV and TP were 0.51%, 0.25%, 0.15% and 0.52%, respectively. The overall prevalences of HCV and HIV remained relatively steady, whereas the prevalence of TP increased sharply after 2010. However, the prevalence of TTI agents varied among volunteer blood donors in different cities/regions and demographic groups. DISCUSSION We collected data on the seroprevalence of TTI agents among volunteer blood donors. Although the risk of TTI is low in China compared to that in some developing countries, sensitive screening methods and recruitment of regular donors are still very important for blood safety and availability.
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Merli MG, Moody J, Mendelsohn J, Gauthier R. Sexual Mixing in Shanghai: Are Heterosexual Contact Patterns Compatible With an HIV/AIDS Epidemic? Demography 2015; 52:919-42. [PMID: 25904346 PMCID: PMC4466078 DOI: 10.1007/s13524-015-0383-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
China's HIV prevalence is low, mainly concentrated among female sex workers (FSWs), their clients, men who have sex with men, and the stable partners of members of these high-risk groups. We evaluate the contribution to the spread of HIV of China's regime of heterosexual relations, of the structure of heterosexual networks, and of the attributes of key population groups with simulations driven by data from a cross-sectional survey of egocentric sexual networks of the general population of Shanghai and from a concurrent respondent-driven sample of FSWs. We find that the heterosexual network generated by our empirically calibrated simulations has low levels of partner change, strong constraints on partner selection by age and education, and a very small connected core, mainly comprising FSWs and their clients and characterized by a fragile transmission structure. This network has a small HIV epidemic potential but is compatible with the transmission of bacterial sexually transmitted infections (STIs), such as syphilis, which are less susceptible to structural breaks in transmission of infection. Our results suggest that policies that force commercial sex underground could have an adverse effect on the spread of HIV and other STIs.
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Affiliation(s)
- M Giovanna Merli
- Duke Population Research Institute, Sanford School of Public Policy, Department of Sociology and Duke Global Health Institute, Duke University, Box 90312, Durham, NC, 27708, USA,
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Yang X, Li S, Attané I, Feldman MW. Commercial sex behaviours among involuntary male bachelors: findings from a survey of migrants in Xi'an, China. J Public Health (Oxf) 2014; 37:305-12. [PMID: 25104838 DOI: 10.1093/pubmed/fdu047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The highly male-biased sex ratio at birth has produced a severe male 'marriage squeeze' in China. However, with an imbalanced sex ratio, the marriage-squeezed or involuntary bachelors can meet their sexual needs only through ways other than marriage. METHODS To investigate the commercial sex behaviours of involuntary bachelors, we conducted a survey on reproductive health and family living among male migrant bachelors in Xi'an City, the capital of Shaanxi Province, from December 2009 to January 2010. RESULTS The prevalence of commercial sex use was 37.2% among unmarried men, 30.1% among married but separated men and 17.2% among married and cohabitating men (χ(2) = 31.33; P = 0.000; df = 2). Marital status, knowledge about acquired immunodeficiency syndrome (AIDS), age and income were associated with the prevalence and frequency of commercial sex behaviours. Condom use was less frequent among involuntary bachelors and was significantly associated with knowledge about AIDS and other sexually transmitted diseases, the frequency of commercial sex behaviours, marital status and age. CONCLUSIONS The higher prevalence of commercial sex behaviours and the lower frequency of condom use indicate a higher risk of disease from commercial sex among involuntary bachelors, implicating both individual and public health.
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Affiliation(s)
- Xueyan Yang
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, Shaanxi Province, P. R. China
| | - Shuzhuo Li
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, Shaanxi Province, P. R. China
| | - Isabelle Attané
- French National Institute for Demographic Studies, INED, Paris 75020, France
| | - Marcus W Feldman
- Morrison Institute for Population and Resource Studies, Stanford University, Stanford, CA 94305, USA
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The current hepatitis C virus prevalence in China may have resulted mainly from an officially encouraged plasma campaign in the 1990s: a coalescence inference with genetic sequences. J Virol 2013; 87:12041-50. [PMID: 23986603 DOI: 10.1128/jvi.01773-13] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
In this study, we investigated hepatitis C virus (HCV) molecular epidemiology and evolutionary dynamics. Both E1 and NS5B sequences were characterized in 379 of 433 patients in southern China and classified into five major subtypes: 1b in 256 patients, 6a in 67 patients, 2a in 29 patients, 3a in 14 patients, and 3b in 13 patients. Using the E1 sequences obtained, along with those from other studies using samples from China, we inferred the HCV epidemic history by means of coalescence strategies. Five Bayesian skyline plots (BSPs) were estimated for the five subtypes. They concurrently highlighted the rapid growth in the HCV-infected population size from 1993 to 2000, followed by an abrupt slowing. Although flanked on both sides by variable population sizes, the plots showed distinct patterns of rapid HCV growth. Coincidently, 1993 to 2000 was a period when contaminated blood transfusions were common in China due to a procedural error in an officially encouraged plasma campaign. The abrupt slowing in 1998 to 2000 corresponded to the central government outlawing paid blood donations in 1998. Using a parametric model, the HCV population growth rates were estimated during 1993 to 2000. It was revealed that the 6a rate was the highest, followed by those of 1b, 2a, 3b, and 3a. Because these rates differed significantly (P < 1e-9) from each other, they may help explain why 6a is increasingly prevalent in southern China and 1b is predominant nationwide. These rates are approximately 10-fold higher than those reported elsewhere. These findings suggested that during the plasma campaign, certain barriers to efficient viral transmission were removed, allowing wide HCV dissemination.
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Nutbeam D, Padmadas SS, Maslovskaya O, Wu Z. A health promotion logic model to review progress in HIV prevention in China. Health Promot Int 2013; 30:270-80. [PMID: 23753059 DOI: 10.1093/heapro/dat037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Using the theory and concepts of health promotion, this paper proposes a logic model for HIV/AIDS prevention and control which provides a structure for describing planned actions and predicted impacts/outcomes from comprehensive HIV prevention interventions. The potential usefulness of the model is examined by reviewing the evolution of HIV prevention and management in China, drawing on evidence from interventions reported from a mixture of study designs and formats. It reports that HIV interventions in China can be considered in two distinctive phases, before and after 2003 when China commenced its 'official' response to the HIV epidemic. The logic model was useful in comparing actions taken over these two periods highlighting the importance of political leadership in distinguishing between the two phases, and the continuing importance of systematic and broadly based public education and communication. We conclude that the logic model can not only be used as a planning model, but can also be applied retrospectively to assess successes and failures in national and local responses to HIV in complex social settings.
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Affiliation(s)
| | - Sabu S Padmadas
- Centre for Global Health, Population, Poverty & Policy, Social Statistics and Demography Division and
| | - Olga Maslovskaya
- EPSRC Care Life Cycle Research Programme and Southampton Statistical Sciences Research Institute, University of Southampton, UK
| | - Zhiwei Wu
- Centre for Public Health Research, Nanjing University, PR China
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Tian D, Li L, Liu Y, Li H, Xu X, Li J. Different HCV genotype distributions of HIV-infected individuals in Henan and Guangxi, China. PLoS One 2012; 7:e50343. [PMID: 23226265 PMCID: PMC3511438 DOI: 10.1371/journal.pone.0050343] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 10/18/2012] [Indexed: 01/29/2023] Open
Abstract
Background Due to shared transmission routes, hepatitis C virus (HCV) infection is highly prevalent among people infected with human immunodeficiency virus (HIV). Highly active antiretroviral therapy (HAART) is associated with hepatotoxicity, leading to the negative effects on patients with HIV/HCV co-infection. In order to provide valuable information for HCV management in this particular population, we investigated the HCV genotypes in HIV-infected individuals from Henan and Guangxi, the two provinces with the most HIV-infected cases in China. Methods Individuals, who acquired HIV infection through various risk routes, were recruited from Henan and Guangxi. Test of antibodies against HCV (anti-HCV) was conducted, and detection of HCV RNA was performed by PCR amplification. HCV subtypes were determined by direct sequencing of amplicons, followed by phylogenetic analysis. Results We recruited a total of 1,112 HIV-infected people in this present study. Anti-HCV was detected from 218 (50.1%) patients from Henan and 81 (12.0%) patients from Guangxi, respectively. The highest prevalence of HIV/HCV co-infection was observed from FBDs (former blood donors) (87.2%) in Henan and IDUs (intravenous drug users) (81.8%) in Guangxi, respectively. The seroprevalence rate of HCV among people with sexual contact was significantly higher in Henan than in Guangxi (18.7% vs. 3.5%, P<0.05). The positive rate of HCV RNA in Henan and Guangxi was 30.6% (133/435) and 11.2% (76/677), respectively. Moreover, we found that 20 anti-HCV negative samples were HCV positive by PCR amplification. HCV subtype 1b (52.7%) was predominant in Henan, followed by subtype 2a (41.9%). The most frequently detected subtypes in Guangxi were 6a (35.6%) and 3b (32.9%). Conclusion The HCV genotype distributions were different in HIV-infected people from Henan and Guangxi. HIV/HCV co-infection was not only linked to the transmission routes, but also associated with the geographic position.
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Affiliation(s)
- Di Tian
- Department of Infectious Disease, Peking University First Hospital, Beijing, China
| | - Lin Li
- Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Yongjian Liu
- Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Hanping Li
- Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Xiaoyuan Xu
- Department of Infectious Disease, Peking University First Hospital, Beijing, China
- * E-mail: (XYX); (JYL)
| | - Jingyun Li
- Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
- * E-mail: (XYX); (JYL)
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22
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Kaufman JA, Zeng W, Wang L, Zhang Y. Community-based mental health counseling for children orphaned by AIDS in China. AIDS Care 2012; 25:430-7. [PMID: 22880692 DOI: 10.1080/09540121.2012.712661] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
There is an urgent need to develop scalable approaches to community-based mental health services for children in rural China and other developing countries involving task shifting from clinicians to trained community workers. Evidence is needed about the effectiveness of interventions for children affected by AIDS in rural areas. This article describes an intervention study aimed at developing, implementing, and evaluating a community-based counseling program for the AIDS orphans of Fuyang, Anhui Province, an area of central China where a tainted blood donation scheme infected countless farmers and left many children orphaned by AIDS. In China these children live in rural settings with no access to mental health services. The authors trained a group of community-based counselors to provide group counseling sessions focusing on self-awareness and communication and to provide a basic therapeutic approach for depression and anxiety. The authors conducted a baseline and two follow-up surveys of 39 children who met the clinical diagnostic criteria for anxiety and depression. There was a statistically significant improvement for the children on anxiety, but there was no statistically significant improvement on depression, with greatest gains immediately following the intervention. We demonstrated the feasibility of task shifting for mental health services in this setting.
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Affiliation(s)
- Joan A Kaufman
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA.
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23
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Hu X, Hong K, Zhao C, Zheng Y, Ma L, Ruan Y, Gao H, Greene K, Sarzotti-Kelsoe M, Montefiori DC, Shao Y. Profiles of neutralizing antibody response in chronically human immunodeficiency virus type 1 clade B'-infected former plasma donors from China naive to antiretroviral therapy. J Gen Virol 2012; 93:2267-2278. [PMID: 22791603 DOI: 10.1099/vir.0.043802-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Broadly neutralizing antibodies (NAbs) such as those generated in chronic human immunodeficiency virus type 1 (HIV-1) infection are considered a key component for an effective HIV-1 vaccine. Here, we measured NAb responses using a panel of 25 Env-pseudotyped viruses, including clade B, C, A, CRF07_BC and CRF01_AE strains, against plasma samples from 103 subjects in a former plasma donor cohort in central China, who were infected with HIV-1 clade B' for at least 10 years and naïve to antiretroviral therapy at the time of sampling. We found that 64 % of samples (n = 66) neutralized at least half of the viruses tested and 2 % (n = 2) neutralized all of the viruses, while 5 % (n = 5) neutralized none of the viruses tested. Strikingly, 29 % of plasma samples (n = 30) neutralized >80 % of the viral strains tested, indicating the presence of broadly reactive NAbs in these patients. When the magnitude (geometric mean ID(50) titres, GMTs) or breadth of neutralization was assessed for correlation with CD4 count or plasma viral load, the only significant positive correlations were observed between viral load and neutralization magnitude (r = 0.2189, P = 0.0263) and between viral load and neutralization breadth (r = 0.1970, P = 0.0461). A moderate difference between progressors and long-term non-progressors was observed in both the breadth (P = 0.0316) and the potency (P = 0.0300). A significant difference was found in the GMTs between intra-clade and inter-clade strains (P<0.001). Heat-map analysis based on k-means clustering of plasma determined a statistically stable cluster of plasma with cross-reactive and potent neutralizing reactivity. These samples could provide physical biomaterials for further virological and serological studies from which useful insights into rational HIV-1 vaccine development and therapeutic design might be derived.
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Affiliation(s)
- Xintao Hu
- State Key Laboratory for Infectious Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Kunxue Hong
- State Key Laboratory for Infectious Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Chunhong Zhao
- State Key Laboratory for Infectious Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Yang Zheng
- State Key Laboratory for Infectious Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Liying Ma
- State Key Laboratory for Infectious Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Yuhua Ruan
- State Key Laboratory for Infectious Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
| | - Hongmei Gao
- Department of Experimental Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Kelli Greene
- Department of Experimental Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Marcella Sarzotti-Kelsoe
- Department of Immunology, Duke University Medical Center, Durham, NC 27710, USA.,Department of Experimental Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - David C Montefiori
- Department of Experimental Surgery, Duke University Medical Center, Durham, NC 27710, USA
| | - Yiming Shao
- State Key Laboratory for Infectious Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, PR China
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Yang X, Attané I, Li S, Yang B. Same-Sex Sexual Behaviors Among Male Migrants in a Context of Male “Marriage Squeeze”. Am J Mens Health 2012; 6:485-96. [DOI: 10.1177/1557988312453479] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The male marriage squeeze in China may increase the prevalence of male same-sex sexual behaviors among unmarried male migrants who lack stable female sexual partners. The same-sex sexual behaviors among unmarried male migrants appear to be at high risk of transmission of human immunodeficiency virus (HIV) and sexually transmitted infections (STIs), mainly because of a lack of knowledge of these diseases. Using data from the “Survey on Reproductive Health and Family Life of Migrant Male Bachelors in Urban Areas” conducted in Xi’an City, Shaanxi Province, in December 2009 and January 2010, this study compares same-sex sexual behaviors of unmarried with that of married male migrants (including married but separated men who are migrating without their spouse or partner and cohabitating men who are migrating with their spouse or partner). It is reported that the prevalence of same-sex sexual behaviors among unmarried males reaches 11%, more than twice the 5.1% reported by married but separated men and thrice the 3.8% reported by cohabitating men. It also appears that the same-sex sexual behaviors is significantly associated with men’s attitudes toward same-sex sexual behaviors (odds ratio = 1.59, p < .001), toward life-long bachelorhood (odds ratio = 1.35, p < .01), and with marital status (odds ratio = 0.37, p < .01). The frequency of condom use appears to be higher among unmarried men than among men who are married, whether or not they migrated with their wives, and is significantly associated with scores on knowledge about HIV/AIDS (estimated coefficient = .12, p < .001) and STIs (estimated coefficient = .22, p < .01). It is also associated with the likelihood of same-sex sexual behaviors (estimated coefficients = .83, p < .01) and marital status (estimated coefficients for married but separated = −.50, p < .05; estimated coefficients for cohabitating = −.77, p < .001).
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Affiliation(s)
| | - Isabelle Attané
- INED (French National Institute for Demographic Studies), Paris, France
| | | | - Bo Yang
- Xi’an Jiaotong University, Xi’an, China
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25
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Zhang Y, Wang M, Li H, Zhang H, Shi Y, Wei F, Liu D, Liu K, Chen D. Accumulation of nuclear and mitochondrial DNA damage in the frontal cortex cells of patients with HIV-associated neurocognitive disorders. Brain Res 2012; 1458:1-11. [PMID: 22554480 DOI: 10.1016/j.brainres.2012.04.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2011] [Revised: 03/28/2012] [Accepted: 04/02/2012] [Indexed: 12/31/2022]
Abstract
Oxidative stress has been suggested to play a key role in the neuropathogenesis of HIV infection. HIV proteins (gp120, Tat) and proinflammatory cytokines can trigger the production of reactive oxygen species (ROS), resulting in DNA and RNA lesions. Among all the lesions induced by ROS, one of the most abundant lesions in DNA and RNA is 8-hydroxydeoxyguanosine (8-oxoG). Here, we studied accumulated DNA oxidative damage induced by ROS in the central nervous system (CNS) in tissue from neuro-AIDS patients. The frontal cortex of autopsy tissue from HIV-1 infected patients was adopted for analysis for HIV-1 subtype, nuclear and mitochondrial DNA lesions by immunofluorescence staining, qPCR and sequencing of PCR cloning. This study provides evidence that HIV infection in the CNS leads to nuclear and mitochondrial genomic DNA damage in the brain. High level of nuclear and mtDNA 8-oxoG damage were identified in the cortex autopsy tissue of HAND patients. Increased accumulation of mtDNA mutations and depletion occurs in brain tissue in a subset of HAND cases, and is significantly different from that observed in control cases. These findings suggest that higher level of ROS in the CNS of HAND patients would contribute to the HIV induced neuro-inflammation and apoptosis of neuronal and glial cells.
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Affiliation(s)
- Yulin Zhang
- Department of Medicine, Beijing You An Hospital, Capital Medical University, Beijing 100069, China
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Preferential CTL targeting of Gag is associated with relative viral control in long-term surviving HIV-1 infected former plasma donors from China. Cell Res 2012; 22:903-14. [PMID: 22290423 DOI: 10.1038/cr.2012.19] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
It is generally believed that CD8(+) cytotoxic T lymphocytes (CTLs) play a critical role in limiting the replication of human immunodeficiency virus type 1 (HIV-1) and in determining the outcome of the infection, and this effect may partly depend on which HIV product is preferentially targeted. To address the correlation between HIV-1-specific CTL responses and virus replication in a cohort of former plasma donors (FPDs), 143 antiretroviral therapy naive FPDs infected with HIV-1 clade B' strains were assessed for HIV-1-specific CTL responses with an IFN-γ Elispot assay at single peptide level by using overlapping peptides (OLPs) covering the whole consensus clade B proteome. By using a Spearman's rank correlation analysis, we found that the proportion of Gag-specific CTL responses among the total virus-specific CTL activity was inversely correlated with viral loads while being positively correlated to CD4 counts, as opposed to Pol- and Env-specific responses that were associated with increased viral loads and decreased CD4 counts. In addition, Vpr-specifc CTL responses showed a similar protective effect with Gag responses, but with a much lower frequency of recognition. Significantly, we also observed an association between HLA-A*30/B*13/Cw*06 haplotype and lower viral loads that was probably due to restricted Gag-specific CTL responses. Thus, our data demonstrate the prominent role of Gag-specific CTL responses in disease control. The advantage of HLA-A*30/B*13/Cw*06 haplotype in viral control may be associated with the contribution of Gag-specific CTL responses in the studied individuals.
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27
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Fu Y, Qin W, Cao H, Xu R, Tan Y, Lu T, Wang H, Tong W, Rong X, Li G, Yuan M, Li C, Abe K, Lu L, Chen G. HCV 6a prevalence in Guangdong province had the origin from Vietnam and recent dissemination to other regions of China: phylogeographic analyses. PLoS One 2012; 7:e28006. [PMID: 22253686 PMCID: PMC3253785 DOI: 10.1371/journal.pone.0028006] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 10/30/2011] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Recently in China, HCV 6a infection has shown a fast increase among patients and blood donors, possibly due to IDU linked transmission. METHODOLOGY/FINDINGS We recruited 210 drug users in Shanwei city, Guangdong province. Among them, HCV RNA was detected in 150 (71.4%), both E1 and NS5B genes were sequenced in 136, and 6a genotyped in 70. Of the 6a sequences, most were grouped into three clusters while 23% represent emerging strains. For coalescent analysis, additional 6a sequences were determined among 21 blood donors from Vietnam, 22 donors from 12 provinces of China, and 36 IDUs from Liuzhou City in Guangxi Province. Phylogeographic analyses indicated that Vietnam could be the origin of 6a in China. The Guangxi Province, which borders Vietnam, could be the first region to accept 6a for circulation. Migration from Yunnan, which also borders Vietnam, might be equally important, but it was only detected among IDUs in limited regions. From Guangxi, 6a could have further spread to Guangdong, Yunnan, Hainan, and Hubei provinces. However, evidence showed that only in Guangdong has 6a become a local epidemic, making Guangdong the second source region to disseminate 6a to the other 12 provinces. With a rate of 2.737×10⁻³ (95% CI: 1.792×10⁻³ to 3.745×10⁻³), a Bayesian Skyline Plot was portrayed. It revealed an exponential 6a growth during 1994-1998, while before and after 1994-1998 slow 6a growths were maintained. Concurrently, 1994-1998 corresponded to a period when contaminated blood transfusion was common, which caused many people being infected with HIV and HCV, until the Chinese government outlawed the use of paid blood donations in 1998. CONCLUSIONS/SIGNIFICANCE With an origin from Vietnam, 6a has become a local epidemic in Guangdong Province, where an increasing prevalence has subsequently led to 6a spread to many other regions of China.
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Affiliation(s)
- Yongshui Fu
- Department of Biochemistry, Medical College of Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangzhou Blood Center, Guangzhou, Guangdong, China
| | - Weibing Qin
- Family Planning Research Institute of Guangdong Province, Guangzhou, Guangdong, China
- The Vaccine Institute, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hong Cao
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ru Xu
- Guangzhou Blood Center, Guangzhou, Guangdong, China
| | - Yi Tan
- Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Teng Lu
- University of Southern California, Los Angeles, California, United States of America
| | - Hongren Wang
- The Vaccine Institute, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wangxia Tong
- Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xia Rong
- Guangzhou Blood Center, Guangzhou, Guangdong, China
| | - Gang Li
- The Vaccine Institute, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Manqiong Yuan
- Department of Pathology and Laboratory Medicine, Viral Oncology Center, University of Kansas Medical Center, Kansas City, Kansas, United States of America
| | - Chunhua Li
- Department of Pathology and Laboratory Medicine, Viral Oncology Center, University of Kansas Medical Center, Kansas City, Kansas, United States of America
| | - Kenji Abe
- Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Ling Lu
- Department of Pathology and Laboratory Medicine, Viral Oncology Center, University of Kansas Medical Center, Kansas City, Kansas, United States of America
- Laboratory for Hepatology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
- * E-mail:
| | - Guihua Chen
- Laboratory for Hepatology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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Yang X. Prevalence and correlates of HIV unsafe sex and STIs among women working in China's entertainment industry. AIDS Care 2011; 23 Suppl 1:75-82. [PMID: 21660753 DOI: 10.1080/09540121.2010.525620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Female entertainment workers in China are at risk of sexually acquiring HIV, but risk factors of their unsafe sex remain understudied. Using information from a venue-based sample of 724 female entertainment workers in Shanghai, this paper examines the prevalence and risk factors of unsafe sex and STIs. While both measures of unsafe sex and history of common STIs suggest that participants in this study appear to have lower rates of unsafe sex and STIs than reported in the literature, venue-based female entertainment workers are at risk of sexually acquiring HIV. Risk factors of unsafe sex include both individual cognitive (information, motivation, and behavioral skills) and social factors. However, HIV-related information and most social factors are not directly and independently associated with unsafe sex. Behavioral intervention is needed for female entertainment workers in China. However, individual-based cognitive approach alone may be limited in effectiveness in reducing unsafe sex among female entertainment workers. Effective intervention needs to take a multi-level approach that addresses both individual cognitive and social risk factors and can particularly benefit from attention to empowering women in sexual relationships and creating a supportive social and working environment.
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Affiliation(s)
- Xiushi Yang
- Sociology and Criminal Justice, Old Dominion University, Norfolk, VA, USA.
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Li D, Chen J, Jia M, Hong K, Ruan Y, Liang H, Liu S, Zhang X, Zhao H, Peng H, Ma P, Shao Y. Loss of balance between T helper type 17 and regulatory T cells in chronic human immunodeficiency virus infection. Clin Exp Immunol 2011; 165:363-71. [PMID: 21707592 DOI: 10.1111/j.1365-2249.2011.04435.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The aim of this study is to characterize the changes of CD4(+) CD25(high) forkhead box P3 (FoxP3(+) ) regulatory T cells (T(reg) ), interleukin (IL)-17 secreting T helper type 17 (Th17) cell frequencies and the balance of these two subsets in a cohort of chronic human immunodeficiency virus type 1 (HIV-1)-infected patients in China. A total of 115 untreated chronic HIV-infected individuals and 32 healthy donors were recruited in this study. Peripheral blood mononuclear cells were isolated from ethylenediamine tetracetic acid (EDTA) anti-coagulated fresh whole blood and stained to characterize the frequencies of T(reg) and Th17. Of a total 115 patients, 42 individuals including 10 elite controllers were followed-up for more than 1 year, and changes of T(reg) and Th17 frequencies were analysed over time. The continuous loss of Th17 cells was accompanied by a concomitant rise in the frequency of T(reg) cells, resulting in a loss of Th17/T(reg) balance during the progressive HIV infection. Meanwhile, the T(reg) levels, Th17 levels and Th17/T(reg) ratios of the elite controller group were comparable to those of the HIV-1 negative controls in the follow-up study. Additionally, we demonstrated that loss of balance between Th17 and T(reg) is associated with an earlier CD4 T cell decline during the course of HIV infection. Our results indicate that a loss of immune-balance of Th17 to T(reg) during HIV-1 disease progression and the persistence of such an immune-balance in the elite controllers may have a critical role in HIV-1 infection and further shed new light into understanding the pathogenesis of HIV-1.
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Affiliation(s)
- D Li
- State Key Laboratory for Infectious Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Extensive HLA-driven viral diversity following a narrow-source HIV-1 outbreak in rural China. Blood 2011; 118:98-106. [PMID: 21562042 DOI: 10.1182/blood-2010-06-291963] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Obstacles to developing an HIV-1 vaccine include extensive viral diversity and lack of correlates of protective immunity. High mutation rates allow HIV-1 to adapt rapidly to selective forces such as antiretroviral therapy and immune pressure, including HIV-1-specific CTLs that select viral variants which escape T-cell recognition. Multiple factors contribute to HIV-1 diversity, making it difficult to disentangle the contribution of CTL selection without using complex analytical approaches. We describe an HIV-1 outbreak in 231 former plasma donors in China, where a narrow-source virus that had contaminated the donation system was apparently transmitted to many persons contemporaneously. The genetic divergence now evident in these subjects should uniquely reveal how much viral diversity at the population level is solely attributable to host factors. We found significant correlations between pair-wise divergence of viral sequences and HLA class I genotypes across epitope-length windows in HIV-1 Gag, reverse transcriptase, integrase, and Nef, corresponding to sites of 140 HLA class I allele-associated viral polymorphisms. Of all polymorphic sites across these 4 proteins, 24%-56% were sites of HLA-associated selection. These data confirm that CTL pressure has a major effect on inter-host HIV-1 viral diversity and probably represents a key element of viral control.
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31
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Fu Y, Xia W, Wang Y, Tian L, Pybus OG, Lu L, Nelson K. The seroprevalence of hepatitis C virus (HCV) among 559,890 first-time volunteer blood donors in China reflects regional heterogeneity in HCV prevalence and changes in blood donor recruitment models. Transfusion 2010; 50:1505-11. [PMID: 20456675 PMCID: PMC3743680 DOI: 10.1111/j.1537-2995.2010.02616.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND A decrease in the prevalence of hepatitis C virus antibody (anti-HCV) has been reported among voluntary blood donors in some regions of China. However, the prevalence of HCV among volunteer blood donors in other regions of China has not been reported. The aim of this study was to investigate the seroprevalence of HCV among 559,890 first-time volunteer blood donors recruited during 2004 through 2007 at the Guangzhou Blood Center, China. STUDY DESIGN AND METHODS Anti-HCV was detected using two different third-generation enzyme immunoassay kits. HCV RNA was detected using reverse transcription-polymerase chain reaction (RT-PCR) targeting the 5'-untranslated region of HCV. RESULTS Among 559,890 donors, 1877 (0.335%) were positive for anti-HCV. The anti-HCV+ rate was significantly higher in males than females (0.37% vs. 0.28%; p < 0.001) and significantly lower among donors living in Guangdong Province than donors who had migrated from other locations (0.30% vs. 0.40%; p < 0.001). Among the 1877 anti-HCV+ donors, 450 were randomly selected for HCV nucleic acid amplification by RT-PCR. Of these, 270 (60%) were HCV RNA+ and 180 (40%) were HCV RNA-. CONCLUSIONS Many donors from outside Guangdong Province were migrant laborers from other areas in China, suggesting that there is regional heterogenicity in HCV prevalence within China. The overall anti-HCV+ rate reported here is among the lowest reported among blood donors in China reflecting the effect of the current recruitment of exclusively volunteer donors.
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Affiliation(s)
- Yongshui Fu
- Guangzhou Blood Center and the Laboratory of Integrated Biosciences, School of Life Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
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Zhu L, Zhang GH, Zheng YT. [Application studies of animal models in evaluating safety and efficacy of HIV-1 microbicides]. DONG WU XUE YAN JIU = ZOOLOGICAL RESEARCH 2010; 31:66-76. [PMID: 20446456 DOI: 10.3724/sp.j.1141.2010.01066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
As the HIV/AIDS pandemic continues unabated, novel prophylactic strategy for the spread of HIV are urgently needed. Topical microbicides are designed to prevent transmission of HIV when applied vaginally or rectally. Although there are many microbicide candidates in the pipeline, animal models for evaluating their safety and efficacy are urgently needed. On the basis of comparing the non-primate small animal models and the non-human primate animal models in evaluating safety and efficacy of HIV microbicides, this review summarizes the major advantages and disadvantages of the relevant animal models. The suggested direction of research that would benefit the development of microbicides is also reviewed.
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Affiliation(s)
- Lin Zhu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, the Chinese Academy of Sciences, Kunming, 650223, China
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Yang X, Xia G, Li X, Latkin C, Celentano D. Social influence and individual risk factors of HIV unsafe sex among female entertainment workers in China. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2010; 22:69-86. [PMID: 20166789 PMCID: PMC2826716 DOI: 10.1521/aeap.2010.22.1.69] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Female entertainment workers in China are at increased sexual risk of HIV, but causes of their unprotected sex remain poorly understood. We develop a model that integrates information-motivation-behavioral skills (IMB) with social influences and test the model in a venue-based sample of 732 female entertainment workers in Shanghai. Most IMB and social influence measures are statistically significant in bivariate relationships to condom use; only HIV prevention motivation and behavioral self-efficacy remain significant in the multiple regressions. Self-efficacy in condom use is the most proximate correlate, mediating the relationship between information and motivation and condom use. Both peer and venue supports are important, but their influences over condom use are indirect and mediated through prevention motivation and/or self-efficacy. Behavioral intervention is urgently needed and should take a multilevel approach, emphasizing behavioral skills training and promoting a supportive social/working environment.
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Affiliation(s)
- Xiushi Yang
- Department of Sociology and Criminal Justice, Old Dominion University, Norfolk, VA 23529, USA.
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Zhao F, Wang Z, Li WJ. Human immunodeficiency virus type 1 subtypes prevalence in central China. Yonsei Med J 2009; 50:644-9. [PMID: 19881967 PMCID: PMC2768238 DOI: 10.3349/ymj.2009.50.5.644] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Revised: 12/26/2008] [Accepted: 01/07/2009] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To study the epidemic characteristics, transmission sources and routes of various subtypes of human immunodeficiency virus type 1 (HIV-1) and sequence variations in Henan, central China. To provide theoretical foundation for Acquired Immune Deficiency Syndrome (AIDS) prevention strategy in this region where the primary HIV transmission route was through former paid blood donation. MATERIALS AND METHODS HIV-1 gene env and gag were amplified by nested polymerase chain reaction (PCR) from uncultured peripheral blood mononuclear cells (PBMCs) obtained from 1,287 HIV-1 confirmed samples in Henan. RESULTS Among 1,287 samples, 5 HIV-1 strains were found including subtypes B' (95.9%), C (0.47%) and recombinant subtypes CRF 07_BC (1.09%), CRF 08_BC (1.79%) and CRF 01_AE (0.78%). Phylogenetic tree analysis found that 1,234 Henan subtype B' were closely related to those commonly found in Thailand, and were distantly related to other international subtypes. The dominant strain in former blood plasma donors (FPDs) was subtype B', and the dominant strains in sexual transmission were subtype B' and BC. Among HIV patients who were most likely infected through routes other than paid blood donation, the percentage of non-B' subtypes was much higher than those of FPD. CONCLUSION These findings suggest that the prevailing strain of HIV-1 in Henan is subtype B', similar to the B' subtype found in Thailand. In addition, for the first time we found subtypes C and recombinant subtypes CRF07_BC, CRF08_BC and CRF01_AE in this region. Indicating that the subtype feature of HIV-1 became more complicated than before in central China.
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Affiliation(s)
- Fei Zhao
- School of Public Health, Zhengzhou University, Zhengzhou, China.
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Ebenstein AY, Jennings E. Bare Branches, Prostitution, and HIV in China: A~Demographic Analysis. GENDER POLICY AND HIV IN CHINA 2009. [DOI: 10.1007/978-1-4020-9900-7_5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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Zhang X, Xu J, Peng H, Ma Y, Han L, Ruan Y, Su B, Wang N, Shao Y. HCV coinfection associated with slower disease progression in HIV-infected former plasma donors naïve to ART. PLoS One 2008; 3:e3992. [PMID: 19098990 PMCID: PMC2602976 DOI: 10.1371/journal.pone.0003992] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2008] [Accepted: 11/20/2008] [Indexed: 11/18/2022] Open
Abstract
Background It remains controversial how HCV coinfection influences the disease progression during HIV-1 infection. This study aims to define the influence of HCV infection on the replication of HIV-1 and the disease progression in HIV-infected former plasma donors (FPDs) naïve to ART. Methodology/Principal Findings 168 HIV-1-infected FPDs were enrolled into a cohort study from Anhui province in central China, and thereafter monitored at month 3, 9, 15, 21 and 33. Fresh whole blood samples were used for CD4+ T-cell counting. Their plasma samples were collected and stored for quantification of HIV-1 viral loads and for determination of HCV and Toxoplasma. Out of 168 HIV-infected FBDs, 11.9% (20 cases), 80.4% (135 cases) and 7.7% (13 cases) were infected with HIV-1 alone, HIV-1/HCV and HIV/HCV/Toxoplasma, respectively. During the 33-month follow-up, only 35% (7 out of 20 cases) HIV-1 mono-infected subjects remained their CD4+ T-cell counts above 200 cells/µl and retained on the cohort study, which was significantly lower than 56% (75 out of 135 cases) for HIV/HCV group and 69% (9 out of 13 cases) for HIV/HCV/Toxoplasma group (p<0.05). CD4+ T cells in HIV mono infection group were consistently lower than that in HIV/HCV group (p = 0.04, 0.18, 0.03 and 0.04 for baseline, month 9, month 21 and month 33 visit, respectively). In accordance with those observations, HIV viral loads in HIV mono-infection group were consistently higher than that in HIV/HCV group though statistical significances were only reached at baseline (p = 0.04). Conclusions/Significance These data indicated HCV coinfection with HIV-1 is associated with the slower disease progression at the very late stage when comparing with HIV-1 mono-infection. The coinfection of Toxoplasma with HIV and HCV did not exert additional influence on the disease progression. It will be highly interesting to further explore the underlying mechanism for this observation in the future.
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Affiliation(s)
- Xiaoyan Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, China CDC, Beijing, China
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Abstract
Drug addiction in China began with the importation of Indian opium by the British in the 16th century and brought severe social and health problems. While drug abuse abated following the establishment of People's Republic of China, modernization and Westernization in the 1980s led to the reemergence of this problem. Drug abuse in China became epidemic, facilitating the spread of HIV/AIDS. The Chinese government has made great efforts to address these problems, focusing both on treatments of drug addiction and on harm-reduction programs. Although the new trends of drug addiction in China pose great public health challenges, these government interventions are likely to successfully stem the problem of drug abuse in the future.
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Affiliation(s)
- Lin Lu
- National Institute on Drug Dependence, Peking University, Beijing, China.
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Starks H, Simoni J, Zhao H, Huang B, Fredriksen-Goldsen K, Pearson C, Chen WT, Lu L, Zhang F. Conceptualizing antiretroviral adherence in Beijing, China. AIDS Care 2008; 20:607-14. [PMID: 18576162 DOI: 10.1080/09540120701660379] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
International health experts agree that China is on the verge of an AIDS crisis. In response, the Chinese government initiated the "Four Frees and One Care" policy in 2003 to decrease economic barriers and increase access to antiretroviral therapies for people with HIV. However, long-term treatment success requires not only access, but high rates of medication adherence. This qualitative interview study with 29 persons receiving HIV care at Beijing's Ditan Hospital identified barriers to and facilitators of medication adherence. The interviews were guided by an a priori conceptual model of adherence with four components: access, knowledge about medications, motivation, and proximal cues to action. Barriers to adherence were related to stigma and fear of discrimination; the medications themselves (including side-effects and complicated dosing regimens); and other economic issues (i.e. costs of transportation, lab tests and hospitalizations). Facilitators included participants' strong will to live, use of electronic reminders and family support. These results support the conceptual model and suggest that successful interventions must minimize stigma as it negatively affects all components of the model for adherence.
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Affiliation(s)
- H Starks
- Department of Medical History and Ethics, University of Washington, Seattle, USA
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39
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Abstract
HIV has advanced from high-risk groups such as intravenous drug users to some in the general population, according to comprehensive new data from the south of China. What needs to be done to halt its spread?
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Design, construction, and characterization of a multigenic modified vaccinia Ankara candidate vaccine against human immunodeficiency virus type 1 subtype C/B'. J Acquir Immune Defic Syndr 2008; 47:412-21. [PMID: 18209682 DOI: 10.1097/qai.0b013e3181651bb2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The rapid spread of HIV-1 underscores the urgent need to develop an effective vaccine. Using modified vaccinia Ankara (MVA) as a vector, we designed and constructed a multigenic candidate vaccine against a recombinant C/B' subtype of HIV-1 that is dominant in southwest China. Five HIV-1 genes (gag, pol, DeltaV2env, tat, and nef) were introduced into 2 separate regions of the MVA genome using modified single- and dual-promoter insertion vectors. Recombinant MVA was selected by immunofluorescence double-staining and foci purification. The end product is a single recombinant MVA, termed ADMVA, that expresses HIV-1 DeltaV2Env and fusion proteins Gag-Pol and Nef-Tat. By in vitro analyses, all expected HIV-1 proteins were expressed in infected chicken embryo fibroblasts and various human cell lines. Additionally, 2 sequential intramuscular injections of 10(6) 50% tissue infectious culture dose (TCID50) of ADMVA into BALB/c and B6 x B10 mice elicited broad cell-mediated immune responses against all 5 viral proteins as determined by interferon-gamma enzyme immunospot assays. The number of spot-forming cells was in the range of 200 to 800 per million splenocytes, and both CD4 and CD8 T-cell responses were detected. Moreover, high serum titers (>1:20,000) of antibodies against HIV-1 gp120 were also elicited. The magnitude of immune responses correlated with the dose of ADMVA, and the vaccine caused no overt adverse consequences, up to 10(7) TCID50 per injection. ADMVA has since been advanced into clinical trials. A phase 1 study has been completed, and a prime-boost with ADVAX (see accompanying article) is now underway.
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Design, Construction, and Characterization of a Dual-Promoter Multigenic DNA Vaccine Directed Against an HIV-1 Subtype C/B′ Recombinant. J Acquir Immune Defic Syndr 2008; 47:403-11. [DOI: 10.1097/qai.0b013e3181651b9d] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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42
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Qiu Y, Shi L, Wang Y, Zhang G, Zheng J, Gong X, Xia H, Zhang P, Ness P, Shan H. Risk factors for hepatitis C virus infection among blood donors in Beijing and implications for improving the pretesting donor screening process. Transfusion 2008; 48:1207-12. [PMID: 18346015 DOI: 10.1111/j.1537-2995.2008.01673.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The objective was to determine risk factors of hepatitis C virus (HCV) infection in blood donors in Beijing. STUDY DESIGN AND METHODS A cross-sectional study was conducted in a total of 112 volunteer blood donors at Beijing Red Cross Blood Center (BRCBC) who were identified between January 2002 and December 2003 due to isolated HCV antibody reactivity at a donor screening procedure. The donors were recalled and interviewed about possible risk factor history. Additional blood samples were tested in repeated enzyme immunoassay, recombinant immunoblot assay, and nested reverse transcription-polymerase chain reaction. Chi-square test, analysis of variance, and multivariate logistic regression analysis were conducted to examine associations between HCV serostatus and potential risk factors. RESULTS Among donors identified with isolated HCV antibody reactivity at donor screening, the prevalence of confirmed HCV infection was 31.3 percent (95% confidence interval [CI], 22.0%-39.2%) and indeterminate HCV infection was 22.3 percent (95% CI, 14.7%-30.3%), and the negative prevalence was 46.4 percent (95% CI, 37.5%-56.1%). The confirmed HCV cases were more likely than the indeterminate HCV cases to have the histories of previous transfusion, plasma donation, and hepatitis infection or elevated alanine aminotransferase (ALT), whereas the HCV-negative subjects were least likely to have the above histories (p < 0.05). CONCLUSION Histories of blood transfusion before 1995, plasma donation, previous hepatitis infection, or elevated ALT were risk factors for HCV infection among blood donors in Beijing.
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Affiliation(s)
- Yan Qiu
- Beijing Red Cross Blood Center, Beijing, China
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Wang Y, Liao SS, Weeks MR, Jiang JM, Abbott M, Zhou YJ, He B, Liu W, Mosack KE. Acceptability of hypothetical microbicides among women in sex establishments in rural areas in Southern China. Sex Transm Dis 2008; 35:102-10. [PMID: 17767093 PMCID: PMC2892031 DOI: 10.1097/olq.0b013e31814b8546] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES AND GOAL The objectives of this study were to measure the potential acceptability of a hypothetical microbicide among women in sex establishments in rural areas of Southern China and demographic, behavioral, and social context factors likely to affect microbicide acceptability. STUDY DESIGN This was a cross-sectional survey, using a quota sampling, among 300 women from sex establishments in 3 rural towns. An interviewer-administered standardized questionnaire was used to measure the acceptability score of hypothetical microbicides' characteristics, as well as sexual relationships and behaviors and other contextual factors. RESULTS Findings showed a generally positive response to microbicides, indicated by an acceptability index score of 2.89 (SD, 0.56, scale of 1-4) in the overall sample. Multivariate analysis shows that the acceptability score varied significantly by study sites, type of sex-work establishments, marital status, sex partner type, vaginal product experience, locus of control by partners, and locus of control by chance. CONCLUSIONS Microbicides may be acceptable among sex workers in rural settings in China; however, contextual factors should be carefully considered in education and promotion of microbicides in the future.
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Affiliation(s)
- Yu Wang
- Department of Epidemiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, China
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Liu P, Xiang K, Tang H, Zhang W, Wang X, Tong X, Takebe Y, Yang R. Molecular epidemiology of human immunodeficiency virus type 1 and hepatitis C virus in former blood donors in central China. AIDS Res Hum Retroviruses 2008; 24:1-6. [PMID: 18275341 DOI: 10.1089/aid.2007.0144] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The prevalence of hepatitis C virus (HCV) among human immunodeficiency virus (HIV-1)-positive former blood donors (FBDs) in Hubei province, central China, and the subtypes of these two viruses are identified. HIV-1-positive specimens were collected from FBDs, transfusion recipients, and their sexual partners in Hubei province, central China. The prevalence of HCV in HIV-1-positive FBDs was 78.6%. The dominant circulating HIV-1 subtype of FBDs was subtype B' (Thai-B); one belonged to U.S.-European subtype B. HCV genotypes 2a (78.6%) and 1b (21.4%) were detected. No recombinant form of HIV-1 was identified. Non-B' subtypes occurring among FBDs indicate the complexity of the HIV-1 prevalence in central China, where HIV is beginning to spread into the general population.
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Affiliation(s)
- Pingping Liu
- The State Key Laboratory of Virology, Wuhan Institution of Virology, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Kunlun Xiang
- The State Key Laboratory of Virology, Wuhan Institution of Virology, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Heng Tang
- Hubei Province Centers for Disease Prevention and Control, Wuhan, Hubei 430079, China
| | - Wei Zhang
- The State Key Laboratory of Virology, Wuhan Institution of Virology, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Xiaoqiong Wang
- The State Key Laboratory of Virology, Wuhan Institution of Virology, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Xiao Tong
- The State Key Laboratory of Virology, Wuhan Institution of Virology, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
| | - Yutaka Takebe
- Laboratory of Molecular Virology and Epidemiology, AIDS Research Center, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo 162-8640, Japan
| | - Rongge Yang
- The State Key Laboratory of Virology, Wuhan Institution of Virology, Chinese Academy of Sciences, Wuhan, Hubei 430071, China
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The first community-based sexually transmitted disease/HIV intervention trial for female sex workers in China. AIDS 2007; 21 Suppl 8:S89-94. [PMID: 18172397 DOI: 10.1097/01.aids.0000304702.70131.fa] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study was the first community-based intervention to test feasibility and effectiveness of an intervention targeting sex workers in China. DESIGN Prospective, community-based, pre/post-intervention trial. METHOD Thirty establishments in Chengjiang, 34 in Ruili and 23 in Longchuan were selected for the study. The study participants were female sex workers. Out-reach workers visited the establishments to conduct intervention activities over 6 weeks. The activities included lectures, discussion, video and audio cassettes, and distribution of educational folders and condoms. Pre- and post-intervention cross-sectional surveys assessed changes in sexually transmitted disease (STD)/AIDS knowledge and condom use. RESULTS After the intervention, knowledge of the three HIV transmission routes increased from 25 to 88% (P < 0.01), knowledge that condoms can reduce the risk of STD/HIV infection increased from 56 to 94% (P < 0.01). Condom use at last sex and in the last three sexual encounters increased from 61 to 85% (P < 0.01) and from 41 to 70%, respectively. Multivariate analyses indicated that the intervention was an independent factor (P < 0.01) for these changes. CONCLUSION The intervention programme was effective at increasing HIV/AIDS knowledge and condom use rates among sex workers in the community and should be expanded.
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Lu L, Fang Y, Wang X. Drug Abuse in China: Past, Present and Future. Cell Mol Neurobiol 2007; 28:479-90. [PMID: 17990098 DOI: 10.1007/s10571-007-9225-2] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Accepted: 10/08/2007] [Indexed: 10/22/2022]
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Chen XS, Yin YP, Tucker JD, Gao X, Cheng F, Wang TF, Wang HC, Huang PY, Cohen MS. Detection of Acute and Established HIV Infections in Sexually Transmitted Disease Clinics in Guangxi, China: Implications for Screening and Prevention of HIV Infection. J Infect Dis 2007; 196:1654-61. [PMID: 18008249 DOI: 10.1086/522008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2007] [Accepted: 05/03/2007] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) has spread throughout China and to some degree has penetrated the general heterosexual population in some regions. METHODS A cross-sectional survey of 11,461 sexually transmitted disease (STD) clinic attendees in 8 cities in Guangxi, China, was conducted for syphilis and for acute and established HIV infections. RESULTS The prevalence of acute and established HIV infections was 1.2% among the participants. Five acute (preseroconversion) HIV infections were detected. Multivariate analysis showed that HIV infection was independently related to unmarried status (odds ratio [OR], 1.73 [95% confidence interval {CI}, 1.00-2.99), less education (OR for less than primary school, 4.21 [90% CI, 1.21-14.58]), residence in city A (OR, 11.48 [95% CI, 2.05-64.31]) or city B (OR, 7.93 [95% CI, 1.75-35.91]), working in the entertainment industry (OR, 3.98 [95% CI, 1.14-13.88]), injection drug use (OR, 25.09 [95% CI, 10.43-60.39]), no condom use during most recent sexual intercourse (OR, 4.97 [95% CI, 1.38-17.88]), and syphilitic infection (OR, 1.91 [95% CI, 1.03-3.56]). CONCLUSIONS HIV prevalence in STD clinics is significantly greater than that in the general population, and subjects were identified who would be missed by conventional surveillance. China's nationwide system of public STD clinics, which reach down to the township level, should be used for HIV control programs.
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Abstract
Drug abuse has a long, but also different history in Germany and China. The Opium War largely influenced the history of China in 19th century; however, China was once recognized as a drug-free nation for 3 decades from the 1950s to the 1980s. Drug abuse has spread quickly since re-emerging as a national problem in China in the late 1980s. The number of registered drug abusers increased from 70 000 in 1990 to more than 1 million by the end of 2005. In past decades, illicit drug trafficking and production have swept most provinces in China, and drug abuse has caused many problems for both abusers and the community. One major drug-related problem is the spread of HIV, which has caused major social and economic damage in China. Germany, the largest developed European country, also faces the drug and addiction problem. Germany has about 150 000 heroin addicts, for whom HIV/AIDS has become a serious threat since the mid 1980s. To control the drug problem, the German Government adopted the “Action Plan on Drugs and Addiction” in 2003; the China Central Government approved a similar regulation in the antidrug campaign in 2005. Germany has experience in reducing drug-related harm. The methadone maintenance treatment (MMT) program has run for more than 20 years and the public has become more tolerant of addicts. In 2003, China began the MMT program for controlling the spread of HIV/AIDS. It is necessary for China to learn from developed countries to acquire success in its antidrug campaign. In this review, we will go over the differences and similarities in drug abuse between Germany and China. The differences are related to history, population and economics, drug policy context, drug laws, HIV/hepatitis C virus infection, the MMT program and so on. These 2 nations have drug abuse problems with different histories and currently use different approaches to handle illicit drug marketing and use. The legal penalties for illicit drug offences reflect the social differences of these 2 nations with respect to the seriousness of particular types of crimes. The characteristics of the MMT program may also influence patterns of drug abuse in these 2 nations and China should improve the MMT program based on the successful model in Europe, the USA, and Australia. We recommend more dialogue and collaboration between Germany and China.
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Affiliation(s)
- Ingo Ilja Michels
- Office of the Federal Drug Commissioner, Federal Ministry of Health, Berlin, 10117 Germany
| | - Yu-xia Fang
- Clinical Pharmacology and Therapeutics Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, 21224 Maryland USA
| | - Dong Zhao
- National Institute on Drug Dependence, Peking University, Beijing, 100083 China
| | - Li-yan Zhao
- National Institute on Drug Dependence, Peking University, Beijing, 100083 China
| | - Lin Lu
- National Institute on Drug Dependence, Peking University, Beijing, 100083 China
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Chen HT, Liang S, Liao Q, Wang S, Schumacher JE, Creger TN, Wilson CM, Dong B, Vermund SH. HIV voluntary counseling and testing among injection drug users in south China: a study of a non-government organization based program. AIDS Behav 2007; 11:778-88. [PMID: 17347877 DOI: 10.1007/s10461-007-9215-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2006] [Accepted: 01/29/2007] [Indexed: 11/29/2022]
Abstract
HIV voluntary counseling and testing (VCT) programs are usually delivered by government health agencies in China. This study examined the feasibility of using a Chinese non-government organization (NGO) to deliver a VCT program to injection drug users (IDUs) in a southern Chinese city. The process data indicated the program successfully recruited and served 226 male and female IDUs in 4 months. The HIV prevalence rate of the study population was 57.5% by rapid HIV testing with a secondary rapid test to confirm. Quantitative and qualitative evaluations indicated that the VCT program was implemented appropriately and participants' HIV knowledge and safe drug and sex practices were significantly improved after participation in the VCT program. This study demonstrates the feasibility of a Chinese NGO to provide VCT for IDUs and documents the processes and outcomes of the program. There remains a great need to find additional sources to provide VCT and other HIV prevention services to IDUs and other high-risk populations in China. Chinese NGOs have the potential to fill this need.
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Affiliation(s)
- Huey T Chen
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, 227 Ryals Public Health Building, Birmingham, AL 35294-0022, USA.
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