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Platt L, French CE, McGowan CR, Sabin K, Gower E, Trickey A, McDonald B, Ong J, Stone J, Easterbrook P, Vickerman P. Prevalence and burden of HBV co-infection among people living with HIV: A global systematic review and meta-analysis. J Viral Hepat 2020; 27:294-315. [PMID: 31603999 PMCID: PMC7383613 DOI: 10.1111/jvh.13217] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022]
Abstract
Globally, in 2017 35 million people were living with HIV (PLHIV) and 257 million had chronic HBV infection (HBsAg positive). The extent of HIV-HBsAg co-infection is unknown. We undertook a systematic review to estimate the global burden of HBsAg co-infection in PLHIV. We searched MEDLINE, Embase and other databases for published studies (2002-2018) measuring prevalence of HBsAg among PLHIV. The review was registered with PROSPERO (#CRD42019123388). Populations were categorized by HIV-exposure category. The global burden of co-infection was estimated by applying regional co-infection prevalence estimates to UNAIDS estimates of PLHIV. We conducted a meta-analysis to estimate the odds of HBsAg among PLHIV compared to HIV-negative individuals. We identified 506 estimates (475 studies) of HIV-HBsAg co-infection prevalence from 80/195 (41.0%) countries. Globally, the prevalence of HIV-HBsAg co-infection is 7.6% (IQR 5.6%-12.1%) in PLHIV, or 2.7 million HIV-HBsAg co-infections (IQR 2.0-4.2). The greatest burden (69% of cases; 1.9 million) is in sub-Saharan Africa. Globally, there was little difference in prevalence of HIV-HBsAg co-infection by population group (approximately 6%-7%), but it was slightly higher among people who inject drugs (11.8% IQR 6.0%-16.9%). Odds of HBsAg infection were 1.4 times higher among PLHIV compared to HIV-negative individuals. There is therefore, a high global burden of HIV-HBsAg co-infection, especially in sub-Saharan Africa. Key prevention strategies include infant HBV vaccination, including a timely birth-dose. Findings also highlight the importance of targeting PLHIV, especially high-risk groups for testing, catch-up HBV vaccination and other preventative interventions. The global scale-up of antiretroviral therapy (ART) for PLHIV using a tenofovir-based ART regimen provides an opportunity to simultaneously treat those with HBV co-infection, and in pregnant women to also reduce mother-to-child transmission of HBV alongside HIV.
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Affiliation(s)
- Lucy Platt
- Faculty of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Clare E. French
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Catherine R. McGowan
- Faculty of Public Health & PolicyLondon School of Hygiene & Tropical MedicineLondonUK
- Humanitarian Public Health Technical UnitSave the Children UKLondonUK
| | | | - Erin Gower
- Centre for Disease Control and PreventionAtlantaUSA
| | - Adam Trickey
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Bethan McDonald
- Oxford School of Public HealthNuffield Department of Population HealthUniversity of OxfordOxfordUK
- Oxford University Hospitals NHS Foundation TrustJohn Radcliffe HospitalOxfordUK
- Department of Clinical ResearchLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jason Ong
- Department of Clinical ResearchLondon School of Hygiene and Tropical MedicineLondonUK
| | - Jack Stone
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | | | - Peter Vickerman
- NIHR Health Protection Research Unit in Evaluation of InterventionsPopulation Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
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Du X, Peng W, Fu Q, Ma Q, Zhu Z, Li T. A Review of Clinical Pharmacokinetic and Pharmacodynamic Profiles of Select Antiretrovirals: Focus on Differences among Chinese Patients. Pharmacotherapy 2019; 39:1179-1189. [PMID: 31550053 DOI: 10.1002/phar.2333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify the pharmacokinetic differences of antiretroviral drugs between HIV-infected Chinese patients and patients of other race/ethnicities. STUDY DESIGN Results from prospective, open-label pharmacokinetic studies among Chinese and historical data from other race/ethnicities. PATIENTS Pharmacokinetics of six commonly used antiretroviral drugs, including zidovudine, lamivudine, tenofovir disoproxil fumarate, nevirapine, efavirenz and lopinavir/ritonavir, was evaluated in HIV-infected Chinese patients and compared with historical data from other race/ethnicities. ANALYSIS Pharmacokinetic analyses were performed at the steady state among HIV-infected Chinese patients. Safety data were collected during the follow-up. The pharmacokinetic parameters including maximal concentrations (Cmax), area-under-curve (AUC) and clearance (Cl/F) from the Chinese patients were compared to the historic data from other race/ethnicities. RESULTS Current evidence, though limited, suggested that these antiretroviral agents were generally safe and effective among HIV-infected Chinese patients. However, compared with other racial groups, Chinese patients exhibited higher Cmax , AUC and lower Cl/F for most of the agents, and the incidences of adverse reactions, for example, liver toxicity, rash, and bone health, were more frequent. CONCLUSIONS These pharmacokinetic differences suggest that lower dosages for commonly prescribed antiretroviral drugs in China might be appropriate to reduce drug-related adverse reactions, while maintain the antiviral efficacy.
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Affiliation(s)
- Xiaoli Du
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Wenxiu Peng
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qiang Fu
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Qing Ma
- Translational Pharmacology Research Core, NYS Center of Excellence in Bioinformatics and Life Sciences, Buffalo, New York
| | - Zhu Zhu
- Department of Pharmacy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Taisheng Li
- Department of Infectious Diseases, AIDS Diagnosis and Treatment Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Giacomelli A, Rusconi S, Falvella FS, Oreni ML, Cattaneo D, Cozzi V, Renisi G, Monge E, Cheli S, Clementi E, Riva A, Galli M, Ridolfo AL. Clinical and genetic determinants of nevirapine plasma trough concentration. SAGE Open Med 2018; 6:2050312118780861. [PMID: 29899984 PMCID: PMC5992792 DOI: 10.1177/2050312118780861] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/14/2018] [Indexed: 01/11/2023] Open
Abstract
Background: Only few data are available on the influence of CYP2B6 and CYP3A4/A5 polymorphisms on nevirapine plasma concentrations in the Caucasian population. Our aim was to assess the impact of CYP2B6 and CYP3A4/A5 polymorphisms on nevirapine plasma concentrations consecutively collected. Methods: We retrospectively analyzed clinical data of all HIV-positive patients who were followed at the Infectious Diseases Unit, DIBIC Luigi Sacco, University of Milan between January 2000 and December 2015. All patients with at least one nevirapine plasma trough concentration (NVP Cmin) determination were tested for CYP2B6 c.516 G>T, CYP3A4*22C>T and CYP3A5*3 A>G polymorphisms. Univariate and multivariate regression analyses were carried out considering NVP Cmin as the dependent variable and genetic polymorphisms and clinical characteristics as independent variables. Results: A total of 143 patients were evaluated. Most of them were males (61.5%) and Caucasian (92.3%). Overall, NVP Cmin varied from 1571 to 14,189 ng/mL (median = 5063 ng/mL, interquartile range = 3915–6854). The median NVP Cmin significantly differed in patients with different CYP2B6 genotypes, but did not vary in those with different CYP3A phenotypes. In the final general linear model, factors significantly associated with a higher NVP Cmin were each extra unit of T alleles of CYP2B6 rs3745274 (β = 0.328, 95% confidence interval = 0.172–0.484; p < 0.0001), older age (β = 0.362, 95% confidence interval = 0.193–0.532; p < 0.0001) and hepatitis C virus coinfection (β = 0.161, 95% confidence interval = 0.006–0.315; p < 0.041). Conclusion: Our study, conducted in a prevalent Caucasian population, highlighted the importance of CYP2B6 genetic variants in influencing nevirapine plasma trough concentration. Furthermore, older age and hepatitis C virus coinfection significantly increase exposure to nevirapine.
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Affiliation(s)
- Andrea Giacomelli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
| | - Stefano Rusconi
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
| | | | - Maria Letizia Oreni
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
| | - Dario Cattaneo
- Clinical Pharmacology Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Valeria Cozzi
- Clinical Pharmacology Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Giulia Renisi
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
| | - Elisa Monge
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
| | - Stefania Cheli
- Clinical Pharmacology Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Emilio Clementi
- Clinical Pharmacology Unit, ASST Fatebenefratelli Sacco, Milan, Italy.,Eugenio Medea Scientific Institute, Bosisio Parini, Italy
| | - Agostino Riva
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
| | - Massimo Galli
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
| | - Anna Lisa Ridolfo
- Infectious Diseases Unit, Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy
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Jin ZY, Liu X, Ding YY, Zhang ZF, He N. Cancer risk factors among people living with HIV/AIDS in China: a systematic review and meta-analysis. Sci Rep 2017; 7:4890. [PMID: 28687813 PMCID: PMC5501798 DOI: 10.1038/s41598-017-05138-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/15/2017] [Indexed: 12/12/2022] Open
Abstract
Cancer is a leading cause of death among people living with HIV/AIDS (PLWHA). We conducted a systematic review and meta-analysis to evaluate prevalence of cancer risk factors among Chinese PLWHA based on 102 articles. Random effects meta-analysis was used to calculate the summary prevalence estimate (sPrev) and 95% confidence interval (CI) for each cancer risk factor by demographic group. Overall, the sPrev for each risk factor among Chinese PLWHA was: 41.1% (95% CI: 35.3–46.9%) for current smoking; 30.3% (95% CI: 23.3–37.4%) for current alcohol consumption; 24.4% (95% CI: 14.7–30.2%) for overweight and obesity; 12.5% (95% CI: 10.6–14.3%) for hepatitis B virus infection; 29.1% (95% CI: 23.6–34.5%) for hepatitis C virus infection; 33.9% (95% CI: 24.3–43.5%) for high-risk human papillomavirus infection from cervical samples and 78.6% (95% CI: 69.4–87.7%) from anal samples; 2.7% (95% CI: 0.7–4.7%) for Epstein-Barr virus (EBV) immunoglobulin M (IgM) positivity, 94.7% (95% CI: 90.7–98.8%) for EBV IgG positivity and 25.6% (95% CI: 12.4–38.8%) for EBV DNA positivity; 14.9% (95% CI: 12.4–17.4%) for human herpes virus 8 infection. The prevalence of major cancer risk factors was high among PLWHA in China, suggesting an urgent need for interventions to reduce cancer risk in this high-risk group.
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Affiliation(s)
- Zi-Yi Jin
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Xing Liu
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Ying-Ying Ding
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, USA
| | - Na He
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
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Population pharmacokinetics of nevirapine in Malaysian HIV patients: a non-parametric approach. Eur J Clin Pharmacol 2016; 72:831-8. [PMID: 27025609 DOI: 10.1007/s00228-016-2049-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 03/16/2016] [Indexed: 10/22/2022]
Abstract
AIMS Nevirapine is the first non-nucleoside reverse-transcriptase inhibitor approved and is widely used in combination therapy to treat HIV-1 infection. The pharmacokinetics of nevirapine was extensively studied in various populations with a parametric approach. Hence, this study was aimed to determine population pharmacokinetic parameters in Malaysian HIV-infected patients with a non-parametric approach which allows detection of outliers or non-normal distribution contrary to the parametric approach. METHODS Nevirapine population pharmacokinetics was modelled with Pmetrics. A total of 708 observations from 112 patients were included in the model building and validation analysis. Evaluation of the model was based on a visual inspection of observed versus predicted (population and individual) concentrations and plots weighted residual error versus concentrations. Accuracy and robustness of the model were evaluated by visual predictive check (VPC). The median parameters' estimates obtained from the final model were used to predict individual nevirapine plasma area-under-curve (AUC) in the validation dataset. The Bland-Altman plot was used to compare the AUC predicted with trapezoidal AUC. RESULTS The median nevirapine clearance was of 2.92 L/h, the median rate of absorption was 2.55/h and the volume of distribution was 78.23 L. Nevirapine pharmacokinetics were best described by one-compartmental with first-order absorption model and a lag-time. Weighted residuals for the model selected were homogenously distributed over the concentration and time range. The developed model adequately estimated AUC. CONCLUSIONS In conclusion, a model to describe the pharmacokinetics of nevirapine was developed. The developed model adequately describes nevirapine population pharmacokinetics in HIV-infected patients in Malaysia.
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Hsieh E, Fraenkel L, Xia W, Hu YY, Han Y, Insogna K, Yin MT, Xie J, Zhu T, Li T. Increased bone resorption during tenofovir plus lopinavir/ritonavir therapy in Chinese individuals with HIV. Osteoporos Int 2015; 26:1035-44. [PMID: 25224293 PMCID: PMC4334679 DOI: 10.1007/s00198-014-2874-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 08/21/2014] [Indexed: 01/08/2023]
Abstract
UNLABELLED We sought to evaluate the effects of antiretroviral therapy on skeletal metabolism in Chinese individuals with human immunodeficiency virus. Patients switched to tenofovir/lamivudine + lopinavir/ritonavir after treatment failure had an increase in bone resorption marker levels by nearly 60%, which is greater than the magnitude previously described in non-Chinese populations. INTRODUCTION Few studies have evaluated the effects of antiretroviral therapy on skeletal metabolism in Asian populations infected with human immunodeficiency virus (HIV). METHODS We performed a secondary analysis of bone turnover markers (BTM) at baseline and 2 years in stored plasma samples collected from 2/2009 to 1/2013 as part of a multi-center trial. Two groups were compared: (1) treatment-naïve patients initiated on zidovudine (AZT)/lamivudine (3TC) plus nevirapine (NVP) and (2) patients who failed first-line therapy and were switched to tenofovir (TDF)/3TC plus lopinavir/ritonavir (LPVr). Tests included the bone resorption marker, C-terminal cross-linking telopeptide of type-1 collagen (CTX), and the bone formation marker procollagen type 1 N-terminal propeptide (P1NP). RESULTS In the TDF/3TC + LPVr group, samples were available from 59 patients at baseline and 56 patients at 2 years. Of these, 36 patients had samples available from both time points. In the AZT/3TC + NVP group, plasma samples were analyzed from 82 participants at baseline and of those, 61 had samples at 2 years. Median change over 2 years was greater in the TDF/3TC + LPVr group for both CTX (+0.24 ng/mL, interquartile ranges (IQR) 0.10-0.43 vs. +0.09 ng/mL, IQR -0.03 to 0.18, p = 0.001) and P1NP (+25.5 ng/mL, IQR 2.4-51.3 vs. +7.11 ng/mL, IQR -4.3 to 21.6, p = 0.012). Differences remained after adjusting for potential confounders in the multivariable analysis. CONCLUSIONS Switching to TDF/3TC + LPVr after treatment failure resulted in greater increases in BTMs than initiation with AZT/3TC + NVP in Chinese patients with HIV. Following this change, bone resorption marker levels increased by nearly 60 %, which is greater than the 25-35% increase from baseline described previously in non-Chinese populations. Further studies are warranted to elucidate these findings.
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Affiliation(s)
- Evelyn Hsieh
- Department of Infectious Diseases, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
- Section of Rheumatology, Yale School of Medicine, 300 Cedar Street, PO Box 208031, New Haven, CT, 06520-8031, USA
| | - Liana Fraenkel
- Section of Rheumatology, Yale School of Medicine, 300 Cedar Street, PO Box 208031, New Haven, CT, 06520-8031, USA
| | - Weibo Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Ying Ying Hu
- Clinical Laboratory, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Yang Han
- Department of Infectious Diseases, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Karl Insogna
- Section of Endocrinology, Yale School of Medicine, 300 Cedar Street, PO Box 208020, New Haven, CT, 06520-8020, USA
| | - Michael T. Yin
- Division of Infectious Diseases, Columbia University Medical Center, 630 West 168 Street, Box 82, New York, NY, 10032, USA
| | - Jing Xie
- Department of Infectious Diseases, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Ting Zhu
- Department of Infectious Diseases, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Taisheng Li
- Department of Infectious Diseases, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
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Hsieh E, Fraenkel L, Bradley EH, Xia W, Insogna KL, Cui Q, Li K, Li T. Osteoporosis knowledge, self-efficacy, and health beliefs among Chinese individuals with HIV. Arch Osteoporos 2014; 9:201. [PMID: 25487753 PMCID: PMC4269230 DOI: 10.1007/s11657-014-0201-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 11/26/2014] [Indexed: 02/03/2023]
Abstract
UNLABELLED Individuals with HIV are at increased risk for osteoporosis and fracture. Using the Health Beliefs Model, we identified key relationships between knowledge, self-efficacy and health beliefs pertaining to physical activity and dietary calcium intake, two key modifiable preventive measures for osteoporosis. PURPOSE Individuals with HIV are at increased risk for osteoporosis and fracture. Few studies have systematically explored concerns related to osteoporosis prevention among this group. Applying the Health Beliefs Model (HBM), we examined associations between osteoporosis-related preventive health behaviors (i.e., physical exercise and dietary intake) and knowledge, self-efficacy and health beliefs in a large cohort of Chinese individuals with HIV. METHODS We conducted a cross-sectional study with participants from an ongoing multi-center trial. Volunteers completed a questionnaire consisting of the International Physical Activity Questionnaire (IPAQ), a calcium and vitamin D intake assessment, the Osteoporosis Knowledge Test, Osteoporosis Self-Efficacy Scale, Osteoporosis Health Beliefs Scale, and relevant sociodemographic and clinical risk factors. RESULTS A total of 263 of 297 eligible participants enrolled in this study. Mean age of participants was 38.4 ± 9.8 years, average BMI was 21.6 ± 2.6 kg/m(2), and 76 % were men. About 30 % of the sample reported low physical activity. Consumption of foods from each calcium and vitamin D-rich category averaged between multiple times per month to weekly. Knowledge regarding osteoporosis was universally low and self-efficacy correlated directly with engagement in preventive behaviors. Women and individuals with lower education perceived greater barriers to adopting preventive behaviors. Multivariate logistic regression adjusted for age, sex and BMI showed that calcium and vitamin D intake was directly correlated with knowledge and self-efficacy, whereas physical activity correlated with manual labor occupation, perceived barriers to exercise and health motivation. CONCLUSIONS Behavioral frameworks such as the HBM may provide important insight into promoting adoption and maintenance of osteoporosis-related preventive behaviors among individuals with HIV.
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Affiliation(s)
- Evelyn Hsieh
- Department of Infectious Diseases, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
- Section of Rheumatology, Yale School of Medicine, 300 Cedar Street, PO Box 208031, New Haven, CT, 06520-8031, USA
| | - Liana Fraenkel
- Section of Rheumatology, Yale School of Medicine, 300 Cedar Street, PO Box 208031, New Haven, CT, 06520-8031, USA
| | - Elizabeth H. Bradley
- Department of Health Policy and Management, Yale School of Public Health, 60 College Street P.O. Box 208034, New Haven, CT 06520-8034, USA
| | - Weibo Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Karl L. Insogna
- Section of Endocrinology, Yale School of Medicine, 300 Cedar Street, PO Box 208020, New Haven, CT, 06520-8020, USA
| | - Qu Cui
- Department of Infectious Diseases, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
| | - Kunli Li
- Co-CRO Medical Development Company, Ltd. Beijing, 46 Dongsi Xi Street, Beijing, 100711, China
| | - Taisheng Li
- Department of Infectious Diseases, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Wangfujing Street, Beijing, 100730, China
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