Objection To investigate the spectrum and survival status of HIV positive cancer in HuBei province, China. Methods HIV positive cancer patients were added up and followed up who had registered in Zhongnan Hospital between January 2004 and June 2009. The prognostic features were determined for HIV patients with cancer. Results The average age of HIV positive and HIV negative group who suffered with malignant neoplasm were 42.5±8.8 years and 55.1±13.7 years respectively (P ＜0.05), mean CD4 counts were (220.9±142.3)/μl and (554.4±174.3)/μl, respectively (P ＜0.05), the types of common cancer were NHL, cervical cancer, liver cancer and lung cancer, colon cancer, breast cancer, respectively. Anticancer and/or ART treatment were the important positive prognostic factors. Additional factors such as age and CD4 count were associated with survival of cancer patients with HIV infection. Conclusion Mean age of HIV positive cancer patients is about 42 years old. NHL, cervical cancer and liver cancer are HIV associated malignant tumor. ART and anticancer can effectively prolong the survival of HIV infected patients with cancer.

Objective To understand the existing deficiency in the work of preventing HIV transmission from mother to child.Methods The diagnostic occasions of 179 HIV positive pregnant women(189 pregnant times)in some counties in Hubei,Shanxi,and Hebei were collected,including measures for prevention.The reasons for the missing prevention for HIV positive pregnant women were analyzed.Results The HIV positive rate in pregnant women in the counties enrolled in this study was 0.26‰.Percentage of HIV pregnant women who were found in antepartum,intrapartum,and postpartum were 66.7%,7.4%,and 25.9% respectively.Some HIV positive pregnant women missed the prevention in all of three periods.In HIV positive pregnant women found antepartum,some rejected prevention.The missing reason for HIV positive pregnant women found intrapartum failed to get ARV drug.HIV positive pregnant women found postpartum missed the prevention.Conclusions There is some progress in the work of preventing HIV transmission from mother to child in China,but some HIV positive pregnant women can not be detected in time,and the percentage of HIV pregnant women who have received comprehensive measures is low.The work of PMTCT therefore needs to be improved.

Objective To investigate the influence of hepatitis B virus (HBV) infection on efficacy of combined antiretroviral therapy (cART) in patients with acquired immunodeficiency syndrome (AIDS).Methods Seventy-eight subjects with human immunodeficiency virus (HIV)/HBV co-infection and 156 subjects with HIV mono-infection were included.CD4+ T cell count,HIV viral load,HBV-markers and liver functions were routinely tested.The differences in survival rate,as well as immunological and virological responses between the two groups (HIV/HBV co-infection group and HIV mono-infection group) during cART were compared.Categorical data were compared by Chisquare test,measurement data were compared by t test,and measurement data with abnormal distribution were compared by Mann-Whitney test.Results At month 42 of cART,HIV RNA levels and CD4+ T cell counts of the two groups were comparable.However,at month 48,54 and 60 of cART,the immunological and virological responses of HIV/HBV co-infection group were less favorable than those of HIV mono-infection group.At each time point of month 12,24,36,48 and 60 of cART,3 out of 13 subjects with HIV/HBV co-infection maintained hepatitis B e antigen (HBeAg)loss; the HBeAg seroconversion rates were 32.1％ (9/28),50.0％ (14/28),53.6％ (15/28),64.3％ (18/28) and 71.4％ (20/28),respectively (x2 =10.189,P=0.037) ; HBV DNA negative rates were 95.1％ (39/41),82.9％ (34/41),68.3％ (28/41),43.9％ (18/41) and 43.9％ (18/41),respectively (x2 =29.982,P=0.000); liver dysfunction rate was 32.1 ％ (25/78),51.4％ (38/74),33.8％ (22/65),47.9％ (23/48) and 6.7％ (3/45),respectively (x2 =28.053,P=0.000).Mortalities in HIV/HBV co-infected and HIV mono-infected individuals were 24.4％ (19/78) and 5.1 ％ (8/156),respectively (x2 =18.841,P＜0.01).Sixteen out of the 19 deaths (84.2 ％) in HIV/ HBV co-infected subjects died of end stage liver diseases.Conclusions HBV co-infection diminishes the long term efficacy of cART.End stage liver diseases are the primary cause of death in HIV/HBV co-infected subjects during cART.

Objective To analyze the incidence,mortality and risk factors of death in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infected patients with combined antiretroviral therapy (cART).Methods A total of 427 HIV/HCV co-infected patients admitted to Zhongnan Hospital of Wuhan University or local disease prevention and control canters from January 2003 to December 2010 were enrolled in the study.The demographic and clinical data of patients were retrospectively studied.Cox progressive regression model was used for data analysis,and Kaplan-Meier method was used to evaluate the effect of end-stage liver diseases on the death.Results of 427 HIV/HCV co-infected patients,53 ( 12.4％ ) died during the follow-up,in which 28 (52.8％) died of liver-related diseases.Male gender ( RR =2.63,P =0.05 ),infection via blood transfusion ( RR =2.15,P =0.04),baseline CD4 + T cells ＜50 cells/μL ( RR =2.83,P =0.02),HIV RNA≥ 104copies/mL at the end of follow-up (RR =2.79,P =0.00 ) and complicated with end-stage liver disease ( RR =7.79,P =0.00) were significantly related to the death.Duration of cART ＞ 5 years is a protective factor for the death ( RR =0.03,P =0.00).Themortality of patients complicated with end-stage liver diseases was 52.7％ ( 29/55 ).Conclusion Liver disease-related death has become the leading cause of death in HIV/HCV co-infected patients,and patients with end-stage liver diseases are of high risk of death.

Objective To investigate the incidence and risk factors of end-stage liver disease (ESLD) in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) co-infected patients after antiretroviral therapy (ART).Methods The demographic and clinical data of HIV-HCV coinfected patients in Zhongnan Hospital,Wuhan University and local Centers for Disease Control and Prevention (CDC) from Jan 2003 to Dec 2010 were analyzed retrospectively. Single factor and multiple factor Logistic regression were used to analyze the correlation between the variables and incidence of ESLD,such as baseline age ≥40,male,previous blood transfusion history,duration of HCV persistent infection,hepatitis B virus (HBV) co-infection (HBsAg positive),HIV RNA≥-1 ×104 copy/mL at last visit,HCV RNA≥ 1.× 105 copy/mL at last visit,CD4 count ＞ 200 / μL at last visit,alanine aminotranferase (ALT) ≥ 2 × upper limit normal (ULN) at last visit,ART containing nevirapine (NVP),follow-up duration,ART duration＞5 years and HCV genotype 1b.The effect of ESLD on the survival of HIV-HCV co-infected patients was analyzed by Kaplan-Meier method.Results Totally 427 HIV-HCV co-infected patients were followed up with average of 3.7 years. Fifty-five patients (12.9％) developed ESLD,and 52 patients (12.2％) died.Factors independently associated with ESLD included baseline age≥40 (OR=2.385,P=0.039),ALT ≥2× ULN (OR=16.374,P=0.000),HBV-coinfection (OR=2.507,P=0.042),duration of ART ＞ 5 years (OR=3.232,P=0.010),and CD4 count ≥200/μL (OR=0.364,P=0.011).The cumulative mortality of HIV-HCV co-infected patients with ESLD was 50.9％,whereas that of HIV-HCV co-infected patients without ESLD was 6.5％ (P=0.000).Conclusion In the ART era,ESLD is common among HIV-HCV co-infected patients in China,which is responsible for reducing the survival time of the patients.

Objective To study the prevalence of food intolerance and to explore its related factors among adult health check-up receivers.Methods A total of 863 adults who took physical examinations in our hospital from April to October 2011 were enrolled in this investigation.Height,body weight and blood pressure were measured,and serum IgG level was measured by enzyme-linked immunosorbent assay (ELISA).Results The total positive rate of food intolerance was 73％,and the leading intolerance items were crab (40.1％ ),egg (29.8％ ),cod fish ( 21.6％ ),milk ( 20.0％ ) and soybean ( 14.4％ ).Females showed significantly higher prevalence of food intolerance than males.Various positive rate of milk or soybean intolerance was found in different age groups.No correlations of serum specific IgG with body mass index and systolic or diastolic blood pressure were observed.In logistic regression analysis,the odds ratio of food intolerance of women was 1.67 ( 95 ％ confidence interval 1.190 to 2.607 ).ConclusionsThe prevalence rate of food intolerance was high.The risk for food intolerance was significantly increased in women.Specific IgG antibody detection may help to early prevent and diagnose food intolerance-related diseases.

Objective To understand major risk factors associated with end-stage liver disease (ESLD) among patients with human immunedeficiency virus (HIV)/hepatitis B virus (HBV) co-infection.Methods Patients with HIV/HBV co-infection were followed-up and factors related to ESLD were analyzed using logistic regression model to estimate odds ratios (ORs) for them. Results A total of 255 patients with HIV/HBV co-infection were investigated, with an incidence of ESLD of 19. 2% ( 49/255 ). Major risk factors associated with ESLD among patients with HIV/HBV co-infection included count of CD4 below 200 cells/μl at baseline, HIV RNA load decreasing to the lower limit of its detection level within six months after antiretroviral treatment (ART), abnormal of serum activities of transaminase (ALT or AST), longer persistently positive of HIV RNA and HBV DNA, and use of lamivudine-based ART, with OR of 6. 503,14. 456, 0. 049, 1. 814, 1. 536 and 0. 012, respectively. Conclusions Lower CD4 count, abnormal serum transaminases, persistent replication of HIV and HBV all are closely related to ESLD in patients with HIV/HBV co-infection. Therefore, lamivudine-based ART should be of choice for patients with HIV/HBV coinfection to decrease incidence of ESLD.

Objective To investigate the implementation of the system of older pregnant women prenatal ultrasound screening for the diagnosis and clinioal significance.Methods Clinical data from March 2004 to April 2009 a total of 10 630 cases of pregnant women receiving prenatal ultrasound examination of fetal malformation data,of which 712 cases of advanced maternal age( expected date of birth aged≥35 years) to implement the system of prenatal ultrasound screening and follow-up of all maternal age pregnancy outcome,the final post-natal diagnosis of fetal malformations in the standard,both young women screened as a control group for comparison to assess the value of prenatal ultrasound diagnosis.Results 712 cases of advanced maternal age,prenatal ultrasound diagnosis of fetal malformations in 32 cases,abnormalities occur in approximately 4.49％,single abnormal in 15 cases,complex deformity in 17 cases,missed 4 cases of malformation detection rate was 88.88％ (36/32).Control group,9918 cases of prenatal ultrasound diagnosis of fetal malformations 243 cases,2.45％ incidence of deformity (243/9 918 ).Conclusion Older pregnant women,prenatal ultrasound screening for malformations occur in approximately 4.49％,higher than the detection rate with screening younger women 2.45％,of older pregnant women according to the results of prenatal diagnostic screening could be effective in reducing the birth rate of deformed children and the rate of misdiagnosis.

Objective To investigate prevalence HPV infections in cervix among HIV-infected Chinese women.Methods From September 2009 to May 2011,293 women with positive HIV underwent cervical cancer screening as study group matched with 200 women with negative HIV as control group.Questionnaires including demographic information and HIV associated information were collected,Pap smear and 23 subtype of HPV were performed in those women.The women with positive HPV were followed up per 6 months,and the period of following up were more than 12 months.Binary logistic analysis was used for high risk factors of HPV persistent infection.Results Prevalent HPV infection was 44.4％ (130/293) in study group and 20.0％ (40/200) in control group,respectively,which reached statistical difference( P ＜0.05).The most common genotype of HPV was HPV 16,which prevalence was 13.7％ (40/293)in study group and 7.0％ (14/200) in control group.The other HPV subtype prevalence was HPV-58,HPV-52,HPV- 43 and HPV-18,which was 9.2％ (27/293),8.2％ (24/293),8.2％ (24/293),6.8％ (20/293) in study group and 3.0％ (6/200),2.5％ (5/200),1.5％ (3/200),2.5％ (5/200) in control group.At time point of 12 months following up,the persistent prevalence of HPV was 47.5％ (48/101) in study group and 21.1％ (8/38) in control group,which reached statistical difference (P＜0.05).Multiple HPV infections ( OR =6.4,95 ％ CI:1.6 - 25.6),abnormal cytology ( OR =18.1,95 ％ CI:4.5 - 76.9 ) and lower CD4 T cell count (compaed with CD4 ＞3.5 × 108/L,if 2.0 × 108 ≤CD4 ≤3.5 × 108,OR =8.1,95％ CI:1.3 -56.3 ; if CD ＜ 2.0 × 108/L,OR =9.1,95％ CI:1.8 - 46.9 ) were independently associated with HPV persistence among HIV-positive subjects.Conclusions Prevalence and persistence of HPV infections were more common among HIV-positive Chinese women than those in HIV-negative Chinese women.Improving immune function,decreasing multiple HPV infections,treating abnormal cervical cytology could decrease prevalence of HPV infection.

Objective To investigate the influence of safe sex education and antiretroviral therapy (ART) on human immunodeficiency virus (HIV) antibody sero-conversion status among HIV-discordant spouses.Methods Totally 1 258 HIV/acquired immunodeficiency syndrome (AIDS) cases and their spouses were enrolled and the related information was collected during 2005 to 2007.The HIV negative spouses were tested for HIV antibody once every 6 months.The effects of safe sex education and ART on sero-conversion status of HIV-discordant spouses were analyzed.The date were analyzed by x2 test.Results Without any intervention,505 out of 1 258 HIV/AIDS spouses were positive for HIV test,with the HIV natural spousal transmission rate of 40.1％.Among 442 blood source and 816 sexual source index HIV cases,HIV was positive in 103 and 402 of their spouses,respectively,with the HIV transmission rates between couples of 23.3％ and 49.3 ％,respectively.HIV transmission rate in sexual source group was higher than that in blood source group (x2 =80.421,P＜0.01).Among 608 male and 650 female index HIV cases,HIV was positive in 333 and 172 of their spouses,respectively,with the HIV transmission rates between couples of 54.8％ and 26.5％,respectively.Rate of HIV transmission from men to women was higher than that from women to men (x2 =104.770,P＜0.01).Among 753 HIV discordant couples,only 5 spouses had HIV sero-conversion (0.7％) after comprehensive intervention measures during 5 years of follow-up period.Among 31 HIV/AIDS patients who were only accepted safe sex education,3 of their spouses were HIV positive (9.7％).The transmission rate was lower than that in patients without any intervention (40.1％) (x2 =11.760,P＜0.01).Among 722 HIV/AIDS patients received ART,2 of their spouses were HIV positive (0.3 ％),which was lower than the transmission rate (9.7％) in ART-na(i)ve group (x2=39.821,P＜0.01).Conclusion Safe sex education should be implemented throughout the health management of HIV/AIDS patients and their spouses.If possible,early ART should be carried out to reduce the risk of HIV transmission between married couples.