Objective To analyze HIV/AIDS epidemic characteristics in Henan Province.Methods The database of HIV/AIDS cases information and follow-up information from the national online case reporting were downloaded.Comprehensive analysis was performed.Results 42 879 cases were confirmed and reported HIV positive,69.05% were former paid plasma donors at the end of 2008.Among these cases reported in 2008,26.64% were heterosexual transmission,and 49.59% (1 802) were found via voluntary counseling and testing.Conclusions The epidemic characteristics of HIV/AIDS in Henan Province was mainly among former paid plasma donors.But the transmission through plasma donor had been interdicted.While the proportion of sexual transmission was increasing,this suggested that education and behavior intervention should be strengthened in order to interrupt further transmission.Counseling and testing become main source of detecting HIV infection.

In order to study PBD-2 and PoIFNgamma, the chimeric gene PBD-2-PoIFNgamma was synthesized by overlap extension PCR, and amplified PoIFNgamma on the basis of this sequence, then cloned into yeast expression vector pPICZalphaA separately to get the recombinant plasmid pPICZalphaA-PBD-2-PoINFgamma and pPICZalphaA-PoINFgamma. The recombinant plasmid was digested by Sac I and introduced into Pichia pastoris X33 cells by electroporation. Positive clones were screened and cultivated in BMMY medium containing 0.5% methanol for 72 h. SDS-PAGE and Western blotting analysis showed that the screened recombinant could secrete PBD-2-PoINFgamma and PoINFgamma separately. The activity of fusion protein was not detected by cytopathic effect inhibition assay and agar diffusion assay, but detected obvious antiviral activity of PoINFgamma. The helix and random coil contents was showed vary greatly between PoIFNgamma and PBD-2-PoLNFgamma by circular dichroism analysis. It was speculated that the fusion protein was not correctly folded and may affect the activity of PBD-2-PoINFgamma.
Animals ; Genetic Vectors ; genetics ; Interferon-gamma ; biosynthesis ; genetics ; Pichia ; genetics ; metabolism ; Recombinant Fusion Proteins ; biosynthesis ; chemistry ; genetics ; Swine ; beta-Defensins ; biosynthesis ; genetics

OBJECTIVETo investigate the progression and drug resistance of long-term non-progressors during three follow-up in Henan province.

METHODSIn May 2009, 26 cases of long-term non-progressors were recruited who infected HIV more than 10 years with blood collection and supply routes, did not receive anti-retroviral therapy, CD4(+)T lymphocyte count ≥350/μl and did not show typical symptoms of AIDS from Weishi, Shangcai, and Linying of Henan Province. Continuous follow-up were conducted three times since 2009 every two years with cohort analysis, the epidemiological information of infection routes, infection time and blood were collected, and 78 parts of 10 ml EDTA anticoagulated whole blood were collected. The changes of CD4 (+) T lymphocytes, viral load, and virus gene variety were characterized from 2009 to 2014. In-house methods were used to explore primary drug resistance of long-term non-progressors. Nonparametric Kruskal-Wallis test were used to compare CD4(+) T lymphocyte count and viral load changes during different follow-up times.

RESULTSThe average age and infection time of 26 cases were (48.51 ± 6.75) years, (13.42 ± 4.26) years, respectively. Three follow-up times, CD4(+) T lymphocyte count P50 (P25-P75) was 573.5 (487.4-789.8), 499.8 (403.5-635.7), and 418.8 (297.6-537.8)/μl (H=63.99,P<0.001), respectively. And natural logarithm of viral load P50 (P25-P75) were 3.93 (3.43-4.55), 4.29 (3.78-4.75), 4.50 (4.01-4.81) (H=3.19,P=0.355), respectively. Subtype and phylogenetic analysis of HIV showed that prevalent cases were B subtype, accounting for 88.5% (23/26), and three cases showed restructuring changes. Two cases appeared highly resistant of 18 infected patients whose viral load >1 000 copies/ml.

CONCLUSIONThe CD4(+)T lymphocyte had a declining trend, virus subtype recombinant changes in a few cases, and primary drug resistance was found of long-term non-progressors in Henan province.

Adult ; CD4 Lymphocyte Count ; China ; Cohort Studies ; Disease Progression ; HIV ; classification ; drug effects ; HIV Infections ; epidemiology ; HIV Long-Term Survivors ; Humans ; Middle Aged ; Phylogeny ; Viral Load

Objective To understand the factors associated with high risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnoses in some areas in Henan province,and evaluate the risk of secondary transmission.Methods A face to face interview was conducted among people infected with HIV through heterosexual contact by using self-designed questionnaires during January-May in 2015.Results Among 361 HIV infected persons,the proportions of those with commercial heterosexual behaviors or sex with irregular sex partners decreased from 77.3％(279/361) and 28.5％(103/361) before diagnosis to 13.6％ (49/361) and 2.5％(9/361) after diagnosis,the difference was significant (x2=16.66,P＜0.001;x2=4.80,P=0.03).The subjects surveyed always had more commercial heterosexual behaviors in Henan,Guangdong and Zhejiang provinces before and after diagnosis.After HIV infection confirmation,the condom use rates were 51.0％(25/49) for commercial heterosexual behaviors,88.5％ (184/208) for sex with regular partners and 88.9％(8/9) for sex with irregular partners,respectively.Multivariate logistic regression analysis indicated that risk behaviors associated with HIV transmission included commercial sexual behaviors,previous HIV detection and age of 35 years or older.Conclusions Extra-marital heterosexual behavior has posed serious challenge to the prevention and control of HIV spread.It is necessary to inform the HIV test results,improve the intervention and promote condom use in people with history of commercial sex and people aged ≥35 years.

Objective: To explore the survival status and influencing factors on former plasma donors (FPD) living with HIV/AIDS after initiation of antiretroviral therapy (ART) during 2002-2017 in Henan province. Methods: A retrospective study was conducted, using data from the ART database of national comprehensive HIV/AIDS information system. The inclusion criteria on patients would include HIV/AIDS cases with current residence in Henan province, route of infection being blood-borne (plasma collection), initiation of ART between 2002 and 2017, and 15 year-olds or above. According to the time of initation on antiviral treatment, observation was carried on between January 1, 2002 and December 31, 2017. Outcome of observation was defined as death caused by AIDS or related diseases. Life Table was used to estimate the survival rate and Kaplan-Meier method was used to draw the survival curve. Log-rank test was used to compare the univariate intergroup survival rates while Cox proportional hazards regression model was used to analyze the influencing factors on survival status among deaths due to AIDS or related diseases. Excel 2010 software and SPSS 23.0 software was used for data cleaning and statistical analysis. Results: A total of 25 825 HIV/AIDS patients were enrolled in this study. During the follow-up period, the overall mortality was 3.9/100 person year (8 354/214 796.3), among all the patients. The accumulate survival rates of 1 year, 4 years, 8 years, 12 years and 16 years after the initiation of ART were 91.2%, 80.1%, 71.2%, 65.7% and 61.5%, respectively. The results from the multivariate Cox proportional hazards regression model analysis showed that male vs. female (aHR=1.46, 95%CI: 1.39-1.53); aged 45-49 years group and aged 60 and older years group of initiating ART vs. aged 15-44 years group of initiating ART respectively (aHR=1.47, 95%CI: 1.40-1.54; aHR=2.50, 95%CI: 2.22-2.81); other marital status vs. being married or under cohabitation (aHR=1.29, 95%CI: 1.21-1.36); baseline CD₄⁺T cells counts (CD₄)<50, 50-199 and 200-349 cells/μl respectively vs. baseline CD₄≥350 cells/μl (aHR=4.50, 95%CI: 4.14- 4.89; aHR=2.49, 95%CI: 2.31-2.69; aHR=1.44, 95%CI: 1.33-1.56); number of opportunistic infections at baseline were one case, 2-3 cases and 4-5 cases respectively vs. non opportunistic infections cases at baseline (aHR=1.17, 95%CI: 1.06-1.29; aHR=1.47, 95%CI: 1.35-1.59; aHR=1.74, 95%CI: 1.60-1.89); taking TMP-SMZ vs. not taking TMP-SMZ (aHR=0.69, 95%CI: 0.65- 0.73). Conclusions The 16-year accumulate survival rate was 61.5% among FPD living with HIV/AIDS after initiation of ART, during 2002 to 2017 in Henan province. The risk factors for FPD death case would include: being males, aged 45 and older years at the initiation of ART, baseline CD₄<350 cells/μl and the number of baseline opportunistic infections cases ≥1. The protective factors on FPD death appeared as: being married or cohabited as wel as on TMP-SMZ.

Objective To understand the infection status of HIV among men who have sex with men (MSM) in Henan province and provide scientific evidence for the development of AIDS prevention and control measures.Methods The analysis was conducted on the data about incidence of HIV infection and related risk factors among MSM in Henan from 2008 to 2013,which were obtained from AIDS reporting information system and AIDS survey in MSM.Results The constituent of HIV infection in MSM increased from 1.3％ in 2008 to 17.1％ in 2013.The HIV infection rate in MSM increased from 4.69％ in 2008 to 8.33％ in 2013 (trend x2=39.24,P＜0.001).Univariate analysis indicated that the risk factors related with HIV infection included age (x2=21.03,P＜0.001),education level (x2=31.66,P＜0.001),occupation (x2=14.59,P=0.01),condom use in the last anal sex (x2=134.97,P＜ 0.001),condom use in anal sex during past 6 months (x2 =97.15,P＜0.001),STI history (x2=67.21,P＜0.001) and syphilis prevalence (x2=163.60,P＜0.001).Multivariate analysis indicated that HIV infection related risk factors included age,STD history,syphilis prevalence and poor awareness of AIDS related knowledge.Conclusion The incidence of HIV infection among MSM in Henan increased rapidly,and homosexual transmission has become the major route of HIV infection.HIV infection related risk behavior is prevalent among MSM,therefore,it is necessary to take effective measures to prevent and control HIV/AIDS in MSM.

Objective To analyze the situation of survival among AIDS patients under co-trimoxazole prophylaxis as initial anti-retroviral therapy(ART),in Henan province during 2007-2011. Methods Information on AIDS patients receiving initial ART during 2007-2011 was collected from the Chinese HIV/AIDS Integrated Control System. Kaplan-Meier estimation was used to generate survival curves,and Cox proportional hazard regression model was used to determine associated factors of survival status. According to the previous CTX use before ART,the subjects were divided into 3 groups including who had never taken CTX,who had taken CTX and still taking now,who had taken CTX and not current taking. Results A total of 13 103 eligible AIDS patients were identified. 1 702 patients died within 6 years after the initiation of ART,with the mortality as 4.46/100 person year. Among the 455 patients who died within 3 months and 970 died within 12 months,the mortality rates were 14.15/100 person year and 7.78/100 person year,respectively. The Kaplan-Meier survival curves showed that the survival time and mortality of the patients who had taken CTX was longer AND lower than those patients who had never taken CTX when starting the ART program. Results from the log-rank test showed that the difference of two groups was statistically significant during 12 months after the ART(log-rank=5.15,P=0.02). After controlling for other variables,results from multivariable analysis of COX model showed that factors as age,gender,marital status,perion between confirmed diagnosis and receiving the ART,baseline CD4+T cells count,clinical stage,initial therapy schedule,date when starting the ART,number of symptoms at baseline,use of CTX before starting the ART and ART being skipped in the last seven days etc,were associated with the time of survival in patients after the initiation of ART. Patients who had been taking CTX at ART initiation were at lower risk of death (adjusted HR=0.71,95%CI:0.63-0.80;P=0.00),compared to those who had never taken the CTX. Conclusion The co-trimoxazole prophylaxis program was associated with the reduced mortality among AIDS patients who were on ART in Henan province,especially during the first year.

Objective To evaluate the effectiveness of the intervention on preventing mother to child transmission of HIV and identify the influencing factors.Methods The data regarding the pregnant women and their infants were collected,including demographic characteristics,pregnancy and delivery,access to antiviral therapy,HIV infection status at age 18 months and survival of infants between 2002 and 2013 through follow-up,Multivariate logistic regression model were used to identify the influencing factors.Results By the end of 2013,a total of 8 621 554 pregnant women received HIV test,among them 2 264 were infected with HIV.The positive rate of HIV is 0.03％.The HIV positive rate decreased year by year (x2=4.871,P=0.027).A total of 1 530 infants were born from 2002 to 2013,among them 1 384 survived and 92 died at age of 18 months,and 54 were lost for follow up.Sixty infants were tested to be HIV-positive,1 324 infants were tested to be HIV-negative.The mother to child transmission rate was 4.34％,the corrective mother to child transmission rate was 6.33％.Receiving HIV prevention service in early pregnancy (OR=0.26,95％ CI:0.09-0.77),standardized antiviral therapy OR=0.42,95％CI:0.21-0.82),artificial feeding (OR=0.06,95％CI:0.02-0.21) might be the mam protective factors,episiotomy on delivery (OR=3.91,95％ CI:1.74-8.80) might be the risk factors.Conclusion The HIV tested positive rate remained to be low and decreased year by year in pregnant women in Henan,but the mother to child HIV transmission rate was high.It is necessary to improve the prevention of mother to child HIV transmission.

Objective To investigate the status of survival and related risk factors among HIV-exposed children in Henan province from 2002 to 2014.Methods A follow-up program was set up when infants as 1,3,6,9,12,18 month olds.Data regarding the HIV-exposed children and their mothers were collected,including service of PMTCT,antiviral therapy,incidence of infectious disease and survival status of infants.Univariate and multivariate logistic regression models were used to explore the risk factors.Results A total number of 1 705 HIV-infected infants were reported from 2002 to 2014.Among them,1 536 infants (90.09％) were still alive when they were at one and a half years old,with another 58 (3.40％) lost to follow up and 111 (6.51％) infants were dead.The cumulative mortality rates in HIV-exposed children,newborn,and HIV-exposed infants were 67.39‰,23.07‰,and 57.01‰,respectively.No statistical significance was found on the decreasing tendency of mortality in different years.The leading cause of death was noticed as pneumonia,with a proportion of 32.43％,followed by suspected AIDS.Early diagnosis had not been made in infants.Low-birth weight (OR=4.97,95％CI:3.12-7.92) seemed to be a risk factor.Early detection in pregnancy (OR=0.46,95％ CI:0.26-0.80) and HARRT provided to children (OR=0.25,95％ CI:0.15-0.42) were recognized as protective factors.Conclusions The mortality of HIV-exposed children were high,which called for the development of programs on early infant diagnosis and HARRT.Measures should be taken to prevent pneumonia and other infectious diseases,together with nutrition support and monitor program on growth.

OBJECTIVETo compare the survival effect of initiation of antiretroviral treatment on AIDS patients at different stages so as to explore the best time of initiation with the treatment.

METHODSInformation regarding the dates of AIDS patient initially receiving the anti-retroviral therapy during 2007-2012 was collected from the Chinese HIV/AIDS Integrated Control System. According to the level of baseline immunology, all the participants were divided into earlier treatment group (baseline CD4(+) T cell counts between 350/µl and 500/µl) and conventional treatment group (baseline CD4(+) T cell counts ≤350/µl). Data was analyzed under Survival and Review methods.

RESULTSA total number of 16 282 cases were selected. The mortality of conventional treatment group was obviously higher than the earlier treatment group (5.78/100 person year vs. 1.64/100 person year), and the median survival time was lower than the earlier treatment group (2.07 year vs. 3.15 year). The cumulative survival rate of the 6-year conventional treatment group was lower than the earlier treatment group (77.39% vs. 92.10%, χ(2) = 156.00, P < 0.01). By means of multi-variable analysis, we found that factors as age, gender, marital status, route of transmission, schedule on initial therapy, number of symptoms at the baseline etc. in the conventional treatment group were associated with survival time of patients after the ART initiation (P < 0.05), while gender, schedule for initial therapy, number of symptoms at baseline etc. in the earlier treatment group, were associated with survival time of patients after the initiation of ART (P < 0.05).

CONCLUSIONEarlier initiation of antiretroviral treatment on AIDS patients could improve the survival rate and prolong the survival time.