1.Epidemiological characteristics of HCV infected children under 15 years of age, in Henan province from 2008 to 2013.
Jie LI ; Wenjie YANG ; Zhe WANG
Chinese Journal of Epidemiology 2014;35(10):1119-1122
OBJECTIVETo describe the epidemiological characteristics and changing trend of HCV-related children in Henan province.
METHODSData was analyzed based on the case-reporting records on hepatitis C from 2008 to 2013.
RESULTSThe number of reported cases and incidence of HCV-related children had increased annually from 2008 to 2012. The reported incidence on HCV-related children increased from 2.37 per 100 000 in 2008, to 3.23 per 100 000 in 2012, but it decreased to 1.77 per 100 000 in 2013. Reported cases on females increased annually. The 0-1 age group had the largest proportion but it decreased annually. Large cities as Zhengzhou, had high incidence, and the mobile population within the province also showed an annual increase, from 49.02% in 2008, to 59.77% in 2013. Time between onset and diagnosis(days) of the disease increased and the M and IQR from 2008 to 2013 appeared as 0(0-2), 0(0-2), 1(0-2), 1(0-3), 1(0-5) and 1(0-3).
CONCLUSIONThe incidence of HCV-related children in Henan province showed an annual increase, along with the increasing trend of mobile population in the province as well as the longer time span between onset and diagnosis of the disease. It is suggested that strengthening the program on monitor, as well as on effective prevention and control measures be in place accordingly. Targets should also be focused on pregnant women, migrants, other key groups, so as to better perform on early detection and treatment.
Adolescent ; Child ; Child, Preschool ; China ; epidemiology ; Cities ; Female ; Hepatitis C ; epidemiology ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male
2.Survival analysis of the AIDS patients under 14 years of age and receiving antiretroviral treatment in Henan province from 2003 to 2014.
Dingyong SUN ; Wenjie YANG ; Yanmin MA ; Qi WANG ; Jia LIU ; Panying FAN ; Ning LI ; Qian ZHU ; Zhe WANG ; Email: WANGZHE@HNCDC.COM.CN.
Chinese Journal of Preventive Medicine 2015;49(8):700-704
OBJECTIVETo analyze the survival status and influencing factors of the AIDS patients under 14 years of age and receiving antiretroviral treatment in Henan Province.
METHODSDatabase of children AIDS patients receiving ART were download from China information system for disease preventioin and control-AIDS, AIDS cases from January, 2003 to June, 2014 were selected to be analyzed. Demographic characteristics baseline laboratory inclusion criteria: F First time receive national free ART during study; aged 14 years or below; and with relatively complete baseline information and follow-up information. 1 037 cases were selected. Patient information about survival status, death, demographic characteristics, and baseline laboratory test results were analyzed. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by COX proportional hazard model.
RESULTSA total of 1 037 AIDS children-cases ((9.52 ± 3.56) years old) which included 628 boys and 409 girls were recruited in the study, 939 cases survived 1 to 9 years from starting ART treatment and 98 cases died. Accumulated survival rate of AIDS children receiving ART from 1 year to 9 years were 96.11%, 94.17%, 92.74%, 91.28%, 90.54%, 89.47%, 88.52%, 88.52%, 86.84%, respectively. Results of multivariate analysis showed baseline count of CD4⁺ T lymphocyte (HR = 0.51, 95% CI: 0.36-0.72), duration from confirmation to the initial ART time (HR = 0.85, 95% CI: 0.75-0.97) and hemoglobin level (HR = 2.26, 95% CI: 1.09-4.70) were influence factors for survival time of AIDS children patients receiving ART.
CONCLUSIONSurvival rate of AIDS children aged 14 years or below and receiving ART in Henan Province was relatively high. Timely surveillance of CD4⁺ T and the hemoglobin level of the AIDS patients so as to timely launch HARRT could extend survival time of AIDS patients.
Acquired Immunodeficiency Syndrome ; drug therapy ; mortality ; Adolescent ; Antiretroviral Therapy, Highly Active ; CD4-Positive T-Lymphocytes ; Child ; Child, Preschool ; China ; Female ; Humans ; Male ; Proportional Hazards Models ; Survival Analysis ; Survival Rate
3.Study on risk factors of hepatitis C virus infection among Han population in Henan province.
Jie LI ; Yanmin MA ; Wenjie YANG ; Dingyong SUN ; Qian ZHU ; Zhe WANG
Chinese Journal of Preventive Medicine 2014;48(11):985-989
OBJECTIVETo study the risk factors of hepatitis C Virus Infection among Han population in Henan Province, providing evidence for the development of targeted prevention and control measures.
METHODSIn this 1: 1 matched case-control study, data of 134 cases and 134 controls were collected in seven hospitals from June 2013 to September 2013. Case group with the following conditions: Han nationality, first diagnosed hepatitis C in 2013, Current address and investigation belong to the same district (county), above 18 years old; with the following conditions can't into case group: not to cooperate with the investigation, late-stage Hepatitis C patients. Control group with the following conditions: Han nationality, with the matched case patients the same gender, in the same hospital for treatment , from the same district (county), the age difference ≤ 5 years old and in the same age group. With the following conditions can't into control group:not to cooperate with the investigation, diagnosed with hepatitis B, hepatitis C patients. Collect 3 ml blood samples to test anti-HCV. Single factors were analyzed with χ(2) between case and control, risk factors were analyzed with logistic regression model.
RESULTSThe ratio about blood donation, blood transfusion, operation and acupuncture of cases were 35.1% (47/134), 27.6% (37/134), 42.5% (57/134), 12.7% (17/134), with differences compared to those of controls (2.2% (3/134), 5.2% (7/134), 21.6% (29/134), 5.2% (7/134))(χ(2) values were 47.60, 24.47, 13.42 and 4.58, all P values <0.05). Compared with those never received blood transfusion and those never donated blood, former blood receptors and blood donors had higher risk of hepatitis C infection(OR: 2.01, 95%CI:1.32-3.05; OR:2.68, 95%CI:1.85-3.88).
RESULTSof multiple nonconditional logistic regression analysis showed that Plasma donors and whole blood donors had higher risk of hepatitis C infection than those never donated plasma and blood (OR:76.71, 95%CI: 10.25-574.25; OR:10.23, 95%CI: 2.15-48.70).
CONCLUSIONBlood transfusion and abnormal blood are independent risk factors among Han population in Henan Province of hepatitis C infection. The Plasma donors, blood donors and with the increase in the times of blood transfusion, the risk of hepatitis C infection is increase.
Aged ; Blood Donors ; Blood Transfusion ; Case-Control Studies ; China ; ethnology ; Hepacivirus ; Hepatitis C ; Humans ; Risk Factors
4.A follow-up study of HIV long-term non-progress populations in Henan province.
Xiujuan XUE ; Guoqing SUN ; Chunhua LIU ; Jia LIU ; Suian TIAN ; Zhe WANG
Chinese Journal of Preventive Medicine 2014;48(8):684-687
OBJECTIVETo explore the related testing indicators variation of HIV long-term non-progress populations.
METHODSThe long-term non-progress populations in some areas of Henan were recruited, and the study was carried out according to different CD4(+)T lymphocytes counts for two groups. The dynamic characteristics of immune status and viral load between LTNP-1group (CD4(+)T lymphocytes ≥ 500/µl, 42 cases) and LTNP-2 group(350/µl ≤ CD4(+)T lymphocytes < 500/µl, 49 cases) from July 2010 to August 2013 were observed. The characteristics of HIV elite controllers during the follow-up were also described.
RESULTSLTNP were recruited, 56% (51 cases) were men, and 44% (40 cases) were women. The study population were aged from 38 to 65 years old. A total of 320 individuals were followed-up, 14 cases were lost, 2 deaths, and 16 cases had received antiretroviral therapy during four years. To analyze the annual changes of CD4(+)T lymphocytes and VL of the group from 2010 to 2013, LTNP-1 group CD4(+)T lymphocytes from 654.0(545.2-809.5) decreased to 494.0(341.0-574.7), and LTNP-2 group decreased from 493.0 (429.5-770.0) to 343.5(253.0-500.8), CD4(+)T lymphocytes decline of over times of two groups in longitudinal analysis (χ(2) = 50.32, P < 0.01; χ(2) = 31.03, P < 0.01). lg (VL) of LTNP-1 group were 3.52 (3.15-4.27), 3.71 (2.70-4.55), 3.86 (3.59-4.55), 3.96 (3.25-4.36), and lg (VL) of TNP-2 group were 4.35 (3.72-4.83), 4.35 (3.97-4.94), 4.71 (3.96-4.95), 5.04(4.78-5.26), respectively (P > 0.05). The same year inter-group comparison found CD4(+)T lymphocytes of LTNP-1 group were higher than LTNP-2 group (Z = 5.23, P < 0.01; Z = 3.06, P < 0.01; Z = 2.51, P < 0.05; Z = 2.47, P < 0.05). VL of LTNP-2 group increased from 4.35(3.97-4.94) to 5.04 (4.78-5.26) during 2011 to 2013, were higher than LTNP-1 group in the same year (Z = 2.28, P < 0.05; Z = 2.58, P < 0.05; Z = 2.76, P < 0.05). 65 cases HCV antibody were positive in 91 individuals, and the HCV antibody positive rate was 76% (32/42), 67% (33/49) between LTNP-1 group and LTNP-2 group. Six elite controllers maintained CD4(+)T lymphocytes ≥ 500/µl, VL<1 000 copies/ml during four years follow-up.
CONCLUSIONThe long-term non-progress populations in Henan were overall healthy, and VL were relatively stable, there was a decreased trend of CD4 year by year, and HCV co-infection rate was high.
Adult ; China ; epidemiology ; Female ; Follow-Up Studies ; HIV Infections ; HIV Long-Term Survivors ; statistics & numerical data ; HIV Seropositivity ; Humans ; Male ; Middle Aged ; T-Lymphocytes ; Viral Load ; statistics & numerical data
5.Effect of co-trimoxazole prophylaxis used for AIDS patients under anti-retroviral therapy.
Wenjie YANG ; Yan LIANG ; Jie LI ; Yanmin MA ; Ning LI ; Dingyong SUN ; Zhe WANG
Chinese Journal of Epidemiology 2014;35(6):689-694
OBJECTIVETo analyze the situation of survival among AIDS patients under cotrimoxazole prophylaxis as initial anti-retroviral therapy (ART), in Henan province during 2007-2011.
METHODSInformation 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.
RESULTSA 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.
CONCLUSIONThe 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.
Acquired Immunodeficiency Syndrome ; drug therapy ; Adolescent ; Adult ; Anti-Retroviral Agents ; therapeutic use ; China ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Proportional Hazards Models ; Trimethoprim, Sulfamethoxazole Drug Combination ; therapeutic use ; Young Adult
6.Analysis of HIV-1 drug resistance among 1 922 individuals experiencing virological failure of first-line antiretroviral therapy in Henan province.
Jia LIU ; Jiangzhou YAN ; Wenjie YANG ; Xiujuan XUE ; Guoqing SUN ; Chunhua LIU ; Suian TIAN ; Dingyong SUN ; Qian ZHU ; Zhe WANG ; Email: WANGZHE@HNCDC.COM.CN.
Chinese Journal of Preventive Medicine 2015;49(11):950-955
OBJECTIVETo study the condition of HIV-1 drug resistance mutation among failures of first-line antiretroviral therapy in Henan province.
METHODThe sub platform of China's legal infectious disease monitoring information reporting system-HIV/AIDS integrated prevention and control data information management system was used to collect the information of patients experiencing first-line antiretroviral treatment failure (virus load ≥ 1 000 copies/ml) more than one year among nine cities of Henan in 2011. A total of 40 cases with no information and 212 cases with incomplete drug resistance results were deleted, and 1 922 cases were included in this study and genotype resistance testing was carried out. Non-conditional logistic regression analysis was used to analyse the influencing factors of drug resistance mutation.
RESULTSA total of 1 922 cases were included in the analysis. 1 039 cases were males, 833 cases were females, the age was (45.7 ± 12.1) years, 82.73% (1 590) were married, and 87.93% (1 690) were transmitted by blood. 64.20% (1 234) patients acquired drug resistance. Nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI) resistance mutations were found in 62.59% (1 203), 49.74% (956) and 0.94% (18) of subjects, respectively. 42.09% (809) of patients harbored NRTI and NNRTI resistance mutations synchronously. ≥ 1TAM was the most commonly emerged NRTI resistance mutation (41.94% (806)), the prevalences of TAM-1 and TAM-2 were 8.48% (163) and 4.24% (81), respectively. K65R/N and Q151M complex existed in 23 and 4 patients, respectively. K103N/S was the most commonly emerged NNRTI resistance mutation (34.32% (659)). Non-conditional logistic regression analysis showed that, factors associated with high drug resistance were the following: transmitted by mother to child (OR = 9.05, 95% CI: 1.14-72.12), clinical stage was IV (OR = 1.70, 95% CI: 1.09-2.66) and 5-year-treated (OR = 1.59, 95% CI: 1.03-2.47). Factors associated with low drug resistance were the following: 1-year-treated (OR = 0.19, 95% CI: 0.13-0.27).
CONCLUSIONComplex patterns of HIV-1 drug resistance mutations were identified among individuals experiencing failure of first-line antiretroviral therapy in Henan province. Factors associated with high drug resistance were lived in Luohe, Shangqiu, Nanyang, Xinyang, transmitted by mother to child, clinical stage was IV, and 5-year-treated.
Adult ; China ; Drug Resistance, Viral ; genetics ; Female ; Genotype ; HIV Infections ; drug therapy ; HIV-1 ; drug effects ; genetics ; Humans ; Infectious Disease Transmission, Vertical ; Male ; Middle Aged ; Prevalence ; Protease Inhibitors ; therapeutic use ; Reverse Transcriptase Inhibitors ; therapeutic use
7.Survival analysis of AIDS patients of 15 years or above years old after initiation antiretroviral treatment in Henan province during 2005 to 2014.
Wenjie YANG ; Panying FAN ; Yan LIANG ; Yugang NIE ; Ning LI ; Dingyong SUN ; Qian ZHU ; Zhe WANG ; Email: WANGZHE@HNCDC.COM.CN.
Chinese Journal of Preventive Medicine 2015;49(12):1061-1066
OBJECTIVETo investigate the survival rate of AIDS patients after receiving antiretroviral therapy(ART) in Henan province and to determine factors associated with survival status.
METHODSDatabase of AIDS patients receiving ART were downloaded from China Information System for Disease Preventioin and Control-AIDS, retrospective study method was conducted to analyze the information.
INCLUSION CRITERIAinitially received national free ART during January, 2005 to December, 2014; aged 15 years or above; and with relatively complete baseline information and follow-up information. The accumulated survival rate of AIDS patients was calculated by life table method and the influencing factors were analyzed by Cox proportional hazard model.
RESULTSTotal 30 376 AIDS patients were enrolled in this study. During the follow-up period, a total of 3 927 cases died from HIV/AIDS related diseases. The mortality of all patients was 3.2/100 person year. After 1, 5, 10 years after the initiation of ART, the rates of accumulate survival rate were 93.7%, 85.3%, and 78.4%, respectively. Stepwise regression was used to conduct the time multiple factors analysis, the results showed that man (HR=1.28, 95%CI: 1.20-1.37), older age (HR=1.20, 95% CI: 1.16-1.24), others marital status except marrage or cohabitation (HR=1.20,95% CI: 1.12-1.29), more number of symptoms (HR=1.11, 95%CI: 1.07-1.14), initial treatment were main stavudine (D4T) or zidovudine (AZT)+ didanosine(DDI)+ nevirapine (NVP) or efevirenz (EFV) (HR=1.12, 95% CI: 1.04-1.20), missing drug in the past 7 days (HR=18.36,95%CI: 17.08-19.74) among AIDS patients had high mortality risk, homosexuality sexual transmission (HR=0.59, 95% CI: 0.40-0.87), higher baseline count of CD4(+)T lymphocyte (relative to 0-200 cells/µl group, HR (95%CI) were 0.57 (0.53-0.62), 0.43(0.37-0.49), 0.33 (0.27-0.40) in 201-350 cells/µl group, 351-500 cells/µl group, and ≥501 cells/µl group, respectively), higher educations (HR=0.89, 95% CI: 0.83-0.95) had low mortality risk.
CONCLUSIONSurvival rate was higher after initial antiretroviral treatment among AIDS patients in Henan province. AIDS patient will have shorter survival time after antiviral treatment under one or more following conditions: higher age, male, initial treatment with D4T or AZT + DDI + NVP or EFV, lower baseline CD4 (+) T lymphocyte count, ever missed antiviral drugs in past 7 days of latest follow-up.
Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; Anti-Retroviral Agents ; therapeutic use ; China ; epidemiology ; Drug Therapy, Combination ; Female ; Humans ; Lymphocyte Count ; Male ; Nevirapine ; therapeutic use ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Stavudine ; therapeutic use ; Survival Analysis ; Survival Rate ; Zidovudine ; therapeutic use