1.Association of CD4 + T lymphocyte count with HBV replication and progression of liver diseases in patients infected with HIV and HBV
Rongrong YANG ; Xi'en GUI ; Yong XIONG ; Shicheng GAO ; Yajun YAN ;
Chinese Journal of General Practitioners 2016;15(6):466-468
The clinical data of 459 patients,who were first diagnosed as HIV/HBV co-infection from January 2007 to December 2013,were retrospectively analyzed.Among all patients,there were 89 cases with CD4 < 50/μl,134 cases with CD4 50-200/μl and 236 cases with CD4 > 200/μl,when HIV infection was diagnosed.In these three groups with different CD4 levels,the HBV DNA positive rates were 49.3% (37/75),50.5% (54/107) and 33.7% (66/196);the HBV viral load were (6.37 ± 1.71) log10 copies/ml,(5.82 ± 1.86) log10 copies/ml and (4.36 ± 1.64) log10 copies/ml;the rates of abnormal liver function were 29.2% (26/89),29.1% (39/134) and 10.6% (25/236);the occurrence rates of end-stage-liver-diseases were 16.9% (15/89),14.9% (20/134) and 5.1% (12/236);the mortality rates were 10.1% (9/89),9.7% (13/134) and 3.8% (9/236),respectively.The HBV DNA positive rates,HBV viral load,the rates of abnormal liver function,the occurrence rates of end-stage-liver-diseases and the mortality rates in CD4 > 200/μl group were lower than that in CD4 < 50/μl group and 50-200/μl group.The results suggest that for HIV and HBV co-infection patients,HBV replication level and prognosis of liver diseases are associated with CD4 + T lymphocyte count.
2.Effectiveness and associated factors of prevention for mother-to-child human immunodeficiency virus transmission in 536 human immunodeficiency virus-positive pregnant women in Hubei Province
Yu DONG ; Xi'en GUI ; Lei TANG ; Jiarong LIU ; Zhen TAN ; Zhijun BAO ; Hongchun LIAO ; Zhizhou DUAN ; Tao WEI ; Ke LIANG
Chinese Journal of Infectious Diseases 2018;36(2):83-89
Objective To evaluate the effectiveness and associated factors of prevention of motherto-child human immunodeficiency virus (HIV) transmission in Hubei Province,and to provide a reference for prevention of mother-to-child transmission of HIV.Methods In this prospective cohort study,HIV-positive pregnant women who were in some counties and cities of Hubei Province from January 2004 to December 2016 were enrolled.Prevention of mother-to-child transmission of HIV was conducted for these HIV-positive pregnant women and their infants,and their clinical data were collected.Descriptive analysis and x2 test were used to analyze the general characteristics of HIV-positive pregnant women and their infants.Logistic regression analysis was adopted to explore the associated factors of mother-to-child HIV transmission.Results In total,536 HIV-positive pregnant women (628 pregnancies) were found,among which,334 pregnant women and 345 infants were enrolled in this study.Twenty-four infants were HIV-positive,which was 6.96% in all infants (95%CI:4.27%-9.64%).The rates of mother-to-child HIV transmission without prevention,formula feeding only,infant medication plus formula feeding,mother and infant medication plus formula feeding were 35.71% (95%CI:21.61%-51.93%),8.82% (95%CI:2.08%-15.57%),7.41% (95%CI:0.92%-24.22%),and0.48% (95%CI:0.01%-2.64%),respectively.No antiretroviral medications during delivery (OR =14.484,95 %CI:1.740-120.577,P=0.013),breastfeeding (OR=6.542,95%CI:2.416-17.713,P=0.000),and CD4-T lymphocyte count<200 cells/μL during delivery (OR=3.060,95%CI:1.076-8.703,P=0.036) were independent risk factors of mother-to-child HIV transmission.Conclusions The rate of mother-to-child HIV transmission without prevention is high in Hubei Province,which can be significantly reduced by comprehensive interventions (mother and infant medication plus formula feeding).Thus,we should diagnose HIV-positive pregnant women as early as possible,and should give pregnant woman antiretroviral therapy plus infant medication and formula feeding to further reduce the rate of mother-to-child HIV transmission.