Visceral leishmaniasis,progressive disseminated histoplasmosis and penicilliosis marneffei are infections found in both human and animals.Their clinical manefestations,morphology of the pathogens under microscope are similar.Misdiagnosis was common and prognosis was poor when wrong therapy was given.This article is to introduce the epidemiology,clinical manefestation,laboratory findings and the treatment of these infections.

Objective To investigate mother-to-child transmission of HIV-1 and the factors that affect transmission. Methods 136 children who were born to HIV positive mothers in a high HIV prevalence region were interviewed and blood samples were examined for anti-HIV anti-HGV and HIV RNA or HIV DNA. Results Among 136 children who were born to HIV positive mothers, 50 were infected with HIV. The MTCT rate was 36.8% (50/136). Thirty eight DNA fragments of HIV-1 gag gene P17 obtained from HIV-1 seropositive mothers were amplified by PCR from uncultured peripheral blood mononuclear cells (PBMCs). Sequence analyses showed that all of them were HIV-1 B subtype. The HIV vertical transmission rate among mothers with AIDS (67.4%, 31/46) was significantly greater than among those with HIV alone (21.1%, 19/90), P

Objective To establish the diagnosis criterion and management protocol for nonalcoholic steatohepatitis(NASH).Methods The data of 75 patients with NASH including 10 chronic hepatitis,10 simple fatty,15 alcoholic liver disease,10 healthy conerol and 40 tpye 2 diabetic patient without viral hepatitis were investigated.Results Among 75 NASH patients,the mean age was 36.8 years,and male were 66(88%);their body mass index(BMI)≥25 were 58 (77.3%).Serum ALT and insulin concentration were elevated in all patients with NASH;60 cases were with hypertriceridemia (80%),30 with normal oral glucose tolerate test (OGTT) (40%),fatty liver was detected in 67 patients (90%)by ultrasonography.The BMI were different between NASH and healthy controls,P

Objective To estimate the clinical features of hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection among acquired immune deficiency syndrome (AIDS) patients and the interaction of lamivudine (3TC) contained antiretroviral therapy (ART) with hepatitis virus replication.Methods From 2004 to 2010,199 human immunodeficiency virus (HIV)/HBV coinfected patients admitted to Zhongnan Hospital of Wuhan University were enrolled,including 76 cases of HIV/HBV/HCV triple infection and 123 cases of HIV/HBV dual infection.Hepatitis B surface antigen (HBsAg) and hepatitis B core antibody (anti-HBc) were detected routinely.HBV DNA,HCV RNA before and after ART with 3TC and incidence of end-stage-liver-diseases in two groups were compared.Categorical data were analyzed by chi-square test,and measurement data were compared by t test.Results Positive rates of HBV DNA in HIV/HBV and HIV/HBV/HCV coinfection group before treatment were 45.5 ％ (56/123) and 25.0 ％ (19/76),respectively (x2 =8.429,P=0.004).The levels of HBV DNA in the two groups before treatment were (5.61±1.88) lg copy/mL and (4.70±1.84) lg copy/mL,respectively (t=2.589,P=0.003).After ART with 3TC,detectable rate of HBV DNA in HIV/HBV/HCV group decreased to 9.2％ (7/76),which was significantly lower than pretreatment (x2 =6.681,P=0.010),but serum HCV RNA increased significantly from 56.6％ (43/76) pretreatment to 72.4％ (55/76) post-treatment (x2 =4.136,P=0.042).The incidence of end-stage-liver-diseases in HIV/HBV/HCV co-infected group was significantly lower than that of HIV/HBV dual infection group (18.8 per 1000 person years vs 42.1 per 1000 person years; x2 =4.459,P =0.035) during an average of 5.6 years of follow up.Conclusion It is possible that there are interactions between HBV and HCV when the two viruses are co infected.The timing of patient enrollment might be an impact factor on study results.

Objective To evaluate the therapeutic effects of antiretroviral therapy(ART)on human immunedeficiency virus (HIV)-1-infected children. Methods Twenty-two HIV-1-infected children who met World Health Organization (WHO) criteria for treatment received ART and were prospectively enrolled in this study. ART contained two kinds of nucleoside reverse transcriptase inhibitor (NRTI) combined with one kind of non-nucleoside reverse transcriptase inhibitor (NNRTI).Before ART and 1-36 months after ART, height, body weight, blood routine, peripheral CD4+ and CD8+ T cell counts and plasma viral load were followed up regularly. Comparison between groups was done by test. Results Among the 22 pediatric AIDS patients, 19 cases (86.4%) achieved clinical improve, whose height and body weight increased significantly 6 months after ART (height = 1 :1.04±0. 02, t=2. 356, P<0. 05; body weight= 1: 1. 14±0. 01,t=2. 567,P< 0. 05) and opportunistic infection rate decreased (72.7 % vs. 27.3 %) ; 3 patients (13.6 % ) deteriorated, whose height and body weight increased slowly and even decreased, 2 of them died. In the 19 improved patients, viral load declined to <2.7 lg copy/mL at month 3 of ART, CD4+ T cell counts and CD4+/CD8+ ratio significantly increased at month 3 of ART (CD4+ T cell counts: 145.50±86.72 vs. 262.80±213.62,t=2. 668, P<0.05; CD4+/CD8+ ratio: 0. 14±0. 11 vs. 0.23±0. 21,t=2. 607, P<0. 05) and CD4+/CD8+ ratio peaked at month 9 and absolute number of CD4+ T cell counts peaked at month 12 and maintained at high level until month 36, peripheral white blood cells (WBC) and red blood cells (RBC) both decreased, while hemoglobin (Hb) contents increased significantly (107.29 ± 13.74 vs. 112. 15±11.20,t=2. 325,P<0. 05). Conclusion ART is an effective strategy for inhibition of HIV-1 replication,reconstruction of immune responses and improvement of clinical symptoms in AIDS children.

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 analyze the infection among nursing staff after occupational exposure to human immunodeficiency virus(HIV)and status of HIV-infected nursing staff,provide basis for prevention of HIV infection among nursing staff.Methods Nurses who sustained HIV occupational exposure in a hospital between January 2004 and June 2015,nurses with positive anti-HIV and admitted to this hospital,consulted in outpatient department,as well as consulted outside this hospital between January 2001 and December 2015 were and analyzed,HIV infection status among nurse's mate was also analyzed.Results 76 nurses who sustained HIV occupational exposure didn't infect with HIV after received standard treatment and follow-up.Among 13 nurses infected with HIV,3 might be with occupational exposure infection previously,5 were with blood transfusion-related infection in the 1990s,4 were with sexually transmitted infection(including 2 male nurses who had sex with man,MSM),1 case with infection of unknown transmission route;secondary transmission occurred in 2 cases;9 nurses are still alive.The infected nurses have received effective antiretroviral treatment and then work at the logistic or administrative department.Conclusion Nurses often suffer from occupational exposure to HIV,occupational exposure infection may occur in the absence of the implementation of standardized management,implementation of standardized management is essential to avoid the occupational exposure of HIV.Sexual transmission(including MSM)has become an important transmission route for HIV infection among nurses.

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.

ObjectiveTo understand the distribution of interleukin(IL)-28B gene polymorphisms in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected Han patients in Hubei Province.MethodsOne hundred Han patients with anti-HIV and anti-HCV double positive in Hubei Province were enrolled.HCV RNA level was detected by fluorescence quantitative polymerase chain reaction (PCR) and genotyping of IL-28B gene was pcrformed by sequencing.The data were analyzed by chi square test.ResultsThe proportion of IL-28B C/C genotype was 95.0 ％ in target population,arnong which 21.1％ (20/95) were HCV RNA negative.While there were no HCV RNA negative cases in C/T and T/T genotypes (0/5;x2 =1.043,P=0.588).ConclusionAmong HIV/HCV coinfccted Han patients in Hubei Province,the proportion of IL-28B C/C genotype is high.

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.