The persistence of the HIV-1 reservoir is still the main obstacle to the cure of HIV. In clinical research, reliable biomarkers are needed to label it. HIV-1 DNA can be continuously detected in the HIV-1 reservoir. It has significant application value in diagnosing HIV-1 infection, the timing of antiretroviral therapy, the prediction of virus rebound, and monitoring treatment effects. The detection technology based on polymerase chain reaction (PCR) is the most commonly used HIV-1 DNA detection method in clinical practice. The continuous innovation and advancement of technology can accurately detect the total, integrated, and unintegrated HIV-1 DNA in infected cells using qualitative or quantitative methods. Different forms of HIV-1 DNA in infected cells have been increasingly reported as biomarkers in HIV infection monitoring and AIDS treatment-related research. This article reviews the progress of HIV-1 DNA.
Humans ; HIV-1/genetics* ; HIV Infections/diagnosis* ; DNA ; Polymerase Chain Reaction ; HIV Seropositivity

OBJECTIVETo analyze the proportion and associated factors of taking subsequent confirmation test among men who have sex with men (MSM) after being tested positive in oral fluid HIV antibody test.

METHODSBy using successive sampling, 1 003 MSM, who were tested positive in oral fluid HIV antibody test in China-Bill & Melinda Gates Foundation AIDS prevention Program (Extension program) in Beijing during May 1 to December 31, 2013, were recruited. The inclusion criteria included: the objects were men who reported having sex with men; the objects aged more than 18 years old; the objects were tested positive in oral fluid HIV antibody test; the objects had not been reported as HIV positives in China Information System for Disease Control and Prevention previously. According to the program strategy, MSM grassroots organizations transferred the respondents to seek subsequent confirmation tests in specific Center for Disease Control and Prevention (CDCs) or hospitals. The subsequent confirmation tests included: fingertip blood HIV antibody rapid test, venous blood Enzyme Linked Immunosorbent Assay (ELISA) HIV antibody test and venous blood Western Blot (WB) HIV antibody test. Chi-square test was adopted to compare the proportion of taking subsequent confirmation tests in different groups. Nonconditional multivaritae binarylogistic regression analysis was taken to identify the associated factors with whether taking subsequent confirmation tests and to calculate the OR (95% CI) values.

RESULTSThe 1 003 respondents were (30.9 ± 9.1) years old. Among all objects, 87.8% (881/1 003) of them took fingertip blood HIV antibody rapid tests and the positive rate was 85.4% (752/881). 98.0% (737/752) of those who were identified as positive in fingertip blood HIV rapid tests took ELISA and WB tests, and the positive rate was 94.4% (696/737). Comparing with those who were expected to seek subsequent confirmation tests in CDCs, the OR (95% CI) value of those who were expected to seek tests in hospitals was 5.10 (1.69-15.36). The OR (95% CI) values of those who used condom sometimes and those who never used condom in anal sex were 5.81 (2.14-15.77) and 3.45 (2.00-5.97) respectively, in comparison with those who reported not having anal sex or using condom consistently in anal sex during the past 6 months. Comparing with the respondents recruited from the internet, the OR (95% CI) values of those recruited in bathrooms, parks/toilets and bars were 0.17 (0.05-0.53), 0.10 (0.04-0.29) and 0.22 (0.06-0.79) respectively. The likelihood of taking subsequent confirmation test decreased with the increase of number of male sexual partners in the past 3 months, and the OR (95% CI) value was 0.92 (0.86-0.99).

CONCLUSIONThe potential HIV positive MSM in the bathroom, park/toilet and bars are less likely to take subsequent confirmation test. Those who do not use condom consistently during anal sex are more likely to seek subsequent confirmation test. Medical organization conducting subsequent confirmation tests is more likely to increase the confirmation test rate of potential HIV positive MSM. The number of male sexual partners has negative correlation with whether to accept the subsequent confirmation test.

Beijing ; Condoms ; HIV Antibodies ; analysis ; HIV Seropositivity ; diagnosis ; Homosexuality, Male ; Humans ; Male ; Mass Screening ; Patient Acceptance of Health Care ; Risk-Taking ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires

OBJECTIVETo investigate the situation of notification and HIV antibody testing of sexual partners of people who lived with HIV, and to analyze the factors which could influence the rate of sexual partner notification of Shanghai.

METHODSHIV-positive people were recruited from Jiading, Jinan and Xuhui District in Shanghai, all of them were diagnosed with HIV from July 1, 1998 to July 30, 2014, and all of them were ≥ 16 years old, ruled out poor compliance, unwillingness to cooperate, mental disorders, deaf and other factors that could not properly answer questions. Face to face questionnaires were used to collect demographics, HIV related knowledge, testing of HIV, status of sexual partners before they have been diagnosed with HIV, notification of sexual partners. These questionnaires were self-designed. The differences of notification situation and the HIV-positive rate among different sexual partners were compared by chi-square tests. The factors which would influence the rate of sexual partner notification were analyzed by logistic regression, and the OR (95% CI) value was calculated.

RESULTSA total of 307 people living with HIV were surveyed, of these 276 (89.9%) were males and 31 (10.1%) were females. The rates of different sexual partner been notified from spouses, homosexual regular partners, heterosexual regular partners, heterosexual no-regular no-commercial partners, homosexual no-regular no-commercial partners to commercial sexual partners were 68.2% (105/154), 44.7% (119/266), 21.4% (22/103), 5.8% (3/52), 5.5% (43/787), and 0.4% (1/235) (χ(2) = 5.22, P < 0.001). Among these been notified sexual partners 277 of them have had HIV antibody tested, 90 persons was HIV-positive, the rate was 32.5%. Confirmed time (OR: 0.37, 95% CI: 0.16-0.86), whether inform staff allowed the HIV-positive people mobilize their sexual partners have HIV-antibody test (OR: 9.63, 95% CI: 3.77-24.55), whether someone else was present during notification (OR: 5.57, 95% CI: 1.96-15.78) and relationship stability (OR: 28.55, 95% CI: 7.93-102.75; OR: 14.13, 95% CI: 4.87-41.02) were associated with HIV-positive people disclosing their infected status to their sexual partners.

CONCLUSIONSThe rate of notification to these partners was low, but the HIV antibody positive rate was high among the sexual partners in the three research districts of Shanghai. Shorter confirmed time, inform staff didn't allow the HIV-positive people mobilize their partners have HIV-antibody test, no other was present during people was told they were HIV-positive, and no fixed sexual relationship, all these could make lower rate of sexual partners to be notified.

China ; Contact Tracing ; Disclosure ; Female ; HIV Antibodies ; blood ; HIV Seropositivity ; diagnosis ; Humans ; Logistic Models ; Male ; Sexual Behavior ; Sexual Partners ; Spouses ; Surveys and Questionnaires

OBJECTIVETo explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.

METHODSWe retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.

RESULTSThe positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.

CONCLUSIONPITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.

Counseling ; Dermatology ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; methods ; Retrospective Studies ; Sex Factors

OBJECTIVETo understand the status of recent infected and newly reported HIV cases in Jiangsu province.

METHODSInformation including general demographic, mode of transmission and sample source of newly reported HIV infected cases was collected. Corresponding serum or plasma samples were collected and tested with BED-CEIA. Proportions of recent HIV infections among different populations were calculated, and associated factors of recent HIV infection calculated.

RESULTSAmong cases infected through different channels as homosexual, heterosexual and needles sharing, the proportions of recent infections were 29.19% , 17.40% and 21.75% , respectively. Statistically significant difference was seen between different populations(P < 0.05). Compared with female cases, male cases were more likely to be recent infected (OR = 1.569, 95%CI: 1.168-2.107). Compared with cases older than 35 years of age, the ones that younger than that age were more likely to be recently infected (OR = 1.556, 95% CI:1.289-1.879). Compared with cases who remained single, those married cases were more likely to be long-term infections(OR = 0.789, 95%CI:0.649-0.960). Compared with patients identified by hospitals, the recent HIV infections were more likely to be found through voluntary counseling programs and testing (OR = 2.278, 95%CI: 1.853-2.801), project-based surveillance programs (OR = 2.409, 95%CI:1.860- 3.120), and unpaid blood donation sites (OR = 2.911, 95%CI:2.118-4.001)(P < 0.05).

CONCLUSIONProportion of MSM ranked 1st in the newly reported HIV cases in Jiangsu province. Related HIV case-finding programs should be strengthened to reduce the secondary transmission.

Age Distribution ; China ; epidemiology ; Female ; HIV Infections ; diagnosis ; epidemiology ; HIV Seropositivity ; Heterosexuality ; Homosexuality ; Humans ; Male ; Marital Status ; statistics & numerical data ; Needle Sharing ; adverse effects ; Sex Distribution

OBJECTIVETo assess the characteristics and influencing factors of HIV detection among HIV/AIDS patients in Zhejiang province.

METHODSHIV/AIDS cases information were selected from the case reporting database of HIV/AIDS Comprehensive Response Information Management System in Zhejiang province in 2012. HIV late diagnosed patients and early diagnosed patients were classified by first CD4(+) T cell counts (less than 200 cells/µl) and positive BED HIV-1 capture enzyme immunoassay (BED-CEIA) tests result. A total of 1 894 patients were enrolled and 1 383 patients were served by BED-CEIA tests. Information including social demographics, transmission routes, test history were collected for analysis. The univariate and multivariate logistic regression methods was used to analyze the characteristics of HIV detection and related influence factors.

RESULTSAmong 1 894 cases, 26.4% (500/1 894) were late diagnosed and 19.2% (361/1 883) were early diagnosed. The highest rate of late diagnose (36.5%, 27/74) and lowest rate of early diagnose(3.9%, 14/74) were both in Lishui city. Age, transmission routes, HIV testing style, permanent residence were independent reasons for late diagnosed. Compared with patients < 20 years old, participants over 50 years old had higher risk of late diagnosed (OR = 2.885, P < 0.05); patients with homosexual behaviors had lower risk of late diagnosed than patients with heterosexual behaviors and other high risk behaviors(OR = 1.471 or 2.416, P < 0.05). Age, marriage status, HIV testing style, transmission routes, the detection unit, permanent residence were independent reasons for early diagnosed. The risky of early diagnosed among patients ≥ 50 years old were 0.432 times than that among patients < 20 years old (OR = 0.432, P < 0.05). Compared with unmarried participants, married patients had lower risk of early diagnosed (OR = 0.603, P < 0.05). Compared with homosexual behaviors, high risk heterosexual behaviors and other risk behavior significantly reduced the chance of early diagnosis(OR = 0.719 or 0.763, P < 0.05).

CONCLUSIONLate diagnoses and early diagnosis coexist among reported HIV/AIDS in Zhejiang province in 2012. The main reasons for late diagnosis of HIV infection are older age, heterosexual behaviors and other risk behavior, testing in hospital, living in other province. The main reasons for early diagnosis of HIV infection are young age, unmarried, homosexual behaviors, testing in CDC, living in Zhejiang province.

Acquired Immunodeficiency Syndrome ; diagnosis ; Adult ; Age Factors ; Aged ; Communicable Diseases ; Delayed Diagnosis ; Early Diagnosis ; HIV Infections ; diagnosis ; HIV Seropositivity ; HIV-1 ; Humans ; Marital Status ; Marriage ; Mass Screening ; Middle Aged ; Risk Factors ; Risk-Taking ; Sexual Behavior

BACKGROUND: Early diagnosis of HIV infection reduces morbidity and mortality. Fourth-generation HIV detection assays are more sensitive because they can detect p24 antigen as well as anti-HIV antibodies. In this study, we evaluated the performance of a new fourth-generation ADVIA Centaur HIV antigen/antibody combo (CHIV) assay (Siemens Healthcare Diagnostics Inc., USA) for early detection of HIV infection and reduction of false positive rate. METHODS: Four seroconversion panels were included. The third-generation ADVIA Centaur HIV 1/O/2 enhanced (EHIV) assay (Siemens Healthcare Diagnostics Inc., USA) and fourth-generation CHIV assay were used to test each panel for HIV infection. The presence of antigen was confirmed using HIV p24 antigen assay. To evaluate false-positivity and specificity, 54 HIV false-positive and HIV-negative serum samples from 100 hospitalized patients and 600 healthy subjects were included. RESULTS: Compared to the EHIV assay, the CHIV assay had a shorter window for three of the seroconversion panels: a difference of 10 days and two bleeds in one panel, and 4 days and one bleed in the other two panels. Only 34 of the 54 (63%) samples known to yield false-positive results by EHIV assay had repeatedly yielded reactive results in the CHIV assay. One of the 600 healthy subjects had a false-positive result with the CHIV assay; thus, the specificity was 99.85% (699/700). CHIV accurately determined the reactive results for the HIV-confirmed serum samples from known HIV patients and Korea Food & Drug Administration (KFDA) panels. CONCLUSIONS: The new fourth-generation ADVIA Centaur HIV assay is a sensitive and specific assay that shortens the serological window period and allows early diagnosis of HIV infection.
False Positive Reactions ; Female ; HIV Antibodies/*blood/immunology ; HIV Core Protein p24/*blood/immunology ; HIV Seropositivity/*diagnosis ; Humans ; Male ; Pregnancy ; Reagent Kits, Diagnostic ; Republic of Korea ; Sensitivity and Specificity ; Time Factors

No abstract available.
Adult ; Biopsy ; Brain/*pathology ; Brain Neoplasms/*pathology ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Gadolinium DTPA/diagnostic use ; *HIV Seropositivity ; Humans ; Image Enhancement/methods ; Immunocompetence ; Lymphoma, Non-Hodgkin/*pathology ; Magnetic Resonance Imaging/*methods ; Male ; Sensitivity and Specificity

OBJECTIVETo Evaluate four kits for screening HIV antibody by comparing and analyzing the HIV antibody screening positive results and Western Blot (WB) test results.

METHODSFrom January 2004 to June 2009, three ELISA kits (Zhongshan, Biomérieux and Livzon) were used for initial screening HIV antibody. The reactive positive samples were reexamed by initial ELISA kit and a rapid kit (Abbot Determine HIV-1/2). All repeatedly reactive positive screening results were followed by WB test.

RESULTSA total of 193 (0.094%) WB confirmed positive results were obtained from 206 151 specimens. The sensitivities and predictive values of negative test result (PVN) of three ELISA kits were all 100% and those of Abbot Determine HIV-1/2 were 93.93%, and 91.67% respectively. All false negative results from Abbot were WB indeterminate. The specificities of Zhongshan, Biomérieux, Livzon and Abbot were 99.88%, 99.89%, 99.96% and 89.38%; the study predictive values of a positive test result (PVP) were 35.58%, 46.46%, 76.61% and 92.20%; the efficiencies were 99.88%, 99.89%, 99.96% and 91.98%; the areas under ROC curve of the three ELISA kits were 0.93, 0.99, and 0.95 respectively. PVP of Livzon was obviously higher than those of Zhongshan (chi(2) = 45.804, P = 0.000), Biomérieux (chi(2) = 25.231, P = 0.000) and Biomérieux was higher than Zhongshan (chi(2) = 2.488, P = 0.115). PVP of Abbot was highest (chi(2) = 18.633, P = 0.000, vs Livzon). There were some specimens with S/CO (optical density of sample/cut off) ratio < 6 or > or = 6 in all three groups with positive, indeterminate and negative WB results. The S/CO ratio from Zhongshan in confirmed positive group (14.29 + or - 2.63) was higher than in positive-negative group (2.80 + or - 3.25) (t = 17.652, P = 0.000). The S/CO ratio from Biomérieux in confirmed positive group(16.09 + or - 2.35) was higher than in positive-negative group (2.14 + or - 1.91) (t = 31.622, P = 0.000). The S/CO ratio from Livzon in confirmed positive group (11.54 + or - 1.95) was higher than in positive-indeterminate group (5.54 + or - 3.57) (t = 6.386, P = 0.000), positive-negative group (3.25 + or - 2.41) (t = 21.772, P = 0.000) and positive-indeterminate group was higher than positive-negative group (t = 2.301, P = 0.033).

CONCLUSIONThe performances of four HIV antibody screening kits are good but estimating WB confirming result in line with S/CO ratio is not available. All repeated screening positive results should be followed by confirmatory tests.

AIDS Serodiagnosis ; methods ; Blotting, Western ; methods ; Enzyme-Linked Immunosorbent Assay ; methods ; statistics & numerical data ; HIV Antibodies ; blood ; HIV Seropositivity ; diagnosis ; Humans ; Indicators and Reagents ; Mass Screening ; Reagent Kits, Diagnostic ; Sensitivity and Specificity

BACKGROUNDPulmonary tuberculosis (PTB) among asymptomatic Chinese patients with HIV infection has not been investigated despite high tuberculosis burden in China. This study was aimed to evaluate the prevalence, risk factors and clinical outcomes of PTB among asymptomatic patients with HIV/AIDS in Guangxi to facilitate the development of diagnostic and treatment strategies.

METHODSAll asymptomatic adult HIV-infected patients with CD4 < 350 cells/µl who attended four HIV clinics in Guangxi between August 2006 and March 2008 were evaluated for active PTB with physical examination, chest X-ray (CXR), sputum smear and/or sputum liquid culture. Data were described using median (interquartile range, IQR) and frequencies. Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with PTB.

RESULTSAmong 340 asymptomatic subjects, 15 (4%) were diagnosed with PTB, with 4 (27%) sputum smear positive and 8 (53%) sputum culture positive. CXR has higher diagnostic sensitivity (87%) than sputum smear (25%) and sputum culture (67%), but lower specificity (56%) compared with sputum smear (99%) and culture (100%). In univariate analysis, injection drug user, body mass index (BMI) < 18 kg/m(2), CD4 < 50 cells/µl and presence of peripheral lymphadenopathy were associated with an increased risk of asymptomatic PTB, while in multivariate analysis only peripheral lymphadenopathy maintained statistical significance (OR = 7.6, 95%CI 1.4 - 40). Patients with negative smear and minor or no abnormalities on CXR had longer interval between screening and TB treatment.

CONCLUSIONSPTB was relatively common in this group of HIV(+) asymptomatic Chinese patients. Diagnosis is challenging especially where sputum culture is unavailable. These findings suggest that an enhanced evaluation for PTB needs to be integrated with HIV care in China and transmission prevention in China to control at both households and health care facilities, especially for patients with factors associated with a higher risk of PTB.

Adult ; China ; Female ; HIV Seropositivity ; complications ; Humans ; Logistic Models ; Lymphatic Diseases ; complications ; Male ; Middle Aged ; Risk Factors ; Sensitivity and Specificity ; Sputum ; microbiology ; Tuberculosis, Pulmonary ; diagnosis ; etiology