Toxoplasmosis, a neglected tropical disease caused by the protozoan parasite Toxoplasma gondii, occurs throughout the world. Human T. gondii infection is asymptomatic in 80% of the population; however, the infection is life-threatening and causes substantial neurologic damage in immunocompromised patients such as HIV-infected persons. The major purpose of this study was to investigate the seroprevalence of T. gondii infection in subjects infected with HIV/AIDS in eastern China. Our findings showed 9.7% prevalence of anti-T. gondii IgG antibody in HIV/AIDS patients, which was higher than in intravenous drug users (2.2%) and healthy controls (4.7%), while no significant difference was observed in the seroprevalence of anti-Toxoplasma IgM antibody among all participants (P>0.05). Among all HIV/AIDS patients, 15 men (7.7%) and 10 women (15.9%) were positive for anti-T. gondii IgG antibody; however, no significant difference was detected in the seroprevalence of anti-Toxoplasma IgG antibody between males and females. The frequency of anti-Toxoplasma IgG antibody was 8.0%, 13.2%, 5.5%, and 0% in patients with normal immune function (CD4+ T-lymphocyte count ≥500 cells/ml), immunocompromised patients (cell count ≥200 and <500 cells/ml), severely immunocompromised patients (cell count ≥50 and <200 cells/ml), and advanced AIDS patients, respectively (cell count <50 cells/ml), while only 3 immunocompromised patients were positive for anti-T. gondii IgM antibody. The results indicate a high seroprevalence of T. gondii infection in HIV/AIDS patients in eastern China, and a preventive therapy for toxoplasmosis may be given to HIV/AIDS patients based on CD4+ T lymphocyte count.
Acquired Immunodeficiency Syndrome/complications ; Antibodies, Protozoan/*blood ; China/epidemiology ; Female ; HIV Infections/*complications ; Humans ; Immunocompromised Host ; Male ; Seroepidemiologic Studies ; Toxoplasma ; Toxoplasmosis/*complications/*epidemiology

PURPOSE: To investigate the patterns and risk factors of the ocular manifestations of acquired immunodeficiency syndrome (AIDS) and their correlation with CD4+ count in the era of highly active antiretroviral therapy (HAART). METHODS: This retrospective study examined 127 AIDS patients who presented to Soonchunhyang University Hospital. Data were collected from patient interviews, clinical examinations, and laboratory investigations. Ophthalmologic examinations included the best-corrected visual acuity, intraocular pressure, anterior segment and adnexal examination, and dilated fundus examination. RESULTS: Of the 127 patients with AIDS, 118 were on HAART and 9 were not. The mean CD4+ count was 266.7 +/- 209.1 cells/microL. There were ocular manifestations in 61 patients (48.0%). The incidence of anterior segment manifestations was higher than posterior segment manifestations at 28.3% and 19.7%, respectively. The mean CD4+ count was significantly (p < 0.05) lower in the patients with posterior versus anterior segment ocular manifestations. The most common ocular manifestation was retinal microvasculopathy (15.0%), followed by keratoconjunctivitis sicca (14.2%), conjunctival microvasculopathy (9.4%), cytomegalovirus retinitis (3.1%), herpes zoster ophthalmicus (2.4%), and blepharitis (1.6%). Retinal microvasculopathy and cytomegalovirus retinitis were common in patients with CD4+ counts <200 cells/microL, while keratoconjunctivitis sicca and conjunctival microvasculopathy were common in patients with CD4+ counts of 200 to 499 cells/microL. There was a significant (p < 0.05) association between ocular manifestation and CD4+ count or age. CONCLUSIONS: The introduction of HAART has changed the landscape of ocular presentations in patients with AIDS. In this study, anterior segment and external ocular manifestations occurred more frequently than posterior segment manifestations. Also, the mean CD4+ count was significantly lower in patients with posterior segment ocular manifestations versus anterior segment ocular manifestations. We found that CD4+ count and age >35 years were independent risk factors for developing ocular manifestations.
Acquired Immunodeficiency Syndrome/*complications ; Adult ; Aged ; Eye Diseases/diagnosis/epidemiology/*etiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Visual Acuity ; Young Adult

OBJECTIVETo investigate Chinese medical features of acquired immunodeficiency syndrome (AIDS) patients with pulmonary infection.

METHODSUsing cluster analysis method, Chinese medical syndromes of 196 AIDS patients with pulmonary infection were analyzed. The distribution features of each syndrome type were analyzed according to the severity and CD4+ numerical analysis.

RESULTSBasic Chinese medical syndrome types could be summed up as three kinds: exterior invasion of wind heat and phlegm heat obstructing Fei syndrome (61 cases, 31.1%), Fei-Pi deficiency and Fei stagnation of phlegm syndrome (64 cases, 32.7%), Fei-Shen deficiency and yin deficiency induced inner heat syndrome (71 cases, 36.2%). There was statistical difference in the severity degree and the distribution of CD4 among the three syndrome types (P < 0.05).

CONCLUSIONSAIDS patients with pulmonary infection involve Fei, Shen, and Pi. The pathogenic factors were related to "wind", "heat", "phlegm", and "xu". The Chinese medical syndrome distribution was closely correlated with patients' immunity.

Acquired Immunodeficiency Syndrome ; complications ; diagnosis ; epidemiology ; Adolescent ; Adult ; Aged ; Cluster Analysis ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Respiratory Tract Infections ; diagnosis ; epidemiology ; etiology ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis ; Young Adult

Along with the rapid spread of HIV / AIDS and TB prevalence, prevention and control of AIDS and tuberculosis has become an urgent problem in the field of public health. Recent studies demonstrate dual infections of HIV and TB are not a simple superposition of two diseases, but a course of mutual promotion. This article has summarized the pathological mechanisms and mutual interactions of HIV/TB dual infections.
Acquired Immunodeficiency Syndrome ; complications ; epidemiology ; prevention & control ; Coinfection ; HIV-1 ; pathogenicity ; Humans ; Mycobacterium tuberculosis ; pathogenicity ; Prevalence ; Public Health ; Tuberculosis ; complications ; epidemiology ; prevention & control

Acquired Immunodeficiency Syndrome ; complications ; epidemiology ; Africa ; epidemiology ; Clinical Trials as Topic ; Humans ; International Cooperation ; Neoplasms ; epidemiology ; etiology ; therapy ; Treatment Outcome

OBJECTIVETo determine the prevalence of herpes simplex virus (HSV) and its correlates among HIV/AIDS patients in a county of Shanxi.

METHODSAll HIV-infected patients in a county in Shanxi province who were receiving antiretroviral treatment (ART) were included in this study. Participants were interviewed using standard questionnaires. Serum samples were tested to determine HSV-1 and HSV-2 infections.

RESULTSA total of 195 AIDS patients were recruited and 195 blood samples were collected. Among 195 AIDS patients, 189 (96.9%) were farmers; 116 (59.5%) were men while 79 were women; 146 (74.9%) were between 20 - 50 years old; 180 (92.3%) were married. The major routes of HIV transmission were blood/plasma donation or transfusion (176 patients, 90.3%). CD(4)(+) T cell counts were between (1 - 1531) × 10(6) cells/L ((323.6 ± 14.8) × 10(6) cells/L), with 44 (26.5%) patients' CD(4)(+) T cell counts less than 200 × 10(6) cells/L. Of which, 154 patients (79.0%) had sexual partners. 86.8% (118 patients) consistently used condoms during the past 6 months, while for the last sexual act, 91.8% (123 patients) used condoms. For anti-HSV-1 status, there were about 164 patients (84.1%) were positive, and 26 (13.3%) were positive for anti-HSV-2. While, 14 (7.2%) were positive for both anti-HSV-1 and anti-HSV-2. Logistic regression analysis indicated that marital status were correlated with HSV-2 infection (OR = 7.41; 95%CI: 2.42 - 22.73; P < 0.01). No socio-demographic and sexual characteristics were identified to be correlated with HSV-1 infection.

CONCLUSIONA substantial proportion of AIDS patients in a rural county of Shanxi province of China were co-infected with HSV-1 and/or HSV-2. Marital status was correlated with HSV-2 infection.

Acquired Immunodeficiency Syndrome ; complications ; epidemiology ; virology ; Adolescent ; Adult ; Child ; China ; epidemiology ; Female ; Herpes Simplex ; complications ; epidemiology ; Herpesvirus 1, Human ; Herpesvirus 2, Human ; Humans ; Logistic Models ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Rural Population ; Young Adult

Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; Antiviral Agents ; therapeutic use ; China ; epidemiology ; HIV ; physiology ; HIV Infections ; complications ; drug therapy ; epidemiology ; Hepacivirus ; physiology ; Hepatitis C ; complications ; drug therapy ; epidemiology ; Humans ; Interferon-alpha ; therapeutic use ; Polyethylene Glycols ; therapeutic use ; Recombinant Proteins ; Ribavirin ; therapeutic use

OBJECTIVETo understand the influencing factors on the death of infants born to HIV infected mothers in areas with high prevalence of HIV/AIDS in China.

METHODSBased on the follow-up cohort study targeting at HIV/AIDS infected pregnant women and their babies initiated in 2004, a survey on the death status and influencing factors on the infants born to HIV/AIDS infected mothers enrolled in this cohort from Jan.2004 to Nov.2007 was carried out during Aug.to Nov.2008 in seven counties of four provinces in China. A total of 498 pairs of HIV-infected mothers and their infants were enrolled and their related information was collected. Single factor and multiple factors Cox model methods were adopted for data analysis.

RESULTSThe total observed person-years of 498 infants was 406.22, among which, 45 infants died, and the mortality density was 110.78 per 1000 child-year. A single factor Cox model showed, the pregnancy in pre-period of HIV/AIDS and HIV/AIDS period (RR = 1.971, 95%CI: 1.143 - 3.396), living status of the pregnancy (RR = 3.062, 95%CI: 1.097 - 8.550), multipara women (RR = 0.517, 95%CI: 0.278 - 0.961), natural childbirth (RR = 0.561, 95%CI: 0.345 - 0.910), premature labor (RR = 5.302, 95%CI: 2.944 - 9.547), low birth weight (RR = 4.920, 95%CI: 2.691 - 8.994), mother-child pairs taking antiretroviral drugs (RR = 0.227, 95%CI: 0.121 - 0.428) and infants infected HIV (RR = 5.870, 95%CI: 3.232 - 10.660) could affect the infants death. The death of HIV-exposed infants was influenced by various factors. The death risk of infants born to HIV infected mothers who were in the danger of pre-period of HIV/AIDS and HIV/AIDS period was greater than the infants delivered by HIV infected mothers who were in preclinical period of HIV/AIDS (RR = 6.99, 95%CI: 1.92 - 25.64). The death risks were greater in the group that the women whose CD4(+)TLC count number lower than 200 cells/microl (RR = 2.05, 95%CI: 1.01 - 4.15). The infants whose mothers had no ARV treatment had higher possibility to die than the others (RR = 6.17, 95%CI: 1.62 - 23.26). The death risk of premature delivered infants was 2.87 times of mature delivered infants (95%CI: 1.12 - 7.35). The death risk of HIV/AIDS infected infants was 9.87 times of the HIV/AIDS uninfected infants (95%CI: 3.81 - 25.62).

CONCLUSIONSome measurements including improving HIV-infected pregnant women's immunity, reducing mother to child transmission of HIV and premature birth, low birth weight are beneficial to reducing infant mortality.

Acquired Immunodeficiency Syndrome ; epidemiology ; mortality ; transmission ; Cause of Death ; China ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant Mortality ; Infant, Newborn ; Mothers ; Pregnancy ; Pregnancy Complications, Infectious ; epidemiology ; Proportional Hazards Models

OBJECTIVETo review HIV/AIDS epidemic history, current situation and prevention policy in China. Data sources Information included in this article was identified by searching PUBMED (1997 - 2006) online resources using the key terms "HIV/AIDS", "epidemic", "prevention", and "China". Study selection Original milestone articles and critical reviews written by major pioneer investigators of the field were selected.

RESULTSThe key issues related to the HIV/AIDS epidemic situation in China and Chinese government prevention policy were summarized. HIV/AIDS epidemic groups and trends for HIV transmission were discussed.

CONCLUSIONIn January 2006, 650 000 people were estimated to be living with HIV in China. The overall HIV/AIDS epidemic is at a low level (0.05%) and concentrated in several at risk populations. However, the data show that new cases of HIV infection are growing every year and spreading from at risk populations to the general population. Premier WEN Jia-bao announced the "Four frees and one care" policy and the Chinese government has developed a series of programs with strong policy measures to stop the spread of HIV/AIDS in China.

Acquired Immunodeficiency Syndrome ; epidemiology ; prevention & control ; Blood Donors ; China ; epidemiology ; HIV Infections ; epidemiology ; prevention & control ; transmission ; Health Education ; Health Policy ; Homosexuality, Male ; Humans ; Male ; Sex Work ; Substance Abuse, Intravenous ; complications

OBJECTIVETo analyze the clinical features of 128 acquired immunodeficiency syndrome (AIDS) patients infected through blood transmission who were coinfected with hepatitis B virus (HBV) and hepatitis C virus (HCV).

METHODSThe prevalence, liver functions, and some immunological profiles of 128 AIDS patients coinfected with HBV and HCV were retrospectively analyzed.

RESULTSAmong the 128 AIDS patients, 107 (83.6%) were coinfected with HCV, among which 40 (31.3%) patients had abnormal liver functions or liver damage and 15 (11.7%) patients experienced hepatitis symptoms. Three (2.3%) AIDS patients were singly coinfected with HBV, and all of them had abnormal liver functions and hepatitis symptoms. Seven (5.5%) patients were coinfected with HIV/HCV/HBV and none of them had abnormal liver functions or hepatitis symptoms. Eleven (8.6%) patients were only infected with HIV.

CONCLUSIONSThe prevalence of blood-transmitted HIV patients coinfected with HCV is higher than with HBV. The clinical outcomes of HIV coinfection with HCV and HBV are different.

Acquired Immunodeficiency Syndrome ; complications ; Adolescent ; Adult ; Aged ; China ; epidemiology ; Comorbidity ; Female ; Hepatitis B ; epidemiology ; Hepatitis C ; epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Transfusion Reaction