AIM: To compare the clinical manifestation of cytomegalovirus(CMV) retinitis and microvascular retinopathy(MVR) in patients with acquired immunodeficiency syndrome(AIDS) in China.METHODS: A total of 93 consecutive pat...AIM: To compare the clinical manifestation of cytomegalovirus(CMV) retinitis and microvascular retinopathy(MVR) in patients with acquired immunodeficiency syndrome(AIDS) in China.METHODS: A total of 93 consecutive patients with AIDS, including 41 cases of CMV retinitis and 52 cases of MVR were retrospectively reviewed. Highly active antiretroviral therapy(HAART) status was recorded. HIV and CMV immunoassay were also tested. CD4+ T-lymphocyte count and blood CMV-DNA test were performed in all patients. Aqueous humor CMV-DNA test was completed in 39 patients. Ophthalmological examinations including best corrected visual acuity(BCVA, by International Standard Vision Chart), intraocular pressure(IOP), slit-lamp biomicroscopy, indirect ophthalmoscopy were performed.RESULTS: In MVR group, the anterior segment examination was normal in all patients with a mean BCVA of 0.93±0.13. Blood CMV-DNA was 0(0, 269000) and 42 patients(80.77%) did not receive HAART. In CMV retinitis group, 13 patients(31.71%) had anterior segment abnormality. The mean BCVA was 0.64±0.35 and blood CMV-DNA was 3470(0, 1 450000). Nineteen patients(46.34%) had not received HAART. MVR group and CMV retinitis group the positive rates of aqueous CMV-DNA were 0 and 50%, respectively.Two patients with MVR progressed to CMV retinitis during the follow-up period.CONCLUSION: In comparison of CMV, patients with MVR have relatively mild visual function impairment. Careful ophthalmological examination and close follow-up are mandatory, especially for patients who have systemic complications, positive CMV-DNA test and without received HAART.展开更多
BACKGROUND: To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodeficiency syndrome(AIDS) complicated with drug-induced erythroderma.METHODS: The clinical data of 12 AIDS p...BACKGROUND: To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodeficiency syndrome(AIDS) complicated with drug-induced erythroderma.METHODS: The clinical data of 12 AIDS patients with drug-induced erythroderma in our hospital were retrospectively analyzed. The general information, offending medications, complications, modified severity-of-illness score for toxic epidermal necrolysis(SCORTEN) scores, and disease outcome spectrums were analyzed.RESULTS: Drug-induced erythroderma was mostly caused by antiviral drugs, antituberculosis drugs, antibiotics, traditional Chinese medicine, and immune checkpoint inhibitors. The spectrum of sensitizing drugs was broad, the clinical situation was complex, and infections were common. The affected areas were greater than 40% body surface area in all patients. The modified SCOTERN score averaged 3.01±0.99. All patients were treated with glucocorticoids, and nine patients were treated with intravenous immunoglobulin(IVIG) pulse therapy at the same time. The average time to effectiveness was 7.08±2.23 days, and the average hospital stay was 17.92±8.46 days. Eleven patients were cured, and one patient died of secondary multiple infections, who had a modified SCORTEN score of 5 points. The mortality rate in this study was 8.3%.CONCLUSIONS: The clinical situation of AIDS patients with drug-induced erythroderma in hospitalized patients is complex and the co-infection rate is high. The use of modified SCORTEN score may objectively and accurately assess the conditions, and the use of glucocorticoid combined with IVIG therapy may improve the prognosis.展开更多
BACKGROUND Human immunodeficiency virus(HIV)infection is a major global public health concern.North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa.AIM To chara...BACKGROUND Human immunodeficiency virus(HIV)infection is a major global public health concern.North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa.AIM To characterize the epidemiological and spatial trends of HIV infection in this region.METHODS A systematic review was carried out on all the published data regarding HIV/acquired immunodeficiency syndrome in North African countries over ten years(2008-2017)following the PRISMA guidelines.We performed a comprehensive literature search using Medline PubMed,Embase,regional and international databases,and country-level reports with no language restriction.The quality,quantity,and geographic coverage of the data were assessed at both the national and regional levels.We used random-effects methods,spatial variables,and stratified results by demographic factors.Only original data on the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.RESULTS A total of 721 records were identified but only 41 that met the criteria were included in the meta-analysis.There was considerable variability in the prevalence estimates of HIV within the countries of the region.The overall prevalence of HIV ranged from 0.9%[95%confidence interval(CI)0.8-1.27]to 3.8%(95%CI 1.17-6.53).The highest prevalence was associated with vulnerable groups and particularly drug abusers and sexually promiscuous individuals.The dense HIV clustering noted varied from one country to another.At least 13 HIV subtypes and recombinant forms were prevalent in the region.Subtype B was the most common variant,followed by CRF02_AG.CONCLUSION This comprehensive review indicates that HIV infection in North African countries is an increasing threat.Effective national and regional strategies are needed to improve monitoring and control of HIV transmission,with particular emphasis on geographic variability and HIV clustering.展开更多
Background:Despite almost two decades of well-funded and comprehensive response efforts by the Chinese Government,human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)remains a major problem in Chi...Background:Despite almost two decades of well-funded and comprehensive response efforts by the Chinese Government,human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)remains a major problem in China.Yet,few studies have recently examined long-term trends in HIV/AIDS prevalence,incidence,and mortality at the national level.This study aimed to determine the prevalence,incidence,and mortality trends for HIV/AIDS over the past 28 years in China.Methods:We conducted a descriptive,epidemiological,secondary analysis of the Global Burden of Diseases,Injuries,and Risk Factors Study 2017 data.To evaluate trends in prevalence,incidence,and mortality over the study period from 1990 to 2017,we calculated values for annual percentage change(APC)and corresponding 95%confidence intervals(CIs)using joinpoint regression analysis.Results:A significant increase in HIV/AIDS prevalence was observed for 1990 to 2009(APC:10.7;95%CI:10.4,11.0;P<0.001),and then remained stable for 2009 to 2017(APC:0.7;95%CI:-0.3,1.7;P=0.1).A significant increase in HIV incidence was also observed for 1990 to 2005(APC:13.0;95%CI:12.6,13.4;P<0.001),and then a significant decrease was detected for 2005 to 2017(APC:-6.5;95%CI:-7.0,-6.1;P<0.001).A significant increase in AIDS-related mortality rate was detected for 1990 to 2004(APC:10.3;95%CI:9.3,11.3;P<0.001),followed by a period of stability for 2004 to 2013(APC:1.3;95%CI:-0.7,3.3;P=0.2),and then another significant increase for 2013 to 2017(APC:15.3;95%CI:8.7,22.2;P<0.001).Conclusions:Although prevalence has stabilized and incidence has declined,AIDS-related mortality has risen sharply in recent years.These findings suggest more must be done to bring people into treatment earlier,retain them in treatment more effectively,actively seek to reenter them in treatment if they dropout,and improve the quality of treatment and care regimens.展开更多
OBJECTIVE:To investigate the effect of a treatment course of comprehensive intervention with Traditional Chinese Medicine(TCM) on the mortality of patients with acquired immunodeficiency syndrome(AIDS) treated with co...OBJECTIVE:To investigate the effect of a treatment course of comprehensive intervention with Traditional Chinese Medicine(TCM) on the mortality of patients with acquired immunodeficiency syndrome(AIDS) treated with combined antiretroviral therapy(c ART).METHODS:AIDS patients who had taken c ART in a national TCM human immunodeficiency virus treatment trial program(NTCMTP) before 2009 were enrolled in this study and followed for 36 months from November 2009.Patients enrolled in the NTCMTP in 2004 were taken as the first group,those enrolled in 2006 as the second group,and those enrolled in 2009 as the third group.Cumulative survival rates were calculated by the life table method.Survival curves for subgroups were compared by the log-rank test.Hazard ratios were calculated with a Cox proportional hazards model.RESULTS:A total of 1443 AIDS patients were followed for 3 years(4198 person-years).During this period,91(6.3%) patients died and 13(0.9%) were lost to follow-up.The total mortality rate was 2.17/100 person-years.The mortality rate of patients enrolled in the NTCMTP in 2004 was 1.49/100 person-years,which was lower than that of patients enrolled in 2006(2.23/100 person-years) and 2009(3.48/100 person-years).After adjusting for other factors,a shorter time of treatment with TCM,male sex,older age,lower CD4 + T-cell counts,and long-term treatment with c ART were risk factors of mortality.CONCLUSION:Long-term treatment with TCM decreased the mortality risk of AIDS patients.Factors such as being male,older age,CD4+ T-cell counts,and time of treatment with TCM and c ART were correlated with mortality.展开更多
OBJECTIVE:To explore the efficacy of integrating Traditional Chinese Medicine(TCM)and anti-retroviral therapy(ART),a customized combination of different classes of medications which was also called cock-tail treatment...OBJECTIVE:To explore the efficacy of integrating Traditional Chinese Medicine(TCM)and anti-retroviral therapy(ART),a customized combination of different classes of medications which was also called cock-tail treatment,on the immunological nonresponse(INR)in people living with human immunodeficiency virus(HIV)(PLWH).METHODS:Relevant literature in databases such as China National Knowledge Infrastructure Database(CNKI),Wanfang Digital Journal,Chinese Medical Journal Database(CMJD),Chinese Biomedical Literature Database(CBM),Pub Med,Cochrane,and Embase was reviewed by two independent investigators.Data were extracted from the studies according to the eligible criteria and analyzed using Review Manager 5.3.RESULTS:Nine randomized controlled trials(RCTs)with 1078 patients were analyzed.Our analyses showed that CD4 T cell counts in the treatment group improved compared with that in the control group[mean difference(MD)=13.51,95%confidence interval(CI):7.42-19.60,P<0.0001].There was no significant difference between the treated and control groups after 3 months(MD=25.31,95%CI:-2.78 to 53.41,P=0.08).However,after 6 and 12 months,the response of the treatment group was superior to the control group(MD=27.45,95%CI:7.09-47.81,P=0.008 and MD=27.34,95%CI:6.31–48.37,P=0.01,respectively).The clinical efficacy of the treatment group was also higher than that of the control group(RR=1.75,95%CI:1.16-2.65,P=0.007).However,CD45 RO and CD45 RA T cell counts did not differ significantly between the two groups(MD=12.37,95%CI:-6.71 to 31.45,P=0.20 and MD=5.67,95%CI:-3.00 to14.35,P=0.20,respectively).CONCLUSION:The combined treatment strategy of integrated TCM and Western Medicine promotes long-term reconstitution of the immune system and thus,is beneficial and has potential use for improving INR in PLWH.However,large-scale RCTs are required to provide evidence for optimal intervention strategies.展开更多
BACKGROUND Pneumocystis jirovecii pneumonia(PJP)is an infectious disease common in immunocompromised hosts.However,the currently,the clinical characteristics of non-HIV patients with PJP infection have not been fully ...BACKGROUND Pneumocystis jirovecii pneumonia(PJP)is an infectious disease common in immunocompromised hosts.However,the currently,the clinical characteristics of non-HIV patients with PJP infection have not been fully elucidated.AIM To explore efficacy of trimethoprim–sulfamethoxazole(TMP-SMX)and caspofungin for treatment of non-human immunodeficiency virus(HIV)-infected PJP patients.METHODS A retrospective study enrolled 22 patients with non-HIV-infected PJP treated with TMP-SMX and caspofungin from 2019 to 2021.Clinical manifestations,treatment and prognosis of the patients were analyzed.RESULTS Five patients presented with comorbidity of autoimmune diseases,seven with lung cancer,four with lymphoma,two with organ transplantation and four with membranous nephropathy associated with use of immunosuppressive agents.The main clinical manifestations of patients were fever,dry cough,and progressive dyspnea.All patients presented with acute onset and respiratory failure.The most common imaging manifestation was ground glass opacity around the hilar,mainly in the upper lobe.All patients were diagnosed using next-generation sequencing,and were treated with a combination of TMP-SMX and caspofungin.Among them,17 patients received short-term adjuvant glucocorticoid therapy.All patients recovered well and were discharged from hospital.CONCLUSION Non-HIV-infected PJP have rapid disease progression,high risk of respiratory failure,and high mortality.Combination of TMP-SMX and caspofungin can effectively treat severe non-HIVinfected PJP patients with respiratory failure.展开更多
Eradicating tuberculosis in human immunodeficiency virus is all the more important to realise India’s ambitious goal of tuberculosis free India by 2025.Although,continuous efforts are being made to address tuberculos...Eradicating tuberculosis in human immunodeficiency virus is all the more important to realise India’s ambitious goal of tuberculosis free India by 2025.Although,continuous efforts are being made to address tuberculosis in human immunodeficiency virus co-infection,it is imperative to closely monitor the implemented strategies,encourage and validate disease notification system in the country,and bring about societal change to view this disease as an ailment only and not as a stigma.展开更多
OBJECTIVE:To investigate the relationship between antiviral restriction factor Sterile Alpha Motif and Histidine-Aspartic acid domain-containing protein 1(SAMHD1)expression and T cell activation,furthermore,identifyin...OBJECTIVE:To investigate the relationship between antiviral restriction factor Sterile Alpha Motif and Histidine-Aspartic acid domain-containing protein 1(SAMHD1)expression and T cell activation,furthermore,identifying objective indexes of lung-spleen Qi deficiency symptom pattern.METHODS:We assessed the profile of T lymphocyte subsets,characteristics of SAMHD1 and human leukocyte antigen DR(HLA-DR)expression in lungspleen Qi deficiency patients.At the same time,people living with human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS)(PLWHA)without obvious clinical symptoms and healthy donors in this area were used as controls.RESULTS:Immunohematologic indexes lower CD4 count,lower CD4/CD8 ratio and higher SAMHD1 level were found in lung-spleen Qi deficiency patients.Furthermore,we demonstrated a positive relationship between SAMHD1 and HLA-DR level as well as with interferon factor in lung-spleen Qi deficiency syndrome and patients without obvious clinical signs and symptoms groups.CONCLUSIONS:These data indicated the positive relationship between SAMHD1 and T cell activation which further elucidated the role of SAMHD1 in cellular immune response.Furthermore,combination of T lymphocyte subsets counts and SAMHD1 level may be used as clinical and biological reference basis for the differentiation and diagnosis of HIV/AIDS traditional Chinese medicine syndromes.展开更多
Background: Primary effusion lymphoma (PEL) is a lymphoid proliferation related to Kaposi sarcoma herpesvirus 8/human herpesvirus 8 (KSHV/HHV8) that affects mainly human immunodeficiency virus (HIV) infected individua...Background: Primary effusion lymphoma (PEL) is a lymphoid proliferation related to Kaposi sarcoma herpesvirus 8/human herpesvirus 8 (KSHV/HHV8) that affects mainly human immunodeficiency virus (HIV) infected individuals but can also occur in other immunodeficiency settings. It is characterized by lymphomatous effusions in different serous body cavities without the presence of a detectable tumor mass. The diagnosis is challenging and the clinical outcomes are poor. Aim: The aim of this paper is to report a rare case of PEL in a man who have sex with women (MSW) with HIV-1/2 infection, history of visceral Kaposi sarcoma (KS) and the development of a seronegative arthritis previous to the lymphoproliferative disease diagnosis. PEL presented with ascites, was treated with high-dose chemotherapy and autologous stem cell transplantation, with a good clinical outcome. Case Presentation: We describe a case of a 48-year-old HIV-1/2-infected patient from a high HHV8 seroprevalent country, hospitalized following a three-month history of increased abdominal volume and general constitutional symptoms. Laboratory data revealed normocytic normochromic anemia and a high level of lactate dehydrogenase. A diagnostic paracentesis was performed with cytology compatible with high-grade B-cell lymphoma. Peritoneal fluid cytology showed large lymphoid cells expressing leucocyte-common antigen CD45 without expression of the CD20 antigen (B-lymphocytes) and positivity for HHV8 by immunocytochemical staining, compatible with the diagnosis of PEL.展开更多
OBJECTIVE:To evaluate the effects of the Wenshen Jianpi recipe(温肾健脾方,WJR)on immune reconstruction and natural killer(NK)cells in immunological non-responders(INRs)of people living with human immunodeficiency viru...OBJECTIVE:To evaluate the effects of the Wenshen Jianpi recipe(温肾健脾方,WJR)on immune reconstruction and natural killer(NK)cells in immunological non-responders(INRs)of people living with human immunodeficiency virus(HIV)(PLWH)and propose new therapeutic strategies for HIV.METHODS:Based on Traditional Chinese Medicine treatment principle“invigorating Qi and warming Yang in the spleen and kidneys”,WJR combined with antiretroviral therapy(ART)therapy was performed in a randomized,double-blind,placebo-controlled study of 60 patients with non-responders.The randomized process was executed by the Clinical Evaluation Center of China Academy of Chinese Medical Sciences.Sixty patients who met the inclusion criteria obtained random numbers(that is the drug number)was randomly divided into a treatment group and a placebo control group according to a 1∶1 ratio.CD4+T cell counts and natural killer(NK)cells counts were evaluated at baseline and 12-week,24-week follow-ups.RESULTS:Four participants received random numbers and did not enter the group due to the patient’s own reasons.A total of 56 patients were enrolled,including 28 in the treatment group and 28 in the control group.CD4+T cell counts in the treatment group were significantly increased at week 24(P=0.01<0.05),which were significantly higher than those in the control group(P=0.01<0.05).Although no significant differences were observed between two groups,the CD56bri CD16-NK cell counts in the treatment group were significantly increased after duration.and CD56dim CD16+NK cell counts in the treatment group were significantly higher than those in the control group after 24 weeks of treatment(P=0.025<0.05).As compared with the control group,the treatment group had significantly lower CD56neg CD16+NK cell counts after 24 weeks of treatment(P=0.023<0.05).CONCLUSIONS:WJR promotes the immune reconstruction of INRs and redistribution of NK cell subsets,notably decreasing CD56neg CD16+NK cell counts in INRs.However,the redistribution of NK cell subsets is not beneficial for immune reconstruction in INRs.Further large-scale RCTs are required to evaluate the effect of WJR on immune recovery in INRs and decipher the underlying mechanism.展开更多
Objective:In order to carry out proper education and intervention of AIDS based on different features and demands of different majors,this study aimed to compare the difference of college students from six majors in C...Objective:In order to carry out proper education and intervention of AIDS based on different features and demands of different majors,this study aimed to compare the difference of college students from six majors in China in the aspects of AIDS-related knowledge,attitudes and behaviors.Methods:A questionnaire survey was carried out among 18,644 students in 30 colleges/universities from 9 provinces of China,who were recruited through stratified cluster sampling.AIDS-related knowledge,attitude,condom-use intention,self-efficacy and sexual behavior of these students were investigated.Results:AIDS-related knowledge level of students majoring in education was the lowest while that of medical students was the highest as well as highest self-efficacy of condom use.Students of music or fine arts had the strongest intention to use condoms,while the students majoring in education had the weakest.The sexually active percentages of male students from different majors ranked as follows:music or fine arts(29.5%),minority nationality(12.2%),science&tech(10.9%),medicine(10.6%),educationmajor(10.0%),and liberal arts(8.2%).Among female students,the rank was music or fine arts(11.0%),science&tech(6.2%),education-major school(4.5%),minority nationality(4.5%),liberal arts(4.1%),and medicine(2.8%).Conclusion:It is urgent to enhance proper AIDS-related education and intervention based on the features and demands of students from different majors or universities,for example,to enhance comprehensive AIDS prevention education among students major in education and to increase behavioral skills to prevent sexually transmitted diseases among students from colleges or faculty of music or fine arts.展开更多
Objective:The overarching objective of this study was to examine the effectiveness of HIV symptom management guidelines in China in reducing the incidence and severity of symptoms and improving patients'quality of...Objective:The overarching objective of this study was to examine the effectiveness of HIV symptom management guidelines in China in reducing the incidence and severity of symptoms and improving patients'quality of life.Methods:We conducted a controlled,pre-and post-implementation design in the HIV/AIDS inpatient unit in Shanghai.Patients recruited from November 2014 to February 2015 were in the intervention group and those from October 2013 to February 2014 were in the control group.There were 74 patients in each group.Participants in the intervention group received interventions based on the HIV symptom management guidelines.Overall symptom severity,depression,and quality of life were measured in two groups at baseline,week 4,and week 8.Results:Totally 126 patients completed the research,65 in the intervention group and 61 in the control group.The total symptom severity scores showed a statistically significant difference between groups across time(P<0.05).It showed that frequencies of fatigue(36.9%vs.44.3%),fever(6.2%vs.11.5%),loss in weight(9.2%vs.16.4%),mouth ulcers(12.3%vs.16.4%),headaches(9.2%vs.19.7%)and depression(F=1.09,P>0.05)in the intervention group were lower than those in the control group in week 8 without statistical significance.The multilevel growth mixture model indicated a greater increase in the total score of quality of life for the group treated according to the symptom management guidelines(P=0.04).Conclusion:The evidence-based HIV symptom management guidelines can improve a patient's quality of life and relieve negative symptoms.The guidelines can be applied in a similar context to other HIV/AIDS units or clinics.展开更多
Aims:This study aimed to describe the adherence level to antiretroviral therapy and its associated factors among people living with HIV in Hunan province,China.Methods:Across-sectional survey study was done at two maj...Aims:This study aimed to describe the adherence level to antiretroviral therapy and its associated factors among people living with HIV in Hunan province,China.Methods:Across-sectional survey study was done at two major HIV treatment sites within Hunan province in China from July 2011 to Oct 2012 through face-to-face interviews.Adherence measures were captured using a 30-day visual analog scale(VAS).Results:A total of 418 participants consented and completed the questionnaires with the mean age being 38 years old.Based on VAS,28%of the participants had lower than 90%ART adherence level.The main reasons for missing drugs were;forgetting,being away from home,being busy and feeling worse after taking drugs.Logistic regression results showed that drug use(B=0.68,OR=2.11),time on ART(B=0.31,OR=0.72)and side effects(B=0.64,OR=1.82)were significantly associated with adherence to ART.Conclusion:Patients on ARVs in Hunan province are faced with adherence challenges notably drug abuse,drug regime scheduling challenges at the initial stages of therapy and drug side effects.It is therefore necessary to institute specific adherence interventions that target those who abuse drugs,ART naïve patients,and those experiencing side effects in order to achieve optimal ART adherence.展开更多
BACKGROUND: Antibiotics are widely given for surgical patients to prevent infection. Because of the lack of study on the rational use of antibiotics in patients with human immunodef iciency virus(HIV)-infected during ...BACKGROUND: Antibiotics are widely given for surgical patients to prevent infection. Because of the lack of study on the rational use of antibiotics in patients with human immunodef iciency virus(HIV)-infected during surgical procedures, we analyzed the risk factors affecting postoperative infectious complications in HIV-infected patients and explore the rational use of perioperative antibiotics.METHODS: This retrospective study consisted of 308 HIV-infected patients, 272 males and 36 females, who had undergone operation at the Shanghai Public Health Clinical Center from November 2008 to April 2012. The patients were divided into postoperative infection and non-infection groups. Their age and clinical variables were compared. The correlation between surgical incision, surgical site infection(SSI) and postoperative sepsis was analyzed. Prophylactic antibiotics were used for patients with type I and II incisions for less than 2 days. Patients with type III incisions were given antibiotics until the infection was controlled. Antiretroviral therapy(ART) was prescribed preoperatively for patients whose preoperative CD4 count was <350 cells/μL. For those patients whose preoperative CD4 count was <200 cells/μL, sulfamethoxazole and fluconazole were given preoperatively as prophylactic agents controlling Pneumocystis carinii pneumonia and fungal infection.RESULTS: A total of 196 patients developed postoperative infectious complications, and 7 patients died. Preoperative CD4 counts, ratio of CD4/CD8 cells, hemoglobin level, and postoperative CD4 counts, hemoglobin and albumin levels were risk factors of perioperative infection in HIV-infected patients. Patients with a preoperative CD4 count <200 cell/μL, anemia, a postoperative CD4 count <200 cell/μL or albumin levels <35 g/L were correlated with a higher rate of perioperative infection. There was a signif icant correlation between SSI and the type of surgical incision. The rate of SSI in patients with type I surgical incision was 2% and in those with type II surgical incision was 38%. All the patients who received type III surgical incision developed SSI, and they were more likely to develop postoperative sepsis.CONCLUSIONS: HIV-infected patients are more likely to develop postoperative infectious complications. The rational use of antibiotics in HIV-infected patients could help to reduce the rate of postoperative infectious complications in these patients.展开更多
Objective:The study was conducted to validate the reliability and factor structure of the Chinese version of the Readiness for Hospital Discharge Scale(RHDS-CH)for people living with HIV(PLWH).Methods:From May 2017 to...Objective:The study was conducted to validate the reliability and factor structure of the Chinese version of the Readiness for Hospital Discharge Scale(RHDS-CH)for people living with HIV(PLWH).Methods:From May 2017 to November 2017,a cross-sectional survey was performed in two AIDS inpatient departments located in two cities in Hunan,China.Reliability was evaluated by examining the internal consistency and split-half reliability of the items.A confirmatory factor analysis was performed to assess the factor structure of the RHDS-CH,and the model was revised according to the modification index.Results:Cronbach'sαfor the RHDS-CH was 0.912,and the split-half reliability of the total scale was 0.831.Initially,the results of the confirmatory factor analysis indicated that the sample did not fit this four-factor model and its 23 items well(x2/df=3,GFI=0.772,TLI=0.823,CFI=0.844,RMSEA=0.100).To improve the model fit indices,we performed model modification with the guidance of modification indices.Finally,the model fit indices showed an acceptable fit to the data(x2/df=2.141,GFI=0.844,TLI=0.899,CFI=0.915,RMSEA=0.075).Coefficients of corrected item-total correlation of the RHDS-CH ranged from 0.435 to 0.726.Conclusion:This study is the first to examine the psychometric properties of the RHDS-CH for PLWH.Our findings showed good reliability and confirmed the four-factor structure model for PLWH.展开更多
Purpose:To provide evidence support for the development of clinical practice guidelines regarding patient adherence to medication protocols used in highly active antiretroviral therapy(HAART)in China.Methods:We analyz...Purpose:To provide evidence support for the development of clinical practice guidelines regarding patient adherence to medication protocols used in highly active antiretroviral therapy(HAART)in China.Methods:We analyzed information contained in recent systematic reviews and metaanalyses regarding patient compliance with medication protocols used in HAART.Results:Nine systematic reviews and one meta-analysis were included in our study which involved three different aspects of patient compliance:influencing factors,assessment methods,and interventions.Conclusions:The high quality data obtained from our study was suitable for use in developing clinically useful guidelines for patent compliance with HAART medication protocols.展开更多
Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and h...Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4<sup>+</sup> count, CD4<sup>+</sup> percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: Of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4<sup>+</sup> count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4<sup>+</sup> count and ALT.展开更多
Introduction: In the 1990s, the development of highly active combination antiretroviral therapy in the treatment of AIDS was highlighted. The great benefit generated by the use of this treatment was the prolongation o...Introduction: In the 1990s, the development of highly active combination antiretroviral therapy in the treatment of AIDS was highlighted. The great benefit generated by the use of this treatment was the prolongation of survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Objective: To identify the prevalence of the nursing diagnosis Lack of Adherence, its defining characteristics and related factors in people living with AIDS, to investigate the association between them and the prevalence rates. Methods: Cross-sectional study with 113 patients in a hospital in northeastern Brazil. For data analysis, the test of Pearson chi-square and Fisher’s exact test were used, and also calculated the prevalence rates. Results: Lack of Adherence diagnosis was present in 69% of the sample investigated. The defining characteristics and related factors that are statistically associated with that diagnosis were: lack of adherence behavior, missing scheduled appointments, complications related to development, insufficient skills to implement the system and complex treatment system. The first two characteristics had the highest chances for the development of this diagnosis. Conclusion: The study showed that the diagnostic studied was prevalent in these patients and 3 characteristics and 2 factors showed significant association.展开更多
Parvovirus B19(B19V)infection can cause pure red cell aplasia(PRCA)in patients with human immunodeficiency virus(HIV)infection.Intravenous immunoglobulin(IVIG)is a preferred treatment option.From July 2019 to March 20...Parvovirus B19(B19V)infection can cause pure red cell aplasia(PRCA)in patients with human immunodeficiency virus(HIV)infection.Intravenous immunoglobulin(IVIG)is a preferred treatment option.From July 2019 to March 2022,four patients with HIV infection were admitted to Guangzhou Eighth People’s Hospital with dizziness and fatigue and were diagnosed with PRCA.Blood investigations revealed severe anemia and the B19V genome.Therefore,the four patients were diagnosed with B19V-induced PRCA.All four patients received red blood cell transfusion in the setting of antiretroviral therapy,and two of the four patients received intravenous immunoglobulin(IVIG).After 3-7 months of treatment,all four patients recovered,although two did not receive IVIG.This suggests that IVIG is not always necessary for the treatment of PRCA in patients with HIV infection and that effective antiretroviral therapy and immunological reconstitution play an important role in the eradication of parvovirus.展开更多
基金Supported by National Natural Science Foundation of China(No.8157089181272981)+2 种基金Beijing Natural Science Foundation(No.7151003)Capital Medical University Fundamental Clinical Research Cooperation Fund(No.16JL73)Beijing Municipal Administration of Hospitals’Ascent Plan(No.DFL20150201)
文摘AIM: To compare the clinical manifestation of cytomegalovirus(CMV) retinitis and microvascular retinopathy(MVR) in patients with acquired immunodeficiency syndrome(AIDS) in China.METHODS: A total of 93 consecutive patients with AIDS, including 41 cases of CMV retinitis and 52 cases of MVR were retrospectively reviewed. Highly active antiretroviral therapy(HAART) status was recorded. HIV and CMV immunoassay were also tested. CD4+ T-lymphocyte count and blood CMV-DNA test were performed in all patients. Aqueous humor CMV-DNA test was completed in 39 patients. Ophthalmological examinations including best corrected visual acuity(BCVA, by International Standard Vision Chart), intraocular pressure(IOP), slit-lamp biomicroscopy, indirect ophthalmoscopy were performed.RESULTS: In MVR group, the anterior segment examination was normal in all patients with a mean BCVA of 0.93±0.13. Blood CMV-DNA was 0(0, 269000) and 42 patients(80.77%) did not receive HAART. In CMV retinitis group, 13 patients(31.71%) had anterior segment abnormality. The mean BCVA was 0.64±0.35 and blood CMV-DNA was 3470(0, 1 450000). Nineteen patients(46.34%) had not received HAART. MVR group and CMV retinitis group the positive rates of aqueous CMV-DNA were 0 and 50%, respectively.Two patients with MVR progressed to CMV retinitis during the follow-up period.CONCLUSION: In comparison of CMV, patients with MVR have relatively mild visual function impairment. Careful ophthalmological examination and close follow-up are mandatory, especially for patients who have systemic complications, positive CMV-DNA test and without received HAART.
基金supported by National Natural Science Foundation of China (81972931)。
文摘BACKGROUND: To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodeficiency syndrome(AIDS) complicated with drug-induced erythroderma.METHODS: The clinical data of 12 AIDS patients with drug-induced erythroderma in our hospital were retrospectively analyzed. The general information, offending medications, complications, modified severity-of-illness score for toxic epidermal necrolysis(SCORTEN) scores, and disease outcome spectrums were analyzed.RESULTS: Drug-induced erythroderma was mostly caused by antiviral drugs, antituberculosis drugs, antibiotics, traditional Chinese medicine, and immune checkpoint inhibitors. The spectrum of sensitizing drugs was broad, the clinical situation was complex, and infections were common. The affected areas were greater than 40% body surface area in all patients. The modified SCOTERN score averaged 3.01±0.99. All patients were treated with glucocorticoids, and nine patients were treated with intravenous immunoglobulin(IVIG) pulse therapy at the same time. The average time to effectiveness was 7.08±2.23 days, and the average hospital stay was 17.92±8.46 days. Eleven patients were cured, and one patient died of secondary multiple infections, who had a modified SCORTEN score of 5 points. The mortality rate in this study was 8.3%.CONCLUSIONS: The clinical situation of AIDS patients with drug-induced erythroderma in hospitalized patients is complex and the co-infection rate is high. The use of modified SCORTEN score may objectively and accurately assess the conditions, and the use of glucocorticoid combined with IVIG therapy may improve the prognosis.
文摘BACKGROUND Human immunodeficiency virus(HIV)infection is a major global public health concern.North African countries carry a disproportionate burden of HIV representing one of the highest rates in Africa.AIM To characterize the epidemiological and spatial trends of HIV infection in this region.METHODS A systematic review was carried out on all the published data regarding HIV/acquired immunodeficiency syndrome in North African countries over ten years(2008-2017)following the PRISMA guidelines.We performed a comprehensive literature search using Medline PubMed,Embase,regional and international databases,and country-level reports with no language restriction.The quality,quantity,and geographic coverage of the data were assessed at both the national and regional levels.We used random-effects methods,spatial variables,and stratified results by demographic factors.Only original data on the prevalence of HIV infection were included and independently evaluated by professional epidemiologists.RESULTS A total of 721 records were identified but only 41 that met the criteria were included in the meta-analysis.There was considerable variability in the prevalence estimates of HIV within the countries of the region.The overall prevalence of HIV ranged from 0.9%[95%confidence interval(CI)0.8-1.27]to 3.8%(95%CI 1.17-6.53).The highest prevalence was associated with vulnerable groups and particularly drug abusers and sexually promiscuous individuals.The dense HIV clustering noted varied from one country to another.At least 13 HIV subtypes and recombinant forms were prevalent in the region.Subtype B was the most common variant,followed by CRF02_AG.CONCLUSION This comprehensive review indicates that HIV infection in North African countries is an increasing threat.Effective national and regional strategies are needed to improve monitoring and control of HIV transmission,with particular emphasis on geographic variability and HIV clustering.
基金supported by a grant from the National Health Commission of the People’s Republic of China(No.2018ZX10721102)。
文摘Background:Despite almost two decades of well-funded and comprehensive response efforts by the Chinese Government,human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS)remains a major problem in China.Yet,few studies have recently examined long-term trends in HIV/AIDS prevalence,incidence,and mortality at the national level.This study aimed to determine the prevalence,incidence,and mortality trends for HIV/AIDS over the past 28 years in China.Methods:We conducted a descriptive,epidemiological,secondary analysis of the Global Burden of Diseases,Injuries,and Risk Factors Study 2017 data.To evaluate trends in prevalence,incidence,and mortality over the study period from 1990 to 2017,we calculated values for annual percentage change(APC)and corresponding 95%confidence intervals(CIs)using joinpoint regression analysis.Results:A significant increase in HIV/AIDS prevalence was observed for 1990 to 2009(APC:10.7;95%CI:10.4,11.0;P<0.001),and then remained stable for 2009 to 2017(APC:0.7;95%CI:-0.3,1.7;P=0.1).A significant increase in HIV incidence was also observed for 1990 to 2005(APC:13.0;95%CI:12.6,13.4;P<0.001),and then a significant decrease was detected for 2005 to 2017(APC:-6.5;95%CI:-7.0,-6.1;P<0.001).A significant increase in AIDS-related mortality rate was detected for 1990 to 2004(APC:10.3;95%CI:9.3,11.3;P<0.001),followed by a period of stability for 2004 to 2013(APC:1.3;95%CI:-0.7,3.3;P=0.2),and then another significant increase for 2013 to 2017(APC:15.3;95%CI:8.7,22.2;P<0.001).Conclusions:Although prevalence has stabilized and incidence has declined,AIDS-related mortality has risen sharply in recent years.These findings suggest more must be done to bring people into treatment earlier,retain them in treatment more effectively,actively seek to reenter them in treatment if they dropout,and improve the quality of treatment and care regimens.
基金Supported by Research Project for Practice Development of National Traditional Chinese Medicine Clinical Research Bases:Evaluation of the clinical effect of Acquired Immune Deficiency Syndrome Acquired Immunodeficiency Syndrome(AIDS)patients treated with Traditional Chinese Medicine in Henan province between 2004 and 2012(No.JDZX2012035)National Special Science and Technology Program on Major Infectious Diseases(No.2013ZX10005010-001)Special of Scientific Research of Traditional Chinese Medicine of Henan Province in China(No.2015ZY02097)
文摘OBJECTIVE:To investigate the effect of a treatment course of comprehensive intervention with Traditional Chinese Medicine(TCM) on the mortality of patients with acquired immunodeficiency syndrome(AIDS) treated with combined antiretroviral therapy(c ART).METHODS:AIDS patients who had taken c ART in a national TCM human immunodeficiency virus treatment trial program(NTCMTP) before 2009 were enrolled in this study and followed for 36 months from November 2009.Patients enrolled in the NTCMTP in 2004 were taken as the first group,those enrolled in 2006 as the second group,and those enrolled in 2009 as the third group.Cumulative survival rates were calculated by the life table method.Survival curves for subgroups were compared by the log-rank test.Hazard ratios were calculated with a Cox proportional hazards model.RESULTS:A total of 1443 AIDS patients were followed for 3 years(4198 person-years).During this period,91(6.3%) patients died and 13(0.9%) were lost to follow-up.The total mortality rate was 2.17/100 person-years.The mortality rate of patients enrolled in the NTCMTP in 2004 was 1.49/100 person-years,which was lower than that of patients enrolled in 2006(2.23/100 person-years) and 2009(3.48/100 person-years).After adjusting for other factors,a shorter time of treatment with TCM,male sex,older age,lower CD4 + T-cell counts,and long-term treatment with c ART were risk factors of mortality.CONCLUSION:Long-term treatment with TCM decreased the mortality risk of AIDS patients.Factors such as being male,older age,CD4+ T-cell counts,and time of treatment with TCM and c ART were correlated with mortality.
基金Supported by National Science and Technology Major Project of China During the 13th Five-year Plan Period:New Adjuvant Strategies of Traditional Chinese Medicine on Immune Reconstruction for Long-term ART-treated People Living with HIV(No.2017ZX10205501)Study of AIDS-related Early Biomarkers for Disease Progression and Epidemic Predicting Model(No.2017ZX10201101)the Beijing Excellent Talent Plan(No.2018000021223ZK04)。
文摘OBJECTIVE:To explore the efficacy of integrating Traditional Chinese Medicine(TCM)and anti-retroviral therapy(ART),a customized combination of different classes of medications which was also called cock-tail treatment,on the immunological nonresponse(INR)in people living with human immunodeficiency virus(HIV)(PLWH).METHODS:Relevant literature in databases such as China National Knowledge Infrastructure Database(CNKI),Wanfang Digital Journal,Chinese Medical Journal Database(CMJD),Chinese Biomedical Literature Database(CBM),Pub Med,Cochrane,and Embase was reviewed by two independent investigators.Data were extracted from the studies according to the eligible criteria and analyzed using Review Manager 5.3.RESULTS:Nine randomized controlled trials(RCTs)with 1078 patients were analyzed.Our analyses showed that CD4 T cell counts in the treatment group improved compared with that in the control group[mean difference(MD)=13.51,95%confidence interval(CI):7.42-19.60,P<0.0001].There was no significant difference between the treated and control groups after 3 months(MD=25.31,95%CI:-2.78 to 53.41,P=0.08).However,after 6 and 12 months,the response of the treatment group was superior to the control group(MD=27.45,95%CI:7.09-47.81,P=0.008 and MD=27.34,95%CI:6.31–48.37,P=0.01,respectively).The clinical efficacy of the treatment group was also higher than that of the control group(RR=1.75,95%CI:1.16-2.65,P=0.007).However,CD45 RO and CD45 RA T cell counts did not differ significantly between the two groups(MD=12.37,95%CI:-6.71 to 31.45,P=0.20 and MD=5.67,95%CI:-3.00 to14.35,P=0.20,respectively).CONCLUSION:The combined treatment strategy of integrated TCM and Western Medicine promotes long-term reconstitution of the immune system and thus,is beneficial and has potential use for improving INR in PLWH.However,large-scale RCTs are required to provide evidence for optimal intervention strategies.
文摘BACKGROUND Pneumocystis jirovecii pneumonia(PJP)is an infectious disease common in immunocompromised hosts.However,the currently,the clinical characteristics of non-HIV patients with PJP infection have not been fully elucidated.AIM To explore efficacy of trimethoprim–sulfamethoxazole(TMP-SMX)and caspofungin for treatment of non-human immunodeficiency virus(HIV)-infected PJP patients.METHODS A retrospective study enrolled 22 patients with non-HIV-infected PJP treated with TMP-SMX and caspofungin from 2019 to 2021.Clinical manifestations,treatment and prognosis of the patients were analyzed.RESULTS Five patients presented with comorbidity of autoimmune diseases,seven with lung cancer,four with lymphoma,two with organ transplantation and four with membranous nephropathy associated with use of immunosuppressive agents.The main clinical manifestations of patients were fever,dry cough,and progressive dyspnea.All patients presented with acute onset and respiratory failure.The most common imaging manifestation was ground glass opacity around the hilar,mainly in the upper lobe.All patients were diagnosed using next-generation sequencing,and were treated with a combination of TMP-SMX and caspofungin.Among them,17 patients received short-term adjuvant glucocorticoid therapy.All patients recovered well and were discharged from hospital.CONCLUSION Non-HIV-infected PJP have rapid disease progression,high risk of respiratory failure,and high mortality.Combination of TMP-SMX and caspofungin can effectively treat severe non-HIVinfected PJP patients with respiratory failure.
文摘Eradicating tuberculosis in human immunodeficiency virus is all the more important to realise India’s ambitious goal of tuberculosis free India by 2025.Although,continuous efforts are being made to address tuberculosis in human immunodeficiency virus co-infection,it is imperative to closely monitor the implemented strategies,encourage and validate disease notification system in the country,and bring about societal change to view this disease as an ailment only and not as a stigma.
基金Supported by the National Natural Science Foundation of China(Construction of HIV Pseudovirus Infected Cell Model and Application of Yiaikang in the Study of T Cell Immune Response,No.82004207)the National Special Science and Technology Program on Major Infectious Diseases(Study on the Scheme of TCM to Reduce the Incidence of Adverse Reactions to AIDS Antiviral Therapy,No.2017ZX10205502002+6 种基金Study on the Scheme of TCM to Reduce the Incidence of AIDS Opportunistic Infection,No.2017ZX10205502003)the Science and Technology Tackling Plan of Henan Province(Exploring the Activation Mechanism of Yiaikang on CD8+T Lymphocytes in HIV/AIDS Patients based on STING/SAMHD1 Pathway,No.202102310178Regulation of HIV/AIDS Treg CellDerived Exosomeso on Activation of CD4+T Cells and the Intervention of Yiaikang,No.212102311126)Subject Construction Project of Henan Characteristic Backbone Subject of TCM of Henan University of TCM(Deep Sequencing/Molecular Docking/Gene Editing Network System to Analyze The Mechanism of TCM Regulating the Immune Function of HIV Patients,No.STG-ZYXKY-2020029)Henan Province TCM Research Project(Explore the Mechanism of Yiaikang in the Treatment of AIDS Immunity Based on HIV gag-CTL Response,No.2018JDZX106,2019AZB003Study on TCM Treatment of Aged AIDS,No.20-21ZYZD03)Key Scientific Research Projects of Colleges and Universities in Henan Province(to Explore the Regulation Mechanism of Yiaikang on AIDS Lung Qi Deficiency Syndrome from TGF-β/Smad/ID,No.20A360010)
文摘OBJECTIVE:To investigate the relationship between antiviral restriction factor Sterile Alpha Motif and Histidine-Aspartic acid domain-containing protein 1(SAMHD1)expression and T cell activation,furthermore,identifying objective indexes of lung-spleen Qi deficiency symptom pattern.METHODS:We assessed the profile of T lymphocyte subsets,characteristics of SAMHD1 and human leukocyte antigen DR(HLA-DR)expression in lungspleen Qi deficiency patients.At the same time,people living with human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS)(PLWHA)without obvious clinical symptoms and healthy donors in this area were used as controls.RESULTS:Immunohematologic indexes lower CD4 count,lower CD4/CD8 ratio and higher SAMHD1 level were found in lung-spleen Qi deficiency patients.Furthermore,we demonstrated a positive relationship between SAMHD1 and HLA-DR level as well as with interferon factor in lung-spleen Qi deficiency syndrome and patients without obvious clinical signs and symptoms groups.CONCLUSIONS:These data indicated the positive relationship between SAMHD1 and T cell activation which further elucidated the role of SAMHD1 in cellular immune response.Furthermore,combination of T lymphocyte subsets counts and SAMHD1 level may be used as clinical and biological reference basis for the differentiation and diagnosis of HIV/AIDS traditional Chinese medicine syndromes.
文摘Background: Primary effusion lymphoma (PEL) is a lymphoid proliferation related to Kaposi sarcoma herpesvirus 8/human herpesvirus 8 (KSHV/HHV8) that affects mainly human immunodeficiency virus (HIV) infected individuals but can also occur in other immunodeficiency settings. It is characterized by lymphomatous effusions in different serous body cavities without the presence of a detectable tumor mass. The diagnosis is challenging and the clinical outcomes are poor. Aim: The aim of this paper is to report a rare case of PEL in a man who have sex with women (MSW) with HIV-1/2 infection, history of visceral Kaposi sarcoma (KS) and the development of a seronegative arthritis previous to the lymphoproliferative disease diagnosis. PEL presented with ascites, was treated with high-dose chemotherapy and autologous stem cell transplantation, with a good clinical outcome. Case Presentation: We describe a case of a 48-year-old HIV-1/2-infected patient from a high HHV8 seroprevalent country, hospitalized following a three-month history of increased abdominal volume and general constitutional symptoms. Laboratory data revealed normocytic normochromic anemia and a high level of lactate dehydrogenase. A diagnostic paracentesis was performed with cytology compatible with high-grade B-cell lymphoma. Peritoneal fluid cytology showed large lymphoid cells expressing leucocyte-common antigen CD45 without expression of the CD20 antigen (B-lymphocytes) and positivity for HHV8 by immunocytochemical staining, compatible with the diagnosis of PEL.
基金Supported by National Science and Technology Major Project of China During the 13th Five-year Plan Period:New Adjuvant Strategies of Traditional Chinese Medicine on Immune Reconstruction for Longterm ART-treated People Living with HIV(2017ZX10205501)Effects of Traditional Chinese Medicine on Intestinal Bacterial Community Structure of AIDS Patients(2017ZX10205501-001-010)National Natural Science Foundation of China:Immune Mechanism of Immunological Non-responders of HIV/AIDS Treated with Traditional Chinese Medicine from Immune Activation and Toll like Receptor Signal Pathway(No.81503571)。
文摘OBJECTIVE:To evaluate the effects of the Wenshen Jianpi recipe(温肾健脾方,WJR)on immune reconstruction and natural killer(NK)cells in immunological non-responders(INRs)of people living with human immunodeficiency virus(HIV)(PLWH)and propose new therapeutic strategies for HIV.METHODS:Based on Traditional Chinese Medicine treatment principle“invigorating Qi and warming Yang in the spleen and kidneys”,WJR combined with antiretroviral therapy(ART)therapy was performed in a randomized,double-blind,placebo-controlled study of 60 patients with non-responders.The randomized process was executed by the Clinical Evaluation Center of China Academy of Chinese Medical Sciences.Sixty patients who met the inclusion criteria obtained random numbers(that is the drug number)was randomly divided into a treatment group and a placebo control group according to a 1∶1 ratio.CD4+T cell counts and natural killer(NK)cells counts were evaluated at baseline and 12-week,24-week follow-ups.RESULTS:Four participants received random numbers and did not enter the group due to the patient’s own reasons.A total of 56 patients were enrolled,including 28 in the treatment group and 28 in the control group.CD4+T cell counts in the treatment group were significantly increased at week 24(P=0.01<0.05),which were significantly higher than those in the control group(P=0.01<0.05).Although no significant differences were observed between two groups,the CD56bri CD16-NK cell counts in the treatment group were significantly increased after duration.and CD56dim CD16+NK cell counts in the treatment group were significantly higher than those in the control group after 24 weeks of treatment(P=0.025<0.05).As compared with the control group,the treatment group had significantly lower CD56neg CD16+NK cell counts after 24 weeks of treatment(P=0.023<0.05).CONCLUSIONS:WJR promotes the immune reconstruction of INRs and redistribution of NK cell subsets,notably decreasing CD56neg CD16+NK cell counts in INRs.However,the redistribution of NK cell subsets is not beneficial for immune reconstruction in INRs.Further large-scale RCTs are required to evaluate the effect of WJR on immune recovery in INRs and decipher the underlying mechanism.
文摘Objective:In order to carry out proper education and intervention of AIDS based on different features and demands of different majors,this study aimed to compare the difference of college students from six majors in China in the aspects of AIDS-related knowledge,attitudes and behaviors.Methods:A questionnaire survey was carried out among 18,644 students in 30 colleges/universities from 9 provinces of China,who were recruited through stratified cluster sampling.AIDS-related knowledge,attitude,condom-use intention,self-efficacy and sexual behavior of these students were investigated.Results:AIDS-related knowledge level of students majoring in education was the lowest while that of medical students was the highest as well as highest self-efficacy of condom use.Students of music or fine arts had the strongest intention to use condoms,while the students majoring in education had the weakest.The sexually active percentages of male students from different majors ranked as follows:music or fine arts(29.5%),minority nationality(12.2%),science&tech(10.9%),medicine(10.6%),educationmajor(10.0%),and liberal arts(8.2%).Among female students,the rank was music or fine arts(11.0%),science&tech(6.2%),education-major school(4.5%),minority nationality(4.5%),liberal arts(4.1%),and medicine(2.8%).Conclusion:It is urgent to enhance proper AIDS-related education and intervention based on the features and demands of students from different majors or universities,for example,to enhance comprehensive AIDS prevention education among students major in education and to increase behavioral skills to prevent sexually transmitted diseases among students from colleges or faculty of music or fine arts.
基金This project was funded by National Natural Science Foundation of China(Grant No.71673057)
文摘Objective:The overarching objective of this study was to examine the effectiveness of HIV symptom management guidelines in China in reducing the incidence and severity of symptoms and improving patients'quality of life.Methods:We conducted a controlled,pre-and post-implementation design in the HIV/AIDS inpatient unit in Shanghai.Patients recruited from November 2014 to February 2015 were in the intervention group and those from October 2013 to February 2014 were in the control group.There were 74 patients in each group.Participants in the intervention group received interventions based on the HIV symptom management guidelines.Overall symptom severity,depression,and quality of life were measured in two groups at baseline,week 4,and week 8.Results:Totally 126 patients completed the research,65 in the intervention group and 61 in the control group.The total symptom severity scores showed a statistically significant difference between groups across time(P<0.05).It showed that frequencies of fatigue(36.9%vs.44.3%),fever(6.2%vs.11.5%),loss in weight(9.2%vs.16.4%),mouth ulcers(12.3%vs.16.4%),headaches(9.2%vs.19.7%)and depression(F=1.09,P>0.05)in the intervention group were lower than those in the control group in week 8 without statistical significance.The multilevel growth mixture model indicated a greater increase in the total score of quality of life for the group treated according to the symptom management guidelines(P=0.04).Conclusion:The evidence-based HIV symptom management guidelines can improve a patient's quality of life and relieve negative symptoms.The guidelines can be applied in a similar context to other HIV/AIDS units or clinics.
文摘Aims:This study aimed to describe the adherence level to antiretroviral therapy and its associated factors among people living with HIV in Hunan province,China.Methods:Across-sectional survey study was done at two major HIV treatment sites within Hunan province in China from July 2011 to Oct 2012 through face-to-face interviews.Adherence measures were captured using a 30-day visual analog scale(VAS).Results:A total of 418 participants consented and completed the questionnaires with the mean age being 38 years old.Based on VAS,28%of the participants had lower than 90%ART adherence level.The main reasons for missing drugs were;forgetting,being away from home,being busy and feeling worse after taking drugs.Logistic regression results showed that drug use(B=0.68,OR=2.11),time on ART(B=0.31,OR=0.72)and side effects(B=0.64,OR=1.82)were significantly associated with adherence to ART.Conclusion:Patients on ARVs in Hunan province are faced with adherence challenges notably drug abuse,drug regime scheduling challenges at the initial stages of therapy and drug side effects.It is therefore necessary to institute specific adherence interventions that target those who abuse drugs,ART naïve patients,and those experiencing side effects in order to achieve optimal ART adherence.
基金supported by grants from the National Science Foundation of ChinaShanghai Pasteur Foundation+1 种基金Shanghai "Rising Star" program(10QA1407900)Novo Nordisk Chinese Academy of Sciences Foundation
文摘BACKGROUND: Antibiotics are widely given for surgical patients to prevent infection. Because of the lack of study on the rational use of antibiotics in patients with human immunodef iciency virus(HIV)-infected during surgical procedures, we analyzed the risk factors affecting postoperative infectious complications in HIV-infected patients and explore the rational use of perioperative antibiotics.METHODS: This retrospective study consisted of 308 HIV-infected patients, 272 males and 36 females, who had undergone operation at the Shanghai Public Health Clinical Center from November 2008 to April 2012. The patients were divided into postoperative infection and non-infection groups. Their age and clinical variables were compared. The correlation between surgical incision, surgical site infection(SSI) and postoperative sepsis was analyzed. Prophylactic antibiotics were used for patients with type I and II incisions for less than 2 days. Patients with type III incisions were given antibiotics until the infection was controlled. Antiretroviral therapy(ART) was prescribed preoperatively for patients whose preoperative CD4 count was <350 cells/μL. For those patients whose preoperative CD4 count was <200 cells/μL, sulfamethoxazole and fluconazole were given preoperatively as prophylactic agents controlling Pneumocystis carinii pneumonia and fungal infection.RESULTS: A total of 196 patients developed postoperative infectious complications, and 7 patients died. Preoperative CD4 counts, ratio of CD4/CD8 cells, hemoglobin level, and postoperative CD4 counts, hemoglobin and albumin levels were risk factors of perioperative infection in HIV-infected patients. Patients with a preoperative CD4 count <200 cell/μL, anemia, a postoperative CD4 count <200 cell/μL or albumin levels <35 g/L were correlated with a higher rate of perioperative infection. There was a signif icant correlation between SSI and the type of surgical incision. The rate of SSI in patients with type I surgical incision was 2% and in those with type II surgical incision was 38%. All the patients who received type III surgical incision developed SSI, and they were more likely to develop postoperative sepsis.CONCLUSIONS: HIV-infected patients are more likely to develop postoperative infectious complications. The rational use of antibiotics in HIV-infected patients could help to reduce the rate of postoperative infectious complications in these patients.
基金the Hunan Key Laboratory Platform for Nursing(2017TP1004).
文摘Objective:The study was conducted to validate the reliability and factor structure of the Chinese version of the Readiness for Hospital Discharge Scale(RHDS-CH)for people living with HIV(PLWH).Methods:From May 2017 to November 2017,a cross-sectional survey was performed in two AIDS inpatient departments located in two cities in Hunan,China.Reliability was evaluated by examining the internal consistency and split-half reliability of the items.A confirmatory factor analysis was performed to assess the factor structure of the RHDS-CH,and the model was revised according to the modification index.Results:Cronbach'sαfor the RHDS-CH was 0.912,and the split-half reliability of the total scale was 0.831.Initially,the results of the confirmatory factor analysis indicated that the sample did not fit this four-factor model and its 23 items well(x2/df=3,GFI=0.772,TLI=0.823,CFI=0.844,RMSEA=0.100).To improve the model fit indices,we performed model modification with the guidance of modification indices.Finally,the model fit indices showed an acceptable fit to the data(x2/df=2.141,GFI=0.844,TLI=0.899,CFI=0.915,RMSEA=0.075).Coefficients of corrected item-total correlation of the RHDS-CH ranged from 0.435 to 0.726.Conclusion:This study is the first to examine the psychometric properties of the RHDS-CH for PLWH.Our findings showed good reliability and confirmed the four-factor structure model for PLWH.
基金We would like to thank the Shanghai Municipal Health Bureau for the funding,number GWⅢ-13-11.
文摘Purpose:To provide evidence support for the development of clinical practice guidelines regarding patient adherence to medication protocols used in highly active antiretroviral therapy(HAART)in China.Methods:We analyzed information contained in recent systematic reviews and metaanalyses regarding patient compliance with medication protocols used in HAART.Results:Nine systematic reviews and one meta-analysis were included in our study which involved three different aspects of patient compliance:influencing factors,assessment methods,and interventions.Conclusions:The high quality data obtained from our study was suitable for use in developing clinically useful guidelines for patent compliance with HAART medication protocols.
文摘Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4<sup>+</sup> count, CD4<sup>+</sup> percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: Of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4<sup>+</sup> count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4<sup>+</sup> count and ALT.
文摘Introduction: In the 1990s, the development of highly active combination antiretroviral therapy in the treatment of AIDS was highlighted. The great benefit generated by the use of this treatment was the prolongation of survival of the people who got this disease, since it is no longer considered fatal, becoming a chronic condition. Objective: To identify the prevalence of the nursing diagnosis Lack of Adherence, its defining characteristics and related factors in people living with AIDS, to investigate the association between them and the prevalence rates. Methods: Cross-sectional study with 113 patients in a hospital in northeastern Brazil. For data analysis, the test of Pearson chi-square and Fisher’s exact test were used, and also calculated the prevalence rates. Results: Lack of Adherence diagnosis was present in 69% of the sample investigated. The defining characteristics and related factors that are statistically associated with that diagnosis were: lack of adherence behavior, missing scheduled appointments, complications related to development, insufficient skills to implement the system and complex treatment system. The first two characteristics had the highest chances for the development of this diagnosis. Conclusion: The study showed that the diagnostic studied was prevalent in these patients and 3 characteristics and 2 factors showed significant association.
基金Guangzhou Basic Research Program on People’s Livelihood Science and Technology(202002020005)National Natural Science Foundation of China(82072265)+1 种基金Technology Planning Project of Guangdong Province(2021B1212040017)Sun Yat-sen University Founded Program(2022_76220_B21127)。
文摘Parvovirus B19(B19V)infection can cause pure red cell aplasia(PRCA)in patients with human immunodeficiency virus(HIV)infection.Intravenous immunoglobulin(IVIG)is a preferred treatment option.From July 2019 to March 2022,four patients with HIV infection were admitted to Guangzhou Eighth People’s Hospital with dizziness and fatigue and were diagnosed with PRCA.Blood investigations revealed severe anemia and the B19V genome.Therefore,the four patients were diagnosed with B19V-induced PRCA.All four patients received red blood cell transfusion in the setting of antiretroviral therapy,and two of the four patients received intravenous immunoglobulin(IVIG).After 3-7 months of treatment,all four patients recovered,although two did not receive IVIG.This suggests that IVIG is not always necessary for the treatment of PRCA in patients with HIV infection and that effective antiretroviral therapy and immunological reconstitution play an important role in the eradication of parvovirus.
