RESUMEN
This study aims to evaluate the epidemiological characteristics of mother-to-child transmission (MTCT) of HIV and identify the possible factors leading to infant HIV infection using a retrospective cohort study of early infant diagnosis (EID). Information on a total of 3,145 exposed infant-mother pairs was collected from the EID platform from July 2014 to December 2019. The MTCT rate was 2.1%. Spatial-temporal maps showed that rates varied by year and by region, with four districts (Baise, Guigang, Guilin, and Hechi) maintaining rates of >2.0% in 2019. The rate of antiretroviral therapy (ART) use was 94.4%, with a gradual increase in prescriptions of highly active ART (HAART) from 83.0% in 2014 to 92.4% in 2019. A majority of 99.5% of infants were receiving artificial feeding. Factors associated with MTCT were ART use (odds ratio [OR] = 0.065, confidence interval [95% CI] = 0.035-0.121) and artificial feeding (OR = 0.091, 95% CI = 0.018-0.452). HAART was more helpful in decreasing the risk of MTCT compared with monotherapy (OR = 0.115, 95% CI = 0.014-0.933). ART during the postpartum period correlated with an increased risk (OR = 11.579, 95% CI = 1.402-95.960) compared with use of ART during pregnancy. This study indicates that MTCT rate of HIV is decreasing meaningfully in Guangxi. Some areas still face challenges in elimination of MTCT and need further resources and interventions. Future program planning should take into consideration the fact that ART use-in particular the use of HAART or ART during pregnancy-and replacement feeding may contribute to the prevention of MTCT.
Asunto(s)
Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Adulto , Antirretrovirales/uso terapéutico , Lactancia Materna/estadística & datos numéricos , China/epidemiología , Diagnóstico Precoz , Femenino , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Humanos , Lactante , Salud del Lactante , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Masculino , Madres , Periodo Posparto , Estudios Retrospectivos , Factores de Riesgo , Análisis Espacio-TemporalAsunto(s)
Portador Sano/epidemiología , Laboratorios/estadística & datos numéricos , Mycobacterium tuberculosis/aislamiento & purificación , Vigilancia de la Población , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Adolescente , Antituberculosos/uso terapéutico , Portador Sano/microbiología , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Lactante , Masculino , Mycobacterium tuberculosis/efectos de los fármacos , Prevalencia , Estudios Retrospectivos , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis Resistente a Múltiples Medicamentos/microbiologíaRESUMEN
Genetic studies on the association of the killer immunoglobulin-like receptor (KIR) genes with HIV-1 infection and disease progression have been widely carried out with somewhat contradictory results. Therefore, we undertook a quantitative assessment based on 25 studies [involving 3,216 HIV-1 infected subjects, 1,690 exposed uninfected subjects, 1,262 healthy controls (HCs), 748 typical progressors (TPs), and 244 long-term nonprogressors (LTNPs)] to further define the roles of KIR in HIV-1 control/susceptibility. An overall analysis, showed that, among the 16 KIR genes, the presence of KIR2DS4 may associate with an elevated risk of HIV-1 infection (p < .05, using HCs), whereas KIR3DS1 may associate with a reduced risk (p < .001, using HCs). In the subgroup analyses, among Africans, KIR2DS4 also revealed a significant risk of HIV-1 infection (p < .05), whereas KIR2DL2, 2DL5, and 2DS3 conferred a protective role (p < .05). KIR2DL2 and 3DL1 showed an increased risk of acquiring infection among Caucasians (p < .05). A negative effect on susceptibility to infection for KIR2DL1, 2DL3, and 3DS1 was found among East Asians. 3DS1 conferred a protective effect of HIV-1 infection among serodiscordant couples (p < .05). Moreover, among Chinese, KIR2DL3 was significantly lower in frequency in TPs when compared with LTNPs (p < .05), indicating a possible role in the delay of disease progression. This meta-analysis supports the individual studies that associate specific KIR genes with HIV-1 infection and disease progression and further emphasizes that this outcome differs according to specific populations.
Asunto(s)
Infecciones por VIH/genética , VIH-1 , Receptores KIR/genética , Progresión de la Enfermedad , Etnicidad/genética , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Genotipo , Salud Global , Infecciones por VIH/epidemiología , Infecciones por VIH/inmunología , Infecciones por VIH/transmisión , Humanos , Polimorfismo Genético , Sesgo de Publicación , Grupos Raciales/genética , RiesgoRESUMEN
Various studies have investigated the risk of recurrent spontaneous abortion (RSA) with plasminogen activator inhibitor-1 ( PAI-1) 4G/5G polymorphism. However, the results have been somewhat contradictory. Therefore, an updated meta-analysis based on 31 studies (5617 cases and 3952 controls) was undertaken to clarify this relationship. The degree of RSA risk was estimated using the odds ratio (OR) and the 95% confidence interval (CI). Overall, the random effects OR was 1.464 (95% CI: 1.269-1.690) for 4G versus 5G, 2.075 (95% CI: 1.563-2.754) for 4G/4G versus 5G/5G, 1.457 (95% CI: 1.211-1.753) for 4G/5G versus 5G/5G, 1.743 (95% CI: 1.358-2.236) for 4G/4G versus 4G/5G + 5G/5G, and 1.600 (95% CI: 1.327-1.930) for 4G/4G + 4G/5G versus 5G/5G, indicating that PAI-1 4G/5G polymorphism could confer an increased risk of RSA. Furthermore, a subgroup analysis showed a significantly elevated susceptibility to RSA in Asians, Caucasians, and Africans. Thus, this study demonstrated that PAI-1 4G/5G polymorphism likely confers a genetic contribution to the development of RSA. The results may aid in developing a theoretical basis for effective strategies to prevent and treat RSA.
Asunto(s)
Aborto Habitual/genética , Predisposición Genética a la Enfermedad/genética , Inhibidor 1 de Activador Plasminogénico/genética , Polimorfismo Genético/genética , Aborto Habitual/diagnóstico , Aborto Habitual/epidemiología , Femenino , Marcadores Genéticos/genética , Predisposición Genética a la Enfermedad/epidemiología , Humanos , EmbarazoRESUMEN
BACKGROUND: Interferon-gamma release assays have not been validated in active TB among pregnant women. Therefore, the objective of this retrospective study was to estimate the diagnostic value of T-SPOT.TB in active TB among pregnant women. MATERIAL/METHODS: Between May 2012 and May 2015, 26 consecutive pregnant women with suspected TB were enrolled in our study. The clinicopathological characteristics and T-SPOT.TB results were reviewed and analyzed. RESULTS: Pregnant patients were divided into a TB group (n=21) and a Non-TB group (n=5). In the TB group, 5 patients had pulmonary TB, 5 had pulmonary TB+ extrapulmonary TB, and 11 had exclusively extrapulmonary TB. The most common site of extrapulmonary TB was pleural (n=11). Statistical analysis showed that the lymphocyte count in the TB group was lower than in the Non-TB group (P<0.05). For detection of active TB during pregnancy, T-SPOT.TB had a high sensitivity of 100.0% (84.5%-100.0%) and a specificity of 80.0% (37.6-96.4%). CONCLUSIONS: T-SPOT.TB shows good performance in detection of active tuberculosis during pregnancy. Interferon gamma release assay for TB screening of pregnant women is recommended in clinical practice because it may be a more appropriate diagnostic tool than the tuberculin skin test.
Asunto(s)
Ensayos de Liberación de Interferón gamma , Complicaciones Infecciosas del Embarazo/diagnóstico , Prueba de Tuberculina , Tuberculosis/diagnóstico , Adulto , China , Femenino , Humanos , Recuento de Linfocitos , Mycobacterium tuberculosis , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Estudios Retrospectivos , Sensibilidad y Especificidad , Tuberculosis/sangre , Tuberculosis/complicacionesRESUMEN
The retrospective study aimed to evaluate the diagnostic value of bronchial brushing and sputum using acid fast bacilli smear, mycobacterial culture and real-time PCR in detection of pediatric pulmonary tuberculosis, sensitivity and specificity of bronchial brushing and sputum examined by the three methods were calculated and compared to each other. Data showed there were no significant difference in sensitivity between bronchial brushing and matched sputum using each method. But the specificity of real-time PCR on bronchial brushing was lower than on sputum. Compared with bronchial brushing, sputum was better specimen in detection of pediatric pulmonary tuberculosis.
Asunto(s)
Broncoscopía , Esputo/microbiología , Tuberculosis Pulmonar/diagnóstico , Adolescente , Niño , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
Glycoproteomics is an important aspect in the research of cancer biomarker discovery. The objective of our study is to screen the profile of serum glycoproteins in hepatocellular carcinoma (HCC) patients and to discover differentially expressed glycoproteins in HCC with or without metastasis. We collected serum from HCC patients and divided them into two groups (non-metastatic HCC group and metastatic HCC group) according to 2002 UICC TNM staging system. Wheat germ agglutinin (WGA) lectin was used to enrich the serum glycoproteins by lectin affinity chromatography. The enriched glycoproteins were labeled with mass-balanced isobaric tags (iTRAQ) and analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Two differential glycoproteins were validated by Western blot and biochemical methods, respectively. Fifteen differential serum glycoproteins with WGA affinity were identified (p < 0.05). Among them, nine proteins were up-regulated (>1.5-folds) and six were down-regulated (<0.5-folds) in HCC patients with metastasis. Expression of alpha-1-antitrypsin (SERPINA1) and apolipoprotein A-I (APOA1) was validated by Western blot and biochemical methods, respectively (p < 0.05). Our study has obtained a set of HCC metastasis-associated glycoproteins which may serve as novel prognostic candidates and potential therapeutic targets for HCC metastasis. SERPINA1 might act as a potential glycoprotein biomarker of HCC metastasis.
Asunto(s)
Carcinoma Hepatocelular/sangre , Glicoproteínas/sangre , Ensayos Analíticos de Alto Rendimiento/métodos , Neoplasias Hepáticas/sangre , Biomarcadores de Tumor/sangre , Western Blotting , Cromatografía Liquida , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Espectrometría de Masas en TándemRESUMEN
Aberrant glycan structure of serum glycoproteins creates unique patterns in different stages of hepatocellular carcinoma (HCC), which provides potential glycan biomarkers for early diagnosis of HCC. In this study, tandem lectin affinity chromatography using aleuria aurantia lectin (AAL) and wheat germ agglutinin (WGA) was processed to purify both fucosylated and sialylated serum glycoproteins from 27 liver cirrhosis (LC) and 27 early HCC patients, in which 122 glycoproteins were finally screened out by liquid chromatography-tandem mass spectrometry (LC-MSMS). Among the 122 proteins identified by LC-MSMS, 8 of them were only identified in HCC serum and another 6 existed only in LC serum. Serum paraoxonase 1 (PON1) was immunoprecipitated from 47 individual patients and blotted by lectins, showing enhanced fucosylation and sialylation in HCC serum than those in LC serum. The area under the ROC curve (AUROC) for AAL-reactive PON1 was 0.892 with a sensitivity of 71.4% and a specificity of 94.7% in differentiating early HCC from LC. Similarly, WGA-reactive PON1 had an AUROC of 0.902 with a sensitivity of 95.2% and a specificity of 78.9%. The data indicated that the glycan differences of serum PON1 might serve as potential glycan biomarkers for distinguishing early HCC from LC patients.
Asunto(s)
Arildialquilfosfatasa/sangre , Carcinoma Hepatocelular/diagnóstico , Glicoproteínas/sangre , Cirrosis Hepática/diagnóstico , Neoplasias Hepáticas/diagnóstico , Adulto , Arildialquilfosfatasa/metabolismo , Biomarcadores de Tumor/sangre , Biomarcadores de Tumor/metabolismo , Western Blotting , Carcinoma Hepatocelular/sangre , Carcinoma Hepatocelular/enzimología , Cromatografía Liquida , Diagnóstico Diferencial , Diagnóstico Precoz , Femenino , Fucosa/metabolismo , Glicoproteínas/metabolismo , Humanos , Cirrosis Hepática/sangre , Cirrosis Hepática/enzimología , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/enzimología , Masculino , Persona de Mediana Edad , Ácido N-Acetilneuramínico/metabolismo , Curva ROC , Espectrometría de Masas en TándemRESUMEN
BACKGROUND: Non-invasive nasopharyngeal carcinoma (NPC) screening usually involves serological testing for the presence of IgA antibodies to Epstein-Barr virus (EBV) capsid antigen (VCA). The present meta-analysis determined the accuracy of VCA-IgA in the diagnosis of NPC. METHODS: A systematic review of studies was conducted and data on the accuracy of VCA-IgA concentrations in the diagnosis of NPC were pooled using random effects models. Receiver operating characteristic curves were used to summarize the overall test performance. RESULTS: Twenty studies met the inclusion criteria for the meta-analysis. The summary estimates for VCA-IgA in the diagnosis of NPC were: sensitivity 0.91 (95% confidence interval (CI): 0.90 - 0.92), specificity 0.92 (95%CI: 0.92 - 0.93), positive likelihood ratio 31.65 (95%CI: 10.99 - 91.15), negative likelihood ratio 0.10 (95%CI: 0.07 - 0.13) and diagnostic odds ratio 414.59 (95%CI: 174.96 - 982.42). The area under the summary receiver operating characteristic curves was 0.98. CONCLUSION: The sensitivity and the specificity of serum VCA-IgA are very high, suggesting that the presence of VCA-IgA in peripheral blood is a valuable predictor for NPC.