The risk of dyslipidemia on PLHIV associated with different antiretroviral regimens in Huzhou.

BACKGROUND: Dyslipidemia is increasingly common in people living with HIV (PLHIV), thereby increasing the risk of cardiovascular events and diminishing the quality of life for these individuals. The study of blood lipid metabolism of PLHIV has great clinical significance in predicting the risk of cardiovascular disease. Therefore, this study aims to examine the blood lipid metabolism status of HIV-infected patients in Huzhou before and after receiving highly active antiretroviral therapy (HAART) and to explore the impact of different HAART regimens on dyslipidemia. METHOD: PLHIV confirmed in Huzhou from June 2010 to June 2022 was included. The baseline characteristics and clinical data during the follow-up period were collected, including some blood lipid indicators (total cholesterol and triglycerides) and HAART regimens. A multivariate logistic regression model and the generalized estimating equation model were used to analyze the independent effects of treatment regimens on the risk of dyslipidemia. RESULT: The overall prevalence of dyslipidemia among PLHIV after HAART was 70.11%. PLHIV receiving lamivudine (3TC) + efavirenz (EFV) + zidovudine (AZT) had a higher prevalence of dyslipidemia compared to those receiving 3TC+EFV+tenofovir disoproxil fumarate (TDF). In a logistic analysis adjusted for important covariates such as BMI, age, diabetes status, etc., we found that the risks of dyslipidemia were higher with 3TC+EFV+AZT (dyslipidemia: odds ratio [OR] = 2.09, 95% confidence interval [Cl]: 1.28-3.41; TG ≥1.7: OR = 2.40, 95%Cl:1.50-3.84) than with 3TC+EFV+TDF. Furthermore, on PLHIV that was matched 1:1 by the HAART regimens, the results of the generalized estimation equation again showed that 3TC+EFV+AZT (TG ≥1.7: OR = 1.84, 95%Cl: 1.10-3.07) is higher for the risk of marginal elevations of TG than 3TC+EFV+TDF. CONCLUSION: The prevalence of dyslipidemia varies according to different antiretroviral regimens. Using both horizontal and longitudinal data, we have repeatedly demonstrated that AZT has a more adverse effect on blood lipids than TDF from two perspectives. Therefore, we recommend caution in using the 3TC+EFV+AZT regimen for people at clinical risk of co-occurring cardiovascular disease.

Analysis of the immunological response to antiviral therapy in patients with different subtypes of HIV/AIDS: a retrospective cohort study.

OBJECTIVE: To evaluate the effectiveness of standardised antiretroviral therapy (ART) among different HIV subtypes in people living with HIV/AIDS (PLWHA), and to screen the best ART regimen for this patient population. DESIGN: A retrospective cohort study was performed, and PLWHA residing in Huzhou, China, between 2018 and 2020, were enrolled. SETTING AND PARTICIPANTS: Data from 625 patients, who were newly diagnosed with HIV/AIDS in the AIDS Prevention and Control Information System in Huzhou between 2018 and 2020, were reviewed. ANALYSIS AND OUTCOME MEASURES: Data regarding demographic characteristics and laboratory investigation results were collected. Immune system recovery was used to assess the effectiveness of ART, and an increased percentage of CD4+ T lymphocyte counts >30% after receiving ART for >1 year was determined as immunopositive. A multiple logistic regression model was used to comprehensively quantify the association between PLWHA immunological response status and virus subtype. In addition, the joint association between different subtypes and treatment regimens on immunological response status was investigated. RESULTS: Among 326 enrolled PLWHA with circulating recombinant forms (CRFs) CRF01_AE, CRF07_BC and other HIV/AIDS subtypes, the percentages of immunopositivity were 74.0%, 65.6% and 69.6%, respectively. According to multivariate logistic regression models, there was no difference in the immunological response between patients with CRF01_AE, CRF07_BC and other subtypes of HIV/AIDS who underwent ART (CRF07_BC: adjusted OR (aOR) (95% CI) = 0.8 (0.4 to 1.4); other subtypes: aOR (95% CI) = 1.2 (0.6 to 2.3)). There was no evidence of an obvious joint association between HIV subtypes and ART regimens on immunological response. CONCLUSIONS: Standardised ART was beneficial to all PLWHA, regardless of HIV subtypes, although it was more effective, to some extent, in PLWHA with CRF01_AE.

Anemia is independently associated with mortality in people living with human immunodeficiency virus/acquired immune deficiency syndrome: A propensity score matching-based retrospective cohort study in China.

Although previous studies have suggested that hemoglobin is related to the health status of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA), the role of anemia in mortality remains unclear. This study aimed to comprehensively quantify the effect of anemia on the mortality risk of PLWHA. In this retrospective cohort study, we thoroughly estimated the effect of anemia on PLWHA mortality, using data collected from January 2005 to June 2022 in the Huzhou area, in 450 subjects extracted from the database of the China Disease Prevention and Control Information System and matched them using a propensity score matching approach to balance potential confounding bias. The potential exposure-response relationship between anemia, hemoglobin concentration, and the mortality of PLWHA was also carefully estimated. A series of subgroup analyses, including interaction analysis, was further conducted to validate the robustness of the effect of anemia on PLWHA death risk. Anemia was significantly associated with an elevated death risk in PLWHA, with an increase of 74% (adjusted hazard ratio [AHR]: 1.74; 95% confidence interval [CI]: 1.03-2.93; p = 0.038) in those with anemia after adjusting for potential confounders. PLWHA with moderate or severe anemia had a higher risk of death, with an 86% increase (AHR = 1.86; 95% CI: 1.01-3.42; p = 0.045). Meanwhile, the AHR tended to increase by 85% on average (AHR = 1.85, 95% CI: 1.37-2.50; p < 0.001) with a per standard deviation (SD) decrease in plasma hemoglobin. Consistent relationships between plasma hemoglobin and the risk of death were further observed in the results from multiple quantile regression models, restricted cubic spline regression models, and a series of subgroup analyses. Anemia is an independent risk factor for HIV/AIDS-related mortality. Our findings may provide new insights into the relevance of PLWHA administration to public health policy, which demonstrate that this low-cost and routinely measured marker (hemoglobin) can be a marker of poor prognosis even before the start of HAART.

[Epidemiological characteristics of severe fever with thrombocytopenia syndrome in Zhoushan, Zhejiang, 2011-2013].

OBJECTIVE: To analyze the epidemiological characteristics of severe fever cases, with thrombocytopenia syndrome (SFTS) in Zhoushan,Zhejiang, 2011-2013 and to provide evidence for the development of related strategies for prevention and control of the disease. METHODS: Data was collected from the studies and related demography of the cases with SFTS in Zhoushan, 2011-2013. Clinical and epidemiological characteristics of the cases with SFTS were analyzed descriptively. RESULTS: During 2011-2013, 45 SFTS cases were reported in Zhoushan city, with fatality rate as 11.11% (5/45), including 41 cases(91.11%)reported in Daishan county. Most cases aged 50 or over, residing in hilly regions (93.33%). The epidemic peak was seen from May to July (84.44%). Incidence rates of the disease did not show significant statistical differences between males and females. Most cases were farmers (42.22% ) and housewives (31.11% ). Most patients complained of fever (97.78%), anorexia (91.11%), fatigue (62.22%), chill (44.44%) and other non-specific clinical manifestations but all appeared progressive thrombocytopenia and leucopenia. Sanitation condition of the patients was generally poor. 68.89% (31/45) of cases had farmed, mowed or involved in other outdoor activities in the previous two weeks, with some of them reported having exposed to tick bites. Three events were reported, epidemiologically. CONCLUSION: SFTS in Zhoushan was a infectious disease with natural foci and caused by SFTSV. Ticks might serve as the main vectors for SFTSV, and might cause direct transmission between humans. Improving the environment for living and carrying out essential protective measures in outdoor activities seemed to be significant in decreasing the incidence rate of the disease.

[The differences in absorption and metabolism of bisphenol A between rats and mice].

OBJECTIVE: To investigate the mechanism of the different levels of serum bisphenol A (BPA) between rat and mouse after oral administration. METHODS: A total of 18 specific pathogen free (SPF) male rats and 18 mice were treated with 300 mg/kg BPA by oral administration, blood samples were taken from rats and mice after BPA administration at 0.5, 1.0, 12.0 h time points (n = 6 at each point). Serum BPA levels were quantified using fluorescence-high performance liquid chromatography (FL-HPLC) analysis. The rats and mice (n = 6, respectively) were perfused with 100 ml of 0.1 mmol/L BPA by intestinal absorption in situ, then the BPA levels of perfusion fluid at 0.5, 1.0, 2.0 h time points and serum at 2.0 h after BPA perfusion were determined by FL-HPLC analysis. The levels of UDP-glucuronosyltransferase 2B1 (UGT2B1) mRNA expression in the liver of rats and mice were analyzed by semi-quantitative RT-PCR and UGT2B1 enzymatic activity was determined by FL-HPLC method. The rats and mice (n = 6, respectively) were treated with 300 mg/kg BPA by oral administration after fasting 24 h, the feces were collected during 24 h and the levels of BPA in feces were determined by FL-HPLC analysis. RESULTS: At 0.5, 1.0, 12.0 h after oral administration at 300 mg/kg BPA, the levels of serum BPA in mice ((66.57 ± 14.95), (51.16 ± 16.06), (22.73 ± 5.00) µg/ml, respectively) were significantly higher than in rats ((15.63 ± 5.65), (18.34 ± 5.02), (7.65 ± 2.58) µg/ml, respectively) (F values were 50.660, 17.957, 8.420, respectively, P < 0.05), the rates of absorption in mice small intestine during 0 h-, 0.5 h-, 1.0 - 2.0 h ((10.20 ± 4.20), (1.49 ± 0.67), (1.31 ± 0.55) µg × cm(-2) × min(-1), respectively) were higher than that in rats ((1.87 ± 0.69), (0.47 ± 0.13), (0.36 ± 0.08) µg × cm(-2) × min(-1), respectively) (F values were 14.954, 8.877, 11.536, respectively, P < 0.05), the serum BPA levels in mice ((22.64 ± 4.35) µg/ml) were significantly higher than in rats ((4.13 ± 0.83) µg/ml) after 2 h perfusion with 0.1 mmol/L BPA (F = 74.643, P = 0.000), the levels of UGT2B1 mRNA expression and enzymatic activity in the rats liver were obviously higher than in the mice liver. After oral administration at 300 mg/kg BPA, the feces BPA levels of rats ((1.50 ± 0.32) mg/g) were significantly higher than that of the mice ((0.57 ± 0.35) mg/g) (F = 21.215, P = 0.001) during 24 h. CONCLUSION: The serum BPA level of mouse is significantly higher than the rat after oral administration at 300 mg/kg BPA, which may be caused by BPA high absorption rate of mouse small intestine and strong ability of BPA glucuronidation and excretion of the rat.