Association of low-level viremia with mortality among people living with HIV on antiretroviral therapy in Dehong, Southwest China: A retrospective cohort study.

OBJECTIVES: To investigate the association of low-level viremia (LLV) with mortality among people living with HIV (PLHIV) on antiretroviral therapy (ART) in Dehong, Southwest China. METHODS: We analysed data collected from a cohort of PLHIV on ART in Dehong. PLHIV were enrolled in this cohort after they started ART, with viral load (VL) tested once a year afterwards. Each VL level was then categorized into one of the four groups: <50, 50-199, 200-999 and ≥1000 copies/ml. VL levels of 50-199 and 200-999 copies/ml were defined as LLV. The VL level for each participant was re-categorized and fitted into an extended Cox regression model as a time-varying covariate to examine the associations of VL level with all-cause and AIDS-related deaths. RESULTS: Among the included 7273 of 8762 PLHIV in this study, median age (interquartile range, IQR) was 36 (30-43) years and 59.9% were male. The patients were followed up for a median duration (IQR) of 6.2 (4.3-8.2) years. Compared with VL <50 copies/ml, LLV 200-999 copies/ml (adjusted hazard ratio [aHR] and 95% confidence interval [95% CI]: 1.56 [1.04, 2.32]) were associated with elevated risk of all-cause mortality and LLV50-199 (aHR [95% CI]: 1.00 [0.68, 1.45]) were not. Similarly, only LLV200-999 copies/ml (aHR [95% CI]: 2.37 [1.36, 4.14]) corresponded to higher risk of AIDS-related mortality. CONCLUSIONS: This study suggests that PLHIV on ART may have elevated death risks even though the viremia is suppressed at a low level. Interventions targeting PLHIV with LLV should be developed to reduce their mortality.

[Incidence and risk factors of HIV infection among sero-negative spouses of people living with HIV/AIDS in Dehong prefecture, Yunnan province].

OBJECTIVE: To study the incidence rate and risk factors of HIV infection among sero-negative spouses of people living with HIV/AIDS (HIV/AIDS) in Dehong prefecture, Yunnan province. METHODS: A prospective cohort study was conducted from February 2009 to December 2014 in Dehong prefecture, Yunnan province. Questionnaire survey and HIV related tests were carried out once a year. RESULTS: By the end of December 2014, 2 091 sero-negative spouses had been recruited, of whom 1 692 were followed-up for at least one time. RESULTS showed that 34 new HIV infections were identified within 5 494.52 person years of follow-up, for an overall incidence of 0.62 per 100 person years. HIV incidence rates appeared as 0.79 per 100 person years, 0.62 per 100 person years, 0.47 per 100 person years in 2009-2010, 2011-2012, 2013-2014, respectively. Data from the Cox proportional hazard regression model indicated that risk factors of HIV infection among sero-negative spouses of HIV/AIDS were: non-consistent condom use (HR=4.64, 95%CI: 1.89-11.40,P= 0.001), HIV/AIDS delayed antiviral retrovirus therapy (ART) for more than one year (HR=3.70, 95% CI: 1.44-9.49,P=0.007) after the HIV negative spouses were initially recruited, HIV/AIDS did not receive any ART (HR=3.62, 95% CI: 1.14-11.51,P=0.029). CONCLUSIONS: The incidence of HIV infection among sero-negative spouses in Dehong prefecture was relatively low. Publicity on consistent condom use program should be emphasized among sero-negative spouses of HIV/AIDS, together with the timely provision of ART to those HIV/AIDS.

[Analysis of follow-up and administration of HIV-infected Burmese in Dehong prefecture of Yunnan province].

OBJECTIVE: To compare follow-up and administration of HIV-infected local Chinese and Burmese in Dehong prefecture of Yunnan province, for scientific development of prevention and control measures. METHODS: 14 270 HIV-infected local Chinese and 5 436 HIV-infected Burmese reported from 1989 to December 31, 2013 in Dehong prefecture were recruited as the subjects of study, comparing the differences of follow-up and management, CD4⁺ T lymphocyte count tests and antiretroviral therapy (ART) between the two groups. RESULTS: The proportion of HIV-infected Burmese identified in Dehong prefecture was 27.6% (5 436/19 706) during 1989-2013. The number had been growing rapidly from 17.1% in 1989-2003, 12.4% in 2004 and 14.7% in 2005 to over 51.4% in 2012, hitting 59.4% in 2013 (trends χ² = 1 732.84, P < 0.000 1). The proportion of HIV-infected Burmese among case reports of various characteristics kept rising over the years. By the end of 2013, 8 095 HIV-infected local Dehong residents and 5 326 HIV-infected Burmese were still alive. 95.8% of them were under follow-up, 88.5% having CD4⁺ T lymphocyte count tests, and 78.3% under ART. Among the HIV-infected B urmese, only 19.2% of them were under follow-up, 13.0% having CD4⁺ T lymphocyte count tests, and 6.1% under ART, significantly lower than the local Dehong residents (P < 0.000 1). CONCLUSION: The proportion of follow-up and administration, CD4⁺ T lymphocyte count tests, and ART of HIV-infected Burmese was low in Dehong prefecture, Yunnan province, which called for more effective follow-up and administration measures.

Three-dimensional culture of human mesenchymal stem cells in a polyethylene terephthalate matrix.

Polyethylene terephthalate (PET) was used as the scaffold material to support the proliferation of human mesenchymal stem cells (hMSCs). The cells were cultured either statically in multi-wells or in a spinner flask agitated at 80 rpm for up to 20 days. To optimize the cell expansion condition, effects of the initial cell density and basic fibroblast growth factor (bFGF) were examined. During culture, cell growth and metabolism were tested. After 20 days, cells were harvested and surface markers were identified and quantified with flow cytometry. The results showed that hMSCs seeded at the lowest density gave the highest expansion fold. hMSCs grown in porous three-dimensional (3D) matrices displayed significantly different characteristics in terms of their proliferation and metabolism. PET matrices with 3D space could sustain cell proliferation for a long time. In addition, a low concentration (5 ng mL(-1)) of bFGF significantly enhanced the expansion of hMSCs in PET. Cell attachment and distribution in PET matrices were studied with confocal laser microscopy and scanning electron microscopy, which also confirmed cell proliferation. Furthermore, most of the cells in PET matrices were CD29, CD44 and CD105 positive, and CD34, CD45 and CD14 negative, confirming that hMSCs cultured in 3D PET matrices can be expanded and maintained in their undifferentiated state for at least 20 days without subculturing.

[Correction of minor exophthalmos by enlargement of orbital volume through conjunctive approach].

OBJECTIVE: To investigate the treatment of minor exophthalmos by enlargement of orbital volume through conjunctive approach. METHODS: Through the conjunctive approach medial to the eye ball, the dissection was performed subperiosteally to expose the ethmoid bone at the medial orbital wall. The exposure bone was 2.5-3.0 cm in length and 2.0-2.5 cm in width. Then the ethmoid bone was fractured to enlarge the orbital volume. From June 2006 to April 2008, 3 cases were treated. RESULTS: The patients recovered in a short time with no visible skin scar. The technique was mini-invasive, and didn't affect the function of eyeball. CONCLUSION: It is easy and effective way to correct the minor exophthalmos by enlargement of orbital volume through conjunctive approach.

Investigation of health and nutrition status of middle-aged and old residents in the urban district of Chongqing.

OBJECTIVE: To investigate the health and nutrition status in middle-aged and old people in the urban district of Chongqing City, China in order to provide a rational diet construction for the population. METHOD: This investigation was performed in 2004 and 1801 public officials both at post and retired in the urban district of Chongqinging City were enrolled in this investigation. Among them 96.7% were at age of over 40. The investigation was based on questionnaire, physical examination, laboratory biochemical test and bone density measurement. RESULT: In the incidences of nutrition-related non-communicable diseases, overweight/obesity accounted for 50.5%, hyperlipidemia 36.1%, hypertension 30.3%, fatty liver 22.3%, osteoporosis 16.1%, hyperuricemia 12.2%, and diabetes 11.2%, while the incidence of dystrophy is low. Correlation analysis of these diseases demonstrated that the rates of hypertension, hyperlipidemia, fatty liver, diabetes, coronary heart disease and gallstone were significantly higher in overweight or obesity than in normal-weight people. The rates of hypertriglyceride, hypercholesteremia, diabetes, hyperuricemia, coronary heart disease, and fatty liver were higher in people with hypertension than in people with normal blood pressure. The rates of hypertension, hypertriglyceride and hypercholesteremia, coronary heart disease and fatty liver were higher in diabetes than in non-diabetes people. CONCLUSION: Our study shows that health and nutrition status of the public officials of Chongqing city is not favourable. Overnutrition is the main problem.