[Survey of prevalence of hepatitis C in people aged 1-69 years in Henan Province, 2020].

Objective: To understand the infection status and epidemiological characteristics of hepatitis C in people aged 1-69 years in Henan Province in 2020. Methods: The estimated sample size was 5 827. From August to December 2020, multistage sampling was used to select 8 counties (districts) in Henan, and two survey sites were selected in each county (district), and a questionnaire survey was conducted in local people aged 1-69 years, blood samples were collected from them for anti-HCV, HCV RNA and genotype detections. Results: A total of 5 165 people aged 1-69 years completed the questionnaire survey. Men accounted for 44.76% (2 312/5 165), women accounted for 55.24% (2 853/5 165). In the people aged 1-69 years, the overall prevalence rates of anti-HCV and HCV RNA were 0.69% (95%CI: 0.68%-0.70%) and 0.20% (95%CI: 0.19%-0.21%) respectively. The prevalence rates of anti-HCV and HCV RNA were 0.48% (95%CI: 0.46%-0.50%), 0.09% (95%CI: 0.08%-0.10%) in men and 0.86% (95%CI: 0.85%-0.87%), 0.30% (95%CI: 0.28%-0.32%) in women. The prevalence rates of anti-HCV and HCV RNA increased with age. The prevalence rates of anti-HCV and HCV RNA were 0.87% (95%CI: 0.86%-0.88%), 0.28% (95%CI: 0.26%-0.30%) in urban residents and 0.53% (95%CI: 0.51%-0.55%), 0.14% (95%CI: 0.13%-0.15%) in rural residents. The genotyping results of 10 HCV RNA positive samples ware genotype 1b (4/10), genotype 2 (3/10), genotype 1b/3 (1/10), genotype 1b/3/6 (1/10) and genotype 2/6 (1/10). Conclusions: The prevalence of hepatitis C was low in Henan in 2020. It is necessary to strengthen hepatitis C surveillance in people aged 40 years and above. The major HCV genotypes were 1b and 2, and mixed genotype infection existed.

[Characteristics and trends of HIV/AIDS cases with the non-martial and non-commercial heterosexual transmission in Henan province, 2015-2020].

Objective: To analysis the characteristics and trends of non-martial and non-commercial heterosexual transmission of HIV/AIDS cases in Henan province between 2015 and 2020. Methods: Information of newly reported HIV/AIDS through non-martial and non-commercial heterosexual transmission was collected from National Comprehensive HIV/AIDS Information system, using SPSS 22.0 to analyze the characteristics and tend of cases. Results: During 2015-2020, a total of 10 877 HIV/AIDS cases infected by non-martial and non-commercial heterosexual transmission were newly reported in Henan province. This mode of infection increased from 32.6% in 2015 to 35.5% in 2020 (trend χ2=81.880,P<0.01). The male to female ratio was 1.9∶1 (7 105∶3 772). The mean age was (45.5±15.8) years, increasing annually (F=5.184,P<0.01). For female cases, the proportion of aged 15-50 years group was decreased annually (trend χ2=69.888, P<0.01). Most HIV/AIDS cases were distributed in the early HIV epidemic areas and Zhengzhou city, the same as the cases of the first CD4+T cells counts (CD4) below 200 cells/µl. The median (P25, P75) first CD4 count was 298 (143, 462) cells/µl. The proportion of the first CD4<200 cells/µl was no significant change annually, while the proportion of the first CD4≥500 cells/µl was decreasing annually (trend χ2=18.961,P<0.01). Conclusions: The reported cases through non-martial and non-commercial heterosexual transmission increased, with most of them were male, married, junior, farmer, migrant laborer, and aged 40-59 years. It is needed to focus on the rural district and the middle-aged population, combined with biological and social factors to control the prevalence of AIDS through comprehensive prevention and control measures.

[Characteristics of newly reported HIV/AIDS cases in Henan province, 2010-2018].

Objective: To analyze the epidemiological characteristics of newly reported HIV/AIDS cases in Henan province during 2010-2018, and to provide theoretical evidence for strategies on prevention and control. Methods: Information about newly reported HIV/AIDS cases in Henan between January 1, 2010 and December 31, 2018 were collected from the National Comprehensive HIV/AIDS Information System. Excel 2010 and software SPSS 23.0 were used for data cleaning and statistical analysis. Results: During 2010-2018, a total of 41 223 HIV/AIDS cases were newly reported in Henan, and the number of newly reported HIV/AIDS cases increased from 3 087 in 2010 to 5 910 in 2018. Sexual contact was the predominant transmission route in newly reported HIV/AIDS cases, and the proportion of sexual transmission increased from 50.6% (1 564/3 087) in 2010 to 98.8% (5 839/5 910) in 2018. The proportion of heterosexual transmission firstly increased from 44.9% (1 387/3 087) in 2010 and then declined to 65.7% (3 885/5 910) in 2018, and the proportion of MSM behavior related transmission increased from 5.7% (177/3 087) in 2010 to 33.1% (1 954/5 910) in 2018. Among the newly reported heterosexual transmitted cases, the proportion of cases with non-marital heterosexual behaviors increased from 69.4% (962/1 387) in 2010 to 91.7% (3 562/3 885) in 2018 (χ(2)=657.802, P<0.001). The number of newly reported HIV/AIDS cases in young people aged 15-24 years and old people aged ≥60 years increased year by year. The youth cases were mainly infected by MSM behavior transmission (52.7%, 2 561/4 856), and heterosexual transmission was the main infection route of the elder cases (86.4%, 5 907/6 833). Among the elder cases infected by heterosexual transmission, cases with non-marital heterosexual behaviors were mainly males, the number of male cases increased from 122 in 2010 to 738 in 2018, and sex composition ratio was between 82.2% and 91.0%, while the sex composition ratio of female cases was increased from 9.0% (12/134) in 2010 to 17.8% (160/898) in 2018. Conclusions: From 2010 to 2018, the number of newly reported HIV/AIDS cases in Henan increased. Sexual transmission had become the main transmission route. AIDS prevention and control should focus on the control of non-marital heterosexual transmission and MSM behavior transmission, and to pay more attention to young people and people aged 60 years and above.

[Study on the risk of mortality and associated factors among HIV-exposed children in Henan province, 2002-2014].

Objective: To investigate the status of survival and related risk factors among HIV-exposed children in Henan province from 2002 to 2014. Methods: A follow-up program was set up when infants as 1, 3, 6, 9, 12, 18 month olds. Data regarding the HIV-exposed children and their mothers were collected, including service of PMTCT, antiviral therapy, incidence of infectious disease and survival status of infants. Univariate and multivariate logistic regression models were used to explore the risk factors. Results: A total number of 1 705 HIV-infected infants were reported from 2002 to 2014. Among them, 1 536 infants (90.09%) were still alive when they were at one and a half years old, with another 58 (3.40%) lost to follow up and 111 (6.51%) infants were dead. The cumulative mortality rates in HIV-exposed children, newborn, and HIV-exposed infants were 67.39‰, 23.07‰, and 57.01‰, respectively. No statistical significance was found on the decreasing tendency of mortality in different years. The leading cause of death was noticed as pneumonia, with a proportion of 32.43%, followed by suspected AIDS. Early diagnosis had not been made in infants. Low-birth weight (OR=4.97, 95%CI: 3.12-7.92) seemed to be a risk factor. Early detection in pregnancy (OR= 0.46, 95%CI: 0.26-0.80) and HARRT provided to children (OR=0.25, 95%CI: 0.15-0.42) were recognized as protective factors. Conclusions: The mortality of HIV-exposed children were high, which called for the development of programs on early infant diagnosis and HARRT. Measures should be taken to prevent pneumonia and other infectious diseases, together with nutrition support and monitor program on growth.

[HCV infection status and related risk factors in drug users under HIV sentinel surveillance in Henan province, 2011-2015].

OBJECTIVE: To understand the hepatitis C virus infection status and related risk factors in drug users in Henan province during 2011-2015 and provide scientific evidence for the development of HCV infection prevention and control measures. METHODS: Cross-sectional questionnaire surveys were conducted among the drug users and blood samples were taken from them for HCV antibody detection during HIV sentinel surveillance period in Henan province from April to June during 2011-2015. RESULTS: The HCV infection rate in drug users increased from 3.70% in 2011 to 6.54% in 2015 (trend χ(2)=25.93, P<0.01). Multivariate analysis indicated that HCV infection related risk factors included age older (OR=1.23, 95% CI: 1.13-1.35, P=0.00), place of domicile (OR=3.45, 95%CI: 2.59-4.60, P=0.00), traditional drug user or mixed drug user (OR=1.46, 95%CI: 1.10-1.93, P=0.01; OR=1.82, 95%CI: 1.18-2.81, P=0.01), injecting drug user (OR=2.88, 95%CI: 2.45-3.39, P=0.00), commercial sex behavior in recent one year (OR=1.44, 95%CI: 1.20-1.72, P=0.00) and drug user in compulsory drug rehabilitation or those receiving methadone maintenance treatment (OR=1.79, 95% CI: 1.28-2.50, P=0.00; OR=1.74, 95% CI: 1.17-2.58, P=0.01). CONCLUSION: The HCV infection rate in drug users was higher in Henan and increased rapidly with years. In order to control HCV spread, it is necessary to strengthen the management of drug users and take effective intervention measures.

[Survival effect after antiretroviral treatment initiating at different times on AIDS patients in Henan province, 2002-2014].

OBJECTIVE: To study the survival effect of AIDS patients after the antiretroviral treatment that initiated at different times and to understand the factors associated with the survival time. METHODS: Information on AIDS patients who started receiving the antiretroviral therapy during 2002-2014 was collected from the Chinese HIV/AIDS Integrated Control System in Henan province. According to the level of baseline immunology, all the participants were divided into earlier treatment group [Baseline CD4(+)T lymphocyte cell counts (CD4) between 350/µl and 500/µl] or conventional treatment group (Baseline CD4 cell counts≤350/µl). Data was analyzed with both Survival and Review methods. RESULTS: A total number of 37 169 cases were selected, including 32 129 cases in the conventional treatment group and 5 040 cases in the earlier treatment group. Mortalities in the conventional treatment group and earlier treatment group were 4.3/100 person year and 1.8/100 person year, respectively. Data on the 11-year cumulative survival rate of both the conventional treatment group and earlier treatment group were 67.9% and 82.3%, respectively. By means of multi-variable analysis, we found that factors as gender, age, marital status, route of infection, number of symptoms, missed taking drugs in the past 7 days, degree of education at baseline of conventional treatment group etc. were associated with survival time of patients after the initiation of antiretroviral treatment (ART) (P<0.05) while factors as gender, age, marital status, ever missed taking drugs in the past 7 days at baseline etc. in the earlier treatment group were associated with the survival time of patients after the ART initiation (P<0.05). CONCLUSION: Strategy including earlier initiation of antiretroviral treatment on AIDS patients who had met the treatment criteria and programs related to the improvement on adherence to medication, could prolong the survival time of AIDS patients, in Henan province.