Expert consensus on the bi-directional screening for Mycobacterium tuberculosis and human immunodeficiency virus / 上海预防医学

Tuberculosis （TB） and human immunodeficiency virus infection / acquired immune deficiency syndrome （HIV/AIDS） are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years， with the promotion and application of new TB and HIV detection technologies worldwide， TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening， summarizes important progress of research and applications， and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.

Human immunodeficiency virus infection status and related factors among men who have sex with men in Jinhua City， Zhejiang Province from 2016 to 2021 / 上海预防医学

ObjectiveTo understand the human immunodeficiency virus（HIV） infection status and related factors by using the HIV/AIDS sentinel surveillance data of men who have sex with men（MSM） in Jinhua City， Zhejiang Province. MethodsSnowball sampling method was used to recruit MSM receiving HIV sentinel surveillance from 2016 to 2021.The inclusion criteria were aged 18 years old and above， reported having anal sex with man in recent 6 months. Questionnaire-based interviews were conducted on a one-on-one basis. Data including the characteristics of demography and ethology were collected. Five milliliter of blood samples were taken after the questionnaire. HIV and syphilis was screened. The time trend was analyzed with χ2 test. Multivariate logistic regression model was used to analyze the factors associated with HIV infection status among MSM. ResultsThe positive rate of HIV was 8.0% （127/1 597）， with an increasing trend （P=0.002）， but the linear correlation was weak（r=0.075）. The positive rate of syphilis was 5.2% （83/1 597）， with no significant difference （P=0.661）.The constituent ratios showed an increasing trend （P<0.05） in using condoms consistently， finding male sexual partners through Internet or dating software， having anal sex in the past week， using condoms every time during anal sex in the past 6 months， accepting prevention services of AIDS in the last year， and the overall awareness of AIDS related knowledge. Multivariate logistic regression analysis showed that who was from national minority （OR=2.27， 95%CI： 1.08‒4.73） and from other provinces （OR=1.68， 95%CI： 1.08‒2.62）， who failed to consistently use condoms every time during anal sex in the past six months （OR=3.03， 95%CI： 2.02‒4.54）， who never accepted prevention services of AIDS in the last year （OR=2.17，95%CI：1.44‒3.27）， who don’t know the knowledge of AIDS （OR=1.86， 95%CI： 1.12‒3.07）， and who was infected with syphilis （OR=2.35， 95%CI： 1.20‒4.61） were at higher risk for HIV infection among MSM. ConclusionThe positive rate of HIV remains at a certain level among MSM in Jinhua. High-risk groups such as the patients with syphilis infections and floating population from other provinces need to be paid close attention. It is suggested to further strengthen the promotion of the use of condoms， awareness of AIDS and syphilis， warning education and comprehensive intervention services.

Functions of HIV-1 Tat and its association with diseases / 中国生物制品学杂志

@#Acquired immune deficiency syndrome,or AIDS,has been a major infectious disease that troubles the public health in a global scale. Human immunodeficiency virus type 1(HIV-1)is the causative reagent responsible for AIDS development. Even though the highly active anti-retroviral therapy(HAART,or the cocktail therapy)that has been widely applied could effectively suppress the infection and replication of HIV-1,the infected people suffer from other related diseases,such as the HIV-associated neurocognitive disorder(HAND). This paper mainly focused on the function of an important regulatory protein of HIV-1,trans-activator of transcription(Tat),and its correlation with HIV-1 replication and HAND development,so as to clarify the importance of developing anti-AIDS drugs targeting Tat protein

Representational Structure of AIDS for Evangelical Religious Leaders / Estrutura Representacional da Aids para Líderes Religiosos Evangélicos

Abstract This study aims to analyze the social representation structure of AIDS for religious leaders of evangelical Pentecostal churches. It is a qualitative and descriptive study based on the structural approach of the Theory of Social Representations, developed with 120 religious leaders. The data were collected through free evocations and analyzed with EVOC software. The terms in the possible central nucleus are sadness, death, and disease. The term sin is an element present in the representational structure of AIDS. It is concluded that the social representation of AIDS for evangelical religious leaders is predominantly negative, similar to that of the emergence of the epidemic.

Resumo Este estudo objetiva analisar a estrutura das representações sociais da aids para os líderes religiosos de igrejas evangélicas pentecostais. Trata-se de um estudo qualitativo e descritivo baseado na abordagem estrutural da Teoria das Representações Sociais, realizado com 120 líderes religiosos. Os dados foram coletados por meio de evocações livres e analisados com o auxílio do software EVOC. Os termos localizados no provável núcleo central são tristeza, morte e doença. O termo pecado é um elemento presente na estrutura representacional da aids. Conclui-se que a representação social da aids para líderes religiosos evangélicos é predominantemente negativa, semelhante à do aparecimento da epidemia.

Psychometric Properties of an Instrument to Assess the Barriers to Antiretroviral Treatment Adherence among the Argentinian Population / Propiedades psicométricas de un instrumento de evaluación de barreras para la adherencia al tratamiento antirretroviral en población argentina / Propriedades psicométricas de um instrumento para avaliar as barreiras à adesão ao tratamento antirretroviral na população argentina

Aim: To adapt and validate an existing instrument to assess the barriers to antiretroviral treatment adherence among individuals with hiv in Córdoba, Argentina. Materials and methods: The final sample population included 180 Argentinian people. The mean age of the participants was 40.61 (sd = 12.032) years and 82.8% were men. Various internal structure and reliability and validity studies with other variables were conducted on the study population (n = 180). Results: The results of confirmatory factor analysis were consistent with the factorial structure of the original study. However, to achieve this, items that had low factorial loads and were redundant had to be eliminated. Coefficient ω values of .833 on the Information sub-scale, .759 on the Motivation subscale, and .888 on the Behavioral Skills subscale were obtained. Significant correlations were determined between the results of adherence and barriers to treatment. Conclusion: The results suggest that the instrument can be used to assess the barriers to antiretroviral treatment adherence in Córdoba, Argentina. Although further research is warranted, these results are promising.

adaptar y validar un instrumento para evaluar barreras a la adherencia antirretroviral en personas que conviven con el vih en Córdoba (Argentina). Materiales y métodos: la muestra final incluyó 180 participantes argentinos. La media de edad fue de 40.61 (de = 12.032) y el 82.8 % fueron hombres. Sobre la muestra (n = 180) se efectuaron estudios de estructura interna, confiabilidad y validez con otras variables. Resultados: el análisis factorial confirmatorio arrojó resultados congruentes con la estructura factorial del estudio original, aunque para ello fue necesario eliminar ciertos ítems que presentaban bajas cargas factoriales y que pueden ser representados por otros ítems, debido a información redundante. Se obtuvieron coeficientes ω = 0.833 en la subescala información; ω = 0.759 en la subescala motivación, y ω = 0.888 en la subescala habilidades comportamentales. Se encontraron correlaciones significativas entre los resultados de adherencia al tratamiento y barreras al tratamiento. Conclusión: aunque se requieren de mayores investigaciones, los resultados son promisorios, sugieren que el instrumento puede usarse para evaluar barreras de la adherencia al tratamiento antirretroviral en Córdoba.

adaptar e validar um instrumento de barreiras à adesão anti-retroviral em pessoas vivendo com hivem Córdoba, Argentina. Materiais e métodos: A amostra final incluiu 180 participantes argentinos. A idade média era de 40,61 anos (sd = 12,032) e 82,8% eram homens. Com a amostra (n = 180) foram realizados estudos de estrutura interna, confiabilidade e validade com outras variáveis. Resultados: a análise fatorial confirma-tória apresentou resultados adequados com a estrutura fatorial do estudo original, embora para isso tenha sido necessário eliminar alguns itens que apresentavam baixas cargas fatoriais e poderiam ser representados por outros itens devido a informações redundantes. Os coeficientes ω = 0,833 foram obtidos na subescala informação; ω = 0,759 na subescala motivação, y ω = 0,888 na subescala competências comportamentais. Correlações significativas foram encontradas entre os resultados do adherencia al tratamiento e do barreiras à adesão ao tratamento. Conclusão: embora mais pesquisas sejam necessárias, os resultados são promissores, sugerindo que o instrumento pode ser usado para avaliar as barreiras à adesão ao tratamento anti-retroviral em Córdoba, Argentina.

Analysis of CT signs of acquired immune deficiency syndrome-associated pneumocystis jirovecii pneumonia / 实用放射学杂志

Objective To explore the common CT signs of acquired immune deficiency syndrome(AIDS)-associated pneumocystis jirovecii pneumonia(PJP).Methods The chest CT data of 123 patients with AIDS-associated PJP were analyzed retrospectively.Results Multifocal lesions in both lungs were found in all cases.Distribution characteristics were as follows:diffuse and symmetrical distribution in both lungs in 100 cases(81.3％),diffuse and asymmetrical distribution in both lungs in 15 cases(12.2％),and scattered distribution in both lungs in 8 cases(6.5％).The density and morphological features were as follows:ground glass opacity in 120 cases(97.6％);"lunate arch sign"in 25 cases(20.3％);pulmonary interstitial proliferation in 103 cases(83.7％);crazy paving pattern in 14 cases(11.4％);patchy or consolidation shadow in 55 cases(44.7％);pulmonary cysts in 26 cases(21.1％);and nodular in 26 cases(21.1％).Other rare signs included pleural effusion in 11 cases,pericardial effusion in 6 cases,mediastinal and hilar lymphadenopathy in 9 cases,and mediastinal emphysema in 1 case.Conclusion The chest CT manifestations of AIDS-associated PJP have certain characteristics,including diffuse and symmetrical distribution of lesions in both lungs,as well as ground glass opacity and interstitial hyperplasia as common signs,especially,"lunate arch sign"and pulmonary cysts are more specific signs.

AIDS complicated with plasmablastic lymphoma: Clinical analysis of 7 cases / 中华临床感染病杂志

Objective:To analyze the clinical characteristics of AIDS complicated with plasmablastic lymphoma (PBL).Methods:Clinical data and laboratory test of 7 AIDS patients complicated with PBL admitted to Yunnan Infectious Disease Hospital from January 2016 to October 2022 were retrospectively analyzed.Results:There were 6 male patients and 1 female patient with a median age of 48 years (41-56 years). All patients had oral and maxillofacial involvement, and only 1 case was stage Ⅱ at the initial Ann Arbor stage, while 6 cases were stage Ⅲ or higher. Six patients had systemic symptoms. All patients had a Ki-67 proliferation index greater than 80% and all presented MYC gene rearrangements, and 6 patients were positive for EBER. All patients received DA-EPOCH-based first-line chemotherapy and antiretroviral therapy (ART), Five patients initiated ART at the same time as chemotherapy, and 2 patients initiated ART before chemotherapy. Four patients achieved complete remission after chemotherapy according to PET-CT evaluation, and 3 patients died.Conclusions:Active chemotherapy combined with ART can maximize the therapeutic benefits of AIDS patients with PBL. The introduction of ART in the first chemotherapy cycle can avoid the rapid disease deterioration in the patients.

Analysis of the occurrence time and risk factors of anemia in AIDS patients caused by HAART regimen containing zidovudine / 中国药房

OBJECTIVE To investigate the occurrence time and risk factors of anemia in patients with acquired immune deficiency syndrome （AIDS） after taking highly active antiretroviral therapy （HAART） containing zidovudine. METHODS The clinical data of 2 150 AIDS patients who were followed up in the care clinic of Liuzhou People’s Hospital from January 1， 2010 to December 31， 2022 were collected. The occurrence time of anemia was analyzed retrospectively， and the risk factors of anemia were analyzed by univariate analysis and binary Logistic regression analysis. RESULTS A total of 854 AIDS patients receiving HAART containing zidovudine were collected， and 107 patients （12.53%） developed anemia. Most of them （63.55%） developed anemia within 3 months after treatment. Baseline hemoglobin [OR＝2.944， 95%CI （1.195， 7.501）， P＝0.019]， baseline CD4+ T lymphocyte count [OR＝2.472， 95%CI （1.117， 5.469）， P＝0.026] and baseline human immunodeficiency virus-ribonucleic acid （HIV-RNA） [OR＝4.299， 95%CI （1.905， 9.705）， P＜0.001] was associated with anemia. CONCLUSIONS The median time of anemia in AIDS patients receiving HAART containing zidovudine is the second month after initiation of treatment. Baseline hemoglobin≤110 g/L， baseline CD4+ T lymphocyte E-mail：1315775863@qq.com count≤100 /mm3， and baseline HIV-RNA≥100 000 copies/mL are independent risk factors for anemia in these patients.

Prevalence of HIV seropositivity and associated factors among the spouses of HIV/AIDS patients in Shanghai， 2018‒2022 / 上海预防医学

ObjectiveTo analyze the HIV infection characteristics and influencing factors among the spouses of HIV/AIDS patients in Shanghai. MethodsA cross-sectional survey was conducted to collect demographic， behavioral， epidemiological and spousal HIV detection information of newly reported and married patients with HIV/AIDS in Shanghai from January 2018 to July 2022 in the comprehensive HIV prevention and control information system of Chinese Center for Disease Prevention and Control. Descriptive analysis was used to analyze the HIV positivity rate of the spouses of HIV patients and the influencing factors were analyzed by univariate and multivariate logistic regression models. ResultsA total of 1 233 subjects were investigated， and the first HIV-testing positivity rate of the spouses of HIV/AIDS patients was 29.3% （361/1 233）. There were statistically significant differences in the HIV-testing positivity rate among spouses of HIV/AIDS patients by different age， gender， education level， occupation， transmission route， quantity of non-marital sexual activities， quantity of homo-sexual activities， and baseline CD4 cell count level （P<0.05）. Spouses of the HIV/AIDS patients aged ≥65 years old， female， heterosexual transmission， less non-marital sex， and no history of homosexual sex had relatively high HIV positive rate. The HIV-positive detection rate of spouses in the ≥65 age group was 1.81 times higher than that in the <45 age group. The HIV-positive detection rate of spouses in the female group was 3.66 times higher than that in the male group， and the HIV-positive detection rate of spouses in the homosexual transmission group was 0.25 times higher than that of the heterosexual transmission group. ConclusionRisk awareness of HIV infection among married people with spouses should be improved. The key populations with the characteristics such as females as the first HIV-positive reporter， and heterosexual transmission should be paid special attention.Their spouses should be mobilized to conduct HIV-testing as early as possible

Clinical characteristics and prognostic features of 63 HIV-associated diffuse large B-cell lymphoma: a single-center real-world study in China / 中华血液学杂志

Objective: This study aimed to look into the clinical characteristics and prognosis of patients with human immunodeficiency virus (HIV) -associated diffuse large B-cell lymphoma (DLBCL) . Methods: Retrospective review of the clinical data of 63 HIV-infected patients with DLBCL diagnosed at Chongqing University Cancer Hospital between July 2008 and August 2021. The Kaplan-Meier method was used to calculate survival curves, and the log-rank test method was used to compare survival between groups. The Cox proportional hazards model was used for multivariate analysis. Results: In 63 patients with HIV-associated DLBCL, 57 (90.5% ) were men, and the median age was 49 (23-87) years. The most common pathological subtype was the germinal center B-cell-like lymphoma (74.6% ) ; 46.0% (29/63) were combined with extranodal lesions. Seventeen of 63 (27.0% ) patients had large masses (≥7.5 cm) . Twenty of 63 (31.7% ) patients had B symptoms. The median CD4(+) T cell count was 203 (4-1022) ×10(6)/L. A total of 49% (25/51) patients had CD4(+) cell count <200×10(6)/L, 56.9% (33/58) had high (3-5) International Prognostic Index (IPI) scores, and 43.1% (25/58) had low (0-2) IPI scores. Further, 78% (46/59) were diagnosed with Ann Arbor Stage Ⅲ/Ⅳ, and 25.4% (16/63) didn't receive chemotherapy. A total of 22.2% (14/63) of patients received less than four cycles of chemotherapy, and 52.4% (33/63) received four or more cycles of chemotherapy. Among patients undergoing chemotherapy, 61.7% (29/47) received R-CHOP-like regimens, and 38.3% (18/47) used CHOP-like regimens. The 1-, 2-, 3-, and 5-year overall survival (OS) rates were 65.0% , 53.8% , 47.1% , and 43.5% , respectively. Univariate analysis revealed that age ≥ 60 years (P=0.012) , Eastern Cooperative Oncology Gruop Performance Status (ECOG-PS) score 2-4 points (P=0.043) , IPI score 3-5 points (P=0.001) , β(2)-MG elevation (≥5.5 mg/L) (P=0.007) , and systemic chemotherapy cycles less than four times (P<0.001) were the negative prognostic factors affecting the OS of patients. The Cox multivariate analysis depicted that age ≥60 years (HR=2.272, 95% CI 1.110-4.651, P=0.025) , IPI score 3-5 points (HR=3.562, 95% CI 1.794-7.074, P<0.001) , ECOG-PS score 2-4 points (HR=2.675, 95% CI 1.162-6.153, P=0.021) , and number of cycles of chemotherapy<4 (HR=0.290, 95% CI 0.176-0.479, P<0.001) were independent risk factors for adverse prognosis of OS. Conclusion: HIV-associated DLBCL is the most common HIV-related tumor, is most commonly seen in men, and has a high 1-year mortality rate. Chemotherapy combined with antiretroviral therapy can improve patient prognosis.

Research progress on kidney transplantation in HIV-positive patients / 器官移植

Patients infected with human immunodeficiency virus (HIV) are prone to renal insufficiency, which may progress into end-stage renal disease (ESRD). HIV infection has been previously considered as an absolute contraindication of transplantation. The lives of HIV-positive ESRD patients can only maintained through dialysis. With the development of medicine, transplantation practitioners at home and abroad attempt to perform kidney transplantation in HIV-positive patients. Whether kidney transplantation is feasible for HIV-positive patients, whether HIV-positive donor kidneys can be used for transplantation, and the efficacy of kidney transplantation for HIV-positive patients has always been hot topics in the field of transplantation. In this article, HIV-associated nephropathy, the conditions of kidney transplantation for HIV-positive patients, the efficacy of kidney transplantation for HIV-positive patients, use of HIV-positive donor kidneys, use of immune-inducing drugs and postoperative use of immunosuppressants for HIV-positive patients were illustrated, aiming to provide reference for kidney transplantation for HIV-positive patients in clinical practice, application of HIV-positive donor kidneys and postoperative management of HIV-positive patients.

Condom stigma among men who have sex with men population: Concept synthesis / 中南大学学报(医学版)

OBJECTIVES@#The epidemic of acquired immune deficiency syndrome (AIDS) among men who have sex with men (MSM) is severe in China. And MSM has now become a key population for the infection and transmission of AIDS. At present, the bottleneck of AIDS prevention and control among MSM population is low rate of continuous condom use and high incidence of unsafe sexual behavior. Inductive summarization of the literature revealed that the most critical reason for low rate of continuous condom use among the MSM population was condom-related stigma. Although many studies mentioned condom-related stigma among MSM populations, there has been no any definition of MSM-related condom stigma and no measurement for it. Therefore, the paper aims to explore barriers to condom use among MSM, then construct the conceptual and operational definition of "MSM-related condom stigma" through Meta synthesis and concept synthesis, and provide a new perspective for AIDS prevention and control among MSM.@*METHODS@#Based on evidence-based method, "PICoS" framework and Meta-synthesis was used to include the literatures. Then, we used synthesized qualitative evidence from included studies to construct the concept and operational definition of MSM-related condom stigma by the means of thematic analysis and concept synthesis.@*RESULTS@#According to the results of the concept synthesis, MSM-related condom stigma refers to any taboos or misbeliefs about condom use or feeling ashamed or embarrassed to talk about using condoms which perceived by individuals at the individual, interpersonal, and social levels.It was demonstrated through 4 sub-themes at operational level: a symbol of distrust, a symbol of HIV/sexual transmitted infections (STIs) prevention, a symbol of an embarrassing topic, and a symbol of violating the traditional cognition of sexual intercourse. According to the Social-ecological Model (SEM), a symbol of distrust refers to that the MSM population believes that not using condoms represents mutual trust between sexual partners, while using condoms is difficult to express intimacy, trust and loyalty between sexual partners. A symbol of HIV/STIs prevention at the interpersonal level refers to that the MSM population believes that condom use is a "symbol" for the prevention or infection of AIDS; on the one hand, if someone proposes to use condoms, he may be considered infected with HIV or have unsafe sex experiences, thus, making it difficult to propose condom use; on the other hand, if they believe that sexual partners are "AIDS free" (often a wrong perception, such as sexual partners may have the risk of AIDS infection although they do not have AIDS), it is considered that condom use is completely unnecessary. The environmental level includes a symbol of an embarrassing topic and a symbol of violating the traditional cognition of sexual intercourse. A symbol of an embarrassing topic refers to the MSM population feels shame about topics related to sexual behavior and is embarrassed to carry/buy/propose condom use or be ashamed to engage in conversations about whether to use condoms during sexual behavior. And a symbol of violating the traditional cognition of sexual intercourse: The MSM population have limitations in their perception of "sex" or "sexual behavior" and believe that real sex (behavior) is unobstructed contact between the bodies and exchange between all body fluids.@*CONCLUSIONS@#The concept of MSM-related condom stigma is proposed for the first time, and its operational definition is given. The concept includes 3 levels and 4 dimensions. It is helpful to understand MSM people's attitude and cognition towards condoms, and adds indicators with cultural sensitivity and behavioral sensitivity to the behavioral intervention for AIDS in the future.

Knowledge, attitude and behavior of AIDS in college students in Songjiang District of Shanghai / 上海预防医学

Objective To determine the status of HIV/AIDS-related knowledge, attitude and behavior in college students, and to provide the theoretical basis for strategy of control and prevention. Methods By using random cluster sampling method, we conducted an anonymous online questionnaire survey on a total of 917 young students in Songjiang District of Shanghai. Results The awareness rate of HIV/AIDS-related knowledge was 71.8% among 903 responders. 11.1% of the students had sexual experience, and the rate was higher in male students than in female students(χ2 = 10.549, P < 0.01). The average age of first sexual intercourse was 18.4±1.3 years old, and 60.0% of the students used condom when having sex for the first time. In this survey, only 28.2% were willing to take anonymous HIV antibody urine test, and 1.8% of the students had been tested for HIV. Conclusion The overall awareness rate of knowledge of prevention and control of HIV/AIDS, the rate of condom use, and the willingness to take anonymous HIV antibody urine test are low among young college students in Songjiang District of Shanghai. We suggest to carry out targeted health education activities and to expand coverage of HIV testing by promoting the anonymous HIV antibody urine test for control the spread of HIV/AIDS among young students.

Associated factors for HIV stigma among the patients on antiretroviral therapy in Wenshan Prefecture / 预防医学

Objective@#To learn HIV related stigma and its associated factors among the patients on antiretroviral therapy ( ART ) in Wenshan Prefecture, Yunnan Province, so as to provide evidence for eliminating HIV discrimination.@*Methods@#A total of 419 subjects were recruited by convenience sampling from three ART clinics in Wenshan City and Maguan County between October 2017 and January 2018. HIV/AIDS Related Stigma and Discrimination Scale developed by Li Xianhong et al was employed. The multivariate linear regression model were used to explore the influencing factors for HIV stigma. @*Results@#The median scores of disclosure concern, public rejection, family stigma, internalized stigma, health service providers＇ stigma were 24.00, 6.00, 10.00, 20.00, 2.00, respectively, and the overall was 68.00. The multivariate linear regression analysis showed that female patients ( standardized β=0.135 ) , patients with opportunistic infection ( standardized β=0.120 ), patients had no HIV infected family member ( standardized β=-0.128 ) , patients without family support ( standardized β=-0.175 ) , patients received gift from ART clinics ( standardized β=0.124 ) , patients scored lower in ART knowledge ( standardized β=-0.117 ) were likely to scored higher in HIV stigma. @*Conclusions@#The stigma on disclosure concern and internalized stigma dimensions are grievous among ART patients in Wenshan Prefecture. Gender, opportunistic infection, HIV infection in family, family support, receiving incentive gifts from clinics and awareness of ART are associated with HIV stigma.

The therapeutics and management of cryptococcus-related immune reconstitution inflammatory syndrome in AIDS patients / 中华临床感染病杂志

Acquired immune deficiency syndrome (AIDS) can cause various opportunistic infections clinically due to severe defects in the body’s cellular immune function. Cryptococcosis is a common serious opportunistic infection in AIDS patients. With the promotion and popularization of high activity antiretroviral therapy (HAART) programs worldwide, the mortality rate of AIDS-related cryptococcosis has been significantly decreased. After initiating antiviral therapy, some patients experienced recurrence and aggravation of clinical symptoms during anti-cryptococcal treatment. The body has an inflammatory response to the excessive immune regulation of cryptococcal antigens, which is called cryptococcus-related immune reconstitution inflammatory syndrome (C-IRIS). C-IRIS seriously affects the quality of life and prognosis of patients. This article reviews the clinical features, pathogenesis and the latest treatment and management strategies of C-IRIS in AIDS patients.

Characteristics of HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou / 预防医学

Objective @#To analyze the characteristics of HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou, and the influencing factors for new infection and local infection, so as to provide the evidence for AIDS prevention and control.@*Methods @#From 2017 to 2019, the newly reported HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou were recruited, and their demographic information, previous sexual behaviors and history of HIV testing were collected in the questionnaire survey. The multivariate logistic regression model was used to analyze the influencing factors for new infections and local infections. @*Results @#A total of 522 participants from 668 newly reported HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou during this period were surveyed．Among 522 cases, 263 ( 50.38% ) were aged 40 years or above, 218 ( 41.76% ) were married, 326 ( 62.45% ) had an educational level of junior high school or below, and 340 ( 65.13% ) were not local. Among 504 cases whose infection time could be determined, 72 ( 14.29% ) were newly infected within one year; age of 40 years below ( OR=4.148, 95%CI: 1.956-8.795 ), history of HIV testing ( OR=2.049, 95%CI: 1.163-3.609 ) and history of sexually transmitted diseases ( OR=2.169, 95%CI: 1.076-4.374 ) were risk factors for new infection. Among 454 cases whose infection location could be determined, 267 ( 58.81% ) were infected in Hangzhou; educational level of high school or below ( OR=2.538, 95%CI: 1.252-5.145 ) , Hangzhou residence ( OR=7.835, 95%CI: 4.227-14.353 ), living in Hangzhou for a year or over ( OR=18.960, 95%CI: 8.755-41.060 ) and monthly income of 3 000 yuan or over ( OR=2.630, 95%CI: 1.546-4.474 ) were risk factors for local infection. @*Conclusions @#The HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Hangzhou are mainly floating population and less educated. The newly infected cases are more likely to be young and middle-aged people and patients with sexually transmitted diseases, the locally infected cases are more likely to be people with permanent residence, less educated and high income.

Clinical manifestation and treatment of ocular immune reconstitution inflammatory response syndrome in acquired immunodeficiency syndrome patients with cytomegalovirus retinitis / 中华实验眼科杂志

Objective:To investigate the ocular characteristics and treatment prognosis of ocular immune reconstruction inflammatory syndrome (IRIS) in patients with cytomegalovirus retinitis (CMVR) complicated with acquired immunodeficiency syndrome (AIDS).Methods:A serial case-observational study was conducted.Seventeen eyes from 15 male 21-to 43-year-old AIDS patients combined with CMVR, who were diagnosed with IRIS at Beijing You'an Hospital, Capital Medical University from February 2016 to December 2018 were included.The best corrected visual acuity (BCVA) of patients was recorded, and the intraocular pressure and anterior segment was measured with a non-contact tonometer and a slit-lamp microscope, respectively.The ocular fundus was observed by fundus photography and optical coherence tomography (OCT). Reverse transcription polymerase chain reaction was used to measure the cytomegalovirus deoxyribonucleic acid (CMV-DNA) content in the aqueous humor during the occurrence of IRIS.The flow cytometry was employed to determine the peripheral blood CD4 + T lymphocyte count before highly active antiretroviral therapy (HAART) and during the occurrence of IRIS.All patients were followed for 3 to 25 months, with an average of 15 months.The HAART time of patients was 17 to 104 days, with an average of (66.1±27.4) days.Patients with anterior segment inflammatory reactions were given the anti-inflammatory and mydriatic treatment.Patients with severe vitreous opacity were intravitreally injected with 4 mg of triamcinolone.Patients with macular edema were given 0.5 mg intravitreal injection of conbercept.The study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Beijing You'an Hospital, Capital Medical University (No.[2017]11). Written informed consent was obtained from each patient prior to any examination. Results:Anterior segment inflammation (Tyndall effect, KP, post-iris adhesion) was found in 9 eyes, vitreous opacities to varying degrees in 11 eyes, and macular edema in 2 eyes.The CMV-DNA content was negative (<500 copies/ml) in 15 eyes.The CD4 + T lymphocyte count in peripheral blood during IRIS was 67 (51, 99) cells/μl, which was significantly higher than 17(6, 20) cells/μl before HAART treatment ( Z=-4.48, P<0.01). Two of the 15 AIDS patients had tuberculosis.The BCVA of the patients was improved from 0.30 (0.10, 0.55) before treatment to 0.50 (0.35, 0.60) after treatment, and the difference was statistically significant ( Z=-2.34, P=0.019). Conclusions:The anterior and posterior segment may be involved in IRIS patients with AIDS and CMVR, and the corresponding ocular treatment is effective.

Comparison of acquired immure deficiency syndrome-related knowledge and behavior between persons with and without human immunodeficiency virus- infection among young male students who have sex with men / 北京大学学报(医学版)

OBJECTIVE@#To understand the differences between young male students who have sex with men (MSM) with and without human immunodeficiency virus (HIV)-infection in acquired immure deficiency syndrome (AIDS)-related knowledge and behavior, and to provide a scientific reference to make targeted and effective measures in AIDS prevention.@*METHODS@#Using snow balling sampling combined with participants' referral, we conducted a questionnaire survey among 548 young MSM students (in whom there were both HIV-positive and HIV-negative) in Harbin, Tianjin, Xi'an, and Chongqing cities from April 2017 to March 2018. The chi-square test and binary Logistic regression were used to compare the differences in AIDS-related knowledge and behavior between males with and without HIV-infection.@*RESULTS@#A total of 583 questionnaires were obtained, of which 548 were valid, with an effective rate of 94.0%. Having a junior college education or below (P=0.002), a monthly consumption level of less than 2 000 RMB (P=0.021), and living off campus (P=0.004) were associated with being tested positive for HIV. In any period of schooling, receiving AIDS prevention education was a protective factor for HIV infection [Primary school OR=0.203 (0.073－0.561), junior high school OR=0.287 (0.142－0.581), senior high school OR=0.271 (0.142－0.518), and university OR=0.322 (0.168－0.616)]. There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public"(P=0.907) and "AIDS-related Knowledge for Youth"(P=0.782), with the awareness rate all about 90%. There was a statistical difference in the need for some specific knowledge (For "AIDS prevention and treatment policy", P=0.012, for "Ways to identify and prevent high-risk sexual behavior", P < 0.001). HIV-positive males had a younger age of first sexual activity (P=0.006), had more sexual partners in the early (P < 0.001) and had lower frequency of condom use (P < 0.001). However, there was no statistical difference in the later number of sexual partners (P=0.247) and the frequency of condom use (For regular sex partners, P=0.735, and for casual sex partners, P=0.765), which might be related to the change of sexual behavior characteristics caused by HIV infection (For regular sex partners, P < 0.001, and for casual sex partners, P=0.006).@*CONCLUSION@#There was no statistical difference between HIV positive and negative young MSM students in the cognition of "AIDS-related Knowledge for Public" and "AIDS-related Knowledge for Youth", which were both lower than 95% required by the state. However, the specificity in the knowledge needs was certainly shown. There was no significant difference in the recent sexual behavior between the two groups, but HIV positive students were more likely to have high-risk sexual behaviors in the early stage, so we should strengthen and move forward the sex education and AIDS prevention education with adjusted contents, and prevent high-risk sexual behaviors within young MSM students in the early stage.

Research progress on the application of liver transplantation in HIV combined with HCV positive patients / 器官移植

With the advent of highly active antiretroviral therapy (HAART), acquired immune deficiency syndrome (AIDS) has gradually evolved from an incurable terminal disease to a controllable chronic disease. Due to the extended survival of AIDS patients, chronic renal failure and (or) chronic liver failure have become the main cause of death, and AIDS patients with chronic liver failure are constantly complicated with hepatitis C virus (HCV) infection. Human immunodeficiency virus (HIV) infection was previously considered as a contraindication for liver transplantation. With the deepening of medical cognition and improvement of surgical management experience, the quantity of HIV positive liver transplantation recipients has been steadily elevated and high long-term survival rate has been achieved. Nevertheless, the 3-, 5-, and 10-year survival rates after liver transplantation of HIV combined with HCV positive patients remain extremely low. In this article, the development of liver transplantation in HIV positive patients, the disease progression of HIV combined with HCV positive patients, and the treatment for the recurrence of viral hepatitis C after the operation were summarized.

Assessment on the third round of Zhejiang Comprehensive AIDS Response program / 预防医学

Objective@#To evaluate the third round of Zhejiang Comprehensive AIDS Response (CARES) program (nine national areas and three provincial areas) and the control effect of AIDS, so as to provide reference for AIDS prevention and control. @*Methods@#According to the final assessment protocol of the third round of China CARES, the data of 23 assessment items which were collected from online database and field investigation for 12 response areas of Zhejiang in 2014 and 2018 were evaluated. The endemic situation and detection of AIDS in CARES areas was compared with those in non-CARES areas, in order to evaluate the achievement of Zhejiang CARES areas.@*Results@#The rates of reaching the standard ranged from 91.30% to 100.00% in 12 CARES areas. Six indexes in leadership and innovation, fifteen (seventeen in total) indexes in HIV/AIDS control and prevention reached the standard. The items that failed included the awareness rates of AIDS and indicators in “prevention and intervention”. The rates of of reaching the standard in “publicity and education”, “monitoring and testing”, “prevention and intervention”, and “treatment and follow-up” increased from 55.56%, 79.17%, 79.76% and 65.00% in 2014 to 91.67%, 100.00%, 90.48% and 100.00% in 2018, respectively. The proportion of HIV testing people in permanent residents was 30.94% in CARES areas in 2018, which was significantly higher than 20.70% in non-CARES areas (P<0.05). The proportion of new reported HIV/AIDS in CARES areas was 50.87%, and the average increase was 4.48%, which was lower than 9.95% in non-CARES areas.@*Conclusion@#The third round of Zhejiang CARES program has remarkable achievement and plays a positive role in the prevention and control of AIDS.