[Cost-effectiveness analysis of HIV testing strategy in hospitals from 2006 to 2010 in Guangzhou].

OBJECTIVE: To evaluate the cost effectiveness of HIV testing strategy in hospitals from 2006 to 2010 in Guangzhou. METHODS: According to the HIV test strategy costs and the number of HIV patients found in Guangzhou, following aspects were calculated as the total cost of HIV testing strategy in hospitals from 2006 to 2010 of Guangzhou, the cost of finding each HIV patient, and the cost of obtaining one quality adjusted life year (QALY) using Markov model. RESULTS: The total HIV test strategy costs increased from 11 106.98 thousand Yuan to 25 105.58 thousand Yuan, and 4599 HIV positive patients were found due to this strategy. The cost-effectiveness of HIV testing were different in hospitals from 2006 to 2010 in Guangzhou. The lowest cost-effectiveness ratio of HIV testing strategy was 11 810 Yuan per HIV positive patient, the highest was 23 510 Yuan, and the average was 16 070 Yuan. According to the Markov model result, 7.2855 QALYs could be gained per HIV patient on average via HIV testing strategy in 113 hospitals in Guangzhou, and the cost of obtaining one QALY was 2210 Yuan. CONCLUSION: The cost effectiveness ratio of HIV testing strategy in hospitals in Guangzhou was significantly lower than the standard of WHO recommended, and it was cost-effective to carry out the HIV testing strategy in Guangzhou.

[Follow-up and outcome as well as the related biological factors on the cases with indeterminate HIV antibody level].

OBJECTIVE: To explore the follow-up visit, outcome and auxiliary diagnosis method on the cases with indeterminate antibody level measured by Western blotting as well as the related biological factors. METHODS: The cases with indeterminate result were followed up according to the National Guideline for Detection of HIV/AIDS (2009) and samples were collected for HIV antibody detection, p24 antigen and nucleic acid were detected as a supplementary diagnosis at the same time. The samples were also be detected for HBV, HCV, TP, HTLV-I/II, ANA, and AFP, and the results were compared to that of screened positive and confirmed negative cases. RESULTS: A total of 73 were followed up successfully and taken a second HIV test, 25 cases were tested positive and 48 were tested negative for HIV during the follow-up period. For the 25 HIV positive cases, the HIV seroconversion rate was 100.00% at any time point when the interval between the first and returning detection was longer than 1 week. The major Western blotting bands for the cases with indeterminate result were p24 and gp160 and it was different between HIV positive and negative cases in Western blotting band profiles. The consistency and sensitivity of nucleic acid detection were higher than 90.00%, and were higher than that of p24 antigen (69.09% (38/55) and 27.27% (6/22)) (χ(2)(consistency) = 6.875, χ(2)(sensitivity) = 18.893, P < 0.05). The positive rates of ANA and AFP of indeterminate cases excluded from HIV infection were 20.83% (10/28) and 6.25% (3/48) and higher than that of screened positive and confirmed negative cases (0.00%), the difference had statistic significance (χ(2)(ANA) = 19.430, χ(2)(AFP) = 5.520, P < 0.05). CONCLUSION: It is critical to get timely diagnosis for the indeterminate cases according to the new national guideline for detection of HIV/AIDS. Nucleic acid detection has higher application value as auxiliary diagnosis for HIV infection than p24 antigen. The increased levels of ANA and AFP may be the factors resulting in the nonspecific indeterminate results.

[Study on the dynamic prevalence of serum antibody against severe acute respiratory syndrome coronavirus in employees from wild animal market in Guangzhou].

OBJECTIVE: To investigate the dynamic trend of specific antibody against severe acute respiratory syndrome (SARS)-CoV in serum collected at various periods among employees in Guangzhou Xinyuan animal market. METHODS: Volunteers from employees of the animal market were recruited and their serum specific antibody against SARS-CoV were determined by enzyme linked immunesorbent assay (ELISA) method. RESULTS: Positive SARS-CoV specific IgG antibody was found 25.61% (n = 328), 13.03% (n = 238), 12.59% (n = 135), 5.04% (n = 139) and 9.43% (n = 53) among volunteers, which were sampled in May 2003, Dec. 2003, Jan. 2004, July 2004 and June 2005 respectively. No specific IgM antibody was found in all of those samples. Among 129 samples which were tested twice or more, 97 were all negative, 18 all positive, 13 changed from positive to negative but only one sample from negative to positive. When the volunteers were divided by the duration of their working experiences as short-term or long-term, those who had worked at animal market for less than or more then 6 months when being tested, the positive rate for long-term employees were relatively constant, however, all of the persons employed after January 2004, when the palm civets and raccoon dogs were culled from the market, were tested negative. CONCLUSION: The prevalence of specific antibody against SARS-CoV in employees of the animal market were somehow related with the presence or absence of palm civet. No serum was tested positive for persons who were employed after palm civets and raccoon dogs were culled from market. This data indicated that the SARS-CoV might have been from the palm civets and raccoon dog, and the animal market seemed to serve as one of the sources of infection.

[Analysis on the risk factors of severe acute respiratory syndromes coronavirus infection in workers from animal markets].

OBJECTIVE: To investigate the possible risk factors of severe acute respiratory syndromes coronavirus (SARS-CoV) infection in workers from animal markets. METHODS: Self-designed questionnaires were used and serum samples were tested. Logistic regression analysis was used to analyze the data. RESULTS: Results from simple factor logistic regression analysis showed that jobs which dealing with domestic livestock, wild livestock, wild animals, aquatics were related to risk factors of SARS-CoV infection. Results from multifactor logistic regression analysis showed that jobs that dealing with wild livestock and poultry were important risk factors with OR 12.28 and 0.41. CONCLUSION: Job that dealing with palm civets was the main risk factor of SARS-CoV infection in animal market workers.