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OBJECTIVE: To investigate the effects of visualized precision electrophysiological diagnosis and transcutaneous low-frequency electrical stimulation (TES) on hypoxia-induced ED in high-altitude areas. METHODS: This study included 152 ED patients from high-altitude hypoxic areas treated by TES based on the parameters obtained from visualized precision electrophysiological diagnosis. We followed up the patients for 1 to 3 months and compared their IIEF-5 scores, nocturnal penile tumescence and rigidity (NPTR) and infrared thermal metabolic technology (TMT)-based temperature of the whole body and diseased parts before and after treatment. RESULTS: All the patients successfully completed 1 to 3 courses of TES. There were no statistically significant differences in the IIEF-5 scores (P<0.05) and penile tip optimal erection rigidity and duration (P<0.01) of the patients before and after treatment. TMT images indicated a temperature change of >1.5 â in the penis and bilateral inguinal regions after treatment, suggesting the effectiveness of electrical stimulation. No recurrence was observed during the follow-up. CONCLUSION: TES based on the parameters obtained from visualized precision electrophysiological diagnosis has a definite effect on hypoxia-induced ED by enhancing oxygen supply to the penile corpus cavernosum and improving its function and structure.
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Altitude , Disfunção Erétil , Hipóxia , Estimulação Elétrica Nervosa Transcutânea , Humanos , Masculino , Estimulação Elétrica Nervosa Transcutânea/métodos , Disfunção Erétil/terapia , Disfunção Erétil/diagnóstico , Pênis/fisiopatologia , Ereção Peniana , Resultado do TratamentoRESUMO
BACKGROUND: Studies on antiretroviral therapy (ART) in children living with HIV (CLHIV) are limited due to the small population and low accession rate of ART. METHODS: All 0-14-year-old CLHIV admitted to the Ganzhou Center for Disease Control and Prevention from January 2006 to June 2023 were included retrospectively. The information of treatment regimens, disease progression, and laboratory tests of the patients under ART were used to explore the outcomes and impacts of long-term ART. The normality of all the data was tested by the Shapiro-Wilk test. RESULTS: From 2006 to 2023, 18 CLHIV were reported in Ganzhou. Among them, 11 received ART and were followed up for 60.0 ± 48.4 months. After receiving ART, the median viral load of them decreased from 89,600 copies/ml to 22 copies/ml (P = 0.007), the median CD4+ T cell count increased from 380.7 cells/µL to 661.9 cells/µL (P = 0.028), and the median CD8+ T cell count decreased from 1065.8 cells/µL to 983.3 cells/µL (P = 0.584). The laboratory test results regarding liver function, renal function, blood cell count, and glucolipid metabolism tended to be within normal reference ranges, and the mean height-for-age z-score and weight-for-age z-score increased. However, all the three CLHIV who received cotrimoxazole developed pneumocystis carinii pneumonia, upper respiratory infection, skin lesions, bacterial pneumonia and/or thrush; the mean body-mass-index-for-age z-score decreased from 0.52 to -0.63. CONCLUSION: For CLHIV, ART could effectively inhibit the replication of HIV and improve the immune function of patients. More studies that focus on ART in CLHIV are urgently needed.
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Fármacos Anti-HIV , Infecções por HIV , Criança , Humanos , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Infecções por HIV/epidemiologia , Estudos Retrospectivos , Antirretrovirais/uso terapêutico , Progressão da Doença , Contagem de Linfócito CD4 , China/epidemiologia , Carga Viral , Fármacos Anti-HIV/uso terapêuticoRESUMO
Olfactory systems in eusocial insects play a vital role in the discrimination of various chemical cues. Odorant receptors (ORs) are critical for odorant detection, and this family has undergone extensive expansion in ants. In this study, we re-annotated the OR genes from the most destructive invasive ant species Solenopsis invicta and 2 other Formicidae species, Ooceraea biroi and Monomorium pharaonis, with the aim of systematically comparing and analyzing the evolution and the functions of the ORs in ant species, identifying 356, 298, and 306 potential functional ORs, respectively. The evolutionary analysis of these ORs showed that ants had undergone chromosomal rearrangements and that tandem duplication may be the main contributor to the expansion of the OR gene family in S. invicta. Our further analysis revealed that 9-exon ORs had biased chromosome localization patterns in all three ant species and that a 9-exon OR cluster (SinvOR4-8) in S. invicta was under strong positive selection (Ka/Ks = 1.32). Moreover, we identified 5 S. invicta OR genes, namely SinvOR89, SinvOR102, SinvOR352, SinvOR327, and SinvOR135, with high sequence similarity (>70%) to the orthologs in O. biroi and M. pharaonis. An RT-PCR analysis was used to verify the antennal expression levels of these ORs, which showed caste-specific expression. The subsequent analysis of the antennal expression profiles of the ORs of the S. invicta workers from the polygyne and monogyne social forms indicated that SinvOR35 and SinvOR252 were expressed at much higher levels in the monogyne workers than in the polygyne workers and that SinvOR21 was expressed at higher levels in polygyne workers. Our study has contributed to the identification and analysis of the OR gene family in ants and expanded the understanding of the evolution and functions of the ORs in Formicidae species.
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Formigas , Receptores Odorantes , Animais , Formigas/genética , Receptores Odorantes/genética , ÉxonsRESUMO
The cell-type-specific recording and manipulation is instrumental to disentangle causal neural mechanisms in physiology and behavior and increasingly requires intersectional control; however, current approaches are largely limited by the number of intersectional features, incompatibility of common effectors and insufficient gene expression. Here, we utilized the protein-splicing technique mediated by intervening sequences (intein) and devised an intein-based intersectional synthesis of transactivator (IBIST) to selectively control gene expression of common effectors in multiple-feature defined cell types in mice. We validated the specificity and sufficiency of IBIST to control fluorophores, optogenetic opsins and Ca2+ indicators in various intersectional conditions. The IBIST-based Ca2+ imaging showed that the IBIST can intersect five features and that hippocampal neurons tune differently to distinct emotional stimuli depending on the pattern of projection targets. Collectively, the IBIST multiplexes the capability to intersect cell-type features and controls common effectors to effectively regulate gene expression, monitor and manipulate neural activities.
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Inteínas , Optogenética , Animais , Inteínas/genética , Camundongos , Neurônios , Processamento de Proteína , Transativadores/genéticaRESUMO
BACKGROUND: Bioresorbable scaffolds (BRS) were considered to be beneficial for coronary bifurcation lesions regarding the avoidance of lateral branch opening incarceration after complete absorption. However, data is limited in this setting. The aim of this meta-analysis was to evaluate the short (6-month) and medium-term (1-year) outcomes of BRS in patients with coronary bifurcation lesions. METHODS: PubMed, EMBASE, Web of Science, Cochrane library databases were searched to find the studies of BRS implantation in patients with coronary bifurcation lesions. The effective outcome was target lesion revascularization. The safety outcomes included major adverse cardiovascular events, target vessel revascularization, myocardial infarction, definite or probable scaffold thrombosis, and cardiac death. RESULTS: A total of 1204 patients involved in 12 studies were included. The pooled estimate rate of target lesion revascularization as efficacy outcome was highly consistent between 6-month and 1-year follow-up, which was 4.74% (95% CI 2.36-9.54%, I² = 41.5%, p = 0.14) and 4.37% (95% CI 3.05-5.69%, I² = 4.6%, P = 0.39). The pooled estimated rate of major adverse cardiovascular events as safety outcome was 5.50% and 7.31% for both 6-month and 1-year follow-up. The pooled estimated rate of target vessel revascularization, myocardial infarction, definite or probable scaffold thrombosis, and cardiac death at 1-year follow-up was 5.92%, 2.52%, 1.69%, and 0.42%. CONCLUSIONS: The application of BRS for coronary bifurcation lesions is acceptable in efficacy outcome, but the high rate of scaffold thrombosis remains of concern (Registered by PROSPERO, CRD42019140341).
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Doença da Artéria Coronariana , Infarto do Miocárdio , Intervenção Coronária Percutânea , Implantes Absorvíveis , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/cirurgia , Vasos Coronários , Morte , Humanos , Infarto do Miocárdio/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Desenho de Prótese , Resultado do TratamentoRESUMO
Dual antiplatelet therapy (DAPT) is the basis of preventing stent thrombosis and ischemic events after percutaneous coronary intervention (PCI), but prolonging the duration of DAPT will increase the risk of bleeding. The optimal duration of DAPT after PCI remains controversial at present. The purpose of this meta-analysis was to investigate the efficacy and safety of short-term DAPT in patients undergoing PCI. PubMed, Embase, Cochrane and Web of science from inception to September 2019 were systematically searched. Randomized controlled trials were included to compare short term (3 months or less) with a standard 12-months DAPT in patients undergoing PCI. Random effect model and fixed effect model wereused to calculate the risk ratio (RR) and 95% confidence interval (CI) of each endpoint. This meta-analysis included 38479 patients undergoing PCI from 8 randomized clinical trials. No difference was observed in the risk of all-cause death (RR 0.92, 95% CI 0.80-1.06, P = 0.25), cardiovascular death (RR 0.88, 0.69-1.12, P = 0.29), myocardial infarction (RR 1.05, 0.94-1.19, P = 0.38), definite or probable stent thrombosis (RR 1.05, 0.80-1.36, P = 0.73), and stroke (RR 1.02, 0.80-1.30, P = 0.89) between short term and standard DAPT. The short-term DAPT could reduce the risk of major bleeding (RR 0.67, 0.48-0.94, P = 0.02) and any bleeding (RR 0.63, 0.48-0.82, P = 0.0005) compared with 12 months of DAPT. In conclusion, the short-term DAPT can reduce the risk of bleeding compared with standard DAPT, without increasing the risk of death or ischemia (Registered by PROSPERO, CRD42020153881).
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Intervenção Coronária Percutânea/métodos , Inibidores da Agregação Plaquetária/uso terapêutico , Feminino , Humanos , Masculino , Inibidores da Agregação Plaquetária/farmacologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Tempo , Resultado do TratamentoRESUMO
To explore the molecular epidemiological status of human immunodeficiency virus type 1 (HIV-1) in Yunnan, China, three HIV-1 near full-length genomes were amplified and sequenced from plasma samples that were collected from Burmese patients newly diagnosed with HIV-1 in Dehong Prefecture in Yunnan Province in 2017. Phylogenetic and bootscanning analyses revealed that all the sequences might be HIV-1 second-generation recombinant forms of circulating recombinant forms (CRF07_BC and CRF83_cpx) and unique recombinant forms. One of the sequences contained six CRF01_AE fragments, five subtype C fragments, and two subtype B fragments, which were separated by 12 breakpoints. These results revealed that the second-generation recombination of HIV-1 within different strains is still ongoing in Dehong, China. Systematic surveys and immediate interventions are urgently needed to prevent the formation of increasingly complex HIV-1 recombinant forms.
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Infecções por HIV , HIV-1 , China/epidemiologia , Genótipo , Infecções por HIV/epidemiologia , HIV-1/genética , Humanos , FilogeniaRESUMO
BACKGROUND AND OBJECTIVE: Intravascular ultrasound (IVUS) could take on a vital position when angiographic images are not clear enough to be precisely visualized or measured by computer-aided technology. This meta-analysis was designed to compare the benefits of IVUS-guided and angiography-guided percutaneous coronary intervention(PCI) strategies for improving clinical outcomes. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were searched for articles published from inception to 13th October, 2019. A comparative study of IVUS-guided and angiography-guided PCI strategies for patients with coronary bifurcation lesions was retrieved. The early endpoint events (≤1 year) and the late endpoint events (>1 years) were determined according to the follow-up time. The former included cardiac death, target lesion or vessel revascularization, stent thrombus, and major adverse cardiac events, while the latter included cardiac death. Statistical software Review Manager Version 5.3 was performed for meta-analysis. RESULTS: Five studies involving7,830 patients with coronary bifurcation lesions were included in this meta-analysis, the incidence of major adverse cardiac events for IVUS-guided strategy in patients with coronary bifurcation lesions were lower than those of patients with angiography-guided strategy at the early follow-up(ORâ=â0.55, 95% CI 0.42 - 0.70, Pâ<â.0001).Meanwhile, cardiac death, target vessel or target lesion revascularization, stent thrombosis were not statistically significant(ORâ=â0.68, 95% CI 0.34 - 1.35, Pâ=â.27; ORâ=â0.78, 95% CI 0.59 - 1.05, Pâ=â.10; ORâ=â0.36, 95% CI 0.12-1.04, Pâ=â.06).However, significant differences in cardiac death between IVUS-guided and angiographic-guided strategies were observed in the late follow - up (ORâ=â0.36, 95% CI 0.23 - 0.57, Pâ<â.00001). CONCLUSION: The IVUS-guided PCI strategy was associated with more clinical benefits compared with angiography-guided PCI strategy in patients with coronary bifurcation lesions. These findings suggest that the IVUS-guided PCI strategy can be recommended as an optimization in this kind of patients.
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Angiografia Coronária/métodos , Doença da Artéria Coronariana/cirurgia , Intervenção Coronária Percutânea/métodos , Complicações Pós-Operatórias/epidemiologia , Ultrassonografia de Intervenção/métodos , Idoso , Angiografia Coronária/efeitos adversos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/efeitos adversos , Complicações Pós-Operatórias/etiologia , Stents/efeitos adversos , Resultado do Tratamento , Ultrassonografia de Intervenção/efeitos adversosRESUMO
Despite being innate, displays of aggression are influenced by cortical activities. Here, using Vglut1 as a marker for inputs from cortical structures, we identify a small population of excitatory neurons located in the posterior amygdala (PA) that project to the ventrolateral division of ventromedial nucleus of the hypothalamus (VMHvl), a region that critically regulates territorial aggression. Indeed, activities of PA Vglut1+ (PAVglut1) neurons, as analyzed by post hoc c-Fos expression, differentiate trials in which attacks occur, or not, during resident-intruder assays. More importantly, chemogenetic activation of VMHvl-projecting PAVglut1 neurons robustly promote aggression while inhibition of these neurons reduces attacks. Finally, a connectivity map places VMHvl-projecting PAVglut1 neurons at the interface between emotion regulation and aggression as they receive broad inputs from limbic structures and project collaterally to the VMHvl and other targets. Taken together, these results point to VMHvl-projecting PAVglut1 neurons as a potential site for cortical gating of territorial aggression.
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Tonsila do Cerebelo/metabolismo , Neurônios/metabolismo , Núcleo Hipotalâmico Ventromedial/metabolismo , Proteína Vesicular 1 de Transporte de Glutamato/metabolismo , Animais , Feminino , Humanos , Masculino , CamundongosRESUMO
Depression is a common psychiatric disorder with heavy economic and social burdens. Searching new agents with better antidepressant-like activities is of great significance for depression therapy. Tauroursodeoxycholic acid (TUDCA), a clinical drug for gallstone treatment, possesses neuroprotective effects in different brain disorders. However, whether it affects depression remains unclear. We addressed this issue by evaluating the effect of TUDCA on depression induced by chronic unpredictable stress (CUS). Results showed that TUDCA treatment at 200 but not 100 mg/kg prevented the 5 weeks of CUS-induced increases in the immobile time of C57BL6/J mice in the experiments of forced swimming test and tail suspension test as well as the CUS-induced decrease in sucrose intake and crossing numbers in the open-field test, and did not enhance the antidepressant-like effect of fluoxetine. Attenuation of neuroinflammation may be involved in the antidepressant-like effect of TUDCA, as TUDCA treatment (200 mg/kg) normalized the levels of tumor necrosis factor-α and interleukin-6 in both hippocampus and prefrontal cortex. The increases in inflammasome and microglial activation markers, including interleukin-ß, nod-like receptor protein 3, and Iba-1, in CUS-treated mice were reduced by TUDCA treatment (200 mg/kg). TUDCA treatment (200 mg/kg) also normalized the changes in markers reflecting the oxidative-nitrosative and endoplasmic reticulum (ER) stress induced by CUS, such as nitric oxide, reduced glutathione, malondialdehyde, glucose-regulated protein 78, and C/EBP homologous protein. These results revealed that TUDCA improved the CUS-induced depression-like behaviors likely through attenuation of neuroinflammation, oxido-nitrosative, and ER stress.
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Antidepressivos/farmacologia , Depressão/tratamento farmacológico , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Estresse Nitrosativo/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Estresse Psicológico/tratamento farmacológico , Ácido Tauroquenodesoxicólico/farmacologia , Animais , Depressão/metabolismo , Modelos Animais de Doenças , Fluoxetina/farmacologia , Elevação dos Membros Posteriores/métodos , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fármacos Neuroprotetores/farmacologia , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/metabolismo , Estresse Psicológico/metabolismo , NataçãoRESUMO
Anion- and solvent-induced single-crystal-to-single-crystal transformation within an iron(II) triazole system has been generated from {[Fe(TPPT)2Cl2]·CHCl3} n (1a) to [Fe(TPPT)(C2O4)0.5Cl(H2O)] n (1b). Luminescence studies indicated that the resultant 1b can be considered as a promising luminescent probe for CrO42- and cyano molecules.
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Background: Z-guggulsterone, an active compound extracted from the gum resin of the tree Commiphora mukul, has been shown to improve animal memory deficits via activating the brain-derived neurotrophic factor signaling pathway. Here, we investigated the antidepressant-like effect of Z-guggulsterone in a chronic unpredictable stress mouse model of depression. Methods: The effects of Z-guggulsterone were assessed in mice with the tail suspension test and forced swimming test. Z-guggulsterone was also investigated in the chronic unpredictable stress model of depression with fluoxetine as the positive control. Changes in hippocampal neurogenesis as well as the brain-derived neurotrophic factor signaling pathway after chronic unpredictable stress/Z-guggulsterone treatment were investigated. The tryptophan hydroxylase inhibitor and the tyrosine kinase B inhibitor were also used to explore the antidepressant-like mechanisms of Z-guggulsterone. Results: Z-guggulsterone (10, 30 mg/kg) administration protected the mice against the chronic unpredictable stress-induced increases in the immobile time in the tail suspension test and forced swimming test and also reversed the reduction in sucrose intake in sucrose preference experiment. Z-guggulsterone (10, 30 mg/kg) administration prevented the reductions in brain-derived neurotrophic factor protein expression levels as well as the phosphorylation levels of cAMP response element binding protein, extracellular signal-regulated kinase 1/2, and protein kinase B in the hippocampus and cortex induced by chronic unpredictable stress. Z-guggulsterone (10, 30 mg/kg) treatment also improved hippocampal neurogenesis in chronic unpredictable stress-treated mice. Blockade of the brain-derived neurotrophic factor signal, but not the monoaminergic system, attenuated the antidepressant-like effects of Z-guggulsterone. Conclusions: Z-guggulsterone exhibits antidepressant activity via activation of the brain-derived neurotrophic factor signaling pathway and upregulation of hippocampal neurogenesis.
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Antidepressivos/farmacologia , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Transtorno Depressivo/tratamento farmacológico , Transtorno Depressivo/metabolismo , Pregnenodionas/farmacologia , Animais , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/metabolismo , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Fluoxetina/farmacologia , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Masculino , Camundongos Endogâmicos C57BL , Neurogênese/efeitos dos fármacos , Neurogênese/fisiologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/efeitos dos fármacosRESUMO
We report an extremely rare case of acute myelomonocytic leukemia (M4) with an MLL-ELL fusion gene lacking the PML-RARα rearrangement that transformed from hypergranular acute promyelocytic leukemia (APL) without showing any karyotypic evolution. The treatment was effective with chemotherapy for M4 and idarubicin plus a cytarabine-based chemotherapy protocol without ATRA.
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OBJECTIVES: To evaluate the rate of HIV seroconversion and the related risk factors among HIV discordant couples in Hubei Province, China. METHODS: HIV seroconversion rates and associated factors in discordant couples were identified during 2010-2012, based on existing data collected in serological and behavioral surveys between 2005 and 2007. RESULTS: At baseline, HIV transmission had occurred in 505 out of 1258 couples and the annual rate of HIV transmission was 6.3% in the absence of an intervention (40.14% after HIV exposure for 6.4 years). Five out of 753 discordant couples were found to have seroconverted during the 5-year follow-up observation after the implementation of interventions. Factors independently associated with HIV seroconversion included an HIV viral load >1000 copies/ml (odds ratio (OR) 18.706, 95% confidence interval (CI) 1.577-221.926), the index partner being on antiretroviral therapy (OR 0.019, 95% CI 0.002-0.180), and condom use in the past 6 months (OR 0.194, 95% CI 0.021-0.795). CONCLUSIONS: HIV-negative partners in serodiscordant couples were at risk of HIV infection if the index partner did not receive any intervention. It is strongly advised that existing interventions are used, such as couples consultations, condom use, and antiretroviral treatment, to minimize the risk of HIV transmission.
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Infecções por HIV/transmissão , Soropositividade para HIV/epidemiologia , Adulto , China/epidemiologia , Características da Família , Feminino , Seguimentos , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Parceiros SexuaisRESUMO
Adult-born granule cells in the dentate gyrus of the rodent hippocampus are important for memory formation and mood regulation, but the cellular mechanism underlying their polarized development, a process critical for their incorporation into functional circuits, remains unknown. We found that deletion of the serine-threonine protein kinase LKB1 or overexpression of dominant-negative LKB1 reduced the polarized initiation of the primary dendrite from the soma and disrupted its oriented growth toward the molecular layer. This abnormality correlated with the dispersion of Golgi apparatus that normally accumulated at the base and within the initial segment of the primary dendrite, and was mimicked by disrupting Golgi organization via altering the expression of Golgi structural proteins GM130 or GRASP65. Thus, besides its known function in axon formation in embryonic pyramidal neurons, LKB1 plays an additional role in regulating polarized dendrite morphogenesis in adult-born granule cells in the hippocampus.
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Dendritos/metabolismo , Giro Denteado/metabolismo , Hipocampo/metabolismo , Neurogênese , Neurônios/metabolismo , Proteínas Serina-Treonina Quinases/metabolismo , Proteínas Quinases Ativadas por AMP , Animais , Animais Recém-Nascidos , Autoantígenos/metabolismo , Axônios/metabolismo , Proteínas de Transporte/metabolismo , Polaridade Celular , Proliferação de Células , Regulação da Expressão Gênica , Complexo de Golgi/metabolismo , Proteínas de Fluorescência Verde/metabolismo , Hipocampo/citologia , Peptídeos e Proteínas de Sinalização Intracelular , Proteínas de Membrana/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Microscopia Confocal , FosforilaçãoRESUMO
To identify possible sources of stigma of epilepsy in key informant groups, "mini-ethnographic" studies were conducted in rural and urban locations in China. Data collected from 45 semistructured interviews and 8 focus group discussions (6 persons each) were analyzed to investigate the world experienced by people with epilepsy. Underpinned by a social constructionist approach to data analysis, emerging themes were identified with the use of computer-assisted data analysis (NVivo 8). A hierarchical model was then constructed, to include practical level issues (attitudes toward risk, attitudes toward costs of epilepsy) and cultural level issues (contrast between rurality and tradition and urbanization and modernity in the Chinese context). The analysis enriches current research on factors and sources of stigma of epilepsy and highlights issues for future practice.
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Epilepsia/epidemiologia , Epilepsia/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Estigma Social , Adulto , Fatores Etários , Idoso , China/epidemiologia , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Características de ResidênciaRESUMO
The clinical and cellular interactions between hepatitis B virus (HBV) and hepatitis C virus (HCV) were investigated in patients co-infected with the human immunodeficiency virus (HIV). One hundred ninety-nine patients followed for 6 years were evaluated to compare the level of HBV DNA and HCV RNA in patients co-infected with HIV and HBV, and patients co-infected with HIV, HBV, and HCV. A full-length HBV genome and HCV JFH1 RNA were co-transfected into HuH-7.5.1 cells in vitro to examine the impact of co-infection and dependence on the HBV PreC mutant for replication interference. Before 2',3'-dideoxy-3'-thiacytidine (3TC)-based antiretroviral therapy (ART) was initiated, HBV DNA was found in 56/123 (45.4%) patients co-infected with HIV and HBV, and in 19/76 (25.0%) patients co-infected with HIV, HBV, and HCV. After 3TC-based ART was initiated, detectable HBV DNA decreased to 7/76 (9.2%) in patients co-infected with HIV, HBV, and HCV, but HCV RNA increased from 43/76 (56.6%) to 60/76 (78.9%) (P = 0.003). In vitro HBV and HCV co-infection led to decreased replication of both viruses. The primary factors that influenced the decreased replication were the order of the HBV and HCV infection and the HBV PreC mutation.
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Infecções por HIV/tratamento farmacológico , Hepacivirus/genética , Vírus da Hepatite B/genética , Hepatite B/genética , Hepatite C/genética , Adulto , Anticorpos Antivirais/análise , Contagem de Linfócito CD4 , Linhagem Celular Tumoral , China , DNA Viral/análise , Feminino , HIV/genética , HIV/imunologia , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/genética , Infecções por HIV/imunologia , Infecções por HIV/virologia , Hepacivirus/imunologia , Hepatite B/complicações , Hepatite B/epidemiologia , Hepatite B/imunologia , Hepatite B/virologia , Antígenos de Superfície da Hepatite B/análise , Vírus da Hepatite B/imunologia , Hepatite C/complicações , Hepatite C/epidemiologia , Hepatite C/imunologia , Hepatite C/virologia , Humanos , Lamivudina/administração & dosagem , Estudos Longitudinais , Masculino , Mutação , Plasmídeos , RNA Viral/análise , Fatores de Risco , Transfecção , Replicação Viral/efeitos dos fármacosRESUMO
OBJECTIVE: To evaluate the effect of comprehensive prevention programs on HIV, HBV and syphilis transmission from mother to child and between premarital couples. METHODS: HIV, HBV and syphilis were screened among pregnant women with interventional measure for infected women; HIV, HBV and syphilis (TP) were screened among premarital couples with medical advice. RESULTS: The HIV, HBsAg and TP positive rates were 8.4 (111/13 280), 54 (711/13 186) and 12.8 (159/12 401) respectively among pregnant women and the total positive rate of the three diseases was 73.8 which was significantly higher than HIV positive rate (P < 0.001). The positive rates of HIV, HBsAg and TP were 17.6 (464/26 324), 95.3 (1826/19 152) and 18.6 (355/19 099) respectively among premarital couples and the total positive rate of the three diseases was 131.5 which was significantly higher than HIV positive rate alone (P < 0.001). Comprehensive prevention was more economical than prevention for HIV alone. CONCLUSION: The comprehensive strategies for prevention of HIV, HBV and syphilis was feasible, effective and economical that could help to actively conduct the preventive measures.
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Síndrome da Imunodeficiência Adquirida , Sífilis , Aconselhamento , Feminino , Infecções por HIV/diagnóstico , Antígenos de Superfície da Hepatite B , Humanos , GravidezRESUMO
OBJECTIVE: To investigate the incidence of hepatotoxicity in acquired immunodeficiency syndrome (AIDS) patients on combined anti-retroviral therapy (cART) containing nevirapine (NVP) and to assess the risk factors and its impact on cART. METHODS: 330 AIDS patients from March 2003 to June 2008 at local county were enrolled and a retrospective study using Kaplan-meier survival and Multivariate logistic regression modeling was conducted. RESULTS: 267 out of 330 patients received NVP based cART and 63 cases received EFV-based cART. The deference of prevalences of hepatotoxicity between the two groups is statistically significant (Chi2 = 6.691, P = 0.01). 133 out of 267 (49.8%) patients on NVP based cART had at least one episode of ALT elevation during a median 21 months (interquartile ranges, IQR 6, 37) follow-up time, amounts for 28.5 cases per 100 person-years. Baseline ALT elevation (OR = 14.368, P = 0.017)and HCV co-infection (OR = 3.009, P = 0.000) were risk factors for cART related hepatotoxicity, while greatly increased CD4+ T(CD4) cell count was protective against hepatotoxicity development (OR = 0.996, P = 0.000). Patients co-infected with HCV received NVP-based cART had the higher probability of hepatotoxicity than those without HCV co-infection (Log rank: Chi2 = 16.764, P = 0.000). 23 out of the 133 subjects (17.3%) with NVP related hepatotoxicity discontinued cART temporarily or shifted NVP to efavirenz. CONCLUSION: NVP related hepatotoxicity was common among ARV naive HIV infected subjects in our cohort. Baseline ALT elevation and HCV co-infection were associated statistically with the development of hepatotoxicity. Hepatotoxicity led to discontinuing cART temporarily or switching to other regimens in some subjects. It suggested that NVP should be used with caution in patients co-infected with HCV among whom anti-HCV therapy before cART initiation may contribute to minimizing the probability of NVP associated hepatotoxicity.
Assuntos
Síndrome da Imunodeficiência Adquirida/metabolismo , Antirretrovirais/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Fígado/efeitos dos fármacos , Nevirapina/efeitos adversos , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Adolescente , Adulto , Povo Asiático , Doença Hepática Induzida por Substâncias e Drogas/virologia , Feminino , Humanos , Incidência , Fígado/metabolismo , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto JovemRESUMO
To examine whether there are any differences in the rates of HIV-spousal transmission between those who have acquired the virus through blood or through sex in central China. A total of 650 HIV-infected individuals were enrolled, 420 of them were either former commercial plasma donors or recipients of blood (blood transmission group [BTG]), and 230 had acquired HIV infection through sex (sex transmission group [STG]). The spousal transmission rate of HIV was 2% per year (94/420, 11.2 years) in BTG and 8.9% per year (115/230, 5.6 years) in STG. There was a significantly higher transmission rate of HIV through male-to-female (11.7% per year, 84/128, 5.6 years) than through female-to-male (5.4% per year, 31/102, 5.6 years, P<0.05) in STG, but there was no significant gender based differences in BTG. In BTG, all HIV-1 tested were subtype B', while in STG, HIV-1 tested were predominantly subtypes CRF01_AE or CRF07_BC. Our results show that the HIV-spousal transmission rate was higher in STG than in BTG, and that there was a higher rate through male-to-female than female-to-male in STG.