Prevalence of HCV Antibody and its Associated Factors: A Study from Sentinel Hospitals in China.

Objective: The prevalence and related factors of serum anti-HCV in different regions and hospitals have not been studied extensively in China. We used routine screening data to determine the prevalence of HCV antibody in hospital patients, evaluate the epidemic trend of hepatitis C and formulate screening strategies. Methods: Patient information and HCV antibody testing results were collected from January 2017 to December 2019 in 77 HCV sentinel hospitals in China. Univariate and multivariate logistic regression was used to determine the characteristics and associations. Results: HCV antibody prevalence rates were distinct among patients in different departments, with a range of 0.33%-6.93%. Patients who were admitted to the liver disease-related departments (a OR = 10.76; 95% CI, 10.27-11.28), Internal Medicine (a OR = 2.87; 95% CI, 2.75-3.00), and Department of Surgery (a OR = 1.95; 95% CI, 1.87-2.04), were more likely to be tested for HCV antibody positive. HCV antibody prevalence was associated with patients aged 45 years and older (a OR = 2.74; 95% CI, 2.69-2.80), testing in infetious disease hospitals (a OR = 2.33; 95% CI, 2.26-2.40) and secondary hospitals (a OR = 1.72; 95% CI, 1.69-1.75). Patients in sentinel hospitals of the Northeast (a OR = 12.75; 95% CI, 12.40-13.11), the Central (a OR = 1.65; 95% CI, 1.61-1.70), and the West (a OR = 1.78; 95% CI, 1.73-1.83) China had higher HCV prevalence than those who were in the Eastern coastal area. Conclusion: Those who were over 45 years old and saw doctors for liver diseases, and invasive diagnosis and treatment should be referred to HCV antibody testing.

Prevalence and correlates of Trichomonas vaginalis infection among female sex workers in a city in Yunnan Province, China.

Sexual transmission is the fastest growing route of HIV transmission in China, and Trichomonas vaginalis(TV) can facilitate HIV transmission and acquisition. Our goal was to determine the prevalence and correlates of TV infection among female sex workers (FSWs). This cross-sectional study was conducted in a city of Yunnan Province in southern China, with confidential face-to-face interviews and laboratory tests for TV (wet mount) and other sexually transmitted infections. A total of 734 FSWs participated in the study. The prevalence of TV was 9.0% (95% confidence interval [CI] 7.02-11.30). In multivariate analyses, adjusted odds ratios of TV infection were 3.0 (95% CI 1.47-6.01) for herpes simplex virus type 2 seropositive, 2.4 (95% CI 1.37-4.14) for Chlamydia trachomatis infection, 2.6 (95% CI 1.30-5.31) for genital ulcer, 1.9 (95% CI 1.11-3.30) for starting age in commercial sex <20 years, and 0.5 (95% CI 0.27-0.87) for vaginal douching. We found a relatively high prevalence of TV infection among FSWs in Yunnan Province. A range of control strategies that include TV screening are recommended among FSWs, which could contribute significantly to the disruption of transmission by the provision of immediate treatment.

Vaginal douching and association with sexually transmitted infections among female sex workers in a prefecture of Yunnan Province, China.

Vaginal douching is a common practice and has been hypothesised to increase a woman's risk for human of contracting HIV and sexually transmitted infections (STIs). Our objective was to assess the prevalence of douching and its association with STIs, genital symptoms and HIV/STI knowledge among female sex workers (FSWs). We conducted a cross-sectional study of 837 FSWs with interviews and laboratory tests for HIV/STIs in a prefecture of Yunnan Province in southern China. Vaginal douching was reported by 84% of the women. We found a higher prevalence of vaginal douching practice among FSWs of Han ethnicity, and who were single or cohabitating. Douching was also significantly more common among more educated FSWs and those with greater knowledge of HIV/STIs, and as well as in FSWs who had experienced clinical symptoms in the previous 12 months. Douching was linked to higher risks of HIV (adjusted odds ratio = 2.29; 95% confidence interval 1.01-5.23) and herpes simplex virus type 2 infections (adjusted odds ratio = 2.18; 95% confidence interval 1.46-3.24) after adjusting for confounding factors. Medical professionals and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities. More prospective studies among FSWs are urgently required to identify the relationship between vaginal douching and HIV/STIs.

Over-expression of a proline specific aminopeptidase from Aspergillus oryzae JN-412 and its application in collagen degradation.

A strain that exhibited intracellular proline-specific aminopeptidase (PAP) activity was isolated from soy sauce koji and identified as Aspergillus oryzae JN-412. The gene coding PAP was cloned and efficiently expressed in Escherichia coli BL21 in a biologically active form. The highest specific activity reached 52.28 U mg(-1) at optimum cultivation conditions. The recombinant enzyme was purified 3.3-fold to homogeneity with a recovery of 36.7% from cell-free extract using Ni-affinity column chromatography. It appeared as a single protein band on SDS-PAGE with molecular mass of approximately 50 kDa. The purified enzyme exhibited the highest activity at 60 °C and pH 7.5. The enzyme activity was inhibited by PMSF and ions like Zn2+ and Cu2+. DTT, ß-mercaptoethanol, EDTA, and ions like Co2+, Mg2+, Mn2+, and Ca2+ had no influence on enzyme activity, whereas Ni2+ enhanced the enzyme activity. By using collagen as a substrate, the purified recombinant prolyl aminopeptidase contributed to the hydrolysis of collagen when used in combination with neutral protease, and free amino acids in collagen hydrolysates was significantly increased.

HIV-infected female sex workers' high risk behavior and attitude changes in Kaiyuan City, Yunnan Province, China.

OBJECTIVE: To investigate the attitude and sexual behavior status and change among HIV positive female workers in entertainment sites in Kaiyuan city, Yunnan province, China. The key information should be applied in the integrated intervention program in future. METHODS: A cohort survey among HIV positive female workers was conducted during 12 months, between 2010 and 2012. All the risk sexual behavior and attitude were collected for assessment for the potential secondary transmission to sexual partners. RESULTS: Of 99 HIV positive women who sell sex in Kaiyuan city, 99 participated in the survey at baseline, 80, 80, 75, and 75 at 3-, 6-, 9-, and 12-month follow-ups. The percentage of participants who reported consistently used condoms in the last one month ranged between 94.5% and 95.5%. The client volume in the last one month, income per sex and age group were significant related with non-insistent condom use with their clients. CONCLUSION: It was suggested that integrated intervention program package should include 100 percent condom use promotion for the HIV positive FSW with all sexual partners, and also, include socially support involved.

Herpes simplex virus type 2 risks in female sex workers in the China-Vietnam border county of Hekou.

OBJECTIVE: To survey the prevalence and risk factors of HSV-2 among Chinese and Vietnamese female sex workers (FSW) in the border county of Hekou, Yunnan Province, China. METHODS: A cross-sectional survey was conducted on demographics, sexual behavior, medical history, and drug use among FSWs. Laboratory samples were obtained to test for HSV-2 and other STIs such as HIV, Syphilis, Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, Bacterial vaginosis, and Yeast infections. Cervicitis and genital warts were also diagnosed. RESULTS: Of the 345 FSWs who participated in this study, 112 (32.5%) were ethnic Chinese and 233 (67.5) were Vietnamese. Among FSWs in Hekou, the prevalence rates were 58.3% for HSV-2, 5.5% for HIV, and 4.1% for bacterial vaginosis (BV). Age<21 (OR: 0.5; 95% CI: 0.3, 0.8), duration of commercial sex work≤3 months (OR: 0.5; 95% CI: 0.3, 0.8), oral and vaginal sex with the last client (as opposed to only vaginal sex) (OR: 1.6; 95% CI: 1.0, 2.7), HIV (OR: 11.4; 95% CI: 1.5, 87.2), and bacterial vaginosis (BV) (OR: 5.6; 95% CI: 1.2, 26.9) were significantly correlated with HSV-2 infection. CONCLUSION: Multivariate analysis showed that several factors were significantly correlated with the high prevalence of HSV-2 in FSWs in the border area between China and Vietnam. Further studies and interventions are needed for HSV-2 epidemiology in the border area.

Estimation of population-size changes and HIV prevalence among female sex workers from 2006 to 2009 in Kaiyuan, Yunnan, China.

OBJECTIVE: This study is to estimate the population size and prevalence of HIV and herpes simplex virus type 2 (HSV-2) infections among female sex workers (FSWs) in Kaiyuan, Yunnan Province, China. METHODS: Eight cross-sectional studies were conducted among FSWs in Kaiyuan from 2006 to 2009. Based on the data from two study time points each year, the total numbers of FSWs and HIV positive FSWs were estimated by using the capture-recapture technique (CR). RESULTS: Estimated sizes of FSWs in Kaiyuan were 1 629, 1 672, 1 186, and 1 014 in the respective years from 2006 to 2009. Although the crude prevalence rates of HIV and HSV-2 varied over time, the adjusted prevalence among this population was relatively stable at 10%-12% and the adjusted HSV-2 prevalence ranged from 67% to72%. CONCLUSION: The reason for the slight decrease of the size of the FSW population is unknown. The adjusted prevalence rates of HIV and HSV-2 among them were stable over the course of this study.

Spatial distribution of HIV/AIDS in Yunnan province, People's Republic of China.

Risk maps for the geographical distribution of human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS) are needed for the direction of HIV prevention interventions. Our study, based on county-level data on the numbers of HIV/AIDS patients in the Yunnan province, People's Republic of China, applied trend surface analysis and spatial autocorrelation analysis to demonstrate the geographical distribution of HIV-positive patients in the province. The case load of HIV was found to be most severe in the central-west region of the province. While Kunming county was shown to be negatively correlated with its surrounding counties, many high-burden counties are surrounded by other counties with similar case numbers. We conclude that intervention efforts in Yunnan province should concentrate on the western and northeast regions, targeting the hotspots of infection.

[HIV/AIDS epidemic situation and data analysis among young students from 2006-2009 in China].

OBJECTIVE: To analyze the HIV/AIDS epidemic situation and related behavioral components among young students in the last years and to provide information for integrated control and prevention programs. METHODS: Data on young students (15 - 24 years) through case reporting system was collected from 2006 to 2009 and continuous sentinel surveillance data regarding 6 national sentinel sites carried out from 2006 to 2009 was also collected. The sentinel sites would include universities, junior college and secondary vocational colleges registered students, using cluster sampling phases method. Self-administered questionnaire survey and blood (HIV antibody testing and syphilis antibody testing) tests were carried out, with the sample size was about 800 cases per site per year. RESULTS: The number of case report on HIV/AIDS among the young students of 15 - 24 years age group had been rising. Similar trend was also observed on the number of reported cases over the years, accounting for the proportions of the total number of reported cases, as 0.39%, 0.50%, 0.83% and 1.02% respectively from 2006 to 2009. Sexual contacts continued to be the major route of transmission, with the increasing proportion of homosexual transmission. In the 6 national sentinel sites of young students which continuous surveillance was conducted during the period from 2006 to 2009, data showed the following facts as: proportion (median) of objects who admitted to have had sex, were: 4.3%, 4.5% and 6.1%, proportions (median) of commercial sex occurred in the past year were: 0.3%, 0.2% and 0.3%; proportions (median) of MSM occurred in the past year were: 0.7%, 0.2% and 0.2%; median of HIV antibody positive rate and syphilis antibody positive rate were 0%; median of awareness rate on HIV/AIDS were: 49.0%, 75.0% and 80.5%; proportion (median) of monitor objects who received intervention services in the past year were: 44.2%, 54.3% and 50.2% respectively. CONCLUSION: In recent years, the HIV/AIDS number through case reporting system on the young students under 15 - 24 years age group, was increasing, but the HIV prevalence among young students was still relatively low, in general. The main transmission was sexual. Some young students had been engaged in commercial sex and MSM activities. Health education should be strengthened to increase the awareness of young students on AIDS/STD prevention. It is necessary to take more effective intervention measures to decrease new infection and control HIV/AIDS epidemic among young students.

[Study on the feasibility and related factors on semen samples from condoms, collected from sexual partners of and by the female sex workers for HIV-antibody testing].

OBJECTIVE: To explore the feasibility and related factors of using semen samples from condoms collected by their female sex workers (FSWs) for HIV-antibody testing. METHODS: FSWs were recruited by outreach workers. Semen samples from condoms of their sexual partners (paid or regular) were collected by FSWs themselves after intercourse and for HIV testing. Male partners were asked to participate in the study. Questionnaires were administered for both FSWs and heir male sexual partners. Blood samples were also collected for HIV testing. RESULTS: In total, 54 FSWs with 43 of their regular sexual partners and 57 casual clients were recruited. HIV prevalence, determined from serum samples, were 33.33% among FSWs, 29.82% and 23.26% among their clients and regular sexual partners. 40.35% and 30.23% of the semen samples from the condoms they used, were tested positive for HIV among clients and regular sexual partners of the FSWs. The sensitivity of semen samples from condoms for HIV-antibodies was 100% among both clients and regular sexual partners of the FSWs, while the rates of specificity were 85.00% and 90.91% respectively. Data from Univariate analysis indicated that among FSWs, factors as the characteristics of self-reported needle sharing and the male sexual partners who had one child, were associated with the disparity between serum and condom semen sample for HIV-antibody testing. CONCLUSION: HIV prevalence in male clients and regular sexual partners of the FSWs might be overestimated according to the HIV-antibody testing results of semen samples from condoms collected by FSWs themselves. Lower specificity indicated that FSWs with positive HIV might have contaminated the semen samples from the condom used by their HIV negative sexual partners.

Estimation of probability of unprotected heterosexual vaginal transmission of HIV-1 from clients to female sex workers in Kaiyuan, Yunnan Province, China.

OBJECTIVE: To estimate the probability of unprotected heterosexual vaginal transmission of HIV-1 from clients to Female Sex Workers (FSWs) in Kaiyuan County, Yunnan province, China, and analyze factors which impact the transmission probability. METHODS: An open cohort research of FSWs in Kaiyuan was created from surveys conducted in April 2008, October 2008, and April 2009. Two cross-sectional surveys of local clients were also carried out in May 2008 and November 2008. A model was developed to estimate the probability of unprotected heterosexual vaginal transmission of HIV-1 from clients to FSWs. RESULTS: The transmission probability from clients to FSWs was estimated as 0.0023 [95%CI 0.0014-0.0032] per unprotected heterosexual act. CONCLUSIONS: The transmission probability among this group engaging in commercial sex in Yunnan province differs from that found in studies from other countries, and future studies should estimate the influence factors of HIV-1 transmission probability, such as stage of HIV infection, co-morbid sexually transmitted infections (STIs).

[Study on the quality of life and its influential factors among HIV positive population.].

OBJECTIVE: To study the quality of life and its influential factors among HIV positive population. METHODS: Quality of life was evaluated among 2608 HIV positive population by WHOQOL (Chinese Version) to calculate the total and four domains' scores of quality of life. Multiple linear regression model was used to analyze the relationship between the factors and the scores of the four domains and the total score of quality of life. RESULTS: Physical, psychological, social, environmental and the total scores of the HIV positive population were 12.96 +/- 1.94, 11.79 +/- 1.19, 13.79 +/- 2.44, 12.40 +/- 1.93 and 51.02 +/- 6.03, respectively. Females had a higher scores than males in the four domains and the total score of quality of life. Through a multiple linear regression model, we found that the influential factors would include gender, age, occupation, family conflict and appetite etc. CONCLUSION: People living with HIV had higher scores in social domain, but lower scores in psychological domain, suggesting that psychological intervention should be strengthened.

[Data analysis of national HIV comprehensive surveillance sites among female sex workers from 2004 to 2008].

OBJECTIVE: To monitor the time trend of behaviors change related to HIV/AIDS epidemic and HIV prevalence, and to provide information and basis for comprehensive HIV prevention responses and evaluation of intervention effectiveness among female sex workers in China. METHODS: During the year of 2004 to 2008, a series of cross-sectional surveys were conducted among female sex workers in community recruited in both entertainment places and in street, during the defined timeframe, a face-to-face interview was conducted with uniformed questionnaire; while, the venous blood specimen was collected. The sample size was 400 per site per survey. RESULTS: In 15 continuous national HIV comprehensive surveillance sites among female sex workers from 2004 to 2008, the median of HIV prevalence was 0.0%; Prevalence (median) of syphilis respectively: 0.5%, 1.8%, 1.6%, 1.8% and 1.0%. The median of target subjects who used condom in the last commercial sex was: 81.8%, 80.5%, 84.6%, 87.0% and 88.9% respectively; the median of always used condom in commercial sex during the last month: 65.8%, 59.6%, 60.3%, 59.8% and 73.7%. The median of awareness rate on HIV/AIDS transmission of female sex workers was: 74.3%, 84.1%, 65.2%, 66.0% and 74.3%. The median of target subjects who attended HIV VCT services were: 12.4%, 20.4%, 25.8%, 25.3% and 31.7%. The median of the proportion of female sex workers who reached intervention in last year respectively: 46.4%, 76.1%, 72.1%, 95.0% and 90.8%. CONCLUSION: Condom use and HIV awareness rate need to enhance further among female sex workers. The proportion of female sex workers who attended VCT and knew their HIV testing result and the proportion of female sex workers who reached intervention in last year both increase. HIV prevalence rate among female sex workers is generally low, but high risk behaviors are still alarming. It is necessary to take more comprehensive and effective prevention measures and intervention.

[Retrospective research on proportion of HIV related death causes in nine counties in China].

OBJECTIVE: To investigate the proportion of HIV related death cause, and its years of potential life lost (YPLL) and work years of potential life lose (WYPLL) in project counties. METHOD: According to the protocol of the third national death causes surveillance and HIV related death causes surveillance, retrospective study was implemented including baseline investigation of deaths' name list, demography information, door-to-door interview and death causes deduction in Gejiu, Ruili and Longchuan county in Yunnan province, Yangdong county in Guangdong province, Luzhai county in Guangxi zhuang Autonomous Region, Weishi and Zhecheng county in Henan province, Xishui county in Hubei province and Gu'an county in Hebei province. RESULTS: The study was conducted among nine counties located in seven provinces. A total of 118 719 cases were included, raw mortality was 5.83 per thousand, 2002 death cases were related to HIV, which contributed 1.67% of total deaths. The average age of HIV death was 38.03 yearsow, which was earlier than the non-HIV-related life-span (63.10 years). The YPLL and WYPLL of HIV death was 33.80 years and 20.50 years, respectively, which had contributed the second highest average YPLL. CONCLUSION: HIV has an important proportion among all death causes, and has contributed severe average YPLL and WYPLL.

[Epidemiologic study on STD/HIV infections among tin mining workers in Gejiu, Yunnan province].

OBJECTIVE: To estimate human immunodeficiency virus (HIV)/sexually transmitted diseases (STDs) related knowledge, the prevalence and risk factors for HIV/STDs among tin miners in Gejiu, Yunnan Province. METHODS: A cross-sectional study was conducted in tin miners working at 5 mining regions from March to June 2006 in Gejiu City, Yunnan Province. A total of 1796 miners were enrolled in the study, and a standardized questionnaire was administered probing socio-demographic factors, knowledge of HIV/STDs and sexual behavior. 7 ml-volume venous blood and 15 ml urine specimens were collected for HIV/STDs testing. RESULTS: Twelve participants [0.7%] (12/1760) were identified HIV positive. While, the positive proportions for syphilis, herpes simplex virus type-2 (HSV-2), Neisseria gonorrhea and Chlamydia trachoma were 1.8% (31/1760), 9.6% (169/1760), 0.8% (14/1773), 4.8% (85/1773), respectively. The total prevalence of STDs was 14.9% (264/1776). Factors associated with HIV infection were illegal drug use (adjusted OR = 17.8; 95% CI: 4.0 - 78.8), frequencies of visiting female sex workers in the past twelve months (adjusted OR = 8.7; 95% CI: 1.9 - 39.0), tattoos (adjusted OR = 6.6; 95% CI: 1.8 - 24.0), surgical operation experiences (adjusted OR = 6.0; 95% CI: 1.6 - 22.5) and toothbrush sharing (adjusted OR = 5.6; 95% CI: 1.0 - 31.3). Factors associated with STDs infection were race (adjusted OR = 2.0; 95% CI: 1.5 - 2.7), age (adjusted OR = 1.7; 95% CI: 1.0 - 2.9), illegal drug use (adjusted OR = 2.3; 95% CI: 1.0 - 5.2), living with spouses (adjusted OR = 1.4; 95% CI: 1.1 - 1.9) and visiting female sex workers (adjusted OR = 1.9; 95% CI: 1.4 - 2.6). Only 4.1% (49/1201) of respondents aware the correct transmission routes of HIV. 21.6% (339/1569) of the miners who had previous sexual experience self-reported visiting female sex workers. CONCLUSION: HIV and other STDs are highly prevalent amongst miners in this region. In addition, the awareness of HIV/STDs is low and multiple routes of HIV transmission, such as heterosexual intercourse and IDU, were also observed in these study subject. HIV/STDs interventions should therefore be reinforced among the miners in this region.

[Study on the association between vaginal douching and sexually transmitted diseases among female sex workers in a county of Yunnan province].

OBJECTIVE: To explore the epidemic characteristics of vaginal douching, human immunodeficiency virus (HIV) and other sexually transmitted diseases(STD) among female sex workers (FSWs) in Yunnan province. METHODS: FSWs were recruited to be investigated on their demographic data, drug abuse and sexual behavior, HIV/AIDS knowledge and procreation health status. Venous blood were collected to test for HIV, herpes simplex virus 2 (HSV-2) and syphilis while urine specimen was for morphine, cervical secretion for Gonorrhoea and Chlamydia trachomatis, and vaginal secretion for Trichomonas. RESULTS: A total number of 833 blood specimen were collected, in which 84 specimen were confirmed to be HIV positive with a prevalence rate of 10.1%. The prevalence rates of syphilis and HSV-2 were 8.2% and 68.4% respectively. 832 vaginal and cervical secretion specimen were collected with the prevalence rates of Gonorrhoea, Chlamydia trachomatis and Trichomonas were 11.5%, 28.2% and 11.9% respectively. In multivariate logistic analysis, the factors associated with vaginal douching were: being Han nationality, locations of sex work at middle/high level, ever heard of HIV/AIDS, emerged hypogastric pain last year, the number of sex work location > or =4. CONCLUSION: Vaginal douching was shown a risk factor for HIV and some STD.