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1.
Zhonghua Gan Zang Bing Za Zhi ; 29(8): 776-780, 2021 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-34517460

RESUMO

Objective: To investigate the long-term characteristic changes of virus, immune status, and liver fibrosis markers in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infected patients after receiving direct-antiviral agents (DAAs). Methods: HIV/HCV co-infected patients who visited the Guangzhou Eighth People's Hospital, Guangzhou Medical University from May 2014 to December 2019 were selected as the research subjects. The changes of virological response rate, peripheral blood CD4(+)T lymphocyte level and serological markers of liver fibrosis (APRI score and FIB-4 index) were observed during 144 weeks of follow-up course after the end of DAAs treatment. Kruskal-Wallis test was used for statistical approach. Results: A total of 103 cases were included in the study. There were 87 males (87.5%), with a median age of 44 years. Sustained virological response rate at 12 weeks (SVR12) after DAAs treatment was 97.6%, and the SVR during the entire follow-up period was at least 95.9%. Compared with baseline, CD4(+)T lymphocyte count were significantly increased equally at 12 weeks (Z = -2.283, P = 0.022), 24 weeks (Z = -3.538, P < 0.001), 48 weeks (Z = -3.297, P = 0.001), 96 weeks (Z = -3.562, P < 0.001), and 144 weeks (Z = -2.842, P = 0.004). APRI score (Z = -6.394, P < 0.001) and FIB-4 index (Z = -2.528, P = 0.011) were significantly lower than baseline at week 4 of DAAs treatment, and thereafter remained at a low level, without further declination. Conclusion: HIV/HCV co-infected patients can maintain high SVR for a long time, acquire good immune reconstitution, and significantly improve liver fibrosis after DAAs treatment.


Assuntos
Coinfecção , Infecções por HIV , Hepatite C Crônica , Hepatite C , Adulto , Antivirais/uso terapêutico , Coinfecção/tratamento farmacológico , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Hepacivirus , Hepatite C/tratamento farmacológico , Hepatite C Crônica/tratamento farmacológico , Humanos , Cirrose Hepática/tratamento farmacológico , Masculino , Resultado do Tratamento
2.
HIV Med ; 21(11): 729-738, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33369035

RESUMO

OBJECTIVES: Talaromycosis is an invasive mycosis endemic to Southeast Asia. This study aimed to investigate the epidemiology, clinical features and prognostic factors of HIV-associated talaromycosis in Guangdong, China. METHODS: We retrospectively evaluated HIV patients hospitalized with histopathology- or culture-confirmed talaromycosis between 2011 and 2017. Factors associated with poor prognosis were identified using logistic regression. RESULTS: Overall, 1079 patients with HIV-associated talaromycosis were evaluated. Both the number and prevalence of talaromycosis among HIV admissions increased from 125 and 15.7% in 2011 to 253 and 18.8% in 2017, respectively, reflecting the increase in HIV admissions. Annual admissions peaked during the rainy season between March and August. Common clinical manifestations included fever (85.6%), peripheral lymphadenopathy (72.3%), respiratory symptoms (60.8%), weight loss (49.8%), skin lesions (44.5%) and gastrointestinal symptoms (44.3%). Common laboratory abnormalities were hypoalbuminaemia (98.6%), anaemia (95.6%), elevated aspartate aminotransferase level (AST) (76.9%), elevated alkaline phosphatase level (55.8%) and thrombocytopenia (53.7%). The median CD4 count was 9 cells/µL. Talaromyces marneffei was isolated from blood and bone marrow cultures of 66.6% and 74.5% of patients, respectively. The rate increased to 86.6% when both cultures were performed concurrently. At discharge, 14% of patients showed worsening conditions or died. Leucocytosis, thrombocytopenia, elevated AST, total bilirubin, creatinine and azole monotherapy independently predicted poor prognosis. CONCLUSIONS: The incidence of HIV-associated talaromycosis has increased in Guangdong with the high HIV burden in China. Skin lesions were seen in less than half of patients. Induction therapy with azole alone is associated with higher mortality. Findings from this study should help to improve treatment of the disease.

3.
Zhonghua Zhong Liu Za Zhi ; 42(9): 713-717, 2020 Sep 23.
Artigo em Chinês | MEDLINE | ID: mdl-32988151

RESUMO

Lung cancer is currently the malignant tumor with the highest morbidity and mortality in the world, and the main type is non-small cell lung cancer. Immune checkpoint inhibitor is a landmark discovery in the history of cancer treatment, which rewrites the history of cancer treatment, and improves the medical treatment of advanced tumors by a big step forward. The article summarizes the research progress of therapeutic drugs against anti-programmed cell death protein and programmed cell death protein ligand antibodies in the clinical diagnosis and treatment of non-small cell lung cancer. The principle of drug action, the differences in the diagnosis and treatment of non-small cell lung cancer in different clinical stages, and future research directions are discussed to provide the usage guidelines of immune checkpoint inhibitors for clinical oncologists.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Inibidores de Checkpoint Imunológico , Neoplasias Pulmonares , Antígeno B7-H1/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Humanos , Inibidores de Checkpoint Imunológico/uso terapêutico , Imunoterapia , Neoplasias Pulmonares/tratamento farmacológico , Receptor de Morte Celular Programada 1/uso terapêutico
4.
Zhonghua Nei Ke Za Zhi ; 59(0): E012, 2020 May 09.
Artigo em Chinês | MEDLINE | ID: mdl-32388937

RESUMO

Objective: To evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) and arbidol in the treatment of COVID-19 in the real world. Methods: The clinical data of 178 patients diagnosed with COVID-19 admitted to Guangzhou Eighth People's Hospital were retrospectively analyzed from January 21 to February 9, 2020. According to the patient's antiviral treatment regimen, 178 patients were divided into 4 groups including LPV/r group (59 patients), arbidol group (36 patients), combination therapy with LPV/r plus arbidol group (25 patients) and the conventional treatment group without any antiviral drugs (58 patients). The main observation end points of the study was the negative conversion time of nucleic acid of the novel coronavirus (2019-nCoV) in pharyngeal swab. Results: The baseline of 4 groups before treatment was consistent and comparable. The negative conversion time of nucleic acid of the 2019-nCoV in pharyngeal swab was (10.20 ± 3.49), (10.11 ± 4.68), (10.86 ± 4.74), (8.44 ± 3.51) days separately in the LPV/r group, the arbidol group, the combination therapy group, and the conventional treatment group without significant difference (F = 2.556, P = 0.058). There was also no significant difference in the rate of negative conversion rate of 2019-nCoV nucleic acid, the improvement ration in clinical symptoms, and the improvement ration of pulmonary infection in the lung CT imaging (P> 0.05). However, a statistically significant difference was found in the proportion of deterioration changing from mild/moderate to severe/critical type at day 7 (χ(2) = 9.311, P = 0.017) as follows: the combination therapy group (24.0%, 6/25), the arbidol group ( 16.7%, 6/36), LPV/r group (5.4%, 3/56) and conventional treatment group (5.2%, 3/58). Moreover, the frequency of adverse reactions in the three groups receiving antiviral drugs was significantly higher than that in the conventional treatment group (χ(2) = 14.875, P = 0.002). Conclusions: No evidences could prove that LPV/r and arbidol could shorten the negative conversion time of novel coronavirus nucleic acid in pharyngeal swab nor improve the symptoms of patients. Furthermore, the combination usage of LPV/r and arbidol may not benefit for improving the disease. Noteworthy, the adverse reactions of the antiviral drugs should be paid careful attention during the treatment.

5.
Eur Rev Med Pharmacol Sci ; 23(8): 3461-3470, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31081101

RESUMO

OBJECTIVE: To study the correlations of micro ribonucleic acid (miR)-126 expression with pathogenesis and prognosis of glioma, and to screen potential biological targets for the diagnosis, treatment and prognosis of glioma. PATIENTS AND METHODS: miR-126 expression in cancer tissues, normal brain tissues, U87MG cells and normal astrocytes in glioma patients was quantitatively analyzed via quantitative reverse transcription-polymerase chain reaction (qRT-PCR). U87MG cells were transfected with miR-126 mimics or miR-126 inhibitor, followed by verification via qRT-PCR. The cell proliferation, apoptosis, migration and invasion after transfection were analyzed using methyl thiazolyl tetrazolium (MTT) assay, Annexin V/propidium iodide (PI) assay, wound healing assay and transwell assay, respectively. The expression levels of proteins related to phosphatase and tensin homolog deleted on chromosome ten/phosphatidylinositol 3-kinase/protein kinase B (PTEN/PI3K/Akt) pathway and double mouse minute 2 homolog (MDM2)-p53 pathway were detected via Western blotting. Moreover, the prognostic analysis was performed using the Kaplan-Meier method and log-rank test. RESULTS: Results of qRT-PCR showed that the miR-126 expression in highly malignant glioma tissues and U87MG cells were significantly lower than those in normal brain cells, and its expression level was significantly higher or lower than that in negative control group after transfection with miR-126 mimics or inhibitor. Analyses of cell proliferation, apoptosis, migration and invasion revealed that the up-regulation of miR-126 could remarkably inhibit the in-vitro proliferation, migration and invasion and promote apoptosis of glioma cells, and vice versa. Results of Western blotting manifested that after overexpression of miR-126, PI3K, p-Akt and MDM2 protein levels in U87MG cells were significantly decreased compared with those in control group, but PTEN and p53 protein expressions were significantly increased, and vice versa. Besides, according to prognostic analysis, the prognosis of patients with a low miR-126 level was poorer. CONCLUSIONS: The miR-126 expression is abnormally low in glioma cells, and miR-126 inhibits the course of glioma through targeted regulation of PTEN/PI3K/Akt and MDM2-p53 pathways, which, therefore, can be used as a new potential biomarker for the diagnosis, treatment and prognosis of glioma.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias Encefálicas/genética , Glioma/genética , MicroRNAs/metabolismo , Transdução de Sinais/genética , Adulto , Encéfalo/patologia , Encéfalo/cirurgia , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Linhagem Celular Tumoral , Feminino , Regulação Neoplásica da Expressão Gênica , Glioma/mortalidade , Glioma/patologia , Glioma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/genética , PTEN Fosfo-Hidrolase/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Prognóstico , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Proteína Supressora de Tumor p53/metabolismo
6.
Zhonghua Gan Zang Bing Za Zhi ; 26(7): 495-498, 2018 Jul 20.
Artigo em Chinês | MEDLINE | ID: mdl-30317770

RESUMO

Objective: To investigate the combined effects of hepatitis B virus and hepatitis C virus (HBV/HCV) infection on the cause of death in patients with acquired immunodeficiency syndrome (AIDS). Methods: The causes of death of 111 cases of AIDS with HBV/HCV (combined infection group) and 210 AIDS patients (single infection group) admitted to our hospital from 2012 to 2016 data were compared using chi-square test. Results: There was no statistically significant difference in gender composition and age in the combined infection groups (P > 0.05). The main causes of death in the combined infection group were severe pneumonia (44.1%), end-stage liver disease (18.9%), and central nervous system infection (14.4%). The main causes of death in the single infection group were severe pneumonia (47.6%) and central nervous system infection (14.3%) and tumor (13.3%). There was no case of end-stage liver disease. The ratio of end-stage liver disease in the former group was significantly higher than that in the latter group (χ(2) = 42.511, P < 0.001). The main cause of death in 12 HIV/HBV/HCV triple-infected patients was end-stage liver disease, accounting for 41.7%, which was significantly higher than 18.9% of end-stage liver disease in HIV/HBV or HIV/HCV dual infection (99 cases). And the difference was statistically significant (χ(2) = 4.539, P = 0.033); however, the ratio of end-stage liver disease in 50 HIV/HBV co-infected patients and 49 HIV/HCV co-infected patients was 16.0% vs. 16.3%, respectively, and the difference was not statistically significant (χ(2) = 0.002, P = 0.965). In the co-infected group, 36 patients had CD4(+) cell counts >100/µl, the primary cause of death was end-stage liver disease, accounting for 38.2%. 75 patients with CD4(+) ≤ 100/µl died due to end-stage liver disease, accounting for 9.3% and the difference was statistically significant (χ(2) = 13.852, P < 0.05). Conclusion: End-stage liver disease is the main cause of death in patients with AIDS combined with HBV or HCV, especially triplet infection and CD4(+) cell count > 100/µl. An early diagnosis and treatment of HBV or HCV infection should commence as soon as possible.


Assuntos
Síndrome de Imunodeficiência Adquirida/mortalidade , Coinfecção/mortalidade , Hepatite B/mortalidade , Hepatite C/mortalidade , Causas de Morte , Infecções por HIV , Humanos
7.
Zhonghua Gan Zang Bing Za Zhi ; 26(4): 282-287, 2018 Apr 20.
Artigo em Chinês | MEDLINE | ID: mdl-29996340

RESUMO

Objective: To investigate the optimal duration of pegylated-alpha interferon (Peg-INFα) combined with ribavirin (RBV) in treating chronic hepatitis C infection in human immunodeficiency virus (HIV)-infected patients. Methods: A multicenter prospective study was conducted. The study subjects were divided into two groups; HIV/HCV co-infections (Group A, n = 158) and control with HCV-monoinfections (Group B, n = 60). All recruited patients received standard Peg-INFα plus RBV therapy. Group A was divided into 3 subgroups according to CD4(+) cell counts: A1 subgroup, 79 cases, CD4(+) counts > 350 cells /µl, who received anti-HCV before combination antiretroviral therapy(cART); A2 subgroup, 45 cases, CD4(+) counts between 200 and 350 cells/µl, who did not start anti-HCV until they could tolerate cART well; A3 subgroup, 34 cases, CD4(+) counts < 200 cells /µl, cART was administered first, and anti-HCV therapy was started when CD4(+) counts > 200 cells/µl. The anti-HCV efficacy of two groups and 3 subgroups were compared. Statistical analysis for normal distribution and homogeneity of variance data was calculated by t-test and the counting data was analyzed by χ (2) test. The Mann-Whitney U test was used for non-normal data. A one-way analysis of variance (ANOVA) was used for the comparison of multiple groups, followed by SNK method. Multiple independent samples were used for non-parametric tests. Results: There was no significant difference in age and baseline HCV RNA levels between groups and subgroups (P > 0.05). By an intent-to-treat (ITT) analysis, in Group A, the ratio of complete early virological response (cEVR) rate was 75.3% (119/158), the ratio of end of treatment virological response (eTVR) rate was 68.4% (108/158), and the ratio of sustained virological response (SVR) rate was 48.7% (77/158); in Group B, the ratio of cEVR rate was 93.3% (56/60), the ratio of eTVR rate was 90.0% (54/60), and the ratio of SVR rate was 71.7% (43/60); The therapeutic index of Group A were lower than those of Group B (P≤0.05). By per-protocol (PP) analysis, the ratio of cEVR rate in Group A [75.2% (88/112)] was still lower than that in Group B [93.3% (56/60)], but no significant differences were found in the ratio of eTVR rate and SVR rate between 2 groups (P > 0.05). Comparing the efficacy of subgroups (A1, A2 and A3) by ITT analysis, the ratios of cEVR rate were respectively 78.5% (62/79), 75.6% (34/45) and 67.6% (23/34); the ratios of eTVR rate were respectively 68.4%(54/79), 80.0%(36/45)and 52.9%(18/34); and the ratios of SVR rate were respectively 41.8%(33/79), 64.4%(29/45)and 44.1%(15/34). The ratio of eTVR in subgroup A2 was obviously higher than that in subgroup A3 and the ratio of SVR in subgroup A2 was statistically higher than that of subgroup A1(P≤0.05). However, by PP analysis, no significant differences of the therapeutic indexes were found among the respective subgroups (P > 0.05). Conclusion: HIV-HCV co-infected patients would have better anti-HCV efficacy with Peg-INFα-2a plus RBV than HCV- monoinfected patients. The best time for initiating anti-HCV therapy in HIV-HCV co-infected patients is when CD4(+) counts 200 cells/ µl.


Assuntos
Antivirais/uso terapêutico , Coinfecção/tratamento farmacológico , Infecções por HIV/tratamento farmacológico , Hepacivirus/efeitos dos fármacos , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Ribavirina/uso terapêutico , Antivirais/administração & dosagem , Quimioterapia Combinada , Infecções por HIV/complicações , Humanos , Interferon-alfa/administração & dosagem , Estudos Prospectivos , Proteínas Recombinantes/uso terapêutico , Ribavirina/administração & dosagem , Resultado do Tratamento
8.
Zhonghua Nei Ke Za Zhi ; 57(5): 317-323, 2018 May 01.
Artigo em Chinês | MEDLINE | ID: mdl-29747285

RESUMO

Cryptococcal meningitis is a common and refractory central nervous system infection, with high rates of mortality and disability. The experts of the Society of Infectious Diseases of Chinese Medical Association have reached this consensus after a thorough discussion. Based on the current situation of cryptococcal meningitis in China, the management of cryptococcal meningitis includes 6 aspects: introduction, microorganism identification, clinical manifestations and diagnosis, principles of antifungal therapy, treatment of refractory and recurrent meningitis, treatment of intracranial hypertension. There is not a separate consensus on human immunodeficiency virus (HIV) infection in patients with cryptococcal meningitis. This article focuses on different antifungal regimens and reducing intracranial pressure by reference to Infectious Disease Society of America (IDSA) guidelines. The importance of early diagnosis, combined long-term antifungal therapy, control of intracranial hypertension are emphasized.


Assuntos
Consenso , Hipertensão Intracraniana/etiologia , Meningite Criptocócica/diagnóstico , Adulto , Antifúngicos/uso terapêutico , China , Humanos , Hipertensão Intracraniana/parasitologia , Masculino , Meningite Criptocócica/tratamento farmacológico
9.
Eur J Clin Microbiol Infect Dis ; 37(6): 1099-1102, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29536323

RESUMO

Talaromyces marneffei (T. marneffei) can cause talaromycosis, a fatal systemic mycosis, in patients with AIDS. With the increasing number of talaromycosis cases in Guangdong, China, we aimed to investigate the susceptibility of 189 T. marneffei clinical strains to eight antifungal agents, including three echinocandins (anidulafungin, micafungin, and caspofungin), four azoles (posaconazole, itraconazole, voriconazole, and fluconazole), and amphotericin B, with determining minimal inhibition concentrations (MIC) by Sensititre YeastOne™ YO10 assay in the yeast phase. The MICs of anidulafungin, micafungin, caspofungin, posaconazole, itraconazole, voriconazole, fluconazole, and amphotericin B were 2 to > 8 µg/ml, >8 µg/ml, 2 to > 8 µg/ml, ≤ 0.008 to 0.06 µg/ml, ≤ 0.015 to 0.03 µg/ml, ≤ 0.008 to 0.06 µg/ml, 1 to 32 µg/ml, and ≤ 0.12 to 1 µg/ml, respectively. The MICs of all echinocandins were very high, while the MICs of posaconazole, itraconazole, and voriconazole, as well as amphotericin B were comparatively low. Notably, fluconazole was found to have a higher MIC than other azoles, and exhibited particularly weak activity against some isolates with MICs over 8 µg/ml. Our data in vitro support the use of amphotericin B, itraconazole, voriconazole, and posaconazole in management of talaromycosis and suggest potential resistance to fluconazole.


Assuntos
Anfotericina B/farmacologia , Antifúngicos/farmacologia , Azóis/farmacologia , Equinocandinas/farmacologia , Infecções por HIV/microbiologia , Talaromyces/efeitos dos fármacos , Anidulafungina , Infecções por HIV/complicações , Humanos , Lipopeptídeos/farmacologia , Micafungina , Testes de Sensibilidade Microbiana , Micoses/tratamento farmacológico , Micoses/microbiologia , Kit de Reagentes para Diagnóstico , Talaromyces/isolamento & purificação , Talaromyces/fisiologia , Voriconazol/farmacologia
10.
Sci Rep ; 7(1): 7392, 2017 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-28785054

RESUMO

In this work, we study the magnetic orders of a classical spin model with anisotropic exchanges and Dzyaloshinskii-Moriya interactions in order to understand the uniaxial stress effect in chiral magnets such as MnSi. Variational zero temperature calculations demonstrate that various helical orders can be developed depending on the interaction anisotropy magnitude, consistent with experimental observations at low temperatures. Furthermore, the uniaxial stress induced creation and annihilation of skyrmions can be also qualitatively reproduced in our Monte Carlo simulations. Our work suggests that the interaction anisotropy tuned by applied uniaxial stress may play an essential role in modulating the magnetic orders in strained chiral magnets.

11.
J Phys Condens Matter ; 29(40): 405806, 2017 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-28695843

RESUMO

Based on the modified Heisenberg-Kitaev model, the effects of magnetic substitution on the magnetic properties of the honeycomb-lattice iridate [Formula: see text] [Formula: see text] are studied using Monte Carlo simulations. It is observed that the long-range zigzag state of the original system is rather fragile and can be replaced by a spin-glass state even for small substitution, well consistent with the experimental observation in Ru-substituted samples (Mehlawat et al 2015 Phys. Rev. B 92 134412). Both the disordered Heisenberg and Kitaev interactions caused by the magnetic ion-doping are suggested to be responsible for the magnetic phase transitions in the system. More interestingly, a short-range zigzag order is suggested to survive above the freezing temperature even at high magnetic impurity doping levels.

12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(6): 740-745, 2017 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-28647974

RESUMO

Objective: To compare the differences of CD(4) (+) T lymphocyte (CD(4)) counts between patients aged 18 and over, to explore the effect of age on treatment, 36 months after having received the China National Free AIDS Antiretroviral Treatment on HIV/AIDS. Methods: Through the National ART Information Ssystem, we selected those HIV/AIDS patients who initiated the ART 36 months after the ART, between January 1, 2010 and December 31, 2012 in Guangzhou, Liuzhou and Kunming. Patients were divided into age groups as 18-49, 50-59 and 60 or over year olds, at the baseline of treatment. Under different levels of baseline CD(4) counts, we chose the baseline and different time-point of CD(4) counts as dependent variables, applied mixed linear model to analyze the effects of age, viral suppression, gender, baseline CD(4)/CD(8) ratio and initial treatment regimen. Results: A total of 5 331 HIV/AIDS patients were recruited. No differences were found on age group ratios between different levels of baseline CD(4) counts. At the level of baseline CD(4)<200 cells/µl, both the 50-59 and 60 or above years old groups had lower CD(4) counts than the 18-49 year-old group, within 36 months after the initiation of ART. However, at the baseline CD(4) level of 200-350 cells/µl, no significant differences on CD(4) counts between the 50-59 year-old and 18-49 year-old groups were noticed. CD(4) counts seemed lower in the 60 and above year-old group than in the 18-49 year-old group. Conclusion: Age might serve as an influencing factor on CD(4) counts within 36 months after the initiation of ART, suggesting that earlier initiation of ART might be of help to the recovery of immune function in the 50-59 year-old group.


Assuntos
Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Linfócitos T/efeitos dos fármacos , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Contagem de Linfócito CD4 , China/epidemiologia , Doenças Transmissíveis , Feminino , Infecções por HIV/epidemiologia , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Adulto Jovem
13.
Zhonghua Gan Zang Bing Za Zhi ; 24(3): 181-5, 2016 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-27095760

RESUMO

OBJECTIVE: To investigate the efficacy and safety of pegylated interferon-alpha (PEG-INF-α) combined with ribavirin in patients co-infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) who failed prior standard interferon therapy. METHODS: A prospective study was performed to analyze HCV RNA load, liver function, and CD4+ count at weeks 0 (baseline), 12, 24, and 48 of treatment and at 24 weeks after drug discontinuation in 20 patients co-infected with HIV and HCV who failed standard interferon therapy and were then treated with PEG-INF-αand ribavirin. RESULTS: Among the 20 patients, 14 were infected with HCV genotype 1b, 3 with HCV genotype 2a, and 3 failed sequencing. At baseline, the mean CD4(+)count, mean CD8(+)count, and mean CD4(+)/CD8(+)ratio were 406.45 ± 210.83 cells/ml, 1 076.45 ± 716.18 cells /ml, and 0.43 ± 0.17, respectively; the mean HCV RNA load was 6.01 ± 1.13 log10IU/ml; 12 patients (60%) had abnormal liver function. A total of 14 patients (70%) achieved complete early virologic response, 15 (75%) achieved end-of-treatment virologic response, 7 (35%) achieved sustained virologic response (SVR), and 8 (40%) experienced recurrence. The incidence rate of drug-related adverse events during the treatment was 50% (10/20); no serious adverse events occurred, and no patient withdrew from the treatment due to adverse events. At week 48, both CD4(+)and CD8(+)counts of all patients declined significantly compared with the baseline values (P= 0.001 and 0.001), but the CD4(+)/CD8(+)ratio increased significantly (P= 0.032). The SVR group had a significantly lower mean baseline HCV RNA load than the non-SVR group (4.95 ± 1.18 log10IU/ml vs 6.59 ± 0.53 log10IU/ml,t= 3.49,P= 0.009). CONCLUSION: In the patients co-infected with HIV and HCV who failed standard interferon therapy, PEG-INF-αcombined with ribavirin has good efficacy and safety, and the patients with a low baseline HCV RNA load are more likely to achieve SVR.


Assuntos
Antivirais/uso terapêutico , Infecções por HIV/complicações , Hepatite C Crônica/tratamento farmacológico , Interferon-alfa/uso terapêutico , Ribavirina/uso terapêutico , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , Coinfecção , Quimioterapia Combinada , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Hepacivirus/classificação , Hepacivirus/efeitos dos fármacos , Hepacivirus/isolamento & purificação , Hepatite C Crônica/complicações , Hepatite C Crônica/virologia , Humanos , Imunoterapia , Interferon-alfa/efeitos adversos , Masculino , Estudos Prospectivos , RNA Viral/sangue , Recidiva , Ribavirina/efeitos adversos , Padrão de Cuidado , Resposta Viral Sustentada , Resultado do Tratamento , Carga Viral
14.
Scand J Immunol ; 83(6): 438-44, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26972443

RESUMO

Myeloid-derived suppressor cells (MDSCs) are known to accumulate during chronic viral infection, including human immunodeficiency virus-1 (HIV-1) and hepatitis C virus (HCV) infection, and play a critical role in suppressing immune responses. However, the role of MDSCs in HIV/HCV coinfection is unclear. Here, we observed a dramatic increase in monocytic MDSCs (M-MDSCs) level in the peripheral blood of HIV/HCV-coinfected patients compared to that of healthy controls; the level of M-MDSCs proportion in coinfection was not higher than that in HIV or HCV monoinfection. Interestingly, we found the M-MDSCs level in coinfected patients correlated well with CD4(+) T cell loss (r = -0.5680; P = 0.0058), HIV-1 load (r = 0.6011; P = 0.0031), HCV load (r = 0.6288; P = 0.0017) and activated CD38(+) T cells (r = 0.5139; P = 0.0144). Initiation of highly active antiretroviral therapy considerably reduced both M-MDSCs and CD8(+) CD38(+) -activated T cell proportion in coinfected patients, and they showed a parallel course of decline. Thus, our results suggest that HIV-1 infection and high chronic immune activation may contribute to the expansion of M-MDSCs and accelerate the disease progression in HIV/HCV-coinfected patients.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Infecções por HIV/imunologia , HIV-1/imunologia , Hepacivirus/imunologia , Hepatite C/imunologia , Células Supressoras Mieloides/imunologia , Adulto , Antirretrovirais/uso terapêutico , China , Coinfecção , Feminino , Infecções por HIV/tratamento farmacológico , Hepatite C/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Carga Viral , Adulto Jovem
15.
Int J STD AIDS ; 27(10): 890-7, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26384940

RESUMO

This study investigated the epidemiological and clinical characteristics of hepatitis B virus (HBV) in HIV-infected adults at the time of antiretroviral therapy (ART) initiation in Guangdong province, China. A total of 2793 HIV-infected adults were enrolled between January 2004 and September 2011. Demographic data and laboratory parameters were collected, HBV-DNA levels were measured, and HBV genotypes were identified before ART initiation. The prevalence of hepatitis B surface antigen (HBsAg) in HIV-infected patients was 13.2%. A total of 266 HIV/HBV co-infected patients and 1469 HIV mono-infected patients were recruited. The median alanine aminotransferase and aspartate aminotransferase levels of HIV/HBV co-infected patients were higher than HIV mono-infected patients (32 U/L vs. 22 U/L, p < 0.001 and 35 U/L vs. 24 U/L, p < 0.001, respectively), whereas the median CD4 cell count of HIV/HBV co-infected patients was lower than HIV mono-infected patients (59 cells/mm(3) vs. 141 cells/mm(3), p < 0.001). The level of CD4 cell count was lower in hepatitis B e-antigen (HBeAg)-positive co-infected patients than HBeAg-negative patients (36 cells/mm(3) vs. 69 cells/mm(3), p = 0.014). A similar result was found in high level of HBV-DNA and low level of HBV-DNA groups (33 cells/mm(3) vs. 89 cells/mm(3), p < 0.001). HBV genotypes were classified as genotypes B and C. Patients infected with genotypes B and C differed significantly in terms of proportion of those who were HBeAg-positive (40.5% vs. 62.2%, p = 0.014). This study indicates a high prevalence of HBsAg in HIV-infected adults in Guangdong. The level of CD4 cell count in HIV/HBV co-infected patients was much lower than HIV mono-infected patients, especially in patients who were HBeAg-positive and had a high level of HBV-DNA. The predominant HBV genotype in HIV/HBV co-infected patients is genotype B.


Assuntos
Coinfecção/virologia , Infecções por HIV/epidemiologia , Vírus da Hepatite B/imunologia , Hepatite B/epidemiologia , Adulto , China/epidemiologia , Coinfecção/epidemiologia , Feminino , Genótipo , Infecções por HIV/complicações , Infecções por HIV/virologia , Hepatite B/complicações , Antígenos de Superfície da Hepatite B/sangue , Vírus da Hepatite B/genética , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Prevalência , Estudos Retrospectivos
16.
Ultrason Sonochem ; 8(4): 335-9, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11510216

RESUMO

Ultrasonic irradiation of mesoporous silica soaked in a mixture of chloroauric acid and isopropanol for 120 min in Ar atmosphere at room temperature yielded Au/SiO2 mesoporous composite, which was characterized by high resolution transmission electron microscopy and optical absorption measurement. The structure of mesoporous silica after sonochemical preparation of gold (Au) nanoparticles within its pores was studied by nitrogen adsorption technique. It has been shown that the structural parameters, such as specific surface area (SSA), porosity (P), the mean pore diameter (lp) were increased significantly after ultrasonic irradiation. It is suggested that the collision of Au nanoparticles with pore walls and localized erosion induced by the asymmetric implosive collapse of cavities on the extensive liquid-solid interface that are responsible for the structural change in the mesoporous solid.

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