Association between maternal HIV infection and the risks of preterm birth and low birth weight in Chengdu, China: a propensity score matching approach.

OBJECTIVES: To estimate the effect of HIV infection on the risk of preterm birth (PTB) and low birth weight (LBW) among Chinese pregnancy women. DESIGN: A retrospective cohort study included HIV-positive pregnant women who gave birth to singletons in Chengdu between 2011 and 2020 and and HIV-negative pregnant women who delivered singletons at the Chengdu Women's and Children's Central Hospital in 2020. SETTING: Data of pregnant women living with HIV were extracted from China's Information System of Prevention of Mother-to-Child Transmission of HIV Management. Additionally, information for HIV-negative pregnant women was extracted from the electronic medical record system of the Chengdu Women's and Children's Central Hospital. PARTICIPANTS: 755 HIV-positive women and 15,094 HIV-negative pregnant women were included. PRIMARY OUTCOME MEASURES: PTB and LBW rates, which were defined by gestational weeks and birth weight. RESULTS: The incidences of PTB and LBW (13.51% and 14.17%, respectively) were significantly higher in the HIV-positive group compared with the HIV-negative group (6.82% and 4.65%). Propensity score matching was performed to improve comparability of the two groups, resulting in 1590 pregnancies with 558 HIV-positive and 1032 HIV-negative women in the final analysis. Conditional logistic regression was used to estimate the effect of maternal HIV status on adverse pregnancy outcomes. After propensity score matching and controlling the potential confounders, HIV infection was strongly associated with higher chances of LBW and PTB with adjusted odd ratios (95% confidence interval) of 2.53 (1.74 to 3.68) and 1.95 (1.33 to 2.85), respectively. CONCLUSIONS: HIV infection was significantly associated with increased risks of PTB and LBW in Chinese pregnant women. Future studies should focus on investigating the mechanisms underlying the association between HIV infection and adverse birth outcomes, and on identifying strategies to reduce the incidence of PTB and LBW in pregnant women living with HIV.

Longitudinal study on growth of human immunodeficiency virus-exposed uninfected children from 2013 to 2019 in Chengdu City / 中华传染病杂志

Objective:To assess the early physical growth and development of human immunodeficiency virus-exposed uninfected (HEU) children by longitudinally comparing the differences of growth and development between HEU group and the healthy human immunodeficiency virus-unexposed uninfected (HUU) control group of children aged 0 to 18 months.Methods:A retrospective cohort study was designed.Maternal information of the human immunodeficiency virus (HIV) infected mothers and follow-up information at 0, 1, 3, 6, 9, 12, and 18 months postpartum of their children (born between January 2013 and December 2019 in Chengdu City) were collected from the Information System of Prevention of Mother-to-Child Transmission of Human Immunodeficiency Virus Management. The HUU control group was matched with HEU group by maternal age, gestational age at birth, and infant gender at a ratio of 1∶1. There were 385 children each included in the HEU and HUU groups. Matched samples t-test and the multilevel models were used to compared the physical developmental differences between the two groups. Results:Weight for age Z scores (WAZ) at 0, 3, 6 months of HEU group were -0.72±1.03, -0.09±1.18 and 0.05±1.09, respectively, which were all lower than WAZ of HUU group (-0.21±1.04, 0.42±1.19 and 0.41±1.16, respectively), which were all significantly different ( t=8.41, 7.47 and 5.18, respectively, all P<0.001). Length for age Z scores (LAZ) at 3, 6, 12, 18 months of HEU group were -0.23±1.36, -0.01±1.48, -0.18±1.20 and -0.32±1.13, respectively, which were all lower than LAZ of HUU group (0.24±1.26, 0.30±1.26, 0.07±1.11 and 0.04±1.05, respectively), which were all significantly different ( t=6.14, 4.04, 2.72 and 4.30, respectively, all P<0.01). Weight for length Z scores (WLZ) at 0, 3, 6 months of HEU group were -1.05±1.18, 0.23±1.03 and 0.22±0.95, respectively, which were all lower than WLZ of HUU group (-0.20±0.98, 0.44±1.03 and 0.45±1.00, respectively), which were all significantly different ( t=10.90, 2.95 and 2.96, respectively, all P<0.01). After possible confounding factors were corrected, the WAZ of HEU children at 0, 3, 6 months were still lower than those of HUU children, the LAZ of 3, 6, 12, 18 months were still lower than those of HUU children, and the WLZ of 0, 3, 6 months were still lower than those of HUU children. Conclusions:The differences between HEU and HUU children in Chengdu City mainly occur within six months of age, but the differences of body length persist until 18 months of age.Prenatal exposure to HIV infection affects both fetal and postnatal body growth and development.

Infection status of HIV and its influence factors among men who have sex with men in Sichuan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate HIV infection status and its influence factors in men who have sex with men (MSM) in Sichuan province.</p><p><b>METHODS</b>A face to face investigation and Syphilis and HIV serological detection were conducted among 2 783 MSM who have the insertion of oral or anal sex with men over the past year recruited by snowball sampling and respondent driven sampling methods in nine cities' Gay venues of Sichuan province. χ(2) test and logistic regression analysis were used for statistical analysis.</p><p><b>RESULTS</b>A total of 2 783 MSM were surveyed, of which HIV and Syphilis infection rates were 11.1% (147/2 783) , 5.3% (310/2 783) , respectively. The HIV infection rates of <20 year-old age group, 20-29 year-old age group, 30-39 year-old age group, 40-49 year-old age group, ≥ 50 year-old age group were 6.6% (15/227), 9.7% (143/1 471), 11.8% (80/679), 18.0% (53/294), 17.0% (19/112) (χ(2) = 25.91, P < 0.05). The risk of HIV infection in 30-39 year-old age group, 40-50 year-old age group,> 50 years age group were 2.05 (1.14-3.69) times, 3.24 (1.75-6.01) times, 2.60 (1.22-5.52) times respectively of the <20 years age group. The risk of HIV infection in middle school and below one was 16.5% (73/443) , higher than the high school/college education MSM (11.1% (99/891) ) and the college and higher education MSM (9.5% (138/1 446)) (χ(2) = 16.46, P < 0.05). The risk of HIV infection in High school/college education MSM were 0.64 (0.45-0.90) times of the middle school and below. The HIV infection rates of MSM who accepted a HIV test and knew the result within the last year was 8.2% (119/1 446) , lower than the group who did not accepted any HIV test (14.3% (191/1 336) ) (χ(2) = 25.81, P < 0.05). The HIV infection rates of MSM who received intervention services was 10.1% (256/2 539), lower than the group who did not receive any intervention services (22.1% (54/244) ) (χ(2) = 32.65, P < 0.05) . The HIV infection rates of Syphilis-positive MSM was 32.0% (47/147) , higher than the Syphilis-negative one (10.0% (263/2 636) ) (χ(2) = 68.06, P < 0.05). Received intervention services (OR (95%CI) was 0.52 (0.40-0.68) ) and accepted a HIV test and knew the result within the last year (OR (95%CI) was 0.52 (0.36-0.74) ) were the protective factors of HIV infection. At the same time, the syphilis infection (OR (95%CI) was 4.01 (2.73-5.88) ) were risk factors for HIV infection.</p><p><b>CONCLUSION</b>The prevalence rates of HIV infections were considered to be high among MSM in Sichuan province. The MSM of low-literacy, 30 years or older, not received any intervention services, not received any intervention services.Syphilis-positive have a greater risk of HIV infection.</p>