2020年全球传染病重要疫情事件回顾

2020年,新型冠状病毒肺炎疫情全球大流行,导致8000万人患病,170万人死亡。脊髓灰质炎疫情继续扩大,阻碍了全球消灭脊髓灰质炎的目标。非洲埃博拉疫情被扑灭。登革热疫情较上一年明显缓解。年底欧洲和亚洲暴发H5N8禽间禽流感疫情。本文对2020年重要传染病疫情事件进行回顾。     

广东省艾滋病患者HIV-1基因亚型分析

目的 了解目前广东省HIV/AIDS患者HIV-1基因型的流行状况.方法 用套式PCR对222例HIV/AIDS患者外周血单核细胞(PBMC)中HIV前病毒DNA膜蛋白env基因C2-V4区及其邻近区域片段进行扩增,并对片段进行序列测定,与国际HIV-1标准毒株序列进行比较,依据同源性确定基因型.结果 222例患者中,...     

HIV-1和GBV-C合并感染的研究进展

研究发现,持续的GBV-C病毒血症和HIV-1感染者长期存活有显著关系,目前对其保护性作用机制了解甚少,可能是GBV-C通过调节化学因子和细胞因子或其受体的表达来实现的.相反的是,有些研究则未观察到GBV-C感染对HIV-1疾病的进展产生有利影响.此文对HIV-1/GBV-C合并感染的流行特点、合并感染对病程进展的影响及GBV-C感染对艾滋病进展的作用机制进行了综述.     

阜新市HIV-1感染者和AIDS患者原发性整合酶基因耐药突变分析

目的 了解阜新市HIV感染者和AIDS患者整合酶基因的变异情况,分析阜新市原发性整合酶基因突变及相关耐药情况,为治疗提供参考依据.方法 收集2018年-2019年阜新市102例HIV-1感染者和AIDS患者外周静脉血,分离血浆,-80℃冻存备用.采用反转录巢式聚合酶链式反应扩增病毒pol基因区并进行序列测定,分析IN区...     

Antibodies to HTLV-1–2, HIV-1 and HIV-2 in syphilitic patients

Antibodies to human immunodeficiency virus type 1 (HIV-1) and type 2 (HIV-2) and to human T-cell leukemia virus (HTLV-1) were investigated by ELISA, Western blot and radioimmunoprecipitation (RIPA) assay in 318 sera (191 males and 127 females) obtained from syphilitic patients. The sera from 10% of the males and 3.1% of the females were positive for HIV-1. None of the sera contained antibodies to HIV-2. Antibodies to HTLV-1–2 were present in the sera of 7.1% of the males and 4.8% of the females who were seronegative for HIV. Five out of 24 (20.8%) HIV-1 positive subjects had antibodies to HTLV-1–2 as well.Sera from another group of 58 syphilitic patients (38 males and 20 females in the Anti-Venereal Disease Department), seronegative for HIV-1 and HIV-2, who denied both i.v. drug abuse and blood transfusion, were investigated in the same manner. None of the males had antibodies to HTLV-1–2, while 2 females (10%) were positive.     

HIV-1/AIDS患者血清铁蛋白与病情进展关系的研究

目的了解HIV-1／AIDS病人血清铁蛋白检测结果与HIV／AIDS患者病情进展的关系。方法使用化学发光法（CLIA）检测已确诊的24例HIV-1阳性患者血清铁蛋白，结合患者的临床资料和其他检验结果，对不同临床分期、贫血程度和消瘦程度的HIV／AIDS患者的血清铁蛋白水平进行分析。结果在24例HIV／AIDS病人中，不同临床分期的患者血清铁蛋白水平比较有统计学差异，AIDS组明显高于ARC组，ARC组明显高于AS组；在不同消瘦程度的组别中存在统计学差异，中度和重度体重减轻的患者铁蛋白水平明显高于体重正常和体重轻度、中度减轻的患者；在不同的贫血组别中存在明显差异，中度和重度贫血组的铁蛋白水平明显高于无贫血患者和轻度贫血者。结论在不同的疾病进展阶段，铁蛋白的水平存在着显著性差异，铁蛋白水平随着病情的进展而升高。铁蛋白是提示HIV／AIDS进展的灵敏指标。     

广州市发现首例HIV-1/HIV-2混合感染

目的探讨首例HIV-1/HIV-2混合感染发现的经过以及对本地艾滋病预防控制的意义。方法对广州市某医院一名门诊患者血样2份(包括初筛试验前后各1份)进行HIV抗体检测。初筛试验采用酶联免疫吸附试验(ELISA)和明胶颗粒凝集试验(PA),确认试验采用蛋白印迹法(WB)。结果患者为男性,非洲马里人,血清经初筛试验为HIV阳性。初筛阳性的血清,以HIV-1/HIV-2 HIVBLOT2.2试剂做蛋白印迹试验(WB),确认为HIV-1阳性,同时HIV-2的特异条带gp36阳性;样本再用HIV-2型的BLOT1.2膜条确认为HIV-2阳性。结论被检者为HIV-1/HIV-2混合感染,这是广州市、广东省首次发现HIV-1/HIV-2混合感染,提示HIV-2可能会以对外交流等方式传入广东。     

HIV-1感染中第二受体与艾滋病进程的关系

第二受体在HIV_1感染及病程变化中有着重要作用,HIV_1所利用的第二受体由CCR5转换为CXCR4被认为是病程进展的标志,而X4型HIV_1也与较差的预后相联系。但是近几年的研究使人们对这种第二受体利用的转换有了新的认识,在近半数HIV_1感染者体内并不发生这种转换,但他们大多数会进展为艾滋病。本文就这一问题作了综述。     

Therapeutic immunisation plus cytokine and hormone therapy improves CD4 T-cell counts,restores anti-HIV-1 responses and reduces immune activation in treated chronic HIV-1 infection

BackgroundThis randomised, open label, phase I, immunotherapeutic study investigated the effects of interleukin (IL)-2, granulocyte-macrophage colony-stimulating factor (GM-CSF), recombinant human growth hormone (rhGH), and therapeutic immunisation (a Clade B DNA vaccine) on combination antiretroviral therapy (cART)-treated HIV-1-infected individuals, with the objective to reverse residual T-cell dysfunction.MethodsTwelve HIV-1⁺ patients on suppressive cART with baseline CD4 T-cell counts >400 cells/mm³ blood were randomised into one of three groups: (1) vaccine, IL-2, GM-CSF and rhGH (n = 3); (2) vaccine alone (n = 4); or (3) IL-2, GM-CSF and rhGH (n = 5). Samples were collected at weeks 0, 1, 2, 4, 6, 8, 12, 16, 24 and 48. Interferon (IFN)-γ, IL-2, IL-4 and perforin ELISpot assays performed at each time point quantified functional responses to Gag p17/p24, Nef, Rev, and Tat peptides; and detailed T-cell immunophenotyping was undertaken by flow cytometry. Proviral DNA was also measured.ResultsMedian baseline CD4 T-cell count was 757 cells/mm³ (interquartile range [IQR] 567–886 cells/mm³), median age 48 years (IQR 42–51 years), and plasma HIV-1-RNA <50 copies/ml for all subjects. Patients who received vaccine plus IL-2, GM-CSF and rhGH (group 1) showed the most marked changes. Assessing mean changes from baseline to week 48 revealed significantly elevated numbers of CD4 T cells (p = 0.0083) and improved CD4/CD8 T-cell ratios (p = 0.0033). This was accompanied by a significant reduction in expression of CD38 on CD4 T cells (p = 0.0194), significantly increased IFN-γ and IL-2 production in response to Gag (p = 0.0122) and elevated IFN-γ production in response to Tat (p = 0.041) at week 48 compared to baseline. Subjects in all treatment groups showed significantly reduced PD-1 expression at week 48 compared to baseline, with some reductions in proviral DNA.ConclusionsMultifarious immunotherapeutic approaches in the context of fully suppressive cART further reduce immune activation, and improve both CD4 T-lymphocyte counts and HIV-1-specific T-cell responses (NCT01130376).     

HIV-1感染者/AIDS患者T淋巴细胞亚群检测分析

目的探讨HIV-1感染者/AIDS患者外周血T淋巴细胞亚群与性别、年龄、检测时间与确认时间间隔之间的关系,了解该人群的免疫状况。方法采用FACSCalibur流式细胞仪及其配套试剂TriTEST CD4 FITC/CD8PE/CD3PerCP测定369例HIV-1感染者/AIDS患者外周血标本并对结果应用SPSS 18.0统计软件进行统计和分析。结果男性CD3+Abs Cnt和CD3+CD8+Abs Cnt明显高于女性,男性TH/S明显低于女性(P均<0.05);不同年龄组T淋巴细胞亚群检测数据进行方差分析发现CD3+Abs Cnt、CD3+CD4+Abs Cnt和TH/S差异有统计学意义(P=0.000、0.000和0.049);不同检测时间与患者确认时间间隔对T淋巴细胞亚群检测结果的影响差异无统计学意义(P均>0.05);≤20岁年龄组CD4+细胞≥500/mm3(12.7%)和41~50岁年龄组CD4+细胞<200/mm3(28.9%)明显高于其他年龄组。结论 HIV-1感染者/AIDS患者T淋巴细胞亚群检测结果受性别、年龄影响,各年龄组研究对象免疫抑制程度不同。     

Improving immunogenicity of HIV-1 envelope gp120 by glycan removal and immune complex formation

HIV-1 envelope (Env) gp120 is an important target for neutralizing antibody (Ab) responses against the virus; however, developing gp120 vaccines that elicit potent and broad neutralizing Abs has proven to be a formidable challenge. Previously, removal of an N-linked glycan at residue 448 by an N to Q mutation (N448Q) has been found to enhance the in vitro antigenicity of neutralizing epitopes in the V3 loop. In this study the mutated gp120 was first compared with wild type gp120 for immunogenicity in mice using a DNA prime and protein boost immunization regimen. The N448Q mutant did not elicit higher titers of anti-gp120 serum Abs and failed to generate anti-V3 Abs. The sera also had no virus-neutralizing activity, even though the mutant induced higher levels of lymphoproliferation and cytokine production. Subsequently, the N448Q mutant was used to construct an immune complex vaccine with the anti-CD4 binding site monoclonal antibody (mAb) 654. The N448Q/654 complex stimulated comparably high levels of serum Abs to gp120 and V3 as the wild type complex. However, Abs against the C1 and C2 regions in the gp120 core were more elevated. Importantly, the mutant complex also elicited higher titers of neutralizing Abs activity than the wild type counterpart. Similar results were achieved with a complex made with gp120 bearing an N448E mutation, confirming the importance of the N448-linked glycan in modulating gp120 immunogenicity. Neutralizing activity was directed to V3 and other undefined neutralizing epitopes. Improved immunogenicity of the immune complexes correlated with alterations in exposure of V3 and other Ab epitopes and their stability against proteases. These data demonstrate the advantage of combining site-specific N-glycan removal and immune complex formation as a novel vaccine strategy to improve immunogenicity of targeted Ab epitopes on critical regions of HIV-1 gp120.