中国某地1994—1998年受血人群HIVo1感染情况调查

目的 了解中国某地1994-1998年受血人群HIV感染状况.方法 2003年11月至2005年2月对某地15个乡镇全部现住人口进行普查,凡在1994-1998年期间有受血史者,进行流行病学调查和采集血液标本,用ELISA进行初筛,阳性者用免疫印迹试验(Western-blot法)进行确认.结果 受血居民HIV-1感染率为15.54%(92/592),这些HIV-1感染者的受血经历仅发生在当地西部地区的6个乡镇中的5所医疗机构.历年受血者均有HIV-1感染发生,高峰为1995年.有偿供血者不筛查HIV抗体是造成受血者感染的主要原因.感染者以青壮年女性为主,女性和男性输血的主要原因分别是生育和外伤.结论 当地曾发生一起典型输血后艾滋病爆发性流行.     

扎伊尔输血后感染HIV的状况

为了调查在艾滋病高发区输血后人免疫缺陷病毒Ⅰ型(HIV-1)的血清阳性率、死亡率及临床表现,作者对1986年11月至1987年2月在扎伊尔首都金沙萨MY医院接受输血者进行了一次前瞻性的病例-对照研究.病例组为90例(男44例,女46例)输血前HIV-1阴性接受HIV-1阳性血的受血者,平均年龄3岁(4月龄～65岁),输血原因主要是疟疾性贫血(占72%),输血总量为98单位,其中未作HIV-1血清学筛选,临时采用患者亲属或其他供血者的血占90%     

河北省某市艾滋病流行特征分析

目的分析某市艾滋病病毒／艾滋病（HIV/AIDS）流行现状、特征及趋势。方法依据该市1989—2006年AIDS常规监测、高危人群哨点监测，流行病学调查及实验室资料，建立数据库并进行综合分析。结果自1989年发现首例HIV感染者至2006年底，累计发现HIV抗体阳性者240例，其中AIDS病人60例，死亡82例。HIV感染者／AIDS病例主要分布在沙河市。从市外既往有偿供血者传人为主转向境内蔓延扩散，经可疑受血感染是该市HIV传播的主要途径，青壮年女性感染率较高。HIV～1型B’亚型、CRF—BC重组株是该市主要流行株。结论该市艾滋病呈低流行状态，局部地区呈聚集性升高，经可疑受血传播HIV已被阻断。     

渝东北HIV-1感染者合并梅毒、丙肝检测结果分析

目的 了解渝东北片区HIV-1感染者中梅毒螺旋体(TP)和丙型肝炎病毒(HCV)的感染情况,为HIV的防控和综合治疗提供科学依据.方法 收集2010-2013年渝东北片区HIV-1感染者血清样本1 087例,进行TP抗体和HCV抗体检测.结果 1 087例HIV-1感染者中,TP感染率为15.64％(170/1 087),HCV感染率为6.26％(68/1 087),TP/HCV混合感染率为1.29％(14/1087).在HIV-1感染者中,TP感染率高于HCV感染率(P＜0.05),TP、HCV感染率男性均高于女性.结论 感染HIV时往往合并梅毒、丙肝感染,治疗HIV感染者的同时,要充分考虑HIV感染丙肝、梅毒对机体的综合影响.     

太原市无偿献血者HIV流行率及血液筛查后残余风险度的评估

目的了解太原市首次/重复无偿献血者艾滋病病毒(HIV)感染情况,评估血液经ELISA筛查后存在的经输血传染HIV的危险度。方法收集2008年-2012年无偿献血者HIV项目实验结果,分别统计男、女首次献血者和重复献血者的HIV阳性数并计算阳性率,用流行率/窗口期数学模型法对经输血传播HIV的残余危险度进行评估。结果太原市2008年-2012年无偿献血者血液标本共389 796次,首次献血者中男性和女性HIV的阳性率分别为0.039 7%和0.001 4%;重复献血者中男性和女性HIV的阳性率分别为0.017 9%和0.004 1%。经评估抗-HIV筛查后无偿献血者HIV的总残余风险为10.518×10-6。结论太原市无偿献血者HIV流行率首次献血者高于重复献血者,男性高于女性,无偿献血者血液仍存在传播HIV的风险。     

受血者受血前HIV、HBV、HCV及梅毒重叠感染的研究

目的探讨受血者受血前HIV、HBV、HCV及梅毒重叠感染. 方法用ELISA、双抗体夹心法检测血清HBV标志物、血清抗-HCV、血清抗-HIV,用RPR及TPPA检测受血者受血前梅毒感染. 结果 19 800例受血者受血前检查中发现血清乙型肝炎HBsAg阳性者2 136例(10.79%),血清抗-HCV阳性者576例(2.91%),血清梅毒(RPR法及TPPA)阳性者16例(0.08%),血清抗-HIV阳性者14例(0.07%),其中HBV、HCV重叠感染74例(0.375%);14例抗-HIV阳性病例中,HIV重叠感染HCV4例(28.5%),HIV重叠感染HBV2例(14.28%),HIV和HCV、HBV三重感染2例(14.28%). 结论在受血者受血前检查中HIV感染者与HCV、HBV重叠感染率较高,进行全面检查不仅可以避免医疗纠纷的发生,还可以为患者治疗提供帮助.     

艾滋病病毒-1母婴传播及阻断措施的研究进展

艾滋病病毒(HIV)分为HIV-1和HIV-2两种。HIV-1的感染力较强,是当今世界HIV流行的主要病毒株,并可引起母婴传播,母亲感染后可在产前、产中或产后将其传播给婴儿。HIV-2的感染力较弱,引起母婴传播的危险性较低,关于HIV-2母婴传播的报道也较少。母婴传播是儿童和婴儿HIV-1感染的主要方式,占儿童和婴儿HIV感染者的90％以上。近年来,关于HIV-1母婴传播的方式、影响因素和干预措施等方面的研究进展较快。本文对近5年来国外相关研究进行综述。     

HIV-2检测方法学进展

实验室检测是HIV感染的诊断、监测和血液筛查的常规方法，是艾滋病早期诊断的主要依据。HIV分为HIV-1和HIV-2，HIV-1广泛分布全球各地，是造成全球艾滋病流行的主要原因，HIV-2主要分布于非洲西部，流行较为局限。我国从1998年陆续有HIV-2感染的报道，多为散发病例，绝大部分都是HIV-1/HIV-2混合感染。目前我国针对HIV-2检测的关注较少，国产可区分HIV-2的检测试剂也没有注册上市。目前HIV-2的检测方法主要是抗体检测和核酸检测，通过快速检测等方法进行初筛检测，免疫印迹试验（WB）和条带免疫试验（LIA）进行确认，依据HIV抗体检测结果确定是否感染HIV-2。随着分子生物学技术的飞速发展，核酸检测实验室诊断方法取得了很大进展。     

贵州省HIV-1毒株亚型与艾滋病流行的关系研究

目的 研究HIV-1毒株基因变异与艾滋病在贵州省快速传播之间的关系.方法 在不同时间采集贵州省多个地区HIV-1感染者样本共190份,利用巢式PCR扩增env和gag基因并测定序列,采用MEGA4.0软件确定样本亚型并分析其与贵州省艾滋病流行之间的关系.结果 贵州省HIV/AIDS的报告数从1998年的66例上升到2009年的8435例,7年增加16.38倍.在不同时间采集的样本中共检出B(9例)、B'(4例)、C(2例)、CRF07 BC(75例)、CRF08 BC(17例)、CRF01 AE(64例)等多种亚型的HIV-1毒株;CRF07 BC、CRF08 BC的env基因离散率在传播过程中基因多态性不断增大(0.035±0.006→0.092±0.011).贵州省HIV亚型1998年以B'亚型(4/11)为主,2002年以CRF07 BC亚型(26/41)为主,而2007年以CRF01 AE(62/119)为主,亚型分布的变化与近年来贵州省艾滋病流行呈现快速上升趋势及2001-2006年以吸毒传播感染为主(吸毒传播感染2610例、性传播感染176例)、2006年后性传播感染人数开始急速上升(吸毒传播感染1713例、性传播感染1833例)的特点有直接关系,HIV主要流行毒株的变化与传播途径高度相关(x2=41.253,P=0.000).结论 不同亚型毒株随时间和主要感染途径的改变而成为当地的主要流行株,性传播人群是贵州省艾滋病防控的重点.

Abstract：

Objective To study the HIV-1 diversity and how did it promot the rapid spread of AIDS,in Guizhou province.Methods A total of 190 HIV-1 positive subjects were collected in different years and regions from Guizhou province.The env and gag genes were amplified with nested PCR and their sequences were determined.The subtypes were identified by the MEGA 4.0 software and the relationships between subtypes and AIDS epidemic were analyzed.Results The number of HIV/AIDS reported cases was increased from 66 in 1998 up to 8435 in 2009,a 16.38 time increase in 7 years.Subtypes B(9),B'(4),C(2),CRF07_BC(75),CRF08_BC(17),CRF01_AE(64)were identified in Guizhou province among the samples collected in various periods of time.The genetic diversities in env gene of CRF07_BC and CRF08_BC increased along with the spreading of HIV (from 0.035±0.006 to 0.092±0.011).Subtype B'(4/11)appeared the main subtype prevailed in Guizhou in 1998 as well as CRF07_BC(26/41)in 2002 and CRF01_AE(62/119)in 2007.The HIV/AIDS epidemic in Guizhou province showed an rapidly upward trend,with the main risk factors of HIV transmission as 2610 cases through injecting drug users(IDUs).and 176 cases due to sexually transmitted infections(STIs),from year 2001 to 2006.However,STIs began to increase rapidly,after 2006,with 1713 cases of IDUs and 1833 cases of STIs.Data indicated that the change of composition of different HIV-1 subtypes was correlated with the mode of transmission in Guizhou province(x2=41.253,P=0.000).Conclusion The types of HIV strains changed over time as well the turnover of the main risk factors.Sexual transmission,including both hetero-and homo-sexual became the main risk factors,suggesting the development of related prevention and control programs,on HIV/AIDS should be considered accordingly in the future.     

1996-2011年西华县HIV/AIDS流行病学分析

目的了解并掌握西华县HIV/AIDS流行病学特征。方法对1996-2011年西华县HIV/AIDS流行病学资料进行统计整理,采用描述性流行病学方法进行分析。结果 1996-2011年西华县累计报告HIV/AIDS 1 246例,其中HIV感染者148例,AIDS病人1 098例,男性733例,女性513例,男女比例1.43:1。报告死亡358例。感染途径以1990-1995年有偿单采血(浆)为主,占81.38%(1 014例),其次为性传播占8.59%(107例),母婴传播占2.65%(33例),输血/血制品传播占7.22%(90例)。结论西华县艾滋病流行形势严峻,各种传播途径并存,并由高危人群向一般人群蔓延趋势,性传播成为现阶段艾滋病传播的主要方式。     

HIV-1 seroprevalence and risk behaviors in an urban African-American community cohort.

OBJECTIVES. Previous attempts at obtaining population estimates of human immunodeficiency virus type 1 (HIV-1) seroprevalence have been beset by problems of cooperation bias. As part of the fourth round of study with an urban African-American community cohort, the following investigation was aimed at assessing HIV-1 prevalence and the relative importance of sex and drug injection as risk factors in infection. METHODS. Personal interviews were conducted in the home with 364 respondents, followed by voluntary blood sample collection from 287 of these individuals. RESULTS. Blood assays showed a point prevalence of 8.4% HIV-1 seropositivity in this community cross section, with a higher female-to-male ratio than appears among acquired immunodeficiency syndrome (AIDS) case reports. Most infected persons were unaware and unsuspecting of their infection. CONCLUSIONS. First, findings underscore the need to focus on risk behaviors rather than on risk groups. Second, the smaller than 2:1 ratio of infected men to women suggests that current AIDS case reports seriously underestimate HIV-1 infection among certain cohorts of African-American women. Finally, widespread ignorance of own infected status and inaccurate risk assessment signal the substantial task for community health educators in reaching inner-city African-American men and women at risk.     

HIV-2 in The Netherlands]

By comparing data from the HIV confirmation laboratories it could be established that in the period prior to February 1991 a HIV-2 infection was demonstrated in at least 18 persons in the Netherlands. Consequently, use of combined HIV-1/2 tests is urgently recommended for screening in diagnostic and blood bank laboratories in the Netherlands. A suspicion of presence of HIV-2 antibodies may arise in the interpretation of a combined HIV-1/2-ELISA, a specific HIV-1-ELISA and the pattern of HIV-1 western immunoblot. Confirmation of the presence of HIV-2 antibodies should be obtained by means of western blots of viral lysates of both HIV-1 and HIV-2 and peptide tests from the transmembranous region. Most persons with a HIV-2 infection originated from Africa south of the Sahara or the Cape Verdean Islands or had had a sexual relationship with a person from these areas. The vast majority was heterosexual and 13 of the 18 infected persons were women. This differs greatly from the epidemiological pattern of HIV-1 infections in the Netherlands. The possibility of further spread of HIV-2 in the Netherlands via heterosexual contacts should be seriously taken into account.     

上海地区638例输血后丙型肝炎病毒感染者的临床分析

目的 分析输血后丙型肝炎病毒(HCV)感染者的临床特征.方法 采用PCR检测HCVRNA载量,ELISA检测抗-HCV,分析输血后HCV感染者的年龄、原发病因、暴露年份、输血成分与输血量、潜伏期、肝功能损害和腹部超声图像改变等.结果 578例感染者中有525例(90.8%)HCV RNA载量≥3.0 log10 copy/ml(M=6.10 log10 copy/ml),其中19.2%病例为3.0～4.0log10 copy/ml、66.1%为5.0～6.0 log10 copy/ml,仅14.7%病例≥7.0log10 copy/ml.HCV RNA定性阳性率为81.5%(44/54),HCV基因型主要为1型,抗-HCV阳性率达99.8%(636/637),其阳性敏感率高于HCV RNA定量和定性检测(均为P=0.000).输血后HCV感染以40～60岁年龄段多见,85.7%病例的暴露时间为1990-1994年,10%以上的感染者中基础疾病为妇产科、骨科疾病和胃肠道出血,79.9%的病例为输入全血者,输血至临床诊断时间平均(8.5±5.5)年;90.1%感染者有肝功能损害,多数病例血清丙氨酸氨基转移酶(ALT)升高水平≤5×ULN,而血清总胆红素升高、ALT和天冬氨酸氨基转氨酶≥5×ULN水平者临床表现较多(P值分别为0.000、0.001和0.009);8.9%感染者腹部超声显示有肝硬化改变,但多见于感染期＞5年者.结论 输血后HCV感染主要集中于1990-1994年,成年人患病率较高,常伴有肝功能损害,感染期＞5年者肝硬化发生率较高,HCV基因型主要为1型,血清HCV RNA载量多为中等水平.

Abstract：

Objective To investigate me clinical-epidemiologic characteristics of patients with hepatitis C virus(HCV)infection by post blood transfusion.Methods Polymerase chain reaction (PCR)and enzynle linked immunosorbent assay(ELISA)were used to detect HCV RNA and anti.HCV,respectively.Analysis was performed on patients'age distribution,cause of primary diseases,years ofexposure,ingredient and amount of transfusion,incubation period,disorder on liver function and changes on abdominal ultrasound image,etc.Results HCV RNA levels were higher than 3.0log10 copy/ml in 90.8%infected patients、with a median as 6.10 log10 copy/ml.19.2%of the patients showed viral load 3.0 to 4.0 iog10 copy/ml,and 66.1%of them showed 5.0 to 6.0 log10 copy/ml.Only 14.7%of the infected persons had HCV RNA levels higher than 7.0 log10 copy/ml.Eighty-one point five percent(44/54)of the infected persons were confirmed as HCV RNA positive by HCV RNA qualitative analysis with HCV genotype as primarily type 1.99.8%(636/637)of the pmients were detected as anti-HCV positive by serological test.The sensitivity of serological test was higher than both quantitative and qualitative HCV RNA assays(P=0.000,P=0.000,respectively).HCV infection post blood transfusion was more seen in common people at 40 to 60 years old Most cases(85.7%)had their first exposure during 1990 to 1994.More than 10% of the cases had primary diseases aS obstetrics,orthopedics or gastrointestinal tract hemorrhage.79.9%of the patients received whole blood product transfusion.The mean interval between transfusion and clinical diagnosis was 8.5±5.5 years.90.1%of the infected patients had liver function damage,while most of them showed elevated alanine aminotransferase(ALT)no more than 5 upper limits of normal(ULN).wheteas Serum total bilirubin(TBIL).ALT and aspartate aminotransferase(AST)≥5×ULN level were showing more clinicaI manifestations(P=0.000.P=0.001,P=0.009,respectively).Abdominal ultrasound among 8.9%of the infected persons showed changes in cirrhosis,and most of them werc older than 50years of age.Conclusion Most of the post transfusion HCV infected cases happened in adulthood,and were mainly exposed during 1990 to 1994.Infected pmients usually had their liver function damaged with elevated ALT no more than 5×ULN and with medium HCV RNA levels.HCV genotype was mainly for type 1.Patients who weTe ofolder age showed higher incidence ofcirrhosis.If a patients'infection period Was longer than 5 years,he/she would show higher incidence of cirrhosis.     

济南市2011至2014年无偿献血者人类免疫缺陷病毒感染现状分析

目的对济南市2011至2014年无偿献血者中的人类免疫缺陷病毒(HIV)感染现状进行分析。 方法使用酶联免疫吸附法(ELISA)对济南市2011至2014年124 705份无偿献血者血液标本进行检测,抗HIV反应阳性标本送往济南市疾病控制中心进行确认。 结果124 705份无偿献血者血液标本中256份ELISA法HIV筛查为阳性,占总人数的0.205%。济南市疾病控制中心确认阳性27例,确认阳性率为0.022%,男性明显高于女性,30岁以下高于30岁以上,可能传播途径以同性为主。 结论济南市无偿献血人群中HIV感染率低于全国水平,感染率与性别、年龄有关,同性传播为主。应加强预防艾滋病相关知识宣传以及献血前评估、鉴别,增加志愿者队伍,加强检测力度,提高检测灵敏性及特异性,保障临床用血安全。     

Backcalculation of the number with human immunodeficiency virus infection in the United States

The method of backcalculation was applied to national surveillance data on the acquired immunodeficiency syndrome (AIDS) in order to estimate the cumulative number of adults with human immunodeficiency virus type 1 (HIV-1) infection as of January 1, 1985 and July 1, 1987. A "plausible range" of estimates was constructed which reflected both uncertainty about the AIDS incubation distribution and random variation from selection and fitting of flexible models of the HIV-1 infection curve. The authors estimated that, as of 1985, 411,000 to 756,000 persons were infected. The infected population included 266,000 to 492,000 homosexual men, 69,000 to 136,000 intravenous drug users, 24,000 to 49,000 homosexual intravenous drug users, and 11,000 to 26,000 persons infected through heterosexual contact. The estimated prevalence of infection among persons aged 15-55 years was 0.31% in whites, 0.78% in Hispanics, and 0.81% in blacks. An estimated 32,000 to 66,000 women were infected. Compared with white women aged 15-55 years, the prevalence of infection was 5.3-fold higher in Hispanic women and 10.2-fold higher in black women. Plausible estimates for the total number infected by July 1987 ranged from 707,000 to 1,376,000, with the most likely estimate equal to 992,000. Backcalculation provides an assessment of the magnitude of the HIV-1 epidemic that is independent of estimates based on prevalence surveys in special populations. The estimates obtained from both methods are consistent and emphasize the need for vigorous programs to prevent the spread of HIV-1, especially in minority communities.     

一起家庭内HIV-1感染的分子流行病学研究

[目的]采用现场流行病学和分子流行病学相结合的方法,以阐明家庭内成员HIV-1病毒传播关系。[方法]通过定性流行病学,调查一家庭内各成员有关HIV-1感染及其相关因素,并应用巢式RT-PCR扩增HIV-1pol区和env区基因,经DNA测序后用遗传进化系统树比对的方法,结合现场调查资料进行综合分析。[结果]该家庭中3人HIV感染毒株亚型均为CRF 07-BC。3个病例毒株的基因同源性高达99%和98%,且克隆基因差异较小,父母之间的基因克隆进化关系成立,但父子之间的进化关系明显大于母子的关系。3人与耐药相关基因突变位点分布情况基本一致,但在A71T位点上的突变率以儿子最高(100%),父亲其次(83%),母亲则未发生突变。[结论]该家庭中母亲是感染了父亲的部分尚未发生变异的病毒株,儿子则感染了父亲体内的变异株,初步提示为家庭内个人密切接触的HIV感染。     

HIV-1 seroprevalence in the general population of Salvador, Bahia State, Northeast Brazil

To estimate HIV-1 seroprevalence in the general population of Salvador, Bahia, Brazil, we conducted a cross-sectional survey of 3,437 residents from 1998 to 2000. Subjects were drawn from 30 sentinel areas representing a wide range of living conditions. Plasma samples were screened for HIV-1 antibodies by ELISA and confirmed by immunofluorescent assay. Subtype determination by HMA was performed after proviral DNA amplification. Phylogenetic analysis using parsimony was performed with the neighbor-joining method. Overall HIV-1 seroprevalence was 0.55% (19/3,446): 0.8% for men and 0.36% for women. Seroprevalence was higher in the 31-45-year age group (1%) and among persons with family income less than twice the minimum wage (0.78%) as compared to 0.33% for the higher income group. Syphilis was detected in 37% of HIV seropositive individuals. Phylogenetic inferences identified 10 samples as subtype B in the env region and 2 samples with Benv/Fgag/Fpol and Fenv/Bgag. Age > or = 30 years, male gender, and income < or = 2 times the minimum wage were identified as risk factors for HIV-1 infection. Extrapolating the proportion of seropositive individuals to Salvador, the number of HIV-1 infected individuals was estimated at 13,750.     

Prevalence of and risk factors for HIV infection in blood donors and various population subgroups in Ethiopia

The aim was to determine the prevalence of HIV infection and risk factors for HIV infection in various population subgroups in Ethiopia. Serum panels from blood donors (n = 2610), from various population subgroups in Ethiopia were tested for anti-HIV-1/2 by ELISA. All ELISA repeatedly reactive samples were subjected for confirmation by immunoblot (IB) and anti-HIV-1 and anti-HIV-2 specific ELISAs. 155/2610 (5.9%) blood donors were HIV-1 infected. Of pregnant women, 84/797 (10.5%) were HIV-1 infected, and 1/797 (0.1%) was HIV-2 infected. 1/240 (0.4%) individuals from the rural population were HIV-1 infected. 198/480 (41.3%) female attendees, and 106/419 (25.3%) male attendees at sexual transmitted disease (STD) clinics were HIV-1 infected. One (0.2%) male, and 2 (0.4%) female STD patients were infected with both HIV-1 and HIV-2. It was concluded that the prevalence of HIV-1 infection varied from 0.4% among urban residents to 25.3-41.3% among STD attendees. There is a low prevalence of HIV-2 present in Ethiopian subjects. Risky sexual behaviour is significantly associated with HIV-infection in Ethiopia.     

献血员丙型肝炎病毒（HCV）感染状况的调查

目的：了解成都市献血员丙型肝炎病毒（HCV）感染状况，方法：本文于1997年10月－1998年10月，采取分层整群抽样方法，开展HCV感染状况状况调查，结果：成都市献血员抗－HCV阳性率为28．71％，女性高于男性，各年龄组间抗－HCV阳性率差异不明显，家庭内接触史，既往肝炎史，合用卫生用具与HCV感染有关，献血浆及其与全血混用方式的抗－HCV阳性率高于献全血，献血时间越长，HCV感染率越高，献血次数越多，HCV感染率越高，家庭经济状况越差，家庭内日常生活接触传播的可能性越大。结论：献血员的HCV感染与献血方式，次数，时间，家庭经济收入及家庭内的接触等有关。