Immunogenicity of the hepatitis A vaccine 20 years after infant immunization

To determine the duration of immunity provided by the Hepatitis A vaccination (HepA), we evaluated a cohort of participants in Alaska 20 years after being immunized as infants. At recruitment, participants received two doses of inactivated HepA vaccine on one of three schedules. We conducted hepatitis A antibody (anti-HAV) testing for participants at the 20-year time-point. Seventy-five of the original 183 participants (41%) were available for follow-up. The overall anti-HAV geometric mean concentration was 29.9 mIU/mL (95% CI 22.4 mIU/mL, 39.7 mIU/mL) and 50 participants (68%) remained seropositive (titer ≥ 20 mIU/mL). Using a fractional polynomial model, the predicted percent seropositive at 25 years was 55.3%, 49.8% at 30 years and 45.7% at 35 years, suggesting that the percent sero-positive could drop below 50% earlier than previously expected. Further research is necessary to understand if protection continues after seropositivity diminishes or if a HepA booster dose may become necessary.     

Immune reconstitution inflammatory syndrome in association with HIV/AIDS and tuberculosis: Views over hidden possibilities

Background  

CD4+ T lymphocyte (CD4) cell count testing is the standard method for determining eligibility for antiretroviral therapy (ART), but is not widely available in sub-Saharan Africa. Total lymphocyte counts (TLCs) have not proven sufficiently accurate in identifying subjects with low CD4 counts. We developed clinical algorithms using TLCs, hemoglobin (Hb), and body mass index (BMI) to identify patients who require ART.     

Immunogenicity and safety of two novel human papillomavirus 4- and 9-valent vaccines in Chinese women aged 20–45 years: A randomized,blinded, controlled with Gardasil (type 6/11/16/18), phase III non-inferiority clinical trial

BackgroundHuman papillomavirus (HPV) infections were the main cause of anogenital cancers and warts. HPV 6/11/16/18 vaccines provide protection against the high-risk types of HPV responsible for 70% of cervical cancers and 90% of genital warts. This randomized, blinded, non-inferiority phase III trial was to determine whether immunogenicity and tolerability would be non-inferior among women after receiving two novel 4- and 9-valent HPV vaccines (4vHPV, HPV 6/11/16/18; 9vHPV, HPV 6/11/16/18/31/33/45/52/58) compared with those receiving Gardasil 4 (4-valent).Methods1680 females between 20 and 45 years were randomized in a 2:1:1 ratio to 20–26, 27–35, or 36–45 y groups. Subjects then equally assigned to receive 4vHPV, 9vHPV or Gardasil 4 (control) vaccine at months 0, 2, and 6. End points included non-inferiority of HPV-6/11/16/18 antibodies for 4vHPV versus control, and 9vHPV versus control and safety. The immunogenicity non-inferiority was pre-defined as the lower bound of 95% confidence interval (CI) of seroconversion rate (SCR) difference > ?10% and the lower bound of 95% CI of geometric mean antibody titer (GMT) ratio > 0.5.ResultsAmong the three vaccine groups, more than 99% of the participants seroconverted to all 4 HPV types. The pre-specified statistical non-inferiority criterion for the immunogenicity hypothesis was met: all the lower bounds of 95% CIs on SCR differences exceeded ?10% for each vaccine HPV type and the corresponding lower bounds of 95% CIs for GMT ratios > 0.5. Across vaccination groups, the most common vaccination reaction were injection-site adverse events (AEs), including pain, swelling, and redness. General and serious AEs were similar in the three groups. There were no deaths.ConclusionsThis study demonstrated that the novel 4- and 9-valent HPV vaccination was highly immunogenic and generally well tolerated, both of which were non-inferior to Gardasil 4 in immunogenicity and safety.     

Mental Health Screening Practices Among Primary Care Providers in High HIV Burden Areas of the South: Does Having Patients with HIV Matter?

The Journal of Behavioral Health Services & Research - Mental health (MH) disorders are associated with HIV-related risk and health outcomes. Primary care providers (PCPs) conducting MH...     

不同种除草剂在半夏种植中的初步筛选及其应用研究

目的研究如何减轻半夏Pinellia ternata(Thunb.)B re it种植中所遇到的杂草危害,为大规模田间种植的高产稳产提供保证,以降低投入,实现利润最大化。方法利用完全随机实验设计研究不同种除草剂的除草效果、产生的药害,提出合理除草优化组合。结果乙草胺在禾本科杂草除草效果上有显著优势,药害较低;乐邦综合除草有效率接近90%,效果好时间长;克无踪除草迅速但产生药害也很大。结论前1年生地除草使用克无踪,第2年春播后喷施乙草胺,杂草多发地点施用1次施田补,第1次倒苗后喷洒乐邦。熟地春季使用1次乙草胺,夏季使用1次乐邦即可。     

贵州省两县不同艾滋病诊断治疗服务模式效果分析

目的 比较贵州省两县不同艾滋病诊断治疗服务模式效果。方法 利用D、P两县综合防治信息,以D县实施艾滋病诊断治疗“一站式服务”（简称“一站式服务”）前一年和后一年为观察时间,实行常规服务的P县为对照县,两县新报告且现住址在本地的成年人类免疫缺陷病毒（human immunodeficiency virus,HIV）感染者/获得性免疫缺陷综合征（acquired immunodeficiency syndrome,AIDS）患者（简称HIV/AIDS）为研究对象,比较确证到抗病毒治疗（antiretroviral therapy,ART）时间、CD4⁺T淋巴细胞（简称CD4）检测比例、ART比例等指标。结果 D县实行“一站式服务”后,确证到ART时间由55.00 d缩短为4.00 d,CD4检测比例由65.52%上升到100.00%,全部病例ART比例由31.03%上升到87.88%,差异均有统计学意义（均有P<0.05）。同期,P县确证到ART时间由68.00 d变为43.50 d,CD4检测比例由90.91%变为88.24%,全部病例ART比例由45.45%变为58.82%,差异均无统计学意义（均有P>0.05）。D县实行“一站式服务”后,与P县相比,全部病例ART比例上升,确证到ART时间缩短。结论 “一站式服务”优化了检测流程,缩短了确证到ART时间,减少HIV/AIDS的丢失。     

贵州兴义市麻风菌株基因分型及传播链分析

目的根据麻风菌株基因型分析传播链特点。方法对2004—2009年贵州省兴义市发现的50例新发和复发麻风病患者的菌株17个串联重复序列（VNTR）位点分型,结合患者地理分布分析病例感染、传播之间的流行病学特征。结果根据AC8b、AC9、AC8a、6-7等位点基因型,兴义市流行的麻风菌有6种基因型相似的聚类株,兴义菌株在 rpoT、21-3、27-5、23-3和（GGT）5位点的拷贝数完全一致,但2号和5号聚集株在12-5位点和18-8位点的拷贝数分别是4,为兴义市所特有菌株;为聚集株的26例患者中,有7例为复发病例,21例有明确的感染传播关系;1号和4号聚类株内的15例患者（57.7%）主要分布在兴义市东南部,4号聚类株为聚集在同一自然村内的布依族患者;家内患者之间感染的菌株基因型不相同。结论兴义市多种菌株与特有菌株长期共存是兴义麻风病高流行的重要因素,具有麻风易感体质的家内成员可感染周围存在的不同菌株而发病;为阻断传播,针对家内接触者和高发乡村加强发现早期病例和进行化学预防很有必要。     

河南省4县HIV感染者/艾滋病病人配偶阳转影响因素分析

目的探讨艾滋病单方阳性配偶阳转情况影响因素,为预防艾滋病二代传播措施制定提供科学依据。方法应用回顾性病例对照研究方法,对河南省4县2006—2010年221对人类免疫缺陷病毒（HIV）阳性者及其配偶进行调查,对可能影响阳转的人口学特征、性生活方式、相关知识知晓等因素进行分析。结果单因素分析结果表明,病例组和对照组之间单阳配偶文化程度（χ²=7.298,P=0.026）、性行为频率（χ²=6.075,P=0.048）、先证阳性者CD₄⁺T淋巴细胞（以下简称CD₄）计数（χ²=10.908,P=0.004）、夫妻双方安全套使用情况（χ²=52.474,P=0.000）和艾滋病知识知晓率（χ²=5.503,P=0.019）差异均有统计学意义;多因素非条件logistic回归显示,先证阳性者的CD₄计数≤200时,将艾滋病传染给配偶的危险性是CD₄计数>350者的3.224倍（95%CI=1.266~8.212）,单方阳性夫妻间经常使用安全套和较少使用安全套的HIV阳转危险性分别为每次均用的16.452倍（95%CI=5.837~46.373）和7.643倍（95%CI=2.878~20.296）。结论HIV先证阳性者高CD₄水平和坚持每次使用安全套是HIV夫妻间传播的保护因素。     

河南省2004-2012年丙型肝炎流行特征分析

目的 描述河南省丙型肝炎流行特征及变化趋势。方法 通过“中国疾病预防控制信息系统”收集2004-2012年河南省丙型肝炎报告病例资料, 对其流行特征进行分析。结果 2004-2012年河南省丙型肝炎报告病例数及发病率逐年增加, 报告病例数从5 146例增加到41 317例, 报告发病率从5.31/10万上升到44.01/10万;女性报告病例数逐年增多, 构成比逐年增大;40~64岁组是病例报告较为集中的年龄阶段, 构成比从2004年的42.87%增加到2012年的60.95%;2004-2012全省各省辖市发病率均呈增长趋势, 发病率较高的地区集中在郑州及其周边省辖市。结论 河南省丙型肝炎病例报告发病数及发病率均逐年上升, 应加强重点地区和重点人群的监测。     

云南省部分地区注射吸毒者海洛因过量情况及影响因素分析

目的 了解云南省部分地区注射吸毒者(IDU)海洛因过量情况及其影响因素。方法 采用横断面调查的方法,于2015年7-8月对云南省红河州和德宏州的4个美沙酮维持治疗(MMT)门诊和2个州强制戒毒所的IDU进行问卷调查,内容包括社会人口学特征、毒品使用情况、过去1年海洛因过量情况以及最近1次海洛因过量情况等。对过去1年发生过海洛因过量的相关因素进行logistic回归分析。结果 共340名IDU符合入选标准,男性占85.3%(290/340),年龄为(37.7±8.7)岁,汉族占65.6%(223/340),HIV阳性检出率为49.4%(167/338),过去6个月使用过新型毒品占22.6%(77/340)。自吸毒以来,曾有过海洛因过量的比例为41.8%(142/340),海洛因过量次数M=3次。在过去1年中海洛因过量发生率为15.6%(53/340),M=1次。发生海洛因过量的年龄为(36.7±8.4)岁,吸毒年限为(16.5±7.6)年,男性占83.0%(44/53)。发生海洛因过量的主要原因为增加海洛因用量(26.4%,14/53)和多药滥用(28.3%,15/53)。非条件logistic回归模型分析显示:过去1年参加过MMT(OR=0.534,95%CI:0.290~0.980)可降低海洛因过量的风险,而过去6个月共用针具(OR=2.735,95%CI:1.383~5.407)和刚出戒毒所不满1年(OR=2.881,95%CI:1.226~6.767)会增加海洛因过量的风险。结论 云南省IDU过去1年海洛因过量发生率较高。需要持续促进该地IDU参加MMT并加强预防和应对吸毒过量宣传教育,特别是对戒毒所吸毒人员出所前的宣传教育,同时应建立针对吸毒人员的戒毒所与MMT门诊转介机制。