Association of hepatitis B and human immunodeficiency virus infections in Tanzanian population groups

A study was performed to determine whether there is a correlation between hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infection in population groups in the Dar es Salaam area in Tanzania where HBV infection is endemic. A panel of 460 sera from army recruits, health personnel and pregnant women was tested. In the whole group seromarkers of HBV infection were found in 61.9 % of 134 HIV positive subjects versus 51.5 % of 326 seronegative subjects, a difference which was not statistically significant (p>0.05). In the group of pregnant women, however, 66.7 % of 120 HIV positive subjects had markers of HBV infection versus 49.0 % of the 157 HIV seronegative subjects (p<0.01). This shows that a considerable proportion of young females are also exposed to HBV at the time they acquire HIV infection.     

Seroprevalence of HHV 8 antibodies among the general population and HIV positive persons in the Czech Republic.

BACKGROUND: The seroprevalence rates of herpesvirus 8 (HHV 8) antibodies were determined for the general Czech population and HIV-positive individuals. OBJECTIVES: Six hundred and sixty six serum samples from the general Czech population and 129 serum samples from HIV-positive persons were tested for the presence of antibodies to the HHV 8 lytic and latent antigens. STUDY DESIGN: HHV 8 antibodies were detected by the indirect immunofluorescence test. RESULTS: In the general Czech population, only 2.4 and 0.3% of the serum samples tested positive for antibodies against the lytic and latent HHV 8 antigens, respectively. As many as 34.9 and 10.9% HIV positive individuals had antibodies to the HHV 8 antigens, respectively. Only three of them have developed Kaposi's sarcoma (KS) to date. At the time of KS diagnosis, the three patients had antibodies to both HHV 8 antigens. HIV-positive homo/bisexuals were at significantly higher risk of acquiring HHV 8 infection compared with HIV-positive heterosexuals. The increase in HHV 8 seroprevalence was associated with progression of the HIV infection from stage A to stage B. No correlation was found between the HHV 8 seroprevalence and CD 4+T-lymphocytes counts or the HIV viral load. CONCLUSIONS: Among the general Czech population, the HHV 8 seroprevalence is as low as in the West European countries. The mean HHV 8 seroprevalence rate in HIV-positive individuals was 34.9% and was comparable with those reported in other low seroprevalence countries.     

Human herpesvirus 8 DNA in HIV-negative Japanese patients with multicentric Castleman's disease and related diseases

Multicentric Castleman's disease (MCD) is a lymphoproliferative disorder characterized by systemic lymphadenopathy and hypergammaglobulinemia. Recently, a French group reported that human herpesvirus 8 (HHV8) DNA was detected in tissue samples of MCD patients. The detection rate was especially high in human immunodeficiency virus (HIV)-positive MCD patients. Thus, HHV8 infection seems to be closely related to HIV infection. In Japan, the HIV infection rate in the general population is very low. To examine whether HHV8 is actually related to MCD in Japan, we performed nested polymerase chain reaction for the HHV8 genome using DNA samples from 7 patients with MCD and 23 patients with related diseases such as POEMS syndrome, amyloidosis, myeloma and lymphoma. They were all HIV-negative Japanese. Three of 7 MCD patients were positive for HHV8. There were no clear differences in clinical characteristics between HHV8-positive patients and negative ones. All other patients were negative for HHV8. Thus, we have shown that some MCD patients in Japan are also infected with HHV8.     

A prospective study of infants born to women seropositive for human immunodeficiency virus type 1. HIV Infection in Newborns French Collaborative Study Group

Assessment of the risks of transmission of infection with human immunodeficiency virus type 1 (HIV-1) from mother to newborn is difficult, partly because of the persistence for up to a year of maternal antibodies transmitted passively to the infant. To determine the frequency of perinatal transmission of HIV infection, we studied from birth 308 infants born to seropositive women, 62 percent of whom were intravenous drug abusers. Of 117 infants evaluated 18 months after birth, 32 (27 percent) were seropositive for HIV or had died of the acquired immunodeficiency syndrome (AIDS) (n = 6); of the 32, only 2 remained asymptomatic. Another 76 infants (65 percent) were seronegative and free of symptoms, whereas 9 (8 percent) were seronegative but had symptoms suggestive of HIV-1 infection. The infants infected with HIV-1 did not differ from the others at birth with respect to weight, height, head circumference, or rate of malformations, but as compared with newborns who were seronegative at 18 months, their serum IgM levels were higher (78 +/- 81 mg per deciliter vs. 38 +/- 39 mg per deciliter; P less than 0.03) and their CD4 lymphocyte counts were lower (2054 +/- 1221 per cubic millimeter vs. 2901 +/- 1195 per cubic millimeter; P less than 0.006). Neither maternal risk factors nor the route of delivery was a predictor of seropositivity at 18 months; however, 5 of the 6 infants who were breast-fed became seropositive, as compared with 25 of 99 who were not (P less than 0.01). We conclude that approximately one third of the infants born to seropositive mothers will have evidence of HIV-1 infection or of AIDS by the age of 18 months, and that about one fifth of this group will have died.     

Prevalence of Hepatitis C virus infection in pregnant women and mother-child transmission in Ouagadougou, Burkina Faso

The aim of our study was to estimate the prevalence of Hepatitis C virus (HCV) among pregnant women and the rate of mother-child transmission. Over one month (April 26 to May 25, 2002) blood samples of 200 pregnant women who gave birth at the maternity of the university hospital and Gounguin center medical of Ouagadougou were tested for anti-HVC antibodies (Ac HCV) and anti HIV antibodies (Ac HIV). Infants born to mother tested positive for Ac HCV and their mother were tested for HCV-RNA. The prevalence of HCV (positive Ac HCV and HCV-RNA) was 2% in pregnant women (4/200). One case of mother-child transmission was found. The virus transmitted was 2a (A/C) genotype. The mother had a high titre of HCV-ARN, was co-infected by HIV and had had history of blood transfusion, excision and tattoo of the gums.     

Prevalence of human herpesvirus 8 and hepatitis C virus in a rural community with a high risk for blood-borne infections in central China

Illegal blood donation in the past decade has caused human immunodeficiency virus (HIV) outbreaks in some rural areas in China. Other HIV-associated virus infections, such as those caused by human herpesvirus 8 (HHV8), in such areas are still not well defined. In order to explore HHV8 and hepatitis C virus (HCV) seroprevalence and potential risk factors in such areas, a cross-sectional study with 305 HIV-positive and 315 HIV-negative subjects recruited from a rural county in Shanxi province was conducted, in which illegal blood collection was reported. Interview questionnaires and serum testing were carried out with these participants. HCV and HHV8 seroprevalence were found to be higher in the HIV-positive than in the HIV-negative group (76.4% vs. 2.5% and 15.4% vs. 4.8%, respectively), whereas the difference in HBV seroprevalence was not significant. Co-infection with HCV and HHV8 was also more prevalent in the HIV-positive group. HIV status (OR 2.71; 95% CI 1.16–6.30) and HBV status (OR 2.56; 95% CI 1.14–5.75) were independently associated with HHV8 infection. HIV status (OR 23.03; 95% CI 9.95–53.27) and blood/plasma selling history (OR 14.57; 95% CI 7.49–28.23) were strongly associated with HCV infection. These findings demonstrate that both HHV8 and HCV infections are prevalent in this community. HIV infection is an important risk factor for both HHV8 and HCV infection. HBV infection is associated with HHV8 infection but not with HCV infection. It is possible that HHV8 and hepatitis B virus, but not HCV, have similar modes of transmission in this population.     

Primary effusion lymphoma in human immune deficiency (HIV)‐negative non‐organ transplant immunocompetent patients

Primary effusion lymphoma (PEL) is a rare non‐Hodgkin's lymphoma most commonly occurring in the context of human immune deficiency (HIV) infection. Herpes virus 8 (HHV‐8) has been associated with PEL and considered to be the etiologic agent. In addition, most cases (60%‐90%) also show evidence of Epstein‐Barr virus (EBV) infection. We describe here an elderly man who was HIV seronegative and immunocompetent, and presented with worsening weakness and ascites. The diagnosis of PEL was rendered cytologically and supported by the results of flow cytometry. The presence of HHV‐8 was demonstrated by immunohistochemistry, whereas EBV‐associated genetic material was absent by EBER ISH. No lymphadenopathy or organ involvement with lymphoma was found. Systemic chemotherapy with lenalidomide was started given the poor prognosis and commodities of severe coronary artery disease; however, the patient did not respond and succumbed to his disease in 4 months. We present detailed cytologic and clinical findings of this very rare occurrence, and review literature of all reported PEL cases of HIV‐negative, nontransplant, immunocompetent patients.     

The incidence of human herpes virus‐8 expression in lymph node biopsies from human immunodeficiency virus‐positive patients

Beukes C A & Thiart J
(2012) Histopathology  61, 942–944 The incidence of human herpes virus‐8 expression in lymph node biopsies from human immunodeficiency virus‐positive patients Aims: Human immunodeficiency virus (HIV)‐related lymphadenopathy is characterized by a wide spectrum of histological changes. Three patterns have been described which correspond to clinical stages of HIV/acquired immune deficiency syndrome (AIDS). Castleman disease is a heterogeneous group of disorders. A recently described variant, multicentric Castleman disease (MCD), of which some cases are associated with human herpes virus‐8 (HHV‐8), has been reported in both HIV‐seropositive and ‐negative patients. Considerable morphological overlap occurs between one of the patterns of HIV lymphadenopathy and this variant. Methods and results: This retrospective histopathological study on 95 cases of HIV‐reactive lymphadenopathy assessed the incidence of the different patterns and HHV‐8 on immunohistochemistry (IHC). Of the 95 cases, 78 (82.1%) were HHV‐8‐negative, of which 46 (59.0%) were classified as pattern A, 20 (25.6%) as pattern B and 12 (15.4%) as pattern C. Nine (31.0%) of 29 cases with pattern B and 8 (40.0%) of 20 cases with pattern C were HHV‐8 positive. In total 15 cases of MCD were diagnosed in this series. Conclusion: This study draws attention to the overlap between HIV lymphadenopathy and MCD. We recommend that cases of HHV‐8‐associated MCD should be investigated for HIV infection.     

Do fewer cases of Kaposi’s sarcoma in HIV-infected patients reflect a decrease in HHV8 seroprevalence?

Infection with human herpes virus 8 (HHV8) is associated with development of Kaposi’s sarcoma (KS); therefore also known as KS-associated herpes virus. KS is closely associated with human immunodeficiency virus (HIV) infection, and consequently HHV8 seroprevalence is higher in HIV-infected compared to HIV-negative patients. Currently, KS is rarely seen in clinical practice, which might be a consequence of an optimized anti-HIV treatment leading to an improved immunological status, or alternatively of a decrease in HHV8 prevalence. To determine the prevalence of HHV8 antibodies in HIV-positive compared to HIV-negative patients from the University Hospital Frankfurt/Main, Germany, and to compare our results with previously published data to illustrate trends in the spread of infection. Hundred serum samples each of HIV-positive and HIV-negative patients were analyzed for HHV8 antibodies by using an IgG immunofluorescence test. The overall HHV8 seroprevalence was 16% with no statistically significant gender-specific differences; however, the distribution between the HIV-infected patients and the HIV-negative control group was significantly different (30 and 2%, respectively). The highest rate of seroprevalence in HIV-infected patients was detected at the age of 40–49 (42%) and the lowest rate at the age of 20–29 years (16.6%). In comparison with formerly conducted studies, our data clearly showed an increase in the HHV8 seroprevalence in HIV-infected patients, both in men and women. Therefore, we conclude that the low rate of clinical KS is associated with an improved immunological status due to an optimized anti-HIV therapy.     

Seroprevalence and risk factors of human herpes virus 8 infection in Central-East Tunisia

Objective

Epidemiology of human herpesvirus 8 (HHV8) is still unknown in Tunisia. We aimed to assess the prevalence of HHV8 infection in adults and children from Central-East Tunisia and in patients with high risk of parenteral or sexual infection.

Methods

We enrolled 553 subjects: 116 blood donors, 100 pregnant women, 100 children, 50 subjects with sexually transmitted infections with positive HIV serology and 50 other without HIV infection, 107 multitransfused patients and 30 kidney transplant patients. Antibodies against HHV8 were tested using a sensitive indirect immunofluorescence assay.

Results

The seroprevalence of HHV8 was found to be 13.8% in blood donors, 13% in pregnant women and 12% in children. In healthy adult population, no association was found between HHV8 seropositivity and sex, sociodemographic characteristics, parenteral risk factors or serological markers of hepatitis B. Rates of HHV8 infection were significantly higher in patients having high-risk sexual behavior with or without HIV infection (P < 10⁻⁴), in polytransfused patients (P < 10⁻⁴) and in patients with kidney transplantation (P = 0.001).

Conclusion

Our findings suggest that HHV8 infection is widespread in Central-East Tunisia such as in the Mediterranean area. HHV8 infection appears to be acquired early in life, probably through saliva. HHV8 transmission by blood transfusion, subject of controversy in literature, is well established in our study. Early screening of this infection should be considered in populations with high risk of Kaposi's sarcoma in our areas.     

Effect of maternal HIV and malaria infection on pregnancy and perinatal outcome in Zimbabwe

OBJECTIVE: To investigate the effect of isolated or concomitant infection with malaria and HIV on pregnancy and neonatal outcome. METHODS: Data were collected on pregnant women admitted during the rainy seasons in the obstetric division of a district referral hospital in northern Zimbabwe in 2000 and 2001. The effects of malaria and HIV infection were determined by multivariate analysis. RESULTS: The prevalence of HIV seropositivity and symptomatic malaria in 986 pregnant women was 8.3% and 14.7%, respectively. HIV-infected women were more likely to develop malaria attacks during pregnancy than seronegative women (odds ratio [OR] = 3.96, 95% confidence interval (CI): 2.42-6.46). Malaria and HIV infections were associated with increased risk of stillbirth (OR = 4.74, 95% CI: 1.34-16.78) and preterm delivery (OR = 4.10, 95% CI: 2.17-7.75), respectively. They were independently associated with increased risk of low birth weight (malaria: OR = 10.09, 95% CI: 6.50-15.65; HIV: OR = 3.16, 95% CI: 1.80-5.54) and very low birth weight (malaria: OR = 5.04, 95% CI: 1.00-25.43; HIV: OR = 10.74, 95% CI: 2.12-54.41), low Apgar score (malaria: OR = 4.45, 95% CI: 1.42-13.94; HIV: OR = 5.94, 95% CI: 1.66-21.30), and fetal growth restriction (malaria: OR = 3.98, 95% CI: 2.51-6.30; HIV: OR = 4.07, 95% CI: 2.40-6.92). Dual infection with malaria and HIV was associated with increased risk of maternal, perinatal, and early infant death. CONCLUSIONS: Women with single HIV or malaria infection have a significantly increased risk of adverse outcomes of pregnancy and childbirth. Dual infection has additional detrimental effects on maternal and infant survival in an area where HIV and malaria coexist.     

Infection of mesothelial cells with human herpes virus 8 in human immunodeficiency virus-infected patients with Kaposi's sarcoma, Castleman's disease, and recurrent pleural effusions.

Recurrent pleural effusions are common complications of hospitalized patients with human immunodeficiency virus (HIV) infection and may pose difficult diagnostic dilemmas. A common cause of recurrent pleural effusions in up to 30% of HIV-seropositive patients is pulmonary involvement by Kaposi's sarcoma, a human herpesvirus 8 (HHV 8)-related neoplasm. The pathogenesis of these effusions is unclear. These recurrent effusions, although benign, have shown significant mesothelial atypia/reactive changes of uncertain etiology. We attempted to evaluate these effusions morphologically and molecularly for the presence of HHV 8, with particular attention to mesothelial cells. All recurrent pleural effusions, as defined by any effusion tapped for cytological examination on more than two occasions, in HIV-positive patients at the National Institutes of Health were examined from 1998 to the present. Cases were stratified according to patients with and without histologically confirmed HHV 8 disease manifestations. Five patients with HHV 8 diseases (four with disseminated Kaposi's sarcoma and one with Castleman's disease) were identified. As a control group, five effusions from HIV-seropositive patients without known HHV 8-related diseases were identified. Cytological examination of effusions in patients with HHV 8-related diseases demonstrated atypical/markedly reactive mesothelial cells accompanied by a polymorphous background of lymphocytes. Molecular studies for B- and T-cell clonality in microdissected whole samples showed no definitive clones in these cases. Conversely, polymerase chain reaction (PCR) studies for the HHV 8 virus was positive in these samples. PCR studies on pure populations of microdissected mesothelial cells from the HHV 8-related effusions were positive for HHV 8 sequences, whereas those from HIV patients with non-HHV 8 related diseases were negative. Immunohistochemistry for HHV 8 (monoclonal antibody to latent nuclear antigen (LNA-1; ORF-73) on cellblock material demonstrated scattered positive mesothelial cells in three of the five cases of HHV 8-associated effusions. HHV 8 has been recently implicated in the pathogenesis of Kaposi's sarcoma and primary effusion lymphoma. Mesothelial cells in recurrent pleural effusions from patients with Kaposi's sarcoma and Castleman's disease appear to be infected with HHV 8. Additional studies need to be done to define the role of mesothelial cell infection in the pathogenesis of these HHV 8-associated effusions and define the prognostic significance.     

Patterns of antibodies against latent and lytic antigens of human herpesvirus 8 in an endemic population and patients with Kaposi's sarcoma in Mozambique

The patterns of antibodies against latent and lytic antigens of human herpesvirus 8 (HHV‐8) were assessed using immunofluorescence assays of samples from 155 persons seropositive for HHV‐8 seen at public health centers and 24 patients with Kaposi's sarcoma (KS) from Mozambique. Of the 155 persons without KS, 48 (31%) had antibodies against latent antigens only, 29 (18.7%) had antibodies against lytic antigens only, and 78 (50.3%) had antibodies against both types of antigen. The HHV‐8 antibody titer tended to increase with age until age 40, after which it began to decrease. High titers of antibodies against latent and lytic antigens of HHV‐8 were detected mostly in persons co‐infected with HIV, and these increased titers could have a predictive value. All patients with KS except four patients who were seronegative for HHV‐8 had elevated titers of HHV‐8 antibodies, predominantly against latent antigens. The data suggest the potential for an increase in the development of KS in this endemic area for HHV‐8. J. Med. Virol. 82:1576–1581, 2010. © 2010 Wiley‐Liss, Inc.     

Seroprevalence and determinants of human herpes virus 8 infection in adult Nigerians with and without HIV-1 infection

Background

There is a dearth of studies on HHV8-HIV co-infections from Nigeria, even as both infections have been shown to be endemic in Africa. This study examined the seroprevalence and determinants of HHV8 infections in adult Nigerians with and without HIV-infection.

Methods

In 2007, a cross sectional study undertaken in a tertiary hospital in Zaria, northern Nigeria enrolled 71 HIV-1 positive adults without Kaposi''s sarcoma and 85 apparently healthy HIV-negative adult volunteers of the general population. Anti-lytic antibodies to HHV8 infection was determined by ELISA. A univariate analysis including age, sex, marital status, past sexually transmitted disease (STD), past blood transfusion, HIV/AIDS staging and CD4 count was used to determine variables associated with HHV8 seropositivity. Significant variables were adjusted in a logistic regression model expressed in odds ratio (OR) with 95% confidence interval (CI). P<0.05 was considered significant

Results

The seroprevalence of HHV8 infection was 62% in HIV-1 positive patients and 25.9% in HIV negative adults (p<0.001). A past history of STD [OR= 2.88, 95% CI= 1.0 – 8.2] and advanced HIV/AIDS (WHO stage 3 and 4) [OR=3.5, 95% CI= 1.21–10.1] were the only variables independently associated with HHV8 seropositivity in HIV-infected patients. In HIV-negative adults, none of the variables was significantly associated with HHV8 seropositivity.

Conclusion

The study findings suggest an adverse interaction between HHV8 and HIV-1. The higher prevalence of HHV8 infection in HIV-infected patients and its association with STD support a predominant sexual route of HHV8 transmission among adult Nigerians.     

Maladie de Kaposi profuse chez un enfant VIH positif,probablement contaminé par sa grand-mère

Kaposi’s disease in children with HIV is rarely reported in everyday practice. This is a case study of cutaneous Kaposi’s disease revealing HIV in a 5-year-old child with polymorphic eruption of papules and nodules on the face, trunk, back, and limbs. Histopathological examination confirmed the diagnosis of Kaposi’s disease. The child’s HIV serology was positive with a CD4 count of 240/mm³, normochromic and normocytic anemia, and a hemoglobin level at 8.5 g/dl. It was found that the child, after early weaning from his HIV-negative mother, had repeatedly suckled his healthy grandmother, who had no skin lesions but was HIV1 positive. Both grandmother and child were referred for treatment in their locality. The case is noteworthy for the way in which the HIV1 virus infected the child during weaning and then being suckled by his grandmother. The child already had an initial dental flare that could have injured his grandmother. Thus, in our case, there is a contamination by HIV1 virus most likely from the grandmother and contamination by the HHV8 virus, source unidentified as a technical plateau was reached.     

HIV‐1 seroconversion promotes rapid changes in cervical human papillomavirus (HPV) prevalence and HPV‐16 antibodies in female sex workers

The extent to which human immunodeficiency virus (HIV‐1) infection impacts on the ability to mount an effective immune response to HPV is unknown, but is relevant in planning HPV vaccine strategies for HIV‐1 infected individuals. This longitudinal study investigated changes shortly after HIV‐1 seroconversion on cervical HPV types and HPV‐16 antibody responses in serum and at the cervix of female sex workers. Typing of HPV DNA from cervical cells was done prior to HIV‐1 seroconversion and within 1 year and greater than 2 years after HIV‐1 seroconversion. Antibody determinations on serum and cervico‐vaginal rinse samples were by HPV‐16 virus‐like particle‐based, enzyme‐linked immunosorbent assay. Of 104 women tested, 40 (38.4%) became HIV‐1 seropositive (HIV‐positive) during the course of the study. Shortly after HIV‐1 seroconversion a significant increase in multiple (>1) HPV infection (OR 4.0, 95% CI 1.3–11.9) was observed compared with HIV‐1 seronegative (HIV‐negative) women and certain changes in HPV type infection. HIV‐1 seroconversion resulted in a reduced prevalence of serum HPV‐16 IgA and cervico‐vaginal IgA and IgG but an increased prevalence of serum HPV‐16 IgG. All HIV‐positive women had been exposed to HPV‐16 as all displayed serum HPV‐16 IgG. Serum HPV‐16 responses were maintained at a high magnitude in the presence of HPV‐16 infection irrespective of HIV infection, but decreased in the absence of HPV‐16 infection. In conclusion, HIV‐1 seroconversion in sex workers rapidly increased cervical HPV infection and caused a reduced ability to produce cervical HPV‐16 antibodies but a continued ability to generate serum IgG antibodies. J. Med. Virol. 81:203–210, 2009. © 2008 Wiley‐Liss, Inc.     

Human papillomavirus infection and cervical abnormalities in Nairobi, Kenya, an area with a high prevalence of human immunodeficiency virus infection

Human papillomavirus (HPV) infection and cervical abnormalities, and their association with human immunodeficiency virus (HIV) infection were studied in 488 women who visited a health center in Nairobi. PCR-based HPV and cervical cytology tests were carried out on all participants, and peripheral CD4+ T cells and plasma HIV RNA were quantitated in HIV positive women. HIV were positive in 32% (155/488) of the women; 77% of these were untreated, and the others had been treated with anti-retroviral drugs within 6 months. Cervical HPV infection was detected in 17% of HIV negative and 49% of HIV positive women. Low-grade squamous intraepithelial lesions were observed in 6.9% of HIV negative and 21% of HIV positive women, while high-grade squamous intraepithelial lesions and cancer were seen in 0.6% and 5.8%, respectively. Multivariate analysis revealed that HIV and HPV infections were associated with each other. Cervical lesions were significantly associated with high-risk HPVs and with HIV infection, depending on HPV infection. HPV infection increased in accordance with lower CD4+ T cell counts and higher HIV RNA levels, and high-grade lesions were strongly associated with high-risk HPV infection and low CD4+ T cell counts. Immunosuppression as a result of HIV infection appears to be important for malignant progression in the cervix. Nationwide prevention of HIV infection and cervical cancer screening are necessary for the health of women in this area. High-risk HPV infection and low CD4+ T cell counts are the risk factors for cervical cancer.     

2010-2015年成都市孕产妇艾滋病哨点监测结果分析

目的 了解成都市孕产期妇女人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)和梅毒的感染现状、艾滋病防治知识知晓情况及其影响因素,为当地防控策略制定和干预效果评估提供科学依据.方法 严格按照《全国艾滋病哨点监测实施方案操作手册》标准,于2010-2015年对符合监测条件的孕产妇开展行为学问卷调查和血清学检测.结果 2010-2015年间共监测孕产妇2400名,未发现HIV抗体阳性者,梅毒阳性检出率及HCV阳性检出率均为0.13％;艾滋病防治知识知晓率70.52％,呈逐年上升趋势(X2=75.68,P＜0.001),且文化水平越高、年龄越小、怀孕生育次数越少,其防治知识知晓率越高.结论 成都市孕产妇人群HIV、梅毒、HCV感染率均处于低于全国较低水平,但该人群艾滋病防治知识知晓率仍有待提升,今后应开展针对性的孕期健康教育及行为干预,预防艾滋病母婴传播的发生.     

Hepatitis B virus infection among pregnant women in Haiti: A cross-sectional serosurvey

BackgroundHepatitis B vaccine administered shortly after birth is highly effective in preventing mother to child transmission (MTCT) of infection. While hepatitis B vaccine was introduced in Haiti as part of a combined pentavalent vaccine in 2012, a birth dose is not yet included in the immunization schedule.ObjectivesDetermine the seroprevalence of hepatitis B virus (HBV) infection among pregnant women to evaluate the risk of MTCT.Study designWe selected 1364 residual serum specimens collected during a 2012 human immunodeficiency virus (HIV) sentinel serosurvey among pregnant women attending antenatal care clinics. Haiti was stratified into two regions: West, which includes metropolitan Port-au-Prince, and non-West, which includes all other departments. We evaluated the association between demographic and socioeconomic characteristics and HIV infection with HBV infection.ResultsOf 1364 selected specimens, 1307 (96%) were available for testing. A total of 422 specimens (32.7%) tested positive for total anti-HBc (38.2% in West vs. 27% in non-West, p < 0.001), and 33 specimens (2.5%) were HBsAg positive (2.1% in West vs. 3% in non-West, p = 0.4). Of HBsAg positive specimens, 79% had detectable HBV DNA. Women aged 30 and older had more than double the odds of positive total anti-HBc than women aged 15–19 years (p < 0.001). Women with secondary (adjusted odds ratio (aOR) = 0.54; 95% CI: 0.36–0.81) and post-secondary education (aOR = 0.40, 95% CI: 0.19–0.79) had lower odds of total anti-HBc positivity compared with women with no education. HIV-status was not associated with HBV infection.ConclusionsHaiti has an intermediate endemicity of chronic HBV infection with high prevalence of positive HBV DNA among chronically infected women. Introduction of a universal birth dose of hepatitis B vaccine might help prevent perinatal HBV transmission.     

Human herpes virus 8‐unrelated primary effusion lymphoma‐like lymphoma: report of a rare case and review of the literature

Primary effusion lymphoma (PEL) is a very rare type of lymphoma usually confined to the body cavities predominantly in immunosupressed patients infected with human herpes virus 8 (HHV‐8). The new term for HHV‐8 independent PEL is HHV8‐unrelated PEL‐like lymphoma. We describe an 89‐year‐old human immunodeficiency virus (HIV)‐negative male patient with HHV8‐unrelated PEL‐like lymphoma in the pleura. No hepatosplenomegaly or lymphadenopathy was detected. Chest radiography and computed tomography revealed right pleural effusion, but no evidence of tumor mass or lymph node enlargement. Cytological analysis of the pleural effusion revealed a high‐grade lymphoma with round nuclei, prominent nucleoli and abundant cytoplasm with immunophenotypes positive for CD45, CD30, CD38, CD7 and CD71. Because of the advanced age, no chemotherapy was given. Effusion resolved spontaneously. One year after the diagnosis, a new pleural effusion developed at the left side. Following thoracentesis and pleurodesis, the patient remained in complete remission for 40 months. To date, 30 cases of HHV8‐unrelated PEL‐like lymphoma/HIV negative have been reported in the literature. The outcome of the HHV8‐unrelated PEL‐like lymphoma patients who were HIV negative seems to be better than HIV‐ and HHV‐8‐positive PEL.