Nef Mutations in Long-term Non-progressors from Former Plasma Donors Infected with HIV-1 Subtype B in China

Objective To study the specific amino acid variation in Nef that may be related to disease progression after infection with HIV-1 subtype B, a predominant strain circulating in China, and to determine whether changes in Nef secondary structure may influence different stages of AIDS development based on the concept that the Nef gene of HIV infection dramatically alter the severity of viral infection and virus replication and disease progression, and that long-term non-progressors （LTNP） of HIV infection are commonly associated with either a deletion of the Nef gene or the defective Nef alleles. Methods The study subjects were divided into LTNPI（n=14）, LTNP2 （n=16） and slow progressor （SP, n=19） groups for mutational analysis of the Nef sequence. The data were obtained by using Bioedit, MEGA, Anthewin and SAS software. Results Residues in Nef TA48/49 and K151 occurred more frequently in the LTNP group while AA48/49 was more frequently observed in the SP group. Of the differences observed in the secondary structure comparison using Nef consensus sequences of these three groups, one was roughly corresponding to the Nef48/49 mutation site. Conclusion TA48/49, Kiss, and AA48/49 in the Nef gene might be associated with the different stages of HIV infection, and there may be a link between the Nef secondary structure and the progression of HIV- 1 infection.     

中医药综合干预对农村地区HIV感染者死亡率的影响

目的探讨中医药综合治疗对农村地区人类免疫缺陷病毒（HIV）感染者死亡率的影响。方法以河南省某HIV感染高发区农村地区2004年10月纳入中医救治项目的HIV感染者为中医治疗组,以未纳入中医救治项目、地理位置临近村庄的HIV感染者为非中医治疗组。通过中医药治疗艾滋病数据库和艾滋病综合防治数据信息系统收集研究对象的相关信息,记录截至2012年10月两组患者的死亡例数,并应用Cox比例风险模型分析影响HIV感染者死亡的因素。结果共纳入患者448例,中医治疗组103例,艾滋病相关死亡15例,死亡密度为2.12/100人年,累计死亡率14.6%;非中医治疗组345例,艾滋病相关死亡90例,死亡密度为3.94/100人年,累计死亡率26.1%,两组患者累计死亡率比较差异有统计学意义（P<0.05）。Cox比例风险模型单因素分析结果显示,非中医治疗组患者的死亡风险是中医治疗组患者的1.84倍（P<0.05）;多因素分析结果显示,非中医治疗组患者的死亡风险是中医治疗组患者的1.90倍（P<0.05）;此外,性别、年龄、婚姻状况和开始服用抗病毒药的时间也是HIV感染者死亡的影响因素（P<0.05）。结论中医药综合治疗可能降低HIV感染者的死亡率,但有待开展前瞻性研究给予客观评价。     

Acceptability of Human Papillomavirus Vaccine for Males: A Review of the Literature

The quadrivalent human papillomavirus virus vaccine was recently licensed for use in males in the United States. This study reviews available published literature on acceptability among parents, health care providers, and young males. Among 23 published articles, half were conducted in the United States. The majority (87%) used quantitative survey methodology, and 13% used more explorative qualitative techniques. Convenience samples were used in most cases (74%) and 26% relied on nationally representative samples. Acceptability of a human papillomavirus virus (HPV) vaccine that protects against cervical cancer and genital warts was high in studies conducted among male college students (74%–78%) but lower in a community sample of males (33%). Among mothers of sons, support of HPV vaccination varied widely from 12% to 100%, depending on the mother's ethnicity and type of vaccine, but was generally high for a vaccine that would protect against both genital warts and cervical cancer. Health providers' intention to recommend HPV vaccine to male patients varied by patient age but was high (82%–92%) for older adolescent patients. A preference to vaccinate females over males was reported in a majority of studies among parents and health care providers. Messages about cervical cancer prevention for female partners did not resonate among adult males or parents. Future acceptability studies might incorporate more recent data on HPV-related disease, HPV vaccines, and cost-effectiveness data to provide more current information on vaccine acceptability.     

An alternative strategy to western blot as a confirmatory diagnostic test for HIV infection

BackgroundIn China, western blot (WB) is the recommended procedure for the diagnosis of HIV infection. However, this technique is time consuming and labor intensive, and its complexity restricts wide application in resource-limited regions.ObjectiveThe aim of this study was to evaluate the efficacy of a dry blood spots (DBS)–urine paired enzyme-linked immunosorbent assay (ELISA) test, instead of WB, for HIV antibody detection.Study designPlasma, DBS, and urine samples were collected from 1213 subjects from different populations. Two diagnostic testing strategies were conducted in parallel. The equivalence of the paired ELISA and WB strategies was assessed.ResultsA diagnosis of HIV was determined in 250 subjects according to the paired ELISA test, and in 249 according to the WB strategy. The discordant case was judged HIV-positive during follow-up. In total, 18 subjects were diagnosed with possible HIV using the paired ELISA test, among whom, 11 subjects tested negative with WB, and one was confirmed to be HIV-positive during follow-up. For the remaining 945 subjects, both strategies indicated a negative result. The kappa test indicated good conformity (kappa = 0.954) between the two diagnostic strategies.ConclusionThe DBS–urine paired ELISA could be applied as an alternative to WB in HIV diagnosis, which would be valuable in resource-limited regions owing to the associated affordability and ease of use.     

Investigating HIV Infection and HIV Incidence Among Chinese Men Who Have Sex with Men with Recent Sexual Debut,Chongqing, China, 2011

HIV among men who have sex with men (MSM) with recent male–male sexual debut, such as within the past 5 years, may be a proxy for recent HIV infection. Using this definition, we explored factors associated with HIV infection in this group to understand the evolving HIV epidemic among MSM in Chongqing. We conducted a cross-sectional respondent-driven sampling survey among Chongqing MSM in 2011. Computer-assisted, self-administered questionnaires were used and blood specimens were collected for HIV and syphilis testing. Three hundred and ninety-one unique MSM were recruited of which 65.7 % (257) had their sexual debut with another man in the past 5 years. HIV prevalence among men with recent sexual debut was 18.7 % suggesting a possible HIV incidence of 3.7 %. Multivariable analysis among men with recent sexual debut suggests that lower education, having more than one male partner, and currently being infected with syphilis are associated with HIV among men with recent sexual debut. HIV prevalence is high among MSM with recent sexual debut in Chongqing, which may be a proxy a high incidence rate. HIV prevention efforts should focus on STD reduction among those MSM with lower educational attainment.     

社区卫生服务机构艾滋病防治对象对HIV检测接受意愿调查

目的了解社区卫生服务机构艾滋病防治对象对艾滋病病毒（HIV）检测的接受意愿及影响因素。方法采用自行设计的调查问卷,在北京、上海等8个城市的社区卫生服务机构,对重点科室（妇产科、皮肤科等）的就诊人员、男男性行为人群（MSM）和娱乐场所女性工作人员进行调查。调查内容包括一般社会人口学信息、艾滋病相关知识、HIV防治服务接受意愿及利用情况等。结果共调查了755人,其中29人HIV阳性。在726名HIV阴性人员中,555人（76．4％）表示愿意接受社区卫生服务机构免费提供的HIV检测服务。多因素Logistic回归分析显示,平均月收入较高（1000～1999元、2000-2999元）、知晓艾滋病知识和以前接受过HIV检测的服务对象,更愿意接受HIV检测,其比值比（OR）和95％可信区间（CD分别为2．51（1．18～5．37）、2．35（1．28～4．32）、2．07（1．14～3．77）、1．85（1．25～2．75）。结论调查对象对社区卫生服务机构开展的HIV检测服务有较高的接受意愿,但也存在诸如担心歧视、个人隐私暴露和业务能力不高以及自身艾滋病知识欠缺等因素的影响,因此在社区卫生服务机构开展HIV检测需要加强受检者隐私保护,同时要扩大HIV防治宣传和提高社区医生的HIV咨询检测知识和技能水平。     

女性性工作者高危行为与HIV传播研究进展

随着经性传播成为艾滋病病毒（HIV）的主要传播途径以来,对女性性工作者人群（FSW）的流行病学调查和行为学监测意义更加突出。为了正确认识和理解FSW高危行为与HIV传播的关系,文章从流行病学及社会学视角,对FSW及其高危行为在HIV经性传播中起的作用和影响范围进行了综述。     

MSM HIV感染者外周血中ADCC反应水平与HIV-1感染早期病毒载量的关系

目的在艾滋病病毒（HIV）感染早期,观察HIV-1特异性抗体依赖的细胞毒性作用（ADCC）与病程进展的关系。方法利用HIV-1特异性多肽刺激和多色流式技术,对前期采集的、感染时间在1年以内的男男性行为人群（MSM）标本进行ADCC检测。结果共采集HIV-1感染者标本58份,CD4＋T淋病细胞计数与外周血病毒载量呈明显负相关（r=-0.281 6,P=0.032 3）。ADCC检测结果显示,病毒载量与HIV-1Pol特异性CD2＋IFN-γ＋细胞占CD3-细胞的比例呈显著的正相关（r=0.260 7,P=0.046 2）;而病毒载量与HIV-1Gp120特异性CD2＋CD107a＋细胞占CD3-[A1]细胞的比例呈显著负相关（r=-0.342 9,P=0.009 0）。结论在HIV-1感染早期,感染者体内即可产生针对Pol和Env蛋白的ADCC反应,其中针对Gp120蛋白的ADCC反应具有控制病程进展的作用。