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Background: Early diagnosis of HIV infection decreases the time from HIV diagnosis to viral suppression and reduces further HIV transmission. The Chinese Guidelines for the Diagnosis and Treatment of HIV/AIDS (2021 edition) state that an HIV RNA level > 5,000 copies/mL is the threshold for diagnosing HIV infection. The impact of low viral load values on HIV diagnosis needs to be investigated. Methods: There were 3455 human immunodeficiency virus (HIV1 + 2) antibody results (immunoblotting method) and 65,129 HIV viral load values at Beijing Youan Hospital from 2019 to 2022. A total of 2434 patients had both antibody confirmatory results and viral load results. The confirmatory antibody results and HIV viral load results of 2434 patients were analyzed to investigate the impact of low viral load values on HIV diagnosis. Results: Of the 2434 patients who had both confirmatory antibody results and viral load results, the viral load values of 140 patients (5.8%) had viral loads ranging from 40 copies/mL to 5,000 copies/mL before positive confirmatory antibody result, and of these 140 patients, the sample receipt time for the viral load tests of 96 (66.7%) individuals was 1 to 6 days earlier than the corresponding sample receipt time for the confirmatory antibody test. In addition, 34 patients (1.4%) had low viral loads ranging from 40 copies/mL to 1,000 copies/mL before positive confirmatory antibody result. Conclusion: This study revealed that there is a risk of missed diagnosis if a threshold of 5000 copies/mL is used for the diagnosis of HIV infection. These data provide valuable information for the early diagnosis of HIV infection, and our findings have potential benefits for decreasing HIV transmission. [ABSTRACT FROM AUTHOR]

Population distribution data with high spatiotemporal resolution are of significant value and fundamental to many application areas, such as public health, urban planning, environmental change, and disaster management. However, such data are still not widely available due to the limited knowledge of complex human activity patterns. The emergence of location-based service big data provides additional opportunities to solve this problem. In this study, we integrated ambient population data, nighttime light data, and building volume data; innovatively proposed a spatial downscaling framework for Baidu heat map data during work time and sleep time; and mapped the population distribution with high spatiotemporal resolution (i.e., hourly, 100 m) in Beijing. Finally, we validated the generated population distribution maps with high spatiotemporal resolution using the highest-quality validation data (i.e., mobile signaling data). The relevant results indicate that our proposed spatial downscaling framework for both work time and sleep time has high accuracy, that the distribution of the population in Beijing on a regular weekday shows "centripetal centralization at daytime, centrifugal dispersion at night" spatiotemporal variation characteristics, that the interaction between the purpose of residents' activities and the spatial functional differences leads to the spatiotemporal evolution of the population distribution, and that China's "surgical control and dynamic zero COVID-19" epidemic policy was strongly implemented. In addition, our proposed spatial downscaling framework can be transferred to other regions, which is of value for governmental emergency measures and for studies about human risks to environmental issues. [ABSTRACT FROM AUTHOR]

Interactions between T follicular helper (Tfh) cells and germinal center B cells are essential for the differentiation of B cells and specific antibody responses against HIV-1 infection. However, the extent to which HIV-1 infection affects the dynamic interplay between these two cell populations in the bloodstream remains unclear. In this study, the dynamics of circulating Tfh (cTfh) and B cells and their relationship in individuals with acute and chronic HIV-1 infection were investigated. Twenty-five study subjects were enrolled from the Beijing PRIMO clinical cohort, a prospective cohort of HIV-1-negative men who have sex with men (MSM) for the identification of cases of acute HIV-1 infection (AHI) at Beijing Youan Hospital, Capital Medical University. Individuals with AHI were selected at random. Matched samples were also collected and analyzed from the same patients with chronic HIV-1 infection. None of the study subjects received antiretroviral therapy during acute or chronic infection. Multicolor flow cytometry was used for the immunophenotypic and functional characterization of cTfh cell and B cell subsets. AHI resulted in increased proportions in bulk cTfh, ICOS+cTfh or IL-21+ICOS+cTfh cells. In both acute and chronic infections, activated memory (AM), tissue-like memory (TLM), and plasmablast (PB) B cell levels were increased whilst resting memory (RM) and naïve mature (NM) B cell levels were decreased. Classical memory (CM) B cells were unaffected during infection. Association analyses showed that the levels of ICOS+cTfh and IL-21+ICOS+cTfh cells were negatively correlated with those of AM, CM, RM cells, and positively correlated with those of NM cells in AHI but not chronic HIV-1 infection stage (CHI). Moreover, the frequency of IL-21+ICOS+cTfh cells was also positively correlated with plasma HIV-1 viral load, and had an opposite association trend with CD4+T cell count in AHI. Our data suggests that HIV-1 infection drives the expansion of cTfh cells, which in turn leads to perturbations of B cell differentiation through ICOS signaling during acute infection stage. These findings provide insight on the role of ICOS in the regulation of cTfh/B cell interaction during AHI and may potentially guide the design of effective strategies for restoring anti-HIV-1 immunity in the infected patients. [ABSTRACT FROM AUTHOR]

The novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic of the coronavirus disease 2019 (COVID-19), which elicits a wide variety of symptoms, ranging from mild to severe, with the potential to lead to death. Although used as the standard method to screen patients for SARS-CoV-2 infection, real-time PCR has challenges in dealing with asymptomatic patients and those with an undetectable viral load. Serological tests are therefore considered potent diagnostic tools to complement real-time PCR-based diagnosis and are used for surveillance of seroprevalence in populations. However, the dynamics of the antibody response against SARS-CoV-2 currently remain to be investigated. Here, through analysis of plasma samples from 84 patients with COVID-19, we observed that the response of virus-specific antibodies against three important antigens, RBD, N and S, dynamically changed over time and reached a peak 5–8 weeks after the onset of symptoms. The antibody responses were irrespective of sex. Severe cases were found to have higher levels of antibody response, larger numbers of inflammatory cells and C-reactive protein levels. Within the mild/moderate cases, pairwise comparison indicated moderate association between anti-RBD vs. anti-N, anti-RBD vs. anti-S1S2, and anti-N vs. anti-S1S2. Furthermore, the majority of cases could achieve IgM and IgG seroconversion at 2 weeks since the disease onset. Analysis of neutralizing antibodies indicated that these responses were able to last for more than 112 days but decline significantly after the peak. In summary, our findings demonstrate the longitudinally dynamic changes in antibody responses against SARS-CoV-2, which can contribute to the knowledge of humoral immune response after SARS-CoV-2 infection and are informative for future development of vaccine and antibody-based therapies. [ABSTRACT FROM AUTHOR]

Background: This paper introduces a comprehensive case management model uniting doctors, nurses, and non-governmental organizations (NGOs) in order to shorten the time from HIV diagnosis to initiation of antiviral therapy, improve patients' adherence, and ameliorate antiretroviral treatment (ART)-related outcomes.Methods: All newly diagnosed human immunodeficiency virus (HIV) cases at Beijing YouAn Hospital from January 2012 to December 2013 were selected as the control group, while all newly diagnosed HIV-infected patients from January 2015 to December 2016 were selected as the intervention group, receiving the comprehensive case management model.Results: 4906 patients were enrolled, of which 1549 were in the control group and 3357 in the intervention group. The median time from confirming HIV infection to ART initiation in the intervention group was 35 (18-133) days, much shorter than the control group (56 (26-253) days, P < 0.001). Participants in the intervention group had better ART adherence compared to those in the control group (intervention: 95.3%; control: 89.2%; p < 0.001). During the 2 years' follow-up, those receiving case management were at decreased odds of experiencing virological failure (OR: 0.27, 95%CI: 0.17-0.42, P < 0.001). Observed mortality was 0.4 deaths per 100 patient-years of follow-up for patients in the control group compared with 0.2 deaths per 100 patient-years of follow-up in the intervention group.Conclusions: People living with HIV engaged in the comprehensive case management model were more likely to initiate ART sooner and maintained better treatment compliance and improved clinical outcomes compared to those who received routine care. A comprehensive case management program could be implemented in hospitals across China in order to reduce the HIV disease burden in the country. [ABSTRACT FROM AUTHOR]

HIV-1 dual infection occurs when an individual is simultaneously or sequentially infected with two or more genetically distinct HIV-1 strains. According to the number of infected strains, HIV-1 dual infection can be divided in double infection and triple infection and so on. Currently, the majority of dual infection cases have been reported to be double infections which can result in detrimental clinical outcomes. The high incidence of double infection among specific high-risk populations increases the likelihood of triple infection, which has been sporadically described. There is no doubt that we are concerned about the association between triple infection and disease progression. However, this relationship is still unclear on the population level. In this study, 70 individuals from the Beijing PRIMO cohort were longitudinally followed up with a median time of 15.75 months for the purpose of investigating the incidence of dual infection. Phylogenetic analyses using bulk and single-genome sequences showed that nine individuals acquired double infection, with the incidence of 9.21 per 100 person-years, and three individuals with triple infection were identified, with the incidence of 3.07 per 100 person-years. The further survival analysis demonstrated that the triple infection group exhibited faster CD4+ T-cell decline. In summary, these results demonstrate for the first time that the triple HIV-1 infection might reduce CD4+ T-cell counts, which would predict a more rapid disease progression. [ABSTRACT FROM AUTHOR]

Background: Lopinavir/ritonavir (LPV/r) is a major antiretroviral treatment in China, but little is known about the performance of first-line LPV/r-based regimen in treatment-naïve patients with human immunodeficiency virus type 1 (HIV-1) infection. This study aims to assess the efficacy and adverse effect events of LPV/r plus lamivudine and tenofovir or zidovudine as an initial antiretroviral treatment in HIV-1-infected individuals for whom cannot take efavirenz (EFV) or is allergic to EFV. Methods: We performed a retrospective study of patients registering with the China's National Free Antiretroviral Treatment Program from July 2012 to January 2017, followed at a tertiary care hospital in Beijing, China. The primary outcome was the proportion of subjects with HIV-1 RNA ≤40 copies/ml at 6 and 24 months of treatment. We assessed the immunological response and adverse events. Results: In total, 4,862 patients were enrolled in the study and 237 were eligible for analysis in each study arm. During the first six months, virological suppression was better with the LPV/r-based regimen than with the EFV-based regimen (93.80 vs 87.80% for P < 0.05). Viral suppression rates continued to increase until 12 months, remain steady thereafter until 24 months, for both groups. The multilevel analysis revealed that patients in the LPV/r group were more likely to display improvements in CD4 T-cell count over time than those in the EFV group (P < 0.001). Grade 3 or 4 laboratory adverse events were observed in 14 patients (5.91%) from the LPV/r group and three patients (1.20%) in EFV group. Conclusion: Our findings demonstrate that LPV/r-containing regimens are effective and well-tolerated in Chinese treatment-naïve patients with HIV-1 infection. [ABSTRACT FROM AUTHOR]

Molecular epidemiology can be used to identify human immunodeficiency virus (HIV) transmission clusters, usually using pol sequence for analysis. In the present study, we explored appropriate parameters to construct a simple network using HIV env and gag sequences instead of pol sequences for constructing a phylogenetic tree and a genetic transmission subnetwork, which were used to identify individuals with many potential transmission links and to explore the evolutionary dynamics of the virus among men who have sex with men (MSM) in Beijing. We investigated 70 acute HIV-1 infections, which consisted of HIV-1 subtype B (15.71%), the circulating recombinant forms CRF01_AE (47.14%), CRF07_BC (21.43%), CRF55_01B (1.43%), and CRF65_cpx (4.29%), and an unknown subtype (10.00%). By exploring the similarities and differences among HIV env, gag and pol sequences in describing the dynamics of the HIV-1 CRF01_AE transmission subnetwork among Beijing MSM, we found that four key points of the env sequences (strains E-2011_BJ.CY_16014, E-2011_BJ.FT_16017, E-2011_BJ.TZ_16064, and E-2011_BJ.XW_16035) contained more transmission information than gag sequences (three key points: strains G-2011_BJ.CY_16014, G-2011_BJ.FT_16017, and G-2011_BJ.XW_16035) and pol sequences (two key points: strains P-2011_BJ.CY_16014 and P-2011_BJ.XW_16035). Although the env and gag sequence results were similar to pol sequences in describing the dynamics of the HIV-1 CRF01_AE transmission subnetwork, we were able to obtain more precise information, allowing identification of key points of subnetwork expansion, based on HIV env and gag sequences instead of pol sequences. Taken together, the key points we found will improve our current understanding of how HIV spreads between MSM populations in Beijing and help to better target preventative interventions for promoting public health. [ABSTRACT FROM AUTHOR]

Plants can be effectively used as bio-monitors of environmental pollution. However, how the particulate matter (PM) and heavy metal retention ability of plants changes in different areas with human disturbance along with monsoon has not yet been investigated in urban ecosystems. In this study, we measured the amount of PM and heavy metals such as Ni, Cr, Cu, Pb, and Zn accumulated by the leaves of Euonymus japonicus during the East Asian monsoon from different functional units in Beijing, China. A rinse-and-weigh method developed in our laboratory was used to determine the mass of the PM, and electro-thermal atomic absorption spectrometry was used for heavy metal analysis. We found that the types of functional units had little influence, whereas the monsoon had a significant effect on the deposition of PM: northwest areas during the monsoon had the lowest effect (with 0.005, 0.453, 0.643, and 1.569 g/m2 fine, coarse, large, and total PM, respectively), and the southeast areas during the monsoon had the highest effect (0.015, 2.687, 1.941, and 4.228 g/m2 for fine, coarse, large, and total PM, respectively). Notable, we found considerable variations in heavy metal accumulation across the functional units analyzed, that is, the accumulation level was higher in communities than in parks (P < 0.0001 for all heavy metals). Moreover, a positive relationship was found between PM retention and heavy metal accumulation by the leaves of E. japonicus. Taken together, our results suggested that the PM and heavy metal retention ability of E. japonicus was sensitive to human disturbance and monsoon in Beijing. Since E. japonicus is a widely distributed tree and has the ability of to purify the atmosphere, it is an ideal plant for mitigating urban environmental pollution. [ABSTRACT FROM AUTHOR]

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With the rapid growth of urbanisation and associated vehicle numbers in China, urban transportation has become responsible for a large increase in the country's energy consumption and, consequently, its air pollution levels. Beijing has been making significant efforts to reduce transportation sector energy consumption and pollution. However, owing to the existence of a large number of private cars, the implementation of effective energy consumption and emission reduction measures has been difficult to achieve. This paper reviews the policies and regulations that have so far been developed to tackle Beijing's transportation sector issues. Perspective and analysis are given on the specific policies and regulations that have been employed, focusing on the overarching regulation mechanism, public transportation infrastructure, vehicle technology-related measures, vehicle activity-related measures and eco-driving -related measures, relevant experiences and lessons are summarised. A key finding concludes that the implementation of driving restriction policy can restrain pollutants emissions significantly, it shows energy consumption and emission reduction should not only be applied to public transportation, but the effective control of emissions from private cars should also attract more attention. To better control energy consumption of urban transport, various measures and solutions are proposed and discussed, including the further popularizing of eco-driving and the widespread application of e-mobility. Specific proposals for developing urban transportation policy are also discussed. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To describe the spectrum of central nervous system (CNS) disorders and the contribution of neurological immune reconstitution inflammatory syndrome (IRIS) in hospitalized HIV/AIDS patients in You'an Hospital, Beijing China. Study design & methods: A retrospective observational study conducted over a 24-month period in You'an Hospial, a public sector referral hospital in Beijing, China. This study enrolled HIV seropositive patients who were admitted for developing new or recurrent neurological and (or) psychiatric symptoms from September 2009 to August 2011. Medical records were reviewed, demographic and clinical data were collected. Patients with peripheral neuropathy and those in delirium were excluded from this study. Results: Of the total 620 HIV/AIDS hospital admissions from September 2009 to August 2011, 60 patients (9.7%) were hospitalized for CNS complications. The diagnosis of HIV infection was made after hospital admission in 16 of the 60 patients (26.7%), and 34 of them (56.7%) were already on antiretroviral therapy (ART) at the point of admission. The median CD4 cell count in these subjects was 39 (21–133) cells/mm3, and 93.3% (56/60) of these patients belonged to stage IV HIV disease according to World Health Organization (WHO) classification. The most frequent diagnosis in these subjects included cryptococcal meningitis (CM, n=13, 22%), cerebral toxoplasmosis (n=10, 17%), and CNS tuberculosis (n=7, 11.7%). The overall mortality was 13% (8/60) and the case-fatality rates were: cryptococcal meningitis 7.7% (1/13), cerebral toxoplasmosis 20% (2/10) and tuberculous meningitis 28.6% (2/7). Of the 34 patients who were on ART, paradoxical neurological IRIS (the conditions of their existing CNS disorders get paradoxically worse after ART because of an exuberant inflammatory response directed towards opportunistic pathogens) was diagnosed in 4 patients (11.8%), 2 of whom related to TB infection (out of 5TB patients, 40%), and the other 2 related to CM (out of 8 patients, 25%). Conclusion: Opportunistic infections, such as cryptococcal meningitis, cerebral toxoplasmosis and CNS tuberculosis were the most frequent diagnosis of CNS disease in hospitalized HIV/AIDS patients in You'an Hospital, Beijing, China. About 10% patients on ART were diagnosed as neurological IRIS in such a group of patients. [Copyright &y& Elsevier]