36 results on '"Jiezhe Yang"'
Search Results
2. Spatiotemporal Pattern and Its Determinants for Newly Reported HIV/AIDS Among Older Adults in Eastern China From 2004 to 2021: Retrospective Analysis Study
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Gang Huang, Wei Cheng, Yun Xu, Jiezhe Yang, Jun Jiang, Xiaohong Pan, Xin Zhou, Jianmin Jiang, and Chengliang Chai
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Public aspects of medicine ,RA1-1270 - Abstract
BackgroundIn recent years, the number and proportion of newly reported HIV/AIDS cases among older adults have increased dramatically. However, research on the pattern of temporal and spatial changes in newly reported HIV/AIDS among older adults remains limited. ObjectiveThis study analyzed the spatial and temporal distribution of HIV/AIDS cases and its influencing factors among older adults in Eastern China from 2004 to 2021, with the goal of improving HIV/AIDS prevention and intervention. MethodsWe extracted data on newly reported HIV/AIDS cases between 2004 and 2021 from a case-reporting system and used a Joinpoint regression model and an age-period-cohort model to analyze the temporal trends in HIV/AIDS prevalence. Spatial autocorrelation and geographically weighted regression models were used for spatial aggregation and influence factor analysis. ResultsA total of 12,376 participants with HIV/AIDS were included in the study. The newly reported HIV infections among older adults increased from 0.13 cases per 100,000 people in 2004 to 7.00 cases per 100,000 people in 2021. The average annual percent change in newly reported HIV infections was 28.0% (95% CI –21.6% to 34.8%). The results of the age-period-cohort model showed that age, period, and cohort factors affected the newly reported HIV infections among older adults. The newly reported HIV/AIDS cases among men who have sex with men (MSM) had spatial clustering, and the hotspots were mainly concentrated in Hangzhou. The disposable income of urban residents, illiteracy rate among people aged 15 years or older, and number of hospital beds per 1000 residents showed a positive association with the newly reported HIV infections among older MSM in the Zhejiang province. ConclusionsHIV/AIDS among older adults showed an increasing trend and was influenced by age, period, and cohort effects. Older MSM with HIV/AIDS showed regional clustering and was associated with factors such as the disposable income of urban residents, the illiteracy rate among people aged 15 years or older, and the number of hospital beds per 1000 people. Targeted prevention and control measures are needed to reduce HIV infection among those at higher risk.
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- 2024
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3. Application of machine learning algorithms in predicting HIV infection among men who have sex with men: Model development and validation
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Jiajin He, Jinhua Li, Siqing Jiang, Wei Cheng, Jun Jiang, Yun Xu, Jiezhe Yang, Xin Zhou, Chengliang Chai, and Chao Wu
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machine learning ,HIV ,MSM ,prediction ,models ,Public aspects of medicine ,RA1-1270 - Abstract
BackgroundContinuously growing of HIV incidence among men who have sex with men (MSM), as well as the low rate of HIV testing of MSM in China, demonstrates a need for innovative strategies to improve the implementation of HIV prevention. The use of machine learning algorithms is an increasing tendency in disease diagnosis prediction. We aimed to develop and validate machine learning models in predicting HIV infection among MSM that can identify individuals at increased risk of HIV acquisition for transmission-reduction interventions.MethodsWe extracted data from MSM sentinel surveillance in Zhejiang province from 2018 to 2020. Univariate logistic regression was used to select significant variables in 2018–2019 data (P < 0.05). After data processing and feature selection, we divided the model development data into two groups by stratified random sampling: training data (70%) and testing data (30%). The Synthetic Minority Oversampling Technique (SMOTE) was applied to solve the problem of unbalanced data. The evaluation metrics of model performance were comprised of accuracy, precision, recall, F-measure, and the area under the receiver operating characteristic curve (AUC). Then, we explored three commonly-used machine learning algorithms to compare with logistic regression (LR), including decision tree (DT), support vector machines (SVM), and random forest (RF). Finally, the four models were validated prospectively with 2020 data from Zhejiang province.ResultsA total of 6,346 MSM were included in model development data, 372 of whom were diagnosed with HIV. In feature selection, 12 variables were selected as model predicting indicators. Compared with LR, the algorithms of DT, SVM, and RF improved the classification prediction performance in SMOTE-processed data, with the AUC of 0.778, 0.856, 0.887, and 0.942, respectively. RF was the best-performing algorithm (accuracy = 0.871, precision = 0.960, recall = 0.775, F-measure = 0.858, and AUC = 0.942). And the RF model still performed well on prospective validation (AUC = 0.846).ConclusionMachine learning models are substantially better than conventional LR model and RF should be considered in prediction tools of HIV infection in Chinese MSM. Further studies are needed to optimize and promote these algorithms and evaluate their impact on HIV prevention of MSM.
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- 2022
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4. A spatial analysis of the epidemiology of HIV-infected students in Zhejiang province, China
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Wanjun Chen, Jiezhe Yang, Jun Jiang, Lin He, Yun Xu, Jinlei Zheng, Jianmin Jiang, and Xiaohong Pan
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Acquired immunodeficiency syndrome ,HIV-infected students ,Men who have sex with men ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background The upsurge in HIV infections among students is a matter of particular concern. However, few studies have explored the epidemiological characteristics including the risky sexual networking of HIV-infected students in Zhejiang province, China. Methods Using the provincial surveillance data of HIV-infected students, we conducted a retrospective epidemiology study to describe the epidemiological characteristics of 628 newly diagnosed cases from 2011 to 2016 and detailed information of 124 cases from 2015 to 2016. Spatial analyses were conducted using ArcGIS software, and statistical analyses were performed using SPSS software. Results A total of 628 cases of HIV/AIDS were diagnosed among students in Zhejiang Province, China between 2011 and 2016. The cases showed an overall increasing trend over time, while the proportions of students with HIV disease status, cases diagnosed by HIV voluntary counseling and testing (VCT), and cases of homosexual transmission remained stable over time. Significant spatial heterogeneity in the cases was seen at the county level. Detailed data on 124 HIV-positive individuals collected from the local Center for Disease Control and Prevention (CDC) from 2015 and 2016, showed that the majority of them (85.5%,) engaged in homosexual behavior, and 93.4% had sex with casual partners. These partners included not only social members, but also other students. Online dating applications represented the most common means of seeking and communicating with homosexual partners. The level of awareness regarding the risk of HIV infection, and the amount coverage of face-to-face education towards students were both low. Conclusions HIV infections among students were characterized by increasing trend and spatial clustering in Zhejiang Province between 2011 and 2016, with homosexual sexual activity being the main mode of infection. Interventions are urgently required to prevent HIV infection in this population by increasing awareness of the disease. HIV testing programs and information regarding disease prevention specifically through online dating applications are needed.
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- 2021
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5. Outbreak of HIV Infection Linked to Nosocomial Transmission, China, 2016–2017
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Xiaohong Pan, Jianmin Jiang, Qiaoqin Ma, Jiafeng Zhang, Jiezhe Yang, Wanjun Chen, Xiaobei Ding, Qin Fan, Zhihong Guo, Yan Xia, Shichang Xia, and Zunyou Wu
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Human immunodeficiency virus ,HIV ,viruses ,nosocomial transmission ,lymphocyte immunotherapy ,China ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
On January 25, 2017, a physician from ZC Hospital in Hangzhou, China, reported to the Zhejiang Provincial Center for Disease Control and Prevention that a potential HIV outbreak might have occurred during lymphocyte immunotherapy (LIT) performed at the hospital on December 30, 2016. We immediately began investigating and identified the index case-patient as an LIT patient’s husband who donated lymphocytes for his wife’s LIT and later screened HIV-reactive. Subsequent contamination by a technician resulted in the potential exposure of 34 LIT patients. Acute HIV infection was diagnosed in 5 persons. Phylogenetic analysis confirmed that the HIV-1 gag, pol, and env gene sequences from the index and outbreak-related cases had >99.5% similarity. Rapid investigation and implementation of effective control measures successfully controlled the outbreak. This incident provides evidence of a lapse in infection control causing HIV transmission, highlighting the need for stronger measures to protect patients from infectious disease exposure.
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- 2018
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6. HIV risk behavior and HIV testing among rural and urban men who have sex with men in Zhejiang Province, China: A respondent-driven sampling study.
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Lin He, Xiaohong Pan, Jiezhe Yang, Qiaoqin Ma, Jun Jiang, Wei Wang, Jiaquan Qiu, Yazhou Zou, Ping Wang, Dongshe Zhao, Hui Wang, and Tingting Jiang
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Medicine ,Science - Abstract
BackgroundCurrently, human immunodeficiency virus (HIV) sentinel surveillance among men who have sex with men (MSM) in China conducted in large and medium-sized cities, and no HIV sentinel surveillance conducted in rural areas. HIV testing and intervention is predominantly conducted in urban areas, there have been a limited number of studies in rural areas MSM, it is necessary to conduct the investigation of HIV risk sexual behavior, HIV testing among rural and urban MSM.MethodBetween December 2013 and August 2015, a cross-sectional study was conducted in rural and urban areas in Zhejiang Province using respondent-driven sampling (RDS). Participants completed face-to-face interviewer-administered questionnaire surveys and were tested for HIV.ResultsA total of 710 MSM participants were recruited, of whom 36.1% were from rural areas. The overall HIV prevalence was 16.6%, and was considerably lower among MSM living in rural areas (3.9%) than those living in urban areas (24.2%). 61.1% participants had not condom use with male sexual behavior in the past 6 months (86.7% in rural areas and 46.7% in urban areas). The social demographic and behavioral characteristics had significance difference among rural and urban MSM. Multivariate logistic regression revealed that, compared to men living in urban areas, MSM living in rural areas MSM were more likely to use dating apps to find sexual partners, were more likely to engage in bisexual behavior, and had lower condom use. 43.0% participants had been tested for HIV in the past year (41.8% in rural areas and 43.6% in urban areas). Multivariate logistic regression also revealed that among participants living in rural areas, having rural health insurance and not accepting HIV intervention were associated with lower HIV testing rates, while a higher monthly income and through use of internet to find sexual partner were associated with higher rates of HIV testing.ConclusionHigh risk behavior was prevalent, and HIV testing rates were low among MSM living in rural areas compare to urban areas in Zhejiang Province, therefore, preventative intervention measures should be immediately among rural MSM urgently to reduce HIV transmission and to promote HIV testing.
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- 2020
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7. New types of drug use and risks of drug use among men who have sex with men: a cross-sectional study in Hangzhou, China
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Lin He, Xiaohong Pan, Ning Wang, Jiezhe Yang, Jun Jiang, Yan Luo, Xingliang Zhang, and Xiting Li
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Men who have sex with men ,New types of drugs ,Rush poppers ,HIV ,Alcohol ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background The use of new types of drugs has become more common among men who have sex with men (MSM). The aim of this study was to describe the patterns of the use of new types of drugs, such as methamphetamine, ketamine, ecstasy, and rush poppers, and to examine the factors associated with drug use and HIV infection among MSM in Hangzhou, China. Methods This cross-sectional study was conducted between August 2015 and April 2016. We used snowball sampling to recruit MSM; participants were recruited from voluntary counseling and testing centers, baths, bars, Blued (an app for the gay community), QQ groups, clubs, and other types of venues. MSM were included if their previous HIV test results were negative or unknown, or they had not been tested for HIV. MSM were excluded if they were known to be HIV positive before the survey. Face-to-face questionnaires were conducted and a venous blood specimen was drawn from each participant following the interview. Results In total, 555 MSM were included; 18.2% (101/555) of the participants had used new types of drugs in the past 3 months. Among the users, 65.3% used single-use rush poppers, while the remainder used ketamine, methamphetamine, ecstasy, or other mixed combinations of drugs. The HIV positivity rate was 14.8% (82/555). Factors associated with increased odds of using new types of drugs in the past 3 months were higher education levels (adjusted odds ratio [AOR] 4.45, 95% confidence interval [CI] 2.12–9.37), having multiple sexual partners (AOR 1.76, 95 CI 1.02–3.05), alcohol use before sexual intercourse (AOR 33.44, 95% CI 10.80–103.50), and seeing friends using new types of drugs. Conclusion We revealed the widespread use of new types of drugs, as well as a high diagnosis rate of new HIV infection, among MSM in Hangzhou. The use of new types of drugs was associated with an increased number of sexual partners among MSM; the high-risk sexual behaviors increased the risk of HIV infection. Attention should be given to the use of new types of drugs in MSM, and supervision programs should be strengthened to combat drug use.
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- 2018
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8. Reduction in HIV community viral loads following the implementation of a 'Treatment as Prevention' strategy over 2 years at a population-level among men who have sex with men in Hangzhou, China
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Lin He, Jiezhe Yang, Qiaoqin Ma, Jiafeng Zhang, Yun Xu, Yan Xia, Wanjun Chen, Hui Wang, Jinlei Zheng, Jun Jiang, Yan Luo, Ke Xu, Xingliang Zhang, Shichang Xia, and Xiaohong Pan
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Men who have sex with men ,Treatment as prevention ,Antiretroviral therapy ,Community viral loads ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Previous studies have shown that the increased coverage of antiretroviral therapy (ART) could reduce the community viral load (CVL) and reduce the occurrence of new HIV infections. However, the impact on the reduction of HIV transmission among men who have sex with men (MSM) is much less certain. The frequency of HIV infections in MSM have been rapidly increasing in recent years in Hangzhou, China. The “Treatment as Prevention” strategy was implemented at a population-level for HIV-infected MSM from January 2014 to June 2016 in Hangzhou; it aimed to increase the ART coverage, reduce the CVL, and reduce HIV transmission. Methods We investigated a subset of MSM diagnosed with HIV pre- and post-implementation of the strategy, using random sampling methods. Viral load (VL) testing was performed for all enrolled individuals; the lower limits of detection were 20 and 50 copies/mL. The data on infections were collected from the national epidemiology database of Hangzhou. Logistic regression analyses were conducted to identify factors associated with the differences in social demographic characteristics and available VL data. Results The ART coverage increased from 60.7% (839/1383) during the pre-implementation period to 92.3% (2183/2365) during the post-implementation period in Hangzhou. A total of 940 HIV-infected MSM were selected for inclusion in this study: 490 (52.1%) and 450 (47.9%) MSM in the pre- and post-implementation periods, respectively. In total, 89.5% (841/940) of patients had data available on VL rates. The mean CVL was 579 copies/mL pre-implementation and this decreased to 33 copies/mL post-implementation (Kruskal-Wallis
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- 2018
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9. The Factors Related to CD4+ T-Cell Recovery and Viral Suppression in Patients Who Have Low CD4+ T Cell Counts at the Initiation of HAART: A Retrospective Study of the National HIV Treatment Sub-Database of Zhejiang Province, China, 2014.
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Lin He, Xiaohong Pan, Zhihui Dou, Peng Huang, Xin Zhou, Zhihang Peng, Jinlei Zheng, Jiafeng Zhang, Jiezhe Yang, Yun Xu, Jun Jiang, Lin Chen, Jianmin Jiang, and Ning Wang
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Medicine ,Science - Abstract
BACKGROUND:Since China has a unique system of delivering HIV care that includes all patients' records. The factors related to CD4+ T-cell recovery and viral suppression in patients who have low CD4+ T cell counts at the initiation of HAART are understudied in the China despite subsequent virological suppression (viral load < 50 copies/mL) is unknown. METHODS:The authors conducted a retrospective cohort study using data from the national HIV treatment sub-database of Zhejiang province to identify records of HIV+ patients. Patient records were included if they were ≥ 16 years of age, had an initial CD4 count < 100 cells/μL, were on continuous HAART for at least one year by the end of December 31, 2014; and achieved and maintained continued maximum virological suppression (MVS) (< 50 copies/ml) by 9 months after starting HAART. The primary endpoint for analysis was time to first CD4+ T cell count recovery (≥ 200, 350, 500 cells/μL). Cox proportional hazard regression was used to identify the risk factors for CD4+ T cell count recovery to key thresholds (200-350, 350-500, ≥ 500 cells/μL) by the time of last clinical follow-up (whichever occurred first), key thresholds (follow-up date for analysis), with patients still unable to reach the endpoints being censored by the end December 31, 2014 (follow-up date for analysis). RESULTS:Of the 918 patients who were included in the study, and the median CD4+ T cell count was 39 cells/μL at the baseline. At the end of follow-up, 727 (79.2%), 363 (39.5%) and 149 (16.2%) patients had return to ≥ 200, 350, and 500 cells/μL, respectively. Kaplan-Meier analysis demonstrated that the rate of patients with CD4+ count recovery to ≥ 200, 350, and 500 cells/μL after 1 year on HAART was 43.6, 8.6, and 2.5%, respectively, after 3 years on treatment was 90.8, 46.3, and 17.9%, respectively, and after 5 years on HAART was 97.1, 72.2, and 36.4%, respectively. The median time to return to 200-350, 350-500, ≥ 500cells/μL was 1.11, 3.33 and 6.91 years, respectively. Factors of age (aHR = 0.77, 95%CI 0.61-0.97), baseline CD4+ count (aHR = 1.60, 95%CI 1.37-1.86), initial regimens, changes in regimen (aHR = 0.58, 95%CI 0.49-0.69), and inclusion of a cotrimoxazole prophylaxis (aHR = 0.66, 95%CI 0.51-0.85) were associated with CD4+ T cell count recovery. CONCLUSION:The proportion of patients with initially low CD4 counts after nine months of treatment and that achieved continuous virological suppression was greater than 70% for persons with CD4+ count ≥ 350. Conversely, only 35% of patients recovered to levels of 500 cells/μL after 5 years of treatment, and levels continued to rise significantly with further long-term HAART. Early HAART intervention will be necessary for achieving effective CD4+ T cell responses and optimal immunological function in HIV+ patients.
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- 2016
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10. Successful virologic outcomes over time among HAART-treated HIV-infected patients
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Xiaohong Pan, Man Jiang, Jinlei Zheng, Xinghui Li, Yang Song, Ying Wang, Mengying Li, Peng Xu, and Jiezhe Yang
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medicine.medical_specialty ,Longitudinal study ,Health (social science) ,Social Psychology ,Transmission (medicine) ,business.industry ,Time trends ,Public Health, Environmental and Occupational Health ,Logistic regression ,medicine.disease ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,medicine ,Observational study ,business ,Generalized estimating equation ,Viral load - Abstract
Few large studies evaluated the effects of time trends on virologic suppression in people living with HIV/AIDS (PLWHA) in China. To address this, An retrospective observational longitudinal study was conducted. We examined annual trends in the rate of virologic suppression, the viral load at the time of virologic suppression, and other determinants of virologic suppression in Zhejiang Province, China in PLWHA between January 2013 and July 2018. Patients who received a treatment regimen for at least 24 weeks were included. Virologic suppression was defined as VL ≤50 copies/mL. Generalized estimating equation logistic regression models were used to adjust for covariates. We included 16,265 patients with 45023 tests. The proportion of patients who experienced an unsuccessful virologic outcome decreased continuously throughout the observation period (18.14% to 6.64%). Time was significantly negatively associated with detectable VL (all ORs
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- 2021
11. Development and Validation of a Risk Prediction Tool to Identify People at Greater Risk of Having Hepatitis C among Drug Users
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Gang Huang, Wei Cheng, Yun Xu, Jiezhe Yang, Jun Jiang, Xiaohong Pan, Xin Zhou, Jianmin Jiang, and Chengliang Chai
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Health, Toxicology and Mutagenesis ,drug use ,HCV prevalence ,risk behaviors ,risk score ,Public Health, Environmental and Occupational Health - Abstract
Background: People who use drugs (PWUD) are among those with the highest risk for hepatitis C virus (HCV) infection. Highly effective direct-acting antiviral agents offer an opportunity to eliminate HCV. A simple tool for the prediction of HCV infection risk in PWUD is urgently needed. This study aimed to develop and validate a risk prediction tool to identify people at greater risk of having hepatitis C among PWUD that is applicable in resource-limited settings. Methods: We extracted data from national HIV/AIDS sentinel surveillance in PWUD (Zhejiang Province, 2016–2021) and developed and validated a risk score to improve HCV testing in PWUD. This risk score consists of seven risk factors identified using multivariable logistic regression modeling (2016–2020, exploratory group). We validated this score using surveillance data for 2021 (validation group). The accuracy of the model was determined using C-statistics. Results: We identified seven risk factors, including sex, age, marital status, educational attainment, and the use of heroin, morphine, and methamphetamine. In the exploratory group, the positive rates of detecting the HCV antibody in the low-risk (0–9 points), intermediate-risk (10–16 points), and high-risk (≥17 points) groups were 6.72%, 17.24%, and 38.02%, respectively (Ptrend < 0.001). In the validation group, the positive rates in the low-, medium-, and high-risk groups were 4.46%, 12.23%, and 38.99%, respectively (Ptrend < 0.001). Conclusions: We developed and validated a drug-specific risk prediction tool for identifying PWUD at increased risk of HCV infection. This tool can complement and integrate the screening strategy for the purpose of early diagnosis and treatment.
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- 2022
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12. Identifying the ongoing and local HIV acquisition among newly diagnosed sexually transmitted HIV/AIDS in China: Innovative approach for HIV epidemic surveillance practice (Preprint)
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Jun Jiang, Wei Cheng, Yun Xu, Jiezhe Yang, Wanjun Chen, Mingyu Luo, Huiling Tang, Xingliang Zhang, Xin Zhou, Xiaohong Pan, and Chengliang Chai
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BACKGROUND Population migration makes it complex and difficult to identify local hotspot of HIV transmission, and compromise the HIV prevention and control efforts. OBJECTIVE Based on individual-based epidemiological investigation and clinical indicators, we developed logical algorithmic approaches for narrowing the scope of time and location of HIV acquisition, and characterizing the ongoing and local HIV acquisition in eastern China. METHODS We recruited newly diagnosed sexually transmitted HIV individuals in Zhejiang province between January 2017 and December 2019. We describe and compare the percentage of HIV acquisition within one year of HIV diagnosis, and HIV acquisition within Zhejiang province among participants within different sociodemographic and transmission route categories. RESULTS We enrolled 7775 participants in total. Among them, 84.8% (6594) were males and 15.2% (1181) were females. Over half of the participants (52.4%, 4063) have been living in Zhejiang province ever since, and 47.6% (3683) of them moved in from other provinces. Through the logical algorithmic approaches, among participants with an inferred time or location of HIV acquisition, 20.1% (1503/7482, 95%CI: 19.2%~21.0%) were infected with HIV within one year prior to HIV diagnosis, and 76.8% (5074/6603, 95%CI: 75.3%~78.4%) were infected with HIV in Zhejiang province. Among participants who moved in from other provinces to Zhejiang, 54.7% (1600/2927) were inferred to be infected with HIV in Zhejiang province. Compared with the corresponding group, participants who were males, had a negative HIV test history, and were infected through homosexual behavior have a higher proportion of infected HIV within one year of HIV diagnosis and within Zhejiang province. Homosexual transmission accounted for 73.4% of study participants who were inferred to be infected with HIV within one year prior to HIV diagnoses in Zhejiang province. CONCLUSIONS Our study found differences in the time and location of HIV infection between different mobility status and transmission routes subgroups. The practice of identifying recent and local HIV infections demonstrates the importance of coordinating more efforts on epidemiological surveillance, especially in areas with higher degree of population mobility. To detect the hotspot of upsurge HIV infection and have a comprehensive understanding of the HIV epidemic in a certain area.
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- 2022
13. A spatial analysis of the epidemiology of HIV-infected students in Zhejiang province, China
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Xiaohong Pan, Jianmin Jiang, Wanjun Chen, Yun Xu, Lin He, Jun Jiang, Jiezhe Yang, and Jinlei Zheng
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Adult ,Male ,China ,medicine.medical_specialty ,Sexual Behavior ,Voluntary counseling and testing ,Population ,Psychological intervention ,HIV Infections ,Infectious and parasitic diseases ,RC109-216 ,Disease ,010502 geochemistry & geophysics ,01 natural sciences ,Men who have sex with men ,Sexual and Gender Minorities ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,HIV Seropositivity ,Epidemiology ,Humans ,Medicine ,030212 general & internal medicine ,Students ,education ,Retrospective Studies ,0105 earth and related environmental sciences ,Acquired Immunodeficiency Syndrome ,Spatial Analysis ,education.field_of_study ,business.industry ,Transmission (medicine) ,medicine.disease ,HIV-infected students ,Infectious Diseases ,Female ,business ,Research Article ,Demography - Abstract
Background The upsurge in HIV infections among students is a matter of particular concern. However, few studies have explored the epidemiological characteristics including the risky sexual networking of HIV-infected students in Zhejiang province, China. Methods Using the provincial surveillance data of HIV-infected students, we conducted a retrospective epidemiology study to describe the epidemiological characteristics of 628 newly diagnosed cases from 2011 to 2016 and detailed information of 124 cases from 2015 to 2016. Spatial analyses were conducted using ArcGIS software, and statistical analyses were performed using SPSS software. Results A total of 628 cases of HIV/AIDS were diagnosed among students in Zhejiang Province, China between 2011 and 2016. The cases showed an overall increasing trend over time, while the proportions of students with HIV disease status, cases diagnosed by HIV voluntary counseling and testing (VCT), and cases of homosexual transmission remained stable over time. Significant spatial heterogeneity in the cases was seen at the county level. Detailed data on 124 HIV-positive individuals collected from the local Center for Disease Control and Prevention (CDC) from 2015 and 2016, showed that the majority of them (85.5%,) engaged in homosexual behavior, and 93.4% had sex with casual partners. These partners included not only social members, but also other students. Online dating applications represented the most common means of seeking and communicating with homosexual partners. The level of awareness regarding the risk of HIV infection, and the amount coverage of face-to-face education towards students were both low. Conclusions HIV infections among students were characterized by increasing trend and spatial clustering in Zhejiang Province between 2011 and 2016, with homosexual sexual activity being the main mode of infection. Interventions are urgently required to prevent HIV infection in this population by increasing awareness of the disease. HIV testing programs and information regarding disease prevention specifically through online dating applications are needed.
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- 2021
14. Social support, stigma, and the mediating roles of depression on self-reported medication adherence of HAART recipients in China
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Ye Ma, Jinlei Zheng, Ying Wang, Man Jiang, Ziqi Zhang, Peng Xu, Xiaohong Pan, Jiezhe Yang, Guang Yang, Yang Song, and Xinghui Li
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Adult ,Male ,China ,medicine.medical_specialty ,Health (social science) ,Adolescent ,Social Psychology ,Social Stigma ,Human immunodeficiency virus (HIV) ,Stigma (botany) ,Medication adherence ,HIV Infections ,Models, Psychological ,medicine.disease_cause ,Medication Adherence ,Psychological health ,03 medical and health sciences ,Social support ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Antiretroviral Therapy, Highly Active ,medicine ,Humans ,030212 general & internal medicine ,Psychiatry ,Depression (differential diagnoses) ,Aged ,030505 public health ,Depression ,business.industry ,Public Health, Environmental and Occupational Health ,Social Support ,Middle Aged ,medicine.disease ,Self Efficacy ,Cross-Sectional Studies ,Female ,Self Report ,0305 other medical science ,business - Abstract
Discrimination of people living with HIV/AIDS (PLWHA) is a persistent issue in China, which affects their psychological health. However, the association between psychological factors and adherence to highly active antiretroviral therapy (HAART) has not been systematically investigated before. Therefore, this study examined the impact of social support, depression, and medication-taking self-efficacy on ART adherence among PLWHA based on Cha et al.'s model, and included "stigma" to the original model to explain the psychological mechanism. Of the 504 participants receiving HAART, 37.8% had mild-to-severe depression. According to structural equation modeling, social support was directly associated with depression, stigma, and adherence; depression partially mediated the positive relationship between social support and adherence self-efficacy and the negative association between stigma and self-efficacy. The modified and extended Cha et al.'s model had a satisfactory fit. Interventions to improve mental health through mental health services, social support, and enhancement of adherence self-efficacy beliefs are required.
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- 2019
15. Outbreak of HIV Infection Linked to Nosocomial Transmission, China, 2016–2017
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Jiafeng Zhang, Jiezhe Yang, Yan Xia, Wanjun Chen, Zunyou Wu, Xiaobei Ding, Qiaoqin Ma, Shichang Xia, Jianmin Jiang, Qin Fan, Pan Xiaohong, and Zhi-hong Guo
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Male ,0301 basic medicine ,Epidemiology ,Human immunodeficiency virus (HIV) ,lcsh:Medicine ,HIV Infections ,medicine.disease_cause ,Disease Outbreaks ,Pre-exposure prophylaxis ,0302 clinical medicine ,Antiretroviral Therapy, Highly Active ,Infection control ,030212 general & internal medicine ,Phylogeny ,Cross Infection ,Coinfection ,Human immunodeficiency virus ,Technician ,nosocomial transmission ,Treatment Outcome ,Infectious Diseases ,Population Surveillance ,Synopsis ,RNA, Viral ,Female ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,China ,History, 21st Century ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,lymphocyte immunotherapy ,viruses ,lcsh:RC109-216 ,business.industry ,Nosocomial transmission ,lcsh:R ,Outbreak ,HIV ,Outbreak of HIV Infection Linked to Nosocomial Transmission, China, 2016–2017 ,medicine.disease ,030104 developmental biology ,Infectious disease (medical specialty) ,HIV-1 ,Pre-Exposure Prophylaxis ,business ,Sentinel Surveillance - Abstract
On January 25, 2017, a physician from ZC Hospital in Hangzhou, China, reported to the Zhejiang Provincial Center for Disease Control and Prevention that a potential HIV outbreak might have occurred during lymphocyte immunotherapy (LIT) performed at the hospital on December 30, 2016. We immediately began investigating and identified the index case-patient as an LIT patient’s husband who donated lymphocytes for his wife’s LIT and later screened HIV-reactive. Subsequent contamination by a technician resulted in the potential exposure of 34 LIT patients. Acute HIV infection was diagnosed in 5 persons. Phylogenetic analysis confirmed that the HIV-1 gag, pol, and env gene sequences from the index and outbreak-related cases had >99.5% similarity. Rapid investigation and implementation of effective control measures successfully controlled the outbreak. This incident provides evidence of a lapse in infection control causing HIV transmission, highlighting the need for stronger measures to protect patients from infectious disease exposure.
- Published
- 2018
16. New types of drug use and risks of drug use among men who have sex with men: a cross-sectional study in Hangzhou, China
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Xiting Li, Yan Luo, Xiaohong Pan, Jun Jiang, Xingliang Zhang, Jiezhe Yang, Ning Wang, and Lin He
- Subjects
Adult ,Male ,China ,Adolescent ,HIV Positivity ,Substance-Related Disorders ,Cross-sectional study ,N-Methyl-3,4-methylenedioxyamphetamine ,Sexual Behavior ,Voluntary counseling and testing ,Ecstasy ,030508 substance abuse ,HIV Infections ,Methamphetamine ,Men who have sex with men ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Odds Ratio ,Humans ,Medicine ,lcsh:RC109-216 ,030212 general & internal medicine ,Rush poppers ,Homosexuality, Male ,business.industry ,virus diseases ,HIV ,Odds ratio ,Alcoholism ,Sexual intercourse ,Cross-Sectional Studies ,Sexual Partners ,Infectious Diseases ,Snowball sampling ,Socioeconomic Factors ,New types of drugs ,0305 other medical science ,business ,Alcohol ,Research Article ,Demography - Abstract
Background The use of new types of drugs has become more common among men who have sex with men (MSM). The aim of this study was to describe the patterns of the use of new types of drugs, such as methamphetamine, ketamine, ecstasy, and rush poppers, and to examine the factors associated with drug use and HIV infection among MSM in Hangzhou, China. Methods This cross-sectional study was conducted between August 2015 and April 2016. We used snowball sampling to recruit MSM; participants were recruited from voluntary counseling and testing centers, baths, bars, Blued (an app for the gay community), QQ groups, clubs, and other types of venues. MSM were included if their previous HIV test results were negative or unknown, or they had not been tested for HIV. MSM were excluded if they were known to be HIV positive before the survey. Face-to-face questionnaires were conducted and a venous blood specimen was drawn from each participant following the interview. Results In total, 555 MSM were included; 18.2% (101/555) of the participants had used new types of drugs in the past 3 months. Among the users, 65.3% used single-use rush poppers, while the remainder used ketamine, methamphetamine, ecstasy, or other mixed combinations of drugs. The HIV positivity rate was 14.8% (82/555). Factors associated with increased odds of using new types of drugs in the past 3 months were higher education levels (adjusted odds ratio [AOR] 4.45, 95% confidence interval [CI] 2.12–9.37), having multiple sexual partners (AOR 1.76, 95 CI 1.02–3.05), alcohol use before sexual intercourse (AOR 33.44, 95% CI 10.80–103.50), and seeing friends using new types of drugs. Conclusion We revealed the widespread use of new types of drugs, as well as a high diagnosis rate of new HIV infection, among MSM in Hangzhou. The use of new types of drugs was associated with an increased number of sexual partners among MSM; the high-risk sexual behaviors increased the risk of HIV infection. Attention should be given to the use of new types of drugs in MSM, and supervision programs should be strengthened to combat drug use.
- Published
- 2018
17. Highlighting the crucial role of Hangzhou in HIV-1 transmission among men who have sex with men in Zhejiang, China
- Author
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Yan Xia, Xiaobei Ding, Jiafeng Zhang, Wenjun Zhang, Jianmin Jiang, Jiezhe Yang, Xiaohong Pan, Yun Xu, and Zhi-hong Guo
- Subjects
0301 basic medicine ,Adult ,Male ,China ,Adolescent ,Population ,lcsh:Medicine ,HIV Infections ,Drug resistance ,Biology ,Article ,Men who have sex with men ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,law ,Genotype ,Drug Resistance, Viral ,Humans ,030212 general & internal medicine ,Young adult ,Homosexuality, Male ,education ,lcsh:Science ,Phylogeny ,Aged ,education.field_of_study ,Multidisciplinary ,Phylogenetic tree ,lcsh:R ,virus diseases ,Middle Aged ,030104 developmental biology ,Transmission (mechanics) ,HIV-1 ,lcsh:Q ,Demography - Abstract
In recent years, the population of men who have sex with men (MSM) constitute a major group for HIV transmission in China. A total of 340 newly reported HIV-infected MSM were recruited proportionally from ten prefectures across Zhejiang province between January and December in 2013. Partial pol gene was amplified and sequenced. Phylogenetic relationship, transmission network and genotypic drug resistance analyses were performed on 311 sequences. HIV-1 subtypes including CRF01_AE (55.9%), CRF07_BC (37.6%), subtype B (1.9%), CRF55_01B (1.3%), CRF68_01B (0.3%), CRF08_BC (0.3%) and URFs (2.6%) were identified. A higher proportion of CRF07_BC and other subtypes existed in the >35 years group, while a higher proportion of CRF01_AE was present in the young group (
- Published
- 2017
18. Adherence to Antiretroviral Therapy and Risk Factors Among MSM Patients in Hangzhou, China: A Cohort Study
- Author
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Jun Jiang, Miaoying Dong, Jianhua Yu, Lin He, Yun Xu, Guoxiang Zheng, Ming-Yu Luo, Xiaohong Pan, Jinlei Zheng, Lin Chen, and Jiezhe Yang
- Subjects
medicine.medical_specialty ,030505 public health ,business.industry ,Human immunodeficiency virus (HIV) ,food and beverages ,virus diseases ,General Medicine ,medicine.disease_cause ,Antiretroviral therapy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antiretroviral treatment ,Medicine ,030212 general & internal medicine ,0305 other medical science ,business ,China ,Cohort study - Abstract
The prevalence of Human Immunodeficiency Virus (HIV) in Zhejiang province has increased substantially in the past three decades. The first case of HIV infection was reported in 1985
- Published
- 2019
19. Prevalence of Active Syphilis Infection and Risk Factors among HIV-Positive MSM in Zhejiang, China in 2015: A Cross-Sectional Study
- Author
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Qiaoqin Ma, Xiaohong Pan, Lin Chen, and Jiezhe Yang
- Subjects
Adult ,Male ,China ,Adolescent ,Cross-sectional study ,Health, Toxicology and Mutagenesis ,Psychological intervention ,syphilis ,lcsh:Medicine ,cross-sectional studies ,HIV Infections ,Logistic regression ,Article ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Risk-Taking ,Acquired immunodeficiency syndrome (AIDS) ,Risk Factors ,Antiretroviral Therapy, Highly Active ,HIV Seropositivity ,medicine ,Odds Ratio ,Prevalence ,Humans ,030212 general & internal medicine ,Homosexuality, Male ,Aged ,business.industry ,Incidence (epidemiology) ,lcsh:R ,Public Health, Environmental and Occupational Health ,virus diseases ,HIV ,acquired immunodeficiency syndrome ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Sexual Partners ,030221 ophthalmology & optometry ,Syphilis ,business ,Demography - Abstract
Objectives: To determine the prevalence of active syphilis infection and explore the risk factors for active syphilis in human immunodeficiency virus (HIV)-positive men who had sex with men (MSM) in Zhejiang Province, 2015. Design: Data on HIV-positive MSM living in Zhejiang Province were obtained from the National Center for AIDS/STD Control and Prevention (NCAIDS) reporting system and the Zhejiang provincial AIDS/STD surveillance system between June and December 2015. The information included risky behavior, years with diagnosed HIV, and highly active antiretroviral therapy (HAART). SPSS 19.0 was used for the data analysis. Results: The analysis included 3616 MSM. Of these, 11.3% (407/3616) had active syphilis. Multivariate logistic regression analysis revealed that HAART was significantly associated with an increased risk of active syphilis infection (odds ratio (OR) = 1.760, 95% confidence interval (CI) 1.187&ndash, 2.611). Compared with participants diagnosed with HIV for <, 2 years, patients diagnosed with HIV for >, 5 years had a higher risk of active syphilis infection (OR = 1.707, 95% CI 1.167&ndash, 2.495). Age and number of sex partners were also independent risk factors for active syphilis infection. Conclusions: The incidence of active syphilis infection is high among HIV-positive MSM in Zhejiang Province, age, number of sex partners, years with diagnosed HIV, and receiving HAART were risk factors. Patients who are elderly, have lived with HIV for a longer period, have more sex partners, and receive HAART should be the focus of interventions to promote changes in behavior and decrease syphilis infection.
- Published
- 2019
20. HIV risk behavior and HIV testing among rural and urban men who have sex with men in Zhejiang Province, China: A respondent-driven sampling study
- Author
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Hui Wang, Qiaoqin Ma, Jun Jiang, Jiaquan Qiu, Jiezhe Yang, Wei Wang, Yazhou Zou, Dongshe Zhao, Tingting Jiang, Ping Wang, Xiaohong Pan, and Lin He
- Subjects
RNA viruses ,Male ,Rural Population ,Safe Sex ,Sexual partner ,Epidemiology ,Cross-sectional study ,HIV Infections ,Pathology and Laboratory Medicine ,law.invention ,Men who have sex with men ,Sexual and Gender Minorities ,0302 clinical medicine ,Immunodeficiency Viruses ,law ,Medicine and Health Sciences ,Mass Screening ,Medicine ,Homosexuals ,030212 general & internal medicine ,Homosexuality ,Young adult ,Geographic Areas ,media_common ,Multidisciplinary ,Geography ,Rural health ,virus diseases ,HIV diagnosis and management ,Sexual Partners ,Medical Microbiology ,HIV epidemiology ,Viral Pathogens ,Viruses ,Infectious diseases ,Bisexuality ,Female ,Pathogens ,0305 other medical science ,Research Article ,Urban Areas ,Adult ,China ,Adolescent ,Sexual Behavior ,Science ,media_common.quotation_subject ,Men WHO Have Sex with Men ,Viral diseases ,Microbiology ,Sampling Studies ,Young Adult ,03 medical and health sciences ,Risk-Taking ,Condom ,Environmental health ,Retroviruses ,Humans ,Homosexuality, Male ,Microbial Pathogens ,030505 public health ,business.industry ,Lentivirus ,Organisms ,Biology and Life Sciences ,HIV ,Rural Areas ,Diagnostic medicine ,Cross-Sectional Studies ,People and Places ,Earth Sciences ,Population Groupings ,Rural area ,business ,Sexuality Groupings - Abstract
BackgroundCurrently, human immunodeficiency virus (HIV) sentinel surveillance among men who have sex with men (MSM) in China conducted in large and medium-sized cities, and no HIV sentinel surveillance conducted in rural areas. HIV testing and intervention is predominantly conducted in urban areas, there have been a limited number of studies in rural areas MSM, it is necessary to conduct the investigation of HIV risk sexual behavior, HIV testing among rural and urban MSM.MethodBetween December 2013 and August 2015, a cross-sectional study was conducted in rural and urban areas in Zhejiang Province using respondent-driven sampling (RDS). Participants completed face-to-face interviewer-administered questionnaire surveys and were tested for HIV.ResultsA total of 710 MSM participants were recruited, of whom 36.1% were from rural areas. The overall HIV prevalence was 16.6%, and was considerably lower among MSM living in rural areas (3.9%) than those living in urban areas (24.2%). 61.1% participants had not condom use with male sexual behavior in the past 6 months (86.7% in rural areas and 46.7% in urban areas). The social demographic and behavioral characteristics had significance difference among rural and urban MSM. Multivariate logistic regression revealed that, compared to men living in urban areas, MSM living in rural areas MSM were more likely to use dating apps to find sexual partners, were more likely to engage in bisexual behavior, and had lower condom use. 43.0% participants had been tested for HIV in the past year (41.8% in rural areas and 43.6% in urban areas). Multivariate logistic regression also revealed that among participants living in rural areas, having rural health insurance and not accepting HIV intervention were associated with lower HIV testing rates, while a higher monthly income and through use of internet to find sexual partner were associated with higher rates of HIV testing.ConclusionHigh risk behavior was prevalent, and HIV testing rates were low among MSM living in rural areas compare to urban areas in Zhejiang Province, therefore, preventative intervention measures should be immediately among rural MSM urgently to reduce HIV transmission and to promote HIV testing.
- Published
- 2020
21. Online dating applications use and risky sexual networking: Analyses based on the cases investigations of HIV-infected students in Zhejiang Province, China
- Author
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Wanjun Chen, Xiaohong Pan, Jiezhe Yang, Jun Jiang, Lin He, Yun Xu, Jinlei Zheng, and Jianmin Jiang
- Published
- 2018
22. Reduction in HIV community viral loads following the implementation of a 'Treatment as Prevention' strategy over 2 years at a population-level among men who have sex with men in Hangzhou, China
- Author
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Xingliang Zhang, Jun Jiang, Yan Luo, Hui Wang, Yan Xia, Lin He, Xiaohong Pan, Jiezhe Yang, Yun Xu, Wanjun Chen, Qiaoqin Ma, Jinlei Zheng, Ke Xu, Jiafeng Zhang, and Shichang Xia
- Subjects
Adult ,Male ,0301 basic medicine ,China ,medicine.medical_specialty ,Databases, Factual ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Logistic regression ,lcsh:Infectious and parasitic diseases ,Men who have sex with men ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Medical microbiology ,Epidemiology ,Humans ,Medicine ,lcsh:RC109-216 ,030212 general & internal medicine ,Homosexuality, Male ,Community viral loads ,business.industry ,Incidence ,HIV ,Treatment as prevention ,Middle Aged ,Viral Load ,030112 virology ,Antiretroviral therapy ,CD4 Lymphocyte Count ,Infectious Diseases ,Anti-Retroviral Agents ,Tropical medicine ,RNA, Viral ,business ,Viral load ,Research Article ,Program Evaluation ,Demography - Abstract
Background Previous studies have shown that the increased coverage of antiretroviral therapy (ART) could reduce the community viral load (CVL) and reduce the occurrence of new HIV infections. However, the impact on the reduction of HIV transmission among men who have sex with men (MSM) is much less certain. The frequency of HIV infections in MSM have been rapidly increasing in recent years in Hangzhou, China. The “Treatment as Prevention” strategy was implemented at a population-level for HIV-infected MSM from January 2014 to June 2016 in Hangzhou; it aimed to increase the ART coverage, reduce the CVL, and reduce HIV transmission. Methods We investigated a subset of MSM diagnosed with HIV pre- and post-implementation of the strategy, using random sampling methods. Viral load (VL) testing was performed for all enrolled individuals; the lower limits of detection were 20 and 50 copies/mL. The data on infections were collected from the national epidemiology database of Hangzhou. Logistic regression analyses were conducted to identify factors associated with the differences in social demographic characteristics and available VL data. Results The ART coverage increased from 60.7% (839/1383) during the pre-implementation period to 92.3% (2183/2365) during the post-implementation period in Hangzhou. A total of 940 HIV-infected MSM were selected for inclusion in this study: 490 (52.1%) and 450 (47.9%) MSM in the pre- and post-implementation periods, respectively. In total, 89.5% (841/940) of patients had data available on VL rates. The mean CVL was 579 copies/mL pre-implementation and this decreased to 33 copies/mL post-implementation (Kruskal-Wallis
- Published
- 2018
23. Genetic diversity of HIV-1 and transmitted drug resistance among newly diagnosed individuals with HIV infection in Hangzhou, China
- Author
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Jingjing Huang, Yan Xia, Jiafeng Zhang, Xiaohong Pan, Jiezhe Yang, Jun Jiang, Yun Xu, Zhi-hong Guo, Xiaobei Ding, and Wenjun Zhang
- Subjects
Genetic diversity ,Protease ,medicine.medical_treatment ,Drug resistance ,Biology ,Virology ,Reverse transcriptase ,Nucleoside Reverse Transcriptase Inhibitor ,Men who have sex with men ,Infectious Diseases ,Genotype ,medicine ,Nested polymerase chain reaction - Abstract
HIV transmitted drug resistance (TDR) can compromise antiretroviral therapy (ART) in resource-limited countries like China where ART has been scaled up and thus leads to an important public health concern. The aim of the study was to elucidate the HIV-1 genetic characteristics and TDR in Hangzhou, China. Two-hundred eleven ART-naive, newly diagnosed individuals were enrolled during January and August 2013. Specimens were classified as recent or chronic infections using the BED capture enzyme immunoassay (BED-CEIA). The pol fragment covering the entire protease and the first 300 codons of the reverse transcriptase gene was amplified by RT-PCR and nested PCR. Genotypic drug resistance (DR) and phylogenetic analysis were performed on the 200 obtained sequences. Multiple genotypes were identified, including CRF01_AE (62.0%), CRF07_BC (31.0%), subtype B (2.0%), CRF08_BC (1.5%), CRF55_01B (1.0%), CRF18_cpx (0.5%), and unique recombinant forms (URFs, 2.0%). All the four URFs were found in men who have sex with men, consisting of a recombination of CRF01_AE with subtype B or CRF07_BC. The prevalence of primary DR in newly diagnosed individuals in Hangzhou was low (4.0%). The proportion of DR mutation to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) was 1.5%, 1.5%, and 1.0%, respectively. BED-CEIA revealed that 21.8% (45/211) of the specimens were associated with recent infections. The prevalence of TDR in recent infections was moderate (6.5%). High HIV diversity and relatively high prevalence of TDR in new infections has been found in Hangzhou, indicating an increasing challenge for future HIV prevention and treatment. J. Med. Virol. 87:1668–1676, 2015. © 2015 Wiley Periodicals, Inc.
- Published
- 2015
24. Trends of subtype variation of human immunodeficiency virus type 1 in Zhejiang Province, China
- Author
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Ya-ping Yao, Yan Xia, Ruolei Xin, Jiezhe Yang, Yanhui Song, Xiaohong Pan, Jiafeng Zhang, Zhi-hong Guo, and Yun Xu
- Subjects
Adult ,Male ,China ,medicine.medical_specialty ,Sexual transmission ,Adolescent ,Genotype ,Sexual Behavior ,Molecular Sequence Data ,Prevalence ,HIV Infections ,Drug resistance ,Biology ,Young Adult ,Medical microbiology ,Virology ,Drug Resistance, Viral ,Genetic variation ,Disease Transmission, Infectious ,Genetics ,medicine ,Humans ,Molecular Biology ,Molecular Epidemiology ,Molecular epidemiology ,Transmission (medicine) ,Genetic Variation ,food and beverages ,Sequence Analysis, DNA ,General Medicine ,Middle Aged ,Infectious Disease Transmission, Vertical ,Cross-Sectional Studies ,Epidemiological Monitoring ,HIV-1 ,Female - Abstract
The epidemic characteristics of human immunodeficiency virus type 1 (HIV-1) in Zhejiang Province have not been systematically identified. This study presented a dynamic analysis of HIV-1 subtype variation in Zhejiang from 2004 to 2008, based on the surveillance of molecular epidemiology or drug resistance. CRF01_AE was the major strain (43.5 %) spreading across the province, second by B/B' (17.9 %), CRF07_BC (17.1 %), and CRF08_BC (13.7 %). The strains were mainly transmitted by heterosexual contact. Novel recombinant strains and vertical transmission were occasionally reported. Floating population from other provinces accounted for a significant number of HIV-1 cases in Zhejiang. These data may provide us rational intervention strategy for further control of HIV dissemination.
- Published
- 2014
25. HIV cause-specific deaths, mortality, risk factors, and the combined influence of HAART and late diagnosis in Zhejiang, China, 2006–2013
- Author
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Yun Xu, Jinlei Zheng, Jun Jiang, Lin He, Lin Chen, Xin Zhou, Hui Wang, Xiaohong Pan, Jiezhe Yang, Qiaoqin Ma, Tingting Jiang, and Jianmin Jiang
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,China ,Delayed Diagnosis ,HIV Infections ,Disease ,Article ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Risk Factors ,Internal medicine ,Antiretroviral Therapy, Highly Active ,Cause of Death ,Medicine ,Humans ,030212 general & internal medicine ,Mortality ,Cause of death ,Demography ,Multidisciplinary ,business.industry ,Proportional hazards model ,Hazard ratio ,Absolute risk reduction ,Retrospective cohort study ,medicine.disease ,030112 virology ,Late diagnosis ,Female ,business - Abstract
To examine patterns of human immunodeficiency virus (HIV) cause-specific deaths, risk factors, and the effect of interactions on mortality, we conducted a retrospective cohort study in Zhejiang, China, from 2006 to 2013. All data were downloaded from the acquired immune deficiency syndrome (AIDS) Prevention and Control Information System. The Cox proportional hazards model was used to assess predictors of cause-specific death. The relative excess risk due to interaction and ratio of hazard ratios (RHR) were calculated for correlations between HAART, late diagnosis, and age. A total of 13,812 HIV/AIDS patients were enrolled with 31,553 person-years (PY) of follow-up. The leading causes of death of HIV patients were accidental death and suicide (21.5%), and the leading cause of death for those with AIDS was AIDS-defining disease (76.4%). Both additive and multiplicative scale correlations were found between receiving HAART and late diagnosis, with RERI of 5.624 (95% CI: 1.766–9.482) and RHR of 2.024 (95% CI: 1.167–2.882). The effects of HAART on AIDS-related mortalities were affected by late diagnosis. Early detection of HIV infection and increased uptake of HAART are important for greater benefits in terms of lives saved.
- Published
- 2017
26. Trends of HIV-1 Subtypes Among Young People in Hangzhou, China
- Author
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Jiafeng Zhang, Yan Xia, Xiao hong Pan, Ke Xu, Yun Xu, Wenjun Zhang, Junfang Chen, Xiaobei Ding, Zhi-hong Guo, Jiezhe Yang, Lin He, and Yan Luo
- Subjects
0301 basic medicine ,Adult ,Male ,China ,Pol genes ,Adolescent ,Genotype ,Immunology ,Human immunodeficiency virus (HIV) ,HIV Infections ,Biology ,medicine.disease_cause ,Polymerase Chain Reaction ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Phylogenetics ,Virology ,medicine ,Humans ,030212 general & internal medicine ,Phylogeny ,Molecular Epidemiology ,Phylogenetic tree ,Molecular epidemiology ,Plasma samples ,virus diseases ,Sequence Analysis, DNA ,030104 developmental biology ,Infectious Diseases ,Cross-Sectional Studies ,pol Gene Products, Human Immunodeficiency Virus ,HIV-1 ,Female ,Nested polymerase chain reaction - Abstract
To investigate the HIV-1 molecular epidemiology among young people (18 to 25 years old) in Hangzhou. Plasma samples from 262 newly diagnosed HIV-1-infected patients were collected between 2009 and 2013 from Hangzhou of Zhejiang province. HIV-1 nucleotide sequences of pol gene regions were amplified using a nested polymerase chain reaction method and sequenced. Phylogenetic and recombination analyses were used to determine the HIV-1 genotypes. Based on all sequences generated, the subtype/circulating recombinant forms (CRFs) distribution was as follows: CRF01_AE (68.70%), CRF07_BC (21.54%), subtype B (3.66%), CRF08_BC (2.44%), 01B (2.03%), BC (0.81%), and C (0.41%). We found that the percentage of CRF07_BC was increasing year by year among young people in Hangzhou. Novel CRFs such as CRF67_01B (HZ2011-15 CD4-4516) and CRF68_01B (HZ2011-20 CD4-4530 and HZ2011-29 CD4-4087) were first discovered in the area in this study. Our study presents a molecular epidemiology investigation describing the structure of HIV-1 strains cocirculating in young people in Hangzhou. Increasing CRF07_BC and new CRFs popular in young people are a challenge for future prevention in Hangzhou.
- Published
- 2016
27. [Analysis of related factors for HIV transmission among 263 pairs of male spouses with positive HIV antibodies in Zhejiang province]
- Author
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Lin, Chen, Xiaohong, Pan, Jiezhe, Yang, Yun, Xu, Hui, Wang, Xin, Zhou, Tingting, Jiang, and Qiaoqin, Ma
- Subjects
Adult ,Male ,Health Knowledge, Attitudes, Practice ,Sexual Behavior ,Sexually Transmitted Diseases ,HIV Infections ,HIV Antibodies ,Middle Aged ,Cross-Sectional Studies ,Risk Factors ,Humans ,Mass Screening ,Female ,Spouses - Abstract
To identify the status and risk factors of transmission in couples which males was HIV-positive in Zhejiang province.A cross-sectional study was conducted among HIV-serodiscordant couple (male positive) and HIV-seroconcordant couple (male first infected). A self-designed questionnaire was complimented containing basic information, the awareness of infection and HIV-testing, sexual relationship power, self-efficacy of condom use, sex. The univariated and multivariate logistic regression methods were used to analyze the influence factors.A total of 263 couples were enrolled in this study, including 210 HIV HIV-serodiscordant couples and 53 HIV-seroconcordant couples. HIV-positive males aged 30-50 accounted for 57.8% (152 cases) and females under junior high school accounted for 79.1% (208 cases). HIV/AIDS accounted for 41.1% (217 cases). The proportion of man who were diagnosed as HIV, MSM and ever heard HIV were 61.9% (130 cases), 38.3% (80 cases) and 81.9% (172 cases), which were higher than that in HIV positive 47.2% (25 cases), 7.5% (4 cases), 64.2% (34 cases); χ(2)=3.80, 18.33, 7.86;P=0.051, 0.001, 0.005. The results revealed that AIDS patients had high risk to infect their spouse than HIV patients (OR=2.93, 95% CI: 1.05-8.21). Male patients who had ever heard " HIV" before were less likely pass virus to their wives than those who had never heard " HIV" (OR=0.13, 95% CI: 0.04-0.41). Compared with heterosexuality man, homosexuality man' wives had high risk to get virus from their husbands (OR=0.14, 95% CI: 0.03-0.73). Female infected with STIs was the independent factors for HIV infection (OR=4.86, 95% CI: 1.23-19.11).Among the couples of male HIV-positive in Zhejiang Province, the risk of spouses infected with HIV virus has relationship with male disease progression, sexual orientation and awareness of AIDS knowledge. For females who infected with sexual diseases in last 6 months might be infected by their spouses.
- Published
- 2016
28. [Research progress on survival analysis of highly antiretroviral therapy for HIV/AIDS]
- Author
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Jinlei, Zheng, Yun, Xu, Lin, He, Jun, Jiang, and Jiezhe, Yang
- Subjects
Acquired Immunodeficiency Syndrome ,China ,Biomedical Research ,Treatment Outcome ,Antiretroviral Therapy, Highly Active ,Humans ,HIV Infections ,Survival Analysis - Published
- 2016
29. The Factors Related to CD4+ T-Cell Recovery and Viral Suppression in Patients Who Have Low CD4+ T Cell Counts at the Initiation of HAART: A Retrospective Study of the National HIV Treatment Sub-Database of Zhejiang Province, China, 2014
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Zhihang Peng, Jiafeng Zhang, Jianmin Jiang, Lin He, Xin Zhou, Ning Wang, Peng Huang, Jiezhe Yang, Jinlei Zheng, Xiaohong Pan, Jun Jiang, Lin Chen, Zhihui Dou, and Yun Xu
- Subjects
0301 basic medicine ,RNA viruses ,CD4-Positive T-Lymphocytes ,Male ,Databases, Factual ,lcsh:Medicine ,HIV Infections ,Pathology and Laboratory Medicine ,Toxicology ,Geographical Locations ,White Blood Cells ,0302 clinical medicine ,Immunodeficiency Viruses ,Animal Cells ,Risk Factors ,Antiretroviral Therapy, Highly Active ,Clinical endpoint ,Medicine and Health Sciences ,Public and Occupational Health ,030212 general & internal medicine ,Viral suppression ,lcsh:Science ,Multidisciplinary ,T Cells ,Pharmaceutics ,Middle Aged ,Viral Load ,Vaccination and Immunization ,medicine.anatomical_structure ,Treatment Outcome ,Medical Microbiology ,Viral Pathogens ,Toxicity ,Viruses ,Female ,Cellular Types ,Pathogens ,Viral load ,Research Article ,Adult ,medicine.medical_specialty ,China ,Asia ,T cell ,Immune Cells ,Immunology ,Antiretroviral Therapy ,Microbiology ,03 medical and health sciences ,Pharmacotherapy ,Antiviral Therapy ,Drug Therapy ,Adverse Reactions ,Internal medicine ,Retroviruses ,medicine ,Highly-Active Antiretroviral Therapy ,Humans ,Microbial Pathogens ,Retrospective Studies ,Pharmacology ,Blood Cells ,business.industry ,Prophylaxis ,lcsh:R ,Lentivirus ,Organisms ,Biology and Life Sciences ,HIV ,Retrospective cohort study ,Cell Biology ,030112 virology ,CD4 Lymphocyte Count ,Regimen ,People and Places ,lcsh:Q ,Preventive Medicine ,business - Abstract
Background Since China has a unique system of delivering HIV care that includes all patients’ records. The factors related to CD4+ T-cell recovery and viral suppression in patients who have low CD4+ T cell counts at the initiation of HAART are understudied in the China despite subsequent virological suppression (viral load < 50 copies/mL) is unknown. Methods The authors conducted a retrospective cohort study using data from the national HIV treatment sub-database of Zhejiang province to identify records of HIV+ patients. Patient records were included if they were ≥ 16 years of age, had an initial CD4 count < 100 cells/μL, were on continuous HAART for at least one year by the end of December 31, 2014; and achieved and maintained continued maximum virological suppression (MVS) (< 50 copies/ml) by 9 months after starting HAART. The primary endpoint for analysis was time to first CD4+ T cell count recovery (≥ 200, 350, 500 cells/μL). Cox proportional hazard regression was used to identify the risk factors for CD4+ T cell count recovery to key thresholds (200–350, 350–500, ≥ 500 cells/μL) by the time of last clinical follow-up (whichever occurred first), key thresholds (follow-up date for analysis), with patients still unable to reach the endpoints being censored by the end December 31, 2014 (follow-up date for analysis). Results Of the 918 patients who were included in the study, and the median CD4+ T cell count was 39 cells/μL at the baseline. At the end of follow-up, 727 (79.2%), 363 (39.5%) and 149 (16.2%) patients had return to ≥ 200, 350, and 500 cells/μL, respectively. Kaplan-Meier analysis demonstrated that the rate of patients with CD4+ count recovery to ≥ 200, 350, and 500 cells/μL after 1 year on HAART was 43.6, 8.6, and 2.5%, respectively, after 3 years on treatment was 90.8, 46.3, and 17.9%, respectively, and after 5 years on HAART was 97.1, 72.2, and 36.4%, respectively. The median time to return to 200–350, 350–500, ≥ 500cells/μL was 1.11, 3.33 and 6.91 years, respectively. Factors of age (aHR = 0.77, 95%CI 0.61–0.97), baseline CD4+ count (aHR = 1.60, 95%CI 1.37–1.86), initial regimens, changes in regimen (aHR = 0.58, 95%CI 0.49–0.69), and inclusion of a cotrimoxazole prophylaxis (aHR = 0.66, 95%CI 0.51–0.85) were associated with CD4+ T cell count recovery. Conclusion The proportion of patients with initially low CD4 counts after nine months of treatment and that achieved continuous virological suppression was greater than 70% for persons with CD4+ count ≥ 350. Conversely, only 35% of patients recovered to levels of 500 cells/μL after 5 years of treatment, and levels continued to rise significantly with further long-term HAART. Early HAART intervention will be necessary for achieving effective CD4+ T cell responses and optimal immunological function in HIV+ patients.
- Published
- 2016
30. [Survey of prevalence of HIV infection, syphilis and HCV infection and related risk behaviors among club drug users in Zhejiang, 2011]
- Author
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Xiaohong, Pan, Jun, Jiang, Huan, He, Lin, Chen, Jiezhe, Yang, Hongbo, Zhang, and Ning, Wang
- Subjects
Male ,Substance-Related Disorders ,Sexual Behavior ,HIV Infections ,Hepatitis C ,Sex Work ,Methamphetamine ,Condoms ,Drug Users ,Risk-Taking ,Surveys and Questionnaires ,Prevalence ,Humans ,Mass Screening ,Female ,Syphilis - Abstract
To understand the prevalence of HIV infection, syphilis and hepatitis C infection and related risk behaviors among club drug users in Zhejiang province.The drug users were interviewed with questionnaires in 2011 to collect the information about their demographic characteristics, sexual behaviors, drug use behaviors and the utilization of intervention services. Blood samples were collected from them to detect HIV, syphilis and HCV antibodies.A total of 3 253 drug users were surveyed, in which 1 298 were club drug users, accounted for 39.9%. The proportion of club drug users was high in northern and central Zhejiang, in females, in age group≤25 years, in local residents and in those having commercial sexual behaviors during previous 12 months. Of the 1 298 club drug users, 91.2% were methamphetamine users, 0.1% were infected with HIV (95% CI: 0.0%-0.2%), 8.1% suffered from syphilis (95% CI: 6.6%-9.6%), 17.3% were infected with HCV (95% CI: 15.2%-19.4%). Among the interviewed club drug users, 12.7% were aware of AIDS, 9.2% had injecting drug use histories, 29.6% reported having commercial sex during the previous 12 months, only 33.4% received free condom and counsel, 14.0% received HIV test. Multivariate logistic regression analysis indicated that living in central and southern Zhejiang was associated with syphilis prevalence, HCV infection and injecting drug use behavior, being female was associated with syphilis prevalence. Injecting drug use and commercial sex during the previous 12 months were associated with HCV infection, and injecting drug use and commercial sex during the previous 12 months were associated with each other. Among the 1 285 club drug users, males, local residents in Zhejiang and those who never received free condom or counsel were more likely to have commercial sex.The prevalence of syphilis and HCV infection are high and unprotected sexual behaviors are common among the club drug users in Zhejiang, but less intervention services were received by them, suggesting that more attention should be paid to the prevention and control of HIV, HCV infections and syphilis in club drug users by taking effective intervention measures and increasing intervention coverage.
- Published
- 2016
31. [Incidence rate of HIV transmission in HIV discordant couples in Zhejiang province, 2009-2013]
- Author
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Lin, Chen, Xiaohong, Pan, Jiezhe, Yang, Yun, Xu, Jinlei, Zheng, Jun, Jiang, and Lin, He
- Subjects
Male ,China ,Family Characteristics ,Risk Factors ,Antiretroviral Therapy, Highly Active ,Incidence ,HIV Seropositivity ,Humans ,Female ,HIV Infections ,Epidemics ,Heterosexuality - Abstract
To identify the HIV transmission in discordant couples and the epidemic characteristics of concordant couples related to HIV infection.HIV/AIDS database was down-loaded from AIDS information reported system for analysis. Patients with HIV-negative couples between 2009 and 2013 in Zhejiang province were enrolled in this study. Information included demography characteristics, highly active antiretroviral therapy (HAART), HIV incidence rate and risk factors, characteristics on HIV concordant couples.The HIV incidence rate on HIV-negative couples of 2 575 HIV/AIDS was 3.56 per 1 000 person-year, reducing from 5.49 per 1 000 person-year in 2009 to 3.20 per 1 000 person-year in 2013. There was a slight increase on HIV incidence rate among couples in those HIV-positive men who were heterosexual, while it decreased among couples of HIV-positive women. Initiation of HAART over 1 years (OR = 0.063, 95% CI: 0.019-0.204) seemed to be a preventive factor for HIV transmission between the couples under study. Factors as history of infection longer than 3 years (OR = 3.564, 95% CI: 1.296-9.804) and beingnon-local resident (OR = 2.626, 95% CI: 1.098-6.230) were risky factors.The incidence rate of HIV transmission between HIV discordant couples was low but imbalance in different areas. People who were non-local residents under HIV discordant status, would need more attention. HAART, time of infection, status of residency appeared risk factors for HIV transmission within the couples.
- Published
- 2015
32. Rates and risk factors associated with the progression of HIV to AIDS among HIV patients from Zhejiang, China between 2008 and 2012
- Author
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Lin Chen, Lin He, Jinlei Zheng, Ning Wang, Renjie Zhang, Jianmin Jiang, Yun Xu, Xiaohong Pan, Jun Jiang, Philip Chun Yeung, and Jiezhe Yang
- Subjects
medicine.medical_specialty ,HAART ,Proportional hazards model ,business.industry ,Research ,HIV diagnosis ,Human immunodeficiency virus (HIV) ,HIV ,virus diseases ,Retrospective cohort study ,HIV screening ,Disease ,medicine.disease ,medicine.disease_cause ,AIDS ,Acquired immunodeficiency syndrome (AIDS) ,Virology ,Internal medicine ,Hiv patients ,medicine ,Molecular Medicine ,Pharmacology (medical) ,business - Abstract
Objectives The objective of this study was to determine the rate of acquired immune deficiency syndrome (AIDS) in Zhejiang province and to identify specific factors associated with progression of this disease. Methods This study utilized a retrospective cohort to identify the specific factors involved in the progression of human immunodeficiency virus (HIV) to AIDS. We collected data of patients existing in care between 2008 and 2012 from the national surveillance system databases. We performed our analyses using a multivariate Cox proportional hazards model. Results This study included 9216 HIV-positive patients (75.6 % male), which yielded 12,452 person-years (py) of follow-up-data. The AIDS progression rates were 33.9 % (2008), 33.6 % (2009), 38.1 % (2010), 30.6 % (2011) and 25.9 % (2012). We observed a significant reduction in the rate of progression Of HIV to AIDS post-2010 (Pearson χ2 = 4341.9, P 500 cells/mm3) at baseline were independently associated with lower rates of HIV progression to AIDS [HR = 0.382, 0.380, 0.187, P
- Published
- 2015
33. [HIV-1 subtype diversity and transmission clusters among men having sex with men who recently got HIV-l infection, in Zhejiang province]
- Author
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Jiafeng, Zhang, Jiezhe, Yang, Xiaohong, Pan, Zhihong, Guo, Xiaobei, Ding, Yun, Xu, Jingjing, Huang, and Yan, Xia
- Subjects
Immunoenzyme Techniques ,Male ,China ,Drug Resistance, Viral ,HIV-1 ,Prevalence ,Humans ,RNA, Viral ,HIV Infections ,Homosexuality ,Genes, pol ,Phylogeny ,Demography - Abstract
To understand the HIV-1 subtype diversity and transmission characteristics in men having sex with men (MSM) in Zhejiang province.A total of 233 newly diagnosed as HIV-1 positive patients in 2011 were screened out by BED capture enzyme immunoassay (BED-CEIA). Among them, 107 eligible subjects were enrolled for further molecular epidemiological study. Viral RNA was extracted from plasma samples and followed by reverse transcription PCR and nested PCR for amplification of pol gene fragments, sequencing, and bioinformatics analysis.There were no statistically significant differences regarding the social demographic distribution between the subjects under study and those recently infected MSM population. The rate of success for sequence acquisition was 94.4% (101/107). The highest proportion of subtype was CRF01_AE (62.4%), followed by CRF07_BC (31.7%) and with three cases of subtype B, one case of CRF55_01B and two cases of unique recombinant form (CRF01_AE/B and CRF01_AE/CRF07_BC). The phylogenetic trees were mainly divided into CRF01_AE cluster 1, cluster 2 and CRF07_BC cluster 3. The strains located in Hangzhou were diffused in the branches of phylogenetic tree. 10 transmission clusters were found, in which 80% involved two or more regions and 90% was associated with patients residing in Hangzhou. Three surveillance drug resistance mutations (M46I, T215S and G190A) were found in three samples (each sample harbored only one resistance mutation). The overall rate of transmitted drug resistance (TDR) was 2.97%.The increasing complexity of HIV was noticed in MSM in Zhejiang province. However, the prevalence of TDR was low. Cross-regional HIV transmission in MSM was common, which inferred from the study. Hangzhou might play a central regional role in the intra-provincial spread of HIV, to form an interwoven complex network in the MSM population.
- Published
- 2015
34. Genetic diversity of HIV-1 and transmitted drug resistance among newly diagnosed individuals with HIV infection in Hangzhou, China
- Author
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Jiafeng, Zhang, Zhihong, Guo, Jiezhe, Yang, Xiaohong, Pan, Jun, Jiang, Xiaobei, Ding, Wenjun, Zhang, Yan, Xia, Yun, Xu, and Jingjing, Huang
- Subjects
Adult ,Male ,China ,Adolescent ,Genotype ,Molecular Sequence Data ,Genetic Variation ,HIV Infections ,HIV Protease Inhibitors ,Real-Time Polymerase Chain Reaction ,Antiviral Agents ,Young Adult ,Drug Resistance, Multiple, Viral ,HIV-1 ,Prevalence ,Humans ,Reverse Transcriptase Inhibitors ,Female ,Protease Inhibitors ,Phylogeny - Abstract
HIV transmitted drug resistance (TDR) can compromise antiretroviral therapy (ART) in resource-limited countries like China where ART has been scaled up and thus leads to an important public health concern. The aim of the study was to elucidate the HIV-1 genetic characteristics and TDR in Hangzhou, China. Two-hundred eleven ART-naive, newly diagnosed individuals were enrolled during January and August 2013. Specimens were classified as recent or chronic infections using the BED capture enzyme immunoassay (BED-CEIA). The pol fragment covering the entire protease and the first 300 codons of the reverse transcriptase gene was amplified by RT-PCR and nested PCR. Genotypic drug resistance (DR) and phylogenetic analysis were performed on the 200 obtained sequences. Multiple genotypes were identified, including CRF01_AE (62.0%), CRF07_BC (31.0%), subtype B (2.0%), CRF08_BC (1.5%), CRF55_01B (1.0%), CRF18_cpx (0.5%), and unique recombinant forms (URFs, 2.0%). All the four URFs were found in men who have sex with men, consisting of a recombination of CRF01_AE with subtype B or CRF07_BC. The prevalence of primary DR in newly diagnosed individuals in Hangzhou was low (4.0%). The proportion of DR mutation to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) was 1.5%, 1.5%, and 1.0%, respectively. BED-CEIA revealed that 21.8% (45/211) of the specimens were associated with recent infections. The prevalence of TDR in recent infections was moderate (6.5%). High HIV diversity and relatively high prevalence of TDR in new infections has been found in Hangzhou, indicating an increasing challenge for future HIV prevention and treatment.
- Published
- 2015
35. [Research progress on high risk sexual behavior among men who have sex with men under antiretroviral treatment]
- Author
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Lin, He, Xiaohong, Pan, Jiezhe, Yang, Jinlei, Zheng, Yun, Xu, Lin, Chen, and Jun, Jiang
- Subjects
Male ,Risk-Taking ,Sexual Behavior ,Humans ,Homosexuality, Male - Published
- 2015
36. [Characteristics and influencing factors of HIV detection among HIV/AIDS patients in Zhejiang province in 2012]
- Author
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Xiaohong, Pan, Lin, Chen, Yun, Xu, Yan, Xia, Zhihong, Guo, and Jiezhe, Yang
- Subjects
Adult ,Acquired Immunodeficiency Syndrome ,Delayed Diagnosis ,Marital Status ,Sexual Behavior ,Age Factors ,HIV Infections ,Middle Aged ,Communicable Diseases ,Early Diagnosis ,Risk-Taking ,Risk Factors ,HIV Seropositivity ,HIV-1 ,Humans ,Mass Screening ,Marriage ,Aged - Abstract
To assess the characteristics and influencing factors of HIV detection among HIV/AIDS patients in Zhejiang province.HIV/AIDS cases information were selected from the case reporting database of HIV/AIDS Comprehensive Response Information Management System in Zhejiang province in 2012. HIV late diagnosed patients and early diagnosed patients were classified by first CD4(+) T cell counts (less than 200 cells/µl) and positive BED HIV-1 capture enzyme immunoassay (BED-CEIA) tests result. A total of 1 894 patients were enrolled and 1 383 patients were served by BED-CEIA tests. Information including social demographics, transmission routes, test history were collected for analysis. The univariate and multivariate logistic regression methods was used to analyze the characteristics of HIV detection and related influence factors.Among 1 894 cases, 26.4% (500/1 894) were late diagnosed and 19.2% (361/1 883) were early diagnosed. The highest rate of late diagnose (36.5%, 27/74) and lowest rate of early diagnose(3.9%, 14/74) were both in Lishui city. Age, transmission routes, HIV testing style, permanent residence were independent reasons for late diagnosed. Compared with patients20 years old, participants over 50 years old had higher risk of late diagnosed (OR = 2.885, P0.05); patients with homosexual behaviors had lower risk of late diagnosed than patients with heterosexual behaviors and other high risk behaviors(OR = 1.471 or 2.416, P0.05). Age, marriage status, HIV testing style, transmission routes, the detection unit, permanent residence were independent reasons for early diagnosed. The risky of early diagnosed among patients ≥ 50 years old were 0.432 times than that among patients20 years old (OR = 0.432, P0.05). Compared with unmarried participants, married patients had lower risk of early diagnosed (OR = 0.603, P0.05). Compared with homosexual behaviors, high risk heterosexual behaviors and other risk behavior significantly reduced the chance of early diagnosis(OR = 0.719 or 0.763, P0.05).Late diagnoses and early diagnosis coexist among reported HIV/AIDS in Zhejiang province in 2012. The main reasons for late diagnosis of HIV infection are older age, heterosexual behaviors and other risk behavior, testing in hospital, living in other province. The main reasons for early diagnosis of HIV infection are young age, unmarried, homosexual behaviors, testing in CDC, living in Zhejiang province.
- Published
- 2014
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