Willingness to Pay for Antiretroviral Drugs Covered by Medical Insurance among People Living with HIV in 18 Chinese Cities

Objective Antiretroviral drugs covered by medical insurance have been gradually used by people living with human immunodeficiency virus(PLWH)in recent years in China.This study aimed to analyze their willingness to pay(WTP)for antiretroviral drugs.Methods A mixed-methods study design involving a cross-sectional survey and in-depth interviews was conducted.A cross-sectional survey was performed to collect data on the general characteristics,economic status,antiretroviral therapy(ART)status,and WTP of PLWH in 18 Chinese cities from August 2022 to February 2023.Multivariate logistic regression was used to analyze the factors associated with WTP.Representatives of PLWH were interviewed via in-depth interviews,and the data were thematically analyzed.Results Among the 941 PLWH,271(28.80%)were willing to pay for antiretroviral drugs covered by medical insurance.For basic medical insurance for urban and rural residents,PLWH with the following characteristics were more willing to pay:an educational level of senior high school or technical secondary school,having an undergraduate degree or higher,frequently working away from their hometowns,and homosexual transmission.Off-farm workers and recipients of government medical aid were more unwilling to pay.For basic medical insurance for urban employees,PLWH with the following characteristics were more willing to pay:frequently working away from their hometowns;homosexual transmission;personal annual income≥100,000 CNY;and adverse events of antiretroviral drugs.The main reasons for PLWH’s WTP for antiretroviral drugs covered by medical insurance were that the drugs had fewer adverse events and were easier to administer.The main reasons for PLWH’s unwillingness to pay were financial difficulties and privacy concerns.Conclusion Nearly one-third of PLWH are willing to pay for antiretroviral drugs covered by medical insurance.In the future,PLWH with a high WTP can be guided to use these drugs.

仿生酶固定化纳米反应器通过级联催化反应实现胆固醇的精确检测

基于酶的生化检测方法具有准确性高、检测速度快等优势,但生物酶的不稳定性限制了这一方法的应用.因此,开发一种活性高、稳定性强、反应效率高的酶包封体系是提高胆固醇生化检测的关键.为此,本研究发展了由二棕榈酸磷脂酰胆碱包覆中空多壳层结构的仿生人造细胞,HoMS的区室化结构和磷脂膜的选择透过性实现了酶的稳定包封和信号的高效传输.本研究通过信号的级联放大实现了胆固醇的快速准确检测.即利用负载胆固醇氧化酶的HoMS@DPPC引发胆固醇氧化反应,产生的中间产物H;2;O;2;作为信号分子,在负载辣根过氧化物酶的HoMS@DPPC催化作用下,促进荧光红染料生成试卤灵,再进行比色检测胆固醇的含量.由级联催化介导的胆固醇信号放大使得该系统可以应用于胆固醇检测,并且该方法表现出高的选择性和准确性,检测范围为0.05~0.3mM,检测限可达4.9μM.该方法可用于动物血清中胆固醇的检测,回收率为90.8%~104.9%,检测值与商业检测方法的结果高度吻合.此外,该系统可与智能设备集成,构建智能比色平台,实现图像分析与胆固醇浓度检测的一体化,为准确、快速的生化检测开辟了新途径.

Survival of People Living with HIV/AIDS from Pre-ART Era to Treat-all Era—China,1985–2022

Introduction:A comprehensive analysis of nationwide survival trends for people living with human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS,PLWHA)from the initial reported case to present has not been conducted.This study evaluated the survival outcomes of PLWHA reported in China from 1985 to 2022.Methods:We analyzed data from PLWHA recorded in the National HIV/AIDS Comprehensive Response Information Management System from 1985 to 2022.Survival rates were calculated using Kaplan-Meier curves,and factors associated with survival time were analyzed using Cox proportional hazard models.Results:Progressive relaxation of antiretroviral therapy initiation criteria led to significant improvements in survival rates across different diagnostic periods in China.The 1-year and 5-year cumulative survival rates increased from 85.2%and 66.1%in the 1985–2003 cohort to 91.1%and 81.4%in the 2016–2022 cohort.Cox proportional hazard analysis revealed elevated mortality risks among males,individuals aged≥65 years,those with injection drug use or other transmission routes,hospital-tested patients,and those with lower CD4 counts at diagnosis or without treatment.Conclusions:Antiretroviral therapy has effectively reduced mortality risk among PLWHA in China.Future efforts should focus on expanding HIV testing to reduce the proportion of late diagnoses with lower CD4 counts and providing targeted,differentiated services for older populations to further decrease mortality risk among PLWHA.

Hollow structures as drug carriers:Recognition,response,and release

Hollow structures have demonstrated great potential in drug delivery owing to their privileged structure,such as high surface-to-volume ratio,low density,large cavities,and hierarchical pores.In this review,we provide a comprehensive overview of hollow structured materials applied in targeting recognition,smart response,and drug release,and we have addressed the possible chemical factors and reactions in these three processes.The advantages of hollow nanostructures are summarized as follows:hollow cavity contributes to large loading capacity;a tailored structure helps controllable drug release;variable compounds adapt to flexible application;surface modification facilitates smart responsive release.Especially,because the multiple physical barriers and chemical interactions can be induced by multishells,hollow multishelled structure is considered as a promising material with unique loading and releasing properties.Finally,we conclude this review with some perspectives on the future research and development of the hollow structures as drug carriers.

Changing Mortality and Patterns of Death Causes in HIV Infected Patients—China,2013-2022

What is already known about this topic?The advent of antiretroviral therapy(ART)has markedly decreased mortality rates among patients infected with human immunodeficiency virus(HIV).Globally,there has been a 43%reduction in acquired immunodeficiency syndrome(AIDS)-related deaths from 2010 to 2022.Additionally,prior research indicates that the initiation of ART at an early stage within China has substantially lowered mortality rates.What is added by this report?Over the previous decade,following the implementation of China’s universal ART access strategy,the patterns of mortality causes among HIVinfected individuals across the country have undergone significant alterations.In 2022,the all-cause mortality rate among this population was reported at 2.7%,with the non-AIDS-related mortality rate at 1.8%.However,it is important to consider that the accuracy of death reporting could contribute to potential misclassification of the underlying causes of death.What are the implications for public health practice?Efforts to enhance health outcomes should persist in emphasizing the advancement of ART strategies,with a particular focus on mitigating non-AIDS-related mortality in the future.