Epidemiology of HIV/AIDS in China: recent trends

We used nationally reported cases (NCAIDS/China CDC,2016) and published literature to summarize up-to the end of 2015 epidemiologic trends in the HIV/AIDS epidemic in China.HIV-positive cases are distributed unevenly with most infections found in southwest China and the most affected population being men who have sex with men.Transmission mode of HIV infection has shifted from drug injection to sexual contact,which accounts for 95% of total reported cases.Two thirds of cases are from heterosexual transmission.Transmission pattern varies greatly throughout China.Some provinces in China reported heterosexual transmission accounted for over 90% of cases while other provinces reported homosexual transmission accounted for over 80% of cases.Patterns of heterosexually acquired HIV also vary widely,with 80% of cases attributed to commercial sex in some provinces,while in other provinces non-commercial extramarital sex accounted for over 70% of cases.Significant increase in HIV infection was observed among young students aged 15-24.China has successfully controlled blood transfusion-and injecting drug-related transmissions of HIV.Homosexual and non-commercial extramarital heterosexual transmissions have become new challenges for China's HIV/AIDS program.Urgent adoption of the UNAIDS/WHO 90-90-90 target will help overcome these new challenges.

Control of HIV/AIDS can be achieved with multi-strategies

Over past three decades,many prevention strategies have been proven effective in reducing human immunodeficiency virus (HIV) transmission.However,none of these strategies alone are effective to stop the spread of HIV.This review discusses a few key prevention strategies,including testing,harm reduction,prevention,prophylaxis,and modern communication strategies.We argue that although there are great challenges remaining to stop HIV transmission via sexual contact and injecting drug use routes,the combination of these effective strategies,control HIV epidemic can be achieved.

Effectiveness of Frequent Viral Load Testing Plus Additional Interventions to Prevent HIV Transmission in Heterosexual,Serodiscordant Couples—Yunnan Province,China,2019-2021

Summary What is already known about this topic?HIV transmission among serodiscordant couples remains a persistent issue in China.However,the practice of combining counseling with antiretroviral therapies(ART)to enhance ART adherence is not widely implemented or recommended in Chinese health guidelines.What is added by this report?

Risks and challenges of HIV infection transmitted via blood transfusion

Promoting biosafety regulations and techniques supports human health and protects individuals and groups from harmful incidents.Particular attention should be paid to those potential infectious hazards associated with blood and other bodily fluids,especially those highly transmitted infectious diseases,such as human immunodeficiency virus(HIV),one of the largest global health threats.Ensuring innovative and adaptive screening and laboratory techniques to reduce the possibility of HIV transmission are integral to managing the disease.We review here the evolution and success of blood screening techniques for HIV,along with current issues that still need to be addressed.Published academic articles and media reports about nosocomial HIV transmission events since 1981 were reviewed to identify current blood screening and transfusion safety trends across the globe,along with specific recommendations from the Chinese perspective.Although most initial screening was limited only to antibody and antigen testing,newer screening tests(such as nucleic acid testing),coupled with risk-based screening of donors,have led to reduced risk of HIV transmission and continues to reduce the“window period,”when an HIV-positive individual may test negative though they have been infected.Further examination of current guidelines and regulations across the globe are discussed,in order to understand where critical gaps in screening may exist.Through examination of this data,it is evident that huge strides have been made since the beginning of the epidemic;however improved technical training of staff and streamlined testing guidelines could help promote efficient screening of HIV,while also supporting those providing care.

A Pilot Program of Pre-Exposure and Post-Exposure Prophylaxis Promotion among Men Who Have Sex with Men-7 Study Sites, China, 2018–2019

Summary What is already known on this topic?Pre-exposure prophylaxis(PrEP)and post-exposure prophylaxis(PEP)had been proved to be effective in HIV prevention among men who have sex with men(MSM)internationally.Use of either PrEP or PEP was found to be limited among Chinese MSM.Relatively little data was reported in China.

Asymptomatic and Pre-Symptomatic COVID-19 in China

As the novel coronavirus disease 2019(COVID-19)pandemic spreads rapidly across the globe many unanswered questions about the basic biology and epidemiology of the disease hamper our response strategies and limit our ability to achieve control and prevent a rebound or so-called“second wave”.One such crucial question is:To what degree do asymptomatic cases contribute to transmission?Early,small studies on this subject have found wide ranging estimates of the prevalence of asymptomatic carriers,and just a handful of studies so far have documented viral shedding by asymptomatic cases[1].We recently re-examined China’s COVID-19 case report data to investigate this question[2].This Editorial aims to describe how asymptomatic cases contribute to transmission and what the implications are for control strategies.

Reported Cases of Respiratory Infectious Diseases--China,January−June,2018−2020

FIGURE 1.The number of respiratory infectious diseases(RID)and non-respiratory infectious diseases(non-RID)in China from January to June in 2018–2020.Respiratory infectious diseases included measles,tuberculosis,epidemic cerebrospinal meningitis,pertussis,scarlet fever,seasonal influenza,diphtheria,infectious atypical pneumonia,avian influenza H7N9,and coronavirus disease 2019(COVID-19).Non-respiratory infectious diseases refer to other notifiable infectious diseases except respiratory infectious diseases.

Diagnosis and Treatment Guidelines for Mesenchymal Stem Cell Therapy for Coronavirus Disease 2019(Beijing,2021)

The coronavirus disease 2019(COVID-19)can be caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection,and has led to millions of deaths among more than 100 million infected people around the world according to the declaration from World Health Organization.Dysregulated immune response of both the innate and adaptive immune systems is subsistent on COVID-19 patients,of which the degree are associated with disease severity,lung damage and long term functional disability.Current treatment options have included antiretroviral drugs,anti-inflammatory factors,antibodies,immune checkpoint inhibitors,and convalescent plasma therapy.More recently,mesenchymal stem cell(MSC)therapy has been explored for the management and control of COVID-19,particularly with the aim of preventing or at least mitigating respiratory co-morbidities.Though the safety and efficacy of stem cell therapy have been validated in multiple phase I–III clinical trials,to date,no standardized stem cell preparation,administration dosage or interval,product QA/QC testing,storage,transportation,or disposal protocols have been established.The present paper proposes a systematic methodology that addresses all the foregoing process steps and evaluation criteria for the efficacious and safe administration of MSCs in the treatment of patients infected with COVID-19.