Socio-Demographic and Occupational Aspects of HIV-HBV Co-Infection in Bangui, Central African Republic (CAR): Hospital-Based Cross-Sectional Study

Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.

Factors Associated with HIV/Tuberculosis Coinfection among People Living with HIV after Initiation of Antiretroviral Treatment in Lingwala Health Zone from 2021 to 2023

Context and objective: Around 8% of incident cases of tuberculosis (TB) were reported among people living with HIV worldwide in 2022. Tuberculosis is the leading cause of death among people living with HIV. Africa accounts for the majority of co-infection episodes, with over 50% of cases in some parts of southern Africa. In the Democratic Republic of Congo (DRC), around 9% of persons living with HIV (PLHIV) develop TB and 11% of TB patients are infected with HIV. The DRC is one of the 30 countries in the world bearing the brunt of co-infection. Despite the efforts made by countries to improve access to antiretroviral traitement (ART), TB remains a major problem among people living with HIV. The Lingwala Health Zone in the provincial city of Kinshasa recorded a large number of cases of HIV/TB co-infection during the study period. The aim of this study was to determine the factors associated with HIV/TB co-infection among PLHIV on ART in the Lingwala health zone (HZ) in Kinshasa. Methods: This was a case-control study conducted in the state-run HIV care facilities in the Lingwala health district among PLHIV who had visited the health facilities during the period 2021-2023. Cases were coinfected patients and controls were PLHIV who had not developed tuberculosis during the study period. Results: A total of 281 PLHIV were enrolled in the study, with 70 cases and 211 controls. Factors associated with HIV/TB co-infection after multivariate analysis were viral load (OR = 5.34;95% CI;1.8-15.8, p = 0.005). History of tuberculosis (OR = 20.84;95% CI;8.6-50.3, p -85.0, p = 0.005) and BMI Conclusion: The results of this study indicate that the detection of these enumerated factors should prompt providers to actively search for tuberculosis with a view to organising early management.

Factors of Adherence to Concurrent Tuberculosis Treatment and Antiretroviral Therapy among HIV-TB Co-Infected Individuals in the East Region, Cameroon in the COVID-19 Era: A Retrospective Cohort Study

Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed in all situations where patients are required to administer their own medication, whatever the type of illness. The general objective of this study was to assess the factors affecting adherence to treatment among HIV-TB co-infected patients in health facilities in the East Region in the COVID context. Method: A retrospective cohort study before and during COVID-19 was conducted in HIV care units in 13 health districts in the East Region of Cameroon. Data were collected using a questionnaire recorded in the Kobo Collect android application, analyzed using SPSS version 25 software and plotted using Excel. Results: The pre-COVID-19 cohort compared to the during-COVID-19 cohort had a 1.90 risk of not adhering to treatment (OR: 1.90, CI {1.90 - 3.37}) and the difference was statistically significant at the 5% level (p-value = 0.029). Frequency of adherence was 65.4% (140/214). Adherence before COVID-19 was 56.9% whereas during COVID-19, it was 74.3%. Conclusion: The implementation of targeted interventions in the COVID-19 context, using evidence-based data and integrating the individual needs of HIV-TB co-infected patients, improved adherence to concurrent anti-tuberculosis treatment and antiretroviral therapy during the COVID-19 Era.

Mathematical Modeling of the Co-Infection Dynamics of HIV and Tuberculosis Incorporating Inconsistency in HIV Treatment

A non-linear HIV-TB co-infection has been formulated and analyzed. The positivity and invariant region has been established. The disease free equilibrium and its stability has been determined. The local stability was determined and found to be stable under given conditions. The basic reproduction number was obtained and according to findings, co-infection diminishes when this number is less than unity, and persists when the number is greater than unity. The global stability of the endemic equilibrium was calculated. The impact of HIV on TB was established as well as the impact of TB on HIV. Numerical solution was also done and the findings indicate that when the rate of HIV treatment increases the latent TB increases while the co-infected population decreases. When the rate of HIV treatment decreases the latent TB population decreases and the co-infected population increases. Encouraging communities to prioritize the consistent treatment of HIV infected individuals must be emphasized in order to reduce the scourge of HIV-TB co-infection.

Cross-Sectional Study of Tuberculosis and HIV/AIDS Co-Infections among Patients Attending Directly Observed Treatment Centers in Bayelsa State, Nigeria

Introduction: Mycobacterium tuberculosis (TB) infects about one quarter of the global population and is transmitted via aerosols by coughing, sneezing, etc. Some socio-behavioral factors may predispose an individual to the disease. Methodology: The study used a cross-sectional design with random stratified sampling technique. Sputum samples from suspected TB patients totaling 600 were obtained from patients attending directly observed treatment (DOTs) centers from different local government areas in Bayelsa. The sputum samples were examined for tuberculosis using the Ziehl-Neelsen staining technique and Gene Xpert molecular method while HIV/AIDS tests were carried out with EDTA blood using the Alere HIV12 test kit and others. Results: The Prevalence of TB by Gene Xpert was 294 (49.0%) and by AFB 217 (36.1%), while TB/HIV co-infection was 94 (32.0%), RRMTB was 34 (11.9%) and HIV 249 (41.5%). Prevalence by age group showed the 20 - 39 years had the highest prevalence of TB 98 (47.0%), TB/HIV 35 (47.0%), RRMTB 17 (48.0%) and HIV 90 (57.0%). By gender the male had slightly higher prevalence of TB 109 (52.0%), TB/HIV 51 (54.0%), RRMTB 20 (56.0%) and HIV 126 (51.0%) than the female. Prevalence among smokers and alcoholics and subjects who engaged in both habits had high prevalence TB 109 (37.0%), TB/HIV 14 (40.0%), RRMTB 14 (40.0%) and HIV 72 (29.0%). For educational status those with tertiary and secondary education had similar high prevalence and for occupation, the self-employed and civil servants had similar elevated prevalence. The prevalence by local government area showed that Yenegoa had the highest with TB 235 (80.0%), TB/HIV 72 (76.6%), RRMTB 24 (68.5%) and HIV 202 (81.2%). Conclusion: An increase in the development of resistance by M. tuberculosis also contributes to the persistence of the disease as well as some socio-economic factors.

2016至2020年杭州地区无偿献血人群HIV感染状况分析

目的了解杭州地区无偿献血人群HIV感染状况,为本地区降低HIV经输血传播风险,制定有效献血者招募及艾滋病防控策略提供数据支持。方法采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)和病原体核酸检测技术(nucleic acid testing,NAT)对2016年1月至2020年12月杭州地区902847例无偿献血者标本进行抗HIV-Ⅰ/Ⅱ抗体/抗原和HIVRNA检测。抗-HIV抗体/抗原或HIVRNA反应性标本送杭州市疾病控制中心进一步采用Western blot法和NAT进行确认。结果2016年1月至2020年12月杭州地区共检测HIV确证阳性103例,阳性检出率为0.01%,其中101例ELISA和NAT筛查均为阳性反应,2例ELISA筛查为阴性反应,NAT为阳性反应。103例感染者中,以男性(91.26%,94/103)、18~35岁(69.90%,72/103)、初次献血者(68.93%,71/103)为主。2016至2020年献血者HIV阳性率呈逐年下降趋势(χ^(2)=7.181,P=0.007)。男女献血者HIV阳性率各年的差异无统计学意义(χ^(2)=10.336,P=0.350;χ^(2)=0.653,P=0.957)。各年龄组献血者HIV阳性率各年的差异无统计学意义(χ^(2)=6.378,P=0.173;χ^(2)=2.318,P=0.678;χ^(2)=5.284,P=0.259;χ^(2)=9.183,P=0.057)。结论近5年HIV感染在杭州市无偿献血人群中呈低流行水平,但仍存在感染风险,应加强在低危人群中招募献血者并且应采用先进的检测技术,选择合适的检测策略,保证血液安全。

CXCL12/CXCR4轴在HIV感染及艾滋病中医证候中的研究现状

机体CXCL12/CXCR4的结构及生物学作用是生理病理功能的基础。HIV-1包膜蛋白与CXCR4结合会促进病毒进入宿主细胞,CXCL12能通过快速内吞作用减少CXCR4的数量抑制HIV的复制及传播。CXCL12/CXCR4轴与炎症、自噬的相互作用在HIV感染中发挥重要作用。研究发现艾滋病不同中医证候的基因表达谱不同,CXCR4在艾滋病肺脾气虚证、气阴两虚证和湿热内蕴证中的表达具有差异,涉及趋化因子信号通路;在艾滋病肺脾气虚证患者外周血中差异基因CXCR4与自噬过程相关,对该证型患者进行中药益艾康胶囊干预,CXCR4表达升高,提示中药益艾康胶囊可以调控自噬相关基因的表达。研究CXCL12/CXCR4在艾滋病中医证候中的作用,有利于更好地发挥中医药的治疗优势,为基因的靶向治疗提供新的方向。

Infections and inequalities: anemia in AIDS, the disadvantages of poverty

Objective:To study anemia in AIDS patients and its relation with socioeconomic, employment status and educational levels.Methods:A total number of 442 patients who visited the Infectious Diseases University Hospital in Buenos Aires, Argentina were included in the study. Patients were dividied into two groups,i.e.one with anemia and the other without anemia. Anemia epidemiology and its relationship with educational level, housing, job situation, monthly income, total daily caloric intake and weekly intake of meat were evaluated.Results:Anemia was found in 228 patients(54%). Comparing patients with or without anemia, a statistically significant difference was found(P<0.0001) in those whose highest educational level reached was primary school, who lived in a precarious home, who had no stable job or were unable to work, whose income was less than 30 dollars per month, whose meat consumption was less than twice a week or received less than 8000 calories per day.Conclusions:The high prevalence of anemia found in poor patients with AIDS suggests that poverty increases the risk to suffer from this hematological complication.The relationship between economic development policies and AIDS is complex. Our results seem to point to the fact that AIDS epidemic may affect economic development and in turn be affected by it. If we consider that AIDS affects the economically active adult population, despite recent medical progress it usually brings about fatal consequences, especially within the poorest sectors of society where the disease reduces the average life expectancy, increases health care demand and tends to exacerbate poverty and iniquity.

Investigation and Analysis on Pathogen Distribution of HIV/AIDS Patients with Opportunistic Infection

Objective: This study aims to understand the distribution of pathogenic bacteria in the region of HIV/AIDS patients with opportunistic infection. Methods: To count the number of the bacterial culture of HIV/AIDS patients in our hospital from October 2011 to December 2014, and observe the distribution of all kinds of pathogenic bacteria. Results: From the 4269 cases of HIV/AIDS patients’ bacteria, 5045 cases were cultured whose main flora distribution wasCandida albicans, 1759 cases. The second one was penicillium, 982 cases. The third one was mycobacteria, 557 cases. And then there are 213 cases ofCryptococcus neoformans, 212 cases of?Klebsiella pneumonia, 209 cases of?E. coli, 157 cases of coagulase-negative staphylococci, 112 cases of?Candida tropicalis, 90 cases of glabrata, 81 cases of?Staphylococcus aureus, 75 cases of?Pseudomonas aeruginosa, 60 cases of Salmonella, 48 cases of Acinetobacter and the distribution of the rest of cultured bacterial was less than 40 cases. Conclusion: There are many kinds of types of Pathogenic bacteria in HIV/AIDS patients with the opportunity to infectious. And the majorities are?Candida albicans,?Penicillium marneffei,?Penicillium,?Mycobacterium,?Cryptococcus neoformans?and so on. The infection sites are widely distributed;respiratory and circulatory are the main infected system. Improving the detection rate and reducing the contamination rate can truly reflect the distribution of pathogenic bacteria, and the distribution can guide the infection work in hospital. At the same time, it’s good to predict and prevent opportunistic infection. Thus, the patients can get immediate treatment.

HIV/AIDS并发亚临床结核病现状研究进展

人类免疫缺陷病毒(human immunodeficiency virus,HIV)与结核分枝杆菌(Mycobacterium tuberculosis,MTB)双重感染一直是全球公共卫生关注的问题,也是临床诊疗工作的重点和挑战。随着人们对于结核病的认识不断完善,人们逐渐认识到亚临床结核病(subclinical tuberculosis,STB)在疾病谱中的重要性。笔者详细探讨了HIV/AIDS并发STB的流行现状、临床特征、筛检与诊断、治疗和预防等方面问题,旨在引起公共卫生和临床从业者的高度关注,鼓励进一步开展深入研究,提高对HIV/AIDS并发STB患者的重视,为制定降低HIV/AIDS与STB共病的措施提供科学依据。

新发HIV/AIDS患者抑郁心理干预效果及其与CD_(4)^(+)T细胞计数的关系研究

背景HIV/AIDS与抑郁症相关,抑郁症加大HIV相关认知紊乱(HAND)风险,并降低患者抗逆转录病毒治疗(ART)依从性,加剧HIV传播风险。国内研究较少报道新发HIV/AIDS患者(PLWHA)抑郁心理干预效果及与CD_(4)^(+)T细胞计数相关性。目的探究新发PLWHA抑郁心理干预效果及与CD_(4)^(+)T细胞计数相关性,为AIDS临床诊疗提供参考。方法2020年4月—2022年6月采用方便取样方法在江西省ART定点医院抽取新发PLWHA抑郁患者,患者确诊后立即启动ART及心理干预,干预总周期为12周。在干预前后采用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)进行评估,并检测CD_(4)^(+)T细胞计数进行分析。结果共纳入新发PLWHA抑郁患者200例,有效随访178例,有效率为89.0%。178例PLWHA抑郁患者轻中度88例(49.4%)、重度90例(50.6%),伴焦虑者173例(97.2%)。患者CD_(4)^(+)T细胞计数均值在干预前为(346.39±156.87)个/μL,干预后为(421.93±149.61)个/μL。干预后,新发PLWHA抑郁患者CD_(4)^(+)T细胞计数高于干预前(t_(配对)=10.971,P<0.05),HAMD、HAMA总分及各因子评分均低于干预前(P<0.05)。干预前,HAMD总分与CD_(4)^(+)T细胞计数分级(以500个/μL为分界值)呈负相关(r_(s)=-0.157,P=0.036)、与HAMA总分呈正相关(r_(s)=0.764,P<0.001)。干预后,HAMD总分与干预后CD_(4)^(+)T细胞计数呈负相关(r_(s)=-0.150,P=0.046)、与HAMA总分呈强正相关(r_(s)=0.939,P<0.001)。干预前,新发PLWHA抑郁患者CD_(4)^(+)T细胞计数<500个/μL者HAMD、HAMA总分高于CD_(4)^(+)T细胞计数≥500个/μL者(P<0.05)。结论新发PLWHA抑郁严重程度与CD_(4)^(+)T细胞计数相关,经专业心理干预能显著改善。

Exosomes in viral infection:Effects for pathogenesis and treatment strategies

Exosomes are small vesicles that carry molecules from one cell to another.They have many features that make them interesting for research,such as their stability,low immunogenicity,size of the nanoscale,toxicity,and selective delivery.Exosomes can also interact with viruses in diverse ways.Emerging research highlights the significant role of exosomes in viral infections,particularly in the context of diseases like COVID-19,HIV,HBV and HCV.Understanding the intricate interplay between exosomes and the human immune system holds great promise for the development of effective antiviral therapies.An important aspect is gaining clarity on how exosomes influence the immune system and enhance viral infectivity through their inherent characteristics.By leveraging the innate properties of exosomes,viruses exploit the machinery involved in exosome biogenesis to set replication,facilitate the spread of infection,and eliminate immune responses.They can either help or hinder viral infection by modulating the immune system.This review summarizes the recent findings on how exosomes mediate viral infection and how they can be used for diagnosis or therapy.This could lead to new clinical applications of exosomes in disease management.

HIV暴露儿童血清逆转影响因素分析

目的研究HIV暴露儿童血清逆转相关影响因素。方法收集2019年1月至2021年12月期间深圳市第三人民医院管理的49例HIV感染孕产妇及所生HIV暴露儿童的一般情况、临床资料及血清结果等。结果49例HIV暴露儿童在出生后48 h、6周、3月龄HIV核酸检测均为阴性。在12、18、21月龄时血清逆转率分别为59.18%、93.87%和100.00%。HIV暴露儿童在12月龄血清是否逆转与母亲分娩方式、抗反转录病毒开始时间、孕期核酸检测结果、CD4^(+)T淋巴细胞计数无关;与HIV暴露儿童的性别、出生胎龄与体重、阻断药物使用种类等也无关。结论未发现12月龄HIV暴露儿童血清逆转的明确影响因素,其3月龄核酸检测与最终血清逆转结果一致性为100%。为尽早排除HIV感染,减少家属顾虑,未来可考虑HIV暴露儿童3月龄前3次核酸阴性结果代替血清逆转。

Future Long-Term Care Setting Preferences and Related Factors among Japanese Middle-Aged and Older People Living with HIV

Since the introduction of antiretroviral therapy, the life expectancy of people living with human immunodeficiency virus (PLWH) has extended. This extension has led to an increase in the aging population in Japan and globally. Providing appropriate long-term care (LTC) for PLWH has thus become increasingly critical. Our study aimed to describe LTC setting preferences and related factors among middle-aged and older Japanese people living with HIV. A cross-sectional survey was conducted at two hospitals in Tokyo. One hundred seventy-five outpatients aged 40 years and above participated in this study. Participants completed an anonymous self-administered questionnaire to assess where they wanted to live once they could no longer care for themselves. Approximately 52.0% preferred a designated facility for older adults or LTC, while 30.3% preferred their home or living with family, a partner, or a friend (“familiar housing”). Bivariate analyses revealed that LTC setting preference was significantly associated with marital status, whether or not the participant had at least one child, and household composition. Furthermore, logistic regression analysis revealed that participants living with non-kin were less likely to prefer living in designated housing facilities for older adults or LTC (adjusted odds ratio = 0.17, 95% confidence interval: 0.05 - 0.63). The study findings suggest that family make-up and composition of cohabiters are critical indicators for LTC setting preference in this population. These findings can be the foundation for future care planning and delivery to meet the unique LTC needs and expectations of the aging population with HIV in Japan and similar global settings.

Investigation and Analysis of HIV Infection among Unpaid Blood Donors in Wuzhou City

Objective: To take the unpaid blood donors in Wuzhou City as the research object, analyze the characteristics and prevalence of HIV infection, further explore its epidemiological characteristics, and lay a solid foundation for the recruitment of unpaid blood donors and the safety of blood transfusion, so as to reduce the risk of HIV transmission through blood transfusion. Methods: This paper collected the anti-HIV test results of unpaid blood donors and the confirmation results of reactive samples from 2015 to 2020, and carried out statistical analysis on the relevant information of positive samples. Result: From 2015 to 2020, a total of 233,242 unpaid blood donors were tested, and the positive rate of anti-HIV initial screening was 0.057% (132/233,242), and the positive rate of anti-HIV confirmed was 0.022% (51/233,242);the comparison of positive rates in each year was P < 0.05. Among the total number of infections, 76.47% (39/51) of confirmed positive persons were infected with HIV alone, followed by combined TP infection, accounting for 15.69% (8/51);for the people between 46 and 55 years old, the infection rate was the highest, reaching 37.3%;and more men (90.2%) were infected than women. In terms of education background, junior high school and below were the majority, accounting for 58.83% of the total;in terms of marital status, the number of unmarried people was 27, accounting for 52.9%. In terms of occupation, there were two main groups: farmers and workers, accounting for 66.7% of the total number of infections, and students accounting for 15.7%. Among the confirmed positives, the proportion of first-time blood donors and whole blood donors was higher than that of those who donated blood again or donated component blood. Conclusion: The situation of HIV infection among unpaid blood donors in Wuzhou City was relatively stable from 2015 to 2020, with no significant change in the absolute number of infected people compared to the previous period (the HIV infection rate from 2010 to 2013 was 0.03%), and most of them were males, unmarried people and those with low education. Therefore, attention must be paid to the consultation and recruitment of blood donors before blood donation, as well as the HIV screening in the laboratory after blood donation, so as to ensure the safety of clinical blood use.

Hepatitis E Virus Infection in HIV Positive ART Naive and Experienced Individuals in Nigeria

Background: Studies have shown Hepatitis E Virus to be a causative agent of acute and chronic hepatitis in severely immunocompromised patients such as organ transplant recipients and person with HIV infection. This study was designed to determine the burden of HEV infection among HIV positive individuals in Nigeria and the effect of HIV treatment on the burden of HEV infection among this group of patients. Methods: Aliquot of plasma samples collected for laboratory investigations such as CD4 enumeration, blood chemistry (AST, ALT, Creatine, Urea) were used to determine the presence of HEV IgG and IgM antibodies using commercially available ELISA. Samples analysed in the study were collected from 180 HIV positive individuals (90 ART naive and 90 ART experienced) attending the ART clinic at the University College Hospital, Ibadan, Nigeria. Results: Twenty two of the 180 (12.2%) samples were positive for either HEV IgG (20/180) or IgM (2/180). The rate of HEV IgG was higher among ART naive individuals and the two IgM positive persons were ART naive. There was no significant difference in the mean CD4 count and mean ALT between HEV seronegative and seropositive individuals (P = 0.8 and 0.2 respectively). Conclusions: The results of this study suggest the need to test for HEV infection in HIV positive individuals for the early diagnosis and proper management since HEV is known to be fulminant in the presence of underlying liver disease that is common among HIV infected persons. In addition, the use of ART may reduce the incidence of HEV infection in HIV positive persons.

具有非局部感染和周期治疗的HIV感染模型的时空动力学分析

该文建立了一类非自治反应扩散HIV细胞模型来研究周期治疗、非局部感染对HIV感染时空动力学的影响.具体地,首先推导出模型基本再生数R0,其由下一代再生算子R的谱半径所定义.然后对模型的动力学行为进行分析,其中包括无感染平衡态的全局稳定性、HIV感染的一致持久性以及周期正平衡态的存在性.最后,通过数值模拟验证了理论结果的正确性并分析了相关重要因素对HIV感染进程的影响,为HIV的临床治疗提供有价值的参考建议.

2014—2023年HIV/AIDS患者与梅毒螺旋体共感染的文献计量学与可视化分析

目的通过对近10年HIV/AIDS患者与梅毒螺旋体共感染的相关报道文献的可视化分析,了解该领域的研究热点和未来趋势。方法以Web of Science Core Collection数据库作为数据源,检索2014-2023年HIV/AIDS患者合并感染梅毒螺旋体的相关文献,使用VOSviewer和CiteSpace对相关文献进行可视化分析。结果共有81个国家,1171家机构进行了相关研究,其中美国、中国、英国研究者发文较多,且合作紧密,发达国家是研究主力。关键词聚类中流行病学、孕妇、产前护理、神经梅毒、眼梅毒、男男性行为人群等反映了研究热点,其中男男性行为人群、眼梅毒是未来研究趋势。结论近10年HIV/AIDS患者合并梅毒螺旋体感染的研究热点从合并感染的流行病学、对神经梅毒的诊断逐渐转变至对眼梅毒及男男性行为人群的关注。

HIV and HCV:from Co-infection to Epidemiology,Transmission,Pathogenesis,and Treatment

Human immunodeficiency virus (HIV) is the infectious agent causing acquired immu-nodeficiency syndrome (AIDS),a deadliest scourge of human society. Hepatitis C virus (HCV) is a major causative agent of chronic liver disease and infects an estimated 170 million people worldwide,resulting in a serious public health burden. Due to shared routes of transmission,co-infection with HIV and HCV has become common among individuals who had high risks of blood exposures. Among hemophiliacs the co-infection rate accounts for 85%; while among injection drug users (IDU) the rate can be as high as 90%. HIV can accelerate the progression of HCV-related liver disease,particularly when immunodeficiency has developed. Although the effect of HCV on HIV infection is controversial,most studies showed an increase in mortality due to liver disease. HCV may act as a direct cofactor to fasten the progression of AIDS and decrease the tolerance of highly active antiretroviral therapy (HARRT). Conversely,HAART-related hepatotoxicity may enhance the progression of liver fibrosis. Due to above complications,co-infection with HCV and HIV-1 has imposed a critical challenge in the management of these patients. In this review,we focus on the epidemiology and transmission of HIV and HCV,the impact of the two viruses on each other,and their treatment.

HIV-infected Female Sex Workers High Risk Behavior and Attitude Changes in Kaiyuan City, Yunnan Province, China

Objective To investigate the attitude and sexual behavior status and change among HIV positive female workers in entertainment sites in Kaiyuan city, Yunnan province, China. The key information should be applied in the integrated intervention program in future. Methods A cohort survey among HIV positive female workers was conducted during 12 months, between 2010 and 2012. All the risk sexual behavior and attitude were collected for assessment for the potential secondary transmission to sexual partners. Results Of 99 HIV positive women who sell sex in Kaiyuan city, 99 participated in the survey at baseline, 80, 80, 75, and 75 at 3-, 6-, 9-, and 12-month follow-ups. The percentage of participants who reported consistently used condoms in the last one month ranged between 94.5% and 95.5%. The client volume in the last one month, income per sex and age group were significant related with non-insistent condom use with their clients. Conclusion It was suggested that integrated intervention program package should include 100 percent condom use promotion for the HIV positive FSW with all sexual partners, and also, include socially support involved.