An Analysis of HIV Monitoring in Shenzhen City from 1997 to 2002

Objectives: To monitor the prevalence and riskfactors of HIV in high-risk populations, to provide ascientific basis for policy-makers to evaluate theeffectiveness of HIV prevention, and to formulate stra-tegic measures for prevention and treatment.Methods: From 1997 to 2002, 3 110 incarceratedcommercial sex workers (CSWs) and 4 748 outpatientsof a sexually-transmitted disease (STD) departmentunderwent HIV antibody testing in Shenzhen. HIVantibody screening of samples was made by enzymelinked immunosorbent assay (ELISA).Results: Among the outpatients, the proportiondiagnosed with an STD were 71.5%, 70%, 87.5%,87.3%, 85.2%, 82.2%, respectively, in the years from1997 to 2002. The predominant STDs presented weresyphilis, non-gonococcal urethritis (NGU) and condy-loma acuminata (CA). One out-patient was found to beHIV-positive in 2001 and another in 2002, with a preva-lence of 0.25 % (1/400). During the same period, theproportion of CSW who reported always using a con-dom were 45.9%, 49.8%, 40.8%, 57.9%, 44.9%,and 58.2%. 13.4% of CSW were drug users, amongwhom 9.3% used injection drugs and 3.2% reportedsharing syringes with others. One CSW was found tobe HIV-positive in the first survey in 1998 with a preva-lence of 0.4 % (1/250). In 2002, two CSW tested posi-tive in the first semiannual study with a prevalence of0.65% (2/307), and one case in the second study, witha prevalence of 0.48% (1/210).Conclusion: The result of this surveillance indicatethat HIV is prevalent among these high-risk popula-tions of commercial sex workers and STD outpatients.

Study on the blood-borne virus co-infection and T lymphocyte subset among intravenous drug users

AIM： To investigate the features of various blood- borne virus infections and co-infection in intravenous drug users （IDUs）, and to examine the correlation of T lymphocyte subsets with virus co-infection. METHODS： Four hundred and six IDUs without any clinical manifestation of hepatitis and 102 healthy persons were enrolled in this study. HBV-DNA and HCV-RNA were detected by fluorescence quantitative PCR. HBsAg, HBeAg, anti-HBc, anti-HCV, HDV-Ag, anti-HGV, anti-HIV, and HCMV-IgM were assayed by enzyme-linked immunosorbent assay （ELISA） and immunochromatographic tests. The levels of Th1 and Th2 cytokines were measured by ELISA and radioactive immune assay （RIA）. The T lymphocyte subpopulation was detected by using fluorescence immunoassay. The similar indices taken from the healthy persons served as controls. RESULTS： The viral infection rate among IDUs was 36.45% for HBV, 69.7% for HCV, 47.3% for HIV, 2.22% for HDV, 1.97% for HGV, and 3.45% for HCMV. The co- infection rate of blood-borne virus was detected in 255 of 406 （62.81%） IDUs. More than 80% （161/192） of subjects infected with HIV were co-infected with the other viruses, such as HBV, HCV. In contrast, among the controls, the infection rate was 17.65% for HBV and 0% for the other viruses. Our investigation showed that there was a profound decrease in the proportion of CD4/CD8 and the percentage of CD3 and CD4, but not in the percentage of CD8. The levels of PHA-induced cytokines （IFN-γ and IL-4） and serum IL-2 were obviously decreased in IDUs. On the other hand, the level of serum IL-4 was increased. The level of IFN-γ and the percentage of CD4 were continuously decreased when the IDUs were infected with HIV or HIV co-infection. IDUs with HIV and HBV co-infection was 15.1% （29/192）. Of those 29 IDU with HIV and HBV co-infection, 51.72% （15/29） and 37.93% （11/29） were HBV-DNA-positive and HBeAg-positive, respectively. But, among IDUs without HIV infection, only 1.68% （2/119） of cases were HBV- DNA-positive.CONCLUSION： HCV, HBV and HIV infections are common in this population of IDU, leading to a high incidence of impaired Thl cytokine levels and CD4 lymphocyte. IDUs with HIV and HBV/HCV co-infection have lower expression of Th1 cytokine with enhancement of the Th2 response. HIV may be causing HBV replication by decreasing Thl function.

Seasonal Mythologies in the Lyrics of Cowboy Junkies

In many of his most memorable ballads, Cowboy Junkies lyricist and lead guitarist Michael Timmins combines imagery of seasonal change, of the year, notably of Winter, with religious and mythological references to create richly textured metaphors and analogies of love, loss and anguish. Some of the band’s songs which display these symbolic networks and thematic linkages which we Will consider here are “Winter’s Song,” “’Cause Cheap is How I Feel,” “Crescent Moon,” “First Recollection,” “Sad to See the Season Go,” “Good Friday” and “Ring on the Sill.” We will show that Timmins succeeds not only in rendering vivid tableaux of life in a world where Winter dominates the seasonal round, but also in making those exterior visions, in effect, objective correlatives of the inner lives of the characters of his ballads.

Frequency of alcohol and smoking cessation counseling in hepatitis C patients among internists and gastroenterologists

Given the overwhelming evidence that both alcoho consumption and smoking accelerate the progression of hepatitis C virus(HCV)-induced liver disease we evaluated the frequency of alcohol and smoking counseling of patients with HCV-induced liver disease by their primary care internists and gastroenterologists.One hundred and twenty-three medical records of consecutive patients with HCV-induced liver disease referred by an internist to a gastroenterologist for its management were reviewed.Patient gender,race,history of and counseling against alcohol and tobacco use by a physician and a gastroenterologist were obtained A database was created using Microsoft Excel.There were 105 African-Americans,12 Caucasians and six patients of other races/ethnicities.Forty-six(37%)pa- tients were daily tobacco users and 34(28%)patients were daily alcohol consumers.There was a statistically significant difference in the frequencies of alcohol(P= 0.0002)and smoking cessation(P=0.0022)between gastroenterologists and internists.This study reveals that internists and gastroenterologists,alike,inadequately counsel patients with hepatitis C about tobacco and alcohol use.