A patient of ALS like disorder in an HIV 1 clade C infected heterosexual m ale is being reported. A 37 year old gentleman presented with subacute, progre ssive asymmetrical onset of weakness and wasting of upper limbs...A patient of ALS like disorder in an HIV 1 clade C infected heterosexual m ale is being reported. A 37 year old gentleman presented with subacute, progre ssive asymmetrical onset of weakness and wasting of upper limbs associated with brisk muscle stretch reflexes and without any sensory or sphincter involvement. While nerve conduction tests were normal, the EMG of proximal and distal limb mu scles on both sides revealed evidence of denervation and reinnervation. Routine blood and urine tests and investigations for underlying causes of motor neuron d isease were noncontributory. He was HIV 1, subtype clade C seropositive. A diag nosis of HIV related anterior horn cell disease was considered and zidovudine, lamivudine and nevirapine were started. After 1 month, there was a subjective im provement of 10%and objective improvement in strength of muscles of proximal up per limb on both sides by one grade power on MRC scale. Reports of amyotrophic l ateral sclerosis (ALS) like illness in HIV are sparse. The reversibility of “A LS” like features in this subgroup of patients might offer an insight into the pathogenesis of amyotrophic lateral sclerosis. This is a first report of ALS l ike illness caused by subtype C of HIV 1 strain.展开更多
This study aimed to reconstruct the origin and worldwide epidemic history of human immunodeficiency virus(HIV)1 subtype C and comprehend how HIV-1 subtype C was introduced into and spread throughout China in the formo...This study aimed to reconstruct the origin and worldwide epidemic history of human immunodeficiency virus(HIV)1 subtype C and comprehend how HIV-1 subtype C was introduced into and spread throughout China in the formof B/C recombinant strains.Envelope sequences ofHIV-1 subtype C and some other subtypes deposited before December 31,2020 were downloaded from the Los Alamos HIV Database and the Chinese National Center for AIDS/STD Control and Prevention Database.The available sequences were screened for quality,and Bayesian analysis was used to build the maximum clade credibility evolutionary tree to analyze and judge the origin and spread of HIV-1 subtype C.HIV-1 subtype C originated in central Africa around 1952,then spread to southern Africa around 1969 and to eastern Africa around 1973.HIV-1 subtype C fromsouthern Africa was introduced into India in 1977.HIV-1 subtype C of eastern Africa was introduced into Brazil in 1987.Indian HIV-1 subtype C was exported to China in three migration events during the period from 1986 to 1989.The two predominant recombinants in China(CRF07_BC and CRF08_BC)emerged in 1988 and 1990,respectively.Other B/C recombinants,namely,CRF64_BC,CRF61_BC and CRF62_BC,originated in 1993,2002 and 2000,respectively.Our study has reconstructed the global origin and evolutionary history of HIV-1 subtype C.In addition,our study demonstrated that the Chinese HIV-1 subtype C originated from three related Indian lineages around the mid to late 1980s and,since then,has formed some B/C recombinants with subtype B that caused a widespread epidemic in China.展开更多
文摘A patient of ALS like disorder in an HIV 1 clade C infected heterosexual m ale is being reported. A 37 year old gentleman presented with subacute, progre ssive asymmetrical onset of weakness and wasting of upper limbs associated with brisk muscle stretch reflexes and without any sensory or sphincter involvement. While nerve conduction tests were normal, the EMG of proximal and distal limb mu scles on both sides revealed evidence of denervation and reinnervation. Routine blood and urine tests and investigations for underlying causes of motor neuron d isease were noncontributory. He was HIV 1, subtype clade C seropositive. A diag nosis of HIV related anterior horn cell disease was considered and zidovudine, lamivudine and nevirapine were started. After 1 month, there was a subjective im provement of 10%and objective improvement in strength of muscles of proximal up per limb on both sides by one grade power on MRC scale. Reports of amyotrophic l ateral sclerosis (ALS) like illness in HIV are sparse. The reversibility of “A LS” like features in this subgroup of patients might offer an insight into the pathogenesis of amyotrophic lateral sclerosis. This is a first report of ALS l ike illness caused by subtype C of HIV 1 strain.
基金supported by Science Priority Grant(2019SKLID602)the State Key Laboratory of Infectious Disease Prevention and Control,and the National Natural Science Foundation of China(grant number:81861138011).
文摘This study aimed to reconstruct the origin and worldwide epidemic history of human immunodeficiency virus(HIV)1 subtype C and comprehend how HIV-1 subtype C was introduced into and spread throughout China in the formof B/C recombinant strains.Envelope sequences ofHIV-1 subtype C and some other subtypes deposited before December 31,2020 were downloaded from the Los Alamos HIV Database and the Chinese National Center for AIDS/STD Control and Prevention Database.The available sequences were screened for quality,and Bayesian analysis was used to build the maximum clade credibility evolutionary tree to analyze and judge the origin and spread of HIV-1 subtype C.HIV-1 subtype C originated in central Africa around 1952,then spread to southern Africa around 1969 and to eastern Africa around 1973.HIV-1 subtype C fromsouthern Africa was introduced into India in 1977.HIV-1 subtype C of eastern Africa was introduced into Brazil in 1987.Indian HIV-1 subtype C was exported to China in three migration events during the period from 1986 to 1989.The two predominant recombinants in China(CRF07_BC and CRF08_BC)emerged in 1988 and 1990,respectively.Other B/C recombinants,namely,CRF64_BC,CRF61_BC and CRF62_BC,originated in 1993,2002 and 2000,respectively.Our study has reconstructed the global origin and evolutionary history of HIV-1 subtype C.In addition,our study demonstrated that the Chinese HIV-1 subtype C originated from three related Indian lineages around the mid to late 1980s and,since then,has formed some B/C recombinants with subtype B that caused a widespread epidemic in China.
