Distribution of Avian Influenza A Viruses in Poultry-Related Environment and Its Association with Human Infection in Henan, 2016 to 2017

Objective To survey avian influenza A viruses(AIVs) in the environment and explore the reasons for the surge in human H7 N9 cases.Methods A total of 1,045 samples were collected from routine surveillance on poultry-related environments and 307 samples from human H7 N9 cases-exposed environments in Henan from 2016 to2017. The nucleic acids of influenza A(Flu A), H5, H7, and H9 subtypes were detected by real-time polymerase chain reaction.Results A total of 27 H7 N9 cases were confirmed in Henan from 2016 to 2017, 24 had a history of live poultry exposure, and 15 had H7 N9 virus detected in the related live poultry markets(LPMs). About 96%(264/275) Flu A positive-environmental samples were from LPMs. H9 was the main AIV subtype(10.05%) from routine surveillance sites with only 1 H7-positive sample, whereas 21.17% samples were H7-positive in H7 N9 cases-exposed environments. Samples from H7 N9 cases-exposed LPMs(47.56%)had much higher AIVs positive rates than those from routine surveillance sites(12.34%). The H7+H9 combination of mixed infection was 78.18%(43/55) of H7-positive samples and 41.34%(43/104) of H9-positive samples.Conclusion The contamination status of AIVs in poultry-related environments is closely associated with the incidence of human infection caused by AIVs. Therefore, systematic surveillance of AIVs in LPMs in China is essential for the detection of novel reassortant viruses and their potential for interspecies transmission.

Role of feline ANP32 proteins in regulating polymerase activity of influenza A virus

Recently,increasing natural infection cases and experimental animal challenge studies demonstrated domestic cats are susceptible to multiple subtypes influenza A virus(IAV)infections.Notably,some subtype IAV strains could circulate in domestic cats after cross-species transmission and even infected humans,posing a threat to public health.Host factors related to viral polymerase activity could determine host range of IAV and acidic nuclear phosphoprotein 32(ANP32)is the most important one among them.However,role of cat-derived ANP32 on viral polymerase activity and host range of IAV is still unknown.In the present study,a total of 10 feline ANP32(feANP32)splice variants(including 5 feANP32A,3 feANP32B,and 2 feANP32E)were obtained from domestic cats by RT-PCR.Sequence alignment results demonstrated amino acid deletions and/or insertions occurred among feANP32 variants,but all feANP32 proteins were primarily localized to cell nucleus.Minigenome replication systems for several representative IAV strains were established and the support ability of feANP32 on IAV polymerase activity was estimated.The results indicated that most feANP32A and feANP32B splice variants were able to support all the tested IAV strains,though the support activity of a single feANP32 protein on polymerase activity varied among different IAV strains.In addition,the role of feANP32 in supporting H3N2 canine influenza virus was determined by investigating viral replication in vitro.Collectively,our study systematically investigated the support activity of feANP32 on IAV,providing a clue for further exploring the mechanism of susceptibility of cats to IAV.

Hepatitis C virus eradication in people living with human immunodeficiency virus:Where are we now?

Hepatitis C virus(HCV)/human immunodeficiency virus(HIV)co-infection still involves 2.3 million patients worldwide of the estimated 37.7 million living with HIV,according to World Health Organization.People living with HIV(PLWH)are six times greater affected by HCV,compared to HIV negative ones;the greater prevalence is encountered among people who inject drugs and men who have sex with men:the risk of HCV transmission through sexual contact in this setting can be increased by HIV infection.These patients experience a high rate of chronic hepatitis,which if left untreated progresses to end-stage liver disease and hepato-cellular carcinoma(HCC)HIV infection increases the risk of mother to child vertical transmission of HCV.No vaccination against both infections is still available.There is an interplay between HIV and HCV infections.Treatment of HCV is nowadays based on direct acting antivirals(DAAs),HCV treatment plays a key role in limiting the progression of liver disease and reducing the risk of HCC development in mono-and coinfected individuals,especially when used at an early stage of fibrosis,reducing liver disease mortality and morbidity.Since the sustained virological response at week 12 rates were observed in PLWH after HCV eradication,the AASLD has revised its simplified HCV treatment algorithm to also include individuals living with HIV.HCV eradication can determine dyslipidemia,since HCV promotes changes in serum lipid profiles and may influence lipid metabolism.In addition to these apparent detrimental effects on the lipid profile,the efficacy of DAA in HCV/HIV patients needs to be considered in light of its effects on glucose metabolism mediated by improvements in liver function.The aim of the present editorial is to describe the advancement in HCV treatment among PLWH.

Genome-wide comparison inferred the origin and evolution of B-cell epitopes on the proteins of human influenza A virus

The novel strain H1N1 caused the outbreak of first pandemic influenza in 21 century. Now it is a common component of current seasonal influenza viruses. The recent transmission and plentiful genome sequences available provided a good opportunity to study the origin and evolution of epitopes on the proteins of human influenza virus. In the present study, the B-cell epitope compositions in the pandemic strains, circulating traditional seasonal strains, swine strains as well as highly virulent avian strain H5N1 were identified with the aid of the Immune Epitope DataBase (IEDB) and were compared at genomic level. A total of 14210 distinct sequences down-loaded from NCBI database were used for analysis. Some epitopes on proteins HA or NA, not conserved in recent seasonal strains, were found in 2009 pandemic strains but existed in the early human strains (1919-1935). The pandemic strain shared higher conserved epitopes with “bird flu” virus H5N1than classic human seasonal strains. The epitopes that could exist at common antigenic regions of HA protein are needed to further identify. The genetic exchanges between human and swine population by transmission was very active but the princepal side of the transmission could be from swine to human. These results provided valuable information on influenza A virus evolution and transmission by means of epitope analysis at genomic level.

Altered gene expression in human brain microvascular endothelial cells in response to the infection of influenza H1N1 virus

Influenza viruses not only cause respiratory illness,but also have been reported to elicit neurological manifestations following acute viral infection.The central nervous system(CNS)has a specific defense mechanism against pathogens structured by cerebral microvasculature lined with brain endothelial cells to form the blood–brain barrier(BBB).To investigate the response of human brain microvascular endothelial cells(hBMECs)to the Influenza A virus(IAV),we inoculated the cells with the A/WSN/33(H1N1)virus.We then conducted an RNAseq experiment to determine the changes in gene expression levels and the activated disease pathways following infection.The analysis revealed an effective activation of the innate immune defense by inducing the pattern recognition receptors(PRRs).Along with the production of proinflammatory cytokines,we detected an upregulation of interferons and interferon-stimulated genes,such as IFN-β/λ,ISG15,CXCL11,CXCL3 and IL-6,etc.Moreover,infected hBMECs exhibited a disruption in the cytoskeletal structure both on the transcriptomic and cytological levels.The RNAseq analysis showed different pathways and candidate genes associated with the neuroactive ligand-receptor interaction,neuroinflammation,and neurodegenerative diseases,together with a predicted activation of the neuroglia.Likewise,some genes linked with the mitochondrial structure and function displayed a significantly altered expression.En masse,this data supports that hBMECs could be infected by the IAV,which induces the innate and inflammatory immune response.The results suggest that the influenza virus infection could potentially induce a subsequent aggravation of neurological disorders.

Current status of liver transplantation for human immunodeficiency virus-infected patients in China's Mainland

According to the report from the Chinese Center for Disease Control and Prevention,the prevalence of human immunodeficiency virus(HIV)infection exceeded 1.2 million individuals by the year 2022,with an annual increase of about 80000 cases.The overall prevalence of hepatitis B surface antigen among individuals co-infected with HIV reached 13.7%,almost twice the rate of the general population in China.In addition to the well-documented susceptibility to opportunistic infections and new malignancies,HIV infected patients frequently experience liver-related organ damage,with the liver and kidneys being the most commonly affected.This often leads to the development of end-stage liver and kidney diseases.Therefore,organ transplantation has emerged as an important part of active treatment for HIV infected patients.However,the curative effect is not satisfactory.HIV infection has been considered a contraindication for organ transplantation.Until the emergence of highly active anti-retroviral therapy in 1996,the once intractable replication of retrovirus was effectively inhibited.With prolonged survival,the failure of important organs has become the main cause of death among HIV patients.Therefore,transplant centers worldwide have resu-med exploration of organ transplantation for HIV-infected individuals and reached a positive conclusion.This study provides an overview of the current landscape of HIV-positive patients receiving liver transplantation(LT)in main-land China.To date,our transplant center has conducted LT for eight end-stage liver disease patients co-infected with HIV,and all but one,who died two months postoperatively due to sepsis and progressive multi-organ failure,have survived.Comparative analysis with hepatitis B virus-infected patients during the same period revealed no statistically significant differences in acute rejection reactions,cytomegalovirus infection,bacteremia,pulmonary infections,acute kidney injury,new-onset cancers,or vascular and biliary complications.

Establishment of a humanized ST6GAL1 mouse model for influenza research

Background:This study aimed to construct and characterize a humanized influenza mouse model expressing hST6GAL1.Methods:Humanized fragments,consisting of the endothelial cell-specific K18 promoter,human ST6GAL1-encoding gene,and luciferase gene,were microinjected into the fertilized eggs of mice.The manipulated embryos were transferred into the oviducts of pseudopregnant female mice.The offspring were identified using PCR.Mice exhibiting elevated expression of the hST6GAL1 gene were selectively bred for propagation,and in vivo analysis was performed for screening.Expression of the humanized gene was tested by performing immunohistochemical(IHC)analysis.Hematologic and biochemical analyses using the whole blood and serum of humanized hST6GAL1 mice were performed.Results:Successful integration of the human ST6GAL1 gene into the mouse genome led to the overexpression of human SiaT ST6GAL1.Seven mice were identified as carrying copies of the humanized gene,and the in vivo analysis indicated that hST6GAL1gene expression in positive mice mirrored influenza virus infection characteristics.The IHC results revealed that hST6GAL1 was expressed in the lungs of humanized mice.Moreover,the hematologic and biochemical parameters of the positive mice were within the normal range.Conclusion:A humanized influenza mouse model expressing the hST6GAL1 gene was successfully established and characterized.

Retrospective analysis of patients with hepatocellular carcinoma complicated with human immunodeficiency virus infection after hepatectomy

BACKGROUND Hepatocellular carcinoma(HCC)is the third leading cause of cancer death worldwide,with a 5-year relative survival rate of approximately 18%.The similarity between incidence and mortality(830000 deaths per year)underscores the bleak prognosis associated with the disease.HCC is the fourth most common malignancy and the second leading cause of cancer death in China.Most patients with HCC have a history of chronic liver disease such as chronic hepatitis B virus(HBV)or hepatitis C virus(HCV)infection,alcoholism or alcoholic steatohepatitis,nonalcoholic fatty liver disease,or nonalcoholic steatohepatitis.Early diagnosis and effective treatment are the keys to improving the prognosis of patients with HCC.Although the total number of human immunodeficiency virus(HIV)-infected patients is declining globally the incidence of HCC is increasing in HIVinfected patients,especially those who are coinfected with HBV or HCV.As a result,people infected with HIV still face unique challenges in terms of their risk of developing HCC.AIM To investigate the survival prognosis and clinical efficacy of surgical resection in patients with HCC complicated with HIV infection.METHODS The clinical data of 56 patients with HCC complicated with HIV admitted to the Third Affiliated Hospital of Nantong University from January 2013 to December 2023 were retrospectively analyzed.Among these,27 patients underwent hepatectomy(operation group)and 29 patients received conservative treatment(nonoperation group).All patients signed informed consents in line with the provisions of medical ethics.The general data,clinicopathological features and prognoses for the patients in the two groups were analyzed and the risk factors related to the prognoses of the patients in the operation group were identified.RESULTS The median disease-free survival(DFS)and overall survival(OS)of HIV-HCC patients in the surgical group were 13 months and 17 months,respectively,and the median OS of patients in the nonsurgical group was 12 months.The OS of the surgical group was significantly longer than that of the control group(17 months vs 12 months,respectively;P<0.05).The risk factors associated with DFS and OS in the surgical group were initial HIV diagnosis,postoperative microvascular invasion(MVI),a CD4+T-cell count<200/μL,Barcelona stage C-D,and men who have sex with men(MSM;P<0.05).CONCLUSION Hepatectomy can effectively prolong the survival of patients with HIV-HCC but MVI identified during postoperative pathological examination,late tumor detection,late BCLC stage,CD4+T<200/μL and MSM are risk factors affecting the survival and prognosis of patients undergoing hepatectomy.In addition,there were significant differences between the surgical group and the nonsurgical group in terms of the initial diagnosis of HIV,Child-Pugh score,alpha-fetoprotein measurement value,and HART-efficient antiretroviral therapy after the diagnosis of HIV(P<0.05).Therefore,these factors may also affect the survival and prognosis of patients.

Effectiveness of onsite and online education in enhancing knowledge and use of human immunodeficiency virus pre-and postexposure prophylaxis

BACKGROUND Enhancing awareness and use of pre-exposure prophylaxis(PrEP)and postexposure prophylaxis(PEP)is vital to curb human immunodeficiency virus(HIV)spread.High-risk behaviors prevalent among sexually transmitted infection clinic outpatients underscore the need for increased PrEP/PEP education in this group.AIM To investigate the effects of both onsite and online health education on the knowledge of,and willingness to use,PrEP and PEP among individuals receiving PEP services.METHODS Participants were drawn from a cohort study on PEP service intervention at an STD/AIDS outpatient clinic in designated HIV/AIDS hospitals in Beijing,conducted from January 1 to June 30,2022.Health education was provided both onsite and online during follow-up.Surveys assessing knowledge of,and willingness to use,PrEP/PEP were administered at baseline and again at 24 wk post-intervention.RESULTS A total of 112 participants were enrolled in the study;105 completed the follow-up at week 24.The percentage of participants with adequate knowledge of,and willingness to use,PrEP significantly increased from 65.2%and 69.6%at baseline to 83.8%and 82.9%at the end of the intervention(both P<0.05).Similarly,those with adequate knowledge of,and willingness to use,PEP increased from 74.1%and 77.7%at baseline to 92.4%and 89.5%at week 24(P<0.05).Being between 31 years and 40 years of age,having a postgraduate degree or higher,and reporting a monthly expenditure of RMB 5000 or more were found to be significantly associated with knowledge of PrEP and PEP(both P<0.05).CONCLUSION The findings show that both onsite and online health education significantly improved the knowledge of,and increased willingness to use,PrEP and PEP in individuals utilizing PEP services.

Oncological features and prognosis of colorectal cancer in human immunodeficiency virus-positive patients: A retrospective study

BACKGROUND Due to the prolonged life expectancy and increased risk of colorectal cancer(CRC)among patients with human immunodeficiency virus(HIV)infection,the prognosis and pathological features of CRC in HIV-positive patients require examination.AIM To compare the differences in oncological features,surgical safety,and prognosis between patients with and without HIV infection who have CRC at the same tumor stage and site.METHODS In this retrospective study,we collected data from HIV-positive and-negative patients who underwent radical resection for CRC.Using random stratified sampling,24 HIV-positive and 363 HIV-negative patients with colorectal adenocarcinoma after radical resection were selected.Using propensity score matching,we selected 72 patients,matched 1:2(HIV-positive:negative=24:48).Differences in basic characteristics,HIV acquisition,perioperative serological indicators,surgical safety,oncological features,and long-term prognosis were compared between the two groups.RESULTS Fewer patients with HIV infection underwent chemotherapy compared to patients without.HIV-positive patients had fewer preoperative and postoperative leukocytes,fewer preoperative lymphocytes,lower carcinoembryonic antigen levels,more intraoperative blood loss,more metastatic lymph nodes,higher node stage,higher tumor node metastasis stage,shorter overall survival,and shorter progression-free survival compared to patients who were HIV-negative.CONCLUSION Compared with CRC patients who are HIV-negative,patients with HIV infection have more metastatic lymph nodes and worse long-term survival after surgery.Standard treatment options for HIV-positive patients with CRC should be explored.

Correlation analysis of human papillomavirus E6/E7 mRNA detection with diagnosis,prognosis and recurrence risk in patients with cervical epithelioma

BACKGROUND Cervical intraepithelial neoplasia(CIN)is an important precursor of cervical cancer.Early detection and treatment can reduce the incidence of cervical cancer.AIM To investigate the detection rate of human papillomavirus(HPV)E6/E7 mRNA in cervical tissue of patients with different types of epithelial cell neoplasia(CIN)and its relationship with CIN progression and diagnosis.METHODS One hundred women with HPV infection detected by cervical exfoliation cytology between January 2022 and January 2023 were retrospectively selected.These patients were graded CIN based on colposcopy and cervical pathology.The positive expression rates of HPV E6/E7 mRNA and HPV[polymerase chain reaction(PCR)-reverse dot crossing]were compared among all groups.Patients with HPV E6/E7 mRNA expression in the grade 1 CIN group were followed up for 1 yr.The relationship between atypical squamous epithelium and high malignant epithelial neoplasia was investigated by univariate and multivariate analysis.RESULTS The diagnostic sensitivity,specificity,and sensitivity of PCR-reverse point hybrid ization technology for secondary CIN were 70.41%,70.66%,and 0.714,respectively.Sensitivity and specificity for secondary CIN were 752%and 7853%,respectively,the area under the curve value was 0.789.Logistic Multifactorial model analysis revealed that the HPV positive rates and the HPV E6/E7 mRNA positive rates were independent risk factors of CIN grade I(P<0.05).In CIN grade I patients with positive for HPV E6/E7 mRNA,in its orientation to grade CIN patients,in its orientation to grade CIN patients,at 69.2%,compared with patients negative for HPV E6/E7 mRNA(30.8%),significant difference(P<0.05).CONCLUSION HPV E6/E7 mRNA and HPV(PCR-reverse dot hybrid)positive expression have a close relationship with CINgrade disease progression and is an independent risk factor for high-grade CIN lesions.

Preferences for oral-vs blood-based human immunodeficiency virus self-testing:A scoping review of the literature

BACKGROUND The evidence on preferences for oral-vs blood-based human immunodeficiency virus self-testing(HIVST)has been heterogenous and inconclusive.In addition,most evaluations have relied on hypothetical or stated use cases using discreet choice experiments rather than actual preferences among experienced users,which are more objective and critical for the understanding of product uptake.Direct head-to-head comparison of consumer preferences for oral-versus bloodbased HIVST is lacking.AIM To examine the existing literature on preferences for oral-vs blood-based HIVST,determine the factors that impact these preferences,and assess the potential implications for HIVST programs.METHODS Databases such as PubMed,Medline,Google Scholar,and Web of Science were searched for articles published between January 2011 to October 2022.Articles must address preferences for oral-vs blood-based HIVST.The study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist to ensure the quality of the study.RESULTS The initial search revealed 2424 records,of which 8 studies were finally included in the scoping review.Pooled preference for blood-based HIVST was 48.8%(9%-78.6%),whereas pooled preference for oral HIVST was 59.8%(34.2%-91%)across all studies.However,for male-specific studies,the preference for blood-based HIVST(58%-65.6%)was higher than that for oral(34.2%-41%).The four studies that reported a higher preference for blood-based HIVST were in men.Participants considered blood-based HIVST to be more accurate and rapid,while those with a higher preference for oral HIVST did so because these were considered non-invasive and easy to use.CONCLUSION Consistently in the literature,men preferred blood-based HIVST over oral HIVST due to higher risk perception and desire for a test that provides higher accuracy coupled with rapidity,autonomy,privacy,and confidentiality,whereas those with a higher preference for oral HIVST did so because these were considered non-invasive and easy to use.Misinformation and distrust need to be addressed through promotional messaging to maximize the diversity of this new biomedical technology.

Rapid inactivation of human respiratory RNA viruses by deep ultraviolet irradiation from light-emitting diodes on a high-temperatureannealed AlN/Sapphire template

Efficient and eco-friendly disinfection of air-borne human respiratory RNA viruses is pursued in both public environment and portable usage.The AlGaN-based deep ultraviolet(DUV)light-emission diode(LED)has high practical potentials because of its advantages of variable wavelength,rapid sterilization,environmental protection,and miniaturization.Therefore,whether the emission wavelength has effects on the disinfection as well as whether the device is feasible to sterilize various respiratory RNA viruses under portable conditions is crucial.Here,we fabricate AlGaN-based DUV LEDs with different wavelength on high-temperature-annealed(HTA)AlN/Sapphire templates and investigate the inactivation effects for several respiratory RNA viruses.The AlN/AlGaN superlattices are employed between the template and upper n-AlGaN to release the strong compressive stress(SCS),improving the crystal quality and interface roughness.DUV LEDs with the wavelength of 256,265,and 278 nm,corresponding to the light output power of 6.8,9.6,and 12.5 mW,are realized,among which the 256 nm-LED shows the most potent inactivation effect in human respiratory RNA viruses,including SARS-CoV-2,influenza A virus(IAV),and human parainfluenza virus(HPIV),at a similar light power density(LPD)of~0.8 mW/cm2 for 10 s.These results will contribute to the advanced DUV LED application of disinfecting viruses with high potency and broad spectrum in a portable and eco-friendly use.

Outcomes of ABO-incompatible liver transplantation in end-stage liver disease patients co-infected with hepatitis B and human immunodeficiency virus

BACKGROUND Human immunodeficiency virus(HIV)-positive patients coinfected with hepatitis B virus(HBV)are eligible for liver transplantation(LT)in Africa and Southeast Asia,particularly China.However,the outcome of HIV-HBV coinfected patients referred for ABO-incompatible LT(ABOi-LT)is unknown.AIM To clarify the outcome of ABOi-LT for HIV-HBV coinfected patients with endstage liver disease(ESLD).METHODS We report on two Chinese HIV-HBV coinfected patients with ESLD who underwent A to O brain-dead donor LT and reviewed the literature on HIV-HBV coinfected patients treated with ABO-compatible LT.The pretransplantation HIV viral load was undetectable,with no active opportunistic infections.Induction therapy consisted of two sessions of plasmapheresis and a single dose of rituximab in two split doses,followed by an intraoperative regimen of intravenous immunoglobulin,methylprednisolone,and basiliximab.Post-transplant maintenance immunosuppressive agents consisted of tacrolimus and mycophenolate mofetil,and prednisone.RESULTS At the intermediate-term follow-up,patients showed undetectable HIV viral load,CD4(+)T cell counts greater than 150 cells/μL,no HBV recurrence,and stable liver function.A liver allograft biopsy showed no evidence of acute cellular rejection.Both patients survived at 36-42 mo of follow-up.CONCLUSION This is the first report of ABOi-LT in HIV-HBV recipients with good intermediate-term outcomes,suggesting that ABOi-LT may be feasible and safe for HIV-HBV coinfected patients with ESLD.

Nonmuscle myosin IIA promotes the internalization of influenza A virus and regulates viral polymerase activity through interacting with nucleoprotein in human pulmonary cells

Influenza A virus(IAV),responsible for seasonal epidemics and recurring pandemics,represents a global threat to public health.Given the risk of a potential IAV pandemic,it is increasingly important to better understand virushost interactions and develop new anti-viral strategies.Here,we reported nonmuscle myosin IIA(MYH9)-mediated regulation of IAV infection.MYH9 depletion caused a profound inhibition of IAV infection by reducing viral attachment and internalization in human lung epithelial cells.Surprisingly,overexpression of MYH9 also led to a significant reduction in viral productive infection.Interestingly,overexpression of MYH9 retained viral attachment,internalization,or uncoating,but suppressed the viral ribonucleoprotein(vRNP)activity in a minigenome system.Further analyses found that excess MYH9 might interrupt the formation of vRNP by interacting with the viral nucleoprotein(NP)and result in the reduction of the completed vRNP in the nucleus,thereby inhibiting subsequent viral RNA transcription and replication.Together,we discovered that MYH9 can interact with IAV NP protein and engage in the regulation of vRNP complexes,thereby involving viral replication.These findings enlighten new mechanistic insights into the complicated interface of host-IAV interactions,ultimately making it an attractive target for the generation of antiviral drugs.

Reservoir of human immunodeficiency virus in the brain:New insights into the role of T cells

Human immunodeficiency virus(HIV)infection of the central nervous system(CNS)has attracted significant attention because it contributes to severe complications of acquired immunodeficiency syndrome(AIDS)and seriously impairs the life quality of infected patients.In this review,we briefly describe the latent infection of HIV in CNS and focus on the role of the important immune cells,such as T cells,in the formation and maintenance of the HIV reservoir in CNS.This review explores the mechanisms by which T cells enter CNS and establish latent infection of HIV in the CNS.In conclusion,we summarize the role of these cells in the interaction between HIV and CNS.With our better understanding of the underlying mechanisms,we propose future directions for the development of novel strategies to eliminate HIV reservoirs in the CNS based on cellular components.

Benign lymphoepithelial cyst of parotid gland without human immunodeficiency virus infection:A case report

BACKGROUND Benign lymphoepithelial cyst(BLEC)of the parotid gland is a rare benign embryonic-dysplastic cystic tumor in the anterolateral neck that occurs most commonly in human immunodeficiency virus(HIV)-positive adults and rarely in non-acquired immune deficiency syndrome patients.The main presentation is a slow-growing,painless mass,and secondary infection may cause acute inflammatory symptoms.CASE SUMMARY A 44-year-old Chinese male patient presented with a 1-year history of a mass in the left side of the neck.On physical examination,a mass similar in size and shape to a quail egg was found in the left parotid gland.The mass was tough,without tenderness,and easily moveable.The results of HIV tests,including antibody and nucleic acid tests and CD4+T cell examination,were negative.Imaging examination revealed a left parotid gland mass.The patient underwent surgical treatment,and BLEC was diagnosed based on postoperative pathology.After 2years of follow-up,the patient survived well without related discomfort.CONCLUSION The detailed characteristics of a BLEC in a patient without HIV infection contribute to an improved understanding of this rare disease.

Glucose metabolism continuous deteriorating in male patients with human immunodeficiency virus accepted antiretroviral therapy for 156 weeks

BACKGROUND The dynamic characteristics of glucose metabolism and its risk factors in patients living with human immunodeficiency virus(PLWH)who accepted primary treatment with the efavirenz(EFV)plus lamivudine(3TC)plus tenofovir(TDF)(EFV+3TC+TDF)regimen are unclear and warrant investigation.AIM To study the long-term dynamic characteristics of glucose metabolism and its contributing factors in male PLWH who accepted primary treatment with the EFV+3TC+TDF regimen for 156 wk.METHODS This study was designed using a follow-up design.Sixty-one male treatmentnaive PLWH,including 50 cases with normal glucose tolerance and 11 cases with prediabetes,were treated with the EFV+3TC+TDF regimen for 156 wk.The glucose metabolism dynamic characteristics,the main risk factors and the differences among the three CD4+count groups were analyzed.RESULTS In treatment-naive male PLWH,regardless of whether glucose metabolism disorder was present at baseline,who accepted treatment with the EFV+3TC+TDF regimen for 156 wk,a continuous increase in the fasting plasma glucose(FPG)level,the rate of impaired fasting glucose(IFG)and the glycosylated hemoglobin(HbA1c)level were found.These changes were not due to insulin resistance but rather to significantly reduced isletβcell function,according to the homeostasis model assessment ofβcell function(HOMA-β).Moreover,the lower the baseline CD4+T-cell count was,the higher the FPG level and the lower the HOMA-βvalue.Furthermore,the main risk factors for the FPG levels were the CD3+CD8+cell count and viral load(VL),and the factors contributing to the HOMA-βvalues were the alanine aminotransferase level,VL and CD3+CD8+cell count.CONCLUSION These findings provide guidance to clinicians who are monitoring FPG levels closely and are concerned about IFG and decreased isletβcell function during antiretroviral therapy with the EFV+3TC+TDF regimen for long-term application.

Anti-phospholipase A2 receptor-associated membranous nephropathy with human immunodeficiency virus infection treated with telitacicept:A case report

BACKGROUND The co-occurrence of Anti-phospholipase A2 receptor-associated membranous nephropathy(anti-PLA2R-MN)and human immunodeficiency virus(HIV)infection is a rare clinical scenario,presenting significant challenges in terms of management and treatment.CASE SUMMARY A 32-year-old Chinese male diagnosed with HIV infection presented with a clinical history of proteinuria persisting for over two years.A kidney biopsy demonstrated subepithelial immune complex deposition and a thickened glomerular basement membrane,indicative of stage I-II membranous nephro-pathy.Immunofluorescence staining revealed granular deposition of PLA2R(3+)along the glomerular capillary loops,corroborated by a strongly positive anti-PLA2R antibody test(1:320).Initial treatment involving losartan potassium,rivaroxaban,tacrolimus,and rituximab was discontinued due to either poor effec-tiveness or the occurrence of adverse events.Following a regimen of weekly subcutaneous injections of telitacicept(160 mg),a marked decline in the 24 h urine protein was observed within a three-month period,accompanied by a rise in serum albumin level.No significant reductions in peripheral blood CD3+CD4+T and CD3+CD8+T cell counts were detected.The patient's physical and psychological conditions showed significant improvements,with no adverse events reported during the treatment course.CONCLUSION Telitacicept might offer a potential therapeutic avenue for patients diagnosed with anti-PLA2R-MN concomitant with HIV infection.

Penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive man: A case report

BACKGROUND Penoscrotal constriction devices are either used as autoerotic stimuli or to increase sexual pleasure or performance by maintaining an erection for a longer period,and a variety of metallic and non-metallic objects are used.On the other hand,penile strangulation is a rare urologic emergency that requires prompt evaluation and intervention to prevent long-term complications.The goal of treating penile incarceration is to remove the foreign object as soon as possible.On the other hand,removal can be very challenging,and often requires resourcefulness and a multidisciplinary approach.CASE SUMMARY A 47-year-old man who has sex with men was transferred to our hospital for persistent phallodynia and scrotal pain,accompanying swelling due to strangulation by stainless steel rings.His medical history included acquired immunodeficiency syndrome.One day prior,he had put three stainless steel rings on his penis and scrotum before sexual intercourse.After sexual intercourse,he was unable to remove them,due to swelling of his penis and scrotum.The swelling persisted,and he felt pain in the affected area the next day,then he was transferred to our hospital by ambulance.The emergency department found that his penis and scrotum were markedly engorged and swollen.We established a diagnosis of penile and scrotal strangulation by stainless steel rings.We unsuccessfully attempted to cut the rings using a cutter,then requested a rescue team via emergency medical service.They cut through each ring in two places,using an electric-powered angle grinder,and successfully removed all of the pieces.Finally,he was discharged and went home.CONCLUSION We report the first case of penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive person.