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Pan X.H.,Zhejiang Provincial Center for Diseases Control and Prevention
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi | Year: 2011

To analyze the relationship between strain subtypes and transmission of HIV infection on marriage-based immigrant women, their spouses and children in rural area of Zhejiang province. Marriage-based immigrant women with HIV infection, their HIV infected spouses and children in rural area in Zhejiang province, were selected as study objects. Analysis on genetic sequence and epidemiologic information was carried out. Subgenomic gag was amplified by nest-PCR analysis on the whole blood samples. Genetic subtype characterization and the source of HIV strains were analyzed. Relationships on sequences were also examined by phylogenetic tree analysis. Genetic sequences of 72 samples from HIV infected marriage-based immigrant women were obtained. The genetic subtypes comprised 21 CRF01_AE (29.2%), 12 CRF07_BC (16.7%), 31 CRF08_BC (43.1%), 6 B (8.3%), 2 C (2.8%). HIV strains from 45 cases (62.5%) were similar to the prevalent HIV strains in the province where former census of marriage-based immigrant women were registered. In total, there were 26 (70.3%) cases from Yunnan province. 84.7% of the infected women had heterosexual behaviors before settling down in Zhejiang province. Genetic sequences of 17 pairs showed the same subtype between the couples and data from phylogenetic tree analysis supported the assumption of transmission linkage in the family. The HIV subtype strains detected in those HIV infected marriage-based immigrant women in the rural area of Zhejiang province characterized with diversity, showing CRF08_BC and CRF01_AE were the main HIV strain subtypes. HIV infection originated mainly from Yunnan province and nearby regions. Heterosexual behaviors of the marriage-based immigrant women in the original region where they had their residence registration, seemed to be the primary high risk factors for these women. Surveillance and intervention programs on these marriage-based immigrant women and their family members should be improved. Source

Chen L.,Zhejiang Provincial Center for Diseases Control and Prevention | Yang J.,Zhejiang Provincial Center for Diseases Control and Prevention | Zhang R.,Zhejiang Provincial Center for Diseases Control and Prevention | Xu Y.,Zhejiang Provincial Center for Diseases Control and Prevention | And 6 more authors.
AIDS Research and Therapy | Year: 2015

Objectives: The objective of this study was to determine the rate of acquired immune deficiency syndrome (AIDS) in Zhejiang province and to identify specific factors associated with progression of this disease. Methods: This study utilized a retrospective cohort to identify the specific factors involved in the progression of human immunodeficiency virus (HIV) to AIDS. We collected data of patients existing in care between 2008 and 2012 from the national surveillance system databases. We performed our analyses using a multivariate Cox proportional hazards model. Results: This study included 9216 HIV-positive patients (75.6 % male), which yielded 12,452 person-years (py) of follow-up-data. The AIDS progression rates were 33.9 % (2008), 33.6 % (2009), 38.1 % (2010), 30.6 % (2011) and 25.9 % (2012). We observed a significant reduction in the rate of progression Of HIV to AIDS post-2010 (Pearson χ2 = 4341.9, P < 0.001). The cumulative AIDS progression incidence rates were 33.4, 35.4, 36.4, 37.0 and 37.04 per 100 py in 1 each of the 5 years of follow-up. This study found that age was an independent risk factor for the progression of HIV to AIDS. Compared with patients infected with HIV by homosexual transmission, patients infected with HIV by heterosexuals transmission or blood transfusion had a reduced hazard ratio (HR) for progression to AIDS (heterosexual transmission: HR = 0.695, 0.524, P = 0.007; blood transfusion: HR = 0.524, P = 0.015). Diagnosed with HIV from 2011 to 2012 and having a higher CD4+ cell count (350-500 cells/mm3; or >500 cells/mm3) at baseline were independently associated with lower rates of HIV progression to AIDS [HR = 0.382, 0.380, 0.187, P < 0.001]. Patients with a CD+ T-cell count of 200-350 cells/mm3 or greater than 350 cells/mm3 were less likely to develop AIDS following HIV diagnosis than were those patients without HAART treatment. Conclusion: This study found a high progression rate from HIV to AIDS in HIV patients residing within Zhejiang province from 2008 to 2010. This rate decreased after 2010, which coincided with the new criteria for HAART treatment, which likely contributed to the observed reduction in the rate of progression. Initiation of HAART with higher CD4+ T-cell count may reduce rate of AIDS progression. Based on our results, we conclude that efficient strategies for HIV screening, as well as early diagnosis and treatment are necessary to reduce the progression of HIV to AIDS. © 2015 Chen et al. Source

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