Co-infection of hepatitis B virus (HBV) and/or hepatitis C virus (HCV) with human immunodeficiency virus (HIV) has an adverse effect on liver disease progression. This study investigated the prevalence of HBV and/or HCV co-infection in HIV-infected patients in Central China. A total of 978 HIV-infected patients from Hunan Province were enrolled. HBV serum markers, anti-hepatitis-C-virus antibody (anti-HCV), HBV DNA, and HBV genotypes were analyzed. The prevalence of hepatitis B surface antigen (HBsAg) and anti-HCV in HIV-infected patients was 19.4 % and 62.4 %, respectively. The prevalence of anti-HCV in HIV-positive intravenous drug users was 93.6 %. Among HBsAg-positive patients, 88.1 % were found to have at least one HBV serum marker. The rates of HIV mono-infection, HBV/HIV dual infection, HCV/HIV dual infection, and HBV/HCV/HIV triple infection were 30.4 %, 7.2 %, 50.2 %, and 12.2 %, respectively. Antibody to HBsAg (Anti-HBs) was more common in anti-HCV-positive than anti-HCV-negative patients (53.3 % vs 40.2 %, P = 0.000), but isolated hepatitis B core antibody (anti-HBc) was more common in anti-HCV-negative than anti-HCV-positive patients (24.2 % vs 12.3 %, P = 0.000). Hepatitis B e antigen (HBeAg) and sexual transmission were independent risk factors for active HBV replication. Intravenous drug use and male sex were independent risk factors, but old age and presence of HBeAg were independent protective factors for anti-HCV. Co-infection of HBV and/or HCV with HIV infection is common in central China. HCV status is associated with anti-HBs and isolated anti-HBc in co-infected patients.
Coxsackievirus A16 (CV-A16) commonly causes mild symptoms, but severe diseases, such as aseptic meningitis, encephalitis, and even fatal cases, have been reported. Thirteen CV-A16 strains were isolated from patients with severe hand, foot, and mouth disease in Yunnan, Southwest China, from 2009 to 2015. Subgenotype B1a and B1b of CV-A16 were predominantly circulating the region with B1b the predominant strain in recent years. The mean rate of nucleotide substitution based on the VP1 gene sequence was 4.545 × 10 substitution per site per year from 2009 to 2015. These results may help in understanding the genetic diversity of CV-A16 and develop a CV-A16 vaccine.
Background Though highly active antiretroviral therapy (HAART) has brought the tremendous benefits to the HIV patients, there are still some patients with low HIV replication after treatment. This study investigated the influencing factors of different levels of viral suppression in HIV-infected patients in Central China. Methods A total of 4424 HIV-infected patients treated in 2016 from Hunan Province were enrolled and divided into 5 groups according to the level of virus replication, characteristics and clinic indicators were analyzed. Results There were 3871 cases (87.5%) who maintained the viral loads under 200 copies/mL after treatment, 261 cases (5.9%) with repeated test results, 57 cases (1.3%) had sustained low-level replication of virus, and 235 cases (5.3%) had long-term high-level replication of virus. Not surprisingly, the trend of CD4 cell counts growth were correlated with the trend of viral loads declination. Age, transmission mode, CD4 cell counts baseline, the interval between test and treat and the final statues between 5 groups were significant differences (P <0.05). Compared with low-level replication group, patients with clinical phase I were more likely be in complete supression group than those with clinical phase IV; Patients transmitted by hetero sex were more likely to be with repeated viral loads than those transmitted by blood transfusion or contaminated blood products or mother-to-child. If we define viral loads always less than 200 copies/mL as the criterion for positive treatment, CD4 cell counts baseline under 500 n/µL and co-infected with HBV were independent risk factors for high HIV-1 replication, but young and test & treat were independent protective factors for viral suppression. Conclusions Early treatment is more effective in inhibiting viral replication, but screening for incomplete viral supression patients should be a routine practice in the management and control of HIV infection.
Aim: Due to the conflict of policies, HIV-1 middle-level viremia during antiretroviral therapy is neglected in China, so its clinical management was retrospectively investigated. Materials & methods: The characteristics and clinical indicators of HIV-1 patients treated in 2016 were analyzed. Results: Of 4370 cases, 1.2% progressed to middle-level viremia and 5.4% had persistent viral loads of ≥1000 copies/ml. Age, transmission mode and the ‘test and treat’ ratio among the three groups were significantly different (p < 0.05). Ordinal regression analysis showed that younger patients with higher CD4 count at baseline achieved better viral suppression if they had treatment as soon as possible. Conclusion: The results supported the ‘test and treat’ policy and suggested that the current treatment standard and testing policies should be adjusted.
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