China and HIV — A Window of Opportunity

Gill, Bates; Okie, Susan

doi:10.1056/nejmp078010

Cited by 46 publications

(50 citation statements)

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“…This may have been partly a result of the increasing number of immunocompromised patients, especially as a result of the prevalence of AIDS after 1985 and the increasing number of organ transplants, and partly because of increased vigilance in the detection of PCP by medical staff. Among the six regions (Guangxi, Henan, Beijing, Guangdong, Shanghai and Zhejiang) with the highest number of PCP cases, Guangxi, Henan and Guangdong showed a severe situation with regard to the spread of AIDS (Gill & Okie, 2007;Sheng & Cao, 2008;Wang, 2007;Yin et al, 2003), with accumulative numbers of HIV/AIDS patients lying in the top five in mainland China. Some big cities, such as Beijing and Shanghai, accumulate a large population of experienced, distinguished doctors, and thousands of patients converged from all over the country to the bigger cities in pursuit of better medication every year.…”

Section: Discussionmentioning

confidence: 99%

“…After 1985, when the first AIDS patient was discovered, HIV/AIDS predominated as the underlying disease and the number of HIV/AIDSassociated PCP cases increased very rapidly. This rise in number was especially obvious after 1995 when HIV/AIDS entered an intensive epidemic period in mainland China (Gill & Okie, 2007;Sheng & Cao, 2008;Wang, 2007). In non-HIV-infected PCP patients, organ transplantation was the most common underlying disease.…”

Section: Discussionmentioning

confidence: 99%

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Retrospective study of Pneumocystis pneumonia over half a century in mainland China

Wang

Wei

et al. 2011

Journal of Medical Microbiology

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A retrospective study was performed on case reports of Pneumocystis pneumonia (PCP) from 1959 to 2009 in mainland China. The epidemiological characteristics of PCP over half a century were investigated over two time spans. The first was from 1959, when the first incidence of PCP was reported, to 1984, before the emergence of AIDS in mainland China. The second was from 1985, when the first AIDS case was reported in mainland China, to the end of 2009. A total of 2351 PCP cases were reported during these two time spans, covering a 51-year period. Only seven PCP cases were reported during the first time span. Six were diagnosed by autopsy, accordingly without treatment, whilst the other was diagnosed by open lung biopsy in a living patient who eventually recovered following treatment with sulfadiazine and pyrimethamine. The other 2344 PCP cases were reported during the second time span ) from 21 provinces, four municipalities and three autonomous regions. Among the 2344 PCP cases, 70.22 % (1646/2344) were identified together with human immunodeficiency virus (HIV) infection or were in AIDS patients. The remaining 698 non-HIV-infected patients had undergone organ transplantation, had other underlying diseases such as malignancy or hypoimmunity, or had undetermined diagnosis. The results of statistical analysis indicated that AIDS was the most common underlying disease of PCP for patients ,1 year and .14 years. For patients aged between 1 and 14 years, haematological malignancy was the most common underlying disease. The trend of the underlying diseases changed with time, showing that the number of PCP patients afflicted by HIV/AIDS increased dramatically, reaching almost threefold during the most recent 5 years compared with the level of the previous 10 years. The number of patients undergoing organ transplantation or with other underlying diseases rose constantly, but the number of malignancies tended to decline from 1995-2004 to 2005-2009. During the second time span (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009), most of the patients (97.61 %) were diagnosed alive and only 56 cases (2.39 %) were identified by autopsy. The mortality of PCP patients treated with anti-Pneumocystis drugs was 14.61 % for those with HIV/AIDS and 15.84 % for those without HIV/AIDS. For the PCP patients without anti-Pneumocystis treatment, all (100 %) of the HIV/AIDS-associated PCP patients died, whilst 13.79 % (4/29) of non-HIV-infected PCP patients survived. These data from epidemiological investigation of PCP in China over a period of half a century may provide useful information for prevention and the development of treatment of PCP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Retrospective study of Pneumocystis pneumonia over half a century in mainland China

Wang

Wei

et al. 2011

Journal of Medical Microbiology

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“…China has rapidly scaled up first-line ART. Approximately 24,400 people were receiving therapy by the end of 2006 (Gill & Okie, 2007). This number increased up to 52,000, including approximately 1,000 children, by August 2008 (Zhang et al, 2009;S.…”

Section: Hiv Care System In Chinamentioning

confidence: 99%

“…Most HIV-infected individuals in China live in rural areas where both medical and technical resources are limited (Gill & Okie, 2007;Shao, 2006). There is growing concern that the side effects of first-line drugs may lead to poor adherence and drug resistance.…”

Section: Hiv Care System In Chinamentioning

confidence: 99%

Strengthening Nurses' Capacity to Provide HIV Care in China

Zhao¹

2010

Journal of the Association of Nurses in AIDS Care

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“…1 In response to the growing HIV epidemic, the Chinese government initiated The China Comprehensive AIDS Response (China CARES) program in 2003, and began providing free access to antiretroviral therapy (ART) and related health care services to HIV-infected people. 2 The ART program initially focused on the people who contracted HIV through illicit blood and plasma donations as well as blood transfusion in the mid-1990s, and then scaled up to other HIV-infected populations, including drug users, commercial sex workers, pregnant women, and children. 3 This program now covers low-income HIV=AIDS patients in urban areas and all patients in rural areas.…”

Section: Introductionmentioning

confidence: 99%

Consistent ART Adherence Is Associated with Improved Quality of Life, CD4 Counts, and Reduced Hospital Costs in Central China

Wang

Zhou

et al. 2009

AIDS Research and Human Retroviruses

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This study aimed to assess levels of ART adherence and to examine the relationship between adherence and treatment outcomes. A longitudinal study in Hunan and Hubei provinces used the CPCRA Antiretroviral Medication Self-Report and a 7-day Visual Analogue Scale to assess levels of adherence, while quality of life was evaluated using SF-36. CD4 cell count and the number, duration, and cost of hospitalizations were collected from participant medical records. Measurements were obtained at baseline, month 3, and month 6. A total of 113 participants enrolled and 98 completed the study. The mean level of adherence was 91%, 89%, and 88% at baseline and at 3 and 6 months, respectively. Of participants, 54=98 (58%) reported taking all doses at all three interviews and were classified as consistent adherers (CA). CAs had better physical function ( p ¼ 0.001), general health ( p ¼ 0.009), vitality ( p ¼ 0.016), social functioning ( p ¼ 0.001), and mental health ( p ¼ 0.023), and presented a higher CD4 cell count ( p ¼ 0.028). CAs also had fewer hospital admissions and readmissions ( p ¼ 0.005), shorter hospital stays ( p ¼ 0.005), and lower hospital expenses ( p ¼ 0.006). Consistent adherence is associated with better outcomes including improved quality of life, higher CD4 counts, and lower health care costs.

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China and HIV — A Window of Opportunity

Cited by 46 publications

References 0 publications

Retrospective study of Pneumocystis pneumonia over half a century in mainland China

Retrospective study of Pneumocystis pneumonia over half a century in mainland China

Strengthening Nurses' Capacity to Provide HIV Care in China

Consistent ART Adherence Is Associated with Improved Quality of Life, CD4 Counts, and Reduced Hospital Costs in Central China

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