[Show abstract][Hide abstract] ABSTRACT: During early HIV-1 infection (EHI), the interaction between the immune response and the virus determines disease progression. Although CD1c + myeloid dendritic cells (mDCs) can trigger the immune response, the relationship between CD1c + mDC alteration and disease progression has not yet been defined.
EHI changes in CD1c + mDC counts, surface marker (CD40, CD86, CD83) expression, and IL-12 secretion were assessed by flow cytometry in 29 patients.
When compared with the normal controls, patients with EHI displayed significantly lower CD1c + mDC counts and IL-12 secretion and increased surface markers. CD1c + mDC counts were positively correlated with CD4+ T cell counts and inversely associated with viral loads. IL-12 secretion was only positively associated with CD4+ T cell counts. Rapid progressors had lower counts, CD86 expression, and IL-12 secretion of CD1c + mDCs comparing with typical progressors. Kaplan-Meier analysis and Cox regression models suggested patients with low CD1c + mDC counts (<10 cells/μL) had a 4-fold higher risk of rapid disease progression than those with high CD1c + mDC counts. However, no relationship was found between surface markers or IL-12 secretion and disease progression.
During EHI, patients with low CD1c + mDC counts were more likely to experience rapid disease progression than those with high CD1c + mDC counts.
[Show abstract][Hide abstract] ABSTRACT: Background
Human immunodeficiency virus (HIV)-positive cases associated with men who have sex with men (MSM) have rapidly increased over the past years. The objective of this study is to comprehensively evaluate the proportions, changing trends, and geographical distribution of MSM-associated HIV cases from Chinese voluntary blood donors by systematically reviewing the available literature.Study Design and Methods
Major English and Chinese research databases were searched for studies reporting study locations, study years, the number of HIV infections among blood donors, and the number of HIV-positive donations associated with MSM in China. The proportion estimates were calculated; subgroup analyses and test for time trend were performed using software of comprehensive meta-analysis.ResultsThirty-four studies met eligibility criteria. The pooled proportion of HIV-positive donations associated with MSM from 2001 to 2012 was 36.5% (95% confidence interval, 29.6%-44.1%). The epidemic was found to be more severe in northeast and north China compared to south China (59.6%; 55.0% vs. 3.8%, respectively). The proportion showed a significantly increasing trend over the study period (10.3% in 2001-2005; 38.6% in 2006-2009; and 47.6% in 2010-2012; trend test chi-square = 16.42, p < 0.001).Conclusion
The relatively high proportion of MSM- associated HIV-positive donors is of concern. Efficient and effective measures focused on public education and improving knowledge of blood safety are needed to prevent this at-risk population from seeking HIV testing through blood donation. It is also imperative to expand the scope of postdonation nucleic acid testing to shorten the window period to improve blood supply safety in China.
[Show abstract][Hide abstract] ABSTRACT: Sixteen original recombinant pseudoviruses were generated by cloning the reverse transcriptase and protease genes of human immunodeficiency virus (HIV)-1 from patients into a plasmid vector (pNL4-3-ΔE-EGFP). By site-directed mutagenesis two restriction endonuclease sites, ApaI and AgeI, were inserted into pNL4-3-ΔE-EGFP. Phenotypic susceptibility of recombinant pseudoviruses to five different classes of antiretroviral drugs was determined using a luciferase reporter assay system. The results were subjected to comparative analyses to detect genotype-phenotype associations. Among 16 strains tested, 12 strains had a discordant genotype-phenotype resistance pattern to at least one drug. In five strains resistance to two, in two strains to three, and in one strain resistance to four drugs was detected. HIV resistance genotyping could predict the phenotype for nevirapine and azidothymidine. For lamivudine, 2'-3'-didehydro-2'-3'dideoxythymidine and didanosine, phenotypic resistance testing was necessary. The study showed that in patients who experienced long-term highly active antiretroviral therapy and virological failure, there is some discordance between genotypic and phenotypic HIV drug resistance. To address the issue of limited resources in China, genotypic and phenotypic resistance testing should be done for different drugs in order to guide clinical therapy more effectively.
[Show abstract][Hide abstract] ABSTRACT: To assess the potential immunological and virological effects that result from short-course antiretroviral treatment during primary HIV infection (PHI). And to investigate whether treatment initiation time, treatment duration and follow-up time after treatment interruption would affect these post-treatment immunovirological outcomes.
We systematically searched PubMed, Cochrane Library (to September 2013) and retrieved conference abstracts for studies regarding effects of early treatment during PHI on CD4 count and viral load (VL). Using the method of calculating weighted mean differences with Stata11.0, we conducted meta-analyses on the effect of early treatment on CD4 count and VL. Then we performed subgroup analyses by follow-up time after treatment interruption, treatment initiation time and treatment duration. Baseline immunovirological characteristics were also analyzed to account for potential bias.
Compared to the untreated arm, treatment during PHI not only increased CD4 count by 85.92 cells/μl but also lowered viral load by 0.30 log copies/ml within one year after treatment interruption. However, the benefits declined gradually, reaching no significance 12-24 months after treatment interruption. Baseline immunovirological characteristics and sensitivity analyses of randomized controlled trials indicated that the benefits mentioned above were underestimated. Extending treatment duration beyond 12 months did not increase efficacy.
Short-course treatment during PHI was associated with immunological and virological benefits which last for at least one year after treatment interruption. The conclusions from our study would help the decision-making in the clinical management of PHI.
PLoS ONE 12/2013; 8(12):e82461. DOI:10.1371/journal.pone.0082461 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background. The number of new HIV infections among MSM of China is rapidly increasing in recent years and behavioral interventions have had limited effectiveness. To control the HIV pandemic may lie in an HIV vaccine. This study examined the factors associated with willingness to participate (WTP) in HIV vaccine clinical trials among China MSM. Methods. A cross-sectional survey was carried out among MSM from three cities in northeast China. Questionnaires pertaining to MSM risk behavior and WTP in HIV vaccine trials were administered through computer assisted self-interviewing (CASI). Results. A total of 626 MSM participated in this survey. 54.8% had occasional male partners and 52.2% always used condoms with male sex partners. HIV prevalence was 5.0%. 76.7% were WTP in a preventive HIV vaccine clinical trial. Results showed that HIV vaccination is a means of protection for spouses and family; family support to participate in vaccine trials and desire for economic incentives were significantly associated with WTP. Conclusions. There was a high proportion of WTP in HIV vaccine trials among Chinese MSM. The high HIV prevalence and high proportion of risky sexual behavior indicate that Liaoning MSM are potential candidates for HIV vaccine trials.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study is to systematically review the published studies and summarize the estimates of HIV and syphilis prevalences among high school and college student MSM in China in order to provide information for conducting targeted interventions.
Pubmed, Chinese National Knowledge Infrastructure, Wanfang and Google Scholar databases were searched in January 2013 to identify relevant articles. Data of eligible citations were extracted by two reviewers. All analyses were performed using Comprehensive Meta-Analysis V2.0 and SPSS V17.0.
Twenty-four eligible studies (6 in English and 18 in Chinese), published between 2006 and 2012, with a total of 3083 student MSM participants, were included. The meta-analyses showed that the prevalences of HIV and syphilis among studied student MSM were 4.4% (95% CI: 3.0%, 6.4%) and 5.7% (95% CI: 4.8%, 6.7%), respectively. HIV prevalence increased over the study period (3.0% in 2003-2006; 4.5% in 2007-2008, and 6.8% in 2009-2010, trend test chi-square = 11.3, p = 0.001).
Student MSM have become high-risk populations for HIV infection in China. The high prevalence of syphilis and the increasing HIV prevalence trend indicate the potential for a more severe HIV epidemic. Comprehensive intervention strategies that address condom promotion, syphilis detection and treatment, and health education need to be tailored to this vulnerable population to prevent HIV and syphilis infections.
PLoS ONE 07/2013; 8(7):e69137. DOI:10.1371/journal.pone.0069137 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A high prevalence of HIV infection is present among men who have sex with men (MSM) in China, but many people living with HIV or AIDS (PLWHs) are unaware of their HIV infection status. Provider-initiated HIV testing and counseling (PITC) is a streamlined model that can significantly enhance HIV detection and detect infections earlier. However, PITC has not yet been widely applied, and no studies have been conducted on MSM's attitudes towards PITC in China. In this study, a total of 438 MSM were recruited in Shenyang city. A multivariate logistic regression model showed that certain conditions made MSM more accepting of PITC: those who had attended VCT (voluntary counseling and testing) more than three times (odds ratio [OR]: 2.95, 95% CI: 1.36-6.37), those who considered PITC beneficial for family and friends (OR: 1.91, 95% CI: 1.25-2.92), those who obtained HIV/AIDS knowledge from brochures (OR: 2.52, 95% CI: 1.64-3.87), those who obtained HIV/AIDS knowledge from the Internet (OR: 1.66, 95% CI: 1.07-2.58), and those who were highly aware of their own risk of being infected with HIV (OR: 2.84, 95% CI: 1.37-5.91). To improve acceptance of PITC among MSM in China, stronger efforts are needed to lower the psychosocial barriers to receiving PITC, to promote HIV/AIDS awareness, and to encourage the extension of HIV testing.
[Show abstract][Hide abstract] ABSTRACT: Background
Yunnan has the largest number of reported HIV/AIDS cases among all Chinese provinces, the reported prevalence of HIV among Yunnan men who have sex with men (MSM) passed 10%, while HIV incidence epidemic and molecular characteristics of new infected Yunnan MSM were not evaluated before.
An 18 months prospective followed up with a frequency of 3 month per visit were conducted among HIV seronegative MSM in Kunming cityduring 2009–2011. Interviewer-administrated questionnaires were carried out. Blood specimens were obtained to test for syphilis and HIV, in which HIV were evaluated by standard HIV enzyme immunoassay (EIA) and HIV nucleic acid amplification testing (NAAT). Near full-length regions of the HIV-1 were evaluated for subtyping, primary drug resistance mutations.
During the follow-up 70.1% of the recruited 378 MSM retained in the cohort. Eleven MSM seroconverted to HIV and fifteen MSM seroconverted to syphilis. The HIV incidence and syphilis incidence was 3.5 (95% CI 1.8-6.2) cases /100 person year(PY) and 5.3 (95% CI 3.0-8.7) cases/100 PY, respectively. Multivariate analysis showed that baseline syphilis infection (aHR, 17.7), occupation (students vs. others [aHR, 5.7], retirees vs. others [aHR, 4.1]), bleeding experience after receptive anal intercourse (aHR,7.6), and minority ethnic(vs. Han) [aHR, 5.7] were independent risk factors for HIV seroconversion(each P<0.05). Among the 7/11 successfully amplified near full-length sequences, 71.4% (5/7) were CRF01_AE, and 28.6% (2/7) were CRF07_BC. Two HIV transmission pairs were detected among seroconverted minority ethnic MSM.
HIV incidence was moderately high among Yunnan MSM. Yunnan province need to strengthen both HIV and syphilis screening among MSM population. Some subpopulations of MSM, such as students, retirees and minority ethnic groups require more HIV epidemic surveillance and strengthened behavior interventions. HIV subtypes and primary drug resistance should be continually monitored to track cross-group transmission of HIV strains.
[Show abstract][Hide abstract] ABSTRACT: To explore the relationship between absolute dendritic cell (DC) counts at the early stage of primary human immunodeficiency virus type 1 (HIV-1) infection (PHI) and subsequent disease progression, we performed a prospective study of 16 rapid progressors (RPs) and 12 typical progressors (TPs) from a PHI cohort of men who have sex with men. Significantly decreased plasmacytoid DC (pDC) and myeloid DC (mDC) counts in the blood of RPs were observed at study entry as compared with TPs and healthy HIV-1-negative subjects. Low baseline pDC counts were significantly associated with rapid disease progression after adjustment for baseline CD4(+) T cell counts, mDC counts, and HIV-1 load. Kaplan-Meier survival analysis showed that low pDC counts were strongly associated with rapid disease progression. Our findings demonstrated the predictive value of blood absolute pDC counts at baseline in PHI for HIV-1 disease progression. Further studies are required to confirm this notion.
[Show abstract][Hide abstract] ABSTRACT: To explore correlations between mRNA (hA3G, hA3F, and hA3B) levels and CD4 T-cell counts and HIV-1 viral loads to evaluate their respective roles in disease progression.
Real-time polymerase chain reaction was used to quantify the mRNA levels of hA3G, hA3B, and hA3F in peripheral blood mononuclear cells from slow progress patients (SP), asymptomatic HIV-infected patients (AS), AIDS patients, and HIV-negative controls.
The levels of hA3G and hA3B mRNA correlated positively with CD4 T-cell counts (r = 0.436, P = 0.002, r = 0.334, P = 0.025), and negatively with HIV-1 viral loads (r = -0.306, P = 0.038, r = -0.301 P = 0.044). The levels of hA3G and hA3B mRNA in HIV-infected subjects were lower than in HIV-negative controls (P < 0.05), and hA3G and hA3B mRNA levels were significantly higher in SP than in AIDS patients (P < 0.05). There was no correlation between the hA3F mRNA level and CD4 T-cell counts or between the hA3F mRNA level and HIV-1 viral loads.
Higher expression levels of hA3G and hA3B mRNA in the peripheral blood mononuclear cells of Chinese HIV-infected individuals were found to be associated with slower HIV disease progression, suggesting their potential roles in antiviral innate immunity.
[Show abstract][Hide abstract] ABSTRACT: Chemokine receptors CCR5 and CXCR4 are of major importance in the pathogenesis of HIV-1 infection because they are co-receptors for human immunodeficiency virus (HIV) entry. We examined the frequency of CD3-CD56+CCR5+ and CD3-CD56+CXCR4+ in HIV-infected long-term slow progressors (SPs), HIV typical progressors (TPs) with or without highly active antiretroviral therapy (HAART), and HIV-seronegative controls. The results showed that the frequency of CD3-CD56+CCR5+ was up-regulated, and frequency of CD3-CD56+CXCR4+ was down-regulated in HAART-naïve HIV TPs group compared with HIV SPs group and HIV-seronegative controls (P < 0.05). The frequency of CD3-CD56+CCR5+ was down-regulated by HAART therapy (P < 0.05). The frequency of CD3-CD56+CCR5+ was lower in HIV SPs compared with controls (P < 0.05). Lower frequency of CD3-CD56+CXCR4+ and higher frequency of CD3-CD56+CCR5+ positively correlated with the level of HIV viral loads and negatively correlated with CD4 T cell counts (P < 0.05). These results indicated that the expression of chemokine receptors on NK cells correlated with HIV disease progression. Chemokine receptors CCR5 and CXCR4 are of major importance in the pathogenesis of HIV-1 infection because they are co-receptors for human immunodeficiency virus (HIV) entry.
[Show abstract][Hide abstract] ABSTRACT: To examine the prevalence of drug resistance mutations among treatment-naive HIV/AIDS patients living in Liaoning province in China, the HIV-1 pol gene from plasma of 91 seropositive treatment-naive patients was amplified and sequenced. Three patients (3.3%) had an M46I amino acid substitution in the protease (PR) gene that decreased susceptibility to IDV, RTV, and NFV and one patient (1.1%) had an M184I amino acid substitution in the reverse transcriptase (RT) gene that confers high-level resistance to 3TC and FTC. Minor mutations were detected in high frequency in the PR gene. The frequencies of minor mutations to protease inhibitors (PI) were I93L (71.4%), L63P (62.6%), V77I (62.6%), M36I/V (33.0%), A71T/V (22.0%), K20R (6.6%), G16E (6.6%), and L10I (5.5%). The relatedness between subtypes and the frequencies of amino acid substitutions in PR were observed; 63P, 77I, and 71V/T were found in HIV-1 subtype B'/B, 16E, 36I, 20R/I, and 82I in non-B, except for CRF07_BC, 10I in subtype A, and 93L in non-A. Although the primary resistance of HIV-1 to antiretroviral drugs is low among the treatment-naive HIV-1 patients living in Liaoning province, the surveillance and monitoring of drug-resistant HIV-1 should be implemented regularly because of the increased access to antiretroviral therapy in China.
AIDS Research and Human Retroviruses 04/2007; 23(3):357-64. DOI:10.1089/aid.2006.0094 · 2.46 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Our objective was to detect the expression of CD226 on natural killer (NK) cells and T cells, and to measure the amount of soluble CD226 in the plasma of HIV-infected individuals, in order to evaluate the function of CD226 in HIV infection. Thirty-four untreated HIV-1-infected patients and 26 normal controls were enrolled and three-color flow cytometry was used to detect the expression of CD226 on T lymphocytes and NK cells in whole blood samples taken from the patients and normal controls, and in HIV-1SF33-infected peripheral blood mononuclear cells (PBMCs). An enzymelinked immunosorbent assay (ELISA) was used to detect the level of soluble CD226 in the plasma of HIV-infected patients and normal controls and in the supernatant of HIV-1SF33-infected cells. The level of CD226 expression on CD3+, CD4+, and CD8+ T cells and on CD3- CD16+ NK cells of HIV-infected patients was significantly higher than that of normal controls (p < 0.01). The level of soluble CD226 in the plasma of HIV-infected patients was also significantly higher than that of normal controls (p < 0.01). After stimulation with HIV-1SF33, the level of CD226 expression on CD3+ T cells and CD3- CD16+ NK cells of cultured PBMCs reached peak values at 48 h, which was earlier than in uninfected control cells (72 h). The level of soluble CD226 in the supernatant of HIV- 1SF33-infected cell culture was higher than that of uninfected cells, and the level of soluble CD226 in the supernatant of HIV-1SF33-infected cells reached the peak value at 72 h, which was earlier than in uninfected control cells (96 h) but later than the time of peak CD226 expression on CD3+ T lymphocytes (48 h). We conclude that CD226 may be involved in the immune response to HIV infection and that further experiments are needed to find the function of CD226 in the pathogenesis of HIV infection.
[Show abstract][Hide abstract] ABSTRACT: Natural killer (NK) cells, natural killer T (NKT) cells, and T lymphocytes were analyzed by using a flow cytometer in 225 human immunodeficiency virus (HIV)-positive individuals infected through the past sale of blood and plasma without receiving antiretroviral therapy in the People's Republic of China. According to CD4 T-cell counts these HIV-infected adults were stratified into three groups: long-term slow progressors, HIV-infected subjects, and AIDS patients. NK cell counts in long-term slow progressors were higher compared to HIV infection and AIDS patients (P < 0.05) and lower compared to normal controls (P < 0.05), whereas NKT cell counts in slow progressors and the HIV infection group were not different from those of normal controls. NK cell counts in HIV-seropositive subjects were positively correlated with CD4 T-cell counts (P < 0.05), and NKT cell counts were positively correlated with CD4 T-cell and CD8 T-cell counts (P < 0.05). The CD8 T-cell counts were higher in slow progressors compared to those with HIV infection, AIDS patients, and normal controls. These results indicated that HIV infection causes alterations of NK cells and T cells in slow progressors, HIV-infected subjects, and AIDS patient groups, but no difference was found in NKT cell counts and percentages in slow progressors and the HIV-infected group compared to normal controls.
[Show abstract][Hide abstract] ABSTRACT: The objective of this paper was to investigate the activation and coreceptor CCR5, CXCR4 expression of T lymphocytes in HIV/AIDS patients of China, and to study their association with disease progression. Seventy-seven HIV/AIDS patients and thirteen normal controls were enrolled and three-color flow-cytometry was used to detect the activation marker HLA-DR, CD38 and the coreceptor CCR5, CXCR4 expression on T lymphocytes in whole blood samples taken from the patients and the controls. The HLA-DR, CD38 and CCR5 expression on CD4, CD8+ T cells in AIDS patients was higher than in asymptomatic HIV-1 infected patients and normal controls (p < 0.05); The activation and CCR5 expression on T lymphocytes significantly correlated with CD4+ T lymphocyte number and viral load. The activation on T lymphocytes and the expression of CCR5 on T lymphocytes in HIV/AIDS patients of China are significantly correlated with disease progression.