The changing face of HIV in China

Yunnan Center for Disease Control and Prevention, Yunnan, People's Republic of China.
Nature (Impact Factor: 41.46). 11/2008; 455(7213):609-11. DOI: 10.1038/455609a
Source: PubMed


HIV has advanced from high-risk groups such as intravenous drug users to some in the general population, according to comprehensive new data from the south of China. What needs to be done to halt its spread?

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Available from: Zhiwei Chen
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    • "Along with the rapid economic development in China, the severity of the country's HIV/AIDS epidemic is also growing. The rapidly increasing HIV prevalence in China has shifted from injection drug users (IDUs) and former blood donors into men who have sex with men and female sex workers [5]–[7]. HCV infection makes the HIV/AIDS epidemic much worse; this is because HCV co-infection facilitates HIV disease progression and increases the morbidity and mortality of AIDS patients [8]–[10]. "
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    ABSTRACT: Human Immunodeficiency Virus (HIV) infection and the resultant Acquired Immunodeficiency Syndrome (AIDS) epidemic are major global health challenges; hepatitis C virus (HCV) co-infection has made the HIV/AIDS epidemic even worse. Interleukin-27 (IL-27), a cytokine which inhibits HIV and HCV replication in vitro, associates with HIV infection and HIV/HCV co-infection in clinical settings. However, the impact of HIV and HCV viral loads on plasma IL-27 expression levels has not been well characterized. In this study, 155 antiretroviral therapy-naïve Chinese were recruited. Among them 80 were HIV- and HCV-negative healthy controls, 45 were HIV-mono-infected and 30 were HIV/HCV-co-infected. Plasma level HIV, HCV, IL-27 and CD4+ number were counted and their correlation, regression relationships were explored. We show that: plasma IL-27 level was significantly upregulated in HIV-mono-infected and HIV/HCV-co-infected Chinese; HIV viral load was negatively correlated with IL-27 titer in HIV-mono-infected subjects whereas the relationship was opposite in HIV/HCV-co-infected subjects; and the relationships between HIV viral loads, IL-27 titers and CD4+ T cell counts in the HIV mono-infection and HIV/HCV co-infection groups were dramatically different. Overall, our results suggest that IL-27 differs in treatment-naïve groups with HIV mono-infections and HIV/HCV co-infections, thereby providing critical information to be considered when caring and treating those with HIV mono-infection and HIV/HCV co-infection.
    Full-text · Article · May 2014 · PLoS ONE
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    • "To understand the expanding HIV epidemic, the Chinese government took steps to scale up HIV screening to identify infected persons for early treatment in order to reduce the mortality and transmission242526. To better understand the trajectory of the HIV-1 epidemic in most-at-risk populations, China adopted the laboratory-based BED incidence assay initially developed at the U.S. CDC in 20025. "
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    ABSTRACT: The HIV-1 BED incidence assay was adopted in China in 2005 for HIV-1 incidence surveillance. A proficiency testing (PT) program was established in 2006 to provide quality assurance services. The BED PT program consisted of two components, an international program provided by the U.S. Centers for Disease Control and Prevention from 2006 and a domestic program started by the National HIV/HCV Reference Laboratory in 2011. Each PT panel consisted of eight coded specimens distributed to participating laboratories semi-annually, and testing results were collected and analyzed. The number of participating laboratories increased progressively from 2006 to 2012. The Chinese HIV-1 incidence laboratory network performed satisfactorily both in international and domestic PT programs. We also demonstrated that the BED assay was highly reproducible among participating laboratories. Our success and lessons learned can be readily replicated in other countries or regions contemplating the establishment of a PT program for assay-based HIV incidence estimation.
    Full-text · Article · Mar 2014 · Scientific Reports
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    • "Historically, the HIV epidemic in China has been confined to certain high-risk populations such as injection drug users (IDUs) and former blood and plasma donors in geographically disparate rural areas [1] [2] [3] [4] [5] [6]. In recent years, the synthesized data suggested that HIV transmission has begun to shift from IDUs to populations at risk through unprotected sex, either through heterosexual contacts or male homosexual sex, accounting for nearly half of all new infections in 2007 [7]. "
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    ABSTRACT: This study assessed the changes of HIV incidence and its predictors among Beijing's men who have sex with men (MSM). Three consecutive cross-sectional surveys were carried out using a consistent respondent-driven sampling (RDS) approach in 2009, 2010, and 2011, respectively. Structured-questionnaire based interviews were completed with computer-assisted self-administration. Incident infection was examined with BED capture enzyme immunoassay (BED-CEIA). The overall rate of HIV prevalence was 8.0% in the three years (95% confidence interval [CI]: 4.9%-11.2%). The overall rate of BED-CEIA incidence was 7.8/100 person years (PY) (95% CI: 5.5-10.1) with 6.8/100PY (95% CI: 3.4-10.2) in 2009, 11.2/100PY (95% CI: 6.2-16.3) in 2010, and 5.8/100PY (95% CI: 2.4-9.3) in 2011, respectively. Multivariable logistic regression analysis revealed that, compared with HIV-negative MSM, recently infected MSM were more likely to be bisexual (adjusted odds ratio [AOR] = 2.1, 95% CI: 1.1-4.1), live in Beijing ≤3 years (AOR = 2.1, 95% CI: 1.2-4.0), and have a negative attitude towards safe sex (AOR = 1.1 per scale point, 95% CI: 1.0-1.1). This study demonstrated a disturbing rise of HIV infections among Beijing's MSM. These findings underscored the urgency of scaling up effective and better-targeted intervention services to stop the rapid spread of the virus.
    Full-text · Article · Jan 2014
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