潍坊市坊子区2012年产前HBsAg筛检及新生儿首针乙肝疫苗接种情况分析

目的：了解住院分娩产妇乙肝病毒表面抗原（ HBsAg）检测及其所生新生儿首针乙肝疫苗及时接种情况,为进一步完善新生儿乙型肝炎的免疫预防策略提供依据。方法对2012年坊子区设有产科的医院每月上报的产妇HBsAg 检测和新生儿首针乙肝疫苗接种资料进行分析。结果坊子区2012年设有产科的医疗机构共报告住院分娩产妇2975名,产前HBsAg筛检2881名,筛检率为96．84％,各医疗机构筛检率在96．55％和97．50％之间;检出HBsAg阳性者66例,阳性率为2．29％,各医疗机构阳性率在0．00％和5．52％之间。新生儿共2975名,其中常住者所生新生儿2612名,流动者所生新生儿363名,常住和流动的新生儿乙肝疫苗接种率分别为96．13％和94．21％,及时接种率分别为93．87％和90．36％,差异均无统计学意义（χ2＝2．98、3．67,P＞0．05）。122名未及时接种首针乙肝疫苗的新生儿系患各种疾病所致。结论坊子区2012年设有产科的医院对住院的孕产妇产前HBsAg筛查率较高,其所生的新生儿24 h内乙肝疫苗及时接种率较高。     

大鼠杂交瘤技术及抗HIV、HBsAg大鼠单克隆抗体的制备

在目前制备单克隆抗体的三个主要体系：小鼠、大鼠和人杂交瘤体系中,大鼠系统具有某些特有的优点。本文以制备抗艾滋病毒和抗乙型肝炎表面抗原的大鼠单克隆抗体为例,较详细的介绍了大鼠杂交瘤的特点及大鼠单克隆抗体制备技术。     

2014—2018年平顶山市湛河区艾滋病自愿咨询检测者HIV抗体调查分析

目的了解平顶山市湛河区艾滋病自愿咨询检测(voluntary counseling and testing, VCT)的人类免疫缺陷病毒(human immunodeficiency virus, HIV)抗体情况,为全区科学防治艾滋病工作提供理论依据。方法通过湛河区疾病预防控制中心2014—2018年3 205例VCT HIV抗体分析,研究同期报告的艾滋病病例的感染状况和人群分布特征。结果 2014—2018年湛河区疾病预防控制中心对3 205人次VCT并进行HIV抗体筛查,阳性21例,阳性率0.66%。VCT HIV抗体阳性和阳性率最高的年份是2016和2017年,各年份间无明显趋势变化,各年份差异无统计学意义;男女性别比为1.60∶1,男性VCT HIV抗体阳性和阳性率高于女性,性别差异无统计学意义;年龄分布以青壮年为主,年龄集中在>20～40岁组,占64.93%;文化程度分布,以初中及以下人群的构成比最高;婚姻状况分布发现,已婚VCT HIV抗体阳性和阳性率最多;不同高危人群HIV抗体检测,男男性行为抗体阳性率是异性性行为的23.24倍。结论疾病预防控制中心VCT是HIV阳性发现的主要部门,需进一步重视和扩大VCT门诊;加强人们艾滋病预防知识的普及工作,特别针对外来务工人员、高危行为者中男男性行为者的健康教育和行为干预;同时对婚检人群抗体阳性的出现引起足够的重视。     

衣壳蛋白:抗HIV感染的新靶点

HIV是由病毒衣壳蛋白（capsid protein,CA）形成的一个蛋白质外壳包绕着内部的核蛋白复合体所构成。HIV-1的CA在病毒的组装和成熟中起着至关重要的作用。同时,病毒传染性很大程度上取决于衣壳的结构和稳定性,因此,衣壳蛋白成为潜在的抗HIV药物研究的重要靶点之一。     

输血相关HIV感染实验室检测技术进展

开展有效的HIV检测能够控制输血传播HIV,阻断其传播途径,同时有助于确保临床输血安全.输血相关人类免疫缺陷病毒检测技术包括抗原、抗体检测和核酸检测等,抗体检测以酶联免疫吸附试验和免疫印迹试验为主要方法,辅以P24抗原和核酸检测技术检测以降低人类免疫缺陷病毒窗口期传播的残余危险度.而输血相关艾滋病的实际发生的程度取决于人群中感染人数的比例和献血者筛检工作的有效性.     

横县2008—2014年新报告及晚发现HIV/AIDS流行病学特征

目的分析2008—2014年横县新报告及晚发现HIV/AIDS病例的流行病学特征,旨在了解该县HIV/AIDS防治现状,为今后科学防治艾滋病提供理论依据。方法采用描述流行病学方法,对2008—2014年横县新报告及晚发现HIV/AIDS病例进行流行病学分析。结果 2008—2014年横县新报告HIV/AIDS病例共计3 011例,且每年均有新报告病例,新报告病例数和死亡数均呈先上升后稳定趋势;新报告病例数位居前3位的地区为百合镇(20.26%)、横州镇(12.69%)和云表镇(10.03%);男性高于女性,男、女性别比为2.87∶1;以≥50岁(57.12%)和25~<50岁(38.82%)的人群为主,且25~<50岁人群呈逐年下降趋势,≥50岁人群呈逐年上升趋势;职业以农民为主,占84.59%。2008—2014年晚发现比例呈先上升后稳定趋势,差异均有统计学意义(P<0.05);人群分布男性高于女性;≥50岁人群高于其他年龄组人群。结论 2008—2014年横县新报告HIV/AIDS的发病率及其晚发现比例均呈先上升后稳定趋势,晚发现比例高于全国水平。     

免疫渗滤法检测血液及尿液HIV抗体的应用评价

评价免疫渗滤法人类免疫缺陷病毒1+2型抗体诊断试剂盒检测人血浆和尿液样本的临床性能。采用对照试验研究,选取背景清晰的研究对象200例,采集同一研究对象的血浆和尿液样本,应用万泰生物药业公司生产的人类免疫缺陷病毒1+2型抗体诊断试剂盒作为考核试剂,法国生物梅里埃公司生产的人类免疫缺陷病毒抗体诊断试剂盒(ELISA法)作为参考试剂进行检测,考核试剂检测结果与参考试剂及研究对象背景进行比较分析。考核试剂检测血浆HIV抗体与参考试剂相比较,阳性符合率100.00%,阴性符合率100.00%,总符合率100.00%,Kappa值1.00,一致性强度为最强;考核试剂检测尿液HIV抗体与参考试剂检测结果相比较,阳性符合率68.29%,阴性符合率100.00%,总符合率87.00%,Kappa值0.72,一致性强度为高度。免疫渗滤法人类免疫缺陷病毒1+2型抗体诊断试剂盒对血浆、尿液样本检测性能优越,适合临床快速诊断。     

Dot-ELISA法检测血液及唾液HIV抗体的应用评价

评价人类免疫缺陷病毒1+2型抗体检测试剂盒(Dot-ELISA法)检测血清和唾液样本的临床性能。采用对照试验研究,选取背景清晰的研究对象200例,采集同一研究对象的血清和唾液样本,应用万泰生物药业公司生产的人类免疫缺陷病毒1+2型抗体检测试剂盒作为考核试剂,法国生物梅里埃公司生产的人类免疫缺陷病毒抗体诊断试剂盒(ELISA法)作为参考试剂,考核试剂检测结果与参考试剂及研究对象背景进行比较分析。考核试剂检测血清HIV抗体与参考试剂相比较,阳性符合率100%,阴性符合率100%,总符合率100%,Kappa值1.00,一致性为最强;考核试剂检测唾液HIV抗体与参考试剂检测结果相比较,阳性符合率98.78%,阴性符合率100%,总符合率99.50%,Kappa值0.99,一致性为最强。Dot-ELISA法人类免疫缺陷病毒1+2型抗体检测试剂盒对血清及唾液样本检测性能优越,适合HIV抗体快速筛查。     

43 例HIV/AIDS 患者抗病毒治疗情况分析

目的:研究来第四军医大学唐都医院传染科就诊的人类免疫缺陷病毒/艾滋病(Human immunodeficiency virus/Acquired immuno deficiency syndrome,HIV/AIDS)患者感染状况及抗病毒治疗效果。方法:采用前瞻性随访研究的方法,收集来我院就诊的HIV/AIDS患者的基本信息,并对其实验室检查结果、治疗方案及后续随访结果进行分析。结果:随访观察的43例HIV/AIDS患者治疗前平均基线CD4+T淋巴细胞计数为(330.74±176.35)cells/μL,CD8+T淋巴细胞计数为(1177.80±321.49)cells/μL,CD4+,CD8+T淋巴细胞比值为0.30±0.19;治疗一年后平均CD4+T淋巴细胞计数为(482.74±217.77)cells/μL,CD8+T淋巴细胞计数为(861.53±282.85)cells/μL,CD4+,CD8+T淋巴细胞比值为0.59±0.28。所有患者治疗一年后血浆HIV-RNA载量均达到检测限以下(500copies/m L)。结论:规范的抗病毒治疗对于改善HIV/AIDS患者预后至关重要;基线CD4+T淋巴细胞计数越低,抗病毒治疗效果越差。     

HIV相关性口腔念珠菌RAPD多态性分析

运用RAPD技术对60株分离自HIV感染者口腔的念珠菌进行分析, 其中P2随机引物扩增条带数量0~5条, 大小300 bp~2 kb, 白色念珠菌以300 bp、400 bp和600 bp 3个主条带为主, 非白色念珠菌也存在类似条带。采用SPSS13.0聚类分析, 分为5个基因群, 14个基因型, 白色念珠菌主要为B群。其中P385和P403对5-氟孢嘧啶耐药, 聚为C1基因型(欧氏距离平方为0.115), P321和P522对两性霉素B耐药, 聚为D1基因型(欧氏距离平方为0.221)。表明HIV感染者口腔来源的念珠菌存在丰富的基因多态性, RAPD技术对于白色念珠菌的基因型鉴定具有重要意义; 念珠菌不同种间具有相对特征性的条带, 同种不同株间存在相似的条带特征; 某些条带特征可能与念珠菌的耐药性相关。     

HIV and HCV： from Co-infection to Epidemiology, Transmission, Pathogenesis, and Treatment

Human immunodeficiency virus (HIV) is the infectious agent causing acquired immu-nodeficiency syndrome (AIDS),a deadliest scourge of human society. Hepatitis C virus (HCV) is a major causative agent of chronic liver disease and infects an estimated 170 million people worldwide,resulting in a serious public health burden. Due to shared routes of transmission,co-infection with HIV and HCV has become common among individuals who had high risks of blood exposures. Among hemophiliacs the co-infection rate accounts for 85%; while among injection drug users (IDU) the rate can be as high as 90%. HIV can accelerate the progression of HCV-related liver disease,particularly when immunodeficiency has developed. Although the effect of HCV on HIV infection is controversial,most studies showed an increase in mortality due to liver disease. HCV may act as a direct cofactor to fasten the progression of AIDS and decrease the tolerance of highly active antiretroviral therapy (HARRT). Conversely,HAART-related hepatotoxicity may enhance the progression of liver fibrosis. Due to above complications,co-infection with HCV and HIV-1 has imposed a critical challenge in the management of these patients. In this review,we focus on the epidemiology and transmission of HIV and HCV,the impact of the two viruses on each other,and their treatment.     

HIV and HCV: from Co-infection to epidemiology, transmission, pathogenesis, and treatment

Human immunodeficiency virus (HIV) is the infectious agent causing acquired immunodeficiency syndrome (AIDS), a deadliest scourge of human society. Hepatitis C virus (HCV) is a major causative agent of chronic liver disease and infects an estimated 170 million people worldwide, resulting in a serious public health burden. Due to shared routes of transmission, co-infection with HIV and HCV has become common among individuals who had high risks of blood exposures. Among hemophiliacs the co-infection rate accounts for 85%; while among injection drug users (IDU) the rate can be as high as 90%. HIV can accelerate the progression of HCV-related liver disease, particularly when immunodeficiency has developed. Although the effect of HCV on HIV infection is controversial, most studies showed an increase in mortality due to liver disease. HCV may act as a direct cofactor to fasten the progression of AIDS and decrease the tolerance of highly active antiretroviral therapy (HARRT). Conversely, HAART-related hepatotoxicity may enhance the progression of liver fibrosis. Due to above complications, co-infection with HCV and HIV-1 has imposed a critical challenge in the management of these patients. In this review, we focus on the epidemiology and transmission of HIV and HCV, the impact of the two viruses on each other, and their treatment.      

多重环介导核酸等温扩增技术检测血液中常见病原体

背景：血液安全性筛查是输血前必要检测项目。目前临床采用血清学检测技术,存在较长的检测窗口期,易产生假阴性检测结果,造成输血交叉感染。目的：建立多重环介导核酸等温扩增技术,实现在一管反应体系内同时检测四种病原体：乙肝病毒,丙肝病毒,艾滋病毒和梅毒螺旋体。方法：通过限制性酶切处理多重环介导核酸等温扩增产物,利用酶切产物的长度分析扩增产物的种类,从而分析待测样本中含有何种血液病原体。结果：检测164例临床样本,其检测结果可以通过琼脂糖电泳,聚丙烯酰胺凝胶电泳及芯片电泳分析,且均可实现对多重扩增产物的酶切片段进行区分和鉴别。结论：多重环介导核酸等温扩增技术可以同时单管检测多种待测血液病原体,可以为临床提高简单、快速、高灵敏和高特异的检测技术。     

四川地区2013—2014年供血浆人群HBsAg、抗-HCV和抗-HIV检测结果分析

目的分析四川地区2013—2014年供血浆人群的血液检测HBs Ag、抗-HCV、抗-HIV阳性率与年龄和性别的相关性,为制定从低危供血浆人群中招募策略及安全供血提供依据。方法收集2013年1月至2014年12月四川地区10家单采血浆公司采集的111 816名供血浆者年龄、性别资料及血浆样品HBs Ag、抗-HCV、抗-HIV确证检测结果,比较分析不同年龄、性别的供浆人群的病毒指标阳性率差异。结果 2013年和2014年总体阳性率分别为0.58%和0.52%,抗-HIV阳性率由2013年的0.02%下降到2014年的0.01%;2013年和2014年总体阳性率随年龄增加呈递减的趋势;HBs Ag不合格率随年龄增加而降低,抗-HCV不合格率在41~55岁年龄段高于18~40岁年龄段,抗-HIV不合格率在18~40岁年龄段高于41~55岁年龄段;女性供血浆者总体阳性率为0.43%,男性为0.77%,女性低于男性;女性HBs Ag、抗-HIV阳性率分别为0.35%和0.01%,低于男性的0.67%和0.03%。结论女性、较年长的供血浆者为供浆低危人群,应该作为重点招募稳定供献血浆的对象,同时应进一步提高献浆前问询技巧,增强对高危人群的评估辨别能力,从而更有效的减少不必要的血浆报废,保证血浆采集安全性,促进采浆事业科学可持续发展。     

江苏省300例艾滋病人群联合检测 HCV、TP、HIV的结果分析

摘要 目的：探究江苏省2017年至2019年度艾滋病哨点监测人群丙型肝炎病毒（Hepatitis C virus,HCV）、梅毒螺旋体（Treponema Pallidum,TP）以及人类免疫缺陷病毒（Treponema Pallidum,HIV）感染状况,以期为制定对应的疾患干预手段提供临床数据支撑。方法：严格按照《全国艾滋病哨点监测实施方案操作手册（2012版）》对入组的900例个体开展相关问卷调查,并对入组对象进行HCV、TP以及HIV感染血清学检测,分别统计3年总体感染情况、年度感染情况、不同年龄段人群感染情况以及合并感染情况。结果：（1）性工作者HCV、TP以及HIV感染率分别为3.00 %、4.00 %和9.00 %,吸毒人群感染率分别为13.00 %、73.00 %和13.00 %,孕产妇感染率分别为1.00 %、0.67 %和1.33 %,比较显示,吸毒人群HCV、TP以及HIV感染率明显高于其余两类人群（P<0.05）;（2）就各年度不同人群HCV、TP以及HIV感染率开展年度横向比较显示,不同年度不同人群的HCV、TP以及HIV感染率差异无统计学意义（P>0.05）;（3）针对不同年龄段不同人群的HCV、TP以及HIV感染率开展比较显示,吸毒人群中≥50岁HCV和HIV感染率明显高于其他年龄段（P<0.05）,性工作者中18~20岁HIV感染率明显高于其他年龄段（P<0.05）,其余差异无统计学意义（P>0.05）;（4）合并感染情况分析显示合并TP以及HIV感染率要高于其他合并感染。结论：吸毒人群是江苏省HCV、TP以及HIV感染高发群体,以≥50岁年龄段感染率最高,总体来看HCV、TP以及HIV感染率呈现逐年降低趋势,但仍应该加强对上述疾患的防控工作。     

Characteristics of HCV Co-Infection among HIV Infected Individuals from an Area with High Risk of Blood-Borne Infections in Central China

Objective

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) co-infection has been proved to be a growing public health concern. The prevalence and genotypic pattern vary with geographic locations. Limited information is available to date with regard to HCV genotype and its clinical implications among those former commercial blood donor communities. The aims of this study were to genetically define the HCV genotype and associated clinical characteristics of HIV/HCV co-infected patients from a region with commercial blood donation history in central China.

Methods

A cross sectional study, including 164 HIV infected subjects, was conducted in Shanxi province central China. Serum samples were collected and HCV antibody testing, AST and ALT testing were performed. Seropositive samples were further subjected to RT-PCR followed by direct sequence coupled with phylogenetic analysis of Core-E1 and NS5B regions performed in comparison with known reference genotypes.

Findings

A total of 139 subjects were HCV antibody positive. Genotype could be determined for 88 isolates. Phylogenetic analysis revealed that the predominant circulating subtype was HCV 1b (65.9%), followed by HCV 2a (34.1%). The HCV viral load in the subjects infected with HIV1b was significantly higher than those infected with HCV 2a (P = 0.006). No significant difference for HCV RNA level was detected between ART status, CD4+ cell count level and HIV RNA level. Serum AST and ALT level were likely to increase with HCV RNA level, although no significance was observed. Those who had conducted commercial donation later than 1991 (OR 3.43, 95% CI: 1.12–10.48) and had a short duration of donation (OR 0.35, 95% CI: 0.13–0.96) were more likely to be infected with HCV 1b.

Conclusion

These results suggest that HCV subtype 1b predominates in this population, and the impact of HIV status and ART on HCV disease progression is not significantly correlated.     

Complementary Role of HCV and HIV in T-Cell Activation and Exhaustion in HIV/HCV Coinfection

Objectives

To investigate whether T-cell activation and exhaustion is linked to HCV- and HIV disease parameters in HIV/HCV infected individuals, we studied T-cell characteristics in HIV/HCV coinfected patients and controls.

Methods

14 HIV/HCV coinfected, 19 HCV monoinfected, 10 HIV monoinfected patients and 15 healthy controls were included in this cross-sectional study. Differences in expression of activation and exhaustion markers (HLA-DR, CD38, PD-1, Tim-3 and Fas) and phenotypic markers on CD4⁺ and CD8⁺ T-cells were analysed by flow cytometry and were related to HCV disease parameters (HCV-viremia, ALT and liver fibrosis).

Results

Frequencies of activated CD4⁺ and CD8⁺ T-cells were higher in HIV/HCV-coinfected compared to healthy controls and HCV or HIV mono-infected individuals. Coinfected patients also showed high expression of the exhaustion marker PD-1 and death receptor Fas. In contrast, the exhaustion marker Tim-3 was only elevated in HIV-monoinfected patients. T-cell activation and exhaustion were correlated with HCV-RNA, suggesting that viral antigen influences T-cell activation and exhaustion. Interestingly, increased percentages of effector CD8⁺ T-cells were found in patients with severe (F3–F4) liver fibrosis compared to those with no to minimal fibrosis (F0–F2).

Conclusions

HIV/HCV coinfected patients display a high level of T-cell activation and exhaustion in the peripheral blood. Our data suggest that T-cell activation and exhaustion are influenced by the level of HCV viremia. Furthermore, high percentages of cytotoxic/effector CD8⁺ T-cells are associated with liver fibrosis in both HCV monoinfected and HIV/HCV coinfected patients.     

Immune Biomarker Differences and Changes Comparing HCV Mono-Infected,HIV/HCV Co-Infected,and HCV Spontaneously Cleared Patients

Background

Immune biomarkers are implicated in HCV treatment response, fibrosis, and accelerated pathogenesis of comorbidities, though only D-dimer and C-reactive protein have been consistently studied. Few studies have evaluated HIV/HCV co-infection, and little longitudinal data exists describing a broader antiviral cytokine response

Methods

Fifty immune biomarkers were analyzed at baseline(BL) and HCV end of treatment follow-up(FU) time point using the Luminex 50-plex assay in plasma samples from 15 HCV-cleared, 24 HCV mono- and 49 HIV/HCV co-infected patients receiving antiretroviral treatment, who either did or did not receive pegylated-interferon/ribavirin HCV treatment. Biomarker levels were compared among spontaneous clearance patients, mono- and co-infected, untreated and HCV-treated, and sustained virologic responders (SVR) and non-responders (NR) at BL and FU using nonparametric analyses. A Bonferroni correction, adjusting for tests of 50 biomarkers, was used to reduce Type I error

Results

Compared to HCV patients at BL, HIV/HCV patients had 22 significantly higher and 4 significantly lower biomarker levels, following correction for multiple testing. There were no significantly different BL levels when comparing SVR and NR in mono- or co-infected patients; however, FU levels changed considerably in co-infected patients, with seven becoming significantly higher and eight becoming significantly lower in SVR patients. Longitudinally between BL and FU, 13 markers significantly changed in co-infected SVR patients, while none significantly changed in co-infected NR patients. There were also no significant changes in longitudinal analyses of mono-infected patients achieving SVR or mono-infected and co-infected groups deferring treatment

Conclusions

Clear differences exist in pattern and quantity of plasma immune biomarkers among HCV mono-infected, HIV/HCV co-infected, and HCV-cleared patients; and with SVR in co-infected patients treated for HCV. Though >90% of patients were male and co-infected had a larger percentage of African American patients, our findings may have implications for better understanding HCV pathogenesis, treatment outcomes, and future therapeutic targets     

HBsAg携带者重叠感染HCV、HDV的血清学调查

对３６２名无症状高滴度ＨＢｓＡｇ携带者用ＲＩＡ法检测ＨＢｅＡｇ、Ａｎｔｉ－ＨＢｅ、Ａｎｔｉ－ＨＣＶ、Ａｎｔｉ－ＨＤＶ。结果表明,ＨＢｅＡｇ阳性率随ＨＢｓＡｇ滴度的增高而增加,且有显著性差异（Ｐ＜０．０５）。重叠感染以ＨＢＶ＋ＨＣＶ最高,占２７．６％;其次是ＨＢＶ＋ＨＤＶ,占９．１％;ＨＢＶ＋ＨＣＶ＋ＨＤＶ最少,占６．４％。但是,以上重叠感染率均与ＨＢｓＡｇ滴度及／或ＨＢｅＡｇ阳性率高低无关（Ｐ＞０．０５）。调查显示,无症状ＨＢｓＡｇ携带者中ＨＢＶ＋ＨＣＶ,或ＨＢＶ＋ＨＤＶ,或ＨＢＶ＋ＨＣＶ＋ＨＤＶ的重叠感染均可发生。