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简介：摘要在HIV感染者中，儿童接受抗逆转录病毒治疗的比例(54%)远低于成年人(62%)。同时，HIV暴露但未感染儿童的早期发育也不及未暴露儿童。2019年7月在墨西哥召开的第11次国际儿童HIV感染研讨会和国际艾滋病学会年会，探讨了如何加强对儿童HIV感染的管理和治疗。

简介：AbstractTransmission network analysis is a crucial evaluation tool aiming to explore the characteristics of the human immunodeficiency virus epidemic, develop evidence-based prevention strategies, and contribute to various areas of human immunodeficiency virus/acquired immunodeficiency syndrome prevention and control. Over recent decades, transmission networks have made tremendous strides in terms of modes, methods, applications, and various other aspects. Transmission network methods, including social, sexual, and molecular transmission networks, have played a pivotal role. Each transmission network research method has its advantages, as well as its limitations. In this study, we established a systematic review of these aforementioned transmission networks with respect to their definitions, applications, limitations, recent progress, and synthetic applications.

简介：摘要目的观察基线HIV-1 RNA > 50万copies/mL的HIV-1感染者，在高效抗反转录病毒治疗（highly active antiretroviral therapy，HAART）前后外周血totalHIV-1 DNA的变化。方法从国家十二五科技重大专项课题中选取基线HIV-1 RNA > 50万copies/mL且HAART 96周HIV-1 RNA < 50 copies/mL的初治HIV-1感染者为试验组，年龄性别相当的基线HIV-1 RNA < 50万copies/mL的HIV-1感染者为对照组。检测两组患者基线和HAART 24、48、96周时total HIV-1 DNA水平。结果基线及HAART 96周，试验组total HIV-1 DNA均高于对照组3.48（3.21~3.80）lg copies/106 PBMCsvs 2.90（2.54~3.30）lg copies /106 PBMCs（p<0.001），2.82（2.38~2.96）lgcopies/106 PBMCs vs 2.37（1.99~2.65） lg copies /106 PBMCs（p=0.001）。HAART 24周、48周，试验组detal HIV-1 DNA较对照组高0.67（0.41~1.03）lg copies/106 PBMCs vs 0.39（0.09~0.73）lg copies/106 PBMCs（P<0.001）, 0.8（0.46~1.16）lg copies/106 PBMCs vs 0.43（0.04~0.63）lg copies/106 PBMCs（P<0.001）。且HAART前后total HIV-1 DNA水平均与基线病载正相关。结论基线极高病载患者HAART 96周内存在较高total HIV DNA水平，建议选择强效HAART方案来有效降低储存库。

简介：AbstractBackground:Human brucellosis is a neglected public health issue in China and reports of HIV-infected individuals complicated with brucellosis are rare. This report describes the case of an HIV-infected patient complicated with brucellosis. We want to raise awareness of clinical diagnosis of brucellosis among clinicians. Furthermore, we should be more concerned about cases with pyrexia of unknown origin, especially in non-epidemic areas of brucellosis in China.Case presentation:We encountered the case of a 31-year-old HIV-infected male with a CD4+ T lymphocyte count of approximately 300. On May 1, 2019, the patient had onset of non-specific caustic irregular fever with body temperature reaching 41.0 ℃. He was admitted to two medical institutions in Yunnan with pyrexia of unknown origin. Finally, on day 7 of hospitalization in the Public Health Clinical Medical Center in Chengdu City, he was diagnosed as having brucellosis infection based on blood culture results.Conclusions:This is the first reported case of brucellosis concomitant with HIV infection in China. Laboratories in infectious disease hospitals and category A level III hospitals in the southern provinces of China should be equipped with reagents for clinical diagnosis of brucellosis and to strengthen the awareness of brucellosis diagnosis in China. Secondly, in provinces with a high incidence of AIDS and brucellosis such as Xinjiang and Henan, it is recommended to implement a joint examination strategy to ensure the early detection, diagnosis, and treatment of this infection.

简介：AbstractAntiretroviral therapy (ART) can effectively inhibit human immunodeficiency virus-1 (HIV-1) replication, but is not curative due to the existence of a stable viral latent reservoir harboring replication-competent proviruses. In order to reduce or eliminate the HIV-1 latent reservoir, characteristics of the latently infected cells need to be intensively studied, and a comprehensive understanding of the heterogenous nature of the latent reservoir will be critical to develop novel therapeutic strategies. Here, we discuss the different cell types and mechanisms contributing to the complexity and heterogeneity of HIV-1 latent reservoirs, and summarize the key challenges to the development of cure strategies for acquired immunodeficiency syndrome (AIDS).

简介：摘要HIV自我检测（自检）是扩大HIV防治重点人群检测覆盖面的一大重要措施和策略，具有巨大的应用价值，并在重点人群中有很高的接受性。WHO于2016年发布了《HIV自检和性伴通知指南》，支持在HIV检测服务中实施HIV自检，并为各国建立相应公共卫生政策提供具体指导，以改善HIV诊断的可及性和利用程度。在此策略的推动下，HIV自检已在许多国家和地区得到应用并取得了巨大的防治成效。为进一步推动HIV自检，提高重点人群的检测率，本文综述了目前国内外自检政策、干预模式、自检方法、自检试剂的准确性和自检前后的咨询服务方面的应用，旨在为进一步推动我国HIV自检工作提供参考依据。

简介：摘要目的比较4种HIV抗体确证试剂盒的检测性能，为临床使用试剂提供参考。方法使用2种免疫印迹法(Western blot, WB)试剂、2种重组/线性免疫印迹法(recombinant immunoblot assay/line immune assay，RIBA/LIA)试剂平行检测185份样本，采用McNermar检验分析试剂检测结果与HIV感染状态的一致性，以最常用MP公司的WB试剂检测结果为参照进行优势比(OR)计算。结果4种试剂检测结果与HIV感染结果一致率为83.24%～92.43%，Kappa值为0.558～0.831。英旻泰公司的WB试剂检测57份HIV未感染样本的OR值为0.932(95%CI：0.446～1.946，P＝0.851)，RIBA试剂的OR值为2.348(95%CI：1.069～5.158，P＝0.034)，LIA试剂的OR值为23.064(95%CI：5.125～103.789，P<0.001)；LIA试剂检测128份HIV感染样本的OR值为0.153(95%CI：0.034～0.700，P＝0.016)。对95份HIV抗体筛查阳性样本检测，LIA试剂有反应的比例最低，与其他3种试剂有反应的比例差异有统计学意义(P值均<0.05)，其他3种试剂差异无统计学意义(P值均>0.05)。出现非特异反应时条带数均≤4条，显色较浅的条带比例占52.1%(37/71)，出现条带主要为gp160(81.3%)、p24(71.9%)和p17(28.1%)。结论两种WB试剂检测结果无显著性差异，RIBA/LIA试剂可减少不确定结果的产生，但LIA试剂对于弱反应性样本存在假阴性风险。

简介：HIV（人类免疫缺陷病毒）是一种通过血液、性行为、母婴垂直传播等途径感染人体的病毒，可以导致艾滋病的发生。为了确诊艾滋病，常常需要进行HIV抗体检验。然而，HIV抗体检验结果的准确性却受到多种因素的影响。这些因素包括但不限于：感染时间、感染类型、个体免疫系统状态、检测方法等。因此，在进行HIV抗体检验时，需要注意这些影响因素，以避免产生误诊或漏诊的情况。

简介：摘要目前人免疫缺陷病毒（human immunodeficiency virus，HIV）感染已经成为可防可控的慢性感染性疾病，HIV感染者的健康相关生活质量问题日益凸显。解决艾滋病最常见的心理健康问题，对于实现和维持病毒抑制，结束艾滋病流行也是必需的。本文综述了近年来HIV感染领域中筛查和解决精神心理健康的相关研究进展，为HIV感染人群的精神心理健康的临床应用提供可参考的依据。

简介：AbstractIntroduction:Malignant syphilis (MS) is a rare and severe variant of secondary syphilis that is frequently associated with HIV infection. The clinical impact of HIV and syphilis co-infection is bidirectional, and the presence of MS is associated with acute HIV infection. Clinically, MS is characterized by nodular and ulcerative lesions affecting the trunk and extremities, which are covered with thick crusts. The treatment of choice for MS remains benzathine penicillin G. Herein, we report a case in which MS was the initial presentation of HIV infection.Case presentation:A 35-year-old male patient came with the chief complaint of extensive erythematous nodular rash for the past one month, with notable ulceration on some lesions with annular configuration along with fever and malaise. Based on the abovementioned clinical, laboratory, and histopathologic findings, the patient was diagnosed with MS and HIV. The diagnosis was established based on histopathological examination and syphilis serological testing.Discussion:Cutaneous disorders are a frequent presenting feature of HIV infection. The clinical manifestations of syphilis in immunosuppressed patients are often severe and/or atypical. The patient was then treated with weekly intramuscular administration of 2.4 million units of benzathine penicillin G for 3 weeks and achieved rapid and significant clinical improvement, with no Jarisch-Herxheimer reaction.Conclusion:Co-infection with syphilis and HIV alters the course of both diseases, and most HIV-infected patients with syphilis have typical disease manifestations associated with decreased CD4+ T-cell counts.

简介：AbstractImportance:Bacteremia tuberculosis (TB) is a severe form of extrapulmonary TB. Studies assessing bacteremia TB in children are limited, especially for HIV-negative children.Objective:To explore the detailed clinical features of the bacteremia TB in children under 18 years of age.Methods:We reviewed the clinical records of the patients retrospectively and collected the strains isolated from their blood cultures. We used mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) to characterize the bacterial genotypes and alamarBlue to determine their drug susceptibility profiles. Polymerase chain reactions and DNA sequencing were used to identify drug-resistant mutations.Results:There were 13 pediatric bacteremia TB patients, 10 of whom were diagnosed with Bacillus Calmette–Guérin (BCG) bacteremia TB. Thirteen patients aged from 0.30 to 11.58 years were enrolled, of whom 76.92% were boys. All had fevers before hospitalization, and 76.92% had respiratory symptoms. All had received BCG vaccinations, and 46.15% had adverse post-vaccination reactions. Compared with Mycobacterium tuberculosis, BCG bacteremia was more likely to appear in younger children. Patients with BCG bacteremia had primary immunodeficiency diseases, and lower CD4, IgA, and IgE levels.Interpretation:Bacteremia TB was rapidly fatal in a large proportion of the immunodeficient children. Because classic findings may not be diagnostically specific, a high level of clinical suspicion is required, especially for patients with certain types of immunosuppression. Studies are needed to develop rapid diagnostic tests and to determine the value of empirical therapy in childhood bacteremia TB.

简介：摘要青少年及青年正处于由儿童向完备成年人转变的阶段，性生理趋于成熟，而性心理尚不完善，具有特有的生理与心理特点，易于发生不安全性行为，从而增加了自身感染HIV的风险。青少年及青年中存在较多的易感因素，近年来HIV感染新报告病例数逐年上升，引起了多方面的关注。本文从青少年及青年HIV感染现状、感染与发现途径、易感因素3个方面综述，为降低青少年及青年HIV感染风险提供参考依据。

简介：AbstractA massive depletion of CD4+ T lymphocytes has been described in early and acute human immunodeficiency virus (HIV) infection, leading to an imbalance between the human microbiome and immune responses. In recent years, a growing interest in the alterations in gut microbiota in HIV infection has led to many studies; however, only few studies have been conducted to explore the importance of oral microbiome in HIV-infected individuals. Evidence has indicated the dysbiosis of oral microbiota in people living with HIV (PLWH). Potential mechanisms might be related to the immunodeficiency in the oral cavity of HIV-infected individuals, including changes in secretory components such as reduced levels of enzymes and proteins in saliva and altered cellular components involved in the reduction and dysfunction of innate and adaptive immune cells. As a result, disrupted oral immunity in HIV-infected individuals leads to an imbalance between the oral microbiome and local immune responses, which may contribute to the development of HIV-related diseases and HIV-associated non-acquired immunodeficiency syndrome comorbidities. Although the introduction of antiretroviral therapy (ART) has led to a significant decrease in occurrence of the opportunistic oral infections in HIV-infected individuals, the dysbiosis in oral microbiome persists. Furthermore, several studies with the aim to investigate the ability of probiotics to regulate the dysbiosis of oral microbiota in HIV-infected individuals are ongoing. However, the effects of ART and probiotics on oral microbiome in HIV-infected individuals remain unclear. In this article, we review the composition of the oral microbiome in healthy and HIV-infected individuals and the possible effect of oral microbiome on HIV-associated oral diseases. We also discuss how ART and probiotics influence the oral microbiome in HIV infection. We believe that a deeper understanding of composition and function of the oral microbiome is critical for the development of effective preventive and therapeutic strategies for HIV infection.

简介：摘要HIV-1储存库的持续存在是治愈HIV的主要障碍，在临床研究中，需要可靠的生物标志物对其进行标记。HIV-1 DNA在HIV-1储存库中可被持续检测到，在HIV-1感染诊断、预测病毒反弹和监测治疗效果等方面具有重要应用价值。PCR的检测技术是临床上常用的HIV-1 DNA检测方法，随着技术的不断创新与进步，可更准确地通过定性或定量检测感染细胞中总的、整合的和未整合的HIV-1 DNA。感染细胞中不同形式的HIV-1 DNA作为生物标志物在HIV感染监测和艾滋病治疗相关研究中报道日益增多。本文对感染细胞中HIV-1 DNA的检测方法及其作为生物标志物的临床应用进展进行综述。

简介：摘要自我采样传递检测是HIV（Human Immunodeficiency Virus）自我检测的延伸。自我采样传递检测的发放方式主要有药房、自动售货机以及社区小组。自我采样传递检测的检测方式主要有尿液HIV抗体检测、干血斑HIV抗体检测、干血斑核酸检测三种。自我采样传递检测是新型的检测模式，可以在一定程度上扩大检测范围，提高HIV检测的可及性。自我采样传递检测在我国推广具有前景，但仍存在一些挑战。

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简介：AbstractHepatitis C infection is not uncommon in pregnant women. Vertical transmission of the virus from mother to fetus is estimated at 4%-8%, however this transmission rate is significantly higher when the mother is co-infected with HIV. Intrauterine blood transfusions can be a necessary part of management for certain perinatal conditions like hemolytic disease of the fetus. Currently there is no published material available on the vertical transmission risk of HCV infection to the fetus as a result of this procedure, irrespective of HIV coinfection. We present a case of a pregnant woman co-infected with HCV and HIV that required an intrauterine blood transfusion during pregnancy. Vertical transmission of either infection to the child did not occur. This provides important evidence that vertical transmission of HCV and/or HIV does not necessarily occur with intrauterine blood transfusions.

简介：摘要目的通过文献回顾，了解我国HIV感染者中HBV感染的流行特征。方法通过对2010-2019年文献检索、文献筛选、质量评价等过程，收集我国有关HIV感染者合并感染HBV的研究文献，对符合纳入标准的文献提取相关数据后进行Meta分析。结果共纳入27项研究，合并样本量为69 816例；我国HIV感染者的HBV合并感染率为11.29%，西部地区（10.73%）和南部地区（14.18%）的合并感染率较高，北部地区（6.36%）最低；血液或血液制品传播、注射吸毒传播、同性性传播、异性性传播、传播途径不详和母婴传播的HIV感染者的HBV合并感染率分别为11.22%、12.76%、9.58%、11.32%、10.34%和2.87%。在HIV各种传播途径中，经母婴传播的HIV感染者的HBV合并感染率最低；南部地区男性HIV感染者的HBV感染率是女性的1.29倍。结论我国HIV感染者的HBV感染率明显高于普通人群的HBV感染率；应加强HIV/HBV共感染者的预防控制。

简介：摘要目的对反式转录激活因子Tat第41位赖氨酸(K41)在HIV-1转录活化过程中的作用进行探讨，并对B、C亚型HIV-1中Tat K41的作用进行比较。方法通过荧光素酶活性实验检测野生型Tat、突变型Tat K41A、Tat K41R对HIV-1转录活性的影响，并比较B、C亚型HIV-1中Tat K41作用的差异；通过免疫沉淀(immunoprecipitation, IP)实验检测B、C亚型HIV-1中Tat K41是否影响Tat与SIRT1的结合；通过Western blot检测细胞核内B、C亚型HIV-1的Tat K41是否影响p65 K310的乙酰化水平。结果与B亚型HIV-1不同，C亚型HIV-1的Tat K41突变后显著降低荧光素酶活性，减弱C亚型Tat与SIRT1的结合，降低细胞核内p65 K310ac的水平。结论C亚型Tat K41在HIV-1转录中发挥重要作用。