Misreporting Rate & Influencing Factors Regarding the Routes of Transmission among Reported HIV Patients in Yili Kazakh Autonomous Prefecture of Xinjiang Uygur Autonomous Region of China

OBJECTIVE:

To understand the misreporting rate regarding the routes of transmission among the reported HIV patients in Yili prefecture of Xinjiang, since 2011.

METHODS:

An investigation focusing on the route of transmission among people living with HIV/AIDS was carried out to clarify the responsible reasons for the situation.

RESULTS:

The overall incorrect reporting rate on the route of transmission was 10.8%.The proportion of heterosexual transmission route was over estimated by 63.8% to 72.0%. However, the proportion of injecting drug was underestimated by 27.5% to 22.2%. The number of cases being confirmed as through heterosexual transmission but incorrectly reported was quite high, contributing 82.6% of all the incorrectly reported cases. Most of the patients that incorrect reported, were moved from injecting drug use to heterosexual transmission, which contributed 79.5% of all the total incorrectly reported cases. Results from multi-factor analysis showed that the risk related to incorrect reporting was 3.64 times in males than in females. People who anticipated to receive HIV testing were 2.23 times more than those who had not. Old-age groups were 3.511, 4.053, 4.415 and 6.524 times higher than those people who were aged below 16 years.

CONCLUSIONS:

The proportion of heterosexual transmission route was over- estimated while the proportion on injecting drug use was underestimated. However, the transmission pattern had changed from injecting drug use at the early epidemic stage, to current sexual transmission mode. We recommended that more attentions should be paid to patients who were males, at older age or those who had no expectation in receiving the HIV testing, during the initial following-up stage.

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By:  Ni MJ1, Chen XL, Hu XY, Ma YY.

• 1Center for STD/AIDS Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, China. 
• Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Jan 10;37(1):90-3. doi: 10.3760/cma.j.issn.0254-6450.2016.01.019.

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Sex Specific Mortality in HIV/AIDS Patients Receiving Antiretroviral Therapy & Risk Factors in Xinjiang Uygur Autonomous Region

OBJECTIVE:

To analyze the sex specific mortality in HIV/AIDS patients receiving highly active antiretroviral therapy (HAART) and risk factors in Xinjiang Uyghur autonomous region (Xinjiang), and provide evidence for the evaluation of the effect of HAART.

METHODS:

A retrospective analysis was conducted on the mortality and survival of 8 061 male cases and 6 001 female cases of HIV infection, who received HAART during July 2004-June 2013 in Xinjiang. The information of the cases were downloaded from national antiretroviral therapy reporting sub-system in national HIV/AIDS reporting system. Cox proportional hazard model was used to identify the risk factors of deaths.

RESULTS:

The male cases were older and had lower CD4 value at baseline compared with the female cases. The major transmission route was injecting drug use in males, but sexual contact in females. The overall mortality of the male cases was higher than that of the females, which was 10.87/100 person-years during the first three month after receiving HAART, and 7.00/100 person-years two years later in males, but 4.77/100 person-years during the first three month and 3.00/100 person-years two years later in females. The results from Cox analysis showed that the risk factors were the CD4 value at baseline and transmission route. Compared with the cases who had lower CD4 value (CD4<200 cells/µl) at baseline, the HR for the cases who had higher CD4 value (CD4≥350 cells/µl) was 4.08 (95% CI: 2.96-5.62) in males and 5.11 (95% CI: 3.16-8.35) in females. Compared with sexual transmission, the HR for IDUs was 1.99 (95% CI: 1.66-2.40) in males and 1.77 (95% CI: 1.24-2.52) in females. The results of cumulative survival analysis showed that in conventional treatment group (CD4<350 cells/µl) , the five year survival rates were 81% and 87% for the males and females infected through sexual contact and 66% and 75% for the males and females infected through injecting drug use, and in early treatment group (CD4≥350 cells/µl) , the five year survival rates were 97% and 98% for the males and females infected through sexual contact and 86% and 97% for the males and females infected through injecting drug use.

CONCLUSION:

In Xinjiang, the higher mortality in male HIV infection cases receiving HAART was related with lower CD4 value at baseline and higher infection rate through injecting drug use. Besides the weak intention for treatment and poor compliancy would be the deeper risk factors.

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By:  Ni M1, Chen X2, Ma Y2, Hu X2.

• 1Center for AIDS and STD Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, China; Email: xjnmj@126.com.
• 2Center for AIDS and STD Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi 830011, China. 
• Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Sep;36(9):971-5.

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The Variations of IL-23R Are Associated with Susceptibility & Severe Clinical Forms of Pulmonary Tuberculosis in Chinese Uygurs

Background

The incidence of tuberculosis (TB) remains high among Chinese Uygurs (a long-dwelling ethnic minority in Xinjiang) in China and the variants in IL-23R likely contribute to individual’s diversity in host response during infection.

Methods

A hospital based one to one matched case–control study was performed to assess the role of single nucleotide polymorphisms (SNPs) and copy number variation (CNV) of IL-23R in susceptibility and clinical features of pulmonary TB in Chinese Uygurs. Thirteen SNPs in IL-23Rwere genotyped by multiplex SNaPshot and a CNV was analyzed using Taqman real-time PCR in 250 pairs of pulmonary TB patients and controls.

Results

The SNP rs7518660 (OR = 4.78, 95 % CI 3.14–8.52) and the CNV in IL23R (OR = 2.75, 95 % CI 1.51–4.98) were significantly associated with susceptibility to pulmonary TB. The SNP rs11465802 (OR = 3.23, 95 % CI 1.85–5.62) was significantly associated with drug-resistance and the SNP rs1884444 (OR = 3.61, 95 % CI 1.90–6.85) was significantly related to cavitary lesion in Chinese Uygurs.

Conclusions

Our study shows for the first time that SNP and CNV in IL23R were associated with susceptibility, drug resistance and cavity formation of pulmonary TB. Our findings indicate that these IL-23R polymorphisms may be considered as risk factors for active pulmonary TB and its severe clinical forms.

Below:  Linkage Disequilibrium Plot of SNPs of IL-23R in the control group. Linkage disequilibrium (LD) blocks in the IL23R polymorphisms black squares indicate significant allelic association between groups of SNPs from the control subjects measured by the D' (left panels) and r 2 (right panels) statistics. A D' or r 2 cutoff of 0.8 is used for LD. High D' values are dark, low D' values are light

Below:  Copy number frequencies distribution of IL-23R between controls and pulmonary TB patients

Full article at:  http://goo.gl/OMqbqd

By:  Daobin Jiang¹²³, Atikaimu Wubuli¹, Xin Hu¹, Syed Ikramullah¹, Abudoujilili Maimaiti¹,Wenbao Zhang^4* and Qimanguli Wushouer^1*

¹Department of Pulmonology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

²Department of Pulmonology, Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine, Urumqi 830054, Xinjiang, China

³Xinjiang Uygur Autonomous Region Respiratory Physiology Pathology Key Laboratory, Urumqi 830054, Xinjiang, China

⁴Clinical Medical Research Institute, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang, China

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