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Hepatitis B virus/human immunodeficiency virus coinfection： interaction among human immunodeficiency virus infection, chronic hepatitis B virus infection, and host immunity

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Chinese Medical Journal 2012年第13期125卷 2371-2377页

作者： li Yi-jia WANG Huan-ling li tai-sheng Department of Infectious Diseases Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China

Objective This review discusses progress in the studies of hepatitis B virus （HBV）/human immunodeficiency virus （HIV） coinfection and focuses on the interaction among HIV infection, chronic HBV infection, and host immunity. Data sources Data and studies pubJished mainly from 2008 to 2011 were selected using PubMed. Study selection Original articles and critical reviews concerning HBV/HIV coinfection and HBV and HIV pathogenesis were selected. Results HIV may accelerate HBV progression by lowering CD4 count, weakening HBV-specific immunity, ＂enriching＂ HBV mutants, causing immune activation, etc. On the other hand, HBV may enhance HIV replication by activating HIV long terminal repeat （LTR） with X protein （HBX） and cause immune activation in synergy with HIV. Paradoxically, HBV may also inhibit HIV dissemination via dendritic cells. Conclusions The interaction among HIV, HBV, and host immunity remains poorly understood. Further research is warranted to elucidate the detailed molecular mechanisms and to translate these mechanisms into clinical practice.

关键词： human immunodeficiency virus hepatitis B virus immunity

Cytomegalovirus retinitis associated with acquired immunodeficiency syndrome

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Chinese Medical Journal 2011年第8期124卷 1134-1138页

作者： GENG Shuang YE Jun-jie ZHAO Jia-liang li tai-sheng HAN Yang Department of Ophthalmology Peking Union Medical College Hospital Peking Union Medical CollegeChinese Academy of Medical Sciences Beijing 100730 China Department of Infectious Diseases Peking Union Medical College Hospital Peking Union Medical CollegeChinese Academy of Medical Sciences Beijing 100730 China

Background Cytomegalovirus （CMV） retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome （AIDS）. This study aimed to investigate the fundus characteristics, systemic manifestations and therapeutic outcomes of CMV retinitis associated with AIDS.Methods It was a retrospective case series. CMV retinitis was present in 39 eyes （25 patients）. Best corrected visual acuities, anterior segment, fundus features, fundus fluorescence angiography （FFA） and CD4＋ T-lymphocyte counts of the patients with CMV retinitis associated with AIDS were analyzed. Intravitreal injections of ganciclovir （400 μg） were performed in 4 eyes （2 patients）.Results Retinal vasculitis, dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface were present in 28 eyes. The vitreous was clear or mildly opaque.Late stage of the retinopathy was demonstrated in 8 eyes characterized as atrophic retina, sclerotic and attenuated vessels, retinal pigment epithelium （RPE） atrophy, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The average CD4＋ T-lymphocyte count in peripheral blood of the patients with CMV retinitis was （30.6±25.3） ×106/L （range,（0-85） × 106/L）. After intravitreal injections of ganciclovir, visual acuity was improved and fundus lesions regressed.Conclusions CMV retinitis is the most severe and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis without clear cause, human immunodeficiency virus （HIV） serology should be performed. Routine eye examination is also indicated in HIV positive patients.

关键词： cytomegalovirus retinitis acquired immunodeficiency syndrome ganciclovir

Steady-state pharmacokinetics of zidovudine in Chinese HIV-infected patients

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Chinese Medical Journal 2012年第11期125卷 1931-1935页

作者： liU li-feng WANG Lu FU Qiang ZHU Zhu XIE Jing HAN Yang liU Zheng-yin YE Min li tai-sheng Department of Infectious Diseases Peking Union Medical College Hospital Peking Union Medical College Beijing 100730 China Department of Pharmacology Peking Union Medical College Hospital Peking Union Medical College Beijing 100730 China Chinese Academy of Medical Sciences STD/AIDS Research Center Beijing You An Hospital Capital Medical University Beijing 100071 China

Background The pharmacokinetics of zidovudine （AZT） are possibly influenced by weight, age, sex, liver and renal functions, severity of disease, and ethnicity. Currently, little information is available on the steady-state pharmacokinetics of AZT in Chinese HIV-infected patients. The current study aimed to characterize the steady-state pharmacokinetics of AZT in a Chinese set-up. Methods Eleven Chinese HIV-infected patients were involved in the steady-state pharmacokinetic study. In total, 300 mg of AZT, as a part of combination therapy, was given to patients, and serial blood samples were collected for 12 hours. The samples were measured by a high-performance liquid chromatography （HPLC） assay, and the results were analyzed by both the non-compartment model and the one-compartment model. Results The Cmax of AZT in Chinese patients was higher than that in non-Asian patients. The half-life of AZT, analyzed by the non-compartment model （P=-0.02）, in male patients （（1.02±0.22） hours） was shorter than that of AZT in female patients （（1.55±0.29） hours）. The AZT clearance, analyzed by the one-compartment model （P=0.045）, in male patients （（262.60±28.13） L/h） was higher than that in female patients （（195.85±60.51） L/h）. Conclusion The present study provides valuable information for the clinical practice of AZT-based highly active antiretroviral therapy in a Chinese set-up.

关键词： human immunodeficiency virus, steady-state pharmacokinetics zidovudine Chinesepatients

Association between Nef-specific CD8 T-cell responses and disease progression in HIV-1 subtype B infection

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Chinese Medical Journal 2006年第19期119卷 1609-1615页

作者： JIAO Yang li tai-sheng XIE Jing HAN Yang QIU Zhi-feng ZUO ling-yan Thomas Mourez WANG Ai-xia Department of Infectious Disease Peking Union Medical College Hospital and AIDS Research Center Chinese Academy of Medical Sciences Beijing 100730 China Laboratory of Human and Molecular Virology University Hospital av. Georges Clemenceau 14033 Caen France

Background The correlation between HIV-1 Nef-specific CD8 T-cell responses and markers of HIV-1 disease progression still remains unclear. This study analysed and compared the role of HIV-1 Nef-specific CD8 T-cell responses in patients with different disease status. Methods Two groups of patients with HIV-1 subtype B infection were selected according to CD4 count and clinical manifestations： long-term nonprogresssors （LTNPs, n = 20） and advanced progressors （APs, CD4 count 〈500 cells/pl, n = 34）. Nef-specific CD8 T-cell responses were studied by interferon- T EliSpot assay against 3 pools of HIV-Nef peptides. Results Nef-specific CD8 T-cell responses did not correlate with viral load or CD4 count in all patients and no significant differences were found in the magnitude of Nef-specific CD8 T-cell responses between groups LTNPs and APs （670 SFC/106 peripheral blood mononuclear cells vs 1107 SFC/106 peripheral blood mononuclear cells, P = 0.255）. Further comparisons showed that there were also no significant correlations observed in group LTNPs, but Nef-specific CD8 T cells correlated negatively with viral load （r = -0.397, P = 0.020） and positively with CD4 count （r = 0.364, P = 0.034） in group APs. Conclusion These data suggest that different correlation patterns between Nef-specific CD8 T-cell responses and disease progression exist in LTNPs and APs. Although a negative association was observed with concurrent plasma HIV RNA in APs, Nef-specific CD8 T-cell responses might fail to play a protective role in different stages of HIV- 1 infection.

关键词： Nef HIV- 1 subtype B CD8 T-cell response IFN-gamma EliSpot

Premature atherosclerosis in patients with acquired immunodeficiency syndrome

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Chinese Medical Journal 2010年第23期123卷 3396-3399页

作者： ZENG Yong YE Yi-cong LUO ling QIU Zhi-feng HAN Yang li Xiao-meng FANG Quan ZHANG Shu-yang li tai-sheng Department of Cardiology Peking Union Medical College Hospital Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730 China Department of Infectious Diseases Peking Union Medical College Hospital Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730 China

Background Increased risk of atherosclerosis has been reported in patients with human immunodeficiency virus （HIV）infection since highly active antiretroviral therapy （HAART） has come into use. However, there is no clear evidence of premature atherosclerosis in Chinese HIV-infected patients. Our study was designed to determine the relationship between HIV infection and atherosclerosis in Chinese HIV-infected patients.Methods One hundred and forty-five patients were enrolled in this study. These included 82 HIV-infected patients （41HAART-treated and 41 antiretroviral therapy （ART） naive patients） and 43 HIV-negative control subjects. Data on traditional cardiovascular risk factors, HIV infection parameters, and treatment regimens were collected. Pulse wave velocity （PWV） was determined using a pulse pressure analyzer to evaluate the function of the arterial wall as an indicator of atherosclerotic vascular damage.Results A higher PWV （（1358.3±117.8） cm/s vs. （1270.2±189.2） cm/s, P=0.010） was found in ART na（i）ve HIV-infected patients compared with control subjects. However, HAART treated patients had lower PWV compared to ART na（i）ve patients （（1283.8±181.4） cm/s vs. （1358.0±117.8） cm/s, P=0.033）. Multiple regression analysis revealed that age （B=5.218, 95% confidence interval （CI） 1.420-9.016, P=0.008）, current smoking （B=-74.671, 95% CI -147.003 to -2.339, P=0.043） and HAART （92.7% patients on a protease inhibitor-free regimen）（B=-169.169, 95% CI-272.508 to -65.831, P=0.010） were associated with reduced PWV in HIV-infected patients.Conclusions Reduced PWV in HIV-infected Chinese patients indicates that they are more likely to develop arterial wall stiffness, possibly by atherosclerosis. A protease inhibitor-free regime may be protective for arterial wall of HIV infected patients.

关键词： human immunodeficiency virus atherosclerosis antiretroviral therapy, highly active

Factors Associated with the Size of HIV DNA Reservoir

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Chinese Medical Journal 2017年第2期130卷 224-230页

作者： Ni-Dan Wang tai-sheng li Department of Infectious Diseases Peking Union Medical College Hospital Peking Union Medical College and Chinese Academy of Medical Sciences Beijing 100730 China

Objective： To review the recent literatures related to the factors associated with the size of the HIV reservoir and their clinical significance. Data Sources： literatures related to the size of HIV DNA was collected from PubMed published from 1999 to June 2016. Study Selection： All relevant articles on the HIV DNA and reservoir were collected and reviewed, with no limitation of study design. Results： The composition and development of the HIV- 1 DNA reservoir in either treated or untreated patients is determined by integrated mechanism comprising viral characteristics, immune system, and treatment strategies. The HIV DNA reservoir is a combination of latency and activity. The residual viremia from the stochastic activation of the reservoir acts as the fuse, continuing to stimulate the immune system to maintain the activated microenvironment for the rebound of competent virus once treatment with antiretroviral therapy is discontinued. Conclusion： The size of the HIV-1 DNA pool and its composition has great significance in clinical treatment and disease progression.

关键词： Antiretroviral Treatment HIV-I DNA Immune Activation, Latent Reservoir Residual Viremia

Overview of antiretroviral treatment in China： advancement and challenges

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Chinese Medical Journal 2011年第3期124卷 440-444页

作者： LUO ling li tai-sheng Department of Infectious Diseases Peking Union Medical College Hospital and AIDS Research Center Chinese Academy of Medical Sciences & Peking Union Medical College Beijing 100730 China

As the severity of the HIV epidemic in China grew, National Free Antiretroviral Treatment （ART） Program was announced since 2003. Even though there still were many difficulties, China had obtained great achievements in fighting against HIV.Over 52 000 adult patients had received first-line HAART thus far and the mortality of AIDS in China decreased significantly. This paper presents an overview of the HIV/AIDS epidemic in China; the status of national free ART program,the difficulties suffered and the achievements made since the initiation of program and the challenges ahead for continued progress for China. This paper also provides suggestions to overcome these challenges.

关键词： human immunodeficiency virus acquired immure deficiency syndrome highly active anti-retroviral therapy National Free Antiretroviral Treatment Program

Conquer coronary artery perforation with magic hands

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Journal of Geriatric Cardiology 2024年第4期21卷 379-386页

作者： Yi-Lun ZOU Jian-Qiang li Ding-Yu WANG Yong-tai GONG li sheng Yue li Department of Cardiology the First Affiliated Hospital of Harbin Medical UniversityHarbinChina

Coronary artery perforation(CAP) poses a significant challenge for interventional cardiologists. Management of CAP depends on the location and severity of the perforation. The conventional method for addressing the perforation of large vessels involves the placement of a covered stent, while the perforation of distal and collateral vessels is typically managed using coils, autologous skin, subcutaneous fat, microspheres, gelatin sponge, thrombin or other substances. However, the above techniques have certain limitations and are not applicable in all scenarios. Our team has developed a range of innovative strategies for effectively managing CAP. This article provides an insightful review of the various tips and tricks for the treatment of CAP.

关键词： coronary sponge perforation

Prevalence of Thrombocytopenia among Chinese Adult Antiretroviral-na（i）ve HIV-positive Patients

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Chinese Medical Journal 2015年第4期128卷 459-464页

作者： Hong-Wei Fan Fu-Ping Guo Yi-Jia li Ning li tai-sheng li Department of Infectious Diseases Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730 China

Background：The prevalence ofthrombocytopenia among Chinese antiretroviral therapy （ART）-na（i）ve HIV-infected adults has not been well-described.The aim of this study was to investigate the prevalence and associated risk factors of thrombocytopenia among Chinese ART-na（i）ve HIV-infected adults.Methods：We performed a cross-sectional study of Chinese adult ART-na（i）ve HIV-infected patients from September 2005 through August 2014.Socio-demographic variables and laboratory results including platelets,CD4＋ cell count,and viral load were obtained from medical records.Factors and outcomes associated with thrombocytopenia were assessed using logistic regression.Results：A total of 1730 adult ART-na（i）ve HIV-infected patients was included.The mean age was 38 years.The prevalence of thrombocytopenia was 4.5％.There were significant differences in the prevalence of thrombocytopenia between patients ＜30 years of age （2.8％） and 30-39 years （4.0％） compared with patients greater than 50 years （7.0％）（P =0.006 and P =0.044,respectively）.The prevalence of thrombocytopenia was also significantly different between patients with CD4＋ counts of 200-349 cells/mm3 （3.3％） and ＞350 cells/mm3 （2.8％） compared with patients with CD4＋ counts of50-199 cells/mm3 （7.1％）（P =0.002 and P =0.005,respectively）.The prevalence of thrombocytopenia was significantly different by hepatitis C virus antibody （HCV-Ab） seropositivity （10.2％ for HCV-Ab positive vs.3.9％ for HCV-Ab negative,P =0.001）.We observed differences in prevalence of thrombocytopenia by mode of transmission of HIV infection：Blood transmission （10.7％） versus men who have sex with men （3.9％）（P =0.002） and versus heterosexual transmission （3.9％）（P =0.001）.In binary logistic regression analyses,age ≥＞50 years,HCV-Ab positivity and having a CD4＋ cell count of 50-199 cells/mm3 were significantly associated with thrombocytopenia with adjusted odds ratio of 2.482 （95％ confidence interval [CI]：1.167,5.281,P=0.018）,2.091 （95％ CI：1.078,4.055,P =0.029） and 2.259 （95％ CI：1.028,4.962,P =0.042）,respect

关键词： HIV Prevalence Thrombocytopenia