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HIV-1 DNA levels in peripheral blood mononuclear cells of patients with HIV-related non-Hodgkin’s lymphoma

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Chinese Medical Journal 2023年第22期136卷 2741-2743页

作者： Zhenyan Wang Jingna Xun Zichen Song Yinzhong Shen Li Liu Jun Chen Tangkai Qi Jianjun Sun Wei Song Yang Tang Shuibao Xu Junyang Yang Bihe Zhao Renfang Zhang department of infection and Immunity Shanghai Public Health Clinical CenterFudan UniversityShanghai 201508China

To the Editor:Human immunodeficiency virus(HIV)patients have an increased risk of non-Hodgkin’s lymphoma(NHL),even in the era of antiretroviral therapy(ART).[1]The specific mechanisms of HIVrelated NHL(HIV-NHL)remain unclear.It is currently thought that HIV causes lymphoma primarily through chronic immune activation and an increased risk of infection with oncoviruses.In addition,HIV may have some other mechanisms that directly contribute to the occurrence of lymphoma.[2]Even with sustained ART,HIV-DNA remains in infected cells,creating a persistent reservoir of HIV infection.It is not known whether HIV reservoirs are involved in the development of HIV-NHL.In the present study,we detected HIV-1 DNA levels in peripheral blood mononuclear cells(PBMCs)and plasma inflammatory cytokines levels in HIV-NHL,and then evaluated their effects on HIV-NHL development and prognosis.

关键词： lymphoma patients sustained

clinical outcomes of people living with human immunodeficiency virus(HIV)with diffuse large B-cell lymphoma(DLBCL)in Shanghai,China

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Chinese Medical Journal 2020年第23期133卷 2796-2802页

作者： Jian-Jun Sun Li Liu Jiang-Rong Wang Yin-Zhong Shen Tang-Kai Qi Zhen-Yan Wang Yang Tang Wei Song Jun Chen Ren-Fang Zhang department of infection and Immunity Shanghai Public Health Clinical CenterFudan UniversityShanghai 201508China

Background:Numerous studies have focused on lymphoma among patients infected with human immunodeficiency virus(HIV).However,little is known about the treatment options and survival rate of lymphoma in the Chinese people living with HIV(PLHIV).Our study aimed to investigate the prognosis and compare outcome of dose-adjusted etoposide,prednisone,vincristine,cyclophosphamide,doxorubicin,and rituximab(DA-EPOCH-R)with standard cyclophosphamide,doxorubicin,vincristine,prednisone and rituximab(R-CHOP)as front line therapy for PLHIV with diffuse large B-cell lymphoma(DLBCL)receiving modern combined antiretroviral therapy(cART).Methods:A retrospective analysis evaluating PLHIV with DLBCL was performed in Shanghai Public Health clinical Center from July 2012 to September 2019.The demographic and clinical data were collected,and overall survival(OS)and progression-free survival(PFS)analyses of patients receiving R-CHOP or DA-EPOCH-R therapy were performed by Kaplan-Meier analysis.Additionally,a Cox multiple regression model was constructed to identify related factors for OS.Results:A total of 54 eligible patients were included in the final analysis with a median follow-up of 14 months(interquartile range[IQR]:8-29 months).The proportion of high international prognostic index(IPI)patients was much larger in the DA-EPOCH-R group(n=29)than that in the R-CHOP group(n=25).The CD4 cell counts and HIV RNA levels were not significantly different between the two groups.The 2-year OS for all patients was 73%.However,OS was not significantly different between the two groups,with a 2-year OS rate of 78%for the DA-EPOCH-R group and 66%for the R-CHOP group.Only an IPI greater than 3 was associated with a decrease in OS,with a hazard ratio of 5.0.The occurrence of grade 3 and 4 adverse events of chemotherapy was not significantly different between the two groups.Conclusions:Outcomes of R-CHOP therapy do not differ from those of DA-EPOCH-R therapy.No HIV-related factors were found to be associated with the OS of PLHIV in the modern cART er

关键词： Diffuse large B-cell lymphoma HIV infection Overall survival Progression free survival

clinical features and treatment outcomes of human immunodeficiency virus-associated cryptococcal meningitis:a 2-year retrospective analysis

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Chinese Medical Journal 2020年第23期133卷 2787-2795页

作者： Wei Song Yin-Zhong Shen Zhen-Yan Wang Tang-Kai Qi Li Liu Ren-Fang Zhang Jiang-Rong Wang Yang Tang Jun Chen Jian-Jun Sun Hong-Zhou Lu department of infection and Immunity Shanghai Public Health Clinical CenterFudan UniversityShanghai 201508China

Background:Cryptococcal meningitis(CM)is one of the most common opportunistic infections caused by Cryptococcus neoformans in human immunodeficiency virus(HIV)-infected patients,and is complicated with significant morbidity and mortality.This study retrospectively analyzed the clinical features,characteristics,treatment,and outcomes of first-diagnosed HIV-associated CM after 2-years of follow-up.Methods:Data from all patients(n=101)of HIV-associated CM hospitalized in Shanghai Public Health clinical Center from September 2013 to December 2016 were collected and analyzed using logistic regression to identify clinical and microbiological factors associated with mortality.Results:Of the 101 patients,86/99(86.9%)of patients had CD4 countinfection with PCP on admission(adjusted odds ratio[AOR],3.933;95%confidence interval[CI],1.166-13.269,P=0.027)and altered mental status(AOR,9.574;95%CI,2.548-35.974,P=0.001)were associated with higher mortality at 8 weeks.Conclusion:This study described the clinical features and outcomes of first diagnosed HIV-associated CM with 2-year follow-up data.Altered mental status and coinfection with PCP predicted mortality in HIV-associated CM.

关键词： clinical features Cryptococcal meningitis HIV Intracranial lesions Mortality

Interventions pathways to reduce tuberculosis-related stigma:a literature review and conceptual framework

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Infectious Diseases of Poverty 2022年第5期11卷 90-90页

作者： Charlotte Nuttall Ahmad Fuady Holly Nuttall Kritika Dixit Muchtaruddin Mansyur Tom Wingfeld Department of Clinical Infection Microbiology and ImmunologyUniversity of LiverpoolLiverpoolUK 不详

Background:Prevention of tuberculosis(TB)-related stigma is vital to achieving the World Health Organisation’s End TB Strategy target of eliminating TB.However,the process and impact evaluation of interventions to reduce TB-stigma are limited.This literature review aimed to examine the quality,design,implementation challenges,and successes of TB-stigma intervention studies and create a novel conceptual framework of pathways to TB-stigma reduction.Method:We searched relevant articles recorded in four scientifc databases from 1999 to 2022,using pre-defned inclusion and exclusion criteria,supplemented by the snowball method and complementary grey literature searches.We assessed the quality of studies using the Crowe Critical Appraisal Tool,then reviewed study characteristics,data on stigma measurement tools used,and interventions implemented,and designed a conceptual framework to illustrate the pathways to TB-stigma reduction in the interventions identifed.Results:Of 14,259 articles identifed,eleven met inclusion criteria,of which three were high quality.TB-stigma reduction interventions consisted mainly of education and psychosocial support targeted predominantly toward three key populations:people with TB,healthcare workers,and the public.No psychosocial interventions for people with TB set TB-stigma reduction as their primary or co-primary aim.Eight studies on healthcare workers and the public reported a decrease in TB-stigma attributed to the interventions.Despite the benefts,the interventions were limited by a dearth of validated stigma measurement tools.Three of eight studies with quantitative stigma measurement questionnaires had not been previously validated among people with TB.No qualitative studies used previously validated methods or tools to qualitatively evaluate stigma.On the basis of these fndings,we generated a conceptual framework that mapped the population targeted,interventions delivered,and their potential efects on reducing TB-stigma towards and experienced by people with TB and healthcare work

关键词： Tuberculosis Stigma Intervention Stigma measurement tool

Genetic diversity and phylogenetic analysis of EG95 sequences of Echinococcus granulosus:Implications for EG95 vaccine application

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Asian Pacific Journal of Tropical Medicine 2017年第5期10卷 497-500页

作者： Wei Pan De-Sheng Chen Yun-Juan Lu Hui-Wen Xu Wen-Ting Hao Ya-Wen Zhang Su-Ping Qin Kui-Yang Zheng Ren-Xian Tang Jiangsu Key Laboratory of Immunity and Metabolism Department of Pathogenic Biology and ImmunologyLaboratory of Infection and ImmunityXuzhou Medical University department of clinical Medicine Xuzhou Medical University

Objective:To analyse the genetic variability of EG95 sequences and provide guidance for EG95 vaccine application against Echinococcus granulosus(E. granulosus). Methods:We analysed EG95 polymorphism by collecting total 97 different E. granulosus isolates from 12 different host species that originated from 10 different countries. Multiple sequence alignments and the homology were performed by Lasergene 1(DNASTAR Inc.,Madison,WI),and the phylogenetic analysis was performed by using MEGA5.1(CEMI,Tempe,AZ,USA). In addition,linear and conformational epitopes were analysed,including secondary structure,NXT/S glycosylation,fibronectin type ecoⅢ(Fnndary Ⅲ) domain and glycosylphosphatidylinositol anchor signal(GPIanchor). The s structure was predicted by PSIPRED method. Results:Our results indicated that most isolates overall shared 72.6-100% identity in EG95 gene sequence with the published standard EG95 sequence,X90928. However,EG95 gene indeed has polymorphism in different isolates. Phylogenetic analysis showed that different isolates could be divided into three subgroups. Subgroup 1 contained 87 isolates while Subgroup 2 and Subgroup 3 consisted of 3 and 7 isolates,respectively. Four sequences cloned from oncosphere shared a high identity with the parental sequence of the current vaccine,X90928,and they belonged to Subgroup 1. However,in comparison to X90928,several amino acid mutations occurred in most isolates besides oncosphere,which potentially altered the immunodominant linear epitopes,glycosylation sites and secondary structures in EG95 genes. All these variations might change their previous antigenicity and thereby affecting the efficacy of current EG95 vaccine. Conclusions:This study reveals the genetic variability of EG95 sequences in different E. granulosus isolates,and proposed that more vaccination trials would be needed to test the effectiveness of current EG95 vaccine against distinct isolates in different countries.

关键词： Echinococcus granulosus Cystic echinococcosis EG95 Vaccine Genetic diversity

Prevalence and risk factors for bone mineral density changes in antiretroviral therapy-naive human immunodeficiency virus-infected adults:a Chinese cohort study

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Chinese Medical Journal 2020年第24期133卷 2940-2946页

作者： Yong-Qin Zeng Jiang Xiao Cui-Lin Li Yu Wang Ling Zhang Xiao-Li Pang Di Wang Juan Du Hong-Xin Zhao department of infection Beijing Ditan HospitalPeking UniversityBeijing 100015China clinical and Research Center of Infectious Diseases Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China

Background Studies have reported that low bone mineral density(BMD)is prevalent in human immunodeficiency virus(HIV)-infected patients;however,the factors that contribute to HIV-related BMD changes are yet to be fully understood.Due to the application of dual X-ray absorptiometry(DXA)among a select group of hospitals only,the prevalence and risk factors of low BMD in HIV-infected populations have not been intensively investigated in China.Thus,the aim of our study was to investigate the prevalence of and risk factors associated with BMD changes among antiretroviral therapy(ART)-naive HIV-positive patients in China.Methods The assessment of the prevalence of and risk factors associated with BMD changes was conducted among 156 ART-naive HIV-infected patients.Demographic and clinical data,as well as results of fasting blood tests were obtained from patients.Further,all patients underwent DXA scans to determine BMD,which was then used to classify patients with osteopenia/osteoporosis.The risk factors of reduced BMD were then evaluated using binary logistic regression.Results Among the 156 ART-naive HIV-infected participants,osteopenia and osteoporosis were diagnosed in 48.7%(76/156)and 4.5%(7/156)of patients,respectively.The lumbar spine was most likely to have reduced BMD(49.4%[77/156]),and the proportion of osteopenia in the left hip(32.7%[51/156])was higher than in the right hip(24.4%[38/156]).In the lumbar spine,bone loss rate in the L1 section(60.9%[95/156])was the most significant(L2,53.2%[83/156];L3,45.5%[71/156];L4,52.6%[82/156]).Further analysis showed that,compared with the neck(26.9%[42/156]in the left,18.6%[29/156]in the right)and the interior(15.4%[24/156]in the left,13.5%[21/156]in the right),the trochanter had the greatest probability of reduced BMD(46.2%[72/156]in the left,28.8%[45/156]in the right).In the risk factor analysis,low body mass index(BMI:<18.5 kg/m2)was positively associated with reduced BMD(Exp(B)=39.743,95%confidence interval:3.234-488.399,P=0.004),and was specifically positively correl

关键词： Human immunodeficiency virus(HIV) Antiretroviral therapy-naive Bone mineral density Body mass index

Helicobacter pylori vac A genotype is a predominant determinant of immune response to Helicobacter pylori CagA

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World Journal of Gastroenterology 2017年第26期23卷 4712-4723页

作者： Alexander Link Cosima Langner Wiebke Schirrmeister Wiebke Habendorf Jochen Weigt Marino Venerito Ina Tammer Dirk Schlüter Philipp Schlaermann Thomas F Meyer Thomas Wex Peter Malfertheiner department of Gastroenterology Hepatology and Infectious DiseasesOtto-von-Guericke University Institute of Medical Microbiology Otto-von-Guericke University Helmholtz Center for infection Research department of Molecular Biology Max Planck Institute for Infection Biology department of Molecular Genetics Medical Laboratory for Clinical ChemistryMicrobiology and Infectious Diseases

AIM To evaluate the frequency of Helicobacter pylori(H. pylori) Cag A antibodies in H. pylori infected subjects and to identify potential histopathological and bacterial factors related to H. pylori Cag A-immune response.METHODS Systematic data to H. pylori isolates, blood samples, gastric biopsies for histological and molecular analyses were available from 99 prospectively recruited subjects. Serological profile(anti-H. pylori, anti-Cag A) was correlated with H. pylori isolates(cag A, EPIYA, vac A s/m genotype), histology(Sydney classification) and mucosal interleukin-8(IL-8) m RNA and protein expression. Selected H. pylori strains were assessed for H. pylori Cag A protein expression and IL-8 induction in co-cultivation model with AGS cells.RESULTS Thirty point three percent of microbiologically confirmed H. pylori infected patients were seropositive for Cag A. Majority of H. pylori isolates were cag A gene positive(93.9%) with following vac A polymorphisms: 42.4% vac A s1m1, 23.2% s1m2 and 34.3% s2m2. Anti-Cag AIg G seropositivity was strongly associated with atrophic gastritis, increased mucosal inflammation according to the Sydney score, IL-8 and cag A m RNA expression. V a c A s a n d m p o l y m o r p h i s m s w e r e t h e m a j o r determinants for positive(vac A s1m1) or negative(vac A s2m2) anti-Cag A serological immune response, which also correlated with the in vitro inflammatory potential in AGS cells. In vitro co-cultivation of representative H. pylori strains with AGS cells confirmed functional Cag A translocation, which showed only partial correlation with Cag A seropositivity in patients, supporting vac A as major co-determinant of the immune response.CONCLUSION Serological immune response to H. pylori cag A + strain in H. pylori infected patients is strongly associated with vac A polymorphism, suggesting the crucial role of bacterial factors in immune and clinical phenotype of the infection.

关键词： Helicobacter pylori Seropositivity 毒力因素 CagA VacA 有免疫力的反应

Interaction Between the Neglected Tropical Disease Human Schistosomiasis and HCV infection in Egypt:a Puzzling Relationship

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Journal of clinical and Translational Hepatology 2014年第2期2卷 134-141页

作者： Mahmoud M. Bahgat Immunology and Infectious Diseases Group Therapeutic Chemistry Department the Centre of Excellence for Advanced Sciences the National Research Centre Dokki Cairo Egypt Research Group of Biomarkers for infection and Immunity Institute of Experimental Infection Research TWINCORE Centre for Experimental and Clinical Infection Research Hannover Germany

Egypt has the highest prevalence of chronic hepatitis C virus (HCV) infection and seropositivity worldwide, and it has been proposed that this enhanced susceptibility to HCV is related to coinfection with schistosomiasis. Although currently, there are no studies regarding the actual prevalence of both human schistosomiasis and schistosomiasis/HCV coinfection evi-dences strongly support that eliminating human schistoso-miasis from Egypt is necessary to reduce both HCV prevalence and liver pathology. The present review highlights the significant impact of the neglected tropical disease human schistosomiasis on both susceptibility of Egyptians to HCV coinfection, severity of the resulting liver pathology, and poor response to antiviral therapy. The immune evasion mechan-isms exerted by the HCV-NS3/4A protease domain, and the possible impact of immune evasion mechanisms exerted by proteases of larval, worm and egg stages of the parasite Schistosoma on human susceptibility to HCV infection are discussed. In addition, schistosome immune evasion mechanisms may include immunosuppression that in turn prevents clearance of HCV viremia and leads to relapsing HCV infection and severe liver pathology. I propose the generation of a replicon system from the most prevailing genotype (HCV-4a) in Egypt and establishing its replication on hepatoplas-toma or immune cells in presence of bilharzial antigens. Finally, the use of a humanized small animal model that can acquire both HCV and S. mansoni infections will be important to further understand in real time the impact of coinfection on both the immune system and liver pathology.

关键词： Egypt Neglected tropical disease Human schistosomiasis HCV Coinfection Immune evasion mechanisms HCV protease Schistosome pro-teases

Expert Recommendation for Novel Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination in HIV-Infected Adults

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Infectious Diseases & Immunity 2021年第3期1卷 133-136页

作者： AIDS and Hepatitis C Professional Group,Chinese Society of Infectious Diseases Taisheng Li Hongzhou Lu 不详 department of Infectious Diseases Peking Union Medical College HospitalChinese Academy of Medical Sciences department of infection and Immunology Shanghai Public Health Clinical Center

The outbreak of coronavirus disease 2019(COVID-19)caused by the novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has become a pandemic.SARS-CoV-2 vaccination is currently being actively promoted worldwide as a promising measure to combat the pandemic.However,human immunodeficiency virus(HIV)-infected individuals who manifest varying degrees of immunodeficiency and chronic inflammation may require special consideration with regards to vaccine types and the timing of immunization depending on specific clinical situations.The present recommendation provides a reference for SARS-CoV-2 vaccination in HIV-infected patients.

关键词： HIV infections Severe acute respiratory syndrome coronavirus 2 Vaccines