Mother to child transmission (MTCT) plays an important role in children HIV infection, and in China, about 0.1% to 0.4% individuals were infected through MTCT. Nucleic aicd amplification testing was powerful tool to assess the effect of prevention of MTCT, mainly by qualification NAT. Here, we described an intrafamiliar transmission event by molecular epidemiology.
Methods
A pregnant woman with seroconversion during pregnant healthcare was followed up by epidemiology survey, together with her husband and newborn. Viral RNA was extracted for the amplification of HIV-1 gag gene and pol gene fragments with One-step RT-PCR. The positive PCR products were subject to DNA sequencing. The sequences of gag gene and pol gene were codon-based aligned and analyzed with MEGA 6.0 to construct neighbor-joining tree, respectively. The genotypic drug resistances were interpretated by Stanford University HIV drug resistance database.
Results
The proband was the pregnant woman, with seroconversion of anti-HIV-antibody screening by Wantai HIV-1/2 Ab kit during pregnant healthcare. Afterward, her husband and son at age of eight months were diagnosed as HIV-1 infection by HIV-1 antibody screening and RT-PCR, respectively, although her son was RT-PCR negative one day after birth. Neighbor-joining (NJ) tree indicated that the three individuals were infected by HIV-1 CRF02_AG, forming a close subcluster with high genetic homogeneity (bootstrap value, 95%). The sequences from the husband were closer to the root or the ancestor of the tree, and the topology structure indicated the transmission timing and evolution relationship, from father to mother and child, as shown by seroepidemiology.
Conclusion
An intra-familial transmission of HIV-1 CRF02_AG was reconstructed by molecular epidemiology and the possible transmission relationship was elucidated. Contagious diseases screening should be reinforced during healthcare before marriage or pregnancy-deliver. Prevention of mother-to-child transmission should be timely and efficiently administered upon diagnosis of infection in pregnant women, to avoid the secondary intra-familial transmission and improve the population quality at birth.
To know their real epidemiological histories in 1,091 probale cases of severe acute respiratory syndrome (SARS) without definite history of contact with SARS patients in the first survey.All the probable SARS cases until June 9, 2003 without definite history of contact with SARS patients in the first epidemiological survey were included in a re-survey with questionnaire. The second survey was carried out during June 9 to 30, 2003.The results showed that history of contact with other SARS patients was obtained in 15.9% of 1 091 probale SRAS cases in the second survey, transmission of SARS to others was found in 10.5% of them, and source of infection in hospital was found in 46.5%. Comprehensive judgement based on epidemiological history showed that probale history of contact with SARS patients could be found in 72.9% of 1,091 probale cases of SARS in the second survey.Source of infection could be found through additional survey in part of probale cases of SARS without it in initial epidemiological survey.
HIV subtypes convey important epidemiological information and possibly influence the rate of disease progression. In this study, HIV disease progression in patients infected with CRF01_AE, CRF07_BC, and subtype B was compared in the largest HIV molecular epidemiology study ever done in China. A national data set of HIV pol sequences was assembled by pooling sequences from public databases and the Beijing HIV laboratory network. Logistic regression was used to assess factors associated with the risk of AIDS at diagnosis ([AIDSAD], defined as a CD4 count < 200 cells/µL) in patients with HIV subtype B, CRF01_AE, and CRF07_BC. Of the 20,663 sequences, 9,156 (44.3%) were CRF01_AE. CRF07_BC was responsible for 28.3% of infections, followed by B (13.9%). In multivariable analysis, the risk of AIDSAD differed significantly according to HIV subtype (OR for CRF07_BC vs. B: 0.46, 95% CI 0.39─0.53), age (OR for ≥ 65 years vs. < 18 years: 4.3 95% CI 1.81─11.8), and transmission risk groups (OR for men who have sex with men vs. heterosexuals: 0.67 95% CI 0.6─0.75). These findings suggest that HIV diversity in China is constantly evolving and gaining in complexity. CRF07_BC is less pathogenic than subtype B, while CRF01_AE is as pathogenic as B.
We report on a case of Vibrio vulnificus (V. vulnificus) detected by metagenomics next-generation sequencing (mNGS) in a 53-year-old male patient with polymicrobial gas gangrene and successful treatment by surgery. This report raises awareness among dermatologists that when a patient is clinically suspected of a special type of pathogenic infection, the mNGS method should be preferred to identify the patient's pathogen infection as soon as possible and then take effective treatment in time to save patients' lives.A 53-year-old male who worked in the aquatic market complained of redness and swelling of the lower limbs, blisters and ulcers with fever for 3 d. We used mNGS to test the pathogens in ulcer secretions. The results were returned in 24 h and indicated: V. vulnificus, Fusobacterium necrophorum, Staphylococcus haemolyticus, Staphylococcus aureus, Streptococcus dysgalactiae and Klebsiella aerogenes. This patient was diagnosed with V. vulnificus infection. The emergency operation was performed immediately under combined lumbar and epidural anesthesia: Left leg expansion and exploration (August 10, 2021). After surgery, we continued to use piperacillin sodium tazobactam sodium 4.5 g every 8 h and levofloxacin 0.5 g for anti-infection treatment. The patient underwent further surgery under lumbar anesthesia on August 17, 2021 and August 31, 2021: Left leg deactivation and skin grafting, negative pressure closed drainage and right thigh skin removal. After treatment, the transplanted flap survived.We could confirm the diagnosis of Vibrio vulnificus infection within 24 h through mNGS detection and then immediately performed emergency surgery.
Beijing has seen a rising epidemic of HIV among students. However, little information was known about the molecular epidemiologic data among HIV-infected students. In this study, the diversity and the prevalence of transmitted drug resistance (TDR) in pol sequences derived from 237 HIV-infected students were analyzed. TDR mutations were found in five men who have sex with men (MSM) population among students. The overall prevalence of TDR in students was 2.1%, comprising 1.3% of protease inhibitors and 0.8% of non-nucleoside reverse transcriptase inhibitors. Our finding indicates a low-level prevalence of TDR mutations among students in Beijing.
Abstract HIV subtypes convey important epidemiological information and possibly influence the rate of disease progression. In this study, HIV disease progression in patients infected with CRF01_AE, CRF07_BC, and subtype B was compared in the largest HIV molecular epidemiology study ever done in China. A national data set of HIV pol sequences was assembled by pooling sequences from public databases and the Beijing HIV laboratory network. Logistic regression was used to assess factors associated with the risk of AIDS at diagnosis ([AIDSAD], defined as a CD4 count <200 cells/µL) in patients with HIV subtype B, CRF01_AE, and CRF07_BC. Of the 20,663 sequences, 9,156 (44.3%) were CRF01_AE. CRF07_BC was responsible for 28.3% of infections, followed by B (13.9%). In multivariable analysis, the risk of AIDSAD differed significantly according to HIV subtype (OR for CRF07_BC vs. B: 0.46, 95% CI 0.39─0.53), age (OR for ≥65 years vs. <18 years: 4.3 95% CI 1.81─11.8), and transmission risk groups (OR for man who have sex with man vs. heterosexual: 0.67 95% CI 0.6─0.75). These findings suggest that HIV diversity in China is constantly evolving and gaining complexity. CRF07_BC is less pathogenic than subtype B, while CRF01_AE is as pathogenic as B.
To investigate the origin and evolutionary history of the spread of HIV-1 subtype B in China, a total of 409 sequences of pol gene sampled from 1994 to 2012 in 29 provinces across China was subjected to phylogenetic and Bayesian molecular clock analyses. The study reveals that subtype B strains in China are genetically diverse and can be classified into four distinct subgroups, namely B′ (Thai-B), BJ-B (Beijing-B), Pan-B (Pandemic-B), and TW-B (Taiwan-B), according to the origin of the sequences. The BJ-B and TW-B are reported for the first time. Phylogeographic analysis reveals that B′ exhibits a nationwide, transprovincial distribution, and is found in 21 provinces in China in this study, whereas the Pan-B, BJ-B, and TW-B lineages are restricted to particular regions. From the same common ancestor of B′, there arise two subclusters in which sequences from Yunnan occupy the basal position. The times of the most recent common ancestors (tMRCAs) of B′ and BJ-B are estimated to be 1983.6 (1975.9–1990.3) and 1995.3 (1989.6–2000.3), respectively. The skyline plot profile reveals an exponential decrease in median number of effective infections of subtype B in China from 1994 to 2009. The existence of four types of B clades also indicates distinct transmission networks of subtype B, originating from different introduction events at different time points. The data presented here offer a new perspective on the epidemic of HIV-1 subtype B in China.
Epidemiological studies have reported associations between traditional cardiovascular risk factors and carotid intima-media thickness (CIMT) or carotid plaque. However, definite risk factors at different phases of carotid atherosclerosis remain controversial. We aimed to explore risk factors and characteristics of carotid atherosclerosis at different stages in a low-income population with a high incidence of stroke in China. Between April 2014 and January 2015, we recruited 3789 stroke-free and cardiovascular disease-free residents aged ≥ 45 years. B-mode ultrasonography was performed to measure CIMT and the presence of carotid plaque. Traditional risk factors were compared between the increased CIMT group and normal CIMT group, and between those with and without carotid plaque. A total of 3789 participants were assessed in this study, with a mean age (standard deviation) of 59.92 (9.70) years. The prevalence of increased CIMT and carotid plaque increased with older age and higher education levels. Age, hypertension, diabetes, and high low-density lipoprotein cholesterol levels were risk factors for increased CIMT and carotid plaque. Furthermore, compared to never smoking, passive smoking was positively associated with increased CIMT, with an odds ratio (95% confidence interval) of 1.26 (1.05, 1.53; P = 0.016); high body mass index was an obvious protective factor against carotid plaque, with an odds ratio (95% confidence interval) of 0.97 (0.95, 0.99; P = 0.004). It is important to identify factors associated with atherosclerosis to prevent cardiovascular disease and stroke and reduce the burden of stroke in this high-risk population.
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