National Center for AIDS/STD Control and Prevention,China CDC

The impact of hepatitis C virus (HCV) co-infection on antiretroviral therapy (ART) outcomes in people living with human immunodeficiency virus (HIV) remains controversial across studies. Using stratified matching methods, we constructed two cohorts - one with HIV/HCV co-infection and one with HIV mono-infection - to compare ART outcomes. Our analysis revealed that HIV/HCV co-infected individuals faced significantly elevated risks of mortality, virological failure, and attrition relative to their HIV mono-infected counterparts. Enhanced prevention, screening, and management (including treatment) of hepatitis C virus within people living with human immunodeficiency virus should be prioritized and strengthened as part of routine clinical care.

Late human immunodeficiency virus (HIV) diagnosis remains prevalent among older adults in China; however, recent national-level evidence characterizing its correlates remains limited. Using nationwide surveillance data spanning 2022-2024 and employing two complementary analytical approaches, this study identified transmission route and geographic region as primary correlates of late HIV diagnosis. Decision-tree analysis further identified two distinct subgroups in eastern China exhibiting particularly elevated proportions of late diagnosis. These findings provide epidemiological evidence to inform more targeted HIV screening strategies tailored to specific population subgroups, geographic regions, and diagnostic settings.

Transgender women (TGW) are individuals whose birth sex is male but whose gender identify is female. They are usually simply classified as men who have sex with men, resulting in their specific needs being overlooked. TGW is a key population affecting the spread of AIDS. Global epidemiological data show that the HIV/AIDS prevalence and new infection rates are significantly higher in TGW than in general population. The prevalence of HIV infection in TGW remains at a high level in different areas of China , with higher infection risks compared with cisgender men who have sex with men. This paper summarizes the factors influencing HIV infection in TGW from multiple dimensions, including personal characteristics, social factors, and healthcare service, to provide references for the research and development of intervention measures in this population.

BackgroundPre-exposure prophylaxis (PrEP) has demonstrated high efficacy in preventing HIV infection among men who have sex with men (MSM). However, improper use can lead to breakthrough infections and diagnostic challenges.Case presentationWe report the case of a 30-year-old MSM who was prescribed on-demand PrEP with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) via telemedicine, following baseline assessments that included a negative HIV antibody test and an undetectable pooled (10-sample) HIV-1 nucleic acid testing (NAT). Five months after initiating PrEP treatment, pooled NAT reported a positive result, while the HIV antibody test remained negative. In the subsequent month, HIV antibody seroconversion was observed; however, the viral load remained at a low level (< 1,000 copies/mL), and Western blot (WB) results were indeterminate. Genotypic testing identified a transient K70KR mutation. Four months after the first positive NAT, WB positive seroconversion occurred, accompanied by an increased viral load (14,064 copies/mL). Subsequently, the patient initiated treatment with Bictegravir/Emtricitabine/Tenofovir Alafenamide and achieved viral suppression within three months.ConclusionsImproper and irregular use of PrEP led to HIV infection in this case. Telemedicine providers should conduct thorough assessments before starting PrEP and offer ongoing adherence support to maximize its effectiveness. This case highlights the importance of using NAT for early HIV detection in PrEP users and suggests including NAT in follow-up assessments to catch PrEP failures early. There is no need for excessive concern regarding the transient drug resistance mutations that may arise following PrEP failure, as these mutations do not compromise the efficacy of HIV treatment.

Objective: To understand the prevalence of peer-recommended self-HIV testing in men who have sex with men (MSM), and provide clue for identifying key individuals who can promote self-HIV testing. Methods: Data were derived from the self-HIV testing kits application system operated by Shijiazhuang Tongxing Non-Governmental Organization from July 1, 2022 to May 31, 2024. Statistical analysis was conducted by using software SPSS 29.0, and χ2 test was used to analyze differences between groups. Visual analysis of recommendation networks was performed by using software yEd Graph Editor 3.24. Results: A total of 1 574 MSM applied for HIV self-testing kits. The majority of the MSM were unmarried (74.7%), with education level of college or abvoe (65.5%), and employed (53.2%). Among them, 54.8% (862/1 574) reported consistent condom use at each sex in the past three months, while 37.2% (585/1 574) uploaded their HIV test results. Additionally, 53 MSM (3.4%) recommended self-HIV testing to other MSM. Notably, MSM aged ≥30 years and MSM who had occasional condoms use at each sex in the past three months were more likely to recommend self-HIV testing to other MSM. The 53 MSM collectively recommended self-HIV testing to another 740 MSM, the average was 13.9 MSM recommended by 1 MSM. Among MSM who accepted recommendation, 3 HIV-positive cases were identified, indicating that 1 HIV infection was detected by 17.7 recommendations. In the four-round recommendation, 10 MSM participated in more than one round recommendation, all of them were HIV prevention volunteers. Others only participating in one round were common MSM. Eleven MSM recommended self-HIV testing to two or more MSM. Conclusions: Peer-recommendation has high efficiency in the promotion of self-HIV testing, with HIV prevention volunteers serving as the primary force and the common MSM acting as a supportive force. Future efforts should be made to fully use key individuals to promote self-HIV testing.

Objective: To investigate the prevalence of baseline dyslipidemia in HIV-infected people before starting antiviral therapy (ART) in China. Methods: The data were collected from HIV/AIDS ART database of Chinese Disease Prevention and Control Information System. A national sample of HIV- infected people who initiated ART from 2018 to 2023 was used to collect baseline information, including sociodemographic characteristics and laboratory test results. According to the Chinese Lipid Management Guidelines (2023) and the National Cholesterol Education Program Adult Treatment Panel Ⅲ guidelines, triglyceride (TG) ≥1.7 mmol/L or total cholesterol (TC) ≥5.2 mmol/L were identified as dyslipidemia. Statistical analysis was performed with software SAS 9.4. An unconditional logistic regression model was used to analyze the factors influencing TG and TC abnormalities in HIV-infected patients before ART. Results: A total of 359 952 adults infected with HIV were included in this study, the prevalence rate of dyslipidemia was 38.41% (138 263/359 952). The abnormal rates of TG and TC were 31.40% (113 041/359 952) and 13.75% (49 494/359 952), respectively. In all age groups except for the 25-44 age groups, the abnormal rates of TG and TC were higher in HIV-infected women than in HIV-infected men. In HIV-infected patients, women, those aged 45-64 years, those lived in northeast region, those had heterosexual transmission, and those with BMI ≥28.0 kg/m2, CD4+T lymphocytes counts ≥500 cells/µl had higher rates of baseline dyslipidemia (all P<0.05). Conclusions: The abnormal rate of TG in HIV-infected people before ART was higher in China from 2018 to 2023, especially in HIV-infected women, and the abnormal rate of TG and TC increased with age. Attention should be paid to the clinical diagnosis and ART selection in the treatment of HIV infection.

Objective: To analyze the epidemic characteristics and trends of newly reported HIV-infected people among Chinese and Burmese in Dehong Dai and Jingpo Autonomous Prefecture (Dehong Prefecture) of Yunnan Province, China, from 2000 to 2023, and provide evidence for formµlating AIDS prevention and control measures for the Burmese living in Dehong. Methods: The data were obtained from the Chinese Disease Control and Prevention Information System. The distribution of HIV-infected people with different population characteristics was analyzed, and the Joinpoint regression model was used to analyze the temporal trend of crude detection rate in different genders, ethnicities, and ages. Results: From 2000 to 2023, 24 989 newly HIV infections were reported in Dehong Prefecture, of which 14 594 (58.4%) were Chinese and 10 395 (41.6%) were Burmese. Compared with Chinese, Burmese women (32.9%, 3 416/10 395), those aged 20-29 (40.9%, 4 248/10 395), and Jingpo people (26.7%, 2 773/10 395) accounted for a higher proportion. The new diagnosis rate of Chinese nationals increased from 1.0/10 000 in 2000 to 15.4/10 000 in 2004, and then showed a downward trend, falling to 1.2/10 000 in 2023. Among them, compared with other age groups, Dai and other ethnic groups and women, the new diagnosis rate among 20-49 age group, Jingpo and men were relatively higher, at 1.7/10 000, 2.3/10 000 and 1.3/10 000 respectively. Regarding the method of detection, the Chinese HIV-infected people were mainly detected by key population testing (35.7%), while the Burmese HIV-infected people by key population testing (28.9%) and physical examination for entry-exit personnel (25.3%). The transmission routes of both nationalities were mainly heterosexual transmission, but compared with Chinese HIV-infected persons, the proportion of Burmese infected persons through non-marital non-commercial transmission was relatively higher (66.4% vs. 60.6%). The proportion of Chinese nationals with a first CD4+T lymphocyte (CD4) counts of <200 cells/µl (28.9%) was higher than that of Burmese nationals (19.8%). Conclusions: The rising trend of HIV infection among Chinese and Burmese people in Dehong Prefecture from 2000 to 2023 slowed down. The new diagnosis rate was higher in the 20-49 age group, Jingpo and men. Compared with Burmese HIV-infected people, the proportion of Chinese HIV-infected people with first CD4 counts <200 cells/µl was relatively higher. Comprehensive interventions should be further carried out for Myanmar nationals, and efforts should be made to expand testing for Chinese nationals.