Objective To analyze the differences of clinical manifestations and organ damage between patients with severe fever with thrombocytopenia syndrome(SFTS) and patients with tsutsugamushi disease, and to investigate the prognostic factors of SFTS. Methods The research was performed on 49 patients with SFTS and 16 patients with tsutsugamushi disease who visited the First Affiliated Hospital of Anhui Medical University from October 2014 to June 2017. The general information of patients including region, age, gender and clinical manifestations were evaluated. Blood routine, liver and kidney function, myocardial enzyme levels, lipase, amylase, electrolytes, C-reactive protein, procalcitonin, prothrombin time(PT) and activated partial thromboplastin time(APTT) were continuously monitored during the course of disease. T test was used for continuous variables of normal distribution, and non-parametric test was used for variables of non-normal distribution. Chi-square test was used for categorical variables. Results The mean age of SFTS patients was 62.1±15.5(ranging from 17 to 87 years) and the mean age of tsutsugamushi patients was 56.1±9.2 (ranging from 47 to 73 years). There was no significant difference between the two groups (t=1.47, P=0.147). There were 25 males(51%) in SFTS patients and 8 males (50%) in tsutsugamushi disease patients. There was no significant difference between the two groups (χ2=0.005, P=0.943). The incidences of headache, vomiting, superficial lymphadenectasis, disturbance of consciousness, proteinuria, hematuria, pulmonary infection, multiple organ dysfunction and acute pancreatitis in SFTS patients were all significantly higher than those in tsutsugamushi disease patients (χ2=8.82, 4.38, 8.71, 11.17, 7.88, 5.56, 4.35, 9.43, and 8.13, respectively, P<0.05 or 0.01). The counts of leukocytes (Z=2.73), neutrophils (Z=2.46), lymphocytes (Z=3.15), platelets (Z=4.25), albumin (Z=2.65) and sodium ion (t=2.10) in SFTS patients were all significantly lower than those in patients with tsutsugamushi disease (P<0.05 or 0.01). The levels of aspartate aminotransferase (Z=2.94), lactate dehydrogenase (Z=3.42), creatine kinase(CK)(Z=2.88), amylase (Z=2.77), lipase (Z=2.82), creatinine (Z=2.07) and urea nitrogen (Z=2.50) in fatal SFTS patients were all significantly higher than those in patients with tsutsugamushi disease (P<0.05 or 0.01). Among 49 SFTS patients, 16 patients died and 33 patients recovered finally. The age(t=3.33), platelet count (Z=2.55), alanine aminotransferase (ALT)(Z=2.10), aspartate aminotransferase (AST)(Z=2.22), lactate dehydrogenase (Z=2.26), CK(Z=3.50), CK-MB (Z=3.10), creatinine (Z=2.17), urea nitrogen (Z=2.36), and sodium (t=2.65) between the two subgroups had significant differences (P<0.05 or 0.01). Conclusions SFTS is more severe and has high mortality, while tsutsugamushi disease has a better prognosis. Early differential diagnosis and early rational treatment are important to reduce the mortalit
{"title":"Differences of clinical manifestations and organ damage between patients with severe fever with thrombocytopenia syndrome and patients with tsutsugamushi disease","authors":"Lifen Hu, Fang-Yuan Xu, Lingling Xia, Xuejiao Ma, Xiao-ping Chang, Ting Wu","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.02.004","url":null,"abstract":"Objective \u0000To analyze the differences of clinical manifestations and organ damage between patients with severe fever with thrombocytopenia syndrome(SFTS) and patients with tsutsugamushi disease, and to investigate the prognostic factors of SFTS. \u0000 \u0000 \u0000Methods \u0000The research was performed on 49 patients with SFTS and 16 patients with tsutsugamushi disease who visited the First Affiliated Hospital of Anhui Medical University from October 2014 to June 2017. The general information of patients including region, age, gender and clinical manifestations were evaluated. Blood routine, liver and kidney function, myocardial enzyme levels, lipase, amylase, electrolytes, C-reactive protein, procalcitonin, prothrombin time(PT) and activated partial thromboplastin time(APTT) were continuously monitored during the course of disease. T test was used for continuous variables of normal distribution, and non-parametric test was used for variables of non-normal distribution. Chi-square test was used for categorical variables. \u0000 \u0000 \u0000Results \u0000The mean age of SFTS patients was 62.1±15.5(ranging from 17 to 87 years) and the mean age of tsutsugamushi patients was 56.1±9.2 (ranging from 47 to 73 years). There was no significant difference between the two groups (t=1.47, P=0.147). There were 25 males(51%) in SFTS patients and 8 males (50%) in tsutsugamushi disease patients. There was no significant difference between the two groups (χ2=0.005, P=0.943). The incidences of headache, vomiting, superficial lymphadenectasis, disturbance of consciousness, proteinuria, hematuria, pulmonary infection, multiple organ dysfunction and acute pancreatitis in SFTS patients were all significantly higher than those in tsutsugamushi disease patients (χ2=8.82, 4.38, 8.71, 11.17, 7.88, 5.56, 4.35, 9.43, and 8.13, respectively, P<0.05 or 0.01). The counts of leukocytes (Z=2.73), neutrophils (Z=2.46), lymphocytes (Z=3.15), platelets (Z=4.25), albumin (Z=2.65) and sodium ion (t=2.10) in SFTS patients were all significantly lower than those in patients with tsutsugamushi disease (P<0.05 or 0.01). The levels of aspartate aminotransferase (Z=2.94), lactate dehydrogenase (Z=3.42), creatine kinase(CK)(Z=2.88), amylase (Z=2.77), lipase (Z=2.82), creatinine (Z=2.07) and urea nitrogen (Z=2.50) in fatal SFTS patients were all significantly higher than those in patients with tsutsugamushi disease (P<0.05 or 0.01). Among 49 SFTS patients, 16 patients died and 33 patients recovered finally. The age(t=3.33), platelet count (Z=2.55), alanine aminotransferase (ALT)(Z=2.10), aspartate aminotransferase (AST)(Z=2.22), lactate dehydrogenase (Z=2.26), CK(Z=3.50), CK-MB (Z=3.10), creatinine (Z=2.17), urea nitrogen (Z=2.36), and sodium (t=2.65) between the two subgroups had significant differences (P<0.05 or 0.01). \u0000 \u0000 \u0000Conclusions \u0000SFTS is more severe and has high mortality, while tsutsugamushi disease has a better prognosis. Early differential diagnosis and early rational treatment are important to reduce the mortalit","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48444062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.02.005
Yan Su, Shigang Zhao, Tao He, Yali Liao, Caiyun Ren
Objective To analyze the clinical characteristics and prognosis of neurobrucellosis (NB). Methods Twenty-seven cases of NB patients who received treatment in Disease Prevention and Control Center of Inner Mongolia Autonomous Region and Inner Mongolia Medical University Hospital from January to December in 2016 were collected. The clinical data of these patients were recorded and systematically analyzed. Results Twenty-four cases (88.89%) had a history of exposure to cattle and sheep. Twenty-four cases (88.89%) were admitted with fever, 18(66.67%) cases with sweat, 16 cases(59.26%) with headache, 14 cases (51.85%) with neurological symptoms of meningitis and meningoencephalitis, 4 cases (14.81% ) with auditory nerve damage and 3 cases (11.11%) with spinal cord damage. Elevated white blood cells were found in 2 cases (7.41%), elevated serum C-reactive protein in 3 cases (11.11%), elevated procalcitonin in 2 cases (7.41%) and elevated erythrocyte sedimentation rate in 15 cases (55.56%). All the 27 patients underwent lumbar puncture and the cerebrospinal fluid test results were abnormal, of which increased protein levels in 17 cases (62.96%), increased mononuclear cell ratio 14 cases (51.85%), increased pressure in 14 cases (51.85%), and reduced chloride levels in 14 cases (51.85%), and reduced glucose levels in 6 cases (22.22%). Positive cerebrospinal fluid culture (CSF) was found in 1 case (3.70%). There were 8 cases (29.63%) with white matter damage, 5 cases (18.52%) with meningeal enhancement, 3 cases (11.11%) with spinal cord lesions, 2 cases (7.41%) with cerebral edema and 2 cases (7.41%) with brain abscess. There were 10 cases (37.04%) with sensory nerve damage in the extremities, 4 cases (14.81%) with auditory nerve damage and 2 cases (7.41%) with motor nerve damage. All patients were treated with regular anti-Berg′s disease for 6 weeks and were followed up for 1 year (every 3 months) after the treatment. Nineteen patients (70.37%) were cured, 7 patients (25.93%) developed sequelae and 1(3.70%) patient died. Conclusions The analysis suggests that NB have a variety of clinical characteristics. CSF examination, imaging examination and neuro electrophysiology detection have contribution to the diagnosis of the NB. Key words: Neurobrucellosis; Clinical features; Cerebrospinal fluid characteristics; Neuroimaging; Neuro electrophysiology
{"title":"Clinical analysis of 27 neurobrucellosis patients","authors":"Yan Su, Shigang Zhao, Tao He, Yali Liao, Caiyun Ren","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.02.005","url":null,"abstract":"Objective \u0000To analyze the clinical characteristics and prognosis of neurobrucellosis (NB). \u0000 \u0000 \u0000Methods \u0000Twenty-seven cases of NB patients who received treatment in Disease Prevention and Control Center of Inner Mongolia Autonomous Region and Inner Mongolia Medical University Hospital from January to December in 2016 were collected. The clinical data of these patients were recorded and systematically analyzed. \u0000 \u0000 \u0000Results \u0000Twenty-four cases (88.89%) had a history of exposure to cattle and sheep. Twenty-four cases (88.89%) were admitted with fever, 18(66.67%) cases with sweat, 16 cases(59.26%) with headache, 14 cases (51.85%) with neurological symptoms of meningitis and meningoencephalitis, 4 cases (14.81% ) with auditory nerve damage and 3 cases (11.11%) with spinal cord damage. Elevated white blood cells were found in 2 cases (7.41%), elevated serum C-reactive protein in 3 cases (11.11%), elevated procalcitonin in 2 cases (7.41%) and elevated erythrocyte sedimentation rate in 15 cases (55.56%). All the 27 patients underwent lumbar puncture and the cerebrospinal fluid test results were abnormal, of which increased protein levels in 17 cases (62.96%), increased mononuclear cell ratio 14 cases (51.85%), increased pressure in 14 cases (51.85%), and reduced chloride levels in 14 cases (51.85%), and reduced glucose levels in 6 cases (22.22%). Positive cerebrospinal fluid culture (CSF) was found in 1 case (3.70%). There were 8 cases (29.63%) with white matter damage, 5 cases (18.52%) with meningeal enhancement, 3 cases (11.11%) with spinal cord lesions, 2 cases (7.41%) with cerebral edema and 2 cases (7.41%) with brain abscess. There were 10 cases (37.04%) with sensory nerve damage in the extremities, 4 cases (14.81%) with auditory nerve damage and 2 cases (7.41%) with motor nerve damage. All patients were treated with regular anti-Berg′s disease for 6 weeks and were followed up for 1 year (every 3 months) after the treatment. Nineteen patients (70.37%) were cured, 7 patients (25.93%) developed sequelae and 1(3.70%) patient died. \u0000 \u0000 \u0000Conclusions \u0000The analysis suggests that NB have a variety of clinical characteristics. CSF examination, imaging examination and neuro electrophysiology detection have contribution to the diagnosis of the NB. \u0000 \u0000 \u0000Key words: \u0000Neurobrucellosis; Clinical features; Cerebrospinal fluid characteristics; Neuroimaging; Neuro electrophysiology","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41937879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.02.006
G. Qian, Zhu Zhao-qin, Qian Xueqin, Wei Jianhao
Objective To investigate the species distribution characteristics of nontuberculous mycobacteria (NTM) in acquired immunodeficiency syndrome(AIDS) patients in Shanghai, and to provide evidences for clinical treatment. Methods A total of 775 Mycobacteria strains were isolated from patients (including 129 isolates from AIDS patients and 646 isolates from HIV-negative patients) admitted to Shanghai Public Health Clinical Center during 2015. All the species were identified by the sequence analysis of 16S rRNA gene and hsp65 gene. Differences in the species distribution were compared between patients with and without HIV infection. CD4+ T lymphocyte count was detected by flow cytometry and its relation with mycobacteria infection was also analyzed. Chi-square test was used for comparison between groups. Results The ratio of NTM isolation from HIV-negative patients was 15.79% (102/646), while that was 46.51% in AIDS patients (60/129), and the difference was statistically significant (χ2=61.38, P 50 cells/μL (20.00% and 15.38%, respectively) (χ2=4.048 and 6.524, respectively, both P 50 cells/μL. Conclusions The prevalence of NTM isolation is significant higher in AIDS patients than HIV-negative patients in Shanghai, and the most prevalent NTM species is MAC. The NTM infection in AIDS patients is related with low CD4+ T lymphocyte counts. Key words: Acquired immunodeficiency syndrome; Nontuberculous mycobacteria; Species identification
{"title":"Species distribution characteristics of nontuberculous mycobacteria isolated from patients with acquired immunodeficiency syndrome in Shanghai","authors":"G. Qian, Zhu Zhao-qin, Qian Xueqin, Wei Jianhao","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.02.006","url":null,"abstract":"Objective \u0000To investigate the species distribution characteristics of nontuberculous mycobacteria (NTM) in acquired immunodeficiency syndrome(AIDS) patients in Shanghai, and to provide evidences for clinical treatment. \u0000 \u0000 \u0000Methods \u0000A total of 775 Mycobacteria strains were isolated from patients (including 129 isolates from AIDS patients and 646 isolates from HIV-negative patients) admitted to Shanghai Public Health Clinical Center during 2015. All the species were identified by the sequence analysis of 16S rRNA gene and hsp65 gene. Differences in the species distribution were compared between patients with and without HIV infection. CD4+ T lymphocyte count was detected by flow cytometry and its relation with mycobacteria infection was also analyzed. Chi-square test was used for comparison between groups. \u0000 \u0000 \u0000Results \u0000The ratio of NTM isolation from HIV-negative patients was 15.79% (102/646), while that was 46.51% in AIDS patients (60/129), and the difference was statistically significant (χ2=61.38, P 50 cells/μL (20.00% and 15.38%, respectively) (χ2=4.048 and 6.524, respectively, both P 50 cells/μL. \u0000 \u0000 \u0000Conclusions \u0000The prevalence of NTM isolation is significant higher in AIDS patients than HIV-negative patients in Shanghai, and the most prevalent NTM species is MAC. The NTM infection in AIDS patients is related with low CD4+ T lymphocyte counts. \u0000 \u0000 \u0000Key words: \u0000Acquired immunodeficiency syndrome; Nontuberculous mycobacteria; Species identification","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41635446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.01.002
Y. Huang, Er-ping Luo, Yiling Zhu, Yi-jing Zhang
Objective To explore the predictive value of neutrophil-to-lymphocyte ratio on the prognosis of H7N9 avian influenza. Methods A retrospective analysis was conducted on 28 H7N9 avian influenza patients (treatment group) at the First Affiliated Hospital of Soochow University from April 2013 to January 2016. Thirty healthy physical examiners in the same period were enrolled as the healthy control group. The 28 patients were followed up for half a year and divided into the improvement group (18 cases) and the death group (10 cases) according to the clinical prognosis. Inflammatory indicators including white blood cells (WBC), neutrophil (N), lymphocyte (L), monocytes (M), platelet (PLT), creatine kinase (CK), lactate dehydrogenase (LDH), high sensitive C reactive protein were collected at day 1, day 3 and week 1 of admission. Calculation of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), ΔNLR3 (day 3 of admission NLR-on day 1 of admission NLR), ΔNLR7 (week 1 of admission NLR -day 3 of admission NLR) and so on calculating ΔPLR3, ΔPLR7, ΔLMR3, ΔLMR7. Differences of the above indicators between the improvement group and death group were compared. The measurement data with normal distribution were tested by t-test of two independent samples, and the count data with non-normal distribution were tested by Mann-Whitney U-test. Univariate and multivariate logistic regression analysis to explore the prognostic factors and the working characteristic curve of subjects was used to evaluate the predictive value of inflammatory response indexes for H7N9 avian influenza death. Results In the treatment group, the baseline WBC, L, N, PLT, the proportion of lymphocytes, neutrophils, monocytes, and NLR, PLR, and LMR were all statistically different compared with the healthy control group (all P<0.01). After treatment, day 3 NLR, ΔNLR3 in improvement group were both significantly decreased to 10.93 (15.71) and 0.87 (-15.63), respectively when compared with death group (17.62[23.63] and 7.42[22.68], respectively) (Z=-2.16 and -2.014, respectively, both P<0.05). Day 7 NLR, ΔNLR7 in improved group were 6.51 (13.23) and -0.37 (-12.38), respectively, which were both lower than those of death group (27.90 [25.64] and 11.54 [-26.22]) with statistically significant differences (Z=-2.444 and -2.111, respectively, both P<0.05). Multivariate logistic regression analysis indicates that ΔNLR3 is the main factor that affects the prognosis of the H7N9 infection (odds ratio [OR]=1.153, 95% confidence interval [CI]: 1.052-1.263, P=0.002). Reciver operating characteristic curve analysis showed that the area under the curve was 0.733 (95% CI: 0.532-0.935, P=0.044). Based on the principle of Youden index, the cut-off value of ΔNLR3 to predict the death risk of H7N9 avian influenza was 5.453 with sensitivity of 0.700 and the specificity of 0.722. The mortality was higher when ΔNLR3 was higher than 5.453. Conclus
{"title":"Clinical application of neutrophil-to-lymphocyte ratio in predicting the prognosis of H7N9 avian influenza","authors":"Y. Huang, Er-ping Luo, Yiling Zhu, Yi-jing Zhang","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.01.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.01.002","url":null,"abstract":"Objective \u0000To explore the predictive value of neutrophil-to-lymphocyte ratio on the prognosis of H7N9 avian influenza. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted on 28 H7N9 avian influenza patients (treatment group) at the First Affiliated Hospital of Soochow University from April 2013 to January 2016. Thirty healthy physical examiners in the same period were enrolled as the healthy control group. The 28 patients were followed up for half a year and divided into the improvement group (18 cases) and the death group (10 cases) according to the clinical prognosis. Inflammatory indicators including white blood cells (WBC), neutrophil (N), lymphocyte (L), monocytes (M), platelet (PLT), creatine kinase (CK), lactate dehydrogenase (LDH), high sensitive C reactive protein were collected at day 1, day 3 and week 1 of admission. Calculation of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), ΔNLR3 (day 3 of admission NLR-on day 1 of admission NLR), ΔNLR7 (week 1 of admission NLR -day 3 of admission NLR) and so on calculating ΔPLR3, ΔPLR7, ΔLMR3, ΔLMR7. Differences of the above indicators between the improvement group and death group were compared. The measurement data with normal distribution were tested by t-test of two independent samples, and the count data with non-normal distribution were tested by Mann-Whitney U-test. Univariate and multivariate logistic regression analysis to explore the prognostic factors and the working characteristic curve of subjects was used to evaluate the predictive value of inflammatory response indexes for H7N9 avian influenza death. \u0000 \u0000 \u0000Results \u0000In the treatment group, the baseline WBC, L, N, PLT, the proportion of lymphocytes, neutrophils, monocytes, and NLR, PLR, and LMR were all statistically different compared with the healthy control group (all P<0.01). After treatment, day 3 NLR, ΔNLR3 in improvement group were both significantly decreased to 10.93 (15.71) and 0.87 (-15.63), respectively when compared with death group (17.62[23.63] and 7.42[22.68], respectively) (Z=-2.16 and -2.014, respectively, both P<0.05). Day 7 NLR, ΔNLR7 in improved group were 6.51 (13.23) and -0.37 (-12.38), respectively, which were both lower than those of death group (27.90 [25.64] and 11.54 [-26.22]) with statistically significant differences (Z=-2.444 and -2.111, respectively, both P<0.05). Multivariate logistic regression analysis indicates that ΔNLR3 is the main factor that affects the prognosis of the H7N9 infection (odds ratio [OR]=1.153, 95% confidence interval [CI]: 1.052-1.263, P=0.002). Reciver operating characteristic curve analysis showed that the area under the curve was 0.733 (95% CI: 0.532-0.935, P=0.044). Based on the principle of Youden index, the cut-off value of ΔNLR3 to predict the death risk of H7N9 avian influenza was 5.453 with sensitivity of 0.700 and the specificity of 0.722. The mortality was higher when ΔNLR3 was higher than 5.453. \u0000 \u0000 \u0000Conclus","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48949750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.01.004
Huixia Li, Jianfei Zheng, Guangwen Huang, Juan Xiao, Jie Gao, Min Yang, N. Feng
Objective To examine the association between maternal syphilis treatmentand the adverse pregnancy outcomes. Methods Syphilis-infected pregnant women retrieved from Information System of Prevention Mother-to-child Transmission of Human Immunodeficiency Virus (HIV), Syphilis, and Hepatitis B Management in Hu′nan Province between January 2012 and December 2017 were retrospectively studied. Information of demographic characteristics, pregnancy history, and syphilis infection/treatment history among these syphilis-infected pregnant women were collected and analyzed. According to the anti-syphilis treatment situation during pregnancy, syphilis-infected pregnant women were divided into three groups: non-treatment group, non-standardized treatment group and standardized treatment group. The incidences of adverse pregnancy outcomes among the three groups were calculated. Multivariate logistic regression was used to control confounding factors and analyze the association between maternal syphilis treatment and the adverse pregnancy outcomes. The adjusted odds ratios (aOR) and 95% confidence interval (CI) were calculated. Results Among 9 059 syphilis-infected pregnant women, 13.9% (1 262), 31.3% (2 834), and 54.8% (4 963) were untreated, non-standardized treated and standardized treated patients, respectively. The incidences of total adverse pregnancy outcomes in the non-treatment, non-standardized treatment and standardized treatment groups were 25.5%(322), 20.8%(589), and 16.2%(806), respectively. The incidences of stillbirth in the three groups were 2.3%(29), 1.3%(38), and 0.6%(28), respectively; those of preterm birth were 12.6%(159), 10.5%(297), and 6.0%(299), respectively; those of low birth weight were 6.4%(81), 6.2%(175), and 3.3%(162), respectively; those of small for gestational age were 10.9%(138), 8.4%(237), and 8.0%(399), respectively; those of neonatal death were 1.3%(17), 1.0%(28) and 0.3%(15), respectively; those of neonatal asphyxia were 1.9%(24), 0.9%(25), and 0.9%(46), respectively; those of neonatal pneumonia were 0.6%(8), 0.9%(26), and 0.6%(32), respectively; those of birth defects were 2.8%(35), 1.3%(37), and 1.1%(57), respectively; those of neonatal congenital syphilis were 2.5%(31), 2.4%(69), and 0.8%(42), respectively. Compared with standardized treatment group, maternal syphilis without treatment was associated with increased risks of total adverse pregnancy outcomes (aOR=1.73), stillbirth (aOR=4.82), preterm birth (aOR=2.52), low birth weight (aOR=1.88), neonatal death (aOR=3.29), neonatal asphyxia (aOR=2.42) and birth defects (aOR=3.26) all P<0.01; maternal syphilis with non-standardized treatment was associated with increased risks of total adverse pregnancy outcomes (aOR=1.34), stillbirth (aOR=2.54), preterm birth (aOR=1.98), low birth weight (aOR=1.84), neonatal death (aOR=2.49) and neonatal congenital syphilis (aOR=1.70, P<0.05 or 0.01). Conclusions Maternal syphilis without treatment or with non-standardiz
{"title":"Association between maternal syphilis treatment and adverse pregnancy outcomes","authors":"Huixia Li, Jianfei Zheng, Guangwen Huang, Juan Xiao, Jie Gao, Min Yang, N. Feng","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.01.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.01.004","url":null,"abstract":"Objective \u0000To examine the association between maternal syphilis treatmentand the adverse pregnancy outcomes. \u0000 \u0000 \u0000Methods \u0000Syphilis-infected pregnant women retrieved from Information System of Prevention Mother-to-child Transmission of Human Immunodeficiency Virus (HIV), Syphilis, and Hepatitis B Management in Hu′nan Province between January 2012 and December 2017 were retrospectively studied. Information of demographic characteristics, pregnancy history, and syphilis infection/treatment history among these syphilis-infected pregnant women were collected and analyzed. According to the anti-syphilis treatment situation during pregnancy, syphilis-infected pregnant women were divided into three groups: non-treatment group, non-standardized treatment group and standardized treatment group. The incidences of adverse pregnancy outcomes among the three groups were calculated. Multivariate logistic regression was used to control confounding factors and analyze the association between maternal syphilis treatment and the adverse pregnancy outcomes. The adjusted odds ratios (aOR) and 95% confidence interval (CI) were calculated. \u0000 \u0000 \u0000Results \u0000Among 9 059 syphilis-infected pregnant women, 13.9% (1 262), 31.3% (2 834), and 54.8% (4 963) were untreated, non-standardized treated and standardized treated patients, respectively. The incidences of total adverse pregnancy outcomes in the non-treatment, non-standardized treatment and standardized treatment groups were 25.5%(322), 20.8%(589), and 16.2%(806), respectively. The incidences of stillbirth in the three groups were 2.3%(29), 1.3%(38), and 0.6%(28), respectively; those of preterm birth were 12.6%(159), 10.5%(297), and 6.0%(299), respectively; those of low birth weight were 6.4%(81), 6.2%(175), and 3.3%(162), respectively; those of small for gestational age were 10.9%(138), 8.4%(237), and 8.0%(399), respectively; those of neonatal death were 1.3%(17), 1.0%(28) and 0.3%(15), respectively; those of neonatal asphyxia were 1.9%(24), 0.9%(25), and 0.9%(46), respectively; those of neonatal pneumonia were 0.6%(8), 0.9%(26), and 0.6%(32), respectively; those of birth defects were 2.8%(35), 1.3%(37), and 1.1%(57), respectively; those of neonatal congenital syphilis were 2.5%(31), 2.4%(69), and 0.8%(42), respectively. Compared with standardized treatment group, maternal syphilis without treatment was associated with increased risks of total adverse pregnancy outcomes (aOR=1.73), stillbirth (aOR=4.82), preterm birth (aOR=2.52), low birth weight (aOR=1.88), neonatal death (aOR=3.29), neonatal asphyxia (aOR=2.42) and birth defects (aOR=3.26) all P<0.01; maternal syphilis with non-standardized treatment was associated with increased risks of total adverse pregnancy outcomes (aOR=1.34), stillbirth (aOR=2.54), preterm birth (aOR=1.98), low birth weight (aOR=1.84), neonatal death (aOR=2.49) and neonatal congenital syphilis (aOR=1.70, P<0.05 or 0.01). \u0000 \u0000 \u0000Conclusions \u0000Maternal syphilis without treatment or with non-standardiz","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43682235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.01.005
Bihui Yang, Mi Zhang, Y. Shu, Jia-fa Liu, Jian-jian Li, Cuixian Yang, Jincheng Lou
Objective To investigate the influence factors of mortality among human immunodeficiency virus (HIV)-infected children under highly active antiretroviral therapy (HAART). Methods Retrospective cohort study of 652 children initiated HAART from 2005 to 2014 was conducted, and enrolled patients were followed-up until December, 2015. Survival data was analyzed using Kaplan-Meier method and Cox regression model was used to identify independent predictors of mortality among these children on HARRT. Chi-square test and Fisher′s exact test were used for comparison between groups. Results Overall, 26 of the children died over a follow-up period of 3 116.24 child-years, with a mortality rate of 0.83 per 100 child-years. Twelve (46%) of deaths occurred during the first six months after starting HAART. Cox regression analysis of variables showed that the World Health Organization (WHO) clinical stages Ⅲ/Ⅳ (hazard rate [HR]=10.717, 95% confidence interal [95% CI]: 4.189-4.749, P=0.000), baseline hemoglobin <80 g/L (HR=14.768, 95% CI: 5.721-38.125, P=0.000), tuberculosis co-infection (HR=4.794, 95%CI: 2.105-10.918, P=0.000), baseline CD4+ T lymphocyte<50 cells/μL (HR=4.219, 95%CI: 1.524-11.680, P=0.006), weight-for-age z-score <-2 (HR=2.983, 95%CI: 1.094-8.135, P=0.033)were independently associated with death, whereas the age <7 year-old at HAART initiation was protectire (HR=0.293, 95% CI: 0.126-0.684, P=0.005). Conclusions The mortality of children receiving HAART is strongly associated with WHO stages Ⅲ/Ⅳ, hemoglobin <80 g/L, weight-for-age z-score <-2, tuberculosis co-infection and older age at treatment. Key words: Child; Acquired immunodeficiency syndrome; Antiretroviral treatment
{"title":"Risks and predictors of mortality among human immunodeficiency virus-infected children receiving highly active antiretroviral therapy in Yunnan Province","authors":"Bihui Yang, Mi Zhang, Y. Shu, Jia-fa Liu, Jian-jian Li, Cuixian Yang, Jincheng Lou","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.01.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.01.005","url":null,"abstract":"Objective \u0000To investigate the influence factors of mortality among human immunodeficiency virus (HIV)-infected children under highly active antiretroviral therapy (HAART). \u0000 \u0000 \u0000Methods \u0000Retrospective cohort study of 652 children initiated HAART from 2005 to 2014 was conducted, and enrolled patients were followed-up until December, 2015. Survival data was analyzed using Kaplan-Meier method and Cox regression model was used to identify independent predictors of mortality among these children on HARRT. Chi-square test and Fisher′s exact test were used for comparison between groups. \u0000 \u0000 \u0000Results \u0000Overall, 26 of the children died over a follow-up period of 3 116.24 child-years, with a mortality rate of 0.83 per 100 child-years. Twelve (46%) of deaths occurred during the first six months after starting HAART. Cox regression analysis of variables showed that the World Health Organization (WHO) clinical stages Ⅲ/Ⅳ (hazard rate [HR]=10.717, 95% confidence interal [95% CI]: 4.189-4.749, P=0.000), baseline hemoglobin <80 g/L (HR=14.768, 95% CI: 5.721-38.125, P=0.000), tuberculosis co-infection (HR=4.794, 95%CI: 2.105-10.918, P=0.000), baseline CD4+ T lymphocyte<50 cells/μL (HR=4.219, 95%CI: 1.524-11.680, P=0.006), weight-for-age z-score <-2 (HR=2.983, 95%CI: 1.094-8.135, P=0.033)were independently associated with death, whereas the age <7 year-old at HAART initiation was protectire (HR=0.293, 95% CI: 0.126-0.684, P=0.005). \u0000 \u0000 \u0000Conclusions \u0000The mortality of children receiving HAART is strongly associated with WHO stages Ⅲ/Ⅳ, hemoglobin <80 g/L, weight-for-age z-score <-2, tuberculosis co-infection and older age at treatment. \u0000 \u0000 \u0000Key words: \u0000Child; Acquired immunodeficiency syndrome; Antiretroviral treatment","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47668940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.01.003
Haohui Deng, Min Xu
Objective To investigate and analyze the relationship between hepatitis B virus (HBV) S gene mutations and the occurrence of HBV-related acute on chronic liver failure (HBV-ACLF). Methods A total of 377 patients were enrolled in this study, including 51 inactive hepatitis B surface antigen (HBsAg) carriers, 78 chronic hepatitis B (CHB) patients, 101 HBV-ACLF patients, 69 HBV-related liver cirrhosis (LC) patients and 78 HBV-related hepatocellular carcinoma (HCC) patients. Serum samples were collected from July 2012 to September 2017 in Guangzhou Eighth People′s Hospital. Nested polyoneras chain reaction (PCR) was performed for all the samples, the HBV whole genome and HBV S gene were amplified. PCR products were sequenced by Sanger sequencing method. HBV genotypes were determined by the phylogenetic tree based on HBV S gene constructed by Mega 7.0 software with the neighbor-joining method. Geneious R10.0.5 software was used to analyze the mutations of the HBV genome. The data in different groups were compared by χ2 test or Fisher′s exact test. The correlation analysis was done by logistic regression. Results Among the 377 patients enrolled in this study, the HBV-ACLF, CHB, inactive HBsAg carriers, and HCC patients infected with HBV genotype B were 83, 51, 34, 31, and 35 cases respectively, and the patients infected with HBV genotype C were 18, 27, 17, 38, and 43 cases respectively. The results of this study showed that 11 mutations were significantly higher in HBV-ACLF patients than CHB patients who were infected with HBV genotype B, including T216C, G285A and A529G in HBV S gene, A1317G in HBV enchanter I, A1762T/G1764A in basal core promoter (BCP) gene, A1846T, C1913A, G1896A, T2045A, C2078G, C2304A in HBV preC/C gene. However, no significant difference mutations were found in HBV-ACLF patients and CHB patients who were infected with HBV genotype C. In the patients infected with HBV genotype B, the prevalence of T216C (sL21S) mutation in HBV-ACLF was significantly higher than those in inactive HBsAg carriers, CHB and HCC patients (χ2=14.474, 10.982, and 5.440, respectively, all P 0.05). Logistic regression analysis showed that male (OR=6.90, 95% CI: 1.52-24.39, P=0.010), hepatitis B e antigen negative (OR=4.73, 95% CI: 1.60-13.94, P=0.005), HBV genotype B (OR=4.80, 95% CI: 1.82-12.16, P=0.006) and G285A mutation (OR=7.72, 95% CI: 5.64-16.37, P=0.006) were the independent risk factors associated with HBV-ACLF. Conclusions The HBV S gene mutation may be associated with HBV-ACLF. Key words: Hepatitis B virus; Mutation; Acute on chronic liver failure
{"title":"The relationship between hepatitis B virus S gene mutations and hepatitis B virus-related acute on chronic liver failure","authors":"Haohui Deng, Min Xu","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.01.003","url":null,"abstract":"Objective \u0000To investigate and analyze the relationship between hepatitis B virus (HBV) S gene mutations and the occurrence of HBV-related acute on chronic liver failure (HBV-ACLF). \u0000 \u0000 \u0000Methods \u0000A total of 377 patients were enrolled in this study, including 51 inactive hepatitis B surface antigen (HBsAg) carriers, 78 chronic hepatitis B (CHB) patients, 101 HBV-ACLF patients, 69 HBV-related liver cirrhosis (LC) patients and 78 HBV-related hepatocellular carcinoma (HCC) patients. Serum samples were collected from July 2012 to September 2017 in Guangzhou Eighth People′s Hospital. Nested polyoneras chain reaction (PCR) was performed for all the samples, the HBV whole genome and HBV S gene were amplified. PCR products were sequenced by Sanger sequencing method. HBV genotypes were determined by the phylogenetic tree based on HBV S gene constructed by Mega 7.0 software with the neighbor-joining method. Geneious R10.0.5 software was used to analyze the mutations of the HBV genome. The data in different groups were compared by χ2 test or Fisher′s exact test. The correlation analysis was done by logistic regression. \u0000 \u0000 \u0000Results \u0000Among the 377 patients enrolled in this study, the HBV-ACLF, CHB, inactive HBsAg carriers, and HCC patients infected with HBV genotype B were 83, 51, 34, 31, and 35 cases respectively, and the patients infected with HBV genotype C were 18, 27, 17, 38, and 43 cases respectively. The results of this study showed that 11 mutations were significantly higher in HBV-ACLF patients than CHB patients who were infected with HBV genotype B, including T216C, G285A and A529G in HBV S gene, A1317G in HBV enchanter I, A1762T/G1764A in basal core promoter (BCP) gene, A1846T, C1913A, G1896A, T2045A, C2078G, C2304A in HBV preC/C gene. However, no significant difference mutations were found in HBV-ACLF patients and CHB patients who were infected with HBV genotype C. In the patients infected with HBV genotype B, the prevalence of T216C (sL21S) mutation in HBV-ACLF was significantly higher than those in inactive HBsAg carriers, CHB and HCC patients (χ2=14.474, 10.982, and 5.440, respectively, all P 0.05). Logistic regression analysis showed that male (OR=6.90, 95% CI: 1.52-24.39, P=0.010), hepatitis B e antigen negative (OR=4.73, 95% CI: 1.60-13.94, P=0.005), HBV genotype B (OR=4.80, 95% CI: 1.82-12.16, P=0.006) and G285A mutation (OR=7.72, 95% CI: 5.64-16.37, P=0.006) were the independent risk factors associated with HBV-ACLF. \u0000 \u0000 \u0000Conclusions \u0000The HBV S gene mutation may be associated with HBV-ACLF. \u0000 \u0000 \u0000Key words: \u0000Hepatitis B virus; Mutation; Acute on chronic liver failure","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47259043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2019.01.006
Y. Wan, Taomei Yang, Dezhu Zhang, G. Tang, Jie Sun, L. Zhuang, L. Fu, Weijia Jiang, Shijun Li
Objective To understand the genetic variations of neuraminidase (NA) genes of avian influenza virus H9N2 in Weining, Guizhou Province, and to provide the scientific evidence for the prevention and control of avian influenza virus. Methods Ribonucleic acids (RNA) were extracted and NA genes were amplified and sequenced from 13 randomly selected H9N2 positive samples from the live poultry market (LPM) environments in north of Weining Yi and Hui and Miao autonomous county (Weining), Guizhou Province during 2015 to 2017. Then the homology, genetic evolution, and sites of stalk deletion areas, potential N-glycosylation, receptor binding regions and drug resistance of H9N2 subtype avian influenza viruses were analyzed by a series of bioinformation software. Results Homology analysis revealed that there were 93.0%-100.0% and 92.1%-100.0% similarity among 13 strains H9N2 avian influenza viruses in nucleotide and amino acid of the NA gene, respectively. All strains belonged to DK/HK/Y280/97 sub-lineage, but their genetic sources were complex and diverse. Thirteen strains had a stalk deletion of 3 amino acid residues TEI at positions 63-65 and 3 isolates had mutation QN to QK at positions 39-40. The potential N-glycosylation sites at amino acid residues 86, 146, 200, and 234 of the NA protein of all strains were highly conserved, while other N-glycosylation sites had quantity and site mutations. There were different mutation types at the three sialic acid binding site areas, especially at 399-404 area. All NA protease activity sites and key sites of the 13 strains had no mutations associated with resistance to the neuraminidase inhibitor drugs. Conclusions All 13 strains H9N2 viruses belongs to DK/HK/Y280/97 sub-lineage in Weining, Guizhou Province during 2015-2017, and their genetic sources are complex and diverse. The mutations on sites of stalk areas, potential N-glycosylation and sialic acid binding site areas are presented at different degrees. Hence, enhancing surveillance and controlling H9N2 avian influenza virus is necessary. Key words: Influenza A virus, H9N2 subtype; Neuraminidase gene; Molecular characteristic
{"title":"Molecular characteristic analysis of neuraminidase genes of avian influenza virus H9N2 in environments in Weining, Guizhou Province during 2015-2017","authors":"Y. Wan, Taomei Yang, Dezhu Zhang, G. Tang, Jie Sun, L. Zhuang, L. Fu, Weijia Jiang, Shijun Li","doi":"10.3760/CMA.J.ISSN.1000-6680.2019.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2019.01.006","url":null,"abstract":"Objective \u0000To understand the genetic variations of neuraminidase (NA) genes of avian influenza virus H9N2 in Weining, Guizhou Province, and to provide the scientific evidence for the prevention and control of avian influenza virus. \u0000 \u0000 \u0000Methods \u0000Ribonucleic acids (RNA) were extracted and NA genes were amplified and sequenced from 13 randomly selected H9N2 positive samples from the live poultry market (LPM) environments in north of Weining Yi and Hui and Miao autonomous county (Weining), Guizhou Province during 2015 to 2017. Then the homology, genetic evolution, and sites of stalk deletion areas, potential N-glycosylation, receptor binding regions and drug resistance of H9N2 subtype avian influenza viruses were analyzed by a series of bioinformation software. \u0000 \u0000 \u0000Results \u0000Homology analysis revealed that there were 93.0%-100.0% and 92.1%-100.0% similarity among 13 strains H9N2 avian influenza viruses in nucleotide and amino acid of the NA gene, respectively. All strains belonged to DK/HK/Y280/97 sub-lineage, but their genetic sources were complex and diverse. Thirteen strains had a stalk deletion of 3 amino acid residues TEI at positions 63-65 and 3 isolates had mutation QN to QK at positions 39-40. The potential N-glycosylation sites at amino acid residues 86, 146, 200, and 234 of the NA protein of all strains were highly conserved, while other N-glycosylation sites had quantity and site mutations. There were different mutation types at the three sialic acid binding site areas, especially at 399-404 area. All NA protease activity sites and key sites of the 13 strains had no mutations associated with resistance to the neuraminidase inhibitor drugs. \u0000 \u0000 \u0000Conclusions \u0000All 13 strains H9N2 viruses belongs to DK/HK/Y280/97 sub-lineage in Weining, Guizhou Province during 2015-2017, and their genetic sources are complex and diverse. The mutations on sites of stalk areas, potential N-glycosylation and sialic acid binding site areas are presented at different degrees. Hence, enhancing surveillance and controlling H9N2 avian influenza virus is necessary. \u0000 \u0000 \u0000Key words: \u0000Influenza A virus, H9N2 subtype; Neuraminidase gene; Molecular characteristic","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42508612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.12.003
Su Lin, Qing-hui Zhou, Yehong Lin, Mingfang Wang
Objective To investigate the association between interleukin-22 (IL-22) single nucleotide polymorphisms (SNPs) and the prognosis of hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF). Methods The patients with HBV-ACLF from the First Affiliated Hospital of Fujian Medical University were retrospectively studied. Seven SNP genotypes of IL-22 gene, including rs2227478, rs2227491, rs1179251, rs1179249, rs2227473, rs2227484, and rs11611206, were detected using imLDR™ multiple SNP typing kit and the distribution features of SNP genotypes were described. The relationship between the distribution of SNP genotypes and alleles and the prognosis of ACLF was analyzed. Comparison of genotypes and allele frequencies between groups were performed by chi-square test of R×C table or Fisher's exact tests. Binary logistic regression analysis was used to analyze whether IL-22 gene polymorphisms was an independent prognostic factor for patients with ACLF. Results A total of 122 patients with HBV-ACLF were included in this study. Ninety-two (75.1%) were male and 30 (24.59%) were female. Patients were stratified as survival group (90 cases) and non-survival group (32 cases) according to the Results of three months follow-up. The genotype distribution of rs2227484 of IL-22 gene was significantly different between the two groups (χ2=6.128, P=0.033). The A allele frequency in the non-survival group (15.6%) was significantly higher than that in the survival group (5.6%) with statistically significance (OR=0.318, 95% CI=0.126-0.804, P=0.012). There was no significant difference in the other six SNP genotypes of IL-22 gene between the two groups (all P >0.05). However, binary logistic regression showed that rs2227484 of IL-22 gene was not an independent risk factor for the short-term mortality in HBV-ACLF patients (adjusted OR=3.102, 95%CI: 0.939-10.250, P=0.063). Conclusions The A allele and AA genotype of rs2227484 of IL-22 gene may be associated with a short-term prognosis in patients with HBV-ACLF. Key words: Hepatitis B virus; Polymorphism, genetic; Interleukin-22; Acute-on-chronic liver failure
{"title":"Association between interleukin-22 genetic polymorphisms and the prognosis of hepatitis B virus related acute-on-chronic liver failure","authors":"Su Lin, Qing-hui Zhou, Yehong Lin, Mingfang Wang","doi":"10.3760/CMA.J.ISSN.1000-6680.2018.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6680.2018.12.003","url":null,"abstract":"Objective \u0000To investigate the association between interleukin-22 (IL-22) single nucleotide polymorphisms (SNPs) and the prognosis of hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF). \u0000 \u0000 \u0000Methods \u0000The patients with HBV-ACLF from the First Affiliated Hospital of Fujian Medical University were retrospectively studied. Seven SNP genotypes of IL-22 gene, including rs2227478, rs2227491, rs1179251, rs1179249, rs2227473, rs2227484, and rs11611206, were detected using imLDR™ multiple SNP typing kit and the distribution features of SNP genotypes were described. The relationship between the distribution of SNP genotypes and alleles and the prognosis of ACLF was analyzed. Comparison of genotypes and allele frequencies between groups were performed by chi-square test of R×C table or Fisher's exact tests. Binary logistic regression analysis was used to analyze whether IL-22 gene polymorphisms was an independent prognostic factor for patients with ACLF. \u0000 \u0000 \u0000Results \u0000A total of 122 patients with HBV-ACLF were included in this study. Ninety-two (75.1%) were male and 30 (24.59%) were female. Patients were stratified as survival group (90 cases) and non-survival group (32 cases) according to the Results of three months follow-up. The genotype distribution of rs2227484 of IL-22 gene was significantly different between the two groups (χ2=6.128, P=0.033). The A allele frequency in the non-survival group (15.6%) was significantly higher than that in the survival group (5.6%) with statistically significance (OR=0.318, 95% CI=0.126-0.804, P=0.012). There was no significant difference in the other six SNP genotypes of IL-22 gene between the two groups (all P >0.05). However, binary logistic regression showed that rs2227484 of IL-22 gene was not an independent risk factor for the short-term mortality in HBV-ACLF patients (adjusted OR=3.102, 95%CI: 0.939-10.250, P=0.063). \u0000 \u0000 \u0000Conclusions \u0000The A allele and AA genotype of rs2227484 of IL-22 gene may be associated with a short-term prognosis in patients with HBV-ACLF. \u0000 \u0000 \u0000Key words: \u0000Hepatitis B virus; Polymorphism, genetic; Interleukin-22; Acute-on-chronic liver failure","PeriodicalId":10127,"journal":{"name":"Chinese Journal of Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47211800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-15DOI: 10.3760/CMA.J.ISSN.1000-6680.2018.12.004
Junli Fan, Min Zhao, X. Gui, Hong-Yan Qiu, Li Wang
Objective To investigate the effect of combined antiretroviral therapy (cART) on anal human papillomavirus (HPV) infection in human immunodeficiency virus (HIV)-infected men who sex with men (MSM). Methods HIV-infected MSM naive of cART who visited Wuhan Dermatological Hospital from June 2012 to December 2013 were enrolled in a longitudinal study before starting cART, including 81 HIV-positive and 50 HIV-negative cases. HPV infection situations between HIV-positive and HIV-negative MSM were compared. And anal HPV infection rate and condyloma acuminate incidence of HIV-positive MSM before and after cART were also compared. HPV genotyping was performed by universal primer PCR and reverse dot hybridization. The statistical analysis was done by t test or χ2 test. Results The prevalence rates of HPV infection, high-risk HPV infection and multiple HPV subtypes infection in HIV-positive MSM were all significantly higher than those in HIV-negative MSM (91.4% vs 62.0%, 75.3% vs 30.0%, 56.8% vs 20.0%, respectively, χ2=16.75, 26.05, and 19.10, respectively, all P<0.05). The prevalence rates of anal HPV infection, high-risk HPV infection and multiple HPV subtypes infection in 77 HIV-positive MSM at month 36 of cART were all significantly decreased than baseline (90.9% vs 74.0%, 75.3% vs 44.2% and 57.1% vs 41.5%, respectively, χ2=7.590, 15.551, and 3.741, respectively, all P<0.05). HPV16 and HPV43 infection rates were reduced from 27.3% at baseline to 15.6% and 13.0%, respectively at month 36 of cART (χ2=16.92 and 14.86, respectively, both P<0.05). Condyloma acuminate incidence also reduced from 16.9% at baseline to 5.2% at month 36 (χ2=4.069, P<0.05). Conclusions The prevalence of anal HPV infection in HIV-positive MSM is higher than HIV-negative MSM. cART could reduce the prevalence of anal HPV infection rate and condyloma acuminate incidence , especially high-risk HPV infection. Key words: Combined antiretroviral therapy; Human papillomavirus; Human immunodeficiency virus; Condyloma acuminatum; Infections
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