中国疾病预防控制中心周报最新文献

What is already known about this topic?: 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.

What is added by this report?: 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.

What are the implications for public health practice?: 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.

What is already known on this topic?: Pre-exposure prophylaxis (PrEP) effectively prevents human immunodeficiency virus (HIV) infection among men who have sex with men (MSM); however, its uptake in China remains low.

What is added by this report?: In a prospective cohort of MSM in Qingdao, recent PrEP use doubled from 4.6% in June 2024 to 10.4% in June 2025, which was accompanied by decreased condomless anal intercourse and increased HIV testing. MSM who seek sexual partners online are less likely to use PrEP.

What are the implications for public health practice?: Public health strategies should prioritize targeted digital interventions for MSM who primarily seek sexual partners online, reinforce health education on the benefits of PrEP, and institutionalize PrEP referral pathways to accelerate PrEP scale-up.

What is already known about this topic?: Late human immunodeficiency virus (HIV) diagnosis remains prevalent among older adults in China; however, recent national-level evidence characterizing its correlates remains limited.

What is added by this report?: 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.

What are the implications for public health practice?: These findings provide epidemiological evidence to inform more targeted HIV screening strategies tailored to specific population subgroups, geographic regions, and diagnostic settings.

What is already known about this topic?: Monkeypox virus (MPXV) is an orthopoxvirus comprising two major genetic clades: clade Ⅰ (subclades Ⅰa and Ⅰb) and clade Ⅱ (subclades Ⅱa and Ⅱb). The 2022-2023 global outbreak was predominantly driven by clade Ⅱb. Clade Ⅰ viruses remain endemic in Central Africa, particularly Democratic Republic of the Congo (DRC), and are historically associated with higher virulence and fatality rates.

What is added by this report?: Two imported MPXV cases were detected in Shanghai via real-time polymerase chain reaction (PCR) in 2025, both originating from DRC. Clade-specific PCR and whole-genome sequencing identified clade Ⅰa.

What are the implications for public health practice?: These cases underscore the ongoing risk of MPXV importation through international travel. The successful detection and management of these clade Ⅰa infections demonstrate the critical importance of port entry screening, enhanced surveillance systems, and coordinated multi-agency prevention and control strategies.

The adoption of the WHO Pandemic Agreement in May 2025 marks a pivotal shift toward institutionalizing global pandemic governance. Anchored in principles of equity, solidarity, and human rights, the agreement establishes a Pathogen Access and Benefit-Sharing (PABS) System, which aims to ensure equitable access to pandemic-related health products (PRHPs). However, operational ambiguities - particularly in defining pathogen scope, integrating traditional knowledge, enforcing manufacturer obligations, and coordinating with multilateral frameworks like the Convention on Biological Diversity and the Nagoya Protocol - pose significant implementation risks. Crucially, the agreement's effectiveness is intertwined with broader health system resilience. However, specific provisions for PABS integration within a strengthened health system architecture remain underdeveloped. Moreover, critical gaps persist regarding financing, compliance, One Health integration, digital governance, community engagement, and alignment with broader health systems. The success of the agreement hinges on resolving these gaps through subsequent protocols and sustained political commitment.

Introduction: The rapid fluorescent focus inhibition test (RFFIT) is a cell-based virus neutralization assay and the gold standard for quantifying rabies virus neutralizing antibodies (RVNA) in serums. It is used to assess the biological efficacy of rabies vaccines and evaluate protective immunity in both humans and animals. Despite its broad application, RFFIT requires thorough validation to ensure reliability.

Methods: RFFIT was validated in this study using the third World Health Organization international standard for anti-rabies immunoglobulin (WHO-3 SRIG) and negative human sera. The validation followed the guidelines outlined by the Food and Drug Administration Guidance for Industry and International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH)Q2 (R1) guidelines and included the assessment of intra-assay and intermediate precision, dilutability, linearity, range, accuracy, specificity, robustness, and stability.

Results: The RFFIT method demonstrated good precision, with intra-assay and intermediate-precision geometric coefficient of variation (GCV) <30%. Dilutability was confirmed, with 95% of positive samples showing geometric mean concentration (GMC) differences within ±30% compared to undiluted controls. The standard and detection values were described by y=1.0091x - 0.1128 (R²⁼0.9948); 95.56% of the samples showed 70%-130% recovery. Specificity was verified using homologous and heterologous antigen competition and a matrix with no significant cross-reactivity. The assay was robust to variations in cells, reagents, and time, with titer differences within ±30%. Stability of samples and reagents under freeze-thaw and different short-term storage conditions was confirmed.

Conclusion: The assay was successfully validated for quantifying RVNA content in serum samples.

Introduction: We explored risk factors for latent tuberculosis infection (LTBI) and developed a risk prediction model using machine learning algorithms.

Methods: Patients with active pulmonary TB in months 3 to 6 of anti-TB treatment in Henan Province, China, July-September 2024 were selected as index cases. Close contacts identified through epidemiological investigation underwent tuberculin-purified protein derivative testing to determine LTBI status. Face-to-face questionnaires were conducted to collect epidemiological data. The dataset was divided into training and testing sets (6:4), using a fixed random seed. Five models - logistic regression (LR), decision tree (DT), random forest (RF), support vector machines (SVM), and multilayer perceptron (MLP) - were trained and evaluated using the mean squared error (MSE) and coefficient of determination. The test set was subjected to external validation. Receiver operating characteristic curve analysis, area under the curve (AUC), and F1-scores were used to quantify predictive performance.

Results: Among 795 close contacts, LTBI prevalence was 401 (50.5%). By MSE, models ranked: SVM (0.121), RF (0.165), DT (0.197), LR (0.229), and MLP (0.233). SVM identified five key predictors: contact type of index case, key population classification, residential area, frequency of participation in group activities, and etiological results. Internal validation showed strong performance (AUC=0.921, F1=0.858), whereas external validation showed moderate performance (AUC=0.752, F1=0.694).

Conclusion: The SVM model incorporating contact type of index case, key population classification, residential area, frequency of group activity participation, and etiological results demonstrated robust predictive value for LTBI risk. This model shows promise for the targeted screening and management of high-risk populations.

Introduction: This study analyzed the epidemiological characteristics of rabies and the causes of post-exposure management failure in Hunan Province from 2019 to 2024, providing evidence for rabies prevention and control strategies in China.

Methods: Data on reported human rabies cases, exposures, and post-exposure prophylaxis (PEP) were analyzed using descriptive epidemiological methods.

Results: 240 rabies cases were reported in Hunan Province (2019-2024) with an average annual incidence rate of 0.0592 per 100,000 people. A significant decreasing trend was observed (χ ² _trend=32.72, P<0.05). Five factors showed statistically significant differences in their effects on the incubation period: site of exposure, wound management, vaccination after exposure, passive immunization preparations, and sources of animals causing exposure (all P<0.05). In the last six years, there was no increasing trend in the proportion of failed PEP as a percentage of all rabies cases in that year (χ ² _trend=1.809, P=0.86). The median incubation period was 16.0 (Interquartile Range, IQR 14.0-22.0) days for failed PEP cases with exposed areas, including to the head and/or face, compared to 31.0 (IQR 24.0-50.0) days for those without such exposure. The difference was statistically significant (U=20.50, P=0.025).

Conclusions: The current situation of rabies prevention and control in Hunan Province remains dire. Therefore, comprehensive measures should be implemented to help reduce the incidence of rabies. These include adopting standardized dog management practices, strengthening control measures in high-risk areas, and improving public awareness of PEP.

What is already known about this topic?: Alcohol is a Group 1 carcinogen; in China, high alcohol use substantially contributes to the non-communicable diseases (NCDs) burden.

What is added by this report?: From 1990-2023, age-standardized high alcohol use-attributable NCDs death and disability-adjusted life years (DALYs) rates declined markedly (-57.6%, -46.9%), while absolute numbers rose slightly (11.8%, 6.9%). In 2023, neoplasms led DALYs, followed by substance use disorders; diabetes and kidney diseases are smaller but rising (160.22%, 2010-2023). Sex disparity persists (male-to-female NCDs DALY ratio 10.64). Provincial and disease-specific burdens are linked.

What are the implications for public health practice?: Prioritize substance use disorders and monitor rising diabetes and kidney diseases; continue reducing the neoplasms burden; tailor prevention by age, sex, region and cause.

What is already known about this topic?: In 2018, past-month and past-year alcohol use prevalence among Chinese adults aged 18+ years was 28.3% and 39.8%, respectively.

What is added by this report?: In 2024, alcohol use prevalence among Chinese individuals aged 15+ years was 20.3% (past-month) and 27.6% (past-year), with higher rates observed among males and young to middle-aged adults. Notably, over 40% of current drinkers engaged in heavy episodic drinking (HED).

What are the implications for public health practice?: Gender-specific intervention strategies targeting males and young to middle-aged adults are needed. The high prevalence of HED among current drinkers warrants particular attention in prevention efforts.