Recent key advances in human immunodeficiency virus medicine and implications for China

In this article we summarize several recent major developments in human immunodeficiency virus treatment, prevention, outcome, and social policy change. Updated international guidelines endorse more aggressive treatment strategies and safer antiretroviral drugs. New antiretroviral options are being tested. Important lessons were learned in the areas of human immunodeficiency virus vaccines and microbicide gels from clinical studies, and additional trials in prevention, especially pre-exposure prophylaxis, are nearing completion. Insight into the role of the virus in the pathogenesis of diseases traditionally thought to be unrelated to acquired immunodeficiency syndrome has become a driving force for earlier and universal therapy. Lastly, we review important achievements of and future challenges facing China as she steps into her eighth year of the National Free Antiretroviral Treatment Program

The Endogenous Th17 Response in NO<inf>2</inf>-Promoted Allergic Airway Disease Is Dispensable for Airway Hyperresponsiveness and Distinct from Th17 Adoptive Transfer

Severe, glucocorticoid-resistant asthma comprises 5-7% of patients with asthma. IL-17 is a biomarker of severe asthma, and the adoptive transfer of Th17 cells in mice is sufficient to induce glucocorticoid-resistant allergic airway disease. Nitrogen dioxide (NO2) is an environmental toxin that correlates with asthma severity, exacerbation, and risk of adverse outcomes. Mice that are allergically sensitized to the antigen ovalbumin by exposure to NO2 exhibit a mixed Th2/Th17 adaptive immune response and eosinophil and neutrophil recruitment to the airway following antigen challenge, a phenotype reminiscent of severe clinical asthma. Because IL-1 receptor (IL-1R) signaling is critical in the generation of the Th17 response in vivo, we hypothesized that the IL-1R/Th17 axis contributes to pulmonary inflammation and airway hyperresponsiveness (AHR) in NO2-promoted allergic airway disease and manifests in glucocorticoid-resistant cytokine production. IL-17A neutralization at the time of antigen challenge or genetic deficiency in IL-1R resulted in decreased neutrophil recruitment to the airway following antigen challenge but did not protect against the development of AHR. Instead, IL-1R-/- mice developed exacerbated AHR compared to WT mice. Lung cells from NO2-allergically inflamed mice that were treated in vitro with dexamethasone (Dex) during antigen restimulation exhibited reduced Th17 cytokine production, whereas Th17 cytokine production by lung cells from recipient mice of in vitro Th17-polarized OTII T-cells was resistant to Dex. These results demonstrate that the IL-1R/Th17 axis does not contribute to AHR development in NO2-promoted allergic airway disease, that Th17 adoptive transfer does not necessarily reflect an endogenously-generated Th17 response, and that functions of Th17 responses are contingent on the experimental conditions in which they are generated. © 2013 Martin et al

Unsafe Sex and STI Prevalence Among HIV-Infected Adults in Guangzhou, China: Opportunities to Deamplify Sexual HIV Transmission

This project examined sexual behavior and STI prevalence among HIV-infected individuals in South China. Adult HIV-infected outpatients in Guangzhou, Guangdong Province, China completed a self-administered survey about behaviors and antiretroviral treatment. Participants were screened for syphilis, gonorrhea, and chlamydia. Univariate and multivariate relationships with any STI were calculated using logistic regression. 810 HIV-infected individuals participated and 3 refused. 52.5 % (n = 415) of individuals reported having sex in the past 3 months, among whom 26.4 % (n = 111) reported inconsistent condom use. 10.4 % (n = 84) of all individuals had at least one sexually transmitted infection (STI). HIV-infected individuals not on antiretroviral treatment had an increased STI risk (aOR 2.5, 95 % CI: 1.4–4.5, P = 0.002). Unsafe sex was markedly reduced among HIV-infected individuals on treatment, possibly a reflection of integrated ART initiation counseling. Improved STI services among HIVinfected individuals are urgently needed to deamplify sexual HIV transmission

Three‐dimensional P wave velocity structure of the Northern Hikurangi margin from the NZ3D experiment: evidence for fault‐bound anisotropy

We present a high‐resolution three‐dimensional (3‐D) anisotropic P wave velocity (Vp) model in the northern Hikurangi margin offshore Gisborne, New Zealand, constructed by tomographic inversion of over 430,000 first arrivals recorded by a dense grid of ocean bottom seismometers. Since the study area covers a region where shallow slow slip events (SSEs) occur repeatedly and the subduction of a seamount is proposed, it offers an ideal location to link our understanding of structural and hydrogeologic properties at megathrust faults to slip behavior. The Vp model reveals an ~30‐km‐wide, low‐velocity accretionary wedge at the toe of the overriding plate, where previous seismic reflection studies show a series of active thrust faults branching from the plate interface. We find some locations with significant Vp azimuthal anisotropy >5% near the branching faults and the deformation front. This finding suggests that the anisotropy is not ubiquitous and homogeneous within the overriding plate, but more localized in the vicinity of active thrust faults. The fast axes of Vp within the accretionary wedge are mostly oriented to the plate convergence direction, which is interpreted as preferentially oriented cracks in a compressional stress regime associated with plate subduction. We find that the magnitudes of anisotropy are roughly equivalent to values found at oceanic spreading centers, where the extensional stress regime is dominant and the crack density is expected to be higher than subduction zones. This consideration may indicate that additional effects such as fault foliation and clay mineral alignment also contribute to upper plate anisotropy along subduction margins

Decreasing Excess Mortality of HIV-Infected Patients Initiating Antiretroviral Therapy: Comparison with Mortality in General Population in China, 2003–2009

To evaluate excess mortality across calendar time comparing HIV-infected patients receiving cART with the general Chinese population