<b> Background: </b> Despite years of Paediatric Antiretroviral therapy in Nigeria, the National implementation plan for the scale up of viral load testing was only rece ntly launched. Viral load determina...<b> Background: </b> Despite years of Paediatric Antiretroviral therapy in Nigeria, the National implementation plan for the scale up of viral load testing was only rece ntly launched. Viral load determination is the most important indicator of ART response. <b>Material & methods:</b> First viral load samples were collected from 663 children living with HIV between December 2017-Decemb er 2019 aged 0 - 18 years on highly active antiretroviral therapy from 4 states within Nigeria. Samples were analyzed at a Polymerase Chain Reaction laboratory of the Federal Teaching Hospital Gombe. <b>Results: </b>Males were 311 (46.9%) and 352 (53.1%) female. Children aged 0 - 9 years constituted 44.9% (298);55.1% (365) were aged 10 - 18 years. This first viral load was primarily routine in 94 .2% (625);2.9% (19) of children respectively had suspected clinical or immunological failure. ART combination was AZT/3TC/NVP in 78.1% (518/663) of CLHIV;TDF/3TC/EFV in 21.2% (141);AZT/3TC/LPV/rtv in 4 (0.6%). Prior to initiation of routine viral load testing $0.55 (366/663) CLHI V had received HAART for 1 - 5 years;7.8% (52/663) for 6 months but < 1 year;32.8% (218/663) 6 - 10 years and 4.1% (27) for >10 years. The most recent CD4 count before viral load request was ≥1000/μL in 24.7% (164) of CLHIV;500 - 999/μL in 42.9% (285);350 - 499 μL in 11% (73) and <350 μL in 21.3% (141) of children. Viral load was ≥1000 c/ml in 51.3% (340/663) of children. Viral load was >1000 c/ml in 59.9% (174/311) males and 47.2% (166/352) females. Viral load was significantly lower among females (P-value 0.02). Of children aged 0 - 9 years 50.3% (150/298) had viral load > 1000 c/ml and 10 - 18 years 52.1% (190/365) (P value 0.660). Viral load was >1000 c/ml in 38.5% (20/52) of children on HAART for 6 months - 1 year and 52.2% (191/366) after receiving HAART for 1 - 5 years. 52.3% (114/218) and 55.6% (15/27) CLHIV had viral load > 1000 c/ml after receiving HAART for 6 - 10 and >10 years respectively (P value 0.29). <b>Conclusion:</b> About half of children on HAART have viral load > 1000 c/ml after more than 1 - 5 years on HAART. Longer duration of ART and use of AZT/3TC/NVP are associated with viral load > 1000 c/ml. Key considerations are poor adherence and/or viral drug resistance. Optimizing ART adherence and resistance monitoring remain key strategies for ART programmes.展开更多
AIM:To evaluate the aspartate aminotransferase(AST) to platelet ratio index(APRI) as a predictive factor of early viral response in chronic hepatitis C naive patients.METHODS:We performed an ambispective case-control ...AIM:To evaluate the aspartate aminotransferase(AST) to platelet ratio index(APRI) as a predictive factor of early viral response in chronic hepatitis C naive patients.METHODS:We performed an ambispective case-control study.We enrolled chronic hepatitis C naive patients who were evaluated to start therapy with PEGylated interferon α-2b(1.5 μg/kg per week) and ribavirin(>75 kg:1200mg and <75kg:1000mg).Patients were allocated into two groups,group 1:Hepatitis C patients with early viral response(EVR),group 2:Patients without EVR.Odds ratio(OR) and 95% confi dence interval(CI) were calculated to assess the relationship between each risk factor and the EVR in both groups.RESULTS:During the study,80 patients were analyzed,45 retrospectively and 35 prospectively.The mean ± SD age of our subjects was 42.9 ± 12 years;weight 70 kg(±11.19),AST 64.6 IU/mL(±48.74),alanine aminotransferase(ALT) 76.3 IU/mL(±63.08) and platelets 209000 mill/mm3(±84 429).Fifty-five(68.8%) were genotype 1 and 25(31.3%) were genotype 2 or 3;the mean hepatitis C virus RNA viral load was 2 269 061 IU/mL(±7220266).In the univariate analysis,APRI was not associated with EVR [OR 0.61(95% CI 0.229-1.655,P=0.33)],and the absence of EVR was only associated with genotype 1 [OR 0.28(95% CI 0.08-0.94,P=0.034)].After adjustment in a logistic regression model,genotype 1 remains signifi cant.CONCLUSION:APRI was not a predictor of EVR in chronic hepatitis C;Genotype 1 was the only predictive factor associated with the absence of EVR in our patients.展开更多
<strong>Background</strong>: The adult ART (antiretroviral therapy) programme started in Nigeria in 2002. After many years of ART in the country, the National implementation plan for the scale up of viral ...<strong>Background</strong>: The adult ART (antiretroviral therapy) programme started in Nigeria in 2002. After many years of ART in the country, the National implementation plan for the scale up of viral load testing was launched in 2016. Viral load estimation is the most important indicator of ART response. <strong>Aim</strong>: To describe viral suppression in adults on the HIV ART programme <strong>Material & methods</strong>: Viral load blood samples of 9450 adults on highly active antiretroviral therapy living with HIV from 4 states within Nigeria were analyzed for HIV RNA in Polymerase Chain Reaction laboratory of the Federal Teaching Hospital, Gombe between December 2017 and December 2019. <strong>Results</strong>: Males were 2577/9450 (27.3%) and 6873 (72.7%) females. Adults aged 26 - 45 years constituted 69.5% (6572). Viral load test was primarily routine in 96.3% (9098). ART was AZT/3TC/NVP in 52.5% (4962);TDF/3TC/EFV in 46.3% (4375). 48.3% (4568/9450) adults had received HAART for 1 - 5 years;7.4% (699) for 6 months but <1 year;37.6% (3551) 6 - 10 years and 6.7% (632) for >10 years. The most recent CD4 count before viral load request was ≥1000/μL in 6.5% (612) of adults;500 - 999/μL in 38.6% (3651);350 - 499 μL in 23.2% (2195) and <350 μL in 31.7% (2992). Viral load was ≥1000 c/ml in 22.9% (2167/9450) of adults. Viral load was >1000 c/ml in 22.8% (587/2577) males and 23.0% (1580/6873) females. Of adults aged 19 - 25 years, 28.4% (211/743) had viral load >1000 c/ml;23.5% (1544/6572);20.0% (294/1473);17.8% (93/523) and 18.0% (25/139) aged 26 - 45 years, 46 - 55 years;56 - 65 years and >65 years also had viral load >1000 c/ml (p value < 0.001) Viral load was >1000 c/ml in 26.0% (182/699) of adults on HAART for 6 months - 1 year and 21.3% (975/4568) after receiving HAART for 1 - 5 years. 24.9% (885/3551) and 19.8% (125/632) adults had viral load > 1000 c/ml after receiving HAART for 6 - 10 and >10 years respectively. (p value < 0.001) <strong>Conclusion</strong>: Over all viral suppression of 77% in our study is high but fell below the WHO threshold of 90%. ART programme in Nigeria requires strengthening.<strong></strong>展开更多
Nanoparticle-based drug delivery system remains a significant challenge in the current treatment of solid tumors,primarily due to their limited penetration capabilities.Herein,we successfully engineer photodynamic gel...Nanoparticle-based drug delivery system remains a significant challenge in the current treatment of solid tumors,primarily due to their limited penetration capabilities.Herein,we successfully engineer photodynamic gel-bombs(DCM@OPR)capable of penetrating deeply into tumor tissues utilizing the photodynamic-triggered explosive energy and receptor-mediated transcytosis,significantly enhancing the therapeutic efficacy of breast cancer.The photodynamic gel-bombs were fabricated by loading powerful components of chlorin e6 and MnO_(2) nanoparticles,as wellas Doxorubicin,into a crosslinked Ca^(2+)-gel.Upon exposure to laser irradiation,the obtained photodynamic gel-bombs are capable of generating explosive energy,resulting in their fragmentation into numerous nanofragments.The photodynamic-triggered explosive energy subsequently drives these nanofragments to deeply penetrate into tumor tissues through gap leakage among tumor cells.In addition,the photodynamictriggered explosive energy also promotes the escape of those therapeutic components(including chlorin e6,MnO_(2) nanoparticles,and doxorubicin)and nanofragments from lysosomes.In the subsequent stages,these nanofragments also exhibit excellent transcytosis capacity,facilitating deep penetration into tumor tissues.As expected,the enhanced penetration and accumulation of therapeutic components into tumor tissues can be achieved,significantly enhancing the anti-proliferation capacity against breast cancer.展开更多
Wireless big data is attracting extensive attention from operators,vendors and academia,which provides new freedoms in improving the performance from various levels of wireless networks.One possible way to leverage bi...Wireless big data is attracting extensive attention from operators,vendors and academia,which provides new freedoms in improving the performance from various levels of wireless networks.One possible way to leverage big data analysis is predictive resource allocation,which has been reported to increase spectrum and energy resource utilization eciency with the predicted user behavior including user mobility.However,few works address how the trac load prediction can be exploited to optimize the data-driven radio access.We show how to translate the predicted trac load into the essential information used for resource optimization by taking energy-saving transmission for non-real-time user as an example.By formulating and solving an energy minimizing resource allocation problem with future instantaneous bandwidth information,we not only provide a performance upper bound,but also reveal that only two key parameters are related to the future information.By exploiting the residual bandwidth probability derived from the trac volume prediction,the two parameters can be estimated accurately when the transmission delay allowed by the user is large,and the closed-form solution of global optimal resource allocation can be obtained when the delay approaches in nity.We provide a heuristic resource allocation policy to guarantee a target transmission completion probability when the delay is no-so-large.Simulation results validate our analysis,show remarkable energy-saving gain of the proposed predictive policy over non-predictive policies,and illustrate that the time granularity in predicting trac load should be identical to the delay allowed by the user.展开更多
文摘<b> Background: </b> Despite years of Paediatric Antiretroviral therapy in Nigeria, the National implementation plan for the scale up of viral load testing was only rece ntly launched. Viral load determination is the most important indicator of ART response. <b>Material & methods:</b> First viral load samples were collected from 663 children living with HIV between December 2017-Decemb er 2019 aged 0 - 18 years on highly active antiretroviral therapy from 4 states within Nigeria. Samples were analyzed at a Polymerase Chain Reaction laboratory of the Federal Teaching Hospital Gombe. <b>Results: </b>Males were 311 (46.9%) and 352 (53.1%) female. Children aged 0 - 9 years constituted 44.9% (298);55.1% (365) were aged 10 - 18 years. This first viral load was primarily routine in 94 .2% (625);2.9% (19) of children respectively had suspected clinical or immunological failure. ART combination was AZT/3TC/NVP in 78.1% (518/663) of CLHIV;TDF/3TC/EFV in 21.2% (141);AZT/3TC/LPV/rtv in 4 (0.6%). Prior to initiation of routine viral load testing $0.55 (366/663) CLHI V had received HAART for 1 - 5 years;7.8% (52/663) for 6 months but < 1 year;32.8% (218/663) 6 - 10 years and 4.1% (27) for >10 years. The most recent CD4 count before viral load request was ≥1000/μL in 24.7% (164) of CLHIV;500 - 999/μL in 42.9% (285);350 - 499 μL in 11% (73) and <350 μL in 21.3% (141) of children. Viral load was ≥1000 c/ml in 51.3% (340/663) of children. Viral load was >1000 c/ml in 59.9% (174/311) males and 47.2% (166/352) females. Viral load was significantly lower among females (P-value 0.02). Of children aged 0 - 9 years 50.3% (150/298) had viral load > 1000 c/ml and 10 - 18 years 52.1% (190/365) (P value 0.660). Viral load was >1000 c/ml in 38.5% (20/52) of children on HAART for 6 months - 1 year and 52.2% (191/366) after receiving HAART for 1 - 5 years. 52.3% (114/218) and 55.6% (15/27) CLHIV had viral load > 1000 c/ml after receiving HAART for 6 - 10 and >10 years respectively (P value 0.29). <b>Conclusion:</b> About half of children on HAART have viral load > 1000 c/ml after more than 1 - 5 years on HAART. Longer duration of ART and use of AZT/3TC/NVP are associated with viral load > 1000 c/ml. Key considerations are poor adherence and/or viral drug resistance. Optimizing ART adherence and resistance monitoring remain key strategies for ART programmes.
文摘AIM:To evaluate the aspartate aminotransferase(AST) to platelet ratio index(APRI) as a predictive factor of early viral response in chronic hepatitis C naive patients.METHODS:We performed an ambispective case-control study.We enrolled chronic hepatitis C naive patients who were evaluated to start therapy with PEGylated interferon α-2b(1.5 μg/kg per week) and ribavirin(>75 kg:1200mg and <75kg:1000mg).Patients were allocated into two groups,group 1:Hepatitis C patients with early viral response(EVR),group 2:Patients without EVR.Odds ratio(OR) and 95% confi dence interval(CI) were calculated to assess the relationship between each risk factor and the EVR in both groups.RESULTS:During the study,80 patients were analyzed,45 retrospectively and 35 prospectively.The mean ± SD age of our subjects was 42.9 ± 12 years;weight 70 kg(±11.19),AST 64.6 IU/mL(±48.74),alanine aminotransferase(ALT) 76.3 IU/mL(±63.08) and platelets 209000 mill/mm3(±84 429).Fifty-five(68.8%) were genotype 1 and 25(31.3%) were genotype 2 or 3;the mean hepatitis C virus RNA viral load was 2 269 061 IU/mL(±7220266).In the univariate analysis,APRI was not associated with EVR [OR 0.61(95% CI 0.229-1.655,P=0.33)],and the absence of EVR was only associated with genotype 1 [OR 0.28(95% CI 0.08-0.94,P=0.034)].After adjustment in a logistic regression model,genotype 1 remains signifi cant.CONCLUSION:APRI was not a predictor of EVR in chronic hepatitis C;Genotype 1 was the only predictive factor associated with the absence of EVR in our patients.
文摘<strong>Background</strong>: The adult ART (antiretroviral therapy) programme started in Nigeria in 2002. After many years of ART in the country, the National implementation plan for the scale up of viral load testing was launched in 2016. Viral load estimation is the most important indicator of ART response. <strong>Aim</strong>: To describe viral suppression in adults on the HIV ART programme <strong>Material & methods</strong>: Viral load blood samples of 9450 adults on highly active antiretroviral therapy living with HIV from 4 states within Nigeria were analyzed for HIV RNA in Polymerase Chain Reaction laboratory of the Federal Teaching Hospital, Gombe between December 2017 and December 2019. <strong>Results</strong>: Males were 2577/9450 (27.3%) and 6873 (72.7%) females. Adults aged 26 - 45 years constituted 69.5% (6572). Viral load test was primarily routine in 96.3% (9098). ART was AZT/3TC/NVP in 52.5% (4962);TDF/3TC/EFV in 46.3% (4375). 48.3% (4568/9450) adults had received HAART for 1 - 5 years;7.4% (699) for 6 months but <1 year;37.6% (3551) 6 - 10 years and 6.7% (632) for >10 years. The most recent CD4 count before viral load request was ≥1000/μL in 6.5% (612) of adults;500 - 999/μL in 38.6% (3651);350 - 499 μL in 23.2% (2195) and <350 μL in 31.7% (2992). Viral load was ≥1000 c/ml in 22.9% (2167/9450) of adults. Viral load was >1000 c/ml in 22.8% (587/2577) males and 23.0% (1580/6873) females. Of adults aged 19 - 25 years, 28.4% (211/743) had viral load >1000 c/ml;23.5% (1544/6572);20.0% (294/1473);17.8% (93/523) and 18.0% (25/139) aged 26 - 45 years, 46 - 55 years;56 - 65 years and >65 years also had viral load >1000 c/ml (p value < 0.001) Viral load was >1000 c/ml in 26.0% (182/699) of adults on HAART for 6 months - 1 year and 21.3% (975/4568) after receiving HAART for 1 - 5 years. 24.9% (885/3551) and 19.8% (125/632) adults had viral load > 1000 c/ml after receiving HAART for 6 - 10 and >10 years respectively. (p value < 0.001) <strong>Conclusion</strong>: Over all viral suppression of 77% in our study is high but fell below the WHO threshold of 90%. ART programme in Nigeria requires strengthening.<strong></strong>
基金supported by the National Natural Science Foundation of China(82293650,82293651,82293652,22075127,22275080)GuangDong Basic and Applied Basic Research Foundation(2023A1515111182)President Foundation of Zhujiang Hospital,Southern Medical University(yzij2023qn07).
文摘Nanoparticle-based drug delivery system remains a significant challenge in the current treatment of solid tumors,primarily due to their limited penetration capabilities.Herein,we successfully engineer photodynamic gel-bombs(DCM@OPR)capable of penetrating deeply into tumor tissues utilizing the photodynamic-triggered explosive energy and receptor-mediated transcytosis,significantly enhancing the therapeutic efficacy of breast cancer.The photodynamic gel-bombs were fabricated by loading powerful components of chlorin e6 and MnO_(2) nanoparticles,as wellas Doxorubicin,into a crosslinked Ca^(2+)-gel.Upon exposure to laser irradiation,the obtained photodynamic gel-bombs are capable of generating explosive energy,resulting in their fragmentation into numerous nanofragments.The photodynamic-triggered explosive energy subsequently drives these nanofragments to deeply penetrate into tumor tissues through gap leakage among tumor cells.In addition,the photodynamictriggered explosive energy also promotes the escape of those therapeutic components(including chlorin e6,MnO_(2) nanoparticles,and doxorubicin)and nanofragments from lysosomes.In the subsequent stages,these nanofragments also exhibit excellent transcytosis capacity,facilitating deep penetration into tumor tissues.As expected,the enhanced penetration and accumulation of therapeutic components into tumor tissues can be achieved,significantly enhancing the anti-proliferation capacity against breast cancer.
基金This work is supported by the National Natural Science Foundation of China(No.61671036).
文摘Wireless big data is attracting extensive attention from operators,vendors and academia,which provides new freedoms in improving the performance from various levels of wireless networks.One possible way to leverage big data analysis is predictive resource allocation,which has been reported to increase spectrum and energy resource utilization eciency with the predicted user behavior including user mobility.However,few works address how the trac load prediction can be exploited to optimize the data-driven radio access.We show how to translate the predicted trac load into the essential information used for resource optimization by taking energy-saving transmission for non-real-time user as an example.By formulating and solving an energy minimizing resource allocation problem with future instantaneous bandwidth information,we not only provide a performance upper bound,but also reveal that only two key parameters are related to the future information.By exploiting the residual bandwidth probability derived from the trac volume prediction,the two parameters can be estimated accurately when the transmission delay allowed by the user is large,and the closed-form solution of global optimal resource allocation can be obtained when the delay approaches in nity.We provide a heuristic resource allocation policy to guarantee a target transmission completion probability when the delay is no-so-large.Simulation results validate our analysis,show remarkable energy-saving gain of the proposed predictive policy over non-predictive policies,and illustrate that the time granularity in predicting trac load should be identical to the delay allowed by the user.
