2021年 · 第01卷第03期

The outbreak of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a pandemic. SARS-CoV-2 vaccination is currently being actively promoted worldwide as a promising measure to combat the pandemic. However, human immunodeficiency virus (HIV)-infected individuals who manifest varying degrees of immunodeficiency and chronic inflammation may require special consideration with regards to vaccine types and the timing of immunization depending on specific clinical situations. The present recommendation provides a reference for SARS-CoV-2 vaccination in HIV-infected patients.

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered a global pandemic. At present, vaccination is being promoted worldwide and has become an important measure to control the pandemic. People with chronic liver diseases, tuberculosis, and rheumatic diseases are at a high risk of infection with SARS-CoV-2 and have a tendency to develop severe illness. Thus, vaccination among this population should be considered a priority. After taking into account domestic and international evidence, established guidelines, and local expert opinions, the operating rules for COVID-19 vaccination in patients with chronic liver diseases, tuberculosis, and rheumatic diseases have been prepared to provide specific suggestions.

Dengue is the most prevalent and rapidly spreading mosquito-borne viral disease. As a dengue non-endemic country, China has experienced several dengue outbreaks in recent years. However, dengue patients in China display clinical characteristics that are distinct from those of patients in dengue-endemic countries. To standardize the diagnosis and treatment of dengue fever, the experts at the Society of Infectious Diseases, Society of Tropical Medicine and Parasitology of the Chinese Medical Association, and the Society of Emergency Medicine of China Association of Chinese Medicine have developed a guideline after reviewing the following guidelines and data: guidelines for diagnosis, treatment, prevention, and control of dengue (World Health Organization, 2009); the guidelines for diagnosis and treatment of dengue (National Health and Family Planning Commission of the People’s Republic of China, 2014, Edition 2); health industry standard of the People’s Republic of China "diagnosis for dengue fever (WS216-2018)" ; and systemic reports on dengue. The new guideline includes eight aspects: introduction, terminology, epidemiology and prevention, etiology and pathogenesis, clinical features, diagnosis, treatment, and problems to be solved.

The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in December 2019 caused a huge blow to both global public health and global economy. At the early stage of the coronavirus disease 2019 (COVID-19) epidemic, asymptomatic individuals with SARS-CoV-2 infection were ignored, without appropriate identification and isolation. However, asymptomatic individuals proved to comprise a high proportion of all SARS-CoV-2-infected individuals, which greatly contributed to the rapid and wide spread of this disease. In this review, we summarize the latest advances in epidemiological characteristics, diagnostic assessment methods, factors related to the establishment of SARS-CoV-2 asymptomatic infection, as well as humoral immune features after SARS-CoV-2 infection or vaccination in asymptomatic individuals, which would contribute to effective control of ongoing COVID-19 epidemic.

Despite the recent success of suppressing human immunodeficiency virus 1 (HIV-1) replication in the peripheral blood with antiretroviral therapy, elimination of the provirus from infected cells remains challenging because the virus can integrate into the host genome and become a latent proviral reservoir. The removal of these latent viral reservoirs from tissue containing infected resting memory CD4+ T cells remains a major barrier to developing a cure for HIV-1. Several novel strategies have recently been developed for curing HIV infection. These include stem cell transplantation with CCR5-Δ32 mutated cells, initial antiretroviral treatment in the very early stage of HIV infection, gene editing to excise the HIV genome or generate CCR5-mutated HIV-1- resistant cells, "shock-and-kill" to reactivate latent HIV using latency reversal agents combined with enhanced immune clearance methods, and an emerging "block-and-lock" strategy to reactivate latent HIV using latency reversal agents combined with enhanced immune clearance methods. However, the high risks and limitations to scale-up in clinics, as well as poor performance in clinical trials, have hampered these efforts. This review aims to describe the present efforts that are being made to combat HIV latency, and critically discuss the limitations and future of the cure for HIV-1.

We present a case of acute-on-chronic liver failure (ACLF) in a patient with hepatitis B virus (HBV)-related decompensated cirrhosis and coronavirus disease 2019 (COVID-19). A 58-year-old woman with HBV-related and decompensated cirrhosis without any anti-viral treatment previously was admitted to the hospital due to a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. On admission, she was in stable condition. Thoracic computed tomography (CT) and laboratory findings showed no significant abnormalities. Entecavir was initiated promptly for HBV, while antiviral therapy and supportive treatment were initiated for COVID-19. Her lung infection exacerbated after 10 days of recurrent fever despite treatments, and there were signs of HBV reactivation. ACLF and multiple organ dysfunction syndrome developed rapidly from day 10 to day 19. The patient’s clinical deterioration was also consistent with pneumonia progression and elevated interleukin 6 levels. SARS-CoV-2 likely precipitated ACLF in cirrhotic patients, either by inducing HBV flare or serving as an acute insult directly. This study discussed the underlying mechanisms of this process and management details. Monitoring HBV status is necessary, and inflammatory parameters might be valuable. HBV suppression should be initiated early, and variceal hemorrhage primary prevention might be beneficial in COVID-19 patients with cirrhosis.

The diagnosis of allergic bronchopulmonary mycosis (ABPM) is usually made on clinical, serologic, and roentgenographic findings. However, the indicators in such diagnostic criteria still lack specificity, which results in a high rate of misdiagnosis. A 47-year-old woman was diagnosed with "tuberculosis" or "pneumonia" for 10 years and after thoracoscopic right upper lung resection the following chest CT showed right lung atelectasis. Brown sputum was seen in the right bronchus via bronchoscopy. Reviewing the surgical pathology specimen, the bronchi were found to be generally cystic dilated, and a large amount of mucus was retained and formed a mucus plug. The final diagnosis of the case was ABPM. The current diagnostic criteria of ABPM do not emphasize the role of bronchoscopy and pathological examination, but bronchoscopy and pathological examination still have important value for some atypical cases with suspected ABPM.