2025年 · 第05卷第01期

The Acquired Immunodeficiency Syndrome Professional Group of the Society of Infectious Diseases of the Chinese Medical Association formulated the first edition of the Chinese Guidelines for the Diagnosis and Treatment of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (referred to as the Guidelines) in 2005. The 2024 edition of the Guidelines has been compiled by updating the 2021 fifth edition, incorporating the latest research advancements in antiviral therapy, comprehensive management, opportunistic infections, concurrent tumors, and the prevention and intervention of HIV infection. The new edition also introduces a new section on "Incomplete immune reconstitution", proposes the concept of "HIV vulnerable populations" for the first time with recommendations for their diagnosis and treatment. This edition of the Guidelines covers 14 sections: epidemiology, pathogenic characteristics, laboratory tests, pathogenesis, clinical presentation and staging, diagnostic criteria, common opportunistic infections, antiretroviral therapy, immune reconstitution inflammatory syndrome, incomplete immune reconstitution, AIDS-related neoplasms, prevention of mother-to-child transmission and conception in serodiscordant couples, pre- and post-exposure prophylaxis, and whole-course management of HIV infection. This edition of the Guidelines aims to assist clinical physicians in making informed decisions in the diagnosis, treatment, and management of HIV/AIDS and will be periodically revised and updated based on domestic and international research progress.

Background: Given the controversial reports on the effect of convalescent plasma (CP) on coronavirus disease 2019 (COVID-19) patients, this study aimed to clarify the efficacy of early CP administration, improve the understanding of its impact on clinical outcomes, guide future research, address safety concerns, and inform public health policies. Methods: In this prospective, multicenter, randomized controlled trial conducted at Razi Hospital (Ahvaz) and Bouali Hospital (Zahedan) in Iran, 232 confirmed COVID-19 patients were randomly assigned into two groups using a computer-generated randomization method. The treatment group (n = 116) received CP with anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) IgG titer ≥1/160 on the first day of admission, along with routine antiviral medications, while the control group received only routine medications (n = 116). Recruitment occurred from 1 March to 30 July 2020, with two months of post-intervention follow-up. The primary outcome was two-month mortality, and secondary outcomes included CP-related side effects and various clinical and laboratory parameters. Results: No significant differences were observed between the groups in terms of age (P = 0.119), sex (P = 0.418), comorbidities (P > 0.05), or pre- and post-treatment changes in temperature, lymphocyte count, erythrocyte sedimentation rate, or platelet count (all P > 0.05). Despite a higher CT severity score at admission in the treatment group (P < 0.001), improvements in respiratory rate, C-reactive protein, and lactate dehydrogenase occurred earlier and were more pronounced compared to the control group (P < 0.05). No side effects related to CP therapy were observed during infusion or follow-up. However, no significant differences were observed between the groups in the mortality rate or length of hospitalization. The mortality rate in the treatment group was 11.2% (13/116), compared to 17.2% (20/116) in the control group (P = 0.130). The median hospital stay was 7 days (95% CI: 6–8 days) for the treatment group and 6 days (95% CI: 5–7 days) for the control group (P = 0.560). Conclusion: While administering CP with a high titer of anti-SARS-CoV-2 IgG early in infection may improve vital signs and laboratory parameters in COVID-19 patients, it does not significantly reduce mortality risk or length of hospitalization compared to routine medications. Overall, the treatment appears to have few side effects, suggesting it may be a safe option for further evaluation in managing early COVID-19 symptoms. Trial registration: This prospective, multicenter, two-parallel randomized controlled trial was prospectively registered in the Iranian Clinical Trials Registry (IRCT20200310046736N1).

Background: Streptococcus suis (S. suis) can be transmitted to humans through exposure to pigs or consumption of raw pork and causes serious diseases. Although infection through skin abrasions is considered an important route of transmission, few studies have reported skin injuries in patients during exposure or before infection. This study explored a rare instance of intraocular infection and bilateral deafness caused by S. suis and emphasized the importance of timely diagnosis and treatment to prevent disease progression. Methods: The diagnosis was made on the basis of clinical symptoms, imaging, molecular detection, and isolated culture methods. Drug susceptibility testing was conducted to determine the effectiveness of antibiotics. Whole-genome sequencing was used to identify the strain’s sequence type and serotype as well as the presence of pathogenicity islands (PAIs). Results: A patient with intraocular infection and bilateral deafness was diagnosed with an S. suis infection. The infection was hypothesized to result from interspecies transmission due to the patient’s occupation and recent skin damage. The isolated strain was sensitive to ampicillin, ceftriaxone, vancomycin, linezolid, levofloxacin, and meropenem. Whole-genome sequencing revealed that the strain belonged to sequence type 353 and serotype 2, showing close similarity to strains isolated from wild boars in Chinese provinces. The strain lacked the 89 complete kb PAI but had a 33 kb PAI with high similarity, potentially indicating variable virulence. Conclusion: This study highlights the importance of employing multiple diagnostic strategies for the timely identification and treatment of S. suis infections. The presence of a potentially less virulent strain emphasizes the need for continuous surveillance and monitoring of emerging S. suis infections, particularly in Asian countries with high-risk populations associated with the pig farming industry.

With the aging of the global population, older people living with HIV (OPLWH) have emerged as a focal point in HIV/AIDS research. Although antiretroviral therapy has demonstrated positive effects in OPLWH, concerns persist regarding overall poor immune reconstitution and elevated rates of age-related comorbidities, such as cardiovascular disease, bone disease, and cognitive impairment. This review aims to elucidate the mechanisms underlying immunosenescence and the interaction of immunosenescence with HIV infection, further exploring its role in the pathogenesis of HIV infection during aging. Aging-induced involution of the immune system, along with chronic inflammation and infection, can induce immunosenescence, leading to immune dysfunction that impairs the effective control of HIV infection. In addition, HIV infection induces immunosenescence through persistent inflammation and immune activation, even under treatment. The combined effects of aging and HIV infection accelerate the progression of immunosenescence in OPLWH, increasing their susceptibility to multiple age-related diseases. The unfavorable prognosis observed among OPLWH is largely attributed to increased levels of immunosenescence. A comprehensive understanding of the relationship between immunosenescence and HIV infection is crucial for developing targeted therapeutic strategies for this vulnerable population.

Co-infection with hepatitis B virus (HBV) and human immunodeficiency virus (HIV) is common as the modes of disease transmission are similar. HIV affects the development of chronic HBV infection, leading to higher HBV DNA levels, cirrhosis, and end-stage liver duisease, and potentially leading to hepatocellular carcinoma. One of the leading causes of mortality and morbidity in HIV-infected individualsis liver disease, despite the administration of antiretroviral therapy for HIV and HBV. Thus, the screening and follow-up of co-infected patients are vital formonitoring of liver disease progression. This study reviews the natural history and pathogenesis of liver disease in the context of HBV/HIV co-infection, current treatments for HBV in patients with HIV, and treatment outcomes in coinfected individuals.

Hepatitis B virus (HBV) infection is a global epidemic whose prevention and control among children warrant significant attention. Despite the availability of effective vaccines, the disease continues to affect millions of children worldwide, underscoring the need for a comprehensive understanding of its epidemiology and natural history in this vulnerable population. While research on HBV in adults has advanced considerably, the natural history of HBV infection in children remains less well-defined and may differ from adult studies due to unique immunological and physiological characteristics. This article reviews the epidemiological characteristics of HBV infection in children worldwide and summarizes the research progress on the natural outcomes of children with chronic HBV infection. Furthermore, the necessity of this review stems from the critical role that early detection, monitoring, and timely intervention play in mitigating the long-term consequences of chronic hepatitis B (CHB) in children. By synthesizing current evidence and identifying knowledge gaps, we hope to inform clinical practice, guide future research directions, and ultimately improve the health outcomes of children living with HBV. In doing so, this review article offers a valuable reference for healthcare providers, researchers, and policymakers working to combat the global challenge of HBV infection among children. The aim is to provide a relevant reference for the monitoring, screening, diagnosis, and treatment of children with CHB.

The rarity of Francisella novicida infection in humans is well-known, and the F. novicida cases occur in immunocompromised patients or those with underlying health problems. Herein, we report the case of a patient with long-term diabetes who died following F. novicida infection that caused multiple organ failure, although F. novicida was effectively eliminated using antimicrobial therapy. Microbiological confirmation of F. novicida infection relies on metagenomic next-generation sequencing (mNGS) and pdpD-2 gene-specific identification. This study highlights the importance of early pathogen diagnosis in severely infected patients, particularly in cases of F. novicida, and indicates that mNGS is a useful tool for early diagnosis.

Due to its technological advantages, single-cell sequencing has become an increasingly utilized tool to unravel the heterogeneity and complexity of individuals. The preparation of a high-quality single-cell suspension from solid tissues is a critical step prior to single-cell RNA sequencing. Based on a brief overview of the steps involved in preparing cell suspensions from solid tissues for single-cell RNA sequencing, we present a detailed analysis of the pivotal steps in the preparation process, including enzymatic digestion, mechanical dissociation, and cell viability evaluation. The clarification of these experimental details will greatly help us obtain high-quality single-cell sequencing data from solid tissues.