ABSTRACT Background This study aimed to characterize the temporal trends of chronic kidney disease (CKD) burden in China during 1990–2019, evaluate their age, period and cohort effects, and predict the disease burden for the next 10 years. Methods Data were obtained from the Global Burden of Disease (GBD) 2019 study. Join-point regression model was used to estimate the average annual percentage change (AAPC) of CKD prevalence and mortality, and the age-period-cohort analysis was used to estimate the age, period and cohort effects. We extended the autoregressive integrated moving average (ARIMA) model to predict the disease burden of CKD in 2020–2029. Results In 2019, there were 150.5 million cases of (10.6%) and 196 726 deaths from (13.8 per 100 000 general population) CKD in China. Between 1990 and 2019, the prevalence and mortality rate of CKD increased significantly from 6.7% to 10.6%, and from 8.3/100 000 to 13.8/100 000. The AAPC was estimated as 1.6% and 1.8%, respectively. Females had a higher CKD prevalence of CKD but a lower mortality rate. Setting the mean level of age, period and cohort as reference groups, the risk of developing CKD increased with age [RRage(15–19) = 0.18 to RRage(85–89) = 2.45]. The cohort risk was significantly higher in the early birth cohort [RRcohort(1905–1909) = 1.56]. In contrast, the increase in age-specific CKD mortality rate after 60–64 years was exponential [RRage(60–64) = 1.24]. The cohort-based mortality risk remained high prior to the 1945–1949 birth cohorts (RRcohort ranging from 1.69 to 1.89) and then declined in the 2000–2004 birth cohort [RRcohort(2000–2004) = 0.22]. The CKD prevalence and mortality are projected to rise to 11.7% and 17.1 per 100 000, respectively, by 2029. Conclusions To reduce the disease burden of CKD, a comprehensive strategy that includes risk factors prevention at the primary care level, CKD screening among the elderly and high-risk population, and access to high-quality medical services is required.

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Temporal trends in prevalence and mortality for chronic kidney disease in China from 1990 to 2019: an analysis of the Global Burden of Disease Study 2019

In response to the coronavirus disease 2019 (COVID-19) pandemic, the Chinese government implemented the dynamic COVID-zero strategy. We hypothesized that pandemic mitigation measures might have reduced the incidence, mortality rates, and case fatality ratios (CFRs) of the human immunodeficiency virus (HIV) in 2020-2022.We collected HIV incidence and mortality data from the website of the National Health Commission of the People's Republic of China from January 2015 to December 2022. We compared the observed and predicted HIV values in 2020-2022 with those in 2015-2019 using a two-ratio Z-test.From January 1, 2015, to December 31, 2022, a total of 480,747 HIV incident cases were reported in mainland China, of which 60,906 (per year) and 58,739 (per year) were reported in 2015-2019 (pre-COVID-19 stage) and 2020-2022 (post-COVID-19 stage), respectively. The average yearly HIV incidence decreased by 5.2450% (from 4.4143 to 4.1827 per 100,000 people, p < 0.001) in 2020-2022 compared with that in 2015-2019. However, the average yearly HIV mortality rates and CFRs increased by 14.1076 and 20.4238%, respectively (all p < 0.001), in 2020-2022 compared with those in 2015-2019. During the emergency phase in January 2020 to April 2020, the monthly incidence was significantly lower (23.7158%) than that during the corresponding period in 2015-2019, while the incidence during the routine stage in May 2020-December 2022 increased by 27.4334%, (all p < 0.001). The observed incidence and mortality rates for HIV decreased by 16.55 and 18.1052% in 2020, by 25.1274 and 20.2136% in 2021, and by 39.7921 and 31.7535% in 2022, respectively, compared with the predicted values, (all p < 0.001).The findings suggest that China's dynamic COVID-zero strategy may have partly disrupted HIV transmission and further slowed down its growth. Without China's dynamic COVID-zero strategy, HIV incidence and deaths in the country would have likely remained high in 2020-2022. There is an urgent need to expand and improve HIV prevention, care, and treatment, as well as surveillance in the future. 

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Impact of the COVID-19 pandemic and the dynamic COVID-zero strategy on HIV incidence and mortality in China

This study aimed to assess the proportion of depression and its associated factors among men living with HIV/AIDS and aged 50 and over in Chongqing, China.This cross-sectional study included 774 men diagnosed as HIV/AIDS and aged 50 and over in four regions. Data were collected through face-to-face interviews with a structured questionnaire. Multivariate logistic regression analysis was performed to identify factors associated with depression. A two-tailed P-value less than 0.05 was considered as statistical significance.A total of 293 participants (37.9%) reported depressive symptoms. Results from multivariate logistic regression suggested that individuals aged ≥70 (AOR = 1.99, 95% CI: 1.28-3.08) and those living in rural areas (AOR = 2.79, 95% CI: 1.96-3.97) were associated with higher odds of depression, while those being employed (AOR = 0.50, 95% CI: 0.32-0.80) and with monthly income >3000 CNY (AOR = 0.47, 95% CI: 0.30-3.74) had lower odds of depression.Our findings indicate a high prevalence of depression among older men living with HIV/AIDS in Chongqing, China. Age, residence, employment, and income have been identified as potential risk factors of depressive symptoms. Mental-health intervention initiatives should be tailored to target adults with a higher risk of depression. 

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Depression and Associated Factors Among Men Living with HIV/AIDS Aged 50 Years and Over in Chongqing, China

Abstract Background The threat posed by sexually transmitted diseases (STDs), such as syphilis, gonorrhea, AIDS/HIV and HBV, to the elderly Chinese population remains unclear. Methods National surveillance data, including case numbers, numbers of deaths, incidence and mortality, on 4 STDs from 2004–2018 was collated. Subjects were divided into two groups of older (aged ≥ 60) and younger (aged＜60) participants. The older group subdivided into those aged 60+ (ages 60–69), 70+ (ages 70–79) and 80+ (≥ 80). Time periods, 2004–2008, 2009–2013 and 2014–2018 were examined. Comparison of epidemiological characteristics between older and younger groups, the 3 sub-divisions of the older groups and incidence trends of the 4 diseases among older participants were analyzed using the χ 2 test. Results STDs incidence was significantly different between older and younger participants. Incidences of syphilis, AIDS/HIV and HBV among older were higher than younger subjects following the years 2006, 2010 and 2015, Besides, the incidences of syphilis, AIDS/HIV and HBV showed increasing trends in 2004–2018. Mortality from all 4 diseases was also higher among older than younger subject. Moreover, mortality from AIDS/HIV increased between 2004 and 2018. Analysis of the 3 sub-divisions of the older group showed that 60 + participants had the highest incidence of gonorrhea, AIDS/HIV and HBV; 70 + participants had the highest mortality from AIDS/HIV and the fastest growth rate of AIDS/HIV incidence and mortality. Conclusion Syphilis, gonorrhea, AIDS/HIV and HBV constituted a threat to the health of older people in China in the time period 2004–2018. 

Epidemiological characteristics of sexually transmitted diseases in older people of mainland China: review of 15-year national surveillance data

Efficacy and safety of ainuovirine versus efavirenz combination therapies with lamivudine/tenofovir disoproxil fumarate for medication of treatment-naïve HIV-1-positive adults: week 48 results of a randomized controlled phase 3 clinical trial followed by an open-label setting until week 96

Although the human immunodeficiency virus (HIV) caused one of the worst epidemics since the late 20th century, China and the U.S. has made substantial progress in tackling its HIV and AIDS epidemic. However, the trends of HIV and AIDS incidence remain unclear in both countries. Therefore, this study aimed to highlight the long-term trends of HIV/AIDS incidence by gender in China and the U.S. population. It may helpful to assess the impact/role of designed policies in control of HIV/AIDS incidence in both countries. The data were retrieved from the Global burden of disease (GBD) database. The age-period-cohort (APC) model and join-point regression analysis were employed to estimate the age-period-cohort effect and the average annual percentage change (AAPC) on HIV incidence. Between 1994 and 2019, we observed an oscillating trend of the age-standardized incidence rate (ASIR) in China and an increasing ASIR trend in the U.S. Despite the period effect in China declined for both genders after peaked in 2004, the age effect in China grew among the young (from 15-19 to 25-29) and the old age groups (from 65-69 to 75-79). Likewise, the cohort effect increased among those born in the early (from 1924-1928 to 1934-1938) and the latest birth groups (from 1979-1983 to 2004-2009). Whereas in the U.S., the age effect declined after it peaked in the 25-29 age group. People born in recent birth groups had a higher cohort effect than those born in early groups. In both countries, females were less infected by HIV than males. Therefore, besides effective strategies and awareness essential to protect the young age groups from HIV risk factors, the Chinese government should pay attention to the elderly who lacked family support and were exposed to HIV risk factors.

Yiran Cui

Papers

Long-Term Changes of HIV/AIDS Incidence Rate in China and the U.S. Population From 1994 to 2019: A Join-Point and Age-Period-Cohort Analysis