Publications by authors named "Yao-kai Chen"
Article Synopsis
- Men who have sex with men (MSM) with experience in oral PrEP are generally willing to adopt long-acting injectable PrEP (LAI-PrEP), with 77.8% expressing interest in free LAI-PrEP.
- Factors influencing this willingness include a higher number of sexual partners, male partners with unknown HIV statuses, and recreational drug use, while those who used event-driven oral PrEP and had poor adherence to oral PrEP were less inclined to switch to LAI-PrEP.
- Findings suggest that LAI-PrEP could enhance PrEP coverage, but special attention is needed for those struggling with adherence to existing oral PrEP methods.
Article Synopsis
- The intestinal epithelial barrier is crucial in the progression of HIV disease, but its damage in different patient groups is not well understood.
- A study compared intestinal damage and related markers among immunological responders (IRs), immunological non-responders (INRs), and healthy controls.
- It found that both IRs and INRs had persistent intestinal damage, with INRs showing more severe damage, which was linked to higher HIV DNA levels and lower CD4 T cell counts.
Article Synopsis
- The study evaluated the efficacy of the Xpert MTB/RIF assay for quickly diagnosing Tuberculosis (TB) and detecting rifampicin resistance in patients with extrapulmonary TB (EPTB) by comparing it to traditional culture methods.
- The Xpert MTB/RIF assay was tested on 1,614 extrapulmonary specimens and showed high sensitivity and specificity, although sensitivity varied based on the type of specimen.
- The findings suggest that Xpert MTB/RIF is a rapid and effective technique for diagnosing EPTB and detecting drug resistance, especially when used alongside drug susceptibility testing for identifying multi-drug resistant TB (MDR-TB).
Article Synopsis
- Studies on gut immune balance in HIV patients are limited; this research focuses on intestinal samples from different groups: immunological nonresponders (INRs), immunological responders (IRs), and HIV-negative controls.
- Key findings reveal that INRs have reduced Th17 and increased Treg cell counts compared to IRs, highlighting a significant difference in the Th17/Treg ratio, which is linked to markers of intestinal health like ZO-1 and I-FABP.
- The Th17/Treg ratio correlates positively with CD4 T cell counts and negatively with intestinal HIV DNA, suggesting that an imbalance in these cells indicates incomplete immune recovery and is associated with intestinal damage in HIV-infected individuals.
Article Synopsis
- Patients with AIDS often experience various CNS infections, but CNS aspergillosis (CNSAG) is rare and can be misdiagnosed.
- A 47-year-old male AIDS patient was initially misdiagnosed with Toxoplasma gondii encephalitis (TE) despite showing no improvement from standard treatments; advanced sequencing methods ultimately revealed CNSAG.
- The case highlights the importance of awareness among clinicians regarding CNSAG, and suggests that advanced diagnostic techniques like metagenomics can aid in quicker and more accurate treatment in complex cases.
Article Synopsis
- The study investigates the best timing for starting antiretroviral therapy (ART) in patients with AIDS-associated Pneumocystis pneumonia (PCP), a serious condition that significantly increases mortality risk.
- Participants were divided into two groups: one started ART within 14 days of PCP diagnosis (Early ART), and the other waited longer than 14 days (Deferred ART), with outcomes measured over 48 weeks.
- Results showed no significant differences in mortality or adverse events between the two groups; however, more patients in the Deferred ART group died before starting treatment, suggesting that early intervention may have potential benefits.
Article Synopsis
- The study investigated the prevalence of pretreatment drug resistance (PDR) among HIV-positive individuals in Chongqing, China, highlighting the challenge PDR poses in HIV management due to rising antiretroviral therapy (ART) usage.
- Data from 1,110 ART-naïve participants revealed that 24.14% had drug resistance mutations, with CRF07_BC being the most common HIV-1 genotype; the overall prevalence of PDR was found to be 10.54%.
- Findings indicated that factors such as being female, delays in starting ART, and specific genotypes like CRF08_BC contributed to increased risk of PDR, emphasizing the need for ongoing monitoring despite the
Article Synopsis
- The study compared the effectiveness of lumbar drainage (LD) and lumbar puncture (LP) for treating increased intracranial pressure (ICP) in HIV-positive patients with cryptococcal meningitis.
- Both treatments showed similar mortality rates and effectiveness in normalizing ICP over 10 weeks, with no significant differences in major outcomes.
- However, the LD group had better cerebrospinal fluid (CSF) clearance but a higher occurrence of localized infections at the puncture site, while LP resulted in more frequent invasive procedures without increasing infection risk.
Article Synopsis
- The study aimed to determine the best timing for starting antiretroviral therapy (ART) in HIV-positive patients with cryptococcal meningitis (CM), but results were inconsistent regarding risks of mortality and immune reconstitution inflammatory syndrome (IRIS).
- Participants in the trial were split into two groups: those starting ART 2-5 weeks after antifungal treatment and those starting 5 weeks later, with survival rates showing no significant difference.
- However, beginning ART within 4 weeks after antifungal treatment was associated with higher mortality, and more severe adverse events were reported in the early-ART group, indicating potential safety concerns.
Article Synopsis
- Significant progress has been made in HIV/AIDS research, including promising treatment options like gene therapy and immunotherapy, although a cure is still not imminent.
- A new approach called "selective elimination of host cells capable of producing HIV" (SECH) focuses on eliminating HIV cellular reservoirs using a cocktail of specific drugs.
- The SECH strategy faces three main challenges that may hinder its application in treating HIV/AIDS patients effectively.
Article Synopsis
- The study focuses on creating a new scoring model to predict mortality risk in HIV patients with cryptococcal meningitis (CM).
- Data was collected from a cohort study in China, identifying key factors linked to high mortality, and validating the model through statistical methods across different time frames.
- The scoring model, based on six factors, proved effective in identifying high-risk patients, demonstrating good sensitivity and specificity for practical use by physicians.
Background: The effectiveness of adjunctive corticosteroid use in patients with coronavirus disease 2019 (COVID-19) remains inconclusive.
Aim: To investigate the effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19.
Methods: We conducted a retrospective analysis of the difference in several outcomes between patients with severe COVID-19 who received corticosteroid therapy (the corticosteroid group) and patients with severe COVID-19 who did not receive corticosteroid therapy (the non-corticosteroid group).
Article Synopsis
- Long non-coding RNA LINC00847 is shown to be upregulated in non-small cell lung cancer (NSCLC) and is associated with poor prognosis in patients.
- Research methods included RT-qPCR, cell tests, a xenograft tumor model, and molecular assays to investigate LINC00847's role in cell proliferation and metastasis.
- The findings suggest that E2F1 promotes LINC00847 expression, which in turn regulates the miR-147a/IFITM1 axis, contributing to NSCLC progression.
Article Synopsis
- Cytomegalovirus retinitis (CMVR) is a serious infection in AIDS patients that can lead to blindness, but antiretroviral therapy (ART) has improved outcomes significantly.
- This study is a prospective, randomized controlled trial involving 300 participants at 17 hospitals in mainland China, comparing early vs. deferred ART initiation following anti-CMV treatment.
- The main goal is to determine how early ART impacts visual loss and other health outcomes over 48 weeks, contributing to better management strategies for CMVR in AIDS patients.
Article Synopsis
- This study investigates the preference between daily and on-demand PrEP (pre-exposure prophylaxis) among men who have sex with men (MSM) in developing countries, specifically in major cities of China.
- Out of 1,933 MSM participants, 57.1% preferred on-demand PrEP, while 42.9% leaned towards daily PrEP; factors like marital status and perceived HIV risk influenced these preferences.
- The study found that individuals currently in a relationship with a female partner had a lower preference for daily PrEP, while those with more male sexual partners and a higher perception of HIV risk preferred daily PrEP.
Article Synopsis
- This study aimed to identify risk factors affecting the prognosis of HIV-infected patients with toxoplasma encephalitis to create a risk scoring system.
- A retrospective analysis involving 94 hospitalized cases revealed a six-week mortality rate of 11.7% and identified seven significant risk factors linked to mortality.
- The developed scoring system showed high accuracy (AUC of 0.976) and can assist in timely treatment decisions for affected patients.
Article Synopsis
- The prevalence of asymptomatic cryptococcal antigenemia (ACA) in HIV-infected individuals ranges from 1.3% to 13%, varying by region.
- Researchers reviewed international studies and guidelines, recommending that Chinese HIV patients get screened for ACA when CD4 counts drop below 200 cells/μL.
- Early detection and treatment of ACA can lower the risk of cryptococcosis and save lives, indicating the need for more research on effective management strategies.
A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections: Study protocol for the optimal early intervention for cryptococcal antigenemia in HIV-infected patients.
Medicine (Baltimore)
October 2020
Article Synopsis
- Asymptomatic cryptococcal antigenemia is prevalent among HIV-infected individuals and can lead to severe conditions like cryptococcal meningitis if untreated, highlighting the need for effective antifungal treatment strategies.
- The study involves a randomized controlled trial with 450 participants divided into three groups: a control group with no treatment, one receiving a gradual dosage of fluconazole, and another on a consistent lower dose, focusing on the incidence of cryptococcal meningitis as the primary outcome.
- The goal is to identify the necessity and the best treatment regimens for antifungal intervention in HIV-infected patients dealing with cryptococcal antigenemia, with potential implications for improving patient management and outcomes.
Article Synopsis
- The study assessed the effectiveness of three antiviral treatment regimens for mild to moderate COVID-19: ribavirin with interferon-α, lopinavir/ritonavir with interferon-α, and a combination of all three.
- In total, 101 patients participated, and comparison of outcomes showed that the median time to negative SARS-CoV-2 tests was shortest in the lopinavir/ritonavir group, but the differences across treatments were statistically insignificant.
- The combined treatment of ribavirin, lopinavir/ritonavir, and interferon-α was associated with a higher incidence of gastrointestinal side effects compared to the other regimens.
A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections: Study protocol for antiretroviral therapy timing in AIDS patients with toxoplasma encephalitis.
Medicine (Baltimore)
July 2020
Article Synopsis
- Toxoplasma encephalitis (TE) is a significant opportunistic infection in AIDS patients, leading to high prevalence and morbidity, which makes the timing for antiretroviral therapy (ART) initiation after TE diagnosis a critical question.
- A clinical study with 200 participants is being conducted to compare early ART initiation (within 14 days of TE diagnosis) versus deferred initiation (after 14 days) and assess outcomes such as mortality rates and CD4+ count changes over 48 weeks.
- The trial aims to determine the optimal ART timing for improving treatment outcomes in AIDS/TE patients, potentially providing valuable insights for future clinical guidelines.
Article Synopsis
- Increased cases of toxoplasma encephalitis in AIDS patients with low CD4+ counts have led to the investigation of the effectiveness of sulfonamide combinations due to limited access to traditional treatments in China.
- This study will compare the effects of a readily available sulfonamides formulation plus clindamycin with the standard TMP-SMX plus azithromycin treatment over a 48-week follow-up period involving 200 participants.
- The trial aims to establish reliable evidence regarding the new treatment's efficacy and safety for AIDS patients suffering from toxoplasma encephalitis.
Article Synopsis
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is primarily diagnosed using real-time RT-PCR, which has some accuracy limitations.
- Researchers developed a new peptide-based luminescent immunoassay that detects IgG and IgM antibodies to improve detection.
- The immunoassay showed positive rates of 71.4% for IgG and 57.2% for IgM in confirmed patients, suggesting it could enhance COVID-19 diagnosis when used alongside RT-PCR.
Article Synopsis
- In December 2019, COVID-19 caused by the novel coronavirus emerged in Wuhan, China, with limited information on its clinical and immunological effects in children.
- A study analyzed twelve pediatric COVID-19 patients, revealing that common symptoms were cough (75%) and fever (58.3%), while children exhibited a longer incubation period (average of 8 days) compared to adults.
- The immune profiles indicated that children had higher levels of T cells and B cells, which may relate to their milder symptoms, and it is recommended that testing for SARS-CoV-2 be conducted for children with potential exposure, regardless of symptoms.