Late HIV Diagnosis and Associated Factors Among Newly Reported HIV/AIDS Cases Aged ≥50 Years — China, 2022–2024

Duo Shan¹, Yalan Wang¹, Yuan Zhao¹, Chunpeng Zang¹, Juan Yang¹, Hui Li¹, Jiarong Ren¹, Mengchi Liu¹, Yufen Liu^1,#

1. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.

^# Corresponding author: Yufen Liu, yufenliu69@chinaaids.cn.

Late HIV diagnosis remains common among older adults in China. Analysis of nationwide surveillance data from 2022–2024 showed that among 162,026 newly reported HIV/AIDS cases aged ≥50 years, 77.78% were diagnosed late. Transmission route and geographic region were key correlates of late diagnosis. In eastern China, two subgroups showed particularly high proportions of late diagnosis: individuals infected through non-marital commercial heterosexual contact (74.6%), and those infected through other heterosexual or MSM transmission routes who were diagnosed in medical institutions (73.0%). These findings provide epidemiological evidence to inform more targeted HIV screening by population subgroup, region, and diagnostic setting.

50岁以上新报告HIV/AIDS病例晚发现及其相关因素分析 — 中国， 2022–2024年

单多¹；王亚兰¹；赵媛¹；臧春鹏¹；杨娟¹；李慧¹；任佳荣¹；刘梦驰¹；刘玉芬^1,#

1. 性病艾滋病预防控制中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^# 通信作者：刘玉芬，yufenliu69@chinaaids.cn。

HIV晚发现在我国老年人群中仍较为常见。基于2022—2024年全国艾滋病综合防治信息系统数据分析显示，在162,026例≥50岁新报告HIV/AIDS病例中，77.78%在确诊时已处于晚发现状态。传播途径和地区与老年人群HIV晚发现相关。在东部地区，两类人群的晚发现比例相对较高：一是经非婚商业异性传播感染者（74.6%），二是经其他异性传播或男男性行为感染并在医疗机构发现的病例（73.0%）。本研究结果为按人群亚组、地区和发现途径开展更有针对性的HIV检测提供了流行病学依据。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.014

Impact of Hepatitis C Virus Co-infection on Antiretroviral Therapy Outcomes in Adults Living with HIV — China, 2002–2023

Decai Zhao^1,&; Jingkun Hu^2,&; Yan Zhao¹; Xiumin Gan¹; Fan Lyu^1,#

1. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.

2. Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, China.

^& Joint first authors.

^# Corresponding authors: Fan Lyu, fanlv@chinaaids.cn.

Due to similar transmission pathways, people living with HIV (PLWH) are prone to co-infection with hepatitis C virus (HCV). However, evidence regarding the impact of HCV co-infection on the antiretroviral therapy (ART) outcomes in PLWH remains debated across previous studies. Based on the National Free Antiretroviral Treatment Program database, we employed stratified and matched methods to extract two retrospective cohorts: 10,953 individuals with HIV/HCV co-infection and 17,348 individuals with HIV mono-infection. Through this method, we controlled for major confounding factors to compare the ART outcomes between the two groups. The results indicated that HIV/HCV co-infected individuals had significantly higher risk of mortality, virological failure, and attrition compared to HIV mono-infected individuals. Notably, the group with a baseline CD4 count of 200–349 cells/μL had the highest risk, with a hazard ratio (HR) for mortality of 2.13 (95% CI: 1.86, 2.44), a HR for virological failure of 1.47 (95% CI: 1.32, 1.64), and an odds ratio (OR) for attrition of 1.92 (95% CI: 1.71, 2.15). The study suggests that we need to strengthen HCV prevention, testing, and treatment among HIV-infected individuals.

合并HCV感染对成年HIV感染者抗逆转录病毒治疗结局的影响 — 中国，2002–2023年

赵德才^1,&; 胡静坤^2,&; 赵燕¹; 甘秀敏¹; 吕繁^1,#

1. 性病艾滋病预防控制中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

2. 复旦大学，上海市重大传染病与生物安全研究院，上海，中国。

^& 共同第一作者。

^# 通信作者：吕繁, fanlv@chinaaids.cn。

HIV和HCV感染途径相似，易发生共感染，但合并HCV感染对于HIV抗逆转录病毒治疗结局的影响，既往研究结果并不一致。本研究使用国家艾滋病抗病毒治疗信息系统2002–2023年收集的真实世界数据，采取分层和匹配的抽样方法，构建两个回顾性队列（分别是10,953例HIV/HCV共感染队列和17,348例单纯HIV感染队列），控制其他主要因素，比较两者HIV抗逆转录病毒治疗结局。结果显示HIV/HCV共感染者治疗过程中发生死亡、病毒抑制失败以及治疗退出的风险均显著高于单纯HIV感染者；特别是基线CD4细胞计数200–349 个/μL组相对风险最高，死亡HR值2.13 (95% CI: 1.86, 2.44)，病毒抑制失败HR值1.47 (95% CI: 1.32, 1.64)，治疗退出OR值1.92 (95% CI: 1.71, 2.15)。研究提示要在HIV人群当中加强HCV预防、检测和治疗。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.016

Increasing Uptake of Pre-Exposure Prophylaxis and Associated Behavioral Changes Among Men Who Have Sex with Men — Qingdao City, Shandong Province, China, 2024–2025

Ruzhuo Liu¹, Peilong Li¹, Lin Ge¹, Meizhen Liao², Xin Song³, Yong Fu³, Houlin Tang¹, Dongmin Li^1,#

1. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China;

2. Shandong Center for Disease Control and Prevention, Jinan City, Shandong Province, China;

3. Qingdao Center for Disease Control and Prevention, Qingdao City, Shandong Province, China.

^# Corresponding author: Dongmin Li, lidongmin@chinaaids.cn.

Pre-exposure prophylaxis (PrEP) coverage among men who have sex with men (MSM) in China is suboptimal, and longitudinal data on uptake dynamics are scarce. This study aims to describe temporal trends in PrEP use and identifies correlates of recent uptake among MSM in Qingdao, China. A prospective cohort study was conducted from January 2024 to June 2025 with 580 MSM enrolled at baseline, of whom 518 (89.3%) completed all follow-up visits. Recent PrEP use doubled from 4.6% to 10.4% during the study period, accompanied by a decrease in condomless anal intercourse and an increase in human immunodeficiency virus testing. Multivariate analysis revealed that MSM who sought sexual partners online were less likely to use PrEP (aOR=0.32, 95% CI: 0.15, 0.67), whereas perceived PrEP effectiveness (aOR=7.43, 95% CI: 3.29, 16.81) and prior post-exposure prophylaxis (PEP) use (aOR=2.20, 95% CI: 1.28, 3.71) were predictors of uptake. Findings suggest PrEP uptake is increasing in Qingdao with positive behavioral shifts; however, public health strategies must prioritize innovative digital interventions to reach MSM active online and institutionalize PEP-to-PrEP pathways to further accelerate scale-up.

男男性行为者中暴露前预防用药率增加及相关行为变化 — 青岛市，山东省，中国，2024-2025年

刘儒卓¹，李培龙¹，葛琳¹，廖玫珍²，宋鑫³，傅泳³，汤后林¹，李东民^1,#

1. 性病艾滋病预防控制中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国；

2. 山东省疾病预防控制中心，济南市，山东省，中国；

3. 青岛市疾病预防控制中心，青岛市，山东省，中国。

^# 通信作者：李东民，lidongmin@chinaaids.cn。

中国男男性行为者（MSM）人群的暴露前预防（PrEP）覆盖率尚不理想，且缺乏关于其使用动态的纵向数据。本研究旨在描述中国青岛市MSM人群PrEP使用的时间趋势，并确定近期使用的相关因素。研究于2024年1月至2025年6月在青岛市开展前瞻性队列研究，基线招募了580名MSM，其中518名（89.3%）完成了所有随访。研究期间，近期PrEP使用率从2024年6月的4.6%增至2025年6月的10.4%，且伴随着无保护肛交的减少和艾滋病病毒（HIV）检测率的增加。多因素分析显示，网络寻找性伴的MSM近期PrEP用药的可能性较低（aOR=0.32，95% CI：0.15，0.67），而感知到PrEP有效性（aOR=7.43，95% CI：3.29，16.81）和既往暴露后预防（PEP）用药史（aOR=2.20，95% CI：1.28，3.71）则是近期PrEP用药的预测因子。青岛市MSM的PrEP用药率正在上升，并伴有积极的行为转变，公共卫生策略应优先针对活跃于网络的MSM开展数字化干预，加强关于PrEP益处的健康教育，并建立制度化的PEP-PrEP转介路径，以进一步加速PrEP的推广。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.015

Imported Cases of Monkeypox Virus Clade Ⅰa — China, 2025

Danlei Liu¹, Ye Lu¹, Chunli Hu¹, Shiwei Yu¹, Liming Xue¹, Guannan Zhang¹, Zaijiong Yi¹, Mao Mao¹, Shenwei Li¹, Qiang Wang¹, Zilong Zhang^1,2,#, Zhengan Tian^1,#

1. Shanghai International Travel Healthcare Center, Shanghai Customs District, Shanghai, China;

2. Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China.

^# Corresponding author: Zilong Zhang, zhangzilong@customs.gov.cn; Zhengan Tian, tianzhengan@customs.gov.cn.

Monkeypox virus (MPXV), an emerging zoonotic pathogen, comprises two main clades with distinct epidemiological and clinical characteristics. This study reports the epidemiological investigation and genomic characterization of imported MPXV clade Ⅰa cases detected in China during 2025. During March and April 2025, two travelers arriving at Shanghai Pudong International Airport from the Democratic Republic of the Congo (DRC) underwent screening for MPXV infection. Clinical specimens were analyzed using real-time polymerase chain reaction (PCR), clade-specific PCR, and whole-genome sequencing to characterize the viral genomes. Both cases tested positive for MPXV infection. Clade-specific PCR and whole-genome sequencing confirmed infection with MPXV clade Ⅰa. The first case yielded partial viral genome data (approximately 7.2 kb; 3.64% genome coverage), whereas the second case produced near-complete genome sequences (196.7 kb; >99% coverage) through combined second- and third-generation sequencing platforms. Phylogenetic analysis revealed that these sequences clustered closely with clade Ⅰa strains currently circulating in the DRC. These findings demonstrate the effectiveness of port-based infectious disease surveillance and multi-agency joint prevention and control mechanisms in identifying and managing imported MPXV cases. Enhanced surveillance capacity, rapid laboratory confirmation, and robust multi-agency collaboration are essential for preventing cross-border transmission of emerging infectious diseases.

输入性猴痘病毒Ⅰa分支感染病例报告 — 中国，2025年

刘丹蕾¹，陆晔¹，胡春立¹，郁施伟¹，薛李明¹，张冠楠¹，易在炯¹，毛毛¹，李深伟¹，王强¹，张子龙^1,2,#，田桢干^1,#

1. 上海国际旅行卫生保健中心（上海海关口岸门诊部），上海海关，上海，中国；

2. 公共卫生学院全球健康中心，南京医科大学，南京市，江苏省，中国。

^# 通信作者: 张子龙，zhangzilong@customs.gov.cn；田桢干，tianzhengan@customs.gov.cn。

猴痘病毒（Monkeypox virus，MPXV）是一种新发人畜共患病病原体，分为两个主要分支，具有不同的流行病学和临床特征。本研究旨在报告2025年中国输入性猴痘病毒Ⅰa分支感染病例的流行病学调查与基因特征分析结果。2025年3月至4月，对两名从刚果民主共和国（DRC）出发、经埃塞俄比亚抵达上海浦东国际机场的入境人员进行猴痘病毒感染筛查。采集临床标本后，采用实时荧光定量PCR进行病毒核酸检测，通过分支特异性PCR及全基因组测序技术开展基因特征分析。两例病例的猴痘病毒检测均呈阳性。经分支特异性PCR和全基因组测序确认，病例感染猴痘病毒Ⅰa分支。其中一例获得部分病毒基因组数据（约7.2 kb，覆盖度3.64%），另一例通过第二代和第三代高通量测序平台获得近完整基因组序列（196.7 kb，覆盖度>99%）。系统发育分析显示，该病毒序列与刚果民主共和国流行的Ⅰa分支毒株密切相关。研究结果突显了口岸传染病监测与联防联控机制在识别和处置输入性高致病性猴痘病例方面的有效性。强化口岸输入性传染病监测、快速实验室确诊，做好海关与疾控、卫生健康等部门的联防联控和数据共享，协同做好输入性病例处置工作，完善从"国门"到"家门"的全流程闭环防控体系，对于新发突发传染病跨境传播防控至关重要。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.013