[HCV in intravenous drug users]

Hepatitis C [HCV] is increasing worldwide including Iran. HCV is more prevalent among intravenous drug abusers [IDU], especially if imprisoned, mostly due to needle sharing. We determined the rate of HCV seropositivity among IDU prisoners and compared it with those of non prisoners. A cross-sectional survey was done on consenting IDU inhabiting two prisons and attending three rehabilitation centers in Tehran, Iran. A questionnaire was completed for each subject and 5mL blood drawn. The samples were kept at 2-8°C until the sera were separated and stored at -70°C. HCV Ab [ELISA 1, third generation, DIA. PRO, Italy] with a sensitivity and specificity of 98% was checked by a single technician. Chi-square, Fisher's exact test and multivariable analysis were used where appropriate. Four-hundred and sixty seven subjects [346 [74.1%] prisoners; 425 [91%] male] were enrolled. Overall 66% tested positive for HCV Ab [287 male [67.5%], 21 female [50%], p<0.02]. HCV seropositivity was higher among prisoners [78.3% vs. 30.6%, p<0.001] and older IDU [76.9% vs. 62.9%, p=0.002]. Multivariable analysis showed association between HCV seropositivity and imprisonment [OR= 9.32, 95%CI: 5.60- 15.51], sharing syringes [OR=2.00, 95%CI: 1.27-3.17], duration of intravenous drug use annually [OR=1.16, 95%CI: 1.08-1.24] and male sex [OR=4.18, 95%CI: 2.02- 8.67]. HCV is rather common among IDU prisoners. Imprisonment is an independent risk factor. The infected IDU going back to the community may be an important source of HCV. Taking effective strategies [high risk group education, provision of sterile syringes, identification and treatment of infected IDU] to reduce the risk of this public health problem is needed urgently

[Celiac disease in Gonbad-Kavoos]

Northeast Iran has one of the highest rates of esophageal cancer in the world which is mainly squamous cell carcinoma [E SCC]. Celiac disease [CD] has been identified as a risk factor for ESCC. The aim of this study is to determine the prevalence of CD in Gonbad at northeast Iran and probable relation between celiac and ESCC. fourteen hundred inhabitants of north eastern Iran were randomly selected. The subjects underwent blood sampling for determination of IgA antibodies against tissue transglutaminase [anti- TTG]. Subjects with positive anti-TTG underwent an interview, upper endoscopy and duodenal biopsy. The duodenal biopsies were classified according to Marsh criteria. A total of 1209 subjects [female: 699] with mean age of 50 +/- 11.7 years were studied. Twelve subjects [female: 9] had a positive anti-TTG [1%]. Four patients did not accept endoscopy. Eight cases underwent endoscopy and duodenal biopsy. Four, two and two subjects had Marsh III, II and I respectively. Flatulence and diarrhea [the most symptoms] were in five and four subjects and characteristic skin manifestation was reported in three subjects. One subject was already diagnosed as CD. although prevalence of ESCC in northeast Iran is significantly higher than central Iran, the prevalence of gluten sensitive enteropathy is the same [1%]. It dose not appear that CD has any impact on the prevalence of ESCC in Iran