Diagnosis of herpes simplex virus 1 and 2 in clinical specimens by tissue culture and polymerase chain reaction

Background: Herpes simplex viruses [HSVs] are responsible for a variety of human diseases. Although lesions are usually self-limited, severe manifestations can occur, particularly in compromised hosts. Effectiveness of therapy for such infections relies upon rapid administration of appropriate antivirals which in turn creates the need to establish a prompt diagnosis and necessitates diagnostic testing that is rapid, sensitive and affordable especially for laboratories in developing countries. The specificity of tests is also crucial, since clinical manifestations of HSV are relatively nonspecific and overlap other potentially severe infections

Objectives: This study aimed at comparing the performance of two relatively affordable diagnostic assays; conventional PCR and tissue culture; in the detection of HSV in different clinical specimens

Methodology: Seventy participants were included and divided into two groups. Group I: comprised 50 patients with suspected herpetic lesions. Group II: comprised 20 subjects without any herpetic clinical manifestations. Samples from participants were tested for HSV pol gene by conventional PCR. Tissue culture was performed by inoculating the samples on Vero cell line

Results: Conventional PCR showed perfect agreement with the gold standard [kappa= 1] with sensitivity, specificity, and accuracy of 100%.Tissue culture assay detected 15 [21.4%] of all positive cases showing substantial agreement with the gold standard [kappa= 0.632] with sensitivity, specificity and accuracy of 57.7%, 100% and 84.29%, respectively

Conclusion: Though tissue culture has its own advantages, conventional PCR could serve as a gold standard for the diagnosis of HSV infection

Fibro-acti test, forn's score, APRI score versus liver biopsy in chronic HCV patients

Chronic infection with hepatitis C virus remain a major health problem worldwide. Clinical management of compensated chronic hepatitis C is largely based on assessment of the degree of liver fibrosis. Liver biopsy although is a gold standard for fibrosis staging is an invasive technique. Evaluating a panel of non-invasive markers of liver fibrosis as Fibro-Acti test, APRI score, Forn's score versus liver biopsy. 20 HCV patients were subjected to APRI score, Forn's score, Fibrosure test, and ultrasound guided liver biopsy, with pathological assement using METAVIR score. APRI correlates significantly to the increase in fibrosis stages with correlation coefficient of 0.716 [p = 0.000], also correlates significantly with PCR with correlation coefficient of 0.616 [p = 0.004] and with necroinflammatory changes. Forn's score showed significant correlation with fibrosis stage of 0.416 [p=0.041] and with hepatic pathology for hepatitis activity of 0.725 [p=0.000]. In the present study FT-AT was found to have a greater diagnostic performance than APRI and Forn's score. FT-AT is the only test in which results are reported for prognostic and treatment planning purposes to wave liver biopsy

Transfer factor activation of the natural killer cell in patients with chronic hepatitis C infection

Infection with hepatitis C virus [HCV] is a leading cause of chronic liver disease worldwide, little is known about how this virus is able to persist or whether this persistance might be because of its ability to alter the early innate immune response. The major HCV envelope protein E2 has been shown to bind to CD81; this leads to restricted cytotoxicity mediated by NK cells. Transfer factor advanced formula plus is formed of bovine and egg colostrum and has been found to increase NK cell activity by 437% above the base line. It is produced by 4 life research company/USA. Also, it contains several growth factors as insulin growth factors [IGF I], [IGF II], Transforming growth factor beta [TGF-B] and epidermal growth factor [EGF]. Assessment of Natural Killer [NK] cell activation by transfer factor in patients with chronic HCV infection whom are not candidate for standard therapy. 30 patients with chronic HCV infection, who are not candidate for standard therapy were subjected to: [1] History and clinical examination. [2] Liver function tests. [3] Viral markers [HBS Ag, HCV Ab]. [4] HCV RNA by PCR in the serum. [5] Flow cytometric analysis of NK cells in blood sample. [6] Patients were given transfer factor plus capsules twice daily before meals for 3 months then re-evaluation was done. Significant reduction of Mean alanine aminotransferase [SGPT] from 79.27 +/- 71.47 to 30.35 +/- 6.21, aspartate aminotransferase [SGOT] from 80.73 +/- 46.88 to 36.40 +/- 3.23 and serum Bilirubin from 1.58 +/- 0.72 to 0.86 +/- 0.33. Significant elevation of serum albumin from 3.19 +/- 0.70 to 3.59 +/- 0.54 and prothormbin activity from 0.63 +/- 0.14 to 0.82 +/- 0.12. No significant change in serum HCV RNA by PCR nor NK cell count by flow cytometry. Transfer factor advanced formula plus is an effective new therapeutic option for patients with chronic HCV infection who are not candidate for standard therapy

Cytokine production in the respiratory tract of children with respiratory syncytial viral infection

Thirty children with respiratory syncytial virus [RSV] infection were studied prospectively during the period 2002-2003. Some of them were intubated and needed ICU stay [n = 12]. The rest were not intubated [n = 18]. Nasal wash [NW] samples were obtained from all these 30 children on days 1 and 3 in addition to tracheal aspirate [TA] samples from the intubated patients also on days 1 and 3 of hospitalization. Ten healthy children were served as controls and were chosen from those undergoing elective surgery. All samples were analyzed for WBC and differential counts; concentrations of RANTES [regulated on activation, normal T cell expressed and presumably secreted], macrophage-inflammatory protein-1-alpha [MIP-1-alpha], interleukin-6 [IL-6], IL-8 and IL-10 and quantitative RSV cultures, except in the control patients