The Inductive Effect of Purified Streptococcal M-protein on Immunity against Streptococcus pyogenes in Rabbit Model.

Aims: The study aimed to know the effects of the purified M-protein on immune system to produce protection against Streptococcus pyogenes in rabbits. Study Design: Case-control study. Place and Duration of Study: In this study, collection samples and bacterial identification were carried out in two hospitals; Child Protection Hospital and Central Child Hospital in Baghdad city, and experimental work was done in Department of Medical Microbiology, College of Medicine-Babylon university, Iraq. The study was done during the period between January to July 2014. Methodology: A total of 260 samples were collected from tonsillitis and pharyngitis cases. Three main parts involved in this study: the first part is bacterial diagnosis based on relied diagnostic procedures. The second part is detection of serogroup of GAS and antistreptolysin O (ASO) antibodies by using latex agglutination test, and the third part is experimental study conducted on the protective immune response against the group A streptococci using rabbit model. M-protein was purified by using Ion exchange chromatography. The rabbit models were immunized with purified M protein according to standard method. The immune response generated against the M protein was checked in an rabbit population. Results: From a total of 260 samples of tonsillitis and pharyngitis cases among children, only 8 (3.07%) isolates were identified as Streptococcus pyogenes. High amount of M-protein was detected in two isolates by indirect bacterial test. The concentration of purified M-protein ranged from 20-24.68 µg/ml. The purified M protein has important role in an induction of the immune response in experimental model. It leads to increased phagocytosis, stimulation of T-cell, and high level of antibody in serum of an immunized rabbits. Conclusion: The purified streptococcal M protein has strong antigenicity, and it has important role in an induction the strong protective immune response in experimental rabbit model. It may be used in future studies as vaccine against streptococcal infection among humans.

role of autoantibody and antioxidant enzymes in patients with type 1 diabetes

To determine autoantibodies and antioxidant enzymes as well as the correlation between them. This study included 80 individuals, 40 patients with type 1 diabetes and 40 healthy individuals without diabetes [as a control group]. The study was carried out during the period from December 2010 to the end of December 2012 at Al-Tahreer General Hospital, Al-Basra Maternity and Pediatric Hospital, and Al-Sader Teaching Hospital. Laboratory investigations were performed to estimate glutamic acid decarboxylase antibody [GADA] and islet cell antigen-2 antibody [IA-2A] by enzyme-linked immunosorbent assay [ELISA], antioxidant enzymes [glutathione peroxidase [GPX] and superoxide dismutase [SOD]], and glycosylated hemoglobin [HbA1c] [as a marker of glycemic control] for these patient and control groups. The high prevalence of GADA and IA-2A had been demonstrated among patients with type 1 diabetes, which was significantly higher [P < 0.001] [72.5%] in comparison to 0% in the control group. These results are suggestive of the autoimmune characteristic of type 1 diabetes. The age of onset of type 1 diabetes is found to affect the frequency of these autoantibodies. The frequency was significantly higher in patients who developed the disease in early childhood [91.7% for GADA and 58.3% for IA-2A] in comparison with those who developed the disease later on [40% for GADA and 20% for IA-2A]; this probably occurred due to genetic and non-genetic factors. Although the statistical analysis of the correlation between gender and autoantibodies showed no significant difference, female patients with type 1 diabetes were found to be more affected than male patients. The frequency of these autoantibodies was found to decrease as the duration of type 1 diabetes increased. The prevalence of GADA and IA-2A in patients with duration of disease less than 5 years was 78.3% and 43.5%, respectively, and began to decrease to 0% for GADA and IA-2A in those with disease duration more than 12 years. These results are attributed to the depletion of islet cell autoantibodies with time. Additionally, HbA1c levels were significantly higher in islet cell autoantibodies-positive patients than in islet cell autoantibodies-negative patients [P < 0.001]. The difficulty in achieving glycemic control despite oral hypoglycemic drug and insulin therapy is attributed to the fact that the pathogenesis of disease in developing type 1 diabetes and latent autoimmune diabetes [LADA] in adults is due to beta-cell destruction rather than insulin resistance as in classical type 2 diabetes. The mean activity of both antioxidant enzymes [SOD and GPX] in red blood cells [RBCs] was significantly lower than the control [P < 0.001]. Also the lower mean activity of both antioxidant enzymes [SOD and GPX] in RBCs showed a higher significant value in patients who had uncontrolled diabetes [HbA1c level > 8%] [P < 0.001]. Patients with LADA who were tested positive for GAD and IA-2A showed a significant decrease in the mean activity of SOD and GPX in comparison to patients with type 2 diabetes who were tested negative to autoantibodies; most of the patients with LADA also had a higher HbA1c level > 8% [P< 0.001]. There is a strong evidence of the role of autoimmunity in the pathogenesis of type 1 diabetes. The oxidative stress SOD and GPX are depleted as well. The correlation reflects the more oxidative stress with poor diabetic patients may progress the complications

Glycemic control among adult diabetics in post-conflict Iraq

To determine the level of glycemic control and factors associated with poor glycemic control among patients type 2 diabeties. A cross sectional study was carried out at National Diabetic Center at Al-Yarmouk teaching hospital and Diabetic consultancy clinic at Al-Kindi hospital. A total of 354 type 2 diabetic patients were enrolled in the period from 1st June to 31st July, 2012. They were selected by systematic random sampling. A face to face interview was done and filling a questionnaire [demographic, lifestyle, socioeconomic, health, clinical characteristics and glycosylated hemoglobin test]. A review of patient's records was taken place too. Out of the total sample, 47.5% had glycemic control [HbA1c<7]. High body mass index, long duration and no self-monitoring of blood glucose were significantly associated with poor glycemic control [p=0.04, 0.001 and 0.002, respectively]. Glycemic control rate are needed to raise because it was low. Further efforts are needed by controlling obesity and training on self-monitoring blood glucose

In vitro, determination of optimal conditions of growth and proteolytic activity of clinical isolates of Trichophyton rubrum

Objective: To determine the effect of some growth conditions in proteolytic activity of clinical isolates of Trichophyton rubrum

Methods: Isolation and identification of a dermatophyte T. rubrum from hair and skin scrapings of patients with dermatophytosis by using the morphological and cultural characteristics. Optimal growth conditions of eight isolates including temperature, pH, culture media type and incubation period were studied, in addition to that the proteolytic activity and its optimal production in liquid media were tested

Results: The results showed that the colonies of T. rubrum on Sabouraud dextrose agar [SDA] were like cotton or powder-like, white or light beige, flat or elevated, with or without pigments on the reverse. The optimal conditions of growth were 30[degree]C, pH6 and SDA media. The proteolytic activity against casein as substrate showed that T. rubrum isolates have an ability to produce exocellular protease ranged from 10.5-80.1U/ml according to the source of each isolates. On the other hand, the proteolytic activity varied based on the pH value, temperature, incubation period and concentration of substrate

Conclusion: The present data may refer to the vital role of proteolytic activity in the invasion and pathogenesis of T. rubrum infection

Effect of Cytomegalovirus and Diabetes Mellitus on the Cytokine Profile of Cellular Immunity in Tuberculosis Patients.

Aims: This study aims to investigate the effect of cytomegalovirus (CMV) and diabetes mellitus (DM) on the cell-mediated immunity against TB represented by cytokine profile Study Design: Case control study. Place and Duration of Study: This study was carried out in Specialized Chest and Respiratory Center in Baghdad, Iraq and Department of Medical Microbiology-College of Medicine -Babylon university Hilla-Iraq, the period of study was October 2012 to January 2013. Methodology: This study was applied on 70 TB patients .It involved also 30 apparently healthy control. The patients consists of 43 males and 27 females with age range 8-76 years old, 29 of them were diabetic .Blood samples were collected from patients and controls to estimate the immune parameters interferon-gamma (IFN-γ) and interleukin - 2(IL-2 )as , and anti –CMV IgG antibodies by enzyme linked immunosorbent assay (ELISA). Results: The immune parameters showed that there is no significant difference in the mean serum concentration between the patients and control groups for IFN-γ and IL-2 (P=0.05), while there was a significant increase in the mean serum concentration of anti- CMV IgG between study groups (P≤0.001). The study also showed that there is a significant decrease in the mean serum concentration of IL-2 and IFN-γ between diabetic TB patients comparing with those nondiabetic TB patients where p values were 0.008 and 0.024 respectively. Conclusion: Both CMV and diabetes mellitus have a role in the suppression of cellular immunity in TB patients.

Changes in personality and mood profile of women with toxoplasmosis

Acquired T. gondii infection of immunocompetent patients may cause central nervous system manifestations [Gullain-Bare syndrome or brain abscess] and may be associated with psychiatric manifestation. Iraq is highly endemic with T. gondii, however, publications on psychiatric manifestation of T. gondii infection are scarce. To demonstrate psychiatric manifestations in women with Toxoplasmosis. A total of 68 toxoplasma positive pregnant women and 68 toxoplasma negative pregnant women were included in this study. It was conducted for the period of 5[th] Aug. 2008 to 28[th] Feb. 2009. ELISA was used to diagnose T. gondii. Questionnaire was used to diagnose personality type and depression was used. The diagnosis was according to ICD[10] and DSM-IV. Rates of pseudpsychopathic and limbic personality epilepsy syndrome were significantly high among toxoplasmosis positive pregnant women. Significant high rate of depression was associated with acquired T. gonii infection. These findings might provide evidence supporting role of T. gondii infection in the onset of some behavioral disorders

Hepatitis C virus infection assessment among chronic hemodialysis patients in Al Kadhmiya teaching hospital

Hepatitis C virus [HCV] has been recognized as an emerging problem in dialysis patients, and viral hepatitis remains a major hazard for both patients and medical staff of hemodialysis [HD] units. The reported yearly incidence of anti-HCV antibody worldwide between HD patients ranges from 10.5% to 24%, while the prevalence of anti-HCV antibody among dialysis patients varies in different countries [5-85%] worldwide, and may exceed 95% in the Middle East To asses the prevalence of anti-hepatitis C virus [HCV] among the hemodialysis unit in Al Kadhmiya Teaching Hospital and to identify the risk factors of infection in relation to age, sex, blood transfusions and duration of dialysis Across-sectional study was conducted in AL Nahrain College of Medicine in Al Kadhmiya Teaching Hospital in dialysis unit during the period from April 2008 to December 2010. 100 patients[58 male and 42 female their ages ranged from [15-75]. are known cases of end stage renal failure on regular haemodialysis. All patients underwent a history and physical examination at baseline and investigations include blood urea nitrogen, creatinine, serum calcium, phosphorus, liver function test and screen for hepatitis C virus antibodies were tested by using Murex anti-HCV ELISA, Positive cases were confirmed by polymerase chain reaction The prevalence of HCV infection in patients in the dialysis unit was 41%. This study showed that there was an association between the history of blood transfusions, duration of the dialysis and kidney transplantation and the prevalence of HCV infection,[P.value<0.001.]. Although the levels of AST and ALT were higher in the positive HCV marker group, there was no statistically significant difference between them. HCV infection is high in hemodialysis unit in alkadhmiya teaching hospital, HCV-related liver disease in patients on long-term dialysis often appears clinically mild, with only modest elevations in AST and ALT levels but most of them asymptomatic. Observation of appropriate preventive measures in the hemodialysis center is highly recommended

Mental health of Iraqi adolescents

To estimate the prevalence of flourishing and the association of mental health status with the socio-demographic characteristics and conduct problems of adolescents. A total of 8807 adolescents were included in this study. Data were obtained from knowledge, attitudes and practices household survey carried out in 2004. Each adolescent was interviewed by a trained team and a specially designed questionnaire was filled. Emotional, psychological and social well-beings were assessed through a series of measurements. Conduct problems were measured by self-reporting of school skipping, smoking, alcohol drinking, inhalant use and arrestment. The prevalence of flourishing, moderate mental health status and languishing were 5.6%, 20.3% and 74.1%, respectively. The prevalence rates of school skipping, smoking, and other conduct problems [alcohol drinking, inhalant use, and arrestment] were 60.1%, 62.8% and 59.2%, respectively. Mental health was significantly associated with age, educational level, and various conduct problems [p<0.001]. No significant sex variation was demonstrated. Flourishing was significantly decreasing with advancing age [p<0.0001] and it was significantly lower among smokers [p<0.0001], and those with other conduct problems [p<0.0001]. The low rate of flourishing among adolescents was associated with a high rate of conduct problems which could be a psychological response to the stressful condition prevailing in the country during the last 3 decades

Hypertension in haemodialysis

Relevant factors involved in the pathogenesis of hypertension among dialysis patients include sodium and water retention, dialysate composition and prescription, increased activity of vasoconstrictuve systems [sympathetic nervous system, rennin-angiotensin system, endothelin and vasopressin], decrease activity of vasodilatory systems [nitric oxide, kinins], increased intracellular calcium, increased arterial stiffness, sleep apnea, hyperparathyroidism, erythropoietin and renovascular disease. The objective of this study is to assess the prevalence of hypertension among uremic patients undergoing haemodialysis and to asses difference of blood pressure reading before and after dialysis. 140 patients with chronic renal failure and acute renal failure on regular haemodialysis. Blood pressure was measured by doctors before dialysis, within 2 hhour of dialysis, after dialysis and after 48 hours of dialysis. We averaged six routine predialysis systolic and diastolic blood pressure. The same was carried out for postdialysis. Patients with preheamodialysis [office BP] > 130/85 mmHg are considered as hypertensive in chronic renal failure, who made up of 74% of the study population. 40% patients were on monotherapy antihypertensive drug. 65% are taking calcium channel blocker, angiotensin coverting enzyme inhibitor 38%, angiotensin Pi receptor blockers 26% and beta blocker 20%. Preheamodialysis blood pressure [Office Bp] overestimated Bp values in relation to 48 h postidalysis. Significant difference was shown between predialysis office blood pressure and 48 hour postdialysis in the recognition of hypertension in heamodialysis patients. The prevalence of hypertension in heamodialysis patients is high [74%] most of the patients used combination of antihypertensive drugs, calcium channel blocker commonly used 65%

Posttraumatic stress disorder among emergency ambulance personnel in Baghdad, Iraq

Emergency ambulance personnel [EAP] are vulnerable to posttraumatic stress disorder [PTSD]. In Iraq, EAPs were exposed to life threatening situation during political violence conflict post 2003 Gulf war. This study was carried out to report on PTSD among EAP. A total of 189 male EAPs [only one female in was in the emergency department] were selected randomly from the Deptartment of ambulance in Baghdad. A questionnaire form was filled for each EAP. The form included the symptoms of PTSD according to DSM-IV [intrusive, avoidance and hyperarousal symptoms]. Demographic data and exposure to violence accident, type of accident and duration of damage were included, also. The mean age of EAP was 38.5 +/- 9.4 years. There was 122 [64.5%] had PTSD. Age, education, marital status and years in emergency ambulance department were significantly associated with PTSD. High rate of PTSD among EAPs was reported. Measures to prevent PTSD and to give further support to EAP are needed. Further studies will clarify the situation of PTSD in Iraq

[Trace elements levels in patients with some different parasitic infections]

To evaluate serum levels of zinc, copper and iron in regard to some different parasitic diseases. A case-control study was carried out during the first 9 months of 2007 in Basrah, Southern Iraq. Blood samples were collected from 230 subjects aged 1 -65 years.One hundred samples out of 230 collected from patients with parasitic infections [35 patients with toxoplasmosis, 32 patients with leishmaniasis, 24 patients with amoebiasis and 9 patients with giardiasis] while the rest 130 were apparently healthy subjects and considered as control group. The absorbance of each serum sample against blank was measured by flame atomic absorption spectrophotometer. Serum zinc levels were decreased significantly in patient group when compared with healthy subjects [p<0.001], while both serum copper and serum iron were increased significantly in patient group when compared with control group [p<0.001]. There was no significant difference in regard to the effect of age and sex on serum trace elements levels in patients and control groups. The significant decrease in serum zinc level and an increase of serum copper and iron in patients might be related to the parasitic infection

Prevalence of hepatitis C virus antibodies among health care workers in Baghdad, Iraq

There are several reports on the occupational risk of hepatitis C virus infection of health care workers [HCWs] by accidental inoculation of infected blood. This study was carried out to determine the prevalence of anti-HCV among a sample of Iraqi HCWs. A total of 1656 HCWs selected from various hospitals and medical units in Baghdad, together with 238 "apparently" healthy subjects [controls] were tested for anti-HCV from June 1995 to April !998. Serum testing was carried out by a third generation of enzyme immunoassay [EIA] for screening for anti-HCV and a third generation recombinant immunoblot assay [RIA-111] for confirmation of the presence of HCV antibodies. A higher rate of anti-HCV [1.51%] was observed among HCWs than controls [0.84%]. The highest prevalence rate of anti-HCV was detected in the renal dialysis group [6.25%] followed by the dentistry group [4.26%]. These were the only groups having a statistically significant higher prevalence of anti-HCV than controls when each group was compared with controls. An increase in the prevalence of anti-HCV with duration of professional practice was demonstrated. The highest rate of anti-HCV was detected among HCWs in cardiovascular surgery hospitals [4.21%] followed by infectious disease hospitals [3.37%]. Efforts to reduce exposure to blood and other body fluids are needed to reduce the risk of the occupational transmission of HCV infection, as no vaccine against HCV infection is available yet

Cancer registration in Basrah 2005: preliminary results.

Cancer is a disease which shows significant variation with time and across geographical entities. In Basrah, Iraq, despite the widespread impression that cancer is increasing, researchers are not yet able to draw clear boundaries as to the extent of cancer and its determinants. In this paper, we make a start in that direction; the aim was to measure as accurately as possible the incidence of cancer (all types) in Basrah, to assess age specific incidence rates and to map the cases across different areas of the governorate. For this purpose we compiled data on every accessible case of cancer. The cancer registry in Basrah was used as the prime source of data on newly diagnosed cancer cases, supported by three other sources: the Cancer Registration Section at the Department of Pathology and Forensic Medicine, College of Medicine, University of Basrah; the Oncology Centre at Al-Sadr Teaching Hospital; and the Oncology Ward in Basrah Maternity and Child Hospital. Other minor sources were also utilized. Information on cases from these sources was subjected to meticulous verification regarding repetition, place of residence and other potential errors. The overall incidence rate was 74.3/100,000 population with a higher rate for females (80.5/100,000) than for males (68.1/100,000). The results indicate clear increase in registered cancer cases with increasing age. The lowest incidence rate was among females aged 5-14 years (10.5/100,000) and the highest was among males aged 65 years and above (660.2/100,000). The results show no major variation in the annual incidence rates of cancer in different areas of Basrah governorate. This finding may suggest a common exposure to cancer risk factors. To reach sound conclusions about extent and determinants of cancer in Basrah, immense multi-spectrum efforts are now needed.

Brain abscess in Iraq during a 10 years period: part 1. epidemiology, aetiology and clinical picture

This study comprises two parts, [this part deals with epidemiology, aetiology and clinical features of brain abscess during a 10 years period, while the second will deal with diagnostic investigation, management and final outcome of brain abscess. The case records of patients with brain abscess admitted to the neurosurgical specialties hospital in Baghdad over a 10 years period extending from 1[st] Jan. 1993 to 31[s] Dec. 2002, inclusive were reviewed. Data obtained included demographic and clinical data. A total of 78 cases [1.2% of total admission] of brain abscess were admitted. Their age ranged from one month to 68 years. The most common aetiological factor was cyanotic heart disease, with the congenital anomaly being unrepaired in all cases. Remote infection foci other than the heart represented minority. Half of the cases had a rapid onset and fluminant progression. The presenting features of the patients older than one year were raised intracranial pressure, and focal neurological deficit and infection. Maintaining a high index of clinical suspicions in patients having one of the infection sources together with neurological signs should be emphasized

Brain abscesses in Iraq during a 10 years period: Part 11. Diagnostic investigations, management -and outcome

This study comprises two parts, the first one dealt with epidemiology etiology and clinical picture of brain abscess. This part describes diagnostic investigation management and final outcome of brain abscess during a 10 years period. The case records of patients with brain abscess admitted to the neurosur, specialties hospital in Baghdad over a 10 years period extending from 1 "Jan. 1993 to 31 " Dec. 2002, inclusive were reviewed. Data obtained included demographic and clinical data. Results of peripheral leukocytes count, ESR and CSF were supportive in 16.7%, 67.9% 78% of cases in which tests were applied, respectively. CT scan was suggestive in 100% of cases. Use of antibiotic therapy as a preliminary treatment line was adopted in 37.8% cases, while surgery as a preliminary line of treatment was adopted in 62.3% of cases. Out 68 cases, complete resolution was encountered in 70.6% ol'cases, sequlae in 11.8% and death in 17.9%. Bad neurological 'status on admission was the most encountered contributing factor for death. Metastasis from a remote infection process is a risky aetiology contributing to bad prognosis. The use Of C I Scan represents all important change in the diagnostic regimen brain abscess in the last 10-15 years

Malnutrition among first year school children in Iraq

Iraqi people have endured an excess burden of morbidity and mortality during the last two decades due to wars and sanctions. This report was carried out to assess the nutritional status of first year primary school children. A total of 3881 school children in Balad district in Salahadin governorate was included in the study. Age, height and weight were recorded. Malnutrition was regarded as value of less than 2 SD of the reference value. Among the total sample, 16.5%, 20.06% and 15.3% were underweight, stunted and wasted, respectively. No significant difference was detected in malnutrition rates between both sexes. High rates of malnutrition were detected among school children

HBV markers and antibody protective level among Iraqi vaccinated and unvaccinated subjects

Iraq is among countries of intermediate hepatitis B endemicity. Although several studies have been carried out on the prevalence of HBV markers, no previous study was done to determine the protective antibody level after HBV vaccination. Therefore, this study was carried out to detect HBV markers and antibody protective level among vaccinated and unvaccinated Iraqi subjects. A total of 400 subjects [298 thalassaemic patients and 102 [healthy] subjects] were included in the study for the period 1[st] Oct. 2002 to 28[th] Feb. 2003. Thalassaemic patients represent the vaccinated group, and the [healthy] subjects represent the unvaccinated control group. The same rate of HBsAg was detected in vaccinated and unvaccinated groups [2%]. Protective anti-HBs level was demonstrated in 229 [76.8%] and 25 [24.5%] of vaccinated and unvaccinated groups, respectively. The protective rate of protective level of anti-HBs among those who receive three primary doses of vaccine [77.7%] was significantly higher than among those who did not complete the course of vaccination. The rate of protective anti-HBs level among those who received the full course of vaccination is lower than that reported in literature. Improper vaccination or handling of the vaccine could also contribute to this low level as result of deterioration of health services during the last 2 decades

Lipid profile among diabetics in Al-Ramadi City, Iraq

Hyperlipidemia is a strong predictor risk of cardiovascular events. There are insufficient data on the lipid profile in diabetics in Iraq. This study was carried out to determine the lipid profile among diabetics in AI-Anbar governorate. A total of 136 diabetics [116 were with type 2 diabetes and 20 were with type 1 diabetes] attending Al-Ramadi general hospital, A l-Anbar, were included in the study. Total cholesterol, triglyceride [TG], high density lipoprotein [HDL], low density lipoprotein [LDL] and very low density lipoprotein [VLDL] were estimated. Elevated total cholesterol, HDL, LDL, VLDL and TG were detected among patients with type I and type2 diabetes. Only level of TG was associated with the duration oftype2 diabetes, while levels of LDL, VLDL and HDL were significantly associated with duration of type 1 diabetes. Lipid and diabetes awareness program for Iraqi population should be applied in an attempt to improve the overall health status of Iraqi population

Low birth weight an Baghdad, Iraq

Many reports demonstrated an increase in low birth weight in the past three decades. This work was carried out to study the prevalence of low birth weight and its determinants among neonates delivered in Baghdad, Iraq. A total of 400 singleton newborns delivered at two hospitals in Baghdad city during 15[th] June to I5[th] Nov. 2003 were included in the study. Half of the neonates were born with low birth weight. Out of the low birth weight neonates, there were 83% preterm neonates. Prevalence of low birth weight neonates was significantly associated with maternal age, age at marriage, parity, and anaemia. This study indicates that the most appropriate approach for prevention low birth weight and prematurity in newborns is through improvement of nutritional status and health services

CMV infection among HIV/AIDS patients in Iraq

The aim of the study was to determine the prevalence of CMV infection among HIV/AIDS patients in relation to disease progression, and to study the mortality during the period of the study. The study included 155 HIV/AIDS patients [148 HIV- infected and seven AIDS patients] and 122 apparently "healthy" controls. CMV [IgG and IgM] antibodies "were determined by ELISA. The patients were followed up for a period of nine months, and retested frequently for development of active CMV infection. The prevalence of CMV [IgG] antibodies in the HIV/AIDS patients was 100%. A significant higher prevalence of CMV [IgM] among AIDS patients [42.9%] than among HIV infected patients [0.0%] and "healthy" controls [0.8%]. No deaths were reported among asymptomatic HIV infected patients while the mortality among AIDS patients was [42.9%]. Only one patient [7.7%] out of 13 asymptomatic HIV infected developed active CMV infection 10 years later by testing for CMV [IgM] in 1991 and 2001. Demonstration of active CMV is of prognostic value in detection of development of AIDS and survival of patients