[Screening of viral hepatitis c in a young tunisian population [more than 175,000 recruits]]

Background: In front of the considerable impact of the viral hepatitis C, the prevention is more than ever a priority, based essentially on the screening

Aim: We realized an epidemiological study in a population of young recruits with the aim of considering prevalence of anti-hepatitis C Virus [anti-HCV] antibodies, describing its epidemiological evolution and establishing a cartography of the viral hepatitis C in Tunisia

Methods: Epidemiological retrospective study of prevalence was realized from the data of the screening of anti-HCV antibodies from 2003 till 2012 of all the young recruits suggested to be incorporated for the national service or suggested to be recruited as career soldier. The study was exhaustive concerning 175 322 young and healthy male adults aged between 20 and 30 years old, originating from all parts of Tunisia. The screening was realized by third and fourth generation ELISA tests then validated by Immunoblot

Results: The prevalence was 0.11% and the confirmed prevalence was 0.07%. The positive subjects were mainly between 20 and 25 years old [82.32%] and 91.05% were detected within the framework of their incorporations to the national service. The lowest prevalence was 0.07% in 2004, and the highest was 0.17% in 2011, without a significant tendency in the increase or in the decrease during the period of study [r = 0.857 ; p = 0.564]. The screening of anti-VHC antibodies had an unequal geographical distribution according to a North-South decreasing gradient. The highest proportions were registered in the North-West [23.23%] and the District of Tunis [22.73%], contrary to the South-East which was weakly affected [3.54%]. The governorates with the highest proportions were Tunis [19.19%], Bizerte [11.62%] and Jendouba [8.59%], the governorates of Monastir and Tataouine were weakly affected [0.51%]

Conclusion: Prevalence of anti-HCV antibodies in the young and male Tunisian population was weak, stable without significant tendency in the increase or in the decrease from 2003 till 2012, characterized by an unequal geographical distribution according to a North-South decreasing gradient

Cerebral venous thrombosis associated with homozygous factor V Leiden mutation in a 15-year-old girl of Tunisian origin

Cerebral venous thrombosis [CVT] is a rare disease. It has numerous and complex etiologies. Inherited or acquired prothrombotic states play a key role in the development of this disease, such as factor V G1691A mutation [FV Leiden]. A 15-year-old girl presented to the Department of Neurology with a complaint of severe headache with visual blurring. The diagnosis of CVT was not initially suspected because of the patient's condition on presentation. An MRI showed thrombosis in the superior sagittal sinus, confirming venous stroke. Anticardiolipin and antiphospholipid antibodies were assessed. In addition, inherited prothrombotic defects, such as protein C, protein S, and antithrombin deficiencies, and genetic mutations for FV Leiden, prothrombin gene G20210A [Fll G20210A], and methyltetrahydrofolate reductase C677T [MTHFR C677T] were studied. All results were unremarkable except for the unique homozygous FV Leiden mutation, which likely contributed to this prothrombotic situation. This study highlights the fact that FV Leiden may play a significant role in the onset of CVT in young patients

Hyperhomocysteinemia, C677T MTHFR polymorphism and ischemic stroke in Tunisian patients

Hyperhomocysteinaemia has been identified as a strong risk factor for ischemic stroke [IS]. A point mutation in methylene tetrahydrofolate reductase [MTHFR C677T] has been associated with increased plasma homocysteine [Hcy] levels. This preliminary study aimed to investigate whether hyperhomocysteinaemia and/or MTHFR C677T mutation are associated with ischemic stroke. A case-control study including 50 consecutive patients with confirmed IS and 97 controls was performed. Fasting plasma homocysteine levels, MTHFR C677T genotypes were assessed. Other factors such as hypertension, obesity, dyslipidemia, diabetes mellitus, recurrent stroke tobacco and alcohol were investigated. Mean plasma homocysteine levels were significantly higher in IS patients than in controls [15.83 +/- 10.60] micro mol/L vs 13,78 +/- 6.29 micro mol/L, p=0.04], while no association of MTHFR C677T variant was observed even with homocysteine. The risk to develop ischemic stroke in hyperhomocysteinemic subjects was 2.4 times more than in subjects with normal Hcy levels [OR= 2.4; 95% CI: 1.13-5.06; p<0.05]. Our findings suggest that high levels of homocysteine but not MTHFR C677T polymorphism represent risk factors for arterial ischemic stroke in Tunisian subjects