Significance of response to hepatitis b recombinant vaccine in subjects with isolated antibody to hepatitis b core antigen

It is important to differentiate whether isolated anti-HBc is due to false positive results or the prior exposure to hepatitis B virus, because individuals with false-positive anti-HBc can benefit from vaccination and their blood can be safely transfused. To distinguish between these two conditions, we evaluated the serologic response to hepatitis B vaccine. Ninety subjects with isolated anti-HBc [cases] and 100 subjects with totally negative hepatitis B serologic markers [controls]] were recruited to receive three doses of hepatitis-B [HB] vaccine. Thirty days after the first dose of the vaccine, anti-HBs titers were checked and individuals with anti-HBs titer >50 mlU/mL did not receive additional doses of the vaccine. However, others completed the vaccination course, and another blood sample was collected 30 days after the third dose to measure anti-HBs level. Nineteen [21.1%] cases and three [3%] controls had no sero-conversion [anti-HBs titers <10 mlU/mL] 30 days after the third dose [p<0.000l]. Primary response, defined as the development of anti-HBs antibody titers >10 mlU/mL 30 days after the third dose, was observed in 43 [47.8%] cases and 92 [92%] controls [p<0.000l]. Also, 31.1% of cases developed anti-HBs titers > 50 mlU/mL 30 days after the first dose of vaccine, but the rate was significantly lower [5%] in the control group [P<0.0001]. Furthermore, half of the individuals with positive isolated anti-HBc developed protective levels of anti-HBs after three doses of HB vaccination. More than 75% of individuals with positive isolated anti-HBc can benefit from vaccination and can be included in donor pool. Also, one fifth seemed to have occult HBV infection. So HB vaccination may be used as a diagnostic tool for clarifying the situation of the subjects with isolated anti-HBc

HLA-DQ2 and HLA-DQ8 genotyping in a sample of Iranian celiac patients and their first-degree relatives

Recent studies have shown a critical role for HLA-DQ2 and HLA-DQ8 in the pathogenesis of celiac disease. No study has been performed on the prevalence of these two HLA types in Iranian celiac patients. We enrolled 24 celiac patients and 37 first-degree relatives in whom the diagnosis of celiac was excluded by sero-logic tests. HLA typing for HLA-DQ2 [DQB1*02], HLA-DQ8 [DQB1*03], HLA-DQ B1*05 and HLA-DQ B1*06 was performed using polymerase chain [PCR] reaction. Twenty two [91.7%] celiac patients and twenty seven [73%] controls were positive for the HLA-DQ2 and/or HLA-DQ8 heterodimers. There was no significant difference between the two groups p=0.068]. However, celiac patients were statistically more positive for homozygote HLA-DQ2, whereas non-celiac participants were more positive for homozygote HLA-DQ8 [p<0.05]. The total prevalence of HLA-DQ2 and/or HLA-DQ8 allels did not significantly differ between the two groups. Hence, first-degree relatives of celiac patients appear to be more susceptible for developing celiac disease. On the other hand, the higher prevalence of homozygote HLA-DQ2 in celiac patients shows its stronger role in disease pathogenesis. Further studies on larger populations are needed in Iran.

[Opium addiction as a cause of gastroduodenal reflux in dyspeptic patients]

Drug abuse as a frequent high risk behavior accompanies many different gastrointestinal complications. In this study we tried to evaluate the prevalence of gastrointestinal reflux among opium addicts. Using a historical cohort design, 62 cases with dyspepsia as the chief complaint entered the study: 30 cases with history of regular use of opium over the last year [exposed group] and 32 cases with no history of addiction at all [unexposed group]. Upper GI tract endoscopy was accompanied by 3 biopsy specimens taken from body and antre of stomach was performed for all the cases. 2 cases in the exposed group and 3 cases in the unexposed group left the study with the diagnosis of malignancy. Mean age of the remaining cases in the exposed group was 48.1 +/- 13.2 and in the unexposed group, it was 37.8 +/- 13.9 years [p= 0.006]. 16 cases [57.1%] in the exposed group and 5 cases [17.2%] in the unexposed group had endoscopic evidence of bile reflux into the stomach [p= 0.003]. Pathologic evidence of bile gastritis including foveolar elongation was reported in 7 cases [25.0%] of the exposed group in comparison with 1 case [3.4%] of the unexposed group [p = 0.025]. The frequency of "helicobacter pylori free gastritis" was 50% in the exposed group and 17.2% in the unexposed group [p = 0.012]. Duodenogastric reflux is not restricted to cases with a history of GI tract surgery and it seems that this problem is common among opium addicts

[Comparing the effectiveness of a "short-term double-dose" hepatitis B vaccination schedule with the "standard 3-dose" schedule: a randomized clinical trial]

With respect to the importance of hepatitis B vaccination of high-risk groups such as prisoners, this study was performed to assess the comparability of a short-course double-dose vaccination schedule with the standard 3-dose schedule. Within a randomized clinical trial, a short-course vaccination [at months 0 and 1] with 20 microgram [double-dose] doses of the vaccine was compared to the standard method of hepatitis B vaccination [at months 0, 1 and 6, with 10-microgram doses] in 100 prisoners in Zahedan city in Iran in 2009. We made sure the sera from all the individuals were negative for markers of previous hepatitis B infection. Subsequently serum from all the participants was tested for anti-HBs antibody 1, 2 and 7 months after the first dose of vaccination. Seroconversion rates [HBsAb>10 mIU/ml] 1, 2 and 7 months after the first dose of vaccination were similar in the routine [11%, 79% and 94%, respectively] relative to the double-dose group [26%, 95% and 93%, respectively]. The mean values of anti-HBs antibody titers were similar in the 1st and 2nd months for the two groups but it was significantly higher [P=0.002] in the routine dose [514 mIU/ml] versus the double-dose group [130 mIU/mL], in the 7th month. Demonstrating comparable results with the standard 3-dose schedule, it seems that short-term double-dose vaccination for hepatitis B is a safe and acceptable method for use in high-risk groups such as prisoners

[ relationship between vitiligo and thyroid gland dysfunctions: a case-control study]

Background: There is controversy about the relationship between vitiligo and thyroid dysfunction

Objective: To evaluate the relationship between vitiligo and thyroid disorders

Patients and Methods: This was a case-control study carried out on individuals with vitiligo in 2004 in Zahedan, that had it for at least 6 months as cases and individuals without vitiligo considered as the control group [Age and sex were matched with case group]. T3, T4, TSH, T3RU in both groups were assessed and FTI was calculated. Then hypo-, hyper- and euthyroid states were determined based on FTI and T3 level [For T3 hyperthyroidism] and data were analyzed by conditional logistic regression

Results: Each study group consisted of 50 individual, 52% female and 48% male. In the patient group, 16% had thyroid dysfunction, 14% of which had hyperthyroidism and 2% hypothyroidism. In control group, 4% had thyroid dysfunction, 2% of which had hyperthyroidism and 2% hypothyroidism. In case group only one patient had signs and symptoms of hyperthyroidism but in control group none had clinical symptoms. With statistical analysis was done odds ratio=7 [P<0.05] and the difference was significant

Conclusion: Vitiligo patients should be evaluated for thyroid dysfunctions to prevent complications of thyroid disease