ABSTRACT
Background: Early diagnosis and treatment are important in prevention of tuberculosis [TB] infection. Recently, many new strategies are validated for diagnosis and monitoring of pulmonary TB cases
Objective: To evaluate the role of Quantiferon-TB Gold in Tube test [QFT-GIT] and y9/32 T cells percentage in diagnosis of pulmonary TB and as tools to monitor the efficacy of anti-tuberculosis treatment
Methods: Two groups [40 patients and 15 healthy control] were enrolled in this study from July, 2009 to February, 2011. Both groups were evaluated by tuberculin skin test [TST], QFT-GIT assay, and y9/d2 T cells byflowcytometry. QFT-GIT assay, and y 9/82 T cells by flowcytometry were done twice for the pulmonary TB patients, first at the start of treatment and second after Smonths of treatment
Results: Among the forty proved pulmonary TB cases, 31[77.5%] cases were only positive for acid-fast bacilli [AFB] smear. Meanwhile, 31[82.5%] cases were positive by TST with specificity and sensitivity of 82.5% and 40% respectively in comparison to 37[92.5%] patients showedpositivity by QFT-GIT assay "tviih specificity and sensitivity of 92.5% and 93.5% respectively. Regarding, the 27 clinically improved pulmonary TB patients, 10 cases turned negative for QFT-GIT after 3 month course of antituberculous treatment. Moreover, Quantitative QFT-G level fall significantly in active tuberculosis patients undergoing treatment [p <0.05]. Whereas, the mean percentage of y 9/62 T declined mildly from 1.31 %to 1.03 % at the start and after 3 months of treatment respectively [P >0.05].Also, it -was noted that the mean percentage ofy9/d2 T decrease with the severity of the disease, 0.36%, 1.37% and 1.57% in stage 3, 2 andl respectively
Conclusion: QFT-GIT assay is a potent immnnodiagnostic test for pulmonary TB but it may not afford enough level of feasibility regarding cure of infection. However, the pretreatment concentration of IFN-y correlates to reversion to negative QFT-GIT. In addition, y9/62 T cells percent which had limited value to monitor the efficacy of anti-TB treatment but these cells could be used to assess the severity of the disease?
ABSTRACT
Background: the persistence of hepatitis B virus [HBV] DNA in liver tissue or serum in the absence of detectable hepatitis B surface antigen [HBsAg] is called occult hepatitis B infection [OBJ]. Both HBV and hepatitis C virus [HCV] are transmitted parenterally, and coinfection is not uncommon, particularly in countries with a high prevalence of one or both viruses
Aim: this study was conducted to assess OBI prevalence in Egyptian patients with HCV related liver diseases, see if anti-HBc alone can. consider a good marker for detection of OBI, to record the serological profile of occult HB V infected patients, and to detect the clinical impact of this coinfection
Methods: after exclusion of HBsAg positive patients, serum samples from 128 Egyptian patients with HCV related liver diseases were included in our study. All the patients were positive for anti-HCV and HCV RNA, and negative for HBsAg. Serum samples were collected and subjected to fiver function tests and virological assays for HBsAg,
Results: occult HBV infection was detected in 21% of our patients with the highest prevalence found in patients with hepatocellular carcinoma [HCC] [44.4%] followed by patients with cirrhosis [22.2%] then chronic hepatitis C patients [16.3%]. Occult HBV infection can be found in both patients who show previous hepatitis B infection, [22%], and in those who were negative for anti-HBc, [19%]. Occult HBV infection was detected with the highest prevalence in patients with anti-HBc only [51.8%], followed by patients with negative all serological markers [29.6%], then [11.1%] were anti-HBc and anti-HBs, and finally [7.4%] were anti-HBc and anti. HBe. Patients co-infected with occult hepatitis B had significantly a higher prevalence of sever fibrosis [12/27 OBJ versus 13/101 HCV only infected patient, P<0.01] and significantly higher prevalence of decompensated liver disease [3/4 OBJ versus 3/14 HCV only infected patient, P<0.05]
Conclusion: OBJ is highly prevalent in Egypt. It is frequently associated with HCV-related chronic liver diseases and it may play a major role as an etiological agent for hepatocellular carcinoma in these patients. Occult HBV infection may have a clinical significance as it may increase the liver fibrosis and worsen the liver disease in HCV patients but we think that it doesn't affect the HCV response to combination therapy