No role of herpes simplex virus type 2 [HSV-2] infection on HIV progression in naive HIV patients

Background: Herpes simplex virus type 2 [HSV-2] is a common infection in human immunodeficiency virus [HIV] patients and may accelerate HIV progression by rising HIV viral load and decreasing CD4 count. However, the available data regarding the influence of HSV-2 seropositivity on HIV progression in HIV individuals are inconclusive. Therefore, we aimed to determine HSV-2 seroprevalence in naive HIV patients and normal controls and also investigate the relation of HIV viral load and CD4 count with HSV-2 seropositivity. Subsequently, we investigated the association of HSV-2 serostatus with changing in CD4 count and HIV viral load in our subjects, after one year follow-up

Methods: In this study, 116 naive HIV patients and 85 healthy controls from Tehran, Iran were enrolled. HSV-2 IgG antibody was detected by ELISA. CD4 count was determined by flowcytometry, and serum HIV RNA copy numbers were determined using real-time PCR

Results: The prevalence of HSV-2 IgG was 18.1% in naive HIV patients and 0% in the control group [P = 0.000]. HSV-2 seroconversion was observed in 2.43% of HIV patients after one year. There was no significant difference regarding HSV-2 serostatus with CD4 count and HIV RNA viral load in our study cohort at baseline and after one year

Conclusion: Our results revealed that the prevalence and incidence of HSV-2 infection are low in our HIV cases, and it is negligible in the control group. However, it seems that HIV/HSV2 co-infection has no role on HIV infection acceleration

Adverse reactions to Mycobacterium bovis bacille Calmette-Guerin vaccination against tuberculosis in Iranian children

PURPOSE: There are considerable variations in the number of adverse reaction reports related to vaccine from different countries. The aim of this study was to review the development of adverse reactions to bacille Calmette-Guerin (BCG) vaccination among hospitalized patients in an Iranian referral hospital. MATERIALS AND METHODS: We identified hospitalized patients with BCG complications in Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran during January 2007-April 2009. Data on demographics, clinical features, laboratory findings, personal history (including vaccination history), family history, and outcomes were retrieved from medical records. RESULTS: There were 46 cases with BCG complication during the 2 years period. All of the children received vaccination at birth. Twenty-eight patients (61%) were male. The mean age of the patients was 13.5 +/-11.3 months (range, 1 to 52 months; median, 10 months). The majority of children (57%) with BCG complication were less than 1 year old. Among hospitalized patients due to BCG complications, suppurative lymphadenitis was occurred in 28 children (61%) and lymphadenopathy was seen in 9 children (20%). Disseminated BCG was detected in 8 patients (17%) and only 1 child (2%) was presented with abscess. In 7% (n = 3) of children, the family history of BCG complications were positive. CONCLUSION: The most common side effect of the BCG vaccine in our study was suppurative lymphadenitis. Disseminated BCG infection in complications leading to hospitalization in our study was 17%. With regard to the difficulty in implementing such a guideline in settings where BCG is given to all newborns, registration of Iranian primary immunodeficiency disorders (PID) patients would be helpful to increase the awareness of medical community of Iran to investigate underlying disease. In addition, BCG vaccination should postpone in each newborn with a family history of PID until the definite condition has been ruled out.

Low prevalence of brucella agglutinins in blood donors in central province of Iran

Brucellosis is a zoonotic disease of worldwide distribution and has great economic importance. Despite its control in many countries, it remains endemic in Iran. Brucellosis was investigated in many high risk occupational groups; however, few studies on the prevalence of brucellosis among blood donors are available. To determine the seroprevalence of brucellosis antibodies in blood donors, a serological study was carried out in central province of Iran. A total of 897 healthy blood donors with mean age 37.23 +/- 10.9 years were enrolled in the study. Laboratory tests including Standard Tube Agglutination Test [STA] and 2-mercaptoethanol [2ME] agglutination were checked in all samples. STA dilution >/= 1:80, and in the presence of 2-mercaptoethanol [2ME] agglutination >/= 20 was considered positive, Out of 897 cases, 11.9% were inhabitants of rural areas. 41.5% had history of consumption of unpasteurized dairy products and 9.3% had history of contact with domestic animals. A very low level of Brucella agglutinins was present in 3[0.33%] of the samples and only one sample [0.11%] was found to be truly positive for Brucella agglutinins. 2ME was negative in all samples. None of these 4 subjects showed signs and symptoms of brucellosis in 6 months follow-up. On the basis of our data, brucellosis has no epidemiological and clinical importance in our blood donors; therefore, it is not recommended to perform screening tests such as, STA and 2ME to identify brucellosis antibodies in the sera of blood donors

cross-sectional study of anemia in human immunodeficiency virus-infected patients in Iran

Anemia is a frequent complication of infection with human immunodeficiency virus [HIV]. The causes of HIV-related anemia are multifactorial. This study was conducted to evaluate the factors associated with anemia in HIV-infected patients. A total of 642 patients with HIV/AIDS attending the HIV Clinic at Imam Khomeini Hospital in Tehran, Iran enrolled in this study. A detailed history and physical examination was done for all the patients. Investigations included CD4+ count, hemoglobin concentration, and red blood cells morphology. Among HIV-infected patients, 87% were males. The mean duration of antiretroviral therapy was 17.9 +/- 9.2 months. The mean [ +/- SD] hemoglobin level was 12.9 +/- 2.31 mg/dL. Evaluation of red blood cell morphology showed macrocytosis in 11%, normocytosis plus normochromia in 41.1%, and microcytosis plus hypochromia in 47.9% of the patients. The prevalence of anemia [defined as hemoglobin<10 mg/dL] was 10.3%. Anemia was positively associated with female sex [OR = 3.01], CD4 level [CD4 count of <200] [OR=3.49], and antituberculous drug administration [OR=4.57]. Female sex, stage of HIV infection, and antituberculous drug use were the most important factors associated with anemia in HIV-infected patients in our study

Frequency of positive purified proterin derivative test in those infected with human immunodeficiency virus

The objective of this study was to determine the frequency of positive purified protein derivative [PPD] skin test in those infected with human immunodeficiency virus [HIV] and to investigate its association with CD4-positive T cell count, demographic factors, and possible routes of transmission in Iran. Fifty-one [36 males and 15 females] patients from an HIV clinic were selected and tested by a 5-tuberculin unit PPD. The mean +/- SD age of patients was 32.2 +/- 7.9 years. The probable route of HIV transmission was intravenous drug using in 21 [41%, CI95%: 28 - 54%] and sexual transmission in 17 [33%, CI95%: 20 - 46%] patients. Thirteen [26%, CI95%: 14 - 38%] patients had other risk factors. There were 13 [25%; 10 males and 3 females] PPD-positive patients among HIV-infected patients when a cut-off value of 5 mm was used; there were 15 [29%; 11 males and 4 females] when a cut-off point of 2 mm was employed. In addition, there was no significant correlation between the PPD test using both cut-off values of 5 and 2 mm, and none of the three probable routes of HIV transmission including intravenous drug using, sexual, and others. The mean +/- SD CD4[+] T cell count was 674 +/- 487/mm[3] in men and 573 +/- 327/mm[3] in women [P > 0.05]. No significant correlation could be demonstrated between the patient's PPD positivity rate and CD4[+] T cell count. Considering the high rate of tuberculin reactivity, more attention should be paid to the importance of PPD test and isoniazid preventive therapy against tuberculosis in HIV-infected patients