ABSTRACT
Purpose: BK virus (BKV) is an opportunistic pathogen which causes significant morbidity and mortality in individuals who are immunodeficient. We aimed to quantitate and characterise BKV and to correlate with the degree of immunosuppression among human immunodeficiency virus (HIV)-1-infected individuals. Methods: BKV DNA detection was carried out using an in-house quantitative real-time polymerase chain reaction on paired whole-blood and urine samples collected from 187 antiretroviral therapy (ART)-naïve HIV-1-infected individuals and 93 healthy individuals who served as controls. Sequencing was performed for a proportion of high BK viral load (VL) samples to observe non-coding control region (NCCR) rearrangements. Results: BKV positivity in urine was 25.6% among HIV-infected individuals and 10.7% in control individuals (P = 0.03). The BK VL showed a significant negative correlation with CD4+ T-cell counts, a positive correlation with WHO clinical staging and no significant correlation with HIV-1 VL. Of 42 BKVs from urine samples sequenced, two showed rearrangements without clinically severe disease or high VL. Their NCCR and VP1 sequence-based genotyping revealed genotype I. In a small subset of individuals (n = 8) on ART who were being followed up, six individuals showed either decrease or complete clearance of virus with ART. Conclusion: There was a higher frequency of BK viruria in HIV-1-infected individuals than among healthy controls and the positivity correlated with the degree of immunosuppression. There was no association of high VL with NCCR rearrangements in urine.
ABSTRACT
Background: Epstein–Barr virus (EBV)‑associated gastric carcinoma is a relatively uncommon entity detected in approximately 10% of gastric adenocarcinoma. Objective: The purpose of this study is to estimate the frequency of EBV‑associated gastric carcinoma and also to assess the nature of presentation, any significant difference between this subgroup and EBV‑negative gastric adenocarcinomas with respect to age and sex predilection, lymph nodal status, site of presentation. Materials and Methods: We prospectively analyzed 100 cases of gastric adenocarcinoma who underwent either a partial or total gastrectomy during the period from March 2010 to August 2011. The tumour and the corresponding normal gastric tissue from the same patient were analyzed for the presence of Epstein–Barr nuclear antigen 1 (EBNA1) messenger ribonucleic acid (mRNA) by real‑time polymerase chain reaction (PCR). Result: EBV was detected in 6% cases of gastric adenocarcinoma. All the positive patients were males. The majority of cases involved the proximal stomach and there was variable lymph nodal involvement. Conclusion: Our study endorses that there is an association between EBV infection and gastric adenocarcinoma in the Indian population. There was no significant difference between this subgroup and EBV‑negative gastric adenocarcinomas with respect to age and sex predilection, lymph nodal status and site of presentation. Short‑term follow‑up of this subgroup of patients seems to indicate a good overall prognosis after appropriate treatment. However, a larger study with long‑term follow‑up is needed to further establish the role of EBV in gastric adenocarcinoma in this study population.
ABSTRACT
Purpose: Emergence of drug resistance following HIV prophylaxis has an important impact on ART program. Objective: To investigate the emergence of drug resistance in HIV‑1 infected pregnant women. Materials and Methods: Fifty‑three HIV‑1 infected pregnant women who had received 4‑12 weeks of antenatal AZT followed by Nevirapine during delivery and Combivir [AZT + 3TC] for 1 week postpartum (group‑1, n = 48) or who come at the time of delivery and received Nevirapine followed by Combivir for 1 week (group‑2, n = 5) were recruited. Samples were collected prior to the start of the prophylaxis and 5‑8 weeks postpartum. In addition, a third sample was collected between 26‑65 weeks postpartum from 7 women. Amplification of HIV‑1 pol gene and drug resistance analysis was done. Result: Two (3.8%) women in group‑1 showed transmitted drug resistance and they continued to show this even at 6 weeks postpartum. One (2%) woman from group‑1 showed a mutation after 6‑8 weeks of prophylaxis. Among the samples collected between 26‑65 weeks postpartum, 3/7 (43%) showed mutations and all these women belong to group‑1. Women belonging to group‑2 didn’t show mutation prior to or following prophylaxis. Conclusion: In contrast to the available data among pregnant women with ART prophylaxis, our data showed reduced frequency of mutations following 5‑8 weeks of postpartum but an emergence of mutation later (26‑65 weeks). The addition of Combivir with the single dose Nevirapine during delivery and the early stage of the disease with higher CD4 counts could be the reasons for this.