Genotype and antiretroviral drug resistance of human immunodeficiency virus-1 in Saudi Arabia

To analyze antiretroviral drug resistance and determine the genotype of human immunodeficiency virus [HIV]-l in Saudi patients by sequencing an amplified region of the viral pol gene. This retrospective study analyzed data from plasma samples submitted for genotypic drug sensitivity monitoring. Samples were analyzed at the Special Infectious Agent Unit, King Fahd Medical Research Center of King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia from August 2004 to June 2009. The Viroseq2.5 kit [Celera/Abbott] was used with ABI Prism 3100 sequencer. All patients were Saudi nationals and were on antiretroviral therapy, some experiencing treatment failure. Based on protease region [PR], genotypes of 63 samples were as follows: C:22, G:21, B:9, CRF02_AG:5, D:3, A:l, F:l, and J:l. Based on reverse transcriptase region [RT], genotypes were as follows: C:23, G:24, B:9, CRF02 AG: 2, D:2, A:l, and F:l. Antiretroviral susceptibility testing results were as follows: 52% of the isolates were susceptible to all 3 major classes of antiretroviral drugs used, 41% had mutations known to confer high level resistance to one or more of the nucleoside analogue reverse transcriptase inhibitors, 16% had mutations known to confer high level resistance to non-nucleoside analogues reverse transcriptase inhibitors, 13% had mutations known to confer high level resistance to one or more of the protease inhibitors [PI]. Most isolates were susceptible to 2 or at least one class of antiretroviral, and only 3% of the isolates had resistance to several members of all 3 classes. Antiretroviral resistance is not uncommon in Saudi patients on antiretroviral therapy

Causes of hospitalization of pilgrims during the Hajj period of the islamic year 1423 [2003]

Approximately 2 to 3 million pilgrims perform Hajj every year. Planning for health care requires knowledge of the pattern of diseases, complications, and outcome of pilgrims who require hospitalization during the Hajj period. In a cross-sectional study we compiled data on all patients admitted to 1487 beds in four hospitals in Mena [793 beds] and three hospitals in Arafat [694 beds] from the seventh to the thirteenth day of the Hajj season of the Islamic year 1423, corresponding to 8 to 14 February 2003. Of 808 patients hospitalized, most [79%] were older than 40 years. There was no sex preponderance. A total of 575 [71.2%] patients were admitted to medical wards, 105 [13.0%] to surgical wards, and 76 [9.4%] to intensive care units. Most patients [84.8%] had one acute medical problem. Pneumonia [19.7%], ischemic heart disease [12.3%], and trauma [9.4%] were the most common admitting diagnoses. More than one third [39%] had co-morbid conditions. A total of 644 [79.7%] patients were discharged from the hospital in stable condition to continue therapy in their residential camps, 140 [17.3%] were transferred to other hospitals in Makkah for specialized services or further care, 19 [2.3%] were discharged against medical advice, and 5 [0.7%] patients died. This study provided information on the most common causes of hospitalization, pattern of diseases, and required medical services for pilgrims in Hajj. It is hoped that this data will be of help to health sector planners and officials to provide optimal and cost-effective health care services to pilgrims in Hajj