Serological Analysis of Human Pandemic Influenza (H1N1) in Thailand.

The study was aimed at determining the prevalence of pandemic influenza (H1N1) 2009 among patients with respiratory tract diseases during July-December 2009 using real-time reverse transcription polymerase chain reaction. Haemagglutination inhibition (HI) assay was performed to detect antibody titres against pandemic influenza in 255 medical personnel, 307 members of the general population during the second week of December 2009 in Khon Kaen province, Thailand, and in 100 stored sera collected from people of different age-groups during 2008. The results showed that the pandemic (H1N1) 2009 had occurred during July-December 2009. The results of the HI test after the wave of this outbreak showed that 123 (48%) of the 255 sera collected from the medical personnel, 109 (36%) of the 307 sera obtained from the general population, and only two of the 100 stored sera from 2008 contained antibodies (HI titres ≥40) against pandemic influenza. Antibody against the pandemic (H1N1) 2009 was found in at least one-third of the population. In conclusion, the prevalence of virus and serological data obtained from the study can be used as the serological background level of the Thai population after the July-December pandemic. Finally, the serological data might be useful for outbreak-prevention and control strategies and for the management of vaccination for the pandemic (H1N1) 2009 in Thailand.

Dynamics of HBV DNA levels, HBV mutations and biochemical parameters during antiviral therapy in a patient with HBeAg-negative chronic hepatitis B.

Chronic hepatitis B virus (HBV) infection leads to long-term sequelae such as cirrhosis and hepatocellular carcinoma. Antiviral therapy aims at controlling the viral replication and thus, decreasing the likelihood of such complications. In this study, we evaluated the dynamics of biochemical and virological parameters over 10 years of antiviral therapy in a Thai patient with chronic HBeAg-negative HBV infection, who had relapsed after two courses of interferon alfa treatment. Lamivudine administration initially led to a significant reduction in alanine aminotransferase (ALT) and HBV DNA levels, but a subsequent emergence of YIDD mutants caused an ALT flare and a virus breakthrough. A 4-log HBV DNA decrease and normalization of the ALT level were achieved within 3 months of adefovir monotherapy without any relapse during follow-up exceeding 20 months. Thus, careful monitoring during treatment and knowledge of cross-resistance to antiviral salvage therapy are crucial for the management of patients with chronic hepatitis B.

The spread of avian influenza H5N1 virus; a pandemic threat to mankind.

Influenza A H5N1 virus infection presents a major public health problem in Asian and Eurasian countries. The World Health organization has voiced their concerns about a potential pandemic with the imminent threat to humankind. In 1997, an outbreak of highly pathogenic H5N1 virus emerged and caused severe systemic disease among poultry and humans in Hong Kong. This article reviews the magnitude of the 2004-2006 outbreaks in various countries and highlights the highly pathogenic avian influenza (HPAI) subtype H5N1 virus as the cause of a major epidemic with potentially vast repercussions on economics, public health and society at large. Not only has this avian influenza (AI) virus infected poultry but has also proven highly pathogenic and fatal to mammalian species including humans and felines. The present review draws a comprehensive picture encompassing epidemiology, inter-species transmission and genetic characterization of this highly virulent virus. Moreover, laboratory diagnostic techniques, vaccination strategies and antiviral therapies aimed at outbreak control and management are also discussed.