A study on seroprevalence of hepatotropic viruses among HIV-positive individuals attending the integrated counselling and testing centre (ICTC) in Mayo hospital of Nagpur city, Maharashtra, India.

Background: Infection with human immunodeficiency virus type-1 and its end stage, acquired immunodeficiency syndrome is the major public health challenge of modern time. A variety of exogenously acquired infectious agents appear to influence the pace of HIV replication, the destruction of CD4+ T cells, and HIV transmission to infants and sexual partners. More persistent elevations in plasma HIV levels have been seen in patients with chronic infections (such as those with tuberculosis and herpes and hepatitis viruses), and such co-infected patients have a more rapid loss of CD4+ T cells and an increased rate of progression to AIDS and death. Within India, variable co-infection rates have been reported from region to region. With the above background, the present study was undertaken to study the seroprevalence of hepatotropic viruses (Hepatitis B virus and Hepatitis C virus) in HIV-positive individuals attending the Integrated Counselling and Testing Centre (ICTC) in Mayo hospital of Nagpur city, Maharashtra, India. Methods: The current prospective study was conducted in the department of microbiology, Indira Gandhi government medical college and Mayo general hospital, Nagpur (Maharashtra) from August 2005 to August 2007. All the patients attending ICTC were included in the study. 300 HIV negative matched controls were also included in the study. All the individuals who were positive for HIV infection were selected for this study and further tested for the presence of hepatitis B surface antigen (HBsAg) and anti-HCV antibodies. Data was compiled in MS excel. Then it was analyzed using online statistical calculator and chi square test were applied with value of P <0.05 was considered statistically significant for interpretation of finding. Results: Maximum numbers of HIV positive patients (38.8%) were in age group of 31-40 years. Present study showed male preponderance in HIV positive patients. Males showed a slightly high seroprevalence of HBsAg (9.21%) compared to females (7.57%) among HIV positive patients. The difference in positivity of two viral agents studied in HIV positive patients was highly significant as compared to HIV-negative individuals (P <0.001). Conclusion: On the basis of the findings that the co-infection of hepatotropic viruses (HBV and HCV) were significantly higher in HIV positive cases than controls, the study concludes that the chronic viral hepatitis is a serious concern in HIV-infected patients. Thus, there is an urgent need to ensure the screening of the same in HIV-infected patients.

Clinical profile of chikungunya fever in patients in a tertiary care centre in Maharashtra, India.

Background & objectives: In India a chikungunya fever outbreak started in December 2005 when the country experienced more than 13 lakhs of chikungunya infected cases. We undertook this study to study detailed clinical profile of chikungunya fever in both indoor and outdoor patients in a tertiary care hospital in Nagpur, Maharashtra in 2006. Methods: Suspected cases of chikungunya fever (n=405) during the period of July to September 2006, having clinical triad of fever, arthralgia and/or rashes were included in the study. Clinical profile was studied in all the cases. Of the 405 samples collected, 166 were tested for serum CHIK IgM antibodies. Results: Of the 166 samples tested for CHIKV IgM antibodies, 87 (52.4%) were positive (confirmed cases). Male: female ratio was 2.3:1. Fever and arthralgia were present in all cases. Rash was present in 27(31%) confirmed and 38(12%) suspected cases. Lymphadenopathy was present in 12 (13.8 %) confirmed and 4 of suspected cases. Chronic polyarthritis was seen in 22 (25.3%) confirmed and 75 (23.6%) suspected cases. Neurological manifestations were observed in 08 (9%) confirmed and 10(3.14%) suspected cases. Mortality was 7(2.2%) in 318 suspected cases and 3 (3.4%) in 87 confirmed cases. Interpretation &conclusions: Our findings showed that about half of the serum samples for CHIKV IgM antibody tested positive from cases suspected to have chikungunya fever. Fever, joint pain and headache were major symptoms. Certain rare manifestations like lymphodenopathy, oral ulcers and encephalitis were also seen. Mortality in confirmed cases was about 3.4 per cent.

Study of metallo-beta-lactamase production in clinical isolates of Pseudomonas aeruginosa.

A study of metallo-beta-lactamase (MBL) production was done in clinical isolates of Pseudomonas aeruginosa. Isolates resistant to ceftazidime and imipenem were screened for MBL production by double disc synergy test (DDST) and minimum inhibitory concentration reduction test. There was complete correlation between two methods for imipenem. For ceftazidime, there was correlation between the two methods in all except four strains. In the screening test for MBL, ceftazidime-EDTA combination was better than imipenem-EDTA combination. 8.05% strains were MBL producers. Presence of MBL producer P. aeruginosa is a cause of concern. Simple DDST can be helpful for monitoring of these emerging resistant determinants.

Bacteriological study of pyogenic meningitis with special reference to C-reactive protein.

Seventy five clinically, biochemically and microscopically diagnosed cases of pyogenic meningitis including 28 adults and 47 paediatric patients were studied. Gram positive isolates in adults and gram negative bacilli in paediatric age group were the predominant organisms. Estimation of C-reactive protein (CRP) in cerebrospinal fluid (CSF) and serum was done in all cases as an early marker for rapid diagnosis of pyogenic meningitis. Simultaneous estimation of CRP levels in serum and CSF was found to have a significant diagnostic utility as compared to culture.