HLA class II (DRB1, DQA1 and DQB1) allele and haplotype frequencies among HIV-infection discordant Thai couples.

We investigated the association of HLA-DRB1, -DQA1 and -DQB1 alleles and haplotypes in 33 Thai HIV discordant couples. A significantly lower frequencies of DRB1*14 (3.0% vs 11.3%, p = 0.048) and DQA1*0103 (0.0% vs 5.63%, p = 0.042) alleles were found in the seropositive individuals when compared with HIV-negative controls. In contrast, there was no significant difference in HLA-DQB1* allele frequencies. The haplotype analysis revealed that DRB1*1501-DQA1*0102-DQB1*0601 (7.6% vs 0.0%, p = 0.002), DRB1*0405-DQA1*0302-DQB1*0401 (7.6% vs 1.3%, p = 0.024) and DRB1*1401-DQA1*0104-DQB1*05031 (6.1% vs 0.0%, p = 0.007) were found to be significantly higher frequencies when compared between HIV seronegative partners and HIV negative controls, but DRB1*1501-DQA1*0102-DQB1*0502 (0.0% vs 8.1%, p = 0.01) was significantly lower. The DRB1*1602-DQA1*0101-DQB1*0502 (4.6% vs 0.0%, p = 0.024) haplotype was found to be significantly higher frequencies in HIV seropositive individuals when compared to HIV negative controls but the DRB1*1502-DQA1*0101-DQB1*0501 (1.5% vs 8.1%, p = 0.049) haplotype was lower.

Serological infectious disease markers in blood donated at Siriraj Hospital.

A retrospective study was done on blood donated at Department of Transfusion Medicine, Siriraj Hospital from 1987 to 1996. The total number of 274,288 units were donated from three types of blood donors : voluntary (61.31%), replacement (35.57%) and paid (3.12%) during 1987-1993. The serological infectious disease markers were found to be highest in replacement donors. The prevalence of anti-HIV, HIV antigen, HBsAg, anti-HCV and positive VDRL were 0.7%, 0.02%, 6.2%, 1.6% and 2.3% respectively. The prevalence of these markers in voluntary donors were 0.3%, 0.01%, 2.6%, 0.9% and 1.0% respectively. In conclusion, the serological infectious disease markers in blood donated at Siriraj Hospital during the 10 years period consisted of 0.44% anti-HIV, 0.01% HIV antigen, 3.7% HBsAg, 1.13% anti-HCV and 1.40% positive VDRL. It was also noted that the prevalence of these markers in new blood donors were higher than those found in repeat blood donors.

Preoperative autologous blood collection and haemodilution with dextran.

Thirty patients, ASA class I-II with haemoglobin level > 12.5 gm percent, who underwent elective gynaecological surgery were included in the study. Control blood samples for haematocrit, haemoglobin, electrolytes, serum osmolarity, coagulogram and platelet function were investigated before the autologous blood was collected and haemodiluted with 3 percent dextran-40 solution. The cardiovascular responses, arterial blood gases, urine output and central venous pressure were also recorded. After the end of haemodilution, another blood samples (as study samples) were once collected for analysis. Haematocrit, haemoglobin, sodium and potassium showed to decrease significantly. However, the serum osmolarrity, coagulogram and platelet function had no any significant differences. All parameters were within normal limits. In conclusion, the autologous blood collection and haemodilution technique was suitable and possibly practical in ever elective surgical patients without any undesirable side effects.

Plasmapheresis in fulminating acute inflammatory polyradiculoneuropathy: The first experience at Siriraj Hospital.

A first experience of plasmapheresis in treatment of fulminating acute inflammatory polyradiculoneuropathy at Siriraj Hospital was reported with an excellent outcome. A 62 year old man had progressive motor weakness of all extremities and progressed to involve bulbar muscles and respiratory muscles within 24 hours. He was intubated and needed assisted ventilation since the admission. His motor power of all limbs showed a flaccid improvement after the total removal of 5,200 ml. He was discharged home after six weeks of hospitalization and total days of ventilation was twenty four days. He had a stormy clinical course in the intensive care unit with severe chest infection of mixed organisms (Klepsiella and Pseudomonas). His motor power regained to grade 4/5 MRC grading on discharging day with healed tracheostomy scar. Rationals for using plasmapheresis in this condition were discussed in detail as well as its usage in other illnesses.