Mother-to-infant transmission of hepatitis C virus [HCV]

Hepatitis C Virus [HCV] infection is a major endemic health problem in Egypt. The risk of vertical transmission of HCV is reported to be highly variable. In Egypt, there is little information about the course of HCV during pregnancy and its vertical transmission. To estimate the seroprevalance rate of HCV infection during pregnancy and to evaluate the clinical aspects of HCV liver disease in mothers with HCV antibodies [HCV Ab's] positive, both during pregnancy and six months after delivery, and to assess the outcome of pregnancy. Prospective clinical study. Departments of Obstetrics and Tropical Medicine, Faculty of Medicine, El Menoufia University. Twenty hundred consecutive pregnant women were studied during a 2-year period, Serologic screening for HCV Ab's was done using ELISA 3. Women found to be positive were tested further using PCR for HCV-RNA. Clinico-biochemical assessment, follow up and recording of the fetal outcome were done. At birth, and at six months age, offspring were tested for HCV Ab's and HCV- RNA. HCV Ab's were positive in 18% [360/2000] of pregnant women and of these HCV-RNA was positive in 7.8% [28/360], Liver function tests [included transaminases] were within normal range in all mothers during pregnancy and six months after delivery. In all women the outcome of pregnancy was favorable. All the neonates born to HCV Ab's positive mothers were positive for HCV antibodies at birth and only one [0.3%] was positive at 6 months. All babies were negative for HCV-RNA. Although there is no evidence of vertical transmission of HCV, further studies together with long term follow up of seropositive mothers and their infants are recommended. HCV infection is only surely diagnosed by PCR for HCV-RNA. Pregnancy does not induce deterioration of liver disease and vice versa, HCV infection does not increase the risk of obstetric complications. National health awareness, guidelines, control methods are the main items for prophylactic programs against HCV. Cost benefit analysis of national screening program, for HCV infection must be considered and routine screening for HCV Ab's during ANC is recommend

Evaluation of polymerase chain reaction [PCR] for rapid diagnosis of clinically suspected tuberculous meningitis

Since conventional bacteriological methods rarely detect mycobacterium tuberculosis in cerebrospinal fluid [CSF] and are of limited use in the diagnosis of tuberculous meningitis [TBM], clinical features suggestive of TBM supported by indirect evidence such as CSF examination and computerized tomography [CT] of the head have been used for the early diagnosis of TBM. The aim of this study was to evaluate the efficacy of PCR in the early diagnosis of TBM. Coded CSF samples from 40 patients with TBM and from 40 patients with other neurological disorders were processed. In the absence of a reliable sensitive and specific test of M. tuberculosis in CSF, we used a set established clinical criteria as the gold standard. Accordingly, the patients were divided into highly probable, probable and possible TBM. The samples were decoded only after completion of the laboratory tests. PCR was positive in 4/4, 16/20 and 12/16, patients with highly probable, probable and possible TBM respectively. PCR along with the suggested clinical criteria offers a rapid and fairly accurate diagnosis of TBM