[Prevalence of HLA-B*57:01 allele in HIV-infected patients in a university hospital in Tehran]

Abacavir is an anti-retroviral medication used to treat HIV infected/AIDS patients and its efficacy has been proven in randomized clinical trials. The most significant adverse reaction associated with abacavir is the acute hypersensitivity phenomenon which manifests in many forms and in severe cases could result in death. Hypersensitivity reaction to abacavir has been closely linked to the presence of HLA-B*57:01 allele. Avoidance of abacavir initiation in allele-positive patients is the most effective strategy in preventing possible severe hypersensitivity reactions. Previous epidemiologic studies have made great strides toward delineating HLA-B*57:01 allele frequency in different regions of the World and the available results indicate significant discrepancy between geographical regions. Despite these efforts, no study to date has determined the allele frequency among Iranian HIV-positive patients. The aim of the present study was to determine the proportion of allele-positive patients among a group of Iranian HIV-infected patients. Between September 2012 and February 2013, 122 HIV-positive patients were selected among patients referred to Imam Khomeini Hospital's Consultation center for high risk behaviors using the convenience sampling method. Sampling scheme was designed in a manner to include equal number of infected patients with and without clinical Acquired Immunodeficiency Syndrome [AIDS]. Patient data was collected using available records and a blood sample for DNA analysis was also obtained. Presence of HLA-B*57:01 allele was determined using the Polymerase Chain Reaction- Sequence Specific Method [PCR-SSP]. Seventy three patients [59.8%] were male. Co-infection with hepatitis B and C was observed in 1.7% and 40.7% of the patients, respectively. History of addiction and anti-retroviral therapy was positive in 50.0% and 60.7% of the patients, respectively. Overall, three patients were allele-positive which corresponds to a frequency of 2.46% [95% CI: 0.005-7.30]. No association between presence of allele and investigated variables were identified. Frequency of HLA-B*57: 01 allele among a group of Iranian HIV-infected patients is estimated to be 2.5%. This rate is comparable to those reported in other Middle-Eastern countries, yet is relatively lower than reports generated from South-Eastern Asia, Europe, and the United States. Future studies with larger sample sizes are needed to corroborate these findings

Evaluation of a novel herbal immunomodulator drug [IMOD] in treatment of experimental canine visceral leishmaniasis

Toxicity and drug resistance against pentavalent antimonials, medications of choice in treatment of leishmaniasis for more than 5 decades, have become important subjects globally. This study was a randomized, open labeled trial that was designed to determine efficacy and safety of IMOD as a novel herbal immunomodulator drug for treatment of canine visceral leishmaniasis [CVL]. Twenty healthy mongrel dogs were infected with Iranian strain of L. Infantum amastigotes and randomly divided to 5 groups with four animals for each included on: I: negative control [non-infected] II: Glucantime[registered sign] III: Glucantime[registered sign] plus IMOD [immune-chemotherapy] IV: IMOD and V: positive control [non-treated]. Physical examination, hematological, biochemical, serological, parasitological, pathological and imaging evaluations were performed pre-/post- interventions every month for 3 months. Comparing with control groups [IandV], immune-chemotherapy group [Glucantime[registered sign] plus IMOD] showed significantly higher efficacy in resolving the clinical signs and hematobiochemistry factors. Based on our results, using IMOD in combination with meglumine antimoniate [Glucantime[registered sign]] has significantly improved CVL than the latter drug alone. So, it seems this new herbal medicine is useful as adjuvant therapy for canine visceral leishmaniasis

Assessment of the effects of a novel herbal immunomodulator drug [IMOD] on cytokine profiles in experimental canine visceral leishmaniasis: a preliminary survey

Cytokines play a fundamental role in the regulation of immune responses in remission and/or relapsing of leishmaniasis. Therefore, immunotherapy for the treatment of canine visceral leishmaniasis [CVL] has represented a principle approach in control of the infection. The present research aimed to evaluating the immunotherapeutic potential of a novel herbal immunomodulator drug [IMOD] on CVL. Twelve mongrel dogs were intravenously infected with Iranian strain of L. infantum and randomly divided into three groups; 1: negative control [non-infected], 2: immunotherapy with IMOD and 3: positive control [non-treated]. Cell proliferation and Th1-/Th2-type cytokines were measured in peripheral blood mononuclear cell [PBMC] by cell proliferation kit I [MTT] and enzyme-linked immunospot [ELISpot] assays, respectively. At the 60 days follow-up assessment, no adverse effects were observed in treated interventional group. Cellular proliferation assay indicated that PBMCs of IMOD group had higher stimulation index [SI] than positive control group [p <0.05]. Enhancement of CD4+ T cells such as IL-2, IL-4 and IL-10 were detected in negative control group due to in vitro IMOD stimulation 30 days post-treatment. In accordance to decreasing trends of Th1 and Th2 cytokines in positive control group, the mean number of IFN-gamma, IL-2, IL-4 and IL-10 spot forming cells [SFCs] down regulated for IMOD group during the study. These data indicate that IMOD had immunomodulatory potential but is not sufficient for total parasitic cure due to balance of Th1/Th2 cytokines. This is a preliminary study and we propose to undertake a series of experiments to evaluate the CVL due to in vitro modulatory effects of IMOD

Wart lesion in a patient associated with HIV infection and treatment under IMOD therapy

We report a 27-year-old hemophilic male who was HIV positive and under Highly Active Antiretroviral Therapy [HAART] along with wart lesions. When IMOD therapy started concurrently with HAART, the skin lesions disappeared

Characterization of immune responses induced by combined clade-A HIV-1 recombinant adenovectors in mice

Numerous evidences indicate that in some HIV-1 positive patients, the humoral and cellular immune responses are induced against HIV-1 proteins and this is inversely related to the progress of infection. The aim of this study was the evaluation of the Adenovectors containing HIV genes in induction of immune responses in mice. The HIV-1 genes including gag p24, rev, nef and exon-1 of tat were amplified from HIV-1 RNA [clade-A]. The cDNA of each gene was cloned into a transfer vector. The transfer vector was then co-transformed into E. coli strain BJ5183 together with pAdenovector ?E1/E3. The recombinant adenoviral construct was transfected into QBI-293A cells. Recombinant viruses were purified and titrated on 293 cell plates. Expression of transgenes was evaluated using western blotting. Then 1012 viral particles were injected into 15 groups of 5 mice and all patterns of combination of these 4 HIV-1 genes were evaluated. After 2 weeks, humoral and cellular immune responses were evaluated using ELISA, cell proliferation and ELISpot [IL-2, IL-4 and IFN- gamma] assays, consecutively. It was demonstrated that each gene was expressed. The response targets were mostly toward Th1, though several Th2 responses were also observed. Single injection in our study induced a good cellular response but the humoral responses were not as strong as the cellular ones. Considering and comparing all results and evaluating the various possible interactions revealed that simultaneous injection of tat and gag has enhanced the humoral and cellular responses

Indeterminate human immunodeficiency virus western blot results in Iranian patients with discordant screening assay results

The Western blot [WB] assay is the most widely accepted confirmatory assay for the detection and confirmation of antibodies to human immunodeficiency virus type 1 [HIV-1] and 2 [HIV-2]. However, indeterminate WB reactivity to HIV-1 and HIV-2 proteins may occur in individuals who do not appear to be infected with HIV. In this study, we describe the results of indeterminate WB reactivity in Iranian patients with discordant screening assays. The samples were obtained from the Iranian Blood Transfusion Center, Tehran, Iran and evaluated in the Biotechnology Process Development Center, Pasteur Institute of Iran, Tehran, Iran between 2003 and 2004. A total of 4707 were tested for the presence of HIV-1 antibodies. Six hundred and four [12.8%] patients tested for HIV were positive for HIV-1 antibody. Nine [1.49%] have discordant results among screening assays and indeterminate WB results as interpreted by Centers for Disease Control and Prevention [CDC] criteria. Most [66.7%] of these indeterminate WB results were due to p24 reactivity. However, 2 [22.2%] display reactivity to both gp41 and gp120 proteins [Positive by World Health Organization [WHO] criteria]. Of 9 WB assays initially indeterminate by the CDC criteria and with follow-up samples, 8 [88.8%] became negative when retested subsequently while one [11.1%] remained indeterminate for more than a year and were thus considered negative. In addition, all the indeterminate samples were negative when assessed by polymerase chain reaction assay. In general, there was an 88.8% concordance between the CDC and WHO criteria for an indeterminate WB result. The CDC II criteria best met the specified objectives for diagnosis in our setting