Hepatitis D virus infection in Kermanshah, west of Iran: seroprevalence and viremic infections

Aim: This study aimed to determine the seroprevalence and viremic infection of hepatitis delta virus [HDV] in Kermanshah

Background: Hepatitis delta is one of the most complex viral infections of liver that along with hepatitis B virus could lead to fulminant hepatitis, progressive chronic hepatitis, cirrhosis, and hepatocellular carcinoma

Methods: Referrals with positive HBs Ag were included and tested for HDV Ab using ELISA. Seropositives were subsequently evaluated for viremia by assaying HDV RNA and HBV DNA using real-time PCR. Viremia-related variables were also assessed

Results: From 1749 patients included, 30 had positive HDV Ab, which makes HDV seroprevalence 1.7%. Twenty-nine out of 30 seropositives were assayed for viremia. Fourteen cases [48.3%]had positive HDV PCR, 18 [62.1%] had positive HBV DNA. Eight patients [27.6%] had simultaneous replication of HBV and HDV, six [20.7%] only had HDV replication, ten [34.5%] only had HBV replication and five [17.2%] had no replication of either viruses

Conclusion: Kermanshah seems to be a low prevalent area in Middle East. Viremic HDV infection was lower compared to Europe and Africa, probably due to genetic variations of the hosts or the differences in genotypes or sub-types of hepatitis B and D viruses

Tuberculous ventriculitis: a rare complication of central nervous system tuberculosis

Tuberculous ventriculitis is an inflammatory infection of the ventricular system of the brain, and is caused by Mycobacterium tuberculosis. We herein present the case of an immunocompromised patient with brain tuberculomas who developed ventriculitis during treatment. The patient was successfully treated with a high dose of steroid, long-term antituberculosis drugs, and aggressive supportive care

Surveying immunogenicity and safety of influenza vaccination in health care workers and HIV-infected individuals

Influenza is a world-wide public health concern. It is one of the most important viral causes of acute respiratory illness, affecting all age groups, recurring several times during a lifetime. We assessed the antibody titers after vaccination against influenza among HIV-infected patients and health care workers [HCWs]. During this before-after study, the antibody responses were assessed in 60 HCW and 60 HIV-infected patients vaccinated with split influenza vaccine [influvac 2005/2006 Solvay's influenza vaccines for the influenza season 2005/2006 in the northern hemisphere]. Although all participants had protective antibody levels against A [H1N1], A [H3N2], and B components of trivalent influenza vaccine [before vaccination], HIV-infected patients showed seroconversion against A [H1N1], A [H3N2], and B components in 75%, 45%, and 28.3% of cases, respectively. The corresponding values were 70%, 33.3%, and 53.3% among HCWs, respectively. There were no repots of any vaccine adverse reaction. A comparable rise in antibody titers against influenza antigens without any adverse reaction supports the previous recommendations for influenza vaccination. Such programs can effectively decrease the probability of influenza infection in both HCWs and HIV-infected patients who are not seriously immune compromised

[Brucella spondylitis and paraspinal abscess]

Brucellosis is a zoonosis with a variety of clinical syndromes including spondylitis. Spondylitis and sacroiliitis are the most frequent complications of skeletal system involvement in brucellosis, but muscle infection and abscess formation are a rare complication and frequently secondary to spondylitis. In this article two cases of brucella spondylitis are presented which has led to abscess formation in one of them, these patients referred with back pain, fever, and with subsequeint MRI examination, wright positive test, were diagnosed as spondylitis. The antibiotic regiment including Doxycycline, Refampin, were prescripted for four months. The clinical signs were disapeared subsequently

Diagnostic value of serological tests [IgA, IgG, IgM] against A-60 antigen in tuberculosis

Tuberculosis [TB] is a common infectious disease worldwide especially in developing countries. Diagnosis of TB is difficult and often needs paraclinical studies. Measuring immunoglobulin's against A-60 antigen of TB microorganism has been reported as a useful technique. The aim of the present study was to evaluate the diagnostic value of serologic test [IgA, IgM, IgG] against A-60 antigen in tuberculosis. For this case-control study, 176 TB patients [124 patients with smear-positive pulmonary TB and 52 patients with extra pulmonary TB] and 283 healthy controls were enrolled. Then, all subjects were tested for IgM, IgA and IgG against A-60 antigen using ELISA technique. Sensitivities of IgM, IgG and IgA test were 15%, 25% and 40%, respectively while the following specificities were also reported 100%, 75% and 90%, respectively. Positive predictive values [PPV] were 100%, 57% and 72%, however, negative predictive values [NPV] were 65%, 72% and 70%, respectively. Combination of immunoglobilins results increased sensitivity, for which the most sensitivity was observed in combination of IgG and IgA results. Our results revealed the usefulness of serologic testing in TB diagnosis. Although its sensitivity is not high enough, combination of immunoglobulin results may improve the sensitivity

[Third attacks of chicken pox in a leukemic child]

Chicken pox is caused by Varicella zoster. Infected persons usually acquire permanent immunity and a reinfection is unusual. We report on a leukemic girl aged 12 years and 4 months, who had two chicken pox infections during 2 months. Leukemia was diagnosed 20 months ago. In her past history she had a first chicken pox infection 2 years before leukemia was diagnosed. Recurrence of chicken pox is possible especially in immune comprised individuals. Our leukemic patrent had 3 attacks of chicken pox