Genotyping of occult hepatitis B virus infection in Egyptian hemodialysis patients without hepatitis C virus infection

Background: occult hepatitis B viral infection is the presence of hepatitis B viral nucleic acids in the serum and/or liver in the absence of hepatitis B surface antigen

Aim: the study aimed to determine the prevalence of occult hepatitis B virus infection among hepatitis C virus-negative hemodialysis patients and to identify their genotypes

Methods: of 144 patients on maintenance hemodialysis, 50 hepatitis B surface antigen and hepatitis C virus nucleic acid-negative patients were selected according to strict inclusion criteria to avoid the effect of confounding variables. The following investigations were done: serum AST and ALT; HBsAg; HBcAb; HCV-Ab; HCV-RNA; and HBV-DNA

Results: positive hepatitis B viral nucleic acid was confirmed in 12/144 [8.3%] hemodialysis patients and 12/50 [24%] in our study group [occult infection]. Mean hemodialysis periods for negative patients and occult hepatitis B virus patients were 27.3 +/- 18.8 and 38.4 +/- 8.14 months, respectively, and this difference was significant [p-value = 0.02]. Mean alanine transaminase levels were 20.27 +/- 5.5 IU/L and 25.3 +/- 9.6 in negative patients and occult infection patients, respectively. This difference was non-significant. Aspartate transaminase levels were 21.4 +/- 10.2 IU/L and 27.3 +/- 4.6 IU/L, respectively, in negative patients and infected patients; this difference was significant [p-value = 0.03]. Half [6/12] of the positive samples belonged to genotype 'B', 33.3% [4/12] to 'C', and 16.6% [2/12] to genotype 'D'

Conclusion: OBI is likely among hemodialysis patients even without HCV coinfection [24%]. Genotype D cannot be the only genotype distributed in Upper Egypt, as the current study reported relatively new results that 50% of the patients with occult B carry genotype B, 33.3% carry genotype C and only 16.6% carry genotype D

Comparative diagnostic methods of tuberculosis in blood samples

Despite the availability of effective preventive measures and chemotherapy, the prevalence of tuberculosis [TB] is increasing in the developing world and in much of the industrialized world as well. Children are among the most vulnerable and the most difficult to diagnose with tuberculosis. Early and precise diagnosis of childhood tuberculosis is necessary in order to prevent mortality and morbidity and unjustified chemotherapy. One of the main objectives of the research in the field of mycobacteriology is the development of new methods that will improve and expedite the diagnosis and treatment of tuberculosis and other mycobacterial infections. HealthTech, in collaboration with DynaGen, Inc., in the United States, developed the MycoDotTM serological assay. Several techniques have been developed to improve the diagnosis of tuberculosis including newer radiometric methods; DNA probes mycolic acid chromatography polymerase chain reaction. We aimed in our work to diagnose active tuberculosis either pulmonary or extra pulmonary by different new diagnostic methods. In this study included 58 children ranged from 5 to 7 years old and suspected to have tuberculosis, based on the findings of history taking, clinical examination, PPD skin test, chest X-ray, and sputum examination by Zeil-Nielsen staining for acid fast bacilli. These patients were classified into four classes class 0: no known recent exposure, no infection [PPDnegative], no disease; class I: latent infection as defined by a positive PPD [>/= 10 mm in duration] and no clinical or radiographic evidence of active TB; class II: active TB confirmed by positive clinical pictures and radiographic evidence of active TB with positive sputum staining; Class III: PPD-positive [>/= 5 mm in duration] with evidence of past disease by history or compatible chest radiograph [e.g., upper lobe fibronodular disease] but negative sputum smear [treated patients]. All patients sera were subjected to TB identification by rapid test and MycoDot tests and PBMC separated from blood for PCR reaction. The positive results of the three tests for diagnosis of TB in the four groups of classes were detected as followings: By PCR the four classes were diagnosed as: Class 0 [5.3%], Class I [50%], Class II [70%] and Class III [14.3%]. By MycoDot diagnosis of the four groups was as: Class 0 [0%], Class I [4.5%], Class II [50%] and Class III [0%]. Diagnosis of the four groups by +ve rapid test was as: Class 0 [0%], Class I [0%], Class II [30%] and Class III [0%]. As a conclusion, PCR is a sensitive and rapid method for detection of latent and active TB within few hours, while in anti-LAM IgG was quite specific detection of active disease. The assay can be performed without sophisticated instrumentation with minimal training, which make the assay for random detection of active TB

Prevelance of tuberculosis among children with type -1 diabetes mellitus attending El-Minia university hospital

Tuberculosis [TB] has been a cause of significant morbidity and mortality for mankind throughout history. Currently, there are tweenty million cases of TB worldwide with eight million new cases each year. Three million deaths annually are directly attributable to tuberculosis. Previous clinic-based studies in developed countries demonstrated an association between tuberculosis and diabetes but did not determine whether this is due to an increase in recently transmitted or reactivated infection of tuberculosis. We aim in this study to identify the epidemiological relationship between TB and diabetes in children by using a simple, rapid and reliable test which is MycoDot test. This study was a cross sectional study done on two groups, the first group was one hundred and ten cases of type -1 diabetic children aged from 5-10 years old who had a regular follow up in pediatric diabetes Mellitus out-patient clinic in El-Minya university hospital. The second group consisted of one hundred and ten children [as a control non-diabetic group] age and sex matched from pediatric out-patient clinic in El-Minya university hospital. The children were subjected to tuberculin skin test and Zeihl Nelseen staining on sputum. The diabetic children only were subjected to chest X -ray. The children's sera were subjected to MycoDot test. Among the one hundred and ten diabetic children, six cases [5.5%] assigned positive TB using MycoDot technique. On the other side the control cases assigned only one positive case [0.9%] using the same test. Among the diabetic children [110], four cases [3.8%] were found positive by Tuberculin skin test, whereas two cases [1.8%] were positive by Zeihl Nelseen staining on sputum. Many studies have explored the association between diabetes and tuberculosis. In developed countries, studies dating to the first half of the past century demonstrated considerable increase in the frequency of tuberculosis among patients with diabetes, although the proportion with comorbidity has ranged widely forn 1.0 to 9.3%. Other studies have shown a higher frequency of diabetes among individuals with tuberculosis. In our results, 5.5% of diabetic children suffered from active TB by MycoDot test which is a simple and reliable test, whereas only one positive case [0.9%] was found in the non-diabetic group by the same test. The formal indicates that risk of TB increases among diabetic children and this will give as an alarm to have regular searching for the presence of active TB among diabetic children

Peripheral blood eosinophils [PBE] apoptosis and fas expression in asthmatic children

This study included three groups of children with matched age and sex. Group 1 consisted of 25 quick relief-treated asthmatic children [not treated with steroids], group 2 included 28 steroid-treated asthmatic children and group 3 consisted of 20 healthy children. All children were subjected to complete medical history, thorough clinical examination, pulmonary function tests [flow expiratory volume at 1 second [FEV1] and peak expiratory flow rate [PEFR]], absolute peripheral blood eosinophils [PBE] count, assessment of apoptosis and Fas expression of PBE by cytometry. It was concluded that there was a decrease of Fas receptors expression on PBE in quick relief treated asthmatic children, which may results in a delay of PBE apoptosis. The delay of PBE apoptosis may play an important role in the pathogenesis of bronchial asthma. The steroid treated asthmatic children may be associated with higher PBE apoptosis and Fas expression on PBE. The increase of Fas expression on PBE in steroid- treated asthmatic children is not the main mechanism of PBE apoptosis induction and other mechanisms must be considered