The Influence of Mycophenolate Mofetil and Azathioprine on the Same Cadaveric Donor Renal Transplantation

In order to evaluate whether immunosuppressive agents such as mycophenolate mofetil (MMF) and azathioprine would differently influence the outcome of the renal transplants, we prospectively analyzed the incidence of acute rejection episodes, cytomegalovirus infection within the first 6 months following renal transplantation and 5 yr graft survival rate after minimizing influences of donor factors by grafting the same cadaveric donor kidney. There was no significant difference in sex, HLA mismatch, cold ischemic time, and patients' weight between the two groups. Contrary to the previous studies which demonstrated that MMF could lower the incidence of acute rejection episodes and improved graft survival rate, the two groups showed no significant difference in the incidence of acute rejection episodes and 5-yr graft survival rate as well. This discrepancy in these results might explain that donor factors could be important to cadaveric renal transplantation. Thus, we suggest that the influences of donor factors should be considered in further clinical studies of cadaveric renal transplantation.

Cytomegalovirus co-infection in patients with HIV/AIDS in north India.

BACKGROUND & OBJECTIVES: Cytomegalovirus (CMV) is a frequent opportunistic infection in immunocompromised individuals particularly those receiving organ transplants and harbouring HIV infection. The classical CMV syndrome may be seen in only a small percentage of patients and tissue diagnosis is cumbersome, costly and requires hospitalization. Hence there is an urgent need to establish accurate and early diagnosis for proper institution of therapy. An attempt was made to detect active CMV co-infection in patients with HIV/AIDS using three assays and the positivity rates in the 2 groups compared. METHODS: In the present study, we used a highly sensitive polymerase chain reaction (PCR) for immediate early gene of CMV, pp65 antigenaemia assay and IgM ELISA assay to detect the presence of CMV co-infection in 37 patients with AIDS and 32 healthy HIV seropositives. Thirty healthy laboratory workers served as normal controls. RESULTS: Of the 37 patients with AIDS, 12 (32.4%) showed a positive reaction by PCR and only 4 patients were positive by the antigenaemia assay. Of the 32 HIV seropositives, only one was positive by PCR (3%), and all were negative for antigen assay. None of the controls showed positivity by any of the tests. The difference in PCR positivity rates between HIV seropositives and patients with AIDS was significant (P < 01). IgM antibodies were positive in four (10.3%) AIDS patients and only one (3%) HIV seropositive, the difference was insignificant. The difference in antigen positivity between IIIV seropositives and AIDS patients was also insignificant. INTERPRETATION & CONCLUSION: CMV appears to be an important co-infection in patients with AIDS in India and PCR is a powerful tool for detection of CMV in blood and is superior to the antigenaemia assay. PCR can be performed with a small volume of blood avoiding any invasive procedure, and can provide quick information for timely institution of therapy.

Seroprevalencia y distribución de anticuerpos IgG Anti-CMV en una población de pacientes que concurrieron al LCSP de mayo 1997 a agosto 2001 / Seroprevalence and distribution of IgG antibodies Anti-CMV in a population of patients who concurred to the LCSP of May 1997 to August 2001

Estudio que tiene como objetivo analizar la seroprevalencia de anticuerpos anti-CMV en una población de pacientes que acudieron al Laboratorio Central de Salud Pública de Paraguay entre mayo de 1997 a agosto de 2001 para la determinación de anticuerpos IgG anti-CMV

Vaccine adjuvants: A new hope for effective immunization

Two important issue regarding the use of immunization to control infections and malignancies in the futureare: 1) the need to render poorly immunogenic, often highly purified, antigens more effective; and 2) the desire to direct the immune response in specific ways to achieve the most relevant response for each disease. The first issue can be solved by a broad range of vaccine adjuvants. The second requires careful selection among the adjuvants to allow directing of the immune response in the most appropriate manner. For exemple, in different settings expansion of a B cell response, cytotoxic T cell response, or enhancement of either a Th1 or Th2 subset response may be desired. These goals are accomplished by the use of several newly developed non-cytokine adjuvants, or by direct injection of the relevant cytokines. Some non-cytokine molecular adjuvants and cytokines used as adjuvants have already been proven effective in animal models and/or in clinical trials. Here, we review the present state of art in the use of vaccine adjuvants for control of various infections diseases.