Effect of obligatory Hepatitis B vaccination program on the prevalence of occult hepatitis B among pregnant women in Egypt: A cross sectional study.

Hepatitis B virus (HBV) infection is a global health problem. HBV is of intermediate endemicity in Egypt. "Occult" HBV (OBI) indicates replication of HBV-DNA in the liver of individuals with negative serum HBsAg. This study aimed to determine the prevalence of OBI among pregnant women in Egypt and to compare this prevalence among HBV vaccinated and unvaccinated women (received obligatory vaccination). This cross-section study included 474 pregnant women in the third trimester divided in two groups. Group I: (n=247) assumed received obligatory hepatitis B vaccination and group II: (n=227), did not receive HBV vaccination. Study participants were screened for HBsAg, anti HBs, anti HBc total, anti HBc IgM, HBeAg, anti HBe, HCV Ab, and HIV Ab by immunoassays and HBV-DNA by Real-Time PCR. Anti HBs was detected in 65 (13.7%) of pregnant women, 36 (14.6%) in the vaccinated group and 29 (12.8%) in the unvaccinated group. The anti HBs levels were significantly higher in the unvaccinated group. HBc Ab showed positive results in 6 cases (2.4%) in the vaccinated group, and 14 cases (6.2%) in unvaccinated group. HBcAb and/or HBsAb were detected in 72 (15.1%) of pregnant women, 39 (15.8%) in the vaccinated group and 33 (14.5%) in the unvaccinated group. HBV-DNA was detected only in one vaccinated pregnant woman. HB vaccination program in Egypt, since 1992 affected the frequency of OBI in pregnant women (p=0.04). In conclusion, HBV infection may persist lifelong in the hepatocytes even when viral functions are suppressed, HBsAb and anti-HBc-positive individuals are present. The levels of HBsAb were higher in unvaccinated pregnant women compared to vaccinated pregnant women. HBV infection in OBI pregnant women may not transmit to the new-born.

Pooled-Testing for SARS-CoV-2 Reverse Transcription Polymerase Chain Reaction (RT-PCR) in asymptomatic healthcare workers in EL-Raghy isolation COVID-19 hospital, Assiut University.

COVID-19 pandemic is a substantial challenge for healthcare systems. Severe acute respiratory syndrome coronavirus (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) tests are considered the gold standard technique for diagnosis of symptomatic and asymptomatic infectious viral carriers and for screening special or at-risk populations. The pooled testing procedure is commonly used to reduce the cost of screening a large number of individuals for infectious diseases. This work was conducted to verify the accuracy of the standard SARS COV-2 RT- real-time PCR kit for detecting a single positive sample in a pool of negative samples. Kit verification using negative and positive samples was performed for the selection of the target pool sizes. RNA extracts from 443 healthcare workers, after 15 days' rotation in EL-Raghy Isolation COVID-19 Hospital, Assiut University during the first outbreak of COVID-19 pandemic (the period from June to September 2020) were obtained and tested. Sixty-three different pool sizes (2, 3, 4, 5, 6, 7, 8, 9, and 10) were tested for the presence of SARS-CoV-2 using RT-qPCR. Of these, 53 pools (84.1%) were negatives and 10 pools (15.9 %) tested positive. The individual number of SARS- COV 2 RT-PCR tests used in different pool sizes was 40 tests. The total number of SARS- COV 2 RT-PCR test used in this study was 110 tests instead of 443 tests which reflect a decrease in cost up to 75.16%. In conclusion, the suggested pooling strategy can reduce testing loads which enable substantial savings in reagent costs, technical burden, and time to generate laboratory results.

Chlamydia trachomatis Infection: its relation to semen parameters and sperm DNA integrity.

The present study was conducted to determine the effect of Chlamydia trachomatis (CT) infection on semen quality and sperm DNA integrity. The study included 60 infertile male patients with CT infection and 25 age matched controls. Diagnosis of patients was based on detection of CT IgA by ELISA in seminal plasma and CT plasmid DNA in the semen sediment. All patients and controls were subjected to the following investigations: history taking, conventional semen analysis, detection of CT IgA, Plasmid DNA in semen samples, reactive oxygen species (ROS) and percentage of DNA fragmentation. There was significant increase in semen ROS levels and the percentage of sperm DNA fragmentation in the CT patient group when compared to the control group (P<0.05) and in those with leukocytospermia when compared to those without leukocytospermia (P<0.05). In the patient group with CT infection there was a positive correlation between the percentage of DNA fragmentation, ROS (r = 0.82 with P<0.0001) and pus cell count. (r = 0.7 with P<0.0001). In patients with leukocytospermia, there was a positive correlation between the percentage of DNA fragmentation, ROS (r = 0.9 with P<0.0001) and pus cell count (r = 0.83 with P<0.0001). In conclusion, sperm concentration, mobility, and viability, are significantly decreased in patients with CT compared to controls. ROS levels and the percentage of sperm DNA fragmentation significantly increased in CT patients especially patients with leukocytospermia.

Toll Like Receptor 3 Polymorphisms in Hepatitis B Virus Infection.

Hepatitis B virus (HBV) is the one of the major causes of chronic liver disease. Individuals exposed to HBV show wide spectrum outcomes including immunized persons, asymptomatic carrier, chronic active hepatitis, cirrhosis and HCC. The outcome of HBV infection and the severity of associated liver diseases are determined by the nature and strength of host immune responses against the virus. There is accumulating evidence that the innate branch of the host immune system plays an important role in the control of HBV infection. Various components including toll-like receptor (TLR) contribute to this nonspecific innate immune response .TLR3 play an important role in innate immune response against viral pathogens. Single nucleotide polymorphisms (SNPs) in the TLR3 could be considered as factors for the susceptibility to viral pathogens including HBV. This study aimed to investigate the distribution of six SNPs of the TLR3 gene in patients infected with HBV and to determine the relation between these SNPs and the clearance of hepatitis B virus. These SNPs were tested by direct sequencing. Three groups were investigated: chronic HBV carrier (25 patients), chronic active HBV carrier (16 patients) and 13 persons who were previously exposed to HBV and became immunized. These 3 groups were examined for six SNPs (rs5743311, rs5743312, rs5743313, rs5743314, rs5743315, and rs78726532). The analysis showed high frequencies of GCTCCA haplotype and CCA haplotype in the immunized group when compared to chronic hepatitis B groups (P < 0.05). These findings indicate that genetic variations in the TLR3 gene could affect the outcome of HBV infection.