Prevalence of HIV infection and the correlates among homeless in Tehran, Iran

<p><b>OBJECTIVE</b>To determine the prevalence of HIV infection among homeless men and women and the related risk behaviors in Tehran, Iran.</p><p><b>METHODS</b>In 2007-2008, Tehran municipality stacked up 10672 homeless men and women for assessment of HIV and began collaboration with Iranian Research Center for HIV/AIDS (IRCHA) departments to conduct HIV infection prevalence surveys in homeless populations. The results were analyzed for associations with demographic information, family support, status of drug abuse and relation with family and friends.</p><p><b>RESULTS</b>Overall HIV prevalence was 1.7% (95% confidence interval 1.4-1.9). Factors independently associated with HIV infection included history of using drugs [AOR 8.15 (4.86-13.67)], older age [AOR 1.80 (1.08-2.99) for 40-55 yr], occupation [AOR 1.64 (1.19-2.24) for unemployed], and no relation with family [AOR 1.82 (1.30-2.54)].</p><p><b>CONCLUSIONS</b>This study supports the idea that injection drug use is contributing to the increased spread of HIV among Iranian homeless. Harm reduction programs should be expanded, particularly among homeless injection drug users.</p>

Acute myocardial infarction in a 35-year-old man with coronary artery aneurysm most probably caused by Kawasaki disease

We present a 35-year-old man with history of Kawasaki disease who referred with myocardial infarction, and angiography, revealing aneurysm of left main and left anterior descending coronary arteries. The patient underwent percutaneous coronary intervention and thrombectomy and was discharged after 6 d. Coronary artery sequels of Kawasaki disease should be considered as one of the underlying causes of acute myocardial infarction in young adults.

Prevalence survey of infection with Treponema pallidum among HIV-positive patients in Tehran

<p><b>OBJECTIVE</b>To identify the frequency of syphilis among Iranian HIV-positive patients.</p><p><b>METHODS</b>A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital, Tehran, Iran. The lab tests including CD4 cell count, cerebrospinal fluid, veneral disease research laboratory (VDRL), fluorescent treponema antibody-absorption (FTA-Abs) and viral load were performed for all the patients. Data regarding medical history and their demographics were also collected.</p><p><b>RESULTS</b>Of all 450 HIV-positive patients, 24 (5.3%) had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45% of them had a definite co-infection of syphilis. 65.3% of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%. We did not find any patient with neurosyphilis.</p><p><b>CONCLUSIONS</b>Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations, the diagnosis of syphilis should be timely established using screening tests among such patients.</p>