First study of genital HPV infection among women living with HIV recruited from May to September 2018 in Eastern Algeria.

BACKGROUND: Genital HPV infection is recognized worldwide as one of the most common, if not the most common, sexually transmitted infection. Several studies have shown a higher prevalence of HPV infection in women living with HIV (WLWH). We aimed to determine the prevalence of HPV, the circulating genotypes, and its association with risk factors among Algerian WLHIV. METHODS: Cervical specimens were collected from 100 WLHIV. The detection of HPV infection was performed by Roche Linear Array test. RESULTS: The overall prevalence of HPV infection was determined at 32%, all including high risk HPV (HR-HPV). We found a great diversity of HR-HPV genotypes, the most common individually were HPV52, HPV16, HPV18 and HPV58, The highest prevalence was found in groups of genotype 52, 25%. HPV16 and 18 were less common (16%). Cervical cytology was abnormal in 66% (81.3% in the HPV + population), with a predominance of inflammatory lesions (75% HPV +), The most important determining risk factor for HPV infection in this series was a low CD4 T cell count <200/mm3 found in 72% of the HPV positive participants. CONCLUSION: Our study is an initial database, to be completed by a multicenter study to determine the most frequent genotypes in Algerian WLHIV, in order to discuss the introduction of the vaccine against HPV in Algeria, especially among WLHIV.

[Extra hepatic manifestations of hepatitis A]. / Les manifestations extra-hépatiques de l'hépatite A.

Viral hepatitis A is characterized by a wide range of clinical pictures ranging from a completely unapparent infection to a fulminant, potentially fatal hepatitis or the classical icteric form. Hepatitis A can develop in an unusual way and extrahepatic manifestations (neurological, renal, haematological, cholecystitis, acute pancreatitis, vasculitis, etc.) can occasionally complicate the course of the disease. Although hepatitis A infection was identified in the early 1970s, there are few or no studies assessing the actual frequency of these complications. They have been studied mainly through clinical case reports. Currently, since the disease has become more common in adults, these complications are being increasingly observed. We present an update on extrahepatic complications during hepatitis A, which should be known by both specialist doctors (infectiologists internists, hepatologists and others) and general practitioners.

Changes in prevalence of hepatitis A and associated factors in Setif-Algeria.

Hepatitis A, a waterborne disease associated with fecal contamination, remains the most common acute hepatitis worldwide. Generally considered to be a disease affecting children living in poor sanitary conditions, hepatitis A affects the adult population if hygiene improves. Studies conducted during the 1980s ranked Algeria as a highly endemic area. Thirty years on, we conducted this cross-sectional epidemiological study with the main objective of estimating the seroprevalence of hepatitis A virus infection in the district of Setif, Algeria. A survey was carried out between June 2010 and September 2011 and focused on 1061 individuals aged 5-19 years old. The seroprevalence of hepatitis A was estimated at 72.3% and varied with age: 56.9% in children aged 5-9 years, 70.4% among those aged 10-14 years, and 85.4% for the 15-19-year-old age group. Factors associated with lower seroprevalence were mainly related to a higher socioeconomic level, including living in an urban area, small household size, parents with a higher educational level, and consumption of bottled mineral water. This study highlights an epidemiological change and predicts that Algeria is in a period of gradual transition to intermediary endemicity. This change is synonymous with a susceptible population growing older, suggesting that serious forms of hepatitis can be expected more frequently. The current preventive strategy against hepatitis A should be revisited.

[Cerebral venous thrombosis during tuberculous meningoencephalitis]. / Thromboses veineuses cérébrales au cours de la méningo-encéphalite tuberculeuse.

Cerebral venous thrombosis is a rare disease characterized by its clinical polymorphism and multiplicity of risk factors. Infections represent less than 10% of etiologies. Tuberculosis is not a common etiology, only a few observations are published in the literature. Between January 2005 and March 2015, 61 patients were hospitalized for neuro-meningeal tuberculosis. Among them, three young women had presented one or more cerebral venous sinus thromboses. No clinical feature was observed in these patients; vascular localizations were varied: sagittal sinus (2 cases), lateral sinus (2 cases) and transverse sinus (1 case). With anticoagulant and antituberculosis drugs, the outcome was favorable in all cases. During neuro-meningeal tuberculosis, the existence of consciousness disorders or neurological focal signs is not always the translation of encephalitis, hydrocephalus, tuberculoma or ischemic stroke; cerebral venous sinus thrombosis may be the cause and therefore should be sought.

[Neurobrucellosis: description of 5 cases in Setif Hospital, Algeria]. / Neurobrucellose: 5 observations à l'hôpital de Sétif, Algérie.

PURPOSE: Brucellosis is a major ubiquitous zoonosis transmitted from livestock to humans. It is a public health problem in developing countries. Between 2003 and 2005, the incidence of brucellosis in Algeria showed a 181% increase from 8.79 to 24.71. Between 2005 and 2007, the incidence remained almost stable. The estimated mean incidence of neurobrucellosis is 4% with clinical manifestations that are variable and often multi-focal in the same patient. The purpose of this retrospective study is to describe 5 cases of neurobrucellosis managed in our department between 2001 and 2007. MATERIALS AND METHODS: It was a retrospective study 5 patients. There were 2 women and 3 men with a mean age of 20 years. RESULTS: Neurological involvement occurred immediately in all patients. Clinical manifestations were variable with meningoencephalitis in 2, meningoencephalitis associated with a polyperipheral neuropathy in 1, meningomyeloradiculitis in 1, and acute diffuse encephalitis in 1. Definitive diagnosis was based on isolation of bacteria from a blood specimen in 1 case and detection of antibodies in blood and cerebrospinal fluid in 4. All patients were treated using a combination of 3 of the following 4 drugs: doxycycline, rifampicine, cotrimoxazole and aminoside. Treatment was associated with corticosteroid therapy in 3 cases. DISCUSSION: Neurobrucellosis can affect any part of the nervous system and can mimic any neurological disease. Early detection and treatment is the only predictor of favorable outcome of neurobrucellosis, but there is no standardized treatment protocol. Neurobrucellosis should be included in differential diagnosis for any patient presenting central or peripheral neurological manifestations especially in endemic zones.

A rare case of cotrimoxazole-induced eosinophilic aseptic meningitis in an HIV-infected patient.

A case of cotrimoxazole-induced meningoencephalitis in an HIV-infected patient without signs of AIDS is reported. The patient developed an apparently generalized seizure, of cotrimoxazole, 1 month after first taking a dose of this drug and a febrile coma after a second dose 3 weeks later. Lumbar puncture revealed eosinophilic aseptic meningitis. The patient quickly recovered without sequelae and was given antiretroviral therapy plus pentamidine aerosolized and pyrimethamine as prophylaxis for opportunistic infections. No other adverse effects were observed. The report describes the diagnosis of this case supported by a commentary, including a literature review.