Immune response to hepatitis A vaccination in HIV-infected men in Greece.

HIV-infected patients are at increased risk for acquiring hepatitis A virus (HAV) infection. We evaluated the seroconversion rate (anti-HAV antibodies ≥ 20 mIU/ml) and the geometric mean antibody titres (GMTs) in a group of 351 HIV infected men, who had received two doses of a hepatitis A vaccine. We analysed blood samples collected at one, six, 12 and 18 months following the administration of the second dose of the vaccine. The seroconversion rate one month after the second dose of the vaccine was 74.4% (260/351). At month 18 after the end of vaccination, 56.1% of the subjects remained seropositive. GMTs were 315, 203, 153 and 126 mIU/ml at months 1, 6, 12, and 18, respectively. Logistic regression revealed that the CD4 count is the only factor affecting response to vaccination (P = 0.019). A higher response rate and higher GMTs were observed in patients with CD4 counts ≥ 500 cells/mm(3) (76.6%) than in patients with CD4 counts 200-499 cells/mm(3). In conclusion, even in patients with near-normal CD4 counts, the response to the hepatitis A vaccine is impaired.

Sir Robert Carswell (1793-1857): coining the term "melanoma".

Melanoma is a neoplastic disorder produced by malignant transformation of the normal melanocyte, accounting for 4% of all skin malignancies. This malignancy was described since antiquity as a "fatal black tumour". In the 19th century, the distinguished pathologist Sir Robert Carswell coined first the term melanoma, provided its pathological description and depicted the lesion in his famous work Pathological Anatomy: Illustrations of the elementary forms of disease.

Multidrug-resistant strains of Neisseria gonorrhoeae in Greece.

Eighty-seven out of 575 gonococci isolated in Greece from 1991 to 1998 belonged to serovar Bropyst and exhibited resistance to penicillin, tetracycline, erythromycin, and chloramphenicol. Conventional and molecular typing showed three clusters, A, B, and C, that were associated with networks of high- frequency transmitters (cluster A with homosexuals and clusters B and C with refugees from Eastern Europe). Study of one isolate revealed mutations in the penA, mtrR, and porB genes that may explain the multidrug-resistant phenotype.

The impact of new antiretroic therapeutic schemes on the cost for AIDS treatment in Greece.

The paper attempts to evaluate the clinical and economic benefits between the administration of the dual and triple antiretroic schemes for the treatment of the HIV disease. Clinical and economic data are derived from patients hospitalized in 1996 and 1997 at the University Department of Dermatology and Venereology of Andreas Sygros Hospital. Methodology is based on the comparison of patients' nosological profile and direct annual cost before and after the administration of the triple treatment. The results of the study present that the triple combination therapy yields superior health outcomes, (decrease in the days of hospitalization and in the opportunistic disease events as well as fewer deaths and loss of production). Cost comparison presents a small decrease in the annual patient's cost, where all cost components are diminished, except the medication cost. A substitution of hospital care by drug therapy is revealed and a great change is taken place in the composition of the drugs' cost. Patient cost for antiretroic drugs has more than doubled from 1996 to 1997.

Seroprevalence of hepatitis B surface antigen (HBsAg) among first-time and sporadic blood donors in Greece: 1991-1996.

Hepatitis B surface antigen (HBsAg) seroprevalence among three major groups of sporadic voluntary blood donors in Greece was studied and compared to the seroprevalence in regular donors. These three groups share many characteristics with the general population. A 6-year retrospective seroepidemiological study was carried out (1991-1996). The study population consisted of donors who were (i) military recruits (n = 80 302), (ii) enlisted military personnel (n = 86 920) and (iii) directed family donors (n = 75403). A specimen was considered as HBsAg positive when found repeatedly reactive by a 3rd-generation immunoassay and confirmed by RIA. The Mantel-Haenszel chi2 procedure was used for stratified analysis of the prevalence rates and Greenland/Robins confidence intervals of the respective weighted relative risk (MHRR) were calculated. The 6-year overall HBsAg seroprevalence among the three sporadic donor groups was 0.84%; this was twice the seroprevalence among a sample of regular donors (n = 45504) in Greece. Seroprevalence was higher among enlisted personnel (1.21 < MHRR = 1.34 < 1.50), during years prior to 1995. Directed family donors had the same overall seropositivity rate as recruits and enlisted personnel. After 1995, all groups had a seroprevalence below 1%, possibly indicating a shift towards lower endemicity in the Greek population.

Lack of reactivation of cytomegalovirus retinitis in an AIDS patient, during and after stopping long-term cidofovir treatment: case report.

The case of an AIDS patient with cytomegalovirus (CMV) retinitis who was treated with cidofovir for 17 consecutive months, without any adverse effect, is presented. In the context of antiretroviral therapy, cidofovir therapeutic regimen was 5 mg/kg of body weight for 2 weeks and 5 mg/kg thereafter every other week. Probenecid, hydration and monitoring for proteinuria were also used to prevent nephrotoxicity. The patient stopped maintenance therapy for CMV retinitis after the permanent rise of CD4+ cells above 100 c/mm3. For more than 10 months after drug withdrawal the patient remains free of retinitis.