Role of HCV coinfection towards disease progression and survival in HIV-1 infected children: a follow-up study of 10 years.

The present study was taken up to evaluate the pattern of disease progression and survival in a group of HIV-1 positive children, coinfected with HCV infection (n=25) in comparison to those without such coinfection (n=23). There was a significant negative correlation between the rate of decline of the CD4 + T cell percentage and the duration of the AIDS-free interval in most (80.0 per cent) of the HCV seropositive children showing such decline (r=-0.588; p=0.005). The HCV seropositive children had twofold higher risk of progression to development of AIDS than HCV seronegatives (RR=2.51; 95 per cent CI:1.34-4.69; p=0.004). There was a significant negative correlation between the rate of decline of CD4 + T cell percentage and overall survival duration for HCV seropositive group (r=-0.609; p=0.003). Moreover, children coinfected with HCV had more than twofold higher risks of death than those without HCV (RR=2.39; 95 per cent CI:1.17-4.89; p<0.01). It appears that HCV infection may be an important contributor to the rapid disease progression and increase in mortality in HCV-HIV-1 coinfected children of thalassemia major.

Prompt laboratory diagnosis in timely containment of a plague outbreak in India.

A focal outbreak of pneumonic plague occurred in a hamlet of village Hatkoti, district Shimla, Himachal Pradesh in the first fortnight of February, 2002. A total of 16 cases with 4 deaths were reported. Diagnosis of plague was confirmed by the laboratory in 10 (63%) cases. Y. pestis was isolated from clinical samples of 3 cases and confirmed by bacteriophage lysis. Molecular tests confirmed the presence of Y. pestis specific pla and F1 genes in 4 cases; DNA fingerprinting had identity with the known sequence of plague bacilli. Paired samples from 5 cases showed more than 4 fold rise and 1 case showed more than 4 fold fall in antibodies against F1 antigen of Y. pestis. The present communication emphasises that timely and systematic laboratory investigations give confirmatory diagnosis in shortest possible time which forms the backbone of the outbreak control in a timely fashion and prevents confusion and controversy.

Risk factors of herpes simplex virus type 2 among STD clinic attenders in Delhi, India.

The present study was conducted to determine the seroprevalence and risk factors associated with HSV-2 infection among sexually transmitted diseases (STD) clinic attenders of Delhi in India. Out of 128 patients included, 76 were males and 52 were females. Antibodies to HSV 1 and 2 and HIV infection were determined by ELISA. Syphilis seropositivity was determined by VDRL test and confirm by TPHA test. Ulcer scrapping were stained by Giemsa for Herpes progenitalis and Donovan bodies and Grams for Haemophilus decreyi infection. The HSV-2 and HSV-I seroprevalence was found to be 85.2% and 77.3% respectively. 87.3% of HSV-2 seropositive patients were asymptomic. 10.7% of patients had coinfection of HSV-2 and HIV. STDs like syphilis, chancroid, gonococcal and non-gonococcal urethritis were significantly associated in HSV-2 infection. Thus the study demonstrates high prevalence of HSV-2 infection in Delhi city. Significant association of HSV-2 infection with previous history of STD (p < 0.02) and multiple sexual partners in males was found (p < 0.002).