BK virus nephropathy developing after renal transplantation and its treatment with ciprofloxacin: a case report.

BK virus nephropathy (BKVN) is among the most important problems in renal transplant recipients. This report presented an assessment of treatment with a fluoroquinolone antibiotic, ciprofloxacin, for 6 months in a 21-year-old male patient who developed BKVN after transplantation. Ciprofloxacin treatment reduced the viral load and improved the clinical findings.

Nitric oxide and malondialdehyde levels in plasma and tissue of psoriasis patients.

BACKGROUND: The pathogenesis of psoriasis has not been known exactly yet. Recently, it has been suggested that increased reactive oxygen species (ROS) such as nitric oxide (NO) and malondialdehyde (MDA) may play a part in the pathogenesis of various skin diseases, including psoriasis. OBJECTIVES: In this study, we aimed to investigate the role of ROS in the pathogenesis of psoriasis. METHODS: A convenience sample of 23 patients with psoriasis and 23 healthy subjects consented to participate in the study. Plasma NO and MDA levels were measured in all participants. Psoriasis area and severity index (PASI) and tissue levels of MDA on lesional and non-lesional skin regions of psoriasis patients were measured. In addition, the correlation between age, gender with plasma NO, plasma MDA and tissue MDA was assessed. RESULTS: Plasma levels of NO and MDA in psoriasis patients (135.8 µmol/L, 4.33 µmol/L, respectively) were statistically significantly higher than those in controls (33.6 µmol/L, 2.03 µmol/L, respectively). Tissue levels of MDA in lesional tissues (49.18 nmol/gr) were significantly higher than those in non-lesional tissues (28.41 nmol/gr). A significant correlation was not found between the PASI and levels of NO and MDA. In addition, a significant negative correlation was found between the plasma NO levels and age. CONCLUSION: NO and MDA levels are elevated in psoriasis patients, which may indicate that oxidative stress plays an important role in the aetiopathogenesis of psoriasis.

Monitoring of hepatitis B virus surface antigen escape mutations and concomitantly nucleos(t)ide analog resistance mutations in Turkish patients with chronic hepatitis B.

BACKGROUND: The hepatitis B virus (HBV) polymerase gene completely overlaps with the envelope gene. In the present study we aimed to monitor the prevalence and pattern of the typical mutations for hepatitis B surface antigen (HBsAg) escape, and concomitantly nucleos(t)ide analog (NUC) resistance mutations, in Turkish patients undergoing different antiviral therapies and in treatment-naïve patients with chronic hepatitis B (CHB). METHODS: The investigation was undertaken between March 2007 and August 2009 and involved a total of 142 patients under NUC therapy (88 males; mean age 42 years (range 13-68); hepatitis B e antigen (HBeAg) negativity in 94 patients; HBV DNA median log 4.3 log(10) IU/ml (range 2.0->6.0); alanine aminotransferase (ALT) median level 76.1 IU/ml (range 12-1082)) and 185 treatment-naïve CHB patients (120 males; mean age 39 years (range 1-76 years); HBeAg negativity in 132 patients; HBV DNA median log 3.5 log(10) IU/ml (range 2.0-6.0); ALT median level 60.7 IU/l (range 8-874)). RESULTS: The overall prevalence of typical HBsAg escape mutations found in the CHB patients was 8.3% (27/327). In the NUC therapy group the prevalence was 8.5% (12/142), with the following patterns: sY100C+sI110V, sL109I, sP120T, sP127T, sG130R+sG145X, sS132A+sY134N, sY134N+sG145R, sC137G, sD144E, sG145R. In the treatment-naïve group the prevalence was 8.1% (15/185), with the following patterns: sL109I, sI110V, sS117INST, sP120T, sP127T, sM133I, sC137L+sG145R, sS143L. However, NUC resistance mutations were found in 7.7% (11/142) of the patients on NUC therapy and 3.8% (7/185) of the treatment-naïve group patients. Interestingly, the treatment-naïve patients had preexisting drug resistance mutations related to lamivudine (rtL180M+rtM204I), adefovir (rtA181V, rtQ215S, rtI233V), entecavir (intermediate susceptibility with rtL180M+rtM204IHBV variant), telbivudine (rtL180M+rtM204I), and tenofovir (rtA194T). CONCLUSIONS: The findings of this study show preexisting typical HBsAg escape and NUC resistance mutations are possible. The genetic arrangement of the HBV genome with polymerase and surface genes overlapping has substantial public health and diagnostic implications and relevance.