[Investigation of human herpesvirus-8 seroprevalence in blood donors and HIV-positive patients admitted to Ege University Medical School Hospital, Turkey]. / Ege Üniversitesi Tip Fakültesi Hastanesine basvuran kan donörlerinde ve HIV-pozitif hastalarda insan herpesvirusu-8 seroprevalansinin arastirilmasi.

Human herpesvirus 8 (HHV-8), classified in Herpesviridae family, is the etiological agent of Kaposi's sarcoma (KS), primary effusion lymphoma and multicentric Castleman's disease. In contrast to the other herpesviruses, HHV-8 seroprevalence is low in general populations; however, the higher prevalence observed in individuals with immunodeficiencies such as AIDS poses an increased risk for KS. The global distribution of HHV-8 shows great variations, with the highest seroprevalence seen in Africa. The number of studies on the seroprevalence of HHV-8 in Turkey are limited. The aim of this study was to determine the HHV-8 seroprevalences in healthy blood donors and HIV-positive patients, that will contribute HHV-8 seroepidemiological data in our country. This study was designed as a cross-sectional study. A total of 551 healthy donors (76 female, 475 male; age range: 18-65 years) admitted to Ege University Medical School Hospital, Blood Center for blood donation between December 2013-January 2014, and 173 HIV-positive patients (30 female, 143 male; age range: 18-65 years) admitted to infectious diseases outpatient clinic between October 2013-January 2014, were included in the study. A commercial ELISA method (KSHV/HHV-8 IgG ELISA Kit, Advanced Biotechnologies Inc, USA) was used for the detection of IgG antibodies that were structured against HHV-8 lytic antigens. In the study, 29 (29/551, 5.3%) of blood donors and 44 (44/173, 25.4%) of HIV-positive patients, with a total of 73 (73/724, 10.1%) cases were found as HHV-8 seropositive. The difference between blood donors and HIV-positive patients in terms of HHV-8 seropositivity rates was statistically significant (5.3% versus 25.4%; p< 0.05). In both of the study groups, no statistically significant difference was detected between HHV-8 seropositivity with gender and age. When considering HIV-positive patients, no statistically significant difference was observed between HHV-8 seropositivity with the duration of anti-HIV positivity, CD4(+) T cell count, HIV-RNA status and history of having sexually transmitted disease. As a result, HHV-8 seroprevalence rate detected in our study is similar to the data of other studies performed in Turkey, as well as the rates reported from other European and Asian countries.

[HIV-1 subtype distribution determined by phylogenetic analysis of pol gene sequences and automated subtyping tools among HIV-1 isolates from the Aegian Region of Turkey]. / Ege Bölgesi'nde izole edilen HIV-1 izolatlarinin alttip dagiliminin pol gen bölgesi filogenetik analizi ve otomatize araçlar kullanilarak belirlenmesi.

Human immunodeficiency virus (HIV) exhibiting remarkable genetic variability, includes two genotypes namely HIV-1 (group M, N, O and P) and HIV-2 (group A-H). HIV-1 group M, which is mainly the cause of the AIDS pandemic, is divided into nine pure subtypes, more than 45 circulating recombinant forms (CRF) and numerous unique recombinant forms (URF). According to the documents of Turkish Government of Health, among a total of 6802 HIV-positive cases, 1096 of them were defined as AIDS as of June 2013 in Turkey. Although subtype B is the predominant subtype, recent studies indicate higher proportion of CRFs similar to their increasing role in the HIV pandemic. The aim of this study was to determine the subtype distribution of HIV-1 strains isolated from 70 patients (61 male, 9 female; age range: 16-73 yrs, mean age: 39.6 yrs) who presented to our institution between April 2008-June 2013. HIV-1 strains were subtyped by phylogenetic analysis of the pol gene region and commonly used automated subtyping tools namely, Stanford HIV db v6.2.0 and Rega v3.0. Pol sequences retrieved from the Los Alamos database and from GeneBank, were trimmed from full-length genomes. Phylogenetic analysis of the 1302 base pair of the pol gene region was performed using Mega v5.2 software. The sequences were aligned using Muscle and phylogenetic distances between sequences were estimated by using Kimura two-parameter model (transition/transversion ratio: 2.0). Tree topology was obtained using neighbour-joining method and bootstrap value was set at 1000. Sixty-one (87.1%) patients were antiretroviral treatment (ART)-naive and nine were on different ART regimens. The subtypes of the isolates according to phylogenetic analysis were found as follows; 31 (44.2%) subtype B, 24 (34.2%) CRF42_BF, 6 (8.5%) B/CRF02_AG recombinants, 5 (7.1%) sub-subtype A1, 1 (1.4%) sub-subtype F1, 1 (%1.4) CRF 25_cpx, 1 (1.4%) CRF02_AG and 1 (1.4%) CRF01_AE. Rega v3.0 subtyping tool produced five discrepant results (4 B/CRF02-AG and 1 CRF42_BF) compared to phylogenetic analysis. Stanford HIVdb v6.2.0 had eight results (3 CRF42_BF, 2 subtype B, 2 sub-subtype A1, 1 CRF25_cpx) that were not concordant with phylogenetic analysis. Stanford HIVdb v6.2.0 was able to subtype all B/CRF02_AG recombinant strains. B/CRF02_AG recombinants which were seen among homosexual men in France were for the first time isolated in Turkey from five men (2 homosexual, 2 bisexual, 1 heterosexual) and one heterosexual woman. CRF42_BF had not been found in Turkey previously and it has not been a common type isolated in neighboring countries either. Full genome sequencing could be helpful to further analysis of those isolates. Our results support the latest studies from Turkey reporting increase in the proportion of CRF-related infections. This is not an unusual finding when geographical location of Turkey is considered. Nevertheless, more comprehensive data regarding molecular epidemiology and subtype distribution of HIV-1 isolates in Turkey are needed.

[Investigation of hepatitis C virus genotype distribution in patients with chronic hepatitis C infections in Antalya Training and Research Hospital, Turkey]. / Antalya Egitim ve Arastirma Hastanesinde kronik hepatit C hastalarinin genotip dagiliminin arastirilmasi

Hepatitis C virus (HCV) infection is a major global health problem due to high chronicity rates, occurrence of severe hepatic diseases, and absence of an accurate therapy and effective vaccine. It is well known that viral genome is highly variable and HCV has at least six genotypes, each of them containing a series of subtypes. HCV genotypes exhibit geographical and epidemiological distribution. Genotype identification is clinically important to decide the dosage and duration of treatment since different genotypes exhibit variable response to treatment. The aim of this study was to determine the HCV genotypes in chronic HCV patients who were followed-up in Antalya Research and Training Hospital, Turkey. Anti-HCV and HCV-RNA positive blood samples obtained from 148 chronic hepatitis C patients (67 female, 81 male; mean age: 50.5 ± 10.8, age range: 17-73 years) who were admitted to Antalya Research and Training Hospital Microbiology Laboratory during January 2011-June 2013, were included in the study. Epidemiological data of the patients and HCV genotype results were evaluated retrospectively. Viral genotypes were determined by real-time (Rt) PCR assay (Abbott Molecular Diagnostic, USA). HCV genotype (Gt)-1 was detected in 119 (80.4%) of the patients, of them 15.9% (19/119) were identified as subtype 1a and 75.6% (90/119) were subtype 1b. The prevalence rates of Gt-2, -3, and -4 were found as 3.4% (n= 5), 11.5% (n= 17), and 2% (n= 3), respectively. Gt-6 was not detected in our patients. Mixed infection with HCV types was detected in four patients (2.7%) by Rt-PCR; of these three were detected as Gt-1 and one was Gt-2 by RFLP (Restriction Fragment Length Polymorphism) and sequencing. The high prevalence of Gt-3 (11.5%) obtained in this study was attributed to the determination of Gt-3 in seven of 13 foreign national subjects. Rt-PCR method used in this study is user independent, standardized, automated, rapid and reliable method, however in case of detection of mixed types, the samples should be confirmed by other methods. In conclusion, we reported that the majority of the chronic hepatitis C infected patients had Gt-1b, and Gt-3 exhibited the highest rate ever reported by other studies from Turkey.

Comparison of immunofluorescence assay and multiplexed microparticle-based immunoassay for detecting Epstein-Barr virus viral capsid antigen antibodies.

A new multiplexed microparticle-based immunoassay was compared with the immunofluorescence assay that is used widely for detecting EBV-specific antibodies in immunocompetent patients. Serum samples of 162 patients submitted for routine EBV diagnosis were tested for viral capsid antigen IgM, viral capsid antigen IgG and serological profile interpretations with both systems. The result concordances were 94.2%, 93.6%, and 92.1%, respectively. Multiplexed microparticle-based immunoassay can be an alternative to immunofluorescence assay especially in laboratories receiving large numbers of samples.

Anti-HTLV-I/II Seroprevalence in Healthy Blood Donors in Izmir, Turkey.

Human T-cell lymphotropic virus type I (HTLV-I) is the first human retrovirus to be associated with malignant disease-namely, adult T-cell leukemia/lymphoma. HTLV-I has also been associated with several diseases. HTLV-I has a worldwide distribution with major endemic foci in the Caribbean and Southern Japan. HTLV-II is a closely related retrovirus that shares considerable genomic homology with HTLV-I but has not been proven to be a pathogen. Major routes of transmission are blood transfusion, breast milk and sexual activity. In this study, we examined the seroprevalance of HTLV-I/II among healthy blood donors attended to Ege University Hospital in Izmir. 913 healthy blood donors were examined for the presence of anti-HTLV-I/II antibody in their sera. Serum specimens were tested with an enzyme immunoassay (EIA) (Organon Teknika, Vironostika HTLV-I/II Microelisa System, Holland). All of the 913 healthy blood donors were seronegative with EIA. These findings indicate that screening of blood donors for HTLV I/II is not necessary at present time.