Association of Polymorphisms in Interleukin-10 and Myeloperoxidase with Infection in Acute Lymphoblastic Leukemia Patients

Acute lymphoblastic leukemia (ALL) is the most common malignancy occurring in childhood and accounts for 77% of all leukemia cases. Long-term survival is greater than 80% with appropriate treatment. Chemotherapy is the most widely used treatment, but it can have significant side effects including neutropenia and immunosuppression.Interleukin (IL-10) is an immunoregulatory cytokine with anti-inflammatory effects. It inhibits some cells like macrophages while stimulating other cells like B cells. IL-10 has been found to be involved in conditions involving an immune response and inflammation, including pneumonia, septic shock, and graft versus host disease (GVHD). Myeloperoxidase (MPO), which catalyzes the production of hypochlorite from chlorides and hydrogen peroxide, is an abundantly expressed hemoprotein with anti-microbial effects and a major player in host defense. MPO has been implicated in the pathogenesis of a number of conditions and associated with certain infections.In this study, polymorphisms in MPO and IL-10 were investigated to test their association with risk of infection in a population of Caucasian patients with ALL. Genotyping was performed by enzyme digest for IL-10 polymorphism -592(C/A) and by pyrosequencing for the MPO polymorphisms -129(G/A) and -463(G/A). Allele frequencies at each site were in Hardy Weinberg Equilibrium (HWE). No significant correlation was found between the genotype at IL-10 -592, MPO -129 or MPO -643 and infection episodes in our patient population. As the study population was relatively small, no strong conclusions can be drawn, but implications for further research can be identified. Public Health Significance: Knowledge of the effects of certain genetic polymorphisms may be important when treating patients with ALL. Patients at increased risk of infection may require prophylaxis or more intense surveillance to ensure a better outcome

Status of HIV and hepatitis C virus infections among prisoners in the Middle East and North Africa: review and synthesis.

INTRODUCTION: The status of HIV and hepatitis C virus (HCV) infections among incarcerated populations in the Middle East and North Africa (MENA) and the links between prisons and the HIV epidemic are poorly understood. This review synthesized available HIV and HCV data in prisons in MENA and highlighted opportunities for action. METHODS: The review was based on data generated through the systematic searches of the MENA HIV/AIDS Epidemiology Synthesis Project (2003 to December 15, 2015) and the MENA HCV Epidemiology Synthesis Project (2011 to December 15, 2015). Sources of data included peer-reviewed publications and country-level reports and databases. RESULTS AND DISCUSSION: We estimated a population of 496,000 prisoners in MENA, with drug-related offences being a major cause for incarceration. Twenty countries had data on HIV among incarcerated populations with a median prevalence of 0.6% in Afghanistan, 6.1% in Djibouti, 0.01% in Egypt, 2.5% in Iran, 0% in Iraq, 0.1% in Jordan, 0.05% in Kuwait, 0.7% in Lebanon, 18.0% in Libya, 0.7% in Morocco, 0.3% in Oman, 1.1% in Pakistan, 0% in Palestine, 1.2% in Saudi Arabia, 0% in Somalia, 5.3% in Sudan and South Sudan, 0.04% in Syria, 0.05% in Tunisia, and 3.5% in Yemen. Seven countries had data on HCV, with a median prevalence of 1.7% in Afghanistan, 23.6% in Egypt, 28.1% in Lebanon, 15.6% in Pakistan, and 37.8% in Iran. Syria and Libya had only one HCV prevalence measure each at 1.5% and 23.7%, respectively. There was strong evidence for injecting drug use and the use of non-sterile injecting-equipment in prisons. Incarceration and injecting drugs, use of non-sterile injecting-equipment, and tattooing in prisons were found to be independent risk factors for HIV or HCV infections. High levels of sexual risk behaviour, tattooing and use of non-sterile razors among prisoners were documented. CONCLUSIONS: Prisons play an important role in HIV and HCV dynamics in MENA and have facilitated the emergence of large HIV epidemics in at least two countries, Iran and Pakistan. There is evidence for substantial but variable HIV and HCV prevalence, as well as risk behaviour including injecting drug use and unprotected sex among prisoners across countries. These findings highlight the need for comprehensive harm-reduction strategies in prisons