Prevalence of Occult Hepatitis B in HIV Positive Patients (Adolescents and Adults) in Kermanshah- Iran

Background Occult hepatitis B infection (OBI) is considered a risk factor for progression of liver disease in patients with hepatitis B virus (HBV) infection. This disease progression is reported to be more significant in those with concomitant HIV infection. We aimed to determine the prevalence rate of OBI in a sample of HIV-positive patients. Materials and Methods: Sixty-six HIV-infected patients with positive Hepatitis B core antigen (HBcAb) and negative Hepatitis B surface antigen HBsAg were included. HBV DNA was measured by real time polymerase chain reaction PCR method. Those with positive HBV viral load were considered as seropositive OBI. Then, the patients were studied regarding age, gender, intravenous drug use (IVDU), CD4 count, and concomitant infection by hepatitis C virus (HCV), available in their medical records. Results: Seventy-seven patients (38.5%) had positive HBc antibody (HBcAb). Of 66 patients who were positive for both HIV and HBc antibody, eight patients (12.12%) had OBI. About 3.7% in age group younger than 40 years and 5.3% in age group older than 40 years, OBI was detected. Forty-four patients (54.5%) were male. OBI rate was 22.2% in males and zero in females (P 350/mL, 4.1% had OBI. In those who were IV drug user, 17.94% and in those who were not IV drug user, 3.57% gad OBI. Conclusion The prevalence of OBI in the studied sample of HIV-infected patients is considerable. As we did not find any significant association between OBI and studied factors except for gender, we think that screening for OBI would be useful for HIV-infected patients, especially male patients

Third Attacks of Chicken Pox in a Leukemic Child

Background: Chicken pox is caused by Varicella zoster. Infected persons usually acquire permanent immunity and a reinfection is unusual. Case Presentation: We report on a leukemic girl aged 12 years and 4 months, who had two chicken pox infections during 2 months. Leukemia was diagnosed 20 months ago. In her past history she had a first chicken pox infection 2 years before leukemia was diagnosed. Conclusion: Recurrence of chicken pox is possible especially in immune comprised individuals. Our leukemic patent had 3 attacks of chicken pox

Septic arthritis of both knees following intra-articulari njection of petrol

Abstract: A 70 years old man was referred to our center with bilateral knee arthritis following intra-articular petrol injection. Because of previous antibiotics use gram stain and culture were negative. Septic arthritis was diagnosed and antibiotics and drainage were started. After 2 years he improved eventually and was able to walk. But, some movement limitation remained

Efficacy of valganciclovir and ganciclovir for cytomegalovirus disease in solid organ transplants: A meta-analysis

Background: Cytomegalovirus (CMV), a problematic virus in solid organ transplant recipients (SOTR) such as liver, can worsen overall mortality and transplant outcome, so its prevention and treatment is a key of success in such patients. This study is aimed to compare the efficacy of ganciclovir (GCV) and valganciclovir (VGC) for prevention and treatment of infection with CMV. Materials and Methods: After sensitive and systematic search in PubMed, EMBASE, Cochrane and other available databases, both prospective and retrospective studies on effect of VGC and GCV in prevention and treatment of CMV disease among SOTR, which had our study criteria, were included. The pooled risk estimates were calculated using random-effects models. Results: Among 1324 title, 19 studies were included. In 11 prophylactic studies (2368 patients), the pooled risk of CMV disease (VGC relative to GCV) was 1.16, 95% confidence interval (CI): 0.91-1.49 and in studies of liver transplant recipients, 1.53, 95% CI: 0.86-2.70. Rate of viremia eradication in VGC to GCV was 1.05, 95% CI: 0.97-1.13. In 3 treatment studies (422 patients), rate of successful treatment in VGC to GCV was 0.98, 95% CI: 0.91-1.06 and viremia eradication 0.95, CI 95% 0.77-1.16. All these values did not show statistically significantly differences between GCV and VGC. Conclusion: It can be concluded that VGC as an alternative to GCV can be used with equal efficacy in prevention and treatment of CMV disease in SOTR

Brucella spondylitis and paraspinal abscess

Brucellosis is a zoonosis with a variety of clinical syndromes including spondylitis. Spondylitis and sacroiliitis are the most frequent complications of skeletal system involvement in brucellosis, but muscle infection and abscess formation are a rare complication and frequently secondary to spondylitis. In this article two cases of brucella spondylitis are presented which has led to abscess formation in one of them, these patients referred with back pain, fever, and with subsequeint MRI examination, wright positive test, were diagnosed as spondylitis. The antibiotic regiment including Doxycycline, Refampin, were prescripted for four months. The clinical signs were disapeared subsequently

Effectiveness of oral levamisole as an adjuvant to hepatitis B vaccination in healthcare workers non-responsive to previous vaccination: A randomized controlled trial

Background: Healthcare workers are at risk for HBV infection through percutaneous or mucosal contact with infected blood, body secretions, or blood products or via sharps injury. Hepatitis B vaccination, despite immunogenicity, may not induce a proper immune response in 5–10% of the general adult population. Increased immune response in healthcare providers that do not respond properly to conventional hepatitis B vaccination is an important health challenge. Therefore, the aim of the present study was to evaluate the effectiveness of hepatitis B vaccination plus oral levamisole as adjuvant in healthcare providers non-responsive to routine vaccination. Materials and methods: The healthcare workers that were non-responsive to previous hepatitis B vaccination were enrolled in a double-blind randomized placebo-controlled clinical trial. The participants were then randomized to two groups including hepatitis B vaccination (as a three-dose series on a 0, 1, and 2-month schedule in the deltoid muscle) plus levamisole (levamisole group) and hepatitis B vaccination plus placebo (placebo group) at a 1:1 ratio. The outcome measure was the HBs antibody titer one month after receiving each dose as well as the seroprotection ratio. The side effects were also evaluated in all participants. Results: In total, 22 subjects finished the trial (11 individual in per group). The median antibody titer one month after receiving the first and third doses increased more in the levamisole group compared to the placebo group but the difference was not significant (p ​= ​0.34, p ​= ​0.66, respectively).The seroprotection ratio after three doses was similarly high in both groups (90.9% in per group). Furthermore, the seroprotection ratio and median antibody titer had no significant correlation with age, sex, BMI, and history of smoking in intervention and control groups (p>0.05). No serious side effects were noted in both groups. Conclusions: Re-vaccination can boost the immune response in healthcare professionals that were non-responsive to previous vaccination although the mean antibody titer was higher in the levamisole group

Prevention of mother-to-child transmission of HIV in Kermanshah, west of Iran from 2014 to 2021

Abstract Background This study aimed to evaluate the implementation of the prevention of mother-to-child transmission (PMTCT) of the HIV-PMTCT program in Kermanshah, west of Iran, from 2014 to 2021. Methods The data of all HIV-infected mothers and their infants who were monitored by the Kermanshah behavioral diseases counseling center was extracted and recorded in a checklist. Results Out of 95 included infant, 45 (47.4%) were girls and 50 (52.6%) were boys. The mothers were mostly infected with HIV via their infected spouse. The pregnancies of 77 cases (82.1%) were in accordance with the national guideline. The average length of treatment for this group was 185 days. Of the 18 mothers who did not receive treatment, nine were diagnosed during childbirth and nine had no available information. All infants born from infected mothers underwent after-birth-antiretroviral prophylaxis, and all remained healthy. There was no statistically significant relationship between the birth weight and height of neonates with maternal age, maternal last viral load, disease stage, education, and maternal CD4 levels. Only a statistically significant relationship was observed between the duration of treatment and the infants’ weight. Conclusion The results suggest the feasibility and effectiveness of the PMTCT program for HIV-positive mothers in Kermanshah. It seems that if pregnant HIV-positive women are diagnosed early and covered by a good prevention program on time, the risk of HIV to their babies will be reduced, significantly