Strongyloides stercoralis hyper-infection syndrome in HIV+/AIDS patients in Iran

Strongyloides stercoralis is an intestinal nematode in humans, distributed through tropical and subtropical regions of the world. In most individuals, the infection has a chronic nature due to auto-infection at the low level. Accelerated auto-infection, mainly after an alteration in immune status, can cause a syndrome of severe hyper-infection or potentially fatal disseminated strongyloidiasis. Due to the increasing numbers of immunocompromised patients in Iran, strongyloidiasis is an emerging public health concern in the country. In the current study, which was carried out between 2003 and 2005, for the investigation on strongyloidiasis in HIV+/AIDS patients, a total of 781 patients were examined by agar plate culture, formalin ether concentration, and direct smear preparation of stool samples. According to the results, 2 out of 781 HIV + /AIDS patients were found infected with S. stercoralis, but both patients were at the progressive stage of AIDS and showing severe hyper-infection syndrome. In both cases, numerous rhabditiform and filariform larvae were found in fresh stool direct smears, and rapid and intensive development of parasite in agar plate cultures. In conclusion, in the progressive stages of AIDS, as a result of immunosuppression conditions or in the context of chemotherapy, S. stercoralis is capable of inducing overwhelming infection. © 2007 Springer-Verlag

Acceptability of HIV Rapid Testing in Diverse Clinical Settings in Iran

Introduction: Rapid HIV testing in clinical settings can identify previously undiagnosed persons and link them to care, as well provide patients with knowledge of their serostatus and risk reduction counseling. We conducted a survey to characterize factors affecting the acceptance or declining of rapid HIV testing among Iranian patients.Methods: This cross-sectional survey was conducted from October 2014 to December 2014 with patients in three different health care centers (an emergency department in an urban hospital, a rural health centre, a voluntary counseling and testing centre (VCT) within Imam Khomeini Hospital, Tehran, Iran and a rural health centre). Participants completed a semi-structured face-to-face questionnaire and were tested by an HIV rapid test (Chembio Sure Check).Results: Of 222 participants, 25 participants were from the urban emergency department, 40 from the urban VCT program, and 157 from the rural health care centre. All did the rapid HIV test; all were HIV negative. HIV-related risk profiles found the urban emergency department patients more likely to have multiple partners (26%, P<0.01) and history of sexually transmitted diseases (27%, P<0.001) compared to VCT patients (9% and 3%, respectively) and rural clinic patients (4% and 1%, respectively). Emergency department patients were also more willing to pay for a HIV rapid test (44%, P<0.01), doing a rapid self-test at home (84%,P=0.01), preferring pharmacies as a place for providing rapid tests (80%, P=0.001). Also level of participants’ awareness was considerably different between mentioned centres (median=11, 12, 10 for emergency department, VCT and rural Health care centre respectively; P=0.012).Conclusions: Increasing knowledge about HIV rapid testing, its availability, and keeping costs low can expand the desire to use the test and ultimately prevent the spread of HIV through lack of knowing one’s serostatus and lack of treatment. Emergency departments in urban Iran may be an opportunity to test persons at high risk for HIV infection

Psychiatric disorders among people living with HIV/AIDS in IRAN: Prevalence, severity, service utilization and unmet mental health needs

Background: HIV and psychiatric disorders are closely correlated and are accompanied by some similar risk factors. Objective: The aim of this study was to assess psychiatric comorbidity and health service utilization for mental problems among people living with HIV/AIDS in Iran. Methods: A total of 250 cases were randomly selected from a large referral center for HIV treatment and care in Tehran, Iran. Psychiatric disorders in the past 12 months including mood, anxiety, and substance use disorders were assessed through face-to-face interview, using a validated Persian translation of the Composite International Diagnostic Interview (CIDI v2.1). Severity of psychiatric disorders, social support, socio-economic status, service utilization and HIV-related indicators were assessed. Results: Participants consisted of 147 men and 103 women. Psychiatric disorders were found in 50.2 (95 confidence interval: 43.8�56.6) of the participants. Major depressive disorder was the most prevalent diagnosis (32.1), followed by substance use disorders (17.1). In bivariate analysis, psychiatric disorders were significantly higher among male gender, single and unemployed individuals and those with lower social support. In multivariate regression analysis, only social support was independently associated with psychiatric disorders. Among those with a psychiatric diagnosis, 41.1 had used a health service for mental problems and 53 had received minimally adequate treatment. Conclusion: The findings of the study highlight the importance of mental health services in the treatment of people living with HIV/AIDS. © 2018 Elsevier Inc

Prevalence and Correlates of Hepatitis C Infection among Male Injection Drug Users in Detention, Tehran, Iran

For the benefit of planning for the future care and treatment of people infected with hepatitis C virus (HCV) and to help guide prevention and control programs, data are needed on HCV seroprevalence and associated risk factors. We conducted a cross-sectional sero-behavioral survey of injection drug users (IDU) detained for mandatory rehabilitation during a police sweep of Tehran, Iran, in early 2006. During the study period, a consecutive sample comprising 454 of 499 (91.0%) men arrested and determined to be IDU by urine test and physical examination consented to a face-to-face interview and blood collection for HCV antibody testing. Overall, HCV prevalence was 80.0% (95% confidence interval (CI) 76.2–83.6). Factors independently associated with HCV infection included history of incarceration (adjusted OR 4.35, 95% CI 1.88–10.08), age of first injection ≤25 years (OR 2.72, 95% CI 1.09–6.82), and history of tattooing (OR 2.33, 95% CI 1.05–5.17). HCV prevalence in this population of IDU upon intake to jail was extremely high and possibly approaching saturation. Findings support that incarceration is contributing to the increased spread of HCV infection in Iran and calls for urgent increased availability of HCV treatment, long-term preparation for the care of complications of chronic infection, and rapid scale-up of programs for the primary prevention of parenterally transmitted infections among drug users

Impact of SARS-CoV-2 Pandemic on Patients with Primary Immunodeficiency

Although it is estimated that COVID-19 life-threatening conditions may be diagnosed in less than 1:1000 infected individuals below the age of 50, but the real impact of this pandemic on pediatric patients with different types of primary immunodeficiency (PID) is not elucidated. The current prospective study on a national registry of PID patients showed that with only 1.23 folds higher incidence of infections, these patients present a 10-folds higher mortality rate compared to population mainly in patients with combined immunodeficiency and immune dysregulation. Therefore, further management modalities against COVID-19 should be considered to improve the survival rate in these two PID entities using hematopoietic stem cell transplantation and immunomodulatory agents. © 2020, The Author(s)

Structural Stability of Transparent Conducting Films Assembled from Length Purified Single-Wall Carbon Nanotubes

Single-wall carbon nanotube (SWCNT) films show significant promise for transparent electronics applications that demand mechanical flexibility, but durability remains an outstanding issue. In this work, thin membranes of length purified single-wall carbon nanotubes (SWCNTs) are uniaxially and isotropically compressed by depositing them on prestrained polymer substrates. Upon release of the strain, the topography, microstructure, and conductivity of the films are characterized using a combination of optical/fluorescence microscopy, light scattering, force microscopy, electron microscopy, and impedance spectroscopy. Above a critical surface mass density, films assembled from nanotubes of well-defined length exhibit a strongly nonlinear mechanical response. The measured strain dependence reveals a dramatic softening that occurs through an alignment of the SWCNTs normal to the direction of prestrain, which at small strains is also apparent as an anisotropic increase in sheet resistance along the same direction. At higher strains, the membrane conductivities increase due to a compression-induced restoration of conductive pathways. Our measurements reveal the fundamental mode of elasto-plastic deformation in these films and suggest how it might be suppressed