Intense intrafamilial transmission of HBV in a rural area in Egypt is a probable cause of non-response to vaccination: A cross-sectional-seroprevalence-community-study.

Background: Worldwide, the prevalence of hepatitis B virus (HBV) infection is decreasing particularly in the vaccinated population. However, there are foci of increased transmission particularly in localized communities and within families. Objective: This study aimed at identifying HBV infection status among family members (FMs) of a cohort of HBsAg positive index cases (ICs) living in a village near Ismailia City, North-East Egypt. Design and participants: The study targeted ICs with chronic hepatitis B and their FMs. All were inquired for socio-demographic data, previous vaccination, kinship, and risk factors. All were tested for hepatitis markers and in HBcAb positive sera, HBV DNA and ALT were added. Results: The study included 96 participants including 14 ICs, 51 (53.1%) were females and 73 (76%) self-reported receiving hepatitis B vaccine after birth. Among 82 FMs, HBcAb was found in 49 (59.76%) of whom overt and occult HBV were diagnosed in 24 (49%) and 18 (36.7%). HBs Ag and HBcAb were more frequent in unvaccinated compared to vaccinated FMs; being 60.9% vs. 32.9% for HBsAg (p < /em>=0.017) and 91.3% vs. 57.5% for HBcAb (p < /em>=0.003). Among the FMs, active HBV were more related to male than female ICs (54.9% vs. 45.2%, p < /em>=0.73) while among children, it is more related to females more than male ICs (38.9% vs. 25%, p < /em>=0.33). In all HBsAg positive participants, HBeAg was negative and HBV DNA load was higher among female than male ICs (median 3500 vs. 2594.5 IU/mL, p < /em>=0.82). Conclusion: The study shows a high rate of HBV transmission among FMs of HBsAg carriers living in a remote area in North-East Egypt. Both overt and occult HBV infections were frequent despite previous vaccinatio

Molecular insights into human transmembrane protease serine-2 (TMPS2) inhibitors against SARS-CoV2: homology modelling, molecular dynamics, and docking studies

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), which caused novel corona virus disease-2019 (COVID-19) pandemic, necessitated a global demand for studies related to genes and enzymes of SARS-CoV2. SARS-CoV2 infection depends on the host cell Angiotensin-Converting Enzyme-2 (ACE2) and Transmembrane Serine Protease-2 (TMPRSS2), where the virus uses ACE2 for entry and TMPRSS2 for S protein priming. The TMPRSS2 gene encodes a Transmembrane Protease Serine-2 protein (TMPS2) that belongs to the serine protease family. There is no crystal structure available for TMPS2, therefore, a homology model was required to establish a putative 3D structure for the enzyme. A homology model was constructed using SWISS-MODEL and evaluations were performed through Ramachandran plots, Verify 3D and Protein Statistical Analysis (ProSA). Molecular dynamics simulations were employed to investigate the stability of the constructed model. Docking of TMPS2 inhibitors, camostat, nafamostat, gabexate, and sivelestat, using Molecular Operating Environment (MOE) software, into the constructed model was performed and the protein-ligand complexes were subjected to MD simulations and computational binding affinity calculations. These in silico studies determined the tertiary structure of TMPS2 amino acid sequence and predicted how ligands bind to the model, which is important for drug development for the prevention and treatment of COVID-19

Impact of the IL-18 gene polymorphism in response to antiviral therapy in chronic HCV genotype 4 patients

^a Introduction Interleukin (IL)-18 is a well-known major proinflammatory cytokine with broad biological effects. The major immunomodulatory functions of IL-18 include enhancing T cell and natural killer cell cytotoxicity. Serum levels of this cytokine were shown to increase in chronic hepatitis C patients compared to non-infected healthy people. An association between IL-18 gene promoter polymorphisms and pegylated interferon (PEG-IFN) and ribavirin treatment outcomes has been reported for individuals with chronic hepatitis C virus genotype 1 (HCV-1). In this study, HCV genotype 4 (HCV-4) patients were assessed for IL-18 gene polymorphisms and treatment outcomes or severity of liver disease because data concerning the impact of IL-18 gene polymorphisms on patients with HCV-4 infections are limited. Methods This study included 123 chronic HCV-4 Egyptian patients and 123 apparently healthy volunteer blood donors who served as a control group. HCV genotyping was performed using the line probe assay. IL-18 genotyping was performed using the TaqMan Real-Time PCR method in all 246 patient and control samples. Results In our study, all patients had HCV-4. IL-18 gene single nucleotide polymorphism (SNP) (-607C/A) genotype distributions and allele frequencies did not differ between HCV patients and normal healthy subjects or between patient groups when compared according to the therapeutic response. Moreover, the presence of an IL-18 SNP was not associated with histological disease severity. We conclude that the presence of the IL-18 SNP rs1946518 does not affect the outcome of chronic HCV-4 treatment in Egyptian patients. Conclusions The IL-18 SNP rs1946518 does not affect response to treatment in chronic HCV-4 patients

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

INTRODUCTION: Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. METHODS: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. RESULTS: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed significant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. CONCLUSIONS: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods

Occult HBV infection status among chronic hepatitis C and hemodialysis patients in Northeastern Egypt: regional and national overview

INTRODUCTION: Occult hepatitis B infection (OBI) is considered to be one of the major risks for patients suffering from end-stage renal disease (ESRD) on regular hemodialysis (HD) and patients with chronic hepatitis C virus (HCV) infection. This study compared the prevalence of OBI among these two high-risk groups in the Suez Canal region, Northeastern Egypt, to obtain a better national overview of the magnitude of OBI in this region. METHODS: Serum samples were collected from 165 HD patients and 210 chronic HCV-infected patients. Anti-HCV antibody, hepatitis B surface antigen (HBsAg), total hepatitis B core (anti-HBc) antibody, and hepatitis B surface antibody (anti-HBs) were detected by enzyme-linked immunosorbent assay (ELISA). HCV RNA was detected using a quantitative real-time RT-PCR assay, and HBV was detected using a nested PCR. RESULTS: All patients were negative for HBsAg. A total of 49.1% and 25.2% of the patients in the HD and HCV groups, respectively, were anti-HBc-positive. In addition, more anti-HBs-positive patients were detected in the HD group compared to the HCV group (52.1% and 11.4%, respectively). Three cases were positive for HBV DNA in the HD group, while eighteen positive cases were detected in the HCV group. Both study groups showed significant differences in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level as well as anti-HBc, anti-HBs and HBV-DNA positivity. CONCLUSIONS: OBI was more prevalent among chronic HCV patients than HD patients in the Suez Canal region, Egypt, with rates of 8.5% and 1.8%, respectively. However, more precise assessment of this infection requires regular patient follow-up using HBV DNA detection methods

Study of some T regulatory cell subsets in patients with multi-drug resistant pulmonary tuberculosis

Background: Regulatory T-cells are CD4+ cells involved in the regulation of suppression of immune response during infection. Many studies revealed that the number of these cells, increase in patients with active pulmonary TB (PTB. Few studies addressed this problem in MDR-PTB. Objective: This work aimed at studying some T reg – cell subsets in patients with MDR-PTB, compared to those with active pulmonary TB who responded to treatment as well as to healthy control subjects. Methods: Three groups were included in the study (20, in each group), group of healthy control and 2 groups as patients’ groups (patients with MDR-PTB and patients’ with PTB responding to treatment). Routine blood work and CXR were done for all subjects in addition to microbiological evaluation of sputum in patients’ groups. T reg – cell subsets in peripheral blood were studied by flow cytometry, using monoclonal antibodies against the following markers, CD4, CD25 and FoxP3 for identification. Results: Patients’ groups, had higher frequency of T reg cell subsets, CD4+ CD25+ FoxP3+ than the group of healthy subject, (P  0.05), but highly significant statistical difference for the percentage of total CD4+ (P < 0.01). Patients’ with more radiologically extensive disease, had higher level of these cells than, in other patients (P < 0.05), with significant positive correlation. Conclusion: Although immune suppression characteristic of T reg – cells seems important in the pathogenesis of MDR-PTB, other mechanisms, immunologic, on non-immunologic are important as well

Stress, anxiety and depression among healthcare workers facing COVID-19 pandemic in Egypt: a cross-sectional online-based study

Objective This study assessed perceived stress, anxiety and depression among healthcare workers facing the COVID-19 pandemic in Egypt.Setting This was an online study where a Google form was prepared including sociodemographic and occupational data as well as three validated questionnaires to assess perceived stress, anxiety and depression, respectively. The form was distributed online to all social media groups including healthcare workers all across the country, and responses were collected until the sample size of 262.Participants Healthcare workers (physicians, dentists, pharmacists, physiotherapists, nurses, technicians and administrators) working in governmental or educational hospitals from all Egyptian governorates who are members of social media groups. The mean age of participants was 33.4±5.9 years, 70% were women, about 70% were married and 66% were physicians.Outcomes The frequency of perceived stress, anxiety and depression observed among the study participants according to the results of their questionnaires. Then the frequencies were compared between different sociodemographic characteristics.Results Only 1.3% showed low perceived stress while 98.5% showed moderate to severe stress. About 9.5% did not experience generalised anxiety, while the remaining 90.5% had different degrees of anxiety as mild anxiety showed the highest per cent affecting about 40% of participants followed by moderate anxiety about 32% then severe anxiety, 18.5%. With regard to depression, 94% of participants showed mild to severe depression.Conclusion This study showed a high prevalence of perceived stress, anxiety and depression among healthcare workers during the COVID-19 pandemic that affected all workers regardless of different sociodemographic characteristics

Efflux MexAB-Mediated Resistance in P. aeruginosa Isolated from Patients with Healthcare Associated Infections

Today, one of the most important challenges for physicians is the adequate treatment of infections due to multidrug resistant organism (MDR). Pseudomonas aeruginosa is considered an opportunistic organism causing different types of healthcare associated infections (HAIs). We aimed to investigate the MDR and pandrug resistance (PDR) rate in P. aeruginosa in our region and detect efflux-pump mexAB genes and the proposed binding interactions of five different categories of antimicrobial agents with the mexB pump. A total of 180 non-duplicated P. aeruginosa strains were isolated from patients with HAIs in the Suez Canal University Hospital. Phenotypically, minimum inhibitory concentration (MIC) was done for all MDR and PDR strains before and after addition of efflux pump inhibitor carbonyl cyanide m-chlorophenyl hydrazone (CCCP). Molecular detection of mexA and mexB genes was done by using polymerase chain reaction (PCR). Most of the isolated strains (126 strains) were MDR (70%); only 10 samples (5.5%) were PDR. MexA and mexB genes were detected in 88.2% (120 strains) and 70.5% (96 strains) of stains, respectively. All PDR strains (10 stains) carried both mexA and mexB genes. Efflux mexAB genes were detected in all MDR and PDR strains (136 strains). Molecular modeling studies were performed to investigate the modes of intermolecular binding interactions between the antimicrobial agents and mexB key amino acids that resulted in MDR and PDR. The current study reported high prevalence of MDR and PDR P. aeruginosa in patients with HAIs in the Suez Canal University Hospitals