Seroprevalence of human T-cell lymphotropic virus type 1 infection (HTLV1) in different patients in the north of Iran

Human T-cell lymphotropic virus type-1 (HTLV1) is a lymphotropic virus which can contribute to carcinogenesis in adult T-cell leukemia, myleopathy and other disorders. 20 million people are affected by this virus in the world. The aim of this study was to determine the incidence of human T-cell lymph tropic virus type 1 infection in patients referred to Emam’s hospital laboratory in Sari. A cross-sectional study was done in 2009 to 2010 based on the different patients that were referred to Emam`s hospital laboratory in Sari. Our samples were selected by simple random selection, after venous blood sample was centrifuged and reserved in -70°C. All the samples were tested by enzyme-linked immuno sorbent assay (ELISA). An ELISA positive result was checked by Western blot (WB) assays. Out of 1200 cases, 776 were female (65%) with ages between 1 and 76 years old. Most of the cases were Mazandaranian (99%); although only one person was recorded as HTLV1 positive (0.08%). He was a 41 years old man, living in Sari, with high school education. He was married (one wife) without any risk factor in past medical history, such as surgery, transfusion and abuse of injection, but he had HBV infection. Most of the females were housewives and most of the males were non-governmental employees; moreover, diabetes was more common among them. The results of the samples show that 122 women were pregnant, 92 cases had transfusion and 642 cases had different surgery. It was observed that the incidence of HTLV1 infection was very rare in the north of Iran (Sari); therefore, the routine HTLV1 screening was not recommended.Key words: Seroprevalence, human T-cell lymphotropic virus type-1 (HTLV1), patients, Iran

Consensus Middle East and North Africa Registry on Inborn Errors of Immunity

Background: Inborn errors of immunity (IEIs) are a heterogeneous group of genetic defects of immunity, which cause high rates of morbidity and mortality mainly among children due to infectious and non-infectious complications. The IEI burden has been critically underestimated in countries from middle- and low-income regions and the majority of patients with IEI in these regions lack a molecular diagnosis. Methods: We analyzed the clinical, immunologic, and genetic data of IEI patients from 22 countries in the Middle East and North Africa (MENA) region. The data was collected from national registries and diverse databases such as the Asian Pacific Society for Immunodeficiencies (APSID) registry, African Society for Immunodeficiencies (ASID) registry, Jeffrey Modell Foundation (JMF) registry, J Project centers, and International Consortium on Immune Deficiency (ICID) centers. Results: We identified 17,120 patients with IEI, among which females represented 39.4%. Parental consanguinity was present in 60.5% of cases and 27.3% of the patients were from families with a confirmed previous family history of IEI. The median age of patients at the onset of disease was 36 months and the median delay in diagnosis was 41 months. The rate of registered IEI patients ranges between 0.02 and 7.58 per 100,000 population, and the lowest rates were in countries with the highest rates of disability-adjusted life years (DALY) and death rates for children. Predominantly antibody deficiencies were the most frequent IEI entities diagnosed in 41.2% of the cohort. Among 5871 patients genetically evaluated, the diagnostic yield was 83% with the majority (65.2%) having autosomal recessive defects. The mortality rate was the highest in patients with non-syndromic combined immunodeficiency (51.7%, median age: 3.5 years) and particularly in patients with mutations in specific genes associated with this phenotype (RFXANK, RAG1, and IL2RG). Conclusions: This comprehensive registry highlights the importance of a detailed investigation of IEI patients in the MENA region. The high yield of genetic diagnosis of IEI in this region has important implications for prevention, prognosis, treatment, and resource allocation

Oral Immunotherapy in Patients with IgE Mediated Reactions to Egg White: A Clinical Trial Study

Background: Oral immunotherapy (OIT) is under consideration as a promising treatment for desensitization of egg-allergic patients. The objective of this study was to assess the effectiveness of egg-white OIT in patients with IgE-mediated allergy to egg white and to compare the clinical and laboratory findings before and after OIT. Methods: This clinical trial was performed from February to August 2018 in Rasool e Akram Hospital, Tehran, Iran. Patients� selection criteria included a history of allergic symptoms, skin prick test (SPT) reactivity to egg white, and the inability to pass the Oral Food Challenge (OFC). Egg-white OIT was done for eight patients in the OIT group for 6 months while egg-white-free products were administrated for controls. The SPT reactivity, specific IgE, and IgG4 for egg white and ovomucoid were evaluated before and after OIT. Results: Hundred percent of the subjects in OIT group were desensitized and tolerated 40 cc raw egg white following 6-month maintenance whereas none of the controls was able to pass the OFC. The findings obtained from the evaluations indicated a significant decrease in the wheal size and specific IgE to egg white after OIT (P = .001). Furthermore, a significant decrease of IgE/IgG4 ratio to egg white was found in OIT group (P = .01). Conclusion: This OIT protocol was successful as all OIT patients were able to continue 6-month OIT process and the reaction threshold to egg white increased in the OIT group. Therefore, it could be regarded as an effective and safe protocol to treat egg-allergic patients. © 2020 Taylor & Francis Group, LLC