Seroprevalence of IgG and IgM anti-Toxoplasma antibodies in HIV/AIDS patients, northern Iran

ObjectiveTo determine the seroprevalence of anti-Toxoplasma gondii (T. gondii) IgG and IgM antibodies in HIV/AIDS patients and uninfected subjects.MethodsThis cross sectional survey was carried out on 78 healthy and 62 HIV⁺/AIDS individuals in northern Iran between September 2007 and October 2008. Five mL of blood samples were collected from each person in case and control groups. Determination of CD4+ counts was performed by flow cytometry. The serum separated from blood samples was evaluated by conventional ELISA technique to determine the presence of antibodies to T. gondii.ResultsForty eight out of 62 (77.4%) HIV/AIDS serum samples were found positive for anti-T. gondii IgG antibody, compared with 59 among 78 (75.6%) HIV negative samples from the same area (P > 0.05). Six out of 62 (9.7%) HIV+/AIDS patients showed anti-T. gondii IgM antibody in their serum samples, compared with 7 among 78 (9%) HIV negative samples (P > 0.05). The mean of CD4+ counts in HIV⁺/AIDS was (430.8±182.3) cells/μL and in control group was (871.0±243.3)% cells/μL (P<0.01). CD4+ estimation in 5 (11.1%) of HIV+/AIDS patients was <200 cells/μL (P < 0.0001).ConclusionsSeroprevalence of latent toxoplasmosis in HIV patients is high, therefore the prevention of toxoplasmic encephalitis, administration of primary prophylaxis with co-trimoxazole to all HIV⁺/AIDS patients are necessary.     

Anti-Chlamydophila immunoglobulin prevalence in sarcoidosis and usual interstitial pneumoniae.

Sarcoidosis and usual interstitial pneumoniae (UIP) are diseases of unknown aetiology affecting the lower respiratory tract. Although there are a number of studies investigating the causal role of these disorders, no micro-organism could be identified as the causal agent. The high incidence of Chlamydophila pneumoniae infections associated with lung injury encouraged the present investigations to screen patients with sarcoidosis and with UIP for their Chlamydophila-specific immune response. Thirty-nine patients with sarcoidosis, 26 patients with UIP and 34 controls were tested for the prevalence of Chlamydophila-specific antibodies in bronchoalveolar lavage fluids (BALF) and sera. Samples were tested for the presence of antibodies in a genus-specific test for Chlamydophila-lipopolysaccharide (LPS) and in a species-specific test for C. pneumoniae. This study revealed a significantly higher prevalence of Chlamydophila LPS-specific immunoglobulin (Ig)-G in the BALF of sarcoidosis patients (36.8%) compared to controls (8.8%) and patients with UIP (12.0%). Similar findings were observed in sera. The prevalence of C. pneumoniae-specific antibodies in BALF was significantly higher in sarcoidosis patients for IgG and IgA (IgG: 74.4%; IgA: 46.2%) and in UIP for IgG (IgG: 50.0%; IgA: 11.5%) compared to controls (IgG: 14.7%; IgA: 14.7%). The elevated prevalence of Chlamydophila-specific antibodies in sarcoidosis patients might implicate Chlamydophila as a causal agent. However, considering the high prevalence of Chlamydophila antibodies in the healthy population, the data presented might reflect Chlamydophila co-infections in pre-injured lungs seen in these patients.     

Enhanced jejunal production of antibodies to Klebsiella and other Enterobacteria in patients with ankylosing spondylitis and rheumatoid arthritis

OBJECTIVE—To measure gut immunity directly in jejunal fluid in patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA).
METHODS—Antibodies against three different Enterobacterias were measured in jejunal perfusion fluids (collected by a double balloon perfusion device) of 19 patients with AS, 14 patients with RA, and 22 healthy controls using enzyme linked immunosorbent assay.
RESULTS—The AS patients had significantly increased jejunal fluid concentrations of IgM, IgG, and IgA class antibodies against Klebsiella pneumoniae, and IgM and IgA class antibodies against Escherichia coli and Proteus mirabilis compared with healthy controls. When compared with the patients with RA, the AS patients had higher concentrations of IgA and IgG class antibodies only against K pneumoniae. The RA patients had higher IgM class antibody concentrations against all three studied Enterobacterias, when compared with the healthy controls, suggesting an enhanced mucosal immune response in these patients. A three month treatment with sulphasalazine did not decrease enterobacterial antibody concentrations in the 10 patients with AS.
CONCLUSION—There is strong direct evidence for an abnormal mucosal humoral immune response particularly to K pneumoniae in patients with AS.

     

Anti-cytomegalovirus antibodies and other atherosclerosis risk factors in patients with cardiovascular diseases

Objective To determine anti-cytomegalovirus (CMV) antibodies along with anti-Chlamydia pneumoniae (CP)antibodies in comparison with inflammatory markers and other risk factors of atherosclerosis in patients with selected cardiovascular diseases(CVD).Methods A total of 228 patients with coronary heart disease (CHD) and/or hypertension (HT), and those who underwent reconstructive vascular surgery (RVS) on carotids or abdominal aorta were tested for the presence of anti-CMV IgG and IgM antibodies as well as for anti-CP IgA antibodies, C-reactive protein (CRP),and interleukin-6 (IL-6). Other risk factors for atherosclerosis, namely age, gender,smoking, hypercholesterolemia, and diabetes mellitus were also analyzed. Results Anti-CMV IgG antibodies were found in 204 patients sera (89.5%),compared with 46 positive of 68 sera in the controls (67.6%), whereas anti-CMV IgM antibodies were detected in 4 of 54 sera of patients tested (7.4%), but not in the controls. The highest proportion of positive sera with not only anti-CMV IgG antibodies (95.6.7%),but also anti-CP IgA antibodies (78.3%), IL-6 (84.8%) and CRP (97.8%), was observed in patients with RVS. The results obtained corresponded to age, hypercholesterolemia, and diabetes. Conclusions The presence of anti-CMV antibodies together with antibodies to CP and markers of inflammation (CRP and IL-6) in our study was associated with CVD, primarily in elderly patients who underwent RVS.     

Evaluation of enzyme-linked immunosorbent assay for Chlamydophila pneumoniae-specific immunoglobulin M in acute respiratory tract infection

Background and objective:   The study evaluated a newly developed ELISA (Hitazyme Chlamydophila pneumoniae ) for detecting anti- C. pneumoniae -specific IgM antibody, by comparing the ELISA assay to a microimmunofluorescence (MIF) test and immunoblotting.
Methods:   One hundred patients with acute respiratory tract infections (58 children and 42 adults) were enrolled in the study. Paired sera were obtained from all subjects for serological testing of C. pneumoniae .
Results:   C. pneumoniae IgM positivity was observed in 36 (62.0%) children and 11 (26.1%) adults. However, MIF test or immunoblot revealed only four positive reactions in these patients. These four IgM-positive patients were also positive by ELISA. A significant increase in IgG and/or IgA antibody titres in paired sera was observed in three of the four patients. Of the remaining 96 patients, no significant increase in IgG or IgA antibody titre in the paired sera was observed. To confirm the positive reactivity of ELISA, positive sera were also analysed by recombinant enzyme immunoassay. Forty-three cases that were IgM-positive only by ELISA were all negative by recombinant enzyme immunoassay and the ELISA results were considered to be false-positives.
Conclusions:   These results indicate that a newly developed ELISA for detecting anti- C. pneumoniae -specific IgM antibody frequently generates false-positive findings in patients with acute respiratory tract infections, at the current cut-off level. Further studies are needed to determine an appropriate cut-off level and the possible causes of the false-positive results in the ELISA.     

<Emphasis Type="Italic">Chlamydia pneumoniae</Emphasis> Infection and Restenosis in Patients with Coronary Heart Disease

Background: The aim of this study was to establish whether Chlamydia pneumoniae is implicated in the development of restenosis in patients with coronary heart disease (CHD) after percutaneous transluminal coronary angioplasty (PTCA). Patients and Methods: 67 patients were selected for study after they underwent control angiography after PTCA. Sera were tested for anti-chlamydial antibodies with a genusspecific ELISA and a species-specific microimmunofluorescence test (MIFT). Oropharyngeal specimens were examined for the presence of antigen with a Chlamydia immunofluorescence test (IFT), C. pneumoniae IFT and semi-nested PCR. In addition, anamnestic findings were also included. To determine the general level of antibodies, an age- and sexmatched control group of 180 persons was also examined for Chlamydia and C. pneumoniae serology. Results: Coronary angiography revealed that 31 of the 67 patients had developed a restenosis. There was no significant correlation between serological and angiographic findings. However, the MIFT showed a higher positive rate, especially in IgA, in the restenosis group. C. pneumoniae was detected in the oropharynx by PCR and/or IFT in 20.8% and 16.0% of the cases in patients with and without a restenosis. PCR found more C. pneumoniae-positive cases in the restenosis patients than IFT. No association was found between the detection of Chlamydia antigen and serology. The women with restenosis were more frequently smokers (p = 0.012). Men with restenosis were significantly older (p = 0.015). C. pneumoniae serology based on the rELISA or the MIFT did not show any correlation with restenosis. Conclusion: No evidence was found to suggest that positive C. pneumoniae serology is a risk factor for the development of restenosis. However, whether the species-specific serological test, especially for IgA-antibodies, and the detection of C. pneumoniae in oropharyngeal specimens by PCR might be reliable diagnostic markers in these cases remains to be determined. Received: March 28, 2002 · Revision accepted: February 3, 2003 Rea Krausse (corresponding author)     

Acute Chlamydia pneumoniae infection with heat-shock-protein-60-related response in patients with acute coronary syndrome

Recent evidence has suggested an association between Chlamydia pneumoniae infection and coronary atherosclerosis. A significant association has also been detected between heat shock protein (HSP) 60 antibody and the severity of coronary atherosclerosis. The aim of this study was to define the relationship between instability of ischemic heart disease (IHD) and serum levels of HSP60 and C. pneumoniae antibodies. Blood samples for the measurement of serum antibody titers were obtained from 1131 patients with ischemic heart disease (65+/-9 years; male/female, 828/303) and 127 non-IHD controls with normal coronary arteries (64+/-9 years; male/female, 60/67) on the day of cardiac catheterization. The serum levels of anti-human HSP60 IgG antibody and anti-chlamydial IgM, but not IgG or IgA, antibody were significantly higher in ACS patients than in stable IHD patients or controls. These results suggest that acute C. pneumoniae infection with HSP60-related immunological responses may contribute to the pathophysiology of acute coronary syndromes.     

Anti-chlamydophila pneumoniae antibodies as associated factor for carotid atherosclerosis in patients with AIDS

Atherosclerosis is a multifactor disease. Lately, infectious factors such as C. pneumoniae have been found to be involved. To determine whether the infection by C. pneumoniae is a risk factor for atherosclerosis in patients with AIDS. Case-control study on 43 patients with AIDS under HAART (16 cases and 27 controls). To document atherosclerosis, a carotid and transcranial Doppler ultrasound was performed. Anti-C pneumoniae antibodies were searched using a microimmunofluorescence test for IgM and IgG levels. To study the associations with risk of atherosclerosis, Odds Ratios were calculated for each IgG anti-C. pneumoniae antibody titre. A titre of 1:64 significantly increased the risk of atherosclerosis. These results suggest that hypertriglyceridemia and C. pneumoniae infection coexistence significantly increases the risk of atherosclerosis. The inverse geometric average of the antibodies titre against C. pneumoniae in individuals with atheromatous plaque fell to 64, two titres above the controls. This difference turned out to be statistically significant. Exposure to C. pneumoniae with antibodies (IgG) should be considered in any HIV diagnosed patient as a risk factor for atherosclerosis, having found that the inverse geometric averages of antibodies titre are significantly different comparing cases and controls, especially in patients with dyslipidemia, hypertriglyceridemia or in patients whose treatments could cause these conditions. In patients with concomitant hypertriglyceridemia, the association increases up to three times. It is advisable that AIDS patients take a serological test to determine exposure to C. pneumoniae, and to assess treatment options.     

Prospective evaluation of Streptococcus pneumoniae serum antibodies in patients with primary immunodeficiency on regular intravenous immunoglobulin treatment

BackgroundThis is a prospective study that assessed pneumococcal antibody levels in PID patients under intravenous immunoglobulin (IVIG) treatment using different brands.MethodsTwenty-one patients receiving regular IVIG every 28 days were invited to participate: 12 with common variable immunodeficiency, six with X-linked agammaglobulinaemia and three with hyper-IgM syndrome.One blood sample was collected from each patient just prior to IVIG administration at a three-month time interval during one year. A questionnaire was filled in with patient's demographic data and history of infections during the study period. Streptococcus pneumoniae antibodies against six serotypes (1, 5, 6B, 9V, 14 and 19F) were assessed by ELISA both in patients’ serum (trough levels) and in IVIG samples.ResultsMedian total IgG trough serum levels were 7.91 g/L (range, 4.59–12.20). All patients had antibody levels above 0.35 μg/mL to the six serotypes on all four measurements. However, only 28.6% of patients had pneumococcal antibodies for the six analysed serotypes above 1.3 μg/mL on all four evaluations during the one-year period. No correlation was found between IgG trough levels and pneumococcal specific antibodies. Eighteen of the 21 patients (85.7%) had infections at some point during the 12-month follow-up, 62/64 (96.9%) clinically classified in respiratory tract infections, four of which were pneumonia.ConclusionsPneumococcal antibodies are present in a high range of concentrations in sera from PID patients and also in IVIG preparations. Even maintaining a recommended IgG trough level, these patients can be susceptible to these bacteria and that may contribute to recurrent respiratory infections.     

Chlamydia pneumoniae and Epstein-Barr antibodies are not associated with carotid thickness: the effect of hypertension

BackgroundTo examine the relationship between Chlamydia pneumoniae (C. pneumoniae) seropositivity and carotid intima-media thickness (IMT) in three selected groups: 1) hypertensives; 2) white coat hypertensives; and 3) normotensives. Epstein-Barr antibodies were also measured.MethodsThe 340 participants underwent 24-h ambulatory blood pressure (BP) monitoring, clinic BP measurements, ultrasound carotid measurements, and serologic analysis (microimmunofluorescence and ELISA).ResultsSignificant differences in IMT were found between the three groups, regarding both mean internal carotid artery (MICA) and mean common carotid artery (MCCA) (one-way ANOVA). In all three groups, no association was found between the carotid IMT and the C. pneumoniae or Epstein-Barr seropositivity.ConclusionsWhen the effect of BP is isolated, there is no association between C. pneumoniae antibody levels and carotid IMT.     

Spectrum of opportunistic and other parasites among HIV/AIDS patients attending a tertiary care hospital

ObjectiveTo determine the spectrum of opportunistic as well as non-opportunistic parasitic infections in HIV/AIDS patients.MethodsA total of 250 HIV sero-positive individuals are included in study. Among them, 76 clinical cases of diarrhea and 8 clinically suspected cases of toxoplasmosis were identified. Fresh stool samples were collected in a suitable container on three consecutive days and processed immediately for identification of oocysts of Cryptosporidium parvum, Isospora belli and Cyclospora. Blood sample was collected from suspected cases of toxoplasmosis and tested for antitoxoplasma immunoglobulin M antibodies using immunoComb Toxo IgM test. Estimation of CD4 counts was also done by flow cytometry from these patients.ResultsThe opportunistic parasites identified in total HIV sero-positive patients were Cryptosporidium spp. (20.8%) and Isospora belli (0.8%). While the non-opportunistic parasite identified were Entamoeba histolytica (4%), Giardia intestinalis (1.6%) and Hymenolepis nana (0.8%). Toxoplasmosis was identified in 2.4% HIV sero-positive patients.ConclusionsIncreasing prevalence of parasitic infections in HIV/AIDS patients suggests that simple steps such as drinking safe water, maintaining high level of environmental and personal hygiene and avoiding contact with contaminated soil are necessary to prevent the occurrence of these diseases in AIDS patients     

Assessment of hepatitis B virus and hepatitis C virus infections and associated risk factors in HIV infected patients at Debretabor hospital,South Gondar,Northwest Ethiopia

ObjectiveTo assess hepatitis B and hepatitis C virus infections and associated risk factors among HIV infected patients at Debretabor hospital.MethodsA cross-sectional study was conducted among HIV/AIDS patients attending Debretabor hospital from February to April, 2012. Venous blood samples were collected from study participants for HBsAg and anti HCV antibody tests. Bivariate and multivariate analyses were used to identify associated variables with HBsAg and anti HCV positivity. Variables having P<0.05 was taken as statistically significant association.ResultsFrom a total of 395 HIV infected patients included in this study, 234 (59.2%) were females and 161 (40.8%) males with mean (±SD) age of 36.31 (±9.91) years. The prevalence of HBsAg and anti HCV antibody was 6.1% and 1.3%, respectively. In multivariate analysis, multiple sexual partner (AOR=8.1, 95% CI=1.8–33.97) and history of opportunistic infections (AOR=3.17, 95% CI=1.3–7.7) were statistically associated with HBsAg positivity. History of blood transfusion (AOR=5.61, 95% CI= 1.03-36.59) was associated with presence of anti–HCV antibody.ConclusionsThe prevalence of HBsAg and anti HCV antibodies in HIV coinfected patients was intermediate. However, it is relevant for HIV infected patients since viral hepatitis co-infections in HIV patients can cause multiple complications. Therefore, routine HBV and HCV screening with reliable diagnostic markers need to be carried out for close monitoring and better management in HIV patients.     

Acute community-acquired bacterial pneumonia in Human Immunodeficiency Virus (HIV) infected and non-HIV-infected adult patients in Cameroon: Aetiology and outcome

Setting: Yaounde Central Hospital, Jamot Hospital, Yaounde, and CEBEC Hospital in Douala.Objective: To determine and compare the bacterial aetiology and outcome of acute community-acquired pneumonia in adult patients with and those without the Human Immunodeficiency Virus (HIV) infection.Design: We studied 110 consecutive adult patients admitted for pneumonia into three hospitals in Cameroon, from November 1991 to December 1992. Blood cultures, sputum microscopy and cultures as well as pneumococcal antigen detection in sera and sputum were performed. Serological analysis for HIV, Mycoplasma pneumoniae, Coxiella burnetti and Chlamydia pneumoniae was also done.Results: Twenty-eight (25.5%) of the 110 patients were HIV positive. Streptococcus pneumoniae was the most common single bacterial aetiology in the two groups. Bacteremia was observed in 12 (15.0%) of 80 patients on whom blood cultures were done and was significantly more common in HIV seropositive than seronegative patients. Mortality was the same in the two groups.Conclusion: There were no differences in aetiology and outcome between HIV seropositive and seronegative patients. However, bacteremia occurred more significantly in the HIV seropositive group.     

Increased prevalence of Chlamydophila pneumoniae but not Epstein-Barr antibodies in essential hypertensives

Conflicting data exist regarding the relationship between Chlamydophila pneunoniae (C. pneumoniae) and hypertension. In this study, both C. pneumoniae IgG and IgA titres and Epstein-Barr virus antibody levels were measured in 146 sustained hypertensives defined by 24 h ambulatory blood pressure monitoring (ABPM) and 54 normotensives. C. pneumoniae antibodies were measured by microimmunofluorescence test. IgG > or = 80 and IgA > or = 40 were defined as elevated antibody titres. Epstein-Barr antibodies were measured in order to investigate whether a possible association exists between hypertension and other, similarly widespread in the general population, intracellular microorganisms. All participants underwent casual blood pressure (BP) readings and 24 h ABPM. Subjects having mean 24 h systolic/diastolic ambulatory BP>125/80 mmHg, with or without antihypertensive medication were defined as hypertensives. Controls were free of any history or clinical evidence of hypertension, cardiovascular or pulmonary disease. Of the total participants, 77 hypertensives (52.7%) and 10 normotensives (18.5%) had IgA titres > or = 40 (crosstabs P < 0.000), whereas 76 hypertensives (52.1%) and 15 normotensives (27.8%) had IgG titres > or = 80, (crosstabs P < 0.002). No difference was found in Epstein-Barr antibodies, between hypertensives and normotensives. In conclusion, C. pneumoniae, but not Epstein-Barr, antibody levels were found significantly higher in sustained hypertensives, suggesting high frequency of chronic C. pneumoniae, infections in this specific group of patients.     

Where is Chlamydophila pneumoniae pneumonia?

BackgroundMolecular diagnostic methods have recently gained widespread use, and consequently, the importance of viral pathogens in community-acquired pneumonia (CAP) has undergone re-evaluation. Under these circumstances, the role of Chlamydophila pneumoniae as a pathogen that causes CAP also needs to be reviewed.MethodsWe reviewed articles that contained data on the frequency of identification of C. pneumoniae pneumonia as a causative pathogen for CAP. The articles were identified by performing a search in PubMed with the keywords “community-acquired pneumonia” and “pathogen”.ResultsSixty-three articles were identified. The reviewed articles demonstrated that the rates of identification of C. pneumoniae as the causative pathogen for CAP were significantly lower in assessments based on polymerase chain reaction (PCR) methods than in those based on serological methods. In some studies, it was possible to compare both serological and PCR methods directly using the same set of samples.ConclusionsThe use of PCR methods, including multiplex PCR assays, has revealed that C. pneumoniae may play a limited role as a pathogen for CAP.     

Serological cross-reaction among Bartonella henselae, Chlamydia pneumoniae and Coxiella burnetii by indirect fluorescence antibody method]

We studied the serological cross-reactions among Bartonella henselae, Chlamydia pneumoniae and Coxiella burnetii by indirect fluorescence antibody (IFA) method, using sera from 8 patients with cat scratch disease (CSD), 13 patients with C. pneumoniae infection and 12 patients with acute Q fever. B. henselae IgG antibody was negative in 13 patients with C. pneumoniae infection, and was positive in 3 (titers being 1:64) of 12 patients with Q fever, whereas B. henselae IgM antibody was negative in all the patients with C. pneumoniae infection or Q fever. C. burnetii IgG antibody was removed by absorption of these 3 sera with C. burnetii antigens, whereas B. henselae IgG antibody did not change. C. pneumoniae IgG antibody was positive in 3 (titers being 1:125 in two, 1:32 in one) of 8 patients with CSD. Both C. pneumoniae and B. henselae IgG antibody titers were significantly reduced by absorption of these 3 sera with B. henselae antigens. C. burnetii IgG or IgM antibodies were negative in all patients with CSD. In conclusion, no serological cross-reaction between B. henselae and C. burnetii was observed. On the other hand. B. henselae IgG antibody cross-reacted to C. pneumoniae antigens, whereas C. pneumoniae IgG antibody did not cross-react to B. henselae antigens. Our findings suggest that determination of B. henselae IgG or IgM antibodies were not influenced by C. pneumoniae and C. burnetii antigens.     

Isotypes and IgG Subclasses of Anti-Fab Antibodies in Human Immunodeficiency Virus-Infected Hemophilia Patients

We reported recently that anti-Fab autoantibodies of the IgG isotype are associated with the decrease of helper/inducer (CD4+) lymphocytes in human immunodeficiency virus-infected (HIV+) hemophilia patients with acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC). In the present study we investigated the subclass distribution of IgG-anti-Fab autoantibodies, and whether anti-Fab antibodies of the IgA and IgM isotypes also are associated with the development of AIDS. Sera of HIV+ patients with AIDS had significantly higher IgA-anti-Fab activity than HIV+ patients with ARC (p<0.02), HIV+ patients without AIDS/ARC (p<0.0001), HIV-negative (HIV-) patients (p<0.001), or healthy controls (p<0.0001). An inverse association was found between IgA-anti-Fab activity and CD4+ cell counts (r = -0.396, p<10^-6). In contrast, no association of CD4+ cell counts was observed with IgM-anti-Fab. However, IgM-anti-Fab was significantly increased in patients with thrombocytopenia. We found a significant association between IgA-anti-Fab activity and serum neopterin concentrations (r = 0.310, p<10^-5). IgG-anti-Fab activity was detected mainly in the IgG3 fraction, although in HIV+ patients with AIDS/ARC various IgG subclasses were present. Affinity-purified anti-Fab antibodies isolated from sera of AIDS patients bound to rgp120-preincubated CD4+ cells of a healthy individual, supporting our hypothesis that anti-Fab antibodies and free circulating gp120 molecules are involved in the elimination of uninfected CD4+ cells. Removal of anti-Fab autoantibodies from the circulation by immune adsorbance might be a useful approach in the treatment of AIDS.     

A STUDY OF ANTIPOLYNUCLEOTIDE ANTIBODIES, ANTI-KLEBSIELLA (K30) ANTIBODIES AND ANTI-DNA ANTIBODY IDIOTYPES IN ANKYLOSING SPONDYLITIS

Recent studies have indicated that both ankylosing spondylitisand the anti-DNA antibodies found in systemic lupus erythematosusmay be related to Klebsiella surface antigens. In order to explorethese possible relationships further, the sera of 24 patientswith ankylosing spondylitis (AS), and 20 controls, have beenexamined for binding to a wide range of antipolynucleotide antibodies,antibodies binding to the Klebsiella pneumoniae polysaccharideK30 and two DNA antibody idiotypes designated 16/6 and 134.We report that although 21% of the AS patients had IgG ssDNAantibodies it is evident that the aetiopathogenesis of thisdisease is not through the mechanism of autoantibodies or thecommon DNA antibody idiotypes tested. KEY WORDS: Ankylosing spondylitis, DNA antibody idiotype, Klebsiella antibody     

Opportunistic and other intestinal parasites among HIV/AIDS patients attending Gambi higher clinic in Bahir Dar city, North West Ethiopia

ObjectiveTo determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among HIV/AIDS patients in Bahir Dar.MethodsCross-sectional study was conducted among HIV/AIDS patients attending Gambi higher clinic from April1-May 30, 2009. Convenient sampling technique was employed to identify the study subjects and hence a total of 248 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration and modified Ziehl-Neelsen staining technique.ResultsOut of 248 enrolled in the study, 171(69.0%) (90 males and 81 females) were infected with one or more intestinal parasites. The highest rate of intestinal parasites were observed among HIV/AIDS patients (80.3%, 151/188), and the infection rate of HIV negative individuals was 33.3% (20/60). Cryptosporidum parvum (43.6%), Isospora belli (15.5%) and Blastocystis hominis (10.5%) were opportunistic parasites that were found only in HIV/AIDS patients.ConclusionsOpportunistic parasite infections are common health problem among HIV/AIDS patients in the study area. Therefore, early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients.     

The Humoral Immune Response in Melioidosis Patients during Therapy

Background: This study was undertaken to identify and quantify the class and subclass antibody responses to the culture filtrate antigen (CFA) of Burkholderia pseudomallei in melioidosis patients under long-term maintenance or eradication therapy. Materials and Methods: Sequential sera samples from seven melioidosis patients collected between January 1992 and April 1998 were analyzed for immunoglobulin (Ig) types and IgG isotypes by ELISA using B. pseudomallei CFA. Results: Melioidosis patients generated a strong IgG, IgA and IgM response to the CFA of B. pseudomallei throughout the infection and IgG1 and IgG2 were the predominant IgG istotypes produced. Although high levels of these antibodies were detected in all the seven patients, the IgG, IgG1 and IgG2 antibodies showed a consistent response and good correlation with the clinical history in all cases. Conclusion: This study suggests that monitoring IgG antibody or IgG1 or IgG2 isotype antibody levels to CFA in patients under maintenance or eradication antibiotic therapy may be useful as a tool to detect the status of infection and as a guideline to determine the duration of maintenance antimicrobial therapy. Received: February 4, 2002 · Revision accepted: October 6, 2002 C. Vasu (corresponding author)