Hepatitis E Virus Seroprevalence Among Blood Donors in Bushehr,South of Iran

Background:

Although so far several studies have determined the hepatitis E virus (HEV) prevalence in some parts of Iran, no data exists regarding the HEV seroprevalence in Bushehr province as the southernmost point in Iran yet.

Objectives:

The aim of this study was to evaluate the seroprevalence of anti-HEV IgG among the blood donors in Bushehr.

Patients and Methods:

A total of 628 blood donor samples were collected from September to October 2013, after obtaining informed written consents, and analyzed for the presence of anti-HEV IgG using commercial HEV enzyme-linked immunosorbent assay (ELISA) kit. All the samples were tested by two ELISA kits and evaluated for liver function test.

Results:

Overall, 105 (16.7%) blood samples were positive for HEV-specific-IgG antibodies, while 523 (83.8%) were negative. The presence of anti-HEV IgG was not associated with gender; however, it was correlated with age. It was indicated that the anti-HEV prevalence increases by age and there was a significant difference between the age groups regarding HEV seropositivity.

Conclusions:

High HEV seroprevalence (16.7%) was observed among the blood donors in Bushehr province. It appears that exposure to HEV increases with age; although, more people should be examined.     

Seroprevalence of Hepatitis E Among Hemodialysis Patients: A Report From Hamadan,Iran

Background:

Previous studies have documented a high prevalence of hepatitis E among patients undergoing maintenance hemodialysis. Available studies reporting on the seroprevalence of hepatitis E in hemodialysis patients in Iran, an endemic region for the disease, are sparse.

Objectives:

The present study aimed to determine the prevalence rate of anti-hepatitis E antibody in hemodialysis patients in Hamadan, Iran.

Patients and Methods:

In this cross-sectional study, all 153 consecutive patients undergoing hemodialysis in two centers were enrolled. Patients’ demographic and clinical data were collected, using a standard questionnaire and from medical records. Serum immunoglobulin G concentrations against hepatitis E were determined using the enzyme linked immunosorbent assay method.

Results:

Thirty patients (19.2%), were seropositive. Seropositive patients were not significantly different from seronegative patients, with regard to age, sex, level of education, access to filtered water, and duration and frequency of hemodialysis. The proportions of patients with hepatitis B, C, and HIV infection were comparable between the two groups.

Conclusions:

One in five patients undergoing maintenance dialysis in Hamadan is seropositive for hepatitis E immunoglobulin G antibody. Future studies are needed to investigate the factors contributing to the observed high prevalence rate and the possibility of parenteral transmission of hepatitis E.     

改用血清原液检测抗-HBc的探索

以ELISA法检测抗,-HBc,且以血清原液(改良法)代替血清的1∶100倍X~2稀释液(常规法)。其结果,抗-HBc的阳性率从94.34％(2200/2332)增至98.94％(839/848),X~2=31.04,P<0.01.检测中未发现假阳性反应增加。与常规法相比,改良法提高了抗-HBc检测的灵敏度与特异度,是对ELISA药盒制备与检测技术的发展。     

Hepatitis B and C among women with illegal social behavior in Isfahan, Iran: Seroprevalence and associated factors

Background

In Iran, there is limited evidence on the prevalence of hepatitis B and C viruses (HBV and HCV) among females who engage in illegal sexual behavior.

Objectives

To determine the prevalence of HBV and HCV infections and their associated factors in this population in Isfahan-Iran.

Patients and Methods

In this cross-sectional study, 100 females who engaged in illegal sexual behavior during 2009-2010 in Isfahan were recruited from welfare to the DIC for women, and referrals were made among those who knew others who engaged in prostitution. Markers for HBV and HCV-Ab were measured by ELISA, and recombinant immunoblot assay was used for confirmation of HCV infection. Also, a questionnaire on demographics and prostitution-associated risk data in a face-to-face interview was completed for each participant. Chi-square and multivariate logistic regression models were used for data analysis.

Results

Of the 100 samples collected, 91 were sufficient for testing. The mean age and time spent in sex work were 30.84 ± 9.34 years and 36 ± 28.5 months, respectively. HBsAg was detected in 1 (1.1%), anti-HBc in 4 (4.4%), anti-HBs in 60 (65.9%), and HCV Ab in 9 (9.9%) subjects. The evidence of vaccination was seen in 54 subjects (59.3%). There were no significant differences in the prevalence of HBV or HCV infection by estimated risk factors, and there was no independent risk factor for these infections.

Conclusions

The high prevalence of HCV infection in this study indicates the need to implement preventive interventions for female sex workers and, perhaps more importantly, to involve their male clients.     

Seroprevalence of Hepatitis Viruses B, C, D and HIV Infection Among Hemodialysis Patients in Kerman Province, South-East Iran

Background

The prevalence of hepatitis viruses in hemodialysis patients has been reported to be much greater than in the general population. Attention to local data, effectively guides health planners so that they can control infections and prevent nosocomial transmissions.

Objectives

This cross sectional study was carried out to determine the prevalence of hepatitis B (HBV), hepatitis C (HCV), and hepatitis D (HDV) viruses, as well as the human immunodeficiency virus (HIV) in dialysis centers in the Kerman Province, in the southeast of Iran.

Patients and Methods

All hemodialysis patients (n = 228) in 7 centers were enrolled in the study. Hepatitis B surface antigens (HBsAg), HCV antibodies (Ab), HDV Ab and HIV Ab were measured using specific enzyme linked immunoassay kits (ULTRA kit, bioMérieux, France) and confirmed by a qualitative PCR assay.

Results

The studied group was comprised of 92 (40.4%) females and 136 (59.6%) males. The mean age of the patients was 51 ± 9.5 years and the duration of hemodialysis was 39.7 ± 7.9 months. Positive HBsAg was found in 7% of cases, HCV Ab in 7%, and patients with both viruses were detected in 1.7% cases. HIV Ab and HDV Ab were negative in all cases. Out of the other risk factors, frequency of blood transfusions was significantly correlated with positive HCV Ab (P < 0.008).

Conclusions

Prevalence of HBV and HCV in hemodialysis patients was moderate to low in the Kerman Province, as in other parts of the country. Strict adherence to protective measures could lead to even lower rates.     

Anticardiolipin antibodies in patients with rheumatoid arthritis

Summary Anticardiolipin antibodies (ACA) were assayed by ELISA in 73 patients with rheumatoid arthritis. Twelve (16.48%) patients showed levels of ACA three standard deviations above the value of the control group and were considered positive; these patients were compared to the group with ACA within the normal levels regarding the following clinical and laboratorial characteristics: spontaneous abortions, central nervous system involvement, systematization and activity of disease, alterations in platelet counts, presence of antinuclear antibodies and rheumatoid factor. Significant statistical association could be demonstrated between systematization and presence of antinuclear antibodies (ANA) and positiveness to ACA (IgG, IgM or both). These findings might indicate that ACA in patients with RA could have relevance to morbidity of disease or perhaps to its pathogenesis.     

Prevalence of anti-endothelial cell antibodies in patients with autoimmune diseases

Summary The prevalence of anti-endothelial cell antibodies (AECA) of IgA, IgG and IgM classes was studied by means of enzyme-linked immunosorbent assays (ELISA) in 466 patients with autoimmune/inflammatory disorders. The reference limits in the ELISAs for the AECA were determined from a random population sample of 249 subjects. The frequency of AECA was highest in patients with SLE (n=42), 14.6% mainly of IgG class, and the presence of AECA correlated with disease activity in these patients. In the RA patient group (n=200), 9.5% had AECA, mostly of IgA type. We found no association between the presence of AECA and extra-articular manifestations of RA or survival rate. In patients with undefined connective tissue disease (n=57), ankylosing spondylitis (n=109), and psoriatic arthritis (n=58), the frequency of AECA corresponded to that of the random population sample. In a cohort of samples sent to the laboratory for determination of anti-nuclear antibodies (ANA) there was a correlation between the presence of ANA and AECA. Our findings indicate that RA patients are characterized by IgA class AECA, whereas SLE patients have IgG class AECA also correlating to disease activity.     

各型病毒性肝炎患者庚型肝炎病毒感染状况

目的:了解武汉地区各型病毒性肝炎患者中庚型肝炎病毒(HGV)感染的情况。方法:用酶联免疫吸附试验(ELISA)及逆转录聚合酶链反应(RT-PCR)方法测定各型病毒性肝炎患者的抗HGV和HGV RNA,并对庚肝病毒感染者进行临床分析。结果:351例各型病毒性肝炎患者中抗HGV阳性者56例,占15.05％;此56例中HGV RNA阳性者21例,占37.50％。各型病毒性肝炎患者中抗HGV阳性率及庚肝抗体阳性者中HGV RNA阳性率分别为:甲肝14.29％(5/35)及20.00％(1/5);乙肝17.29％(37/214)及35.14％(13/37);丙肝14.52％(9/62)及55.56％(5/9);戊肝4.00％(1/25),0.00％(0/1);非甲～戊肝26.67％(4/15),50.00％(2/4)。56例抗HGV阳性者中43例有输血、使用血制品或静脉药癌史,占76.79％。HGV感染在肝炎各临床类型分布为急性、慢性和重型肝炎患者无明显差异,且无性别和年龄分布的差异。HBV重叠感染HGV患者的SALT及TBil水平明显高于单纯HBV感染者(P<0.05),而HGV和其它肝炎病毒((HAV、HCV、HEV)重叠感染患者与单纯其它肝炎病毒感染者的SALT及TBiL水平无明显差异(P>0.05)。结论:武汉地区各型病毒性肝炎患者均可存在HGV感染。HGV可单独感染或与其它病毒混合感染。血液传播是HGV感染的主要途径。乙型肝炎患者合并庚肝病毒重叠感染可加重病情,而甲、丙、戊型肝     

肠易激综合征患者外周血炎性细胞因子、表达失衡的分析

背景：肠易激综合征（IBS）的发病机制不明，炎性细胞因子表达失调可能在其中发挥一定作用。目的：研究IBS患者血浆炎性细胞因子白细胞介素（IL）-6、IL-18、IL-13的表达。方法：选取42例IBS患者和20名对照者，以酶联免疫吸附测定（ELISA）检测血浆IL-6、IL-18、IL-13水平。结果：与对照组相比，腹泻型IBS组血浆IL-6和IL-18水平、便秘型IBS组血浆IL-18水平显著升高（P均〈0．05）。腹泻型和便秘型IBS组血浆IL-13水平与对照组相比无显著差异。感染后IBS（pIBS）组血浆IL-6、IL-18水平较对照组显著升高（P〈0.05），pIBS组和非pIBS组血浆IL-13水平与对照组相比无显著差异。结论：IBS患者血浆促炎细胞因子水平升高，感染因素影响了腹泻型IBS血浆细胞因子的变化，促炎细胞因子可作为IBS的潜在生物学标记物。     

Hepatitis E vaccine

Hepatitis E is an emerging disease in resource-poor regions of the world. It is estimated that about 2 billion people live in areas endemic for this disease. The inability to reproducibly culture hepatitis E virus makes it impossible to develop traditional live or inactivated vaccines. However, significant progress has been made in developing and testing recombinant subunit vaccines based on the viral capsid protein. This review summarizes these efforts.     

定量PCR检测乙型肝炎患者血清HBV DNA及其临床意义

目的:了解不同临床类型乙型肝炎患者HBV DNA含量并探讨其临床意义。方法:应用荧光定量聚合酶链反应(FQ-PCR)技术检测163例乙型肝炎患者血清HBV DNA含量,应用ELISA法检测上述患者HBV感染血清免疫学标志物(HBV-M),并对两者进行比较。结果:血清HBV DNA水平在不同乙型肝炎临床类型中无显著性差异(P>0.05);与HBV-M对比,HBsAg、HBeAg、抗-HBc阳性病人的检出率为87.76％,HBsAg、抗-HBe、抗HBc病人的检出率为45.71％,HBsAg、抗-HBc病人的检出率为42.86％,抗-HBc单项阳性病人的检出率亦达40.00％;血清HBVDNA含量与黄疸的程度及转氨酶水平的高低未见相关。结论:提示HBV DNA的复制状态与不同乙型肝炎临床类型无明显相关关系;HBV DNA含量高低与肝功能受损程度亦无相关关系。     

胃癌患者血管内皮生长因子-A的测定及其临床意义

背景:胃癌的生长和转移与新生血管的生成密切相关。血管内皮生长因子(VEGF)鄄A在肿瘤组织中大量表达,在肿瘤血管生成中发挥重要作用。目的:测定胃癌患者循环血液中VEGF鄄A的含量,并探讨其临床意义。方法:选取经内镜和病理检查证实的135例胃癌患者和48例胃良性疾病患者,采用酶联免疫吸附测定(ELISA)方法测定其血浆和血清VEGF鄄A含量。10例手术前胃癌患者和10例胃良性疾病患者于1周后、16例胃癌患者于术后3周再次测定血清VEGF鄄A含量。结果:135例胃癌患者的血浆和血清VEGF鄄A含量显著高于48例胃良性疾病患者(血浆:74.1pg/ml±96.0pg/ml对23.7pg/ml±16.9pg/ml,P<0.001;血清:342.1pg/ml±277.8pg/ml对80.0pg/ml±36.4pg/ml,P<0.0001)。10例手术前胃癌患者1周前后的血清VEGF鄄A含量分别为264.3pg/ml±148.2pg/ml和265.2pg/ml±142.9pg/ml,10例胃良性疾病患者分别为71.4pg/ml±16.2pg/ml和78.0pg/ml±14.3pg/ml,差异均无显著性(P>0.05)。16例胃癌患者术前和术后3周的血清VEGF鄄A含量分别为328.4pg/ml±141.7pg/ml和103.5pg/ml±52.2pg/ml,差异有显著性(P<0.0001)。结论:胃癌患者的血浆和血清VEGF鄄A含量显著增高,血清VEGF鄄A含量较稳定。胃癌切除术后血清VEGF鄄A含量显著降低。     

活动期溃疡性结肠炎患者血清vaspin水平及其临床意义

脂肪细胞因子与机体内能量稳定相关,并介导多种免疫应答和炎症反应。内脏脂肪特异性丝氨酸蛋白酶抑制剂vaspin是近年发现的一种与炎症反应有关的脂肪细胞因子。目的:检测活动期溃疡性结肠炎(UC)患者的血清vaspin水平并探讨其临床意义。方法:选取2008年1月~2013年4月苏州市立医院收治的150例活动期UC患者,以150名健康体检者作为正常对照组。采用ELISA法检测血清vaspin水平,并分析其与UC临床特征的相关性。结果:UC患者血清vaspin水平显著高于正常对照者[(1.86±0.38)μg/L对(0.96±0.43)μg/L,P0.01],并与血清CRP水平和疾病活动指数呈显著正相关(r=0.628,P0.01;r=0.514,P0.05),与血清ESR水平和病变部位无关(r=0.098,P0.05;r=0.124,P0.0)5)。结论:Vaspin可能在UC发生、发展的病理生理机制中发挥重要作用。     

Current Knowledge on Hepatitis E

Although only a single serotype of hepatitis E virus (HEV), the causative agent of hepatitis E, has been identified, there is great genetic variation among the different HEV isolates reported. There are at least four major recognized genotypes of HEV: genotypes 1 and 2 are mainly restricted to humans and linked to epidemic outbreaks in nonindustrialized countries, whereas genotypes 3 and 4 are zoonotic in both developing and industrialized countries. Besides human strains, genotype 3 and 4 strains of HEV have been genetically characterized from swine, sika deer, mongooses, sheep, and rabbits. Currently, there are approximately 11,000 human and animal sequences of HEV available at the International Nucleotide Sequence Database Collaboration. HEV is the major cause of waterborne outbreaks of hepatitis in areas of poor sanitation. Additionally, it is responsible for sporadic cases of viral hepatitis in not only endemic but industrialized countries as well. Transmission of HEV occurs predominantly by the fecal-oral route, although parenteral and perinatal routes have been reported. HEV infection develops in most individuals as a self-limiting, acute, icteric hepatitis; with mortality rates around 1%. However, some affected individuals will develop fulminant hepatic failure, a serious condition that is frequently fatal without a liver transplant. This complication is particularly common when the infection occurs in pregnant women, where mortality rates rise dramatically to up to 25%. Among the preventive measures available to avoid HEV infection, two separate subunit vaccines containing recombinant truncated capsid proteins of HEV have been shown to be highly effective in the prevention of disease. One of them, HEV 239, was approved in China, and its commercialization by Innovax began in November 2012 under the name Hecolin^®.     

食管癌患者血清可溶性肿瘤坏死因子受体水平测定

背景:目前尚无敏感性和特异性较高的血清肿瘤标志物用于临床诊断食管癌。目的:通过测定食管癌患者血清可溶性肿瘤坏死因子受体(sTNFR)水平的变化,探讨其在食管癌诊断和监控中的临床意义。方法:应用双抗体夹心酶联免疫吸附测定(ABC鄄ELISA)检测56例食管癌患者和10名健康成人的血清sTNFR鄄Ⅰ、sTNFR鄄Ⅱ水平,并与血清癌胚抗原(CEA)水平进行比较。结果:食管癌患者的血清sTNFR鄄Ⅰ和CEA水平显著高于健康对照组(P<0.001),而sTNFR鄄Ⅱ水平则显著低于健康对照组(P<0.001);sTNFR鄄Ⅰ与CEA的阳性率无显著差异,但均显著低于sTNFR鄄Ⅱ(P<0.001)。食管癌切除术后,患者的血清sTNFR鄄Ⅰ、sTNFR鄄Ⅱ水平均呈升高趋势,而CEA水平则无明显变化。结论:同时检测血清sTNFR鄄Ⅰ、sTNFR鄄Ⅱ水平有助于诊断食管癌和评估机体的免疫状态。     

吸烟对脑血栓患者血浆组织因子水平的影响

目的观察吸烟脑血栓患者及吸烟健康者血浆组织因子水平的变化,探讨吸烟对脑血栓形成的影响。方法采用双抗体夹心酶联免疫吸附法测定45例吸烟脑血栓患者和43例不吸烟脑血栓患者及42例吸烟健康者和45例不吸烟健康者血浆组织因子水平。结果吸烟脑血栓患者血浆组织因子水平明显高于不吸烟脑血栓患者和不吸烟健康者(P<0.01);吸烟健康者血浆组织因子水平明显高于不吸烟健康者(P<0.01)。重度吸烟者血浆组织因子水平明显高于中度吸烟者、轻度吸烟者及不吸烟健康者(P<0.05或0.01)。吸烟指数与血浆组织因子水平呈正相关(r=0.43,P<0.01)。结论长期吸烟致血浆组织因子水平升高可能在脑血栓形成中发挥重要作用。     

冠心病患者血清抗氧化型低密度脂蛋白抗体水平与临床表现的关系

目的探讨冠心病患者外周血抗氧化型低密度脂蛋白抗体水平的临床意义。方法研究对象按照临床表现分为稳定型心绞痛组、不稳定型心绞痛组、急性心肌梗死组和对照组。酶联免疫吸附法测定血清中IgG型抗氧化型低密度脂蛋白抗体水平。Gemini评分对患者的冠状动脉狭窄程度进行定量测定。结果冠心病患者抗氧化型低密度脂蛋白抗体水平显著高于对照组,以急性冠状动脉综合征患者尤为显著,抗氧化型低密度脂蛋白抗体升高具有延迟效应,以入院后7~10天的水平最高,各组之间的差异明显。冠心病患者冠状动脉狭窄程度在各组之间差异无显著性。抗氧化型低密度脂蛋白抗体水平与冠状动脉狭窄程度之间无显著相关性。结论抗氧化型低密度脂蛋白抗体水平在不同冠心病临床类型之间存在显著差异,提示自身免疫在动脉粥样硬化疾病的转归中发挥重要作用。抗氧化型低密度脂蛋白抗体有望成为独立于冠状动脉狭窄程度外的评估动脉粥样硬化风险的指标。     

Pregnancy Decisions Among Women with HIV

Nearly 80% of women currently infected with HIV are of childbearing age. As women of childbearing age continue to be at risk of contracting HIV, there will be an increased need for choices about whether or not to have biological children. The purpose of this exploratory study was to investigate the influence of partners, physicians, and family members on pregnancy decisions, as well as the impact of HIV stigma on these decisions. Results indicated that most women chose not to become pregnant since learning their HIV diagnosis and the woman’s age at the time of diagnosis is significantly associated with this decision. Additional factors included fear of transmitting HIV to their child, personal health-related concerns, and desire to have children. Women with a procreative inclination were more likely to choose to become pregnant which outweighed social support and personal health concerns. Implications and suggestions for future research are noted.     

Seroprevalence of Hepatitis B Surface Antigen and Anti Hepatitis C Antibody in Zahedan City,Iran: A Population-Based Study

Background

There have been studies regarding the prevalence of hepatitis B surface antigen (HBsAg) and anti-hepatitis C antibody (HCVAb) in Iran. However, the majority of these have reported a variety of rates, depending on their study population, which limits the generalizability of their results to the general population. On the other hand, cultural diversity in the different provinces of Iran also necessitates the performing separate population-based studies in the various regions.

Objectives

To evaluate the population-based prevalence of HBsAg and HCVAb and their correlates in Zahedan City, Iran.

Patients and Methods

Included in this study were 2587 individuals, using a random and cluster sampling approach. The participants were drawn from the Family Registry of the public health centers in Zahedan City, Iran, from 2008 to 2009. Following data collection from the interviews, subjects were assessed for seropositivity of HBsAg and HCVAb. We then calculated the prevalence of HBsAg and HCVAb, and evaluated these viral markers for an association with; age, sex and potential risk factors.

Results

Weighted seroprevalence of HBsAg and HCVAb was 2.5% (CI 95% : 1.9 to 3.3 %) and 0.5% (CI 95% : 0.27 to 0.9 %), respectively. Prevalence of HBsAg increased significantly with age (P value < 0.001), but this was not true for HCVAb (P value: 0.67). We observed no sex dominance in the prevalence of HBsAg (3.2% and 2.2% for males and females, respectively, P value: 0.15) or HCVAb (0.4% and 0.7% for males and females, respectively, P value: 0.27). In a multivariate regression analysis, every additional year in age resulted in a 2% increment in the odds of HBsAg seropositivity. HBsAg was also three times more prevalent among married, than single subjects (with a P value reaching toward significance: 0.065) in multivariate analysis. Prevalence of HCVAb did not differ with respect to any of the potential risk factors.

Conclusions

This is the first population-based study on the prevalence of HCVAb and one of the few population based studies on HBsAg in Zahedan City. We detected lower prevalence rates of HBsAg and HCVAb than in previous studies conducted in Zahedan City. In addition to improvements in social awareness and general health elements, we think that the observed low prevalence rates have been achieved due to the efficiency of mass vaccination projects, implemented against HBV infection in Iran.