High prevalence of hepatitis C virus-ribonucleic acid positivity in anti-hepatitis C virus negative renal transplant patients

Background

Hepatitis C virus (HCV) infection is common in renal transplant (RT) patients. Some of these patients remain anti-HCV negative despite presence of infection and these are identified by a positive HCV-ribonucleic acid (RNA) test.

Methods

We studied 404 RT patients for prevalence of HCV-RNA positivity in anti-HCV negative patients. Serum was tested for presence of anti-HCV antibodies using a third generation HCV micro-ELISA (enzyme-linked immunosorbent assay) test, which utilises a combination of HCV structural and nonstructural antigens. The RNA was extracted from patient serum for HCV viral quantification using Quiagen Ql Amp Viral RNA mini extraction kit. The HCV-RNA viral load was performed on Corbet Rotor Gene 3000 thermocycler using Taqman principle.

Results

About 308 patients were anti-HCV negative and 96 were anti-HCV positive, resulting in prevalence of overt HCV infection of 23.7%. A total of 130 anti-HCV negative patients tested positive for HCV-RNA making a prevalence of occult HCV infection of 42.2%. There was no significant difference in the rate of overt or occult HCV infection between males and females. Patients with HCV infection (whether overt or occult) had received more number of dialysis sessions (62.5 vs 32.2) and blood transfusions (2.78 vs 1.99) when compared to those without HCV infection (P=0.001). The mean duration on dialysis was also longer (8.15 months vs 4.53 months) in patients with HCV infection (P= 0.0001).

Conclusion

A direct test for HCV viraemia is important to accurately determine the epidemiology of HCV infection in RT patients who remain anti-HCV negative despite harbouring active HCV infection.     

Hepatitis C Virus Infection in Haemodialysis Patients: “Wolf in Sheep's Clothing”

Background

170 million people are infected with the Hepatitis C virus (HCV) around the world. Approximately 50%-70% patients infected with HCV develop chronic liver disease. Haemodialysis patients constitute an especially important group with high HCV prevalence. Outbreaks of HCV infection in dialysis units have been documented. Detection of anti-HCV antibodies is a convenient and conventional mode of documentation. However, in this group, it has it''s own caveats.

Methods

48 patients who had undergone or were on haemodialysis (HD) and had undergone a minimum of 15 dialysis sittings were studied. HCV infection was documented both by anti-HCV antibody detection and HCV RNA testing. A comparative evaluation of results by both tests was done.

Results

Out of a total of 48 patients, HCV RNA was detected in 38 (79.16%) and anti-HCV antibodies in 13(27.07%). Out of 48 patients 10(20.83%) were negative for both parameters. 22.91% (11/48) of patients were positive for both HCV RNA and anti-HCV antibody. 56.25% (27/48) were HCV RNA positive but anti-HCV antibodies were not detectable in their sera. 2 patients (04.16%) had a positive anti-HCV antibody status despite HCV RNA being negative. In 20.83% (10/48) both parameters were undetectable.

Conclusion

Chronic liver disease (CLD), particularly due to HCV infection, is a major complication amongst haemodialysis (HD) patients. Without reliable assays for antigenemia and the inability of antibody tests to define viremia in all cases, the detection of viral nucleic acid is necessary for diagnosis of active HCV infection.Key Words: Hepatitis C virus, Haemodialysis     

The influence of HAART on the efficacy and safety of pegylated interferon and ribavirin therapy for the treatment of chronic HCV infection in HIV-positive individuals

Objective

This study was performed to investigate the impact of HAART versus no HAART and nucleoside free versus nucleoside containing HAART on the efficacy and safety of pegylated interferon and ribavirin therapy for the treatment of chronic HCV infection in HIV/HCV co-infected patients. In addition a control group of HCV mono-infected patients undergoing anti-HCV therapy was evaluated.

Methods

Multicenter, partially randomized, controlled clinical trial. HIV-negative and -positive patients with chronic HCV infection were treated with pegylated interferon alfa-2a and ribavirin (800 - 1200 mg/day) for 24 - 48 weeks in one of four treatment arms: HIV-negative (A), HIV-positive without HAART (B) and HIV-positive on HAART (C). Patients within arm C were randomized to receive open label either a nucleoside containing (C1) or a nucleoside free HAART (C2).

Results

168 patients were available for analysis. By intent-to-treat analysis similar sustained virological response rates (SVR, negative HCV-RNA 24 weeks after the end of therapy) were observed comparing HIV-negative and -positive patients (54% vs. 54%, p = 1.000). Among HIV-positive patients SVR rates were similar between patients off and on HAART (57% vs. 52%, p = 0.708). Higher SVR rates were observed in patients on a nucleoside free HAART compared to patients on a nucleoside containing HAART, though confounding could not be ruled out and in the intent-to-treat analysis the difference was not statistically significant (64% vs. 46%, p = 0.209).

Conclusions

Similar response rates for HCV therapy can be achieved in HIV-positive and -negative patients. Patients on nucleoside free HAART reached at least equal rates of sustained virological response compared to patients on standard HAART.     

Acute hepatitis C in persons infected with the human immunodeficiency virus (HIV): The "Real-life Setting" proves the concept

Objectives

Outbreaks of sexually transmitted acute HCV infection have been described recently in several cities in the western world. The epidemic affects mainly MSM who are coinfected with HIV and is supposably linked to certain sexual risk practices. Here, we compared our findings with current knowledge and recommendations.

Methods

HIV-positive patients with the diagnosis of acute HCV infection were included in the retrospective analysis. The patients came from outpatient infectious disease centers in northern German cities. We looked at markers of HIV and HCV infection and compared patients who received treatment and those who did not. Treated patients were followed up to 72 weeks.

Results

Three hundred nineteen HIV-positive patients with the diagnosis of acute hepatitis C between 2001 and 2008 and were included in the analysis. All patients were male, 315 (99%) patients were of caucasian origin, 296 (93%) declared homosexual contacts as a risk factor for HCV infection, intravenous drug use was declared in 3 (1%) cases. Median age at HCV diagnosis was 40 years (range 20-69 years). Median HCV viral load was 1.2 × 10⁶ IU/mL, 222 patients (70%) had HCV genotype 1, 59 (18%) genotype 4. The median time of HIV infection was 5.5 years (range 0 to 22.4 years). Median HIV viral load was 110 copies/mL (range 25 to 10 × 10⁶ copies/mL). The median CD 4 count was 461 cells/mm³ (range 55- 1331 cells/mm³). Two hundred and fourty-six patients (77%) received anti-HCV treatment, and 175 (55%) had completed therapy by the time of the analysis. Median treatment duration was 33 weeks (IQR 24.1-49.9). 93 of the 175 treated patients (53%) reached a sustained virological response (SVR). In the multivariate analysis, ART at diagnosis, HCV RNA drop at week 12, hemoglobin levels and higher platelets were associated with SVR. Treatment duration was significantly higher in the SVR group (40.6 weeks vs 26.6 weeks, p < 0.0001). Seventy-three patients (23%) did not receive anti-HCV treatment. In 19 of the untreated patients (26%) the hepatitis C virus was cleared spontaneously.

Conclusions

Our findings confirm that acute hepatitis C in HIV infected patients affects mainly MSM who acquire HCV sexually. Patients had a short duration of HIV infection and a stable immunological situation. In this real-life setting from urban regions in northern Germany, treatment rates appear to be high and effective.     

Serum alpha-fetoprotein level is higher in hepatitis C than hepatitis B infected chronic liver disease patients

Background:

The frequency of raised serum alpha-fetoprotein may vary in relation to hepatitis B or C infection in chronic liver disease (CLD). The study evaluated the frequency of hepatitis B and C in patients with chronic liver disease and correlated the levels of serum alpha-fetoprotein with hepatitis B and C infection in the patients.

Materials and Methods:

Eighty-six patients with CLD were recruited for the study. Fifty subjects, with no CLD were used as control. Hepatitis B surface Antigen (HBsAg) and hepatitis C antibody were determined using enzyme-linked immunosorbent assay (ELISA) technique (Human diagnostics, Germany and HCV Murex 40 Anhet laboratories, USA) while liver function tests were evaluated using express plus chemistry auto analyzer. Alpha-fetoprotein was assayed using ELECSYS 1010 auto analyser.

Results:

There were 60 males and 26 females, with a mean age of 46 + 6.5 years, while the controls were 25 males and 25 females with a mean age of 41 ± 2.5 years. Thirty-six subjects (41.7%) were seropositive for HBsAg while 24 (27.9%) were seropositive for Hepatitis C Virus (HCV) antibody. The mean alpha fetoprotein level was 359 ± 9.9 ng/mL while mean control value was 1.93 ± 0.24 ng/mL. Liver function test parameters were elevated compared with control subjects (P < 0.001). The increase in serum alpha-fetoprotein was higher (P < 0.001) in HCV than HBsAg positive patients.

Conclusion:

Serum alpha-fetoprotein level was highest in HCV compared to HBsAg positive and hepatitis negative patients with CLD.     

Progression of liver fibrosis in HIV/HCV genotype 1 co-infected patients is related to the T allele of the rsI2979860 polymorphism of the IL28B gene

Objective

HIV/HCV co-infection is characterised by accelerated progression of liver disease. Recently, the rsl2979860 C/T polymorphism in the IL28B gene has been linked to progression towards cirrhosis in HCV mono-infected patients and to treatment response of HCV-infection in HIV/HCV co-infected patients. Our aim was to clarify by non-invasive techniques if this polymorphism affects fibrosis progression in HIV/HCV co-infection.

Methods

In a cross-sectional design, liver stiffness (transient elastography), surrogate markers of liver fibrosis (APRI and FIB-4 scores) and rsl2979860 genotypes were analysed in 84 HCV/H1V co-infected patients. IL28B genotypes were determined by real-time PCR using a light cycler. In 56 HIV/HCV co-infected patients we also studied progression of fibrosis in relation to rsl2979860 C/T genotypes over two years.

Results

82% of the patients were on HAART (74% without detectable HI viremia) and 67% were haemophiliacs, respectively. HCV genotype 1 was present in 62%. Cross-sectional median liver stiffness was 7.4 kPa and correlated with APRI and FIB-4 scores (r = 0.6 each, p < 0.001). Frequencies of IL28B genotypes were: CC 50%, CT 43% and TT 7%. In the cross-sectional analysis liver stiffness values were not different between the various IL28B-genotypes. Upon follow-up under HAART carriers of a C allele did not show further progression, while liver stiffness significantly increased in HIV/HCV co-infected patients with the T allele (p = 0.047).

Conclusion

Although progression of liver fibrosis was low under HAART in our cohort, progression was more pronounced in HIV/HCV genotype 1 co-infected patients with the T allele.     

Infectious Disease Markers in Blood Donors

Background

The infectious disease markers for which blood donors are screened include anti-human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV), rapid plasma reagin (RPR) card test for syphilis and malarial parasites.

Methods

A total of 6751 donors were screened over three years to assess the prevalence of infectious disease markers. Screening for anti-HIV I and II, HBsAg and anti-HCV was carried out by enzyme linked immunosorbent assay (ELISA). Syphilis was tested using RPR card test. Malarial parasite was tested by detection of genus specific plasmodium lactate dehydrogenase.

Result

The overall seropositivity for anti-HIV I and II was nine (0.13%), for HBsAg 67 (0.99%), for anti-HCV 13 (0.19%) and for syphilis 42 (0.62%). No sample showed malarial parasites. There was no significant difference (p>0.05) in the seropositivity of various markers between voluntary and replacement donors. There was a significant decline (p<0.05) in the prevalence of seropositivity for HCV and syphilis, but not for HIV and HBsAg over the three year period of the study.

Conclusion

The prevalence of infectious disease markers was similar to that reported by other studies. However, no significant difference was seen in the marker positivity in voluntary and replacement donors, which is at variance from other studies.Key Words: Infectious disease, Blood donors     

Transfusion Transmitted Infections in Armed Forces: Prevalence and Trends

Background

This study presents data on the prevalence rate of infectious markers among voluntary and replacement donors in the blood transfusion service in Armed Forces from 2000 to 2004.

Methods

39,646 units of blood were collected from donors during the period from 2000 to 2004. All the samples were screened for hepatitis B surface antigen (HBsAg), human immunodeficiency virus (HIV) 1&2, hepatitis C virus (HCV), and by venereal disease research laboratory test (VDRL).

Results

24,527 (61.9%) were voluntary donations and 15,119 (38.1%) replacement donations. Prevalence of HBsAg had decreased, amongst voluntary donors from 1.67% to 0.77% but the positivity rate has not showed significant change. Seropositivity of HIV had decreased both in voluntary and replacement donors to 0.22% and 0.86% respectively. The seropositivity for anti-HCV showed steady decrease amongst voluntary donors from 0.46% to 0.20% in 2004, but in replacement donors, there was an increase in reactivity rate from 0.43% to 0.65%.

Conclusion

The increased seropositivity for HCV, HIV and HBsAg could be decreased by introduction of nucleic acid amplification testing (NAT) in minipools for HCV and HIV and introduction of anti-HBcAg (IgM) for hepatitis B virus (HBV) infection. But this may not be possible in near future in developing countries due to financial constraints. At present implementation of strict donor criteria and with use of sensitive laboratory screening tests it is possible to reduce the incidence of transfusion transmitted infections (TTI) in Indian scenario.Key Words: Transfusion transmitted infections, Human immunodeficiency virus, Hepatitis C virus, Hepatitis B virus     

Molecular study of HCV detection,genotypes and their routes of transmission in North West Frontier Province,Pakistan

Objective

To determine hepatitis C virus (HCV) genotypes and explore the associated risk factors in chronic HCV patients.

Methods

A total of 116 patients with chronic hepatitis C were subjected to polymerase chain reaction (PCR) based detection out of which 112 chronic HCV patients [53 male (47.32%), 59 female (52.68%); mean age (43.76±16.40) years; mean BMI (23.8±3.9) kg] were enrolled in this study. The frequency of 6 HCV genotypes and associated risk factors were evaluated from five districts of North West Frontier Province (NWFP).

Results

Genotype 3 was the most prevalent in 73 samples (65.17%) followed by genotype 1 in 24 (21.42%) and genotype 2 in 13 (11.60%) samples. Genotype 3 had significantly high prevalence (P=0.000 2). The results showed that 48 (42.85%) samples were infected with HCV 3a; 25 (22.32%) with 3b; 14 (12.50%) with 1a; 10 (8.92%) with 1b; 11 (9.82%) with 2a; 2 (1.78%) with 2b; and 2 were untypable. The distribution of HCV genotypes in Mardan, Charsadda, Peshawar, Sawabi and Nowshehra districts was different. Use of unsterile equipment for medication, barbers and previous history of hospitalization were the main risk factors for HCV transmission.

Conclusions

Genotype 3a and 3b, 1a, 1b and 2a are the common genotypes in NWFP. Genotype 4, 5, and 6 can not be found in a single sample. The level of awareness about various modes of transmission of HCV among the population is found to be very low.     

Biliary tract infection and bacteraemia: presentation, structural abnormalities, causative organisms and clinical outcomes

Background

Biliary tract infection is a common cause of bacteraemia and is associated with high morbidity and mortality. Few papers describe blood culture isolates, underlying structural abnormalities and clinical outcomes in patients with bacteraemia.

Aims

To determine the proportion of bacteraemias caused by biliary tract infection and to describe patient demographics, underlying structural abnormalities and clinical outcomes in patients with bacteraemia.

Design

Prospective cohort study.

Methods

Biliary tract infection that caused bacteraemia was defined as a compatible clinical syndrome and a blood culture isolate consistent with ascending cholangitis. Patients aged 16 years and over were included in the study. From June 2003 to May 2005, demographic and clinical data were collected prospectively on all adult patients with bacteraemia. Radiological and endoscopic retrograde cholangiopancreatography findings were collected retrospectively.

Results

In 49 patients, the biliary tract was the site of infection for 39/592 (6.6%) community‐acquired and 19/466 (4.1%) hospital‐acquired episodes of bacteraemia. Three patients had mixed bacteraemias, and four had recurrent bacteraemia. The proportion of patients presenting with a structural abnormality was 34/49 (69%), and, of these structural abnormalities, 18/34 (53%) were pre‐existing or newly diagnosed malignancies. Gram‐negative organisms caused 55/58 (95%) episodes of bacteraemia. The most common Gram‐negative organisms were Escherichia coli (34/55; 62%) and Klebsiella pneumoniae (14/55; 26%). Of the E coli isolates, 6/34 (18%) were extended spectrum β‐lactamase producers or multiply drug resistant. Thirty‐day mortality was 7/49 (14%). There was no difference in time taken to administer an effective antibiotic to survivors and non‐survivors (0.86 vs 1.05 days, respectively, p = 0.92). Of the seven who died, four died from septic shock within 48 h of admission caused by “susceptible” Gram‐negative organisms. Two others died from disseminated malignancy.

Conclusions

The proportion of bacteraemias caused by biliary tract infection was 5.5%. The most common infecting organisms were E coli and K pneumoniae. There was a strong association with choledocholithiasis and malignancies, both pre‐existing and newly diagnosed. Death was uncommon but when it occurred was often caused by septic shock within 48 h of presentation.     

The prevalence of Linguatula serrata nymphs in camels slaughtered in Mashhad slaughterhouse,Northeast, Iran

Objective

To evaluate the prevalence of nymphal stages of L. serrata in mesenteric lymph nodes of camels slaughtered in Mashhad slaughterhouse, Northeast of Iran.

Methods

For this purpose, mesenteric lymph nodes of 400 camels of different sex and age were examined. The lymph nodes were examined macroscopically and a digestion method was also applied for investigation of samples which was negative macroscopically.

Results

The mesenteric lymph nodes of 73 camels out of 400 (18.25%) were infected by L. serrata nymphs.

Conclusions

Prevalence of L. serrata nymphs in males and females and different age was not significantly different (P>0.05), but difference was observed between the prevalence in different seasons (P< 0.05). The potential importance of these findings to human health is discussed. This is the first report of infection with L. serrate of camels in camels slaughtered at northeast of Iran.     

Aggressive Use of Diagnostic Services is Counterproductive

Background

Medical fraternity requisitions diagnostic tests for multiple reasons. More often than not, the tests lead to more tests either to exclude or to confirm doubts raised by the test results. These tests have an inherent morbidity, discomfort and cost. Growing expenditure on diagnostic tests without matching improvement in the health status warrants an internal audit of the laboratory utilization.

Methods

A retrospective utility audit was done for certain routinely advised laboratory tests at a hospital. Blood urea estimation in annual / periodic medical examination (AME/ PME), bleeding and clotting time in pre-anaesthetic check-up and aspartate aminotransferase (AST) and antibodies to hepatitis C virus (anti-HCV) in diagnostic work-up of acute onset jaundice were included in the audit.

Results

During the study period, 793 individuals underwent AME / PME and urea estimation did not provide any additional information in these cases which was not inferred by serum creatinine. Similarly, in diagnostic workup of acute onset jaundice, 6049 aspartate aminotransferase (AST) estimations in 1024 patients did not contribute anything more than what was inferred by alanine aminotransferase (ALT). Prevalence of anti HCV antibodies in acute onset jaundice in serving soldiers (11 out of 1225; 0.89%) though more than that in the blood donors from the same population (17 out of 4105; 0.41%) was less than anticipated false positives (18 out of 1225; 1.5%) as per the claimed specificity (98.5%) of the test kit. None of the 2766 bleeding and clotting time tests detected a bleeding or coagulation disorder.

Conclusion

The study reveals significant overuse of the laboratory that may not be good for the patient and the organization in terms of direct and indirect costs due to false positive results. This laboratory overload adversely affects the quality and availability of laboratory results. Therefore, a test should only be advised, if positive or negative result would dictate a change in patient management.Key Words: Laboratory overuse, Aspartate aminotransferase, Anti HCV, Bleeding time, Clotting time, Blood urea     

Study of Clinicobiochemical Spectrum of Hypothyroidism

Background

The aim of this study was to assess the clinico biochemical spectrum of hypothyroidism and the relative importance of thyroid function tests, clinical symptoms and signs in thyroid dysfunction.

Methods

A retrospective study was done and 1702 requisitions for screening of hypothyroidism were analysed. The clinical presentation of cases was correlated with the results of thyroid profile tests.

Results

31.5% of the 1702 cases referred had thyroid dysfunction in the form of subclinical or overt hypothyroidism. In the hypothyroid group generalized weakness, weight gain and myxoedema was common. In cases of primary infertility and depression, subclinical and overt hypothyroidism was high (40% and 45.8% respectively). The average age of females with subclinical hypothyroidism was 30.8 years, 5.4 years less than females with overt hypothyroidism.

Conclusion

We conclude that hypothyroidism is common and often under-diagnosed. Therefore routine evaluation of female patients with weight gain, generalized weakness, infertility, depression and mood changes should include thyroid profile.Key Words: Hypothyroidism, Thyroid profile, Screening, Infertility, Depression     

Seroprevalence of Borrelia burgdorferi in North Eastern India

Background

There is paucity of data on Lyme disease in India. A seroprevalence study of B burgdorferi infection was carried out in North-Eastern states of India to assess the same.

Methods

Sera from 500 individuals of North-Eastern states of India were tested for IgG antibody by enzyme linked immunosorbent assay using commercial kits containing recombinant antigen.

Result

Out of 500 persons, 65 (13%) were positive for B burgdorferi specific lgG Females showed higher positivity rate as compared to males (15.86% vs 10.95%). Higher prevalence rate was observed in the age group of 15-30 years in both sexes (11.48% in male and 18.69% in female). Arunachal Pradesh showed higher seroprevalence rate (17.8%) as compared to other North-Eastern states (8.46-9.6%).

Conclusion

Seropositivity to B burgdorferi suggests infection by the organism and presence of Lyme disease in these areas. Further population and vector biology studies are required to find out the exact species involved in transmission of the organism.Key Words: Lyme Disease, Seroprevalence, Borrelia burgdorferi     

Serological Evidence of Chronic Chlamydia pneumoniae Infection in Coronary Artery Disease

Background

Recent studies have suggested that Chlamydia pneumoniae infection could be involved in atherosclerosis and related clinical manifestations such as coronary artery disease, carotid artery stenosis and myocardial infarction.

Methods

Serum IgG, IgM and IgA antibodies to chlamydia genus specific antigen were measured by enzyme linked immunosorbent assay (ELISA) in 100 cases of angiographically demonstrated coronary artery disease (CAD) and 100 randomly selected healthy individuals as controls after matching for age and sex. All the samples positive for chlamydia genus specific IgG antibodies were then subjected to Chlamydia pneumoniae species specific IgG antibody ELISA.

Results

Seroprevalence of chlamydia genus specific IgG antibodies in control group was 59% with an increase in seropositivity with increasing age. The overall seroprevalence of IgG antibodies was 76% in CAD group and the prevalence was significantly high in all age groups as compared to controls. The odds ratio was 2.20 for seropositivity of chlamydia genus specific IgG antibodies in patients with myocardial infarction (MI) and/or angina than in control group. No significant association was observed for IgA and IgM anti-chlamydial antibodies. The odds ratio for prevalence of Chlamydia pneumoniae species specific IgG antibodies in CAD patients increased to 2.55 in comparison to age and sex matched controls.

Conclusion

Current study supports the reported association between C pneumoniae infection and CAD in Indian population.Key Words: Chlamydia pneumoniae, Coronary artery disease     

Association of a variant in the regulatory region of NADPH oxidase 4 gene and metabolic syndrome in patients with chronic hepatitis C

Background

Given the important contribution of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase system to the generation of reactive oxygen species induced by hepatitis C virus (HCV), we investigated two single nucleotide polymorphisms (SNPs) in the putative regulatory region of the genes encoding NADPH oxidase 4 catalytic subunit (NOX4) and its regulatory subunit p22phox (CYBA) and their relation with metabolic and histological variables in patients with HCV.

Methods

One hundred seventy eight naïve HCV patients (49.3% male; 65% HCV genotype 1) with positive HCV RNA were genotyped using specific primers and fluorescent-labeled probes for SNPs rs3017887 in NOX4 and −675 T → A in CYBA.

Results

No association was found between the genotype frequencies of NOX4 and CYBA SNPs and inflammation scores or fibrosis stages in the overall population. The presence of the CA + AA genotypes of the NOX4 SNP was nominally associated with a lower alanine aminotransferase (ALT) concentration in the male population (CA + AA = 72.23 ± 6.34 U/L versus CC = 100.22 ± 9.85; mean ± SEM; P = 0.05). The TT genotype of the CYBA SNP was also nominally associated with a lower ALT concentration in the male population (TT = 84.01 ± 6.77 U/L versus TA + AA = 109.67 ± 18.37 U/L; mean ± SEM; P = 0.047). The minor A-allele of the NOX4 SNP was inversely associated with the frequency of metabolic syndrome (MS) in the male population (odds ratio (OR): 0.15; 95% confidence interval (CI): 0.03 to 0.79; P = 0.025).

Conclusions

The results suggest that the evaluated NOX4 and CYBA SNPs are not direct genetic determinants of fibrosis in HCV patients, but nevertheless NOX4 rs3017887 SNP could indirectly influence fibrosis susceptibility due to its inverse association with MS in male patients.     

Occurrence of Clinostomum complanatum in Aphanius dispar (Actinoptrygii: Cyprinodontidae) collected from Mehran River,Hormuzgan Province,South of Iran

Objective

To investigate the possibility of Aphanius dispar (A.dispar) acting as intermediate host for Clinostomum complanatum (C. complanatum), from Mehran River, Hormuzgan Province of Iran.

Methods

During a biological study of A. dispar in Mehran River, Hormuzgan Province, South of Iran, a total of 97 fish specimens were collected in 24 January 2006.

Results

4 specimens (4.12%) including 1 male and 3 female were found infected with C. complanatum metacercaria. These metacercaria were coiled in the epiderm on the body surface of infected fishes. The infection is known as yellow spot disease. The parasite abundance, intensity and prevalence were 0.05%, 1.25% and 4.12%, respectively. The infection was higher in females than males.

Conclusions

To the best of our knowledge, this is the first report on occurrence of C. complanatum metacercaria in A. dispar in Iran.