فهرست مطالب amitis ramezani

The COVID-19 pandemic has led to great efforts to achieve effective vaccines with different approaches around the world, and different vaccine platforms have been developed against SARSCoV-2. Meanwhile, these technologies are still being investigated to obtain more data on the efficacy of combined vaccine platforms. The purpose of this study is to investigate the power of neutralizing antibodies of vaccinated people against COVID-19 in different vaccination regimens in Iran. We investigated Sinopharm/Sinopharm, Sinopharm/PastoCovac or Plus, AstraZeneca/AstraZeneca and AstraZeneca/ PastoCovac Plus recipients. The sera samples were collected from vaccinated individuals 3 weeks after the booster shots. cVNT test was done on the samples after sera dilution. The results showed that all the vaccine regimens induced neutralizing antibodies. Nevertheless, the combinational vaccine regimens in Sinopharm primed individuals showed greater neutralizing potency comparing to the homologous group. Moreover, PastoCovac Plus showed similar ability to AstraZeneca vaccine regarding neutralizing Wuhan and BA.5 variants.

After the outbreak of SARS-CoV-2, another crisis has come to attention with the progression or persistence of symptoms of COIVD-19, known as long-COVID, which is very important due to the increasing number of reports of late-detected symptoms and their potential impact on the quality of life. In this study, long-term disorders were investigated in people who received three doses of the vaccines in order to distinguish between the side effects caused by COVID or the vaccine and the factors affecting it. Vaccinated people of four different vaccination regimens who received two doses of Sinopharm or AstraZeneca vaccines and got a booster dose of PastoCovac/Plus were followed from the first vaccine dose to 6 months after the booster shot. All adverse events were recorded through an in-depth interview using a researcher-made questionnaire, as well as COIVD-19 history and other demographics. Out of a total of 329 follow-up subjects, 30 cases (9.1%) were identified with long-term complications during the follow-up, who had at least one recorded history of COIVD-19 disease. The average age of these people was 40.5±9.3 and the average BMI was 27.23±4.6. The most common underlying diseases in this group were thyroid disorders (20%), hyper lipedema (10%) and hypertension (6%). The examination of registered complications showed that menstrual problems in women (30%), hair loss (20%), joint disorders (20%), headache (13%) and skin manifestations (10%) were the most common complications, respectively, and the identified symptoms were mainly stable until the end of the study with an average duration of 154 days. In 19 of these people, the vaccine was diagnosed as the main cause of the complication though there was no significant difference between the vaccine regimens. In the other 11 people, infection with SARS-CoV-2 was considered as the main trigger of the complication, although the role of the vaccine as a trigger for the exacerbation of complications cannot be neglected. In the current timeframe in which the vast majority of the world's population have got vaccinated against COIVD-19, it is difficult to identify late-onset disorders as side effects of vaccines or prolonged manifestations of COIVD-19. Therefore, some complications, though late, may be a possible consequence of SARS-CoV-2 infection or vaccination. This study has the advantage of long-term follow-up, which provides different forms of late events compared to the date of infection and vaccination of COIVD-19. The rate of late-onset disorders in the present study also highlights the importance of long-term follow-up studies in populations worldwide.

Data on the safety of COVID-19 vaccines in obese or overweight subjects are limited and have been conducted in several studies with a small sample size worldwide. The aim of this study was to investigate and compare the incidence of adverse events after the first and second doses of Sinopharm and COVID-19 booster in overweight and obese subjects compared to normal weight subjects.

261 subjects who had received three doses of COVID-19 vaccine (two doses of Sinopharm + Sinopharm or PastoCovac or PastoCovac Plus booster) were enrolled in the study. Subjects' demographic characteristics and vaccine adverse events were recorded in a questionnaire during a telephone interview on days 7 and 21 after each dose of COVID-19 vaccine. Subsequently, the frequency of adverse events was compared between the 3 study groups.

Of the 261 participants, 59 were obese (BMI ≥ 30), 96 were overweight (BMI = 25-29.9), and 106 were normal weight (BMI = 24.9-18). The overall frequency of adverse events after all three doses of the COVID-19 vaccine was higher in obese subjects than in overweight or normalweight subjects. Pain at the injection site was the most common adverse event reported within seven days of booster vaccination in all groups. No adverse events occurred after receiving the PastoCovac booster in obese/overweight subjects, and the incidence of adverse events after PastoCovac plus booster and Sinopharm booster administration was similar. Overall, no serious vaccine-related adverse events were observed in the three groups.

The results of this study indicate that the inactivated and protein-based COVID -19 vaccines are safe and did not cause serious adverse events in obese or overweight individuals. In addition, the PasteCovac booster is more suitable for these people because it has no adverse effects. Therefore, further studies with a larger sample size are needed to identify a more effective booster with fewer adverse events in obese subjects

The present study aims to provide an insight to the comprehensive efforts of Pasteur Institute of Iran (PII) regarding COVID-19 management, research, achievements, and vaccine production, though there are many challenges. The relevant literature review was investigated through national and international database and also reports from the related research departments. Six strategies were taken by PII to manage the pandemic of COVID-19. While this pandemic has been hopefully controlled, SARS-CoV-2 could still be a potential threat. Therefore, COVID-19 data management and updated studies, as well as long-term safety and efficacy of the SARS-CoV-2 vaccines are still on the agenda.

Dendritic cells (DCs) play crucial roles in cellular immunity as the most powerful antigen presenting cells. They have been widely used for antigen delivery in vivo and in vitro. There are different ways to generate DCs and also gene transduction. In this study we introduce some optimization in order to produce high amount of well differentiated murine DCs for potential immunotherapy and vaccine development applications.

Murine bone marrow cells were isolated from male BALB/c mice and the cells were cultured with complete RPMI in presence of the same ratio of IL-4 and GM-CSF. Some changes were made in the medium and the lysis buffer applications to increase the differentiation rate of the cells. Lentiviral virions were applied to transfer the genes of interest to DCs with no pre-maturation steps. CD11c, MHC-II, CD80 and CD86 were assessed by flow cytometry.

The optimized steps led to significant increase in number of the isolated cells. IL-4 usage in a similar dose to GM-CSF led to macrophage formation inhibition. Lentiviral virions resulted in successful gene delivery along with well-maturated DCs.

The introduced optimized steps could be followed in different DC applications by using lentiviral virions to transduce DCs, independent of the pre-maturation steps.

Betulinic acid (BA) is an antileishmanial herbal drug with low solubility and high toxicity. To our knowledge, this is the first study in which betulinic acid is loaded into Anionic Linear Globular Dendrimer (ALGD) in order to resolve the toxicity and insolubility problem. In order to solve mentioned problems, BA was loaded into ALGD nanocarrier. The formulation was characterized in terms of chemical bonds and morphology using Fourier Transform Infrared (FTIR) Spectroscopy, Atomic Force Microscopy (AFM) and Proton Nuclear Magnetic Resonance (1HNMR) methods. According to our study insoluble BA could loaded well into ALGD. This loading caused an increase in the solubility rate of BA by more than 700-fold and a decrease in the toxicity effects to zero in vivo environment. Overall, BD at a dose of 40 mg/kg caused a significant decreased in the number of parasite (leishmania major (L. major)) in vitro and in vivo without inducing any toxic effect.

Today, with the introduction of the interferon-free direct acting antiviral (DDA) drug regimen, as well as the brilliant advances that have been made in the prevention, diagnosis and treatment of hepatitis C, medical science has come closer to eradicating hepatitis C infection. Now the question is why, despite the existence of such very effective treatments that can even eradicate the infection, the infection is still stable in many patients and reduces the quality of life of many people, the death of many patients and also transmission to other people and thus its prevalence has increased in the community. Therefore, in this study, we aimed to examine the treatment status of patients with hepatitis C and also the therapeutic capacity of these patients in Arak city.

In this study, which is a descriptive-analytical study, people with chronic hepatitis C in Arak city in 2018-19, whose disease was confirmed, were included in the study. Then, the information of these patients was collected in a questionnaire that contained demographic information, risk factors, tests and treatment process of the patient, through the information obtained from the laboratory and also during a telephone interview. Finally, the collected data were analyzed using SPSS software version 24.

In this study, a total of 429 patients whose PCR or Elisa test were positive in the years 98-97. We were able to conduct a complete telephone interview with 152 patients and prepare a complete questionnaire for them, of which 96 had a positive PCR and 56 had a positive Elisa. After interviewing the first group, it was found that 70% of patients have completed treatment and 30% have not started treatment or left it incompletely. In the second group it was found that only 43% of the patients followed and completed the treatment, and 57% did not follow the treatment. The main reason for not pursuing treatment was lack of knowledge about the disease and then addiction and treatment costs, respectively.

The treatment process in PCR-positive patients was more favorable than in ELISA-positive patients. In the first group, lack of knowledge about the dangers of the disease and in the second group, lack of knowledge about the disease was the main reason for not treating these patients. Therefore, one of the ways to eradicate hepatitis C in the community is to provide adequate information to patients.

Treatment of leishmaniasis is a challenge due to problems such as high price and dose of the drug, drug resistance and side effects.

The study aims to introduce plants compounds, which their antileishmanial effects were approved in vivo conditions.

This study as a review article was performed by searching the keywords of “medicinal plants with in vivo antileishmanial effects, nanocarrier, clinical trials, and mechanism of action” in the well-known databases to 2018. In this study, 14 medicinal plant compounds with antileishmanial effects were reviewed and mechanism of action and their in vivo therapeutic effect were evaluated.

It was found that while some of these compounds had low antileishmanial effects, their efficacy against leishmaniasis was significantly increased through loading into nanocarriers.

This study indicated that active component of medicinal plants especially along with nano carriers can be of interest for the treatment of Leishmania.

 Clostridium difficile is the main cause of Antibiotic-Associated Diarrhea (AAD) in the hospital setting. Today, the use of probiotics for the prevention and treatment of AAD and colitis is increasing. In this study, we investigated the effect of probiotic yogurt on the frequency of Clostridium difficile.

 In this randomized clinical trial study, 132 elderly patients admitted to the infectious ward of Vali-e-Asr Hospital in Arak, who were under antibiotic treatment, were randomly divided into two groups, case (yogurt probiotic, 200 mg/d for 8 days) and control group (common yogurt). All patients were trained about the signs of colitis. We evaluated the colitis signs and the presence of Clostridium difficile by Polymerase Chain Reaction (PCR) and compared them between the groups. The obtained data were analyzed with appropriate statistical tests in SPSS V. 16.

 The Research Ethics Committee of Arak University of Medical Sciences approved this study (Code: 10-165-93). Also, it was registered at the Iranian Registry of Clinical Trials (Code: IRCT2016092229915N1).

 Clostridium difficile was detected in 4 (6.1%) patients of the case, and 1 (1.5%) patient of the control group, at the beginning of the study. There was no significant difference between the frequency of Clostridium difficile and colitis syndrome between two groups at the end of the study (P>0.05).

 Probiotic yogurt has no significant effect in reducing the frequency of Clostridium difficile and colitis syndrome in our study.

Despite considerable efforts to control AIDS pandemic, it is still one of the significant infectious concerns worldwide. The advance in medical research has led to the development of highly active antiretroviral therapy with a considerable effect to suppress the disease. However, an effective vaccine capable of eradication the HIV pandemic is not available yet. Failure to develop a prophylactic vaccine diverted the efforts to clinical trials of therapeutic vaccines.

Here, we review different approaches to dendritic cell-based HIV therapeutic vaccines. We have summarized the dendritic cell-based trials as HIV therapeutic vaccination, registered in the United States clinical trial database. Results and

The strategies applied in the clinical trials were mostly of low success rates; however, by using dendritic cell therapy, they could trigger the host immune response against HIV-1 infections.

  Toxoplasma gondii infection has public health importance and can lead to serious diseases in immunosuppressed patients, such as HIV cases. Appropriate control of T. gondii infection in HIV patients requires information about the prevalence of T. gondii antibodies and DNA in different population. In this study, we aimed to determine the prevalence of Toxoplasma gondii antibodies and DNA in HIV patients in Tehran, Iran. A total of 149 HIV patients from the Iranian Research Center for HIV/AIDS, Tehran, Iran were enrolled in the study. Anti-Toxoplasma IgG and IgM were detected by ELISA and T. gondii DNA was evaluated by PCR and quantitative real-time PCR. IgG positive samples were also assessed for their avidity. Anti-Toxoplasma IgG and IgM were positive in 46.3% and 2.7% of cases respectively. 92.7% of our patients showed past infection and 4.3% revealed recently acquired toxoplasmosis based on their IgG avidity test. T. gondii DNA was not detected by PCR but real-time PCR results showed DNA in 4.7% of total patients and 13.1% of the IgG seropositive cases. Our findings indicated that latent toxoplasmosis was relatively prevalent in our study population, but new T. gondii infection had low prevalence. Almost half of our patients were IgG negative and at risk of acquiring toxoplasma infection. Low copy numbers of DNA were detected in 4.7% of the cases without any clinical manifestation. Therefore, detection and monitoring of anti-Toxoplasma antibodies and DNA in HIV patients is substantial to estimate the risk of reactivation and new infection.

Nowadays, nanocarriers are used for leishmaniasis treatment due to development of drug resistance and several side effects with conventional therapeutics. In this study we aimed to evaluate in vivo effects of four synthesized nanodrugs including amphotericin B-nanochitosan (AK), betulinic acid-nanochitosan (BK), amphotericin B-dendrimer (AD), and betulinic acid-dendrimer (BD) in the treatment of Leishmania major infection (L. major) in mice model by using pathological analyses to choose the most effective nanodrug in leishmaniasis. The four nanodrugs efficacy in the improvement of L. major lesion in a mice model was evaluated by using pathological analyses including measurement of organs size and parasite number. Additionally, the nanodrugs toxicity was evaluated by measurement of various blood factors. The histopathological results of the present study showed that BK, at the dose of 20 mg/kg, and AK, at the dose of 10 mg/kg, were more effective in decreasing the parasite number in the kidney, liver, and spleen. Moreover, BK20 mg/kg and AK10 mg/kg decreased the organs size significantly while AD50 mg/kg and BD40 mg/kg were less effective. However, none of the four nanodrugs had increased the blood factors and they were not toxic. Overall, the pathologic findings of various mice organs treated with different formulations showed that AK10 mg/kg and BK20 mg/kg were more effective in recovery of L. major’s pathological effects in comparison to AD50 mg/kg and BD40 mg/kg. Therefore, it seems that AK and BK, in this mentioned dosage, could be considered as a proper candidate for treatment of leishmaniasis.

Hepatitis A virus (HAV) is a major cause of acute viral hepatitis throughout the world. The severity of HAV clinical symptoms in infected cases is related to age. Age - specific seroprevalence studies are a reliable method to estimate the susceptibility rate to HAV in populations and can help establish vaccination implementation policies.
In this studyweaimedto determine the age - specificHAVseroprevalenceamon 1 to 23 years subjects residing in Tehran, Iran.
In this cross - sectional study, blood samples of 1120 cases (516 male and 604 female) referred to hospitals’ biochemical laboratories in Tehran, Iran, between the ages of 1 - 23 years were tested for total hepatitis A antibody (anti - HAV) by ELISA. Stratification of the study population was conducted according to age.
The overall prevalence of total anti - HAV was 6% (95% CI: 4.74% - 7.52%). HAV prevalence rates according to age groups were as follows: 5.7% between 1 - 5 years, 1.7% between 6 - 10 years, 4.2% between 11 - 15 years, 5.5% between 16 - 19 years, and 15.3% between 20 - 23 years. Except the 6 - 10 year age group, an increase in HAV seropositivity was observed with age. Anti - HAV seropositivity in terms of age groups was significantly different from each other (P = 0.000). The HAV seroprevalence rate was 32.8% in males and 67.2% in females with a significant difference between genders (P = 0.025).
Our study demonstrates that most young children are susceptible to HAV infection, whereas adolescents and young adults are at more risk for HAV acquisition. Therefore HAV vaccination of young children seems logic and beneficial.

Community-acquired pneumonia (CAP) is an acute infectious disease of respiratory system. CAP is a common and potentially serious illness and is associated with considerable morbidity and mortality particularly in elder adult patients and those with significant comorbidities. One of the important causes of pneumonia is Mycoplasma pneumonia which has a mild course and rarely leads to hospitalization. In this study we aimed to determine the prevalence of pneumonia caused by M. pneumoniae in hospitalized patients in Arak city.
This study was conducted in 415 hospitalized patients older than 18 years, diagnosed with CAP in Valiasr hospital in Arak city. Pharyngeal swabs or sputum were taken from all patients and tested for M. pneumoniae by real time PCR.
A total of 415 cases with mean age 53.73± 19.88 years were enrolled in the study. 54.7% of them were men and 45.3% were female. M. pneumonia was detected in 9.4% of patients. Cases were infected with M. pneumoniae had significantly lower age compared to patients with pneumonia due to other pathogens (P value: 0.001). The highest incidence of mycoplasma pneumonia was observed in the spring and summer.
This study showed that M. pneumonia is causative agent of pneumonia in 9.4% of hospitalized CAP patients. Due to highest prevalence of mycoplasma pneumonia in spring and summer and in younger cases, M. pneumoniae should be considered as a causative agent of pneumonia in younger hospitalized CAP patients in these seasons.

Spondylitis is a serious disease caused by a variety of pathogens. The identification of spondylitis etiologies is a very important medical issue. This study was conducted to compare clinical, laboratory and radiological features of the patients with tuberculous (TS), brucellar (BS) and pyogenic spondylitis (PS) in a central city of Iran.
In this retrospective study, we obtained the data of 100 patients with spondylitis from a hospital in Arak city. The patients were divided into three groups including TS (8 cases), BS (71 cases) and PS (21 cases), based on the spondylitis etiology.
The mean age of cases with TS, BS, and PS was 67.25±20.26, 55.39±15.60 and 52.19±12.74 years, respectively. The most common clinical feature was back pain followed by fever. Twenty-one cases had psoas abscess which was more common in PS group. No significant difference regarding the involved vertebral regions was observed between the groups. Intravenous drug use, history of vertebral surgery and chronic renal failure were frequent in patients with PS, and all TS cases had pulmonary involvement.
Our data showed that presence of concomitant pulmonary involvement and a confirmed history of tuberculosis are suggestive of tuberculous spondylitis. However, the distinction between TS and BS is still problematic and only a combination of clinical data, laboratory findings, radiological features and history of TB can be helpful in differentiation of TS and BS.

Herpes simplex virus type 2 (HSV-2) is a common infection in human immunodeficiency virus (HIV) patients and may accelerate HIV progression by rising HIV viral load and decreasing CD4 count. However, the available data regarding the influence of HSV-2 seropositivity on HIV progression in HIV individuals are inconclusive. Therefore, we aimed to determine HSV-2 seroprevalence in naïve HIV patients and normal controls and also investigate the relation of HIV viral load and CD4 count with HSV-2 seropositivity. Subsequently, we investigated the association of HSV-2 serostatus with changing in CD4 count and HIV viral load in our subjects, after one year follow-up.
In this study, 116 naïve HIV patients and 85 healthy controls from Tehran, Iran were enrolled. HSV-2 IgG antibody was detected by ELISA. CD4 count was determined by flowcytometry, and serum HIV RNA copy numbers were determined using real-time PCR.
The prevalence of HSV-2 IgG was 18.1% in naïve HIV patients and 0% in the control group (P = 0.000). HSV-2 seroconversion was observed in 2.43% of HIV patients after one year. There was no significant difference regarding HSV-2 serostatus with CD4 count and HIV RNA viral load in our study cohort at baseline and after one year.
Our results revealed that the prevalence and incidence of HSV-2 infection are low in our HIV cases, and it is negligible in the control group. However, it seems that HIV/HSV2 co-infection has no role on HIV infection acceleration.

Hepatitis D virus (HDV) is a defective RNA virus that depends on the hepatitis B surface antigen (HBsAg) for its replication. Infection with hepatitis D virus in hepatitis B virus chronic carriers causes accelerated progression to chronic active hepatitis, cirrhosis and hepatic carcinoma. In studies conducted in Iran and different countries, different prevalence of HDV had been reported. The aim of this study was to determine the frequency of hepatitis D virus infection in chronic hepatitis B patients in Arak city.
Patients and This cross-sectional study was conducted on 95 chronic hepatitis B patients in Arak city. Demographic characteristics and risk factors for HDV transmission were recorded. Hepatitis D antibody (Anti-HDV) was determined by ELISA in the serums of patients.
In this study 95 chronic hepatitis B patients were enrolled. 61% of cases were male and 39% were female. Anti-HDV was detected in 2 (2.1%) of chronic hepatitis B patients. There was no significant association between HBV/HDV co-infection and sex, age, education level and occupation (P values: 0.74, 0.52, 0.95 and 0.65 respectively). There was no history of injection drug use, unprotected sexual contacts, tattooing and history of familial contact in hepatitis D infected patients.
Our results showed that Arak is an area of low HDV infection in Iran.

Plasmid mediated AmpC β-lactamase resistance in Escherichia coli is an emerging problem worldwide. Phenotypic methods are commonly used for detection of resistance production in Gram-negative isolates, but molecular data about the prevalence of plasmid-mediated AmpC-type resistance at the national level are needed. Hence, a prospective study was undertaken to determine of antibiotic resistance and detection of plasmid-mediated AmpC beta-lactamases among clinical isolates of Escherichia coli from Patients of Vali-e-Asr hospital in Qom city.

In this cross-sectional, descriptive study (conducted between 20 March and 20 May, 2016), 61 specimens of E. coli were collected from patients visiting Vali-e-asr Hospital in Qom, Iran, using conventional microbiological methods. To determine antibiotic resistance of the specimens, antibiogram obtained from disk diffusion test was used. Then, the screened strains were examined for PCR amplification of (CITM, FOX)-type plasmid-mediated AmpC beta-lactamases- producing genes. The results were analyzed by using SPSS software.

Among 61 E. coli specimens, 54 specimens (88.5%) were associated with urine and the rest (11.5%) with blood. In terms of gender, 49 patients (80.3%) were female and 12 patients (19.7%) were male. Among the specimens, the highest and least antibiotic resistance was observed against amoxicillin and imipenem, respectively. Resistance to ceftazidime was seen in 27 specimens (69.2%). From the results, CITM was identified in 7.4% of specimens, but FOX was not detected in specimens.

Results showed that the prescription of antibiotics for patients with plasmid-mediated AmpC beta-lactamases -producing strains not only did not stimulate recovery, but also led to the formation of resistant strains. In addition, the phenotypic methods do not produce the actual number of AmpC β-lactamase strains. Therefore, the conduction of genotypic studies in society leads to effective and faster treatment of patients, and prevents the spread of resistant bacterial isolates.

Mycoplasmataceae are the smallest self-replicating organisms without cell wall. The Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma urealyticum are associated with genitourinary tract and non-genital infections and could cause complications such as infertility, preterm delivery, itching vagina, abortion. This study designed for rapid detection of Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma urealyticum among infected women by Multiplex PCR .
In this cross-sectional descriptive study in a period of 6 months (June to November 2015), 115 vaginal swabs samples were collected from women with genital tract infections referring to diagnostic laboratories in Tehran. All specimens were subjected to Multiplex PCR and cultivation methods. The results and the sensitivity and specificity of test were analyzed by Chi-squared and Independent T tests using SPSS software.
Our results indicated that 38 cases (33%) were positive for Mycoplasma infection by cultivation method while 54 cases (46.9%) were positive by Multiplex PCR method. Mycoplasma hominis, Mycoplasma genitalium andUreaplasma urealyticum were detected in 13.9%, 7.8% and 23.4% respectively. In 1.8% we found coinfection that infected by two species. The maximum rate of infection were detected among 30- 42 years old group, that statistically is significant (P= 0.001). The sensitivity of Multiplex PCR method for detection of Mycoplasma hominis, Mycoplasma genitalium andUreaplasma urealyticum were 100% while its specificity for them were 96.1%, 97.2% and 92.63% respectively.
Regarding the importance of genital Mycoplasmas among genital infections and their related complications and regarding the difficulty of cultivation method and its low sensitivity, we recommend Multiplex PCR method for their detection. Multiplex PCR method is very sensitive and rapid and its specificity for detection of all genital Mycoplasmas significantly is acceptable.
Iranian Journal of Infectious Diseases and Tropical Medicine Vol 21 , No 74 , 2016
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Key words: Mycoplasma hominis, Mycoplasma genitalium ,Ureaplasma urealyticum, Multiplex PCR

Hepatitis C virus (HCV) infection is a worldwide concern and it is the major cause of liver disease. Several genotypes of the HCV have been reported from different regions of the world. The determination of the HCV genotypes is important for the prediction of response to antiviral treatment and clinical outcomes. So, HCV genotyping in each region is of great importance. This investigation was performed to determine the distribution of HCV genotypes in Arak city, Central province of Iran.
Patients & In this cross sectional study, 174 cases with chronic HCV infection from Arak city were enrolled. HCV infection was confirmed by positive results in HCV antibody (anti-HCV) and HCV-RNA tests. HCV genotypes were determined using a PCR based genotyping kit.
A total of 174 HCV infected patients with mean age of 37.5±10.24 years were enrolled. 97.7% of cases were male and 2.3% were female. The main route of HCV transmission was injection drug use (IDU) which was observed in 59.8% of cases. Genotyping results demonstrated that subtype 3a (52.9%) was the most prevalent HCV type in Arak, followed by subtype 1a (22.9%) and subtype 1ab (17.8%).
This study showed that HCV subtype 3a was the most prevalent HCV type, followed by subtype 1a and subtype 1ab in Arak, central province of Iran. Investigation of HCV genotypes in different parts of the country is needed to facilitate treatment options and preventive strategies.

The household transmission of hepatitis B virus (HBV) is a major health problem. High incidence of HBV infection is observed within the household contacts of HBV carriers. We aimed to evaluate serological markers of hepatitis B infection among family members of HBV carriers in Arak, central Iran.
Data were collected from the 100 chronic HBV carriers (subjects with positive HBsAg for at least 6 months period) as index cases and 700 members of their family. Then, we checked serologic markers of hepatitis B [hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and hepatitis B surface antibody (anti- HBs)] using the ELISA test.
The prevalence rate of HBsAg, anti-HBs and anti-HBc among household members was 23.3%, 20.4% and 23% respectively. Isolated anti-HBc (positive anti-HBc with negative HBsAg and anti-HBs) found in 0.4% of family members. Mothers and children with 47.6% and 17.2% had the highest and lowest rates of HBV infection, respectively (P=0.00). There was a significant difference between mothers and spouses of index case (47.6% and 29.8%) regarding HBsAg positivity (P=0.03).
The low rate of HBV infection reported in children reveal the effective prevention of HBV transmission with the universal vaccination programs and also importance of pregnant women screening for HBV serological markers.

Kaposi’s sarcoma is a vascular malignancy, which frequently occurs among immunocompromised individuals such as transplant recipients and patients with acquired immunodeficiency syndrome. Human herpesvirus 8 (HHV-8) is considered the etiological agent of all forms of Kaposi’s sarcoma. Though some seroepidemiological studies conducted on the prevalence of HHV-8 in Iran, there are insufficient data on the prevalence of HHV-8 viremia in HIV infected patients. We therefore, aimed to determine the prevalence of HHV-8 viremia in general population and HIV infected patients without Kaposi’s sarcoma in Tehran, Iran.
We conducted a cross sectional survey on 99 patients with HIV infection referred to Iranian Research Center for HIV/AIDS and 40 healthy controls in Tehran, Iran from January to April 2014. The presence of HHV-8 DNA was detected in buffy coat samples of enrolled subjects using nested PCR assay.
A total of 99 HIV infected patients with mean age of 37.9±10 yr and 40 healthy controls with mean age of 39±11.5 yr were enrolled in the study. The mean CD4 count was 410.3± 211.4 cells/mm3. HHV-8 DNA was not detected in both healthy control and HIV patient groups.
This survey showed low rate of HHV-8 DNA in healthy controls and HIV patients. Considering our findings HHV-8 infection does not seem to be widespread in our population. Further studies focusing on different regions of Iran appear to be required to have a more accurate estimation.

Primary infection with BK virus (BKV) is occurred during childhood and usually asymptomatic, but after initial infection, BKV may persist lifelong in the kidney and genitourinary tract. Reactivation may occur in individuals with compromised immunity such as renal transplant recipients. Due to the role of BKV in BK virus-associated nephropathy (BKVAN) and potentially renal allograft rejection, the detection of BKV in renal transplant candidates is very important. The aim of this study was to evaluate the frequency of BK viremia in end stage renal disease cases who were candidates for renal transplantation.
In this cross-sectional study, 50 cases with end stage renal disease who were candidates for renal transplantation were recruited from the main dialysis unit in Tehran, Iran. Presence of BK viremia was determined in plasma samples of cases using real time PCR.
A total of 50 renal transplant candidates with mean age 37.8±13 yr were enrolled in the study. Fifty two percent of subjects were male. Forty six (92%) of them were under HD and 4 (8%) were on PD. BK virus was not detected in any plasma samples of renal transplant candidates.
This study showed absence of BK viremia in our renal transplant candidates. However, due to the important role of BKV in BKVAN and renal graft failure and rejection, further studies involving larger number of cases are required to elucidate the rate of the BKV in renal transplant candidates.

Hepatitis B virus potentially accelerates graft rejection and mortality in renal transplantation population. Vaccination of graft candidates without prior immunization against HBV seems essential before transplantation but some candidates of transplantation have not received HBV vaccine at the time of receiving graft. We aimed to evaluate immunogenicity of an enhanced regimen (4 doses of double-strength intramuscular shots) after kidney transplantation in candidates without history of prior HBV vaccination.
This quasi-experimental study was conducted, 49 renal graft recipients in Sina Hospital (Tehran University of Medical Sciences, Tehran, Iran) of age >18, receiving graft within past 6 months and negative history of hepatitis B vaccination from 2010-2011. Participants received 40 μg intramuscular (IM) shots of a recombinant vaccine in the months 0, 1, 2 and 6. The titer of HBsAb was measured 8 weeks after the 3rd and 4th injections. Cases with HBsAb titers less than 10 mIu/ml were considered as non-responder while antiHBs≥10 mIu/ml was considered protective.
The overall response rate was 57.14% (28/49 patients). Protective HBsAb titers were detected in 44.89% patients following 3rd dose and reached to 57.14% after injecting the 4th shots. The mean HBsAb titers were 50.00 (±88.35) mIu/ml and 229.45 (±356.56) mIu/ml after the 3rd and 4th shots respectively. Responders showed significantly younger age in comparison to non-responders (P=0.013). The vaccine was well tolerated in all patients with no side effects.
Regarding the relative good response rate following HBV vaccination in graft recipients, we suggest a post-transplantation enhanced regimen of 4-dose double-strength IM shots against HBV in patients without prior immunization.

Occult hepatitis C virus (HCV) infection is defined as the presence of HCV-RNA in liver or peripheral blood mononuclear cells (PBMCs) in the absence of detectable hepatitis C antibody (anti-HCV) or HCV-RNA in the serum. Low concentrations of HCV-RNA may be detected in PBMCs of hemodialysis (HD) patients and this could have a great impact on the management of HD patients. The aim of this study was to detect the occult HCV infection in Iranian HD patients. Patients and A total of 70 anti-HCV negative HD patients from three dialysis units in Tehran, Iran were included in this study. In these cases, presence of HCV-RNA in plasma samples was tested by reverse transcriptase-nested polymerase chain reaction (RT-nested PCR). In cases with negative anti-HCV and plasma HCV-RNA, genomic HCV-RNA was checked in PBMC specimens by RT-nested PCR. Seventy anti-HCV negative HD patients were enrolled in the study. 32.85% and 1.43% of cases had elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) respectively. 7.14% of patients had elevated levels of both ALT and AST. HCV-RNA was negative in plasma samples of all anti-HCV negative HD subjects. The genomic HCV-RNA was not detected in any PBMC samples of HD cases with negative anti-HCV and plasma HCV-RNA. Occult HCV infection was not detected in our HD patients despite of elevated levels of liver enzymes in some participants. Further studies involving larger number of HD patients are required to elucidate the rate of occult HCV infection in HD cases.