فهرست مطالب arezoo aghakhani

Variations in mitochondrial DNA copy number (mtDNA-CN) of peripheral blood leukocytes (PBLs), as a potential biomarker for gastric cancer (GC) screening has currently been subject to controversy. Herein, we have assessed its efficiency in GC screening, in parallel and in combination with serum pepsinogen (sPG) I/II ratio, as an established indicator of gastric atrophy.

The study population included GC (n = 53) and non-GC (n = 207) dyspeptic patients. The non-GC group was histologically categorized into CG (n = 104) and NM (n = 103) subgroups. The MtDNA-CN of PBLs was measured by quantitative real-time PCR. The sPG I and II levels and anti-H. pylori serum IgG were measured by ELISA.

The mtDNA-CN was found significantly higher in GC vs. non-GC (OR = 3.0; 95% CI = 1.4, 6.4) subjects. Conversely, GC patients had significantly lower sPG I/II ratio than the non-GC (OR = 3.2; CI = 1.4, 7.2) subjects. The combination of these two biomarkers yielded a dramatic amplification of the odds of GC risk in double-positive (high mtDNA-CN-low sPGI/II) subjects, in reference to double-negatives (low mtDNA-CN-high sPGI/II), when assessed against non-GC (OR = 27.1; CI = 5.0, 147.3), CG (OR = 13.1; CI = 2.4, 72.6), or NM (OR = 49.5; CI = 7.9, 311.6) groups.

The combination of these two biomarkers, namely mtDNA-CN in PBLs and serum PG I/II ratio, drastically enhanced the efficiency of GC risk assessment, which calls for further validations.

  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.

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.

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.

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.

Due to their similar routes of transmission, human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infection occurs considerably. HBV infection progresses more rapidly in HIV-infected patients. Therefore, HBV vaccination of all non-immune HIV infected patients is recommended. On the other hand, HIV-infected subjects have suboptimal responses to HBV vaccine. In this study, we aimed to determine the immune responses to standard HBV vaccination in HIV-infected patients. Fifty-six HIV infected patients who lacked evidence of either prior HBV infection or immunity were subjected to standard HBV vaccination, as 3 intramuscular injections of the standard dose (20 μg) of recombinant HBV vaccine at months 0, 1 and 6. Hepatitis B surface antibody (anti-HBs) titers were checked in all cases one month after the vaccination. A protective antibody response was defined as an anti-HBs titer of ≥10 IU/L. HBV seroprotection was observed in 56.6% of HIV-infected patients. There was no significant difference between cases with and without seroprotection regarding age, sex, possible route of HIV acquisition, CD4 count, receiving antiretroviral therapy (and its duration) and HCV infection. Our study confirms previous reports that HIV-infected patients have a lower response rate to the standard HBV vaccination compared to general population. So other strategies are needed to improve the HBV vaccine response rate in HIV cases.

Distinction between brucellar epididymo-orchitis (BEO) and nonspecific epididymo-orchitis (EO) is an important medical issue. This study was conducted to compare demographic, clinical and laboratory features, treatment and outcome of patients with BEO and nonspecific EO in Arak city, Markazi Province, Iran. We compared the clinical and laboratory characteristics of 40 BEO and 40 non-specific EO patients. The diagnosis of brucellosis was based on the symptoms, compatible clinical findings and standard tube agglutination test. Epididymo-orchitis was diagnosed by swelling and tenderness of scrotal skin, testis and epididymis, which was confirmed by sonography. BEO can be distinguished from nonspecific EO based on having a history of living in rural areas, contact with domestic animals, and consumption of unpasteurized dairy products. Other criteria include seasonal pattern, gradual onset (P<0.05), sweating (P<0.001), arthralgia (P=0.02), associated lower urinary tract symptoms (P=0.004) and lower rate of leukocytosis and abnormal urine analysis (P=0.002). Our results showed that brucellosis should be considered as a cause of EO in endemic areas like Iran. Combination antibiotic therapy to manage BEO is usually effective and all patients in this study responded quite satisfactory to the treatment.

Interleukin (IL)-10 is an important anti-inflammatory and immunomodulatory cytokine. Some authors believe that single nucleotide polymorphisms (SNP) in the promoter region of the IL-10 gene have been associated with susceptibility to HIV infection and progression to AIDS, but its role is not clearly defined yet. The present study was undertaken to evaluate the association between HIV infection susceptibility and progression with SNP in the promoter region of the IL-10 gene. This study was carried out on 70 HIV infected patients (39 treatment naïve and 31 undertreatment) and 31 matched healthy controls. The biallelic polymorphisms in the IL-10 gene promoter (-592, -1082) were analyzed by polymerase chain reaction and direct sequencing. At position -1082, G/A was the most common genotype and A was the most prevalent allele and at position -592, A/C was the most prevalent genotype and -592 C was the most common allele in HIV positive patients; although there was not any significant difference between cases and controls regarding genotypes and alleles of these regions. Genetic polymorphisms of IL-10 promoter region may not associate with HIV infection outcome and the lack of this association suggests that other genes may influence on HIV infection course.

Occult Hepatitis B virus (HBV) infection (OBI) is defined as the presence of HBV-DNA in the liver or serum with undetectable hepatitis B surface antigen (HBsAg). Hemodialysis (HD) patients are at risk of acquiring parenterally transmitted infections.. The aim of this study was to assess the prevalence of OBI in HD patients..Patients and A hundred HBsAg negative HD patients were included in this study from main dialysis units in Tehran, Iran. HBsAg, hepatitis B surface antibody (anti-HBs), hepatitis B core antibody (anti-HBc) and liver enzymes levels were examined in all subjects. The presence of HBV-DNA was determined in plasma samples using real-time PCR.. A hundredpatients with a mean age of 58.5 ± 16.1 years were enrolled in this study. In total, 56.7% were male and 43.3% female. Anti-HBs, anti-HBc, anti-HCV and anti-HIV were detected in 56.7%, 2%, 5.2% and 1% of patients, respectively. Isolated anti-HBc was detected in 2% of cases. HBV-DNA was detected in 1% of HBsAg negative patients.. This study showed a low rate of isolated anti-HBc and occult HBV infection in HD patients. It can be due to improvement of people’s knowledge about HBV transmission routes, HBV vaccination of HD patients and regular surveillance of HBV infection..

Although hepatitis B vaccine immunogenicity is high, certain risk factors such as age, tobacco consumption, obesity and genetic background have been associated with low responsiveness to HBV vaccine. We aimed to evaluate the role of occult hepatitis B virus (HBV) infection in non-responder adults to HBV vaccine in a low endemic area for HBV. A total of 52 subjects who were non-responder to HBV vaccine were enrolled in the study. HBsAg, anti-HBs and anti-HBc were tested in all subjects. The presence of HBV-DNA was determined in plasma samples by real-time PCR. A total of 52 cases with median age 34 years were enrolled in the study. 63.5% of patients were male and 36.5% were female. Isolated anti-HBc (HBsAg negative, anti-HBs negative and anti-HBc positive) was detected in 3.8% of cases. HBV-DNA was not detected in our cases. This study showed no evidence of occult HBV infection in our HBV vaccine non-responders even in cases with isolated anti-HBc.

Brucellosis is a worldwide bacterial zoonotic disease. Infection with brucella species results in the activation of cell-mediated immune response. The interaction between T-helper cell type 1 (Th1) /Th2 cytokines determines the outcome of disease. The analysis of cytokine levels is valuable to determine the role of immune system in brucella pathogenesis. The aim of this study was to investigate the levels of serum interlukine-8 (IL-8) and its relation with treatment acute brucellosis patients. Thirty-three acute brucellosis patients and 19 controls were enrolled in the study. The diagnosis of brucellosis was on the basis of the symptoms، clinical findings and standard tube agglutination test. IL-8 levels were tested in controls and patients before and after treatment by ELISA. IL-8 levels were significantly lower in brucellosis cases compared to controls. At the end of the treatment، the serum levels of this cytokine increased but there is no significant difference between this cytokine levels before and after treatment. This study showed that IL-8 was lower in brucellosis cases and after treatment، the serum levels of IL-8 increased in these patients. Further studies with more patients are needed to determine the role of this cytokine in the pathogenesis of brucellosis.

Breast cancer is the most common malignancy in women throughout the world. There are controversial reports on the role of human papillomavirus (HPV) infection in breast carcinogenesis. The aim of this study was to assess the presence of HPV-DNA in invasive breast carcinoma to determine the association between HPV infection and breast carcinoma. The study included formalin-fixed paraffin-embedded tissue samples of 100 cases with invasive ductal carcinoma of breast and 50 control tissues of mammoplasty specimens. HPV-DNA was purified and amplified through GP5+/GP6+ and MY09/MY11 primers. All tested carcinomas as well as normal tissues were negative for all types of HPV in PCR assay. Our results do not support the association between HPV infection and breast carcinoma. Further studies involving larger number of cases are required to elucidate the role of HPV infection in breast carcinogenesis.

Tetanus and diphtheria are vaccine-preventable, infectious diseases with significant morbidity and mortality. Immunization by the diphtheria and tetanus toxoid (DT) has been applied in Iran for almost 50 years. However, there are very few data about the rate of immunity to these diseases in the adult population. the humoral immunity to tetanus and diphtheria among blood donors in Arak city, central provice of Iran were investigated.Patients and A total of 530 consecutive blood donor samples were collected from Blood Transfusion Organization, Central province of Iran. All samples were tested for diphteria and tetanus IgG antibodies using enzyme-linked immunosorbent assay (ELISA). From 530 cases, 91.9% were male and 8.1% were female. 99.6% of cases had protective levels of diphtheria antibody. Protective levels of tetanus antibody were found in 96% of subjects. There was not any significant difference between diphtheria and tetanus antibodies levels and age and sex. The obtained data showed that high proportion of the adult population in Arak have sufficient protection against diphtheria and tetanus. The high protective level of immunity to diphtheria and tetanus in Iran can be due to widespread use of booster vaccines in Iranian high schools and during the military services or for pregnant women in their 3rd trimester.

Follicular thyroid carcinoma (FTC) is the second most common type of thyroid cancer after papillary carcinoma. It usually grows slowly and is clinically indolent; but rarely, its aggressive forms with distant metastases can occur. We report here an uncommon case of bilateral orbital metastasis of FTC. A 70-year-old woman presented with bilateral exophtalmus and past medical history of thyroid nodule surgery 15 years ago. Radiologic evaluation showed massive bilateral orbital mass with extension to calvarium. Tumor decompressed and removed with the suction and curettage and the patient was treated with chemoradiotherapy after operation. Pathologic examination showed metastatic follicular thyroid carcinoma. Although orbital metastasis of follicular thyroid carcinoma is uncommon, FTC should be considered as a potential primary neoplasm in a patient with orbital mass.

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. Although occult HCV infection is less aggressive than classic chronic HCV infection، nevertheless it is important in management of hemodialysis (HD) patients. Occult HCV infection has been described in two different clinical settings: in patients with normal liver enzymes or in patients with abnormal values of liver enzymes. The aim of this study was to detect the occult HCV infection in hemodialysis patients with elevated liver enzymes. This cross sectional study was performed in hemodialysis patients referring to 3 dialysis units in Tehran. In 30 anti-HCV negative HD patients with elevated liver enzymes، 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، HCV-RNA was checked in PBMC specimens by RT-nested PCR. A total of 30 HD patients with mean age 54. 4± 14. 1years and mean dialysis duration 81. 2 ±64. 4 months were enrolled in the study. All HD subjects were negative for HCV-RNA in plasma and occult HCV infection with RT-nested PCR method. Occult HCV infection was rare in HD patients with elevated levels of liver enzymes.

Laboratory reference values are an important tool for clinical management of patients. Reference values being used in most laboratories in Iran have been provided from the established reference values from developed countries. However, several variables can affect on these laboratory parameters. Therefore, this study was carried out to establish the reference values of hematological parameters in the blood donors of central province of Iran as a general population. Blood samples of 1100 male blood donors were collected consecutively from Blood Transfusion Organization. Complete blood cell (CBC) count in 2012 and differential was performed using an automated hematology analyzer. The median and 95% reference values (2.5th-97.5th) for Hb and platelet counts were 15.5 g/dl (14.1-17.7) and 209 ×109 cells/L (151-322) respectively. The median for total WBC count, neutrophil, lymphocyte, monocyte and eosinophil were 6.7 ×109 cells/L (4.3-11.2), %58 (%50-%70), 40% (30-49%), 0% (0-2) and %1 (0-3%), respectively. The hematological profile of the population in central province of Iran was different from the reports of other countries and also the standards reference ranges described in textbook. So, further nationwide study should be carried out to establish the hematological reference values of the Iranian population as a whole.

Brucellosis is a zoonotic disease and it’s still endemic in Iran. There are some reports regarding brucellosis infection in family members sharing same risk factors and remain unrecognized. However, few studies on the importance of family screening are available. We aimed to screen household members of index cases with acute brucellosis for detecting additional unrecognized cases in central province of Iran. 163 family members of 50 index cases were enrolled in the study. Standard Tube Agglutination Test (STA) and 2-mercaptoethanol (2ME) agglutination were checked in all samples. A case with STA titer ≥ 1:80, 2-mercaptoethanol (2ME) agglutination ≥ 40 and compatible signs and symptoms was considered positive for brucellosis. 15 (9.2%) of family members were seropositive for Brucella agglutinin and among them, 8 (53.3%) were asymptomatic and 7 (46.7%) were symptomatic. STA titer ranged from 1:80 to 1:640 in seropositive members. 4 of the 15 seropositive cases who identified by screening came from one index case with 6 family members. All symptomatic seropositive cases treated for Brucella infection and recovered without any complications in 6 months follow up. On the basis of our data, family members of brucellosis patients are at risk of disease acquisition, and screening of household members provides an effective way for early diagnosis and prompt treatment. However cost benefit of screening should be evaluated to reach definite decision for the implementation of the screening as a nationwide program.

Hepatitis D virus (HDV) is a defective virus dependent on hepatitis B virus (HBV) for its replication. Due to HDV transmission routes, patients undergoing hemodialysis and those with HIV infection are at risk of acquiring HDV..

This study was aimed to determine the frequency and genotype of HDV infection among patients with HIV infection and those undergoing hemodialysis..Patients and

720 cases including 120 patients undergoing hemodialysis, and 600 patients with HIV infection were studied. All cases with positive results for HBsAg were evaluated for the presence of anti-HDV antibodies. Samples with Anti-HDV positive results were subjected to nested PCR for HDV-RNA confirmation, and sequenced for HDV genotype determination..

HBsAg was found in 9 (7.5%) of 120 patients undergoing hemodialysis, and 9 (1.5%) of 600 patients with HIV infection. 3 (33.3%) of patients undergoing hemodialysis with positive results for HBsAg, and 5 (55.5%) of cases with HIV infection and positive results for HBsAg, had positive findings for anti-HDV which were then subjected to nested PCR. The amplification results confirmed that in 3 (37.5%) samples HDV-RNA was detected. Overall 2.5% of patients undergoing hemodialysis, and 0.8% of cases infected with HIV had positive results for anti-HDV and 1.7% and 0.2% of cases undergoing hemodialysis and patients infected with HIV had positive findings for HDV-RNA respectively. All of the HDV isolates were clustered in clade 1..

The survey showed that overall HDV frequency was not high in our high risk cases. Therefore, practitioners and health care managers should become aware of the risk of dual infection with HBV and HDV especially in high risk patients..