Current Issue : October - December Volume : 2016 Issue Number : 4 Articles : 5 Articles
Background: Despite increased deliverance of antiretroviral therapy (ART), morbidity and mortality\nfrom TB are still predominant among HIV/AIDS infected patients in Ethiopia. Thus, current\nstudy aimed to determine magnitude and predictors of tuberculosis among cohort of HIV infected\npatients at Arba Minch General Hospital, Ethiopia, 2015. Methods: Hospital based retrospective\nfollow-up study was conducted among study population which was HIV/AIDS infected individuals\nregistered from September 2007 to 2013. The data were collected using structured data abstraction\nform and four ART trained nurses were used to abstract the data. The data were checked for\ncompleteness, cleaned and entered into Epi Info 7.0 and analyzed using SPSS version (IBM-21).\nResults were summarized by using table of frequency, graph, and measure of central tendency.\nStatistical significance was inferred at P- 0.05. Adjusted odd ratio (AOR) with 95% confidence\ninterval (CI) was used to determine predictors. Result: Four hundred ninety six patient�s\ncharts were abstracted. Cumulative and incidence density of tuberculosis were 21.4% (95% CI:\n21.3, 21.44) and 5.36 per 100 person year respectively. Cigarette smokers (AOR: 2.82, 95% CI\n(1.27 - 6.27)), household with family size of 3 - 4 (AOR: 2.26, 95% CI (1.14 - 4.50)), baseline WHO\nclinical stage III (AOR: 20.26, 95% CI (7.09 - 57.6)) and IV (AOR: 22.9, 95% CI (6.91 - 76.4)) and\nheamoglobin level of <10 (AOR: 2.56, 95% CI (1.22 - 5.33)) were important predictors (risk factors)\nof tuberculosis among HIV infected patients. Conclusion and recommendation: Relatively\nhigh incident tuberculosis cases were established among HIV infected patients and history of cigarette\nsmoking; family size; hemoglobin level and base line WHO clinical stage were responsible\nfor this incidence. Therefore; early initiation of HAART as per current guideline should get stressed,\nand the finding that smoking was important predictors for TB in Ethiopia had obvious TB control\nimplication which required high attention focused on fighting against cigarette smoking among\nHIV infected cohort....
Background: Vaccine-associated paralytic poliomyelitis (VAPP) and immunodeficient long-term polio excretors\nconstitute a significant public health burden and are a major concern for the WHO global polio eradication\nendgame.\nCase presentation: Poliovirus type 3 characterized as Sabin-like was isolated from a 5-month-old Albanian child\nwith X-linked agammaglobulinemia and VAPP after oral polio vaccine administration. Diagnostic workup and\ntreatment were performed in Italy. Poliovirus replicated in the gut for 7 months. The 5� non coding region (NCR),\nVP1, VP3 capsid proteins and the 3D polymerase genomic regions of sequential isolates were sequenced. Increasing\naccumulation of nucleotide mutations in the VP1 region was detected over time, reaching 1.0 % of genome\nvariation with respect to the Sabin reference strain, which is the threshold that defines a vaccine-derived poliovirus\n(VDPV). We identified mutations in the 5�NCR and VP3 regions that are associated with reversion to neurovirulence.\nDespite this, all isolates were characterized as Sabin-like. Several amino acid mutations were identified in the VP1\nregion, probably involved in growth adaptation and viral persistence in the human gut. Intertypic recombination\nwith Sabin type 2 polio in the 3D polymerase region, possibly associated with increased virus transmissibility, was\nfound in all isolates. Gamma-globulin replacement therapy led to viral clearance and neurological improvement,\npreventing the occurrence of persistent immunodeficiency-related VDPV.\nConclusions: This is the first case of VAPP in an immunodeficient child detected in Albania through the Acute\nFlaccid Paralysis surveillance system and the first investigated case of vaccine associated poliomyelitis in Italy since\nthe introduction of an all-Salk schedule in 2002. We discuss over the biological and clinical implications in the\ncontext of the Global Polio Eradication Program and emphasize on the importance of the Acute Flaccid Paralysis\nsurveillance....
Objective. To identify blood biomarkers to predict severity and mortality in AIDS PCP patients. Methods. Biomarkers including\nclinical parameters and plasma inflammatory cytokines were assessed in 32 HIV-infected patients with Pneumocystis pneumonia\n(PCP) at time of admission. Predictive value of the biomarkers for clinical severity and in-hospital mortality was evaluated\nby corresponding ROC curve. Results. Levels of CRP, WBC, LDH, HBDH, and Ferritin were significantly higher in the severe\nand nonsurvivor AIDS PCP patients. These important biochemical indicators have inverse correlation with oxygenation index,\nespecially levels of LDH(P = 0.008, R2 = 0.258), HBDH(P = 0.001, R2 = 0.335), and Ferritin (P = 0.005, R2 = 0.237). Plasma IL-8\nand IL-6 levelswere significantly higher in patients with PaO2/FiO2 ââ?°Â¤ 200mmHg and nonsurvivors than in thosewith PaO2/FiO2 >\n200mmHg and survivors. Severe and nonsurvival groups showed higher ratio of mean IL-6/IL-10 level (1.78 Ã?± 1.56, P < 0.001; 1.11\nÃ?± 0.72, P = 0.043), larger AUC (95% CI 0.781ââ?¬â??1.000, P < 0.001; 95% CI 0.592ââ?¬â??0.917, P = 0.043), and more significantly inverse\ncorrelation with the oxygenation index. Conclusion. Plasma IL-8, LDH, and HBDH levels and IL-6/IL-10 ratio could be helpful for\nearly evaluation of the severity and predicting fatal outcomes in AIDS PCP patients....
Background: Invasive aspergillosis is a life-threatening disease, and its incidence has increased in the recent past.\nDectin-1 recognizes �²-glucans and mediates innate immune responses to Aspergillus fumigatus. Transcription factor\nPU.1 has been the focus of recent research due to its role in inflammation and infection. However, its role in\nDectin-1 regulation during A. fumigatus infection remains to be elucidated.\nMethods: THP-1 cells were stimulated with A. fumigatus conidia. We then used real-time RT-PCR, Western blot, and\nimmunofluorescence assays to analyze the mRNA and protein levels and cellular distribution, respectively, of Dectin-1\nand PU.1 in stimulated THP-1 cells. Additionally, we used the luciferase reporter assays, chromatin immunoprecipitation\n(ChIP) assays, electrophoretic mobility shift assays (EMSA), and RNA interference experiments to investigate the role of\nPU.1 in Dectin-1 regulation.\nResults: Our results revealed that Dectin-1 mRNA and protein levels as well as the PU.1 protein level were increased in\nTHP-1 cells stimulated with A. fumigatus conidia, while the mRNA expression level did not significantly change between\nthe stimulated and control groups. We also observed that PU.1 translocated into the nucleus in stimulated THP-1 cells.\nThe results of the luciferase reporter assay showed that PU.1 promoted human Dectin-1 (hDectin-1) gene activity. ChIP\nand EMSA indicated that PU.1 could bind with hDectin-1 gene promoter at three potential transcription factor-binding\nsites (TFBSs). In addition, knockdown of PU.1 significantly decreased Dectin-1 expression.\nConclusions: This study demonstrated the novel role of PU.1 in the immune response to A. fumigatus through\nupregulation of Dectin-1 expression and its translocation to the nucleus in A. fumigatus-stimulated THP-1 cells....
Background: Hepatitis B virus (HBV) variants belong to different genotypes, A-J, whose worldwide distribution is\nlinked with geography, probably because viral spread was associated with ancient human migrations.\nHBV genotype G (HBV-G) is an aberrant genotype with little sequence divergence, suggesting a recent origin.\nHBV-G is strongly associated with certain risk groups such as intravenous drug users (IDUs) and men who have sex\nwith men (MSM), but hardly with geography. The origin and epidemiology of HBV-G remain unresolved, as is the\ndisease association.\nMethods: To estimate the prevalence and possible time of introduction of HBV-G into the MSM community in\nAmsterdam, the Netherlands, we have retrospectively analysed 226 blood serum samples from HBsAg positive MSM\nenrolled in the Amsterdam Cohort Studies (ACS) on HIV infection and AIDS dating from 1984 to 1999 using\ngenotype-specific PCR assays.\nResults: Of the 226 HBsAg-positive samples, 149 were HBV DNA positive. Of those, 104 were positive for HBV\ngenotype A (HBV-A) and five for HBV-G, and 40 showed a dual infection with both HBV-A and HBV-G. Being\nHIV-infected was significantly associated with a reduced HBV DNA viral load in blood, but not with the prevalence\nof HBV-G. Early virus already contained stop codons in the precore region and a 36 bp insertion in the core gene\nwhich are the characteristics of HBV-G.\nConclusions: HBV-G was introduced before 1985 into the Amsterdam MSM community. Early isolates show very\nlimited sequence variation, confirming a low evolutionary rate. HBV-G acquisition was independent of HIV infection,\nbut being HIV-infected was significantly associated with a reduced HBV viral load in blood, indicating a beneficial\neffect of early HIV infection in controlling HBV replication....
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