Ahmed El-Gohary

Role of a sentinel surveillance system in the context of global surveillance of infectious diseases

Summary In some nation states, sustained integrated global epidemiological surveillance has been weakened as a result of political unrest, disinterest, and a poorly developed infrastructure due to rapidly increasing global inequality. The emergence of severe acute respiratory syndrome has shown vividly the importance of sensitive worldwide surveillance. The Agency for Cooperation in International Health, a Japanese non-governmental organisation, has developed on a voluntary basis a sentinel surveillance system for selected target infectious diseases, covering South America, Africa, and Asia. The system has uncovered unreported infectious diseases of international importance including cholera, plague, and influenza; current trends of acute flaccid paralysis surveillance in polio eradication; and prevalence of HIV, syphilis, hepatitis B, and hepatitis C in individual areas covered by the sentinels. Despite a limited geographical coverage, the system seems to supplement disease information being obtained by global surveillance. Further development of this sentinel surveillance system would be desirable to contribute to current global surveillance efforts, for which, needless to say, national surveillance and alert system takes principal responsibility.

Genomic polymorphisms in 3β-hydroxysterol Δ24-reductase promoter sequences

It was recently reported by the present team that 3β‐hydroxysterol Δ24‐reductase (DHCR24) is induced by hepatitis C virus (HCV) infection. In addition, upregulation of DHCR24 impairs p53 activity. In human hepatoma HuH‐7 cells, the degree of DHCR24 expression is higher than in normal hepatic cell lines (WRL68) at the transcriptional level. The genomic promoter sequence of DHCR24 was characterized and nucleotide substitutions were observed in HuH‐7 cells at nucleotide numbers −1453 (G to A), −1420 (G to T), −488 (A to C) and −200 (G to C). The mutations of these sequences from HuH‐7 cell types to WRL68 cell types suppressed DHCR24 gene promoter activity. The sequences were further characterized in hepatocytes from patient tissues. Four tissues from HCV‐positive patients with cirrhosis or hepatocellular carcinoma (#1, 2, 3, 5) possessed HuH‐7 cell type sequences. Interestingly, one patient with liver cirrhosis (#4) possessed WRL68 cell‐type sequences; this patient had been infected with HCV and was HCV negative for 17 years after interferon therapy. Next, the effect of HCV infection on these polymorphisms was examined in humanized chimeric mouse liver and HuH‐7 cells. The human hepatocytes possess WRL68 cell type and did not show the nucleotide substitution after HCV infection. The HCV‐replicon was removed by interferon treatment and established the cured K4 cells. These cells possess HuH‐7 cell type sequences. Thus, this study showed the genomic polymorphism in DHCR24 promoter is not directly influenced by HCV infection.

Serum and Urinary Interferon-Gamma-Inducible Protein 10 in Lupus Nephritis

Lupus nephritis is a serious manifestation of systemic lupus erythematosus (SLE). The objective of this study was to identify the sensitivity, specificity, and cut‐off values of IP‐10 in the serum and urine of patients with lupus nephritis compared to renal biopsy, albumin/creatinine ratio, and serum anti‐dsDNA.

Prevalence of hepatitis E virus among acute sporadic hepatitis patients in Suez

Abstract The objective of this study was to describe our experience with an enzyme-linked immuno-sorbent assay (ELISA) developed by us, and to clarify whether or not hepatitis E virus (HEV) is present in Egypt among patients with acute sporadic hepatitis. One hundred and forty patients with acute viral hepatitis consecutively admitted to the Fever Hospital of Suez were enrolled. Serum was tested for bilirubin, aminotransferases, and viral hepatitis markers, including anti-hepatitis A virus IgM, hepatitis B surface antigen, anti-hepatitis B core IgM, anti-hepatitis C virus, anti-cytomegalovirus IgM and anti-HEV IgG. Four patients (2.8%) showed positivity for anti-HEV alone. Also, there was association between anti-HEV and anti-hepatitis A virus IgM, anti-cytomegalovirus IgM, anti-hepatitis C virus and hepatitis B surface antigen in seven (5%), four (2.8%), two (1.4%), and one patient (0.7%), respectively. It was concluded that HEV is present in Egypt and it can occur endemically as sporadic cases, and that the ELISA used can detect acute hepatitis E infection as well as probable past infection.