Ali Eslamifar

Risk factors for human brucellosis in Iran: a case–control study

BACKGROUND Brucellosis is a zoonotic disease of worldwide distribution. Despite its control in many countries, it remains endemic in Iran. The aim of this study was to determine the risk factors for brucellosis acquisition in the central province of Iran. METHODS A matched case-control study was conducted in the central part of Iran. A total of 300 subjects (150 cases and 150 controls) were enrolled in the investigation. Brucellosis cases were defined on the basis of epidemiologic, clinical, and laboratory criteria. Subjects were interviewed using a questionnaire to obtain risk factor information. We used odds ratios and conditional logistic regression models to explore the association between the disease and the variables studied. RESULT Significant risk factors for infection were related to the existence of another case of brucellosis in the home (OR=7.55, p=0.0001) and consumption of unpasteurized dairy products (OR=3.7, p=0.014). Keeping cattle and cattle vaccination were also important risk factors. CONCLUSIONS Pasteurization of dairy products and education regarding fresh cheese must be pursued for eradication of brucellosis. A major risk factor for acquiring brucellosis is the existence of another infected family member. Therefore screening family members of an index case of brucellosis may lead to the detection of additional cases.

Effect of Matricaria chamomilla L. flower essential oil on the growth and ultrastructure of Aspergillus niger van Tieghem

The antifungal activity of Matricaria chamomilla L. flower essential oil was evaluated against Aspergillus niger with the emphasis on the plants mode of action at the electron microscopy level. A total of 21 compounds were identified in the plant oil using gas chromatography/mass spectrometry (GC/MS) accounting for 92.86% of the oil composition. The main compounds identified were alpha-bisabolol (56.86%), trans-trans-farnesol (15.64%), cis-beta-farnesene (7.12%), guaiazulene (4.24%), alpha-cubebene (2.69%), alpha-bisabolol oxide A (2.19%) and chamazulene (2.18%). In the bioassay, A. niger was cultured on Potato Dextrose Broth medium in 6-well microplates in the presence of serial two fold concentrations of plant oil (15.62 to 1000 microg/mL) for 96 h at 28 degrees C. Based on the results obtained, A. niger growth was inhibited dose dependently with a maximum of approximately 92.50% at the highest oil concentration. A marked retardation in conidial production by the fungus was noticed in relation to the inhibition of hyphal growth. The main changes of hyphae observed by transmission electron microscopy were disruption of cytoplasmic membranes and intracellular organelles, detachment of plasma membrane from the cell wall, cytoplasm depletion, and complete disorganization of hyphal compartments. In scanning electron microscopy, swelling and deformation of hyphal tips, formation of short branches, and collapse of entire hyphae were the major changes observed. Morphological alterations might be due to the effect on cell permeability through direct interaction of M. chamomilla essential oil with the fungal plasma membrane. These findings indicate the potential of M. chamomilla L. essential oil in preventing fungal contamination and subsequent deterioration of stored food and other susceptible materials.

Occult Hepatitis B Virus Infection in Hemodialysis Patients With Isolated Hepatitis B Core Antibody: A Multicenter Study

Occult hepatitis B virus (HBV) infection is characterized by presence of HBV infection with undetectable hepatitis B surface antigen (HBsAg). Occult HBV infection harbors potential risk of HBV transmission through hemodialysis (HD). The aim of this study was to assess the occult HBV infection in hemodialysis patients with isolated hepatitis B core antibody (anti‐HBc). A total of 289 HD patients from five dialysis units in Tehran, Iran, were included in this study. Hepatitis B surface antigen (HBsAg), Hepatitis B surface antibody (anti‐HBs), anti‐HBc, Hepatitis C antibody (anti‐HCV), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were tested in all subjects. The presence of HBV‐DNA was determined quantitatively in plasma samples of HD patients with isolated anti‐HBc (HBsAg negative, anti‐HBs negative and anti‐HBc positive) by real‐time PCR using the artus HBV RG PCR kit on the Rotor‐Gene 3000 real‐time thermal cycler. Of 289 patients enrolled in this study, 18 subjects (6.2%, 95% confidence interval (CI), 3.5%–8.9%) had isolated anti‐HBc. HBV‐DNA was detectable in 9 of 18 patients (50%, 95% CI, 27%–73%) who had isolated anti‐HBc. Plasma HBV‐DNA load was less than 50 IU/ml in all of these patients. Our study showed that detection of isolated anti‐HBc could reflect unrecognized occult HBV infection in HD patients. The majority of these infections are associated with low viral loads.

Association of human leukocyte antigen polymorphism with outcomes of hepatitis B virus infection

Background and Aim:  Host genetic and environmental factors are viewed as a common basis of the different outcomes of hepatitis B virus (HBV) infection. Human leukocyte antigen (HLA) plays an important role in immunological reaction to HBV infection. In this study, we aimed to determine the association between HBV infection and HLA‐A, B, and DRB1 alleles in northern Iran.

Occult hepatitis B virus infection in HIV-infected patients with isolated hepatitis B core antibody.

Objective: Detection of hepatitis B virus (HBV) DNA without detectable hepatitis B surfaceantigen (HBsAg) is defined as occult HBV infection. In patients co-infected with human immunodeficiency virus (HIV) and HBV, HIV interferes with the natural history of HBV infection by enhancing HBV replication, leading to more severe liver disease. The aim of this study was to assess occult HBV infection in Iranian HIV-positive patients with isolated hepatitis B core antibody (anti-HBc). Methods: The presence of HBV-DNA was determined quantitatively in plasma samples of HIV-infected patients with isolated anti-HBc by real-time PCR using the artus HBV RG PCR kit on the Rotor-Gene 3000 real-time thermal cycler. Hepatitis C antibody (anti-HCV), alanine aminotransferase (ALT), aspartate aminotransferase (AST), HIV viral load and CD4+ count were also tested in all subjects. Results: Of 106 patients enrolled in this study, 22 subjects (20.75%, 95% CI 13–28) had isolated anti-HBc. HBV-DNA was detectable in 3 of the 22 patients (13.6%, 95% CI 0.0–28) who had isolated anti-HBc. Conclusion: A serological profile of isolated anti-HBc could be associated with occult HBV infection in Iranian HIV-infected patients. Therefore the risk of transmission of HBV is probable in these patients.

Efficacy and long‐term immunogenicity of hepatitis B vaccine in haemodialysis patients

Background:  Hepatitis B vaccine is effective in protection against hepatitis B virus (HBV) infection in haemodialysis (HD) patients, but the antibody response is variable in this population and the persistence of immunity in them remains largely unknown. In this study we aimed to evaluate the efficacy and long‐term immunogenicity of hepatitis B vaccine in HD patients.

The role of human papillomavirus infection in prostate carcinoma

Abstract Human papillomavirus (HPV) infections are associated with benign and malignant lesions of the female and male anogenital tract. Currently the possible role of HPV infections in prostate carcinogenesis is a subject of great controversy. In this study we aimed to investigate the role of HPV infection in prostate carcinoma (PCa). The study included formalin-fixed paraffin-embedded tissue samples of 104 primary prostate adenocarcinoma cases and 104 control tissues of benign prostatic hyperplasia (BPH). HPV-DNA was purified and amplified through MY09/MY11 and GP5+/GP6+ primers and subsequently subjected to sequencing. HPV-DNA was found in 13 of 104 (12.5%) PCa and 8 of 104 (7.7%) BPH samples. High-risk HPVs were detected in 10 of 13 (76.9%) PCa and 5 of 8 (62.5%) BPH samples with positive HPV-DNA. Low-risk HPVs were detected in 3 of 13 (23.1%) PCa and 3 of 8 (37.5%) BPH specimens with positive HPV-DNA. There was no significant difference between PCa and BPH specimens regarding HPV-DNA presence or the detection of high-risk and low-risk types of HPV. Our data do not support the role of HPV infection in prostate carcinoma. Further studies are required to elucidate the role of HPV infection in human prostate carcinogenesis.

Lack of occult hepatitis B virus infection among blood donors with isolated hepatitis B core antibody living in an HBV low prevalence region of Iran.

BACKGROUND Occult hepatitis B virus (HBV) infection in blood donors is considered a potential threat for the safety of the blood supply, however conclusive studies on this issue are lacking. The aim of this study was to assess the occult HBV infection in blood donors with isolated hepatitis B core antibody (anti-HBc) living in the city of Arak, in the Central Province of Iran, as a low prevalence region for HBV. METHODS A total of 531 voluntary blood donors in Arak, Iran were included in this study. Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), anti-HBc, and hepatitis C antibody (anti-HCV) were tested in all subjects. The presence of HBV-DNA was determined quantitatively in plasma samples of cases with isolated anti-HBc (HBsAg-negative, anti-HBs-negative, and anti-HBc-positive) by real-time PCR using the artus HBV RG PCR kit on the Rotor-Gene 3000 real-time thermal cycler. RESULTS Of 531 subjects enrolled in this study, 11 (2.1%, 95% confidence interval 0.8-3.2%) had isolated anti-HBc. HBV-DNA was not detected in any of the cases with isolated anti-HBc. CONCLUSIONS Our study showed that all the blood donors with isolated anti-HBc were negative for HBV-DNA, and occult HBV infection did not occur in the blood donors of this low prevalence region for HBV infection.

Assessing subtype and drug-resistance-associated mutations among antiretroviral-treated HIV-infected patients

Background:Several studies have reported an increasing number of therapeutic failures with antiretroviral drugs in HIV-infected patients. The emergence of viral-resistant strains is a major problem for the medical management of infected individuals. The aim of this study is to determine viral subtypes and drug-resistance mutations among antiretroviral-treated HIV-infected patients. Methods:A total of 42 antiretroviral-treated but still viremic HIV-infected patients were enrolled. The HIV pol regions were amplified and sequenced to determine subtypes and antiretroviral-resistant mutations. Results:The subtype distribution was 48% A/D recombinants, 43% subtype B, 5% subtype A and 5% CRF01-AE recombinants. Drug-resistant mutations were most common in subtype B (53%) and A/D recombinant strains (44%). Virus samples from 19% of participants had no drug-resistant mutations; 2, 2 and 76% of samples carried one, two and at least three drug-resistant mutations, respectively. The prevalence of nucleoside transcriptase inhibitor mutations was 76%, with M184V and L74V present in 60 and 38% of samples, respectively. The prevalence of nonnucleoside transcriptase inhibitor mutations was 74%, with P225H present in 55% of study specimens. The prevalence of protease inhibitor mutations was 45%, with major mutation L90M seen in 33% and minor mutation A71V in 36% of samples. Of note, the P225H and A71V are ‘minor’ drug-resistance mutations conferring only minimal drug-resistance phenotypes in the absence of major mutations. Conclusion:Our study found a high prevalence of drug-resistant mutations in Iranian HIV-infected patients. Our data support the need for continued surveillance of resistance patterns to help guide therapeutic approaches and limit transmission of these variants.

Comparison of QuantiFERON TB-G-test to TST for detecting latent tuberculosis infection in a high-incidence area containing BCG-vaccinated population

OBJECTIVE Until recently, the only tool for detection of latent tuberculosis infection (LTBI) was the tuberculin skin test (TST). QuantiFERON-TB Gold In-Tube test (QFT) is a promising in vitro diagnostic test for LTBI that has potential advantages over the TST. In this study we aimed to compare QFT with TST for diagnosis of LTBI. PATIENTS AND METHODS A total of 186 BCG-vaccinated subjects enrolled in study. They underwent TST and QFT assay. They divided in two groups. Group 1 includes individuals who were at low risk for exposure to M. tuberculosis (LRG) and Group 2 includes individuals who were likely to have been exposed to M. tuberculosis infections (HRG). RESULTS Overall agreement between QFT and TST was 89.3% (kappa = 0.052). In LRG, agreement between the two tests was 52.6% (95% confidence interval, 44-60%) with kappa-values of 0.019. In HRG agreement between the two tests was 63.2% (95% confidence interval, 42-84%) with kappa-values of 0.28. CONCLUSION In conclusion, the QFT assay showed acceptable results for determining latent M. tuberculosis infection in vaccinated population. The decision to select QFT over TST will depend on the population, purpose of testing and resource availability.