Presence of HPV, EBV and HMTV Viruses Among Egyptian Breast Cancer Women: Molecular Detection and Clinical Relevance.

BACKGROUND: Oncogenic viruses, their possible association with breast cancer (BC) and effect on its clinical course are interesting issue. The present study evaluates the presence of human papillomavirus (HPV), EpsteinBarr virus (EBV), and human mammary tumor virus (HMTV) in BC and their relation with clinico-pathological characteristics. PATIENTS AND METHODS: This study was conducted on 80 Egyptian women with BC and 30 control women without known oncological disease. Forty formalin-fixed paraffin-embedded (FFPE) tissues, forty fresh tissue samples, and white blood cells (WBCs) of BC patients and WBCs of controls were subjected to a qualitative polymerase chain reaction (PCR). Quantitative real-time PCR was used to measure viral loads in fresh tissues of BC. The result was correlated with clinico-pathological characteristics of BC. RESULTS: HPV was detected in 33 (41.25%), EBV in 30 (37.5%) and HMTV in 33 (41.25%) BC patients. None of the control women was positive for HPV or EBV while HMTV was detected in 7 (23.3%). Among 40 BC WBCs specimens, HPV/HMTV were found together in 25%, followed by EBV/HMTV in 2.5% and EBV/HPV in 2.5%. However, the three viruses (HPV/EBV/HMTV) were found together in only 5%. In the 40 fresh BC tissues, the three viruses were found together in 12 (30%), EBV/HMTV in 7 (17.5%), HPV/HMTV in 4 (10%), and HPV/EBV in 4 (10%). EBV, HMTV, or multiple viral infections were associated with younger age of BC women. HPV, EBV, and HMTV median loads in fresh tissues were 4.8×103 copies/µL, 6.3×103 copies/µL, and 97 copies/µL, respectively. CONCLUSION: WBCs could be a more suitable specimen instead of fresh tissue for HMTV detection in BC patients to avoid invasive procedures. The presence of HPV, EBV, and HMTV together in Egyptian women with BC was significantly associated with younger age.

Microbiological profile of ventilator-associated pneumonia among intensive care unit patients in tertiary Egyptian hospitals.

INTRODUCTION: Ventilator-associated pneumonia (VAP) is one of the common serious infectious diseases encountered in the intensive care unit (ICU), which highly affects the healthcare cost and patient prognosis. VAP is caused by various antimicrobial-resistant aetiological agents and the clinical manifestations lack sensitivity and specificity, making the prompt treatment is a challenge. This study aimed to investigate the microbial profile of VAP causing microorganisms among ICU patients in Egypt, antimicrobial susceptibility patterns and the genetic diversity among the frequently isolated organisms. METHODOLOGY: Throughout the period from August 2016 to August 2017, endotracheal aspirate (ETA) specimens were collected from ICU patients with clinically suspected VAP in two tertiary hospitals in Cairo. ETA specimens were investigated for the microbial content. The antimicrobial susceptibility was determined by the Kirby-Bauer method. ERIC-PCR was performed for genotyping. RESULTS: Fifty microbiologically confirmed VAP cases were identified. The most frequently isolated microorganisms were Klebsiella spp., followed by Pseudomonas aeruginosa, Acinetobacter baumannii. Candida spp. was the most isolated fungi. A single isolate of each Cupriavidus pauculus and Aeromonas salmonicida was isolated. Antimicrobial susceptibility profiles indicated 40% of isolates were multidrug-resistant (MDR). ERIC-PCR revealed no genetic relatedness among K. pneumoniae isolates, the most frequently isolated microorganism. CONCLUSIONS: Gram-negative bacteria are the main causative agents of VAP cases, which mostly are MDR. Microorganisms like C. pauculus and A. salmonicida should be taken into consideration as VAP causative agents. There was no common source of infection suggesting likely endogenous sources of K. pneumoniae, the main causative agent of VAP in this study.

Epstein-Barr virus and cytomegalovirus infections and their clinical relevance in Egyptian leukemic pediatric patients.

BACKGROUND: Epstein-Barr virus (EBV) and human cytomegalovirus (CMV) infections are environmental risk factors affecting the outcome of cancer due to an impairment in the cell-mediated immunity. Therefore, this study aimed to detect the frequency of EBV and CMV DNA and their association with clinical characteristics and outcome of pediatric leukemic patients. METHODS: Samples of 50 immunocompromised pediatric leukemic patients and 30 apparently healthy children were subjected to the amplification of EBV DNA by one version of PCR targeting the Bam H1 W region of the genomic region of EBV, and the amplification of CMV DNA by targeting the CMV UL97 genomic region by a second round PCR. All investigations were performed on WBCs and sera. Results were correlated with the clinical and laboratory characteristics of the disease, and with overall survival. RESULTS: EBV and CMV DNA were detected in 20 and 54% of leukemic patients, respectively. Nine out of ten patients with EBV DNA (90%) were positive for CMV DNA in their sera. The presence of EBV DNA or CMV DNA was associated with neutropenia and a low total leukocyte count (TLC) (p = 0.02, 0.03, respectively). The presence of severe CMV disease, longer duration of febrile neutropenia, neutropenia, lymphopenia, thrombocytopenia and the presence of EBV DNA in patients' sera were significantly associated with worse overall survival. CONCLUSION: The detection of CMV disease and EBV DNA is relatively common in leukemic children and is significantly associated with a decline in the overall survival.

Impact of SEN virus on immunoblot INNO-LIA HCV reactivity pattern and disease outcome in Egyptian hepatocellular carcinoma patients.

Recently, a novel virus designated SEN virus (SENV), which is thought to be related to posttransfusion hepatitis, was discovered. The aim of the present study was to investigate the prevalence and clinical significance of 2 SENV variants (SENV-D and SENV-H) in patients with hepatocellular carcinoma (HCC) and healthy adults. Also, to investigate the possible effect of SEN virus on the humoral immune response against different proteins of HCV through analyzing reactivity patterns of the confirmatory INNO-LIA HCV Ab III update in relation to SEN viremia. We investigated SEN virus infection in 41 patients with HCC (25 males and 16 females) and twenty healthy blood donors (12 males and 8 females). All samples were taken from the National Cancer Institute, Cairo University. We used semi nested polymerase chain reaction (PCR) amplification to detect SENV-D and SENV-H strains in serum. All patients were tested against HCV antibody by ELISA and HCV viremia by RT-PCR. Furthermore, nineteen patients positive for HCV antibody by EIA (10 positive for SEN DNA and 9 non viremic for SEN) were confirmed in the immunoblot assay. SENV DNA was detected in 68 % (28 of 41) of patients with HCC and in 64 % (21 of 33) HCV-related HCC, in comparison to 5% (1 of 20) healthy blood donor populations. The blood biochemical parameters, and performance status did not differ significantly between the SENV DNA-positive and- negative patients. However, the overall survival rate was 50 % after two years follow up in SENV DNA-positive and 14 % in SENV DNA-negative HCC patients. Reactivity to NS5 and E2 were less (22 % and 44 % of cases) in SENV negative cases, than in SENV positive cases (70 % and 80 % of cases, respectively). In conclusion, SENV DNA seems to be highly prevalent among Egyptian HCC patients. Cross reactivity between SENV proteins and HCV NS5, E2 or the increased immune response in SENV positive cases and consequently the increased reactivity to HCV NS5 and E2 proteins could not be ruled out. Although there was no apparent effect of SENV on biochemical tests, survival rates of SENV DNA-positive HCC patients were higher thannegative cases, which might be due to other factors affecting survival in our Egyptian HCC patients.

The biological significance of serum complements C3 and C4 in HCV-related chronic liver diseases and hepatocellular carcinoma.

This study aims to evaluate the diagnostic power of serum complements C3 and C4 in early detection of hepatocellular carcinoma (HCC) in HCV-infected patients with liver cirrhosis (LC). Twenty patients with HCC and twenty patients with chronic liver diseases (CLD) were recruited for the study. Twenty healthy non-HCV infected subjects were also included as negative controls. Serum complements C3 and C4 levels were estimated with nephelometry while HCV antibody was detected by third generation ELISA kits. Serum samples were also tested for alpha-fetoprotein by microparticle enzyme immunoassay kits. Serum levels of complements C3 (124.1 +/- 34.4 mg/dl) & C4 (55.9 +/- 28.8 mg/dl) in cases of liver cirrhosis without HCC, were lower than in HCC cirrhotic patients (136.9 +/- 39.1 mg/dl) and (62.3 +/- 20.7 mg/dl), respectively (P > 0.05). On the other hand, serum levels of C3 & C4 were significantly higher in HCC group than in controls (101.9 +/- 18.7 mg/dl) and (23.8 +/- 8.9 mg/dl), respectively (P < 0.01, P < 0.001). Regarding levels of C3 &C4 in CLD patients, they were significantly higher than controls (P < 0.05, P < 0.001). The optimal cut-off values selected by Receiver Operating Characteristic (ROC) curve were 112 mg/dl for C3 and 45 mg/dl for C4. Based on these data, the positive predictive values, negative predictive values, and the accuracies for C3 were 59.1%, 55.6%, and 58.1% and for C4 were 65.2%, 75%, and 67.7%, respectively. In conclusion, the combined use of both AFP and C4 at cut-off 8 ng/ml & 88.1 mg/dl, respectively will result in improving detection of HCC in HCV-related liver cirrhosis patients.