MDR1 gene C3435T polymorphism in chronic hepatitis C patients.

BACKGROUND: MDR1 is a highly polymorphic gene that encodes P-glycoprotein (P-gp). This protein anchor to the cell membrane and transports toxins, xenobiotic, chemicals, and drugs from the intracellular to extracellular and thus protect cells. Polymorphism of the MDR1 gene seems to be effective in gene expression and response to treatment. Since one of the main mechanisms of drug resistance is the removal of the drug from the cell by ATP-dependent efflux proteins, thus MDR1, single nucleotide polymorphism (SNP) C3435T can be used as a predictor for treatment outcomes. METHODS: The peripheral blood-EDTA samples were collected from 71 patients with chronic hepatitis C. The total genomic DNA extraction was carried out. The PCR was performed for detection of the MDR1 gene in HCV patients and MDR1 gene polymorphism was genotyped by the PCR-RFLP method. RESULTS: Out of 71 patients 52 (73.3%) were male, 19 (26.7%) female with mean age-min-max; 41.17 ± 8.3-(26-59). The distribution of MDR1 genotype in 48(67.6%) responders were CC 13 (27%), CT 34 (71%) and TT 1(2%), while MDR1 genotypes in 8 (11.3%) non responders were CC 2(25%), CT 1(12.5%) TT 5(62.5%) and in 15(21.1%) recurrence were 5 (33%) CC, 6 (40%) CT and 4 (27%) TT genotype. The patients with heterozygous CT (C3435T) genotype 34/48(71%) were found better response than non-responders with TT 5/8(62.5%) genotype (p < 0.05). CONCLUSION: Our result reveals that 71% of the responders were CT genotypes (C3435T) and 62.5% of non-responders were TT genotype (T3435T). With aforementioned results, determination of different forms of SNPs in MDR1 gene should be considered as a predictor in the treatment of all chronic HCV patients. The homozygous TT genotype and high prevalence of T allele may be related to low antiviral response during combined therapy in treatment of chronic HCV patients.

Global View of HIV Prevalence in Prisons: A Systematic Review and Meta-Analysis.

BACKGROUND: We aimed to estimate the global prevalence of HIV, as well as cross-countries comparison in people who are in prison. METHODS: We systematically assessed published studies reporting HIV prevalence among prisoners in the world. We searched international datasets banks, including PubMed, SCOPUS, Cumulative Index to Nursing and ISI web of science along with local databases and included original articles reporting data on the prevalence of HIV from 1980 to 2017. RESULTS: We included 72 studies that reported HIV prevalence for 2,275,930 adult male and female prisoners. The pooled estimate of HIV prevalence was 3.4% (95% CI 3.2%-3.6%); however, the prevalence of HIV across individual studies varied considerably (ranging from 0 in Bosnia and Herzegovina to More than 20% in Iran, Zambia, Spain) and statistical heterogeneity was substantial (I2=0.99, Q=121; P<0.0001). The prevalence of HIV among prisoners in the continents Asia, Africa, North America and Europe was estimated as 3.0% (95% CI 3.3%-4.3 %), 6% (95% CI -0.0%-2.0%), 4% (95% CI 3.0%-4.0%), 5.0% (95% CI 0.0%-11%), respectively. CONCLUSION: Protecting prisoners' health protects general public health. Successful HIV preventive measures in prisons include provision of HIV education and information; clean needles and syringes; drug treatment; and condoms. Governments have a moral and ethical obligation to prevent the spread of HIV/AIDS in prisons and to provide compassionate care, treatment and support for those infected.

Determining the Role of Helicobacter pylori in Chronic Sinus Infections Using the Polymerase Chain Reaction.

BACKGROUND: Helicobacter pylori are becoming increasingly recognized as a possible pathological cause of chronic rhinosinusitis (CRS). OBJECTIVES: Considering the prevalence of CRS and its impact on quality of life, we decided to determine the role of H. pylori in chronic sinus infections by using the PCR technique. PATIENTS AND METHODS: In a case-control analytical epidemiologic survey, the study population was selected by consecutive sampling from patients with CRS undergoing endoscopic sinus surgery during years 2010 - 2012. Patients were divided into two groups. The study group consisted of patients with CRS and the control group consisted of patients with nasal obstruction caused by concha bullosa, without inflammation or infection of the sinuses. Sampling was performed during surgery from the infected tissue and from the middle turbinate mucosa. Eventually, bacterial DNA was extracted and used for the PCR test, in order to isolate H. pylori. RESULTS: Nine patients (18%) with CRS had H. pylori isolated from their samples whereas in the control group, H. pylori were only found in two patients (4%); this difference was statistically significant (P = 0.025). The indicator wasn't statistically significant between males and females. There was no statistical correlation in relative frequency of H. pylori for different age groups (P > 0.05). CONCLUSIONS: There was a significant correlation between CRS and presence of H. pylori in sinonasal mucosa. This relationship may reflect the role of H. pylori as one of the pathogenic factors in the development of CRS. However, further studies are required to confirm this role.

The Prevalence Rate of Helicobacter pylori Infection in, Chronic Otitis Media With Effusion Patients.

BACKGROUND: Otitis media with effusion (OME) is a common disease in children. Viral or bacterial infections, allergy, adenoids, functional abnormalities of the Eustachian tube, and gastroesophageal reflux might have a possible role in the pathogenesis of OME. However, the exact pathogenesis of OME is still unsettled. OBJECTIVES: The purpose of this study was to compare Helicobacter pylori prevalence rates in the nasopharynx of pediatric patients with and without OME. PATIENTS AND METHODS: Eighty-four patients (50 males and 34 females) who were subjected to adenoidectomy and myringotomy were included in the study group. Ninety-one patients (48 males and 43 females) who had only adenoidectomy were selected as the control group. Detection of H. pylori was done by polymerase chain reaction (PCR). RESULTS: Adenoid samples were positive for H. pylori in 21 (25%) patients in study group and 18 (19.8%) patients in control group. In the study group, 36 (42.8%) effusion samples (otitis media) of the patients were positive for H. pylori. In an analysis that compared H. pylori-negative and -positive children, the odds ratio (OR) for the occurrence of H. pylori was 1.35 (95% CI, 0.66 - 2.71). The association of age with H. pylori positivity decreased for 1-5 years age group, (1.09; 95% CI, 0.39 - 3.05) but increased for the 6-10 years group (OR, 1.48; 95% CI, 0.61-3.58). Furthermore, the association of sex with H. pylori positivity decreased for the male group (OR, 1.21; 95% CI, 0.50 - 2.91), but increased in the female group (OR, 1.44; 95% CI, 0.51-0.4.05). CONCLUSIONS: Heavy colonization of H. pylori in adenoid tissue and middle ear might have a role in pathogenesis of this infection. For OME cases resistant to medical treatment, it might be meaningful to evaluate the patient for H. pylori.