Molecular epidemiology of hepatitis C virus genotypes and subtypes among injecting drug users in Hungary.

The aim of this study was to determine the geographical distribution of hepatitis C virus genotypes/subtypes among people who inject drugs (PWID) recruited at 22 needle exchange sites and drug outpatient services in all seven Planning and Statistical Regions of Hungary. Of 198 such PWID, 147 (74.2%), 45 (22.7%) and six (3.0%) carried genotype 1, 3 or 4, respectively, and 31 (72.1%) of the 43 genotype 1 sequences were of subtype 1a. Genotype 3 was significantly more prevalent in provincial towns than in the capital, Budapest. Injecting for a longer period and an older age both correlated with a higher prevalence of genotype 3, suggesting possible future changes in genotype distribution. The distributions of hepatitis C virus genotypes/ subtypes differed significantly between the tested PWID and the general population. The identification of genotype 3 reflected its worldwide occurrence among PWID. Our results underline the importance of genotyping before treatment, especially among people who have ever injected drugs in Hungary.

Phylogenetic analysis of a nosocomial transmission of hepatitis B virus at a paediatric haematology ward.

A nosocomial Hepatitis B virus (HBV) outbreak at a paediatric onco-haematology unit was investigated using molecular biological methods to determine the origin of the infections. The National Reference Laboratory of Hepatitis Viruses received seven HBsAg positive sera from patients and one from the brother of a patient. A fragment of the preS1/preS2/S genes from all samples was amplified, the PCR products were sequenced and a rooted phylogenetic tree was constructed. All nucleotide sequences from the different patients were very similar and 6 of the 8 sequences were identical, suggesting a common origin of the infections. These sequences were closely related to those amplified from a nosocomial HBV epidemic in another hospital in Hungary. The on-scene investigation revealed several malpractices. The two hospital departments had close connections and some of the patients were treated in both institutions. Present report underlines the importance of developing screening protocols for hepatitis viruses and that of the introduction of regular training programs for health care professionals in the field of hospital hygiene.

Inflammatory- and immune responses in relation to bacterial replication in mice following re-infections with Chlamydophila pneumoniae.

OBJECTIVE: Investigation of chronic infections with Chlamydophila pneumoniae. METHODS: BALB/c mice were repeatedly infected with C. pneumoniae and tested during a 1-year period. Production of histamine, IFN-gamma, IL-6 and antibodies was monitored by ELISA. Live bacteria were cultured and DNA was detected by PCR. Cellular immunity was tested by ELISPOT. RESULTS: After re-infections, culture positivity and persistence of DNA in lungs and blood were shorter. Detection of DNA at late time points indicated persistent infection in a few mice. Histamine was produced after primary and re-infections, and the level correlated with the number of viable bacteria in lung. IFN-gamma, IL-6 levels, IgG2/IgG1 ratio, IgA titres, and level of chlamydial heat-shock protein antibodies were higher after re-infections. IgM antibodies were demonstrated even after re-infections. High number of IFN-gamma-producing splenocytes was observed after the third inoculation. CONCLUSION: These results promote an understanding of the patho- and immune mechanisms after C. pneumoniae re-infections.

Chronic infections and histamine, CRP and IL-6 levels after percutaneous transluminal coronary angioplasty.

OBJECTIVE AND DESIGN: Our hypothesis was that percutaneous transluminal coronary angioplasty (PTCA) reactivates certain pathogens that contribute to inflammatory processes after the intervention. SUBJECTS: We determined the levels of antibodies to human Hsp60 and levels of histamine, CRP and IL-6 in sera from 28 patients of unstable angina prior to and on days 4 and 14 after PTCA. We compared the presence of Chlamydophila pneumoniae (Cpn) and human cytomegalovirus (HCMV) DNA in peripheral blood, and levels of antibodies to Cpn, HCMV, herpes simplex virus, Epstein-Barr virus and mycobacterial Hsp65 in the serum. RESULTS: Higher prevalence of Cpn and HCMV DNA was demonstrated after PTCA than before, but titers of antibodies to the pathogens did not increase. Levels of histamine, CRP and IL-6 were enhanced after PTCA. There was no association between the levels of histamine, CRP and IL-6 and the rate of pathogen DNA, or antibody titers to the pathogens, except an association between Cpn IgA and histamine levels before PTCA. CONCLUSIONS: Reactivation of Cpn and HCMV and inflammatory change characterized by increased levels of histamine, CRP and IL-6 following PTCA are suggested. An association might exist between Cpn IgA antibody and histamine levels in patients of unstable angina.