Reactivation of HBV infection in low grade lymphoma patient.

Reactivation of hepatitis B virus is a complication of chronic or HBV infection in patients with malignancies, especially hematological disorders, under cytotoxic or immunosuppressive therapy. The immunosuppression favors HBV replication with the massive infection of hepatocytes. Once immunity is restored when chemotherapy therapy is discontinued, a rapid, immune-mediated destruction of the infected hepatocytes ensues, clinically manifested as hepatitis, liver failure or even death. We report a case of HBV reactivation in a patient with B cells non-Hodgkin lymphoma, with HBsAg negative and protective titre of anti-HBs, after 5 months of combined chemotherapy. Currently, there are no data to support routine pre-emptive anti-HBV therapy in patients with negative HBsAg and undetectable viremia before the initiation of chemotherapy. The case presented in this paper is included in the group of patients that is studied in LIMFOVIR Grant (convention no 41012/2007). This research grant is funded by the National Center of Programs Management, program 4 - Partnerships in Priority Fields. The grant is coordinated by the National Institute of Infectious Diseases Prof. Dr. Matei Bals, Bucharest. The grant team include also the Emergency University Hospital Bucharest, Hematology Department, the "Carol Davila" University of Medicine and Pharmacy, Bucharest, the "Victor Babes" National Institute of Research and Development, the Institute of Electrotechnical Research, Bucharest and the Polytechnic University, Bucharest. The manager of the grant is Associated Professor dr. Victoria Arama.

Preliminary data on the involvement of B, C and D hepatitis viruses in the etiopathogenesis of chronic lymphoproliferative syndromes in Romania.

UNLABELLED: THE AIMS OF THE STUDY: Evaluation of the prevalence of HBV, HCV, HDV infection in patients with chronic lymphoproliferative diseases (CL), identification of the most involved viral genotypes, correlation between viremia dynamics and CL evolution, detection of molecular mechanisms implicated in CL pathogenesis, identification of lymphocytic receptors for viral antigens and biologic markers for early diagnosis of CL. METHODS: We present preliminary results of the first year of our research grant. This is a prospective, analytic, observational study in patients diagnosed with CL and HBV, HCV, HDV chronic infection. We included the following forms of CL: non-Hodgkin malignant lymphoma (NHL), Hodgkin lymphoma (HL) and chronic lymphocytic leukemia (CLL). We used the following commercial test kits: HCV RNA Real time PCR on a COBAS TaqMan (Roche Diagnostics) analyzer with 28 to 140.000.000 UI/ml detection range for HCV viremia, HBV DNA Real time PCR on a COBAS TaqMan (Roche Diagnostics) analyzer with 6 to 110.000.000 UI/ml detection range for HBV and the Roboscreen-RoboGene AJ kit with 10-10.000.000 replica/ml detection range for HDV. RESULTS: We have included 20 patients with CL and chronic hepatitis infection so far. Median age of the patients was 61 years. The identified CL forms were: B cell NHL (15 cases), T cell NHL (1 case), CLL (3 cases), Hodgkin lymphoma (1 case), equally distributed in aggressive and indolent forms of CL. HCV infection was diagnosed in 10 patients with CL, HBV infection was found in 10 patients with CL, 3 of them having co-infection HBV + HDV. In 4 patients with HBV infection viremia was over 20.000 IU/ml and the pattern of the CL was the aggressive form of the disease. The feature of the co-infection HBV + HDV was the predominance of indolent forms of CL. Among patients with HCV infection, only 3 cases were detected with viremia over 600.000 IU/ml and CL was represented by aggressive forms of the disease. We also have immunohistochemical data available in 19 cases, which seem to confirm the role of hepatitis viruses in lymphoproliferative disease etiopathogenesis. CONCLUSIONS: We ascertained an almost equally represented prevalence of HCV and HBV infection in patients with CL. The levels of HBV, HCV and HDV viremia were low in most of the cases. The most frequent form of CL was B cell NHL. We found an equal distribution between indolent and aggressive forms of NHL associated to hepatitis virus infection.

The phagocytosis function and the antibody reactivity in the thymectomized and thymectomized-irradiated adult rats.

The authors have investigated the influence of the thymus on peritoneal macrophages phagocytosis and antiflagellar agglutinin serum antibodies to "H" Salmonella typhi in the adult rat with diminished immunologic potential. The results show that the immune reactions diminish in intensity in the thymectomized animal. The immune reactions are also diminished in the thymectomized animal exposed to radiation as compared to control irradiated but non-thymectomized.

The in vitro effect of a thymic polypeptidic extract on the function of T-cells and macrophages.

A thymic polypeptidic extract with a molecular weight of under 10,000 daltons was used in in vitro experiments to test its effect on the E-rosetting reaction of the T-total and T-helper lymphocytes from the peripheral blood of patients with thyroid cancer, Cushing's syndrome and others, as well as from healthy persons. The effect of the extract on peritoneal macrophages phagocytosis from both irradiated and normal rats was also tested in vitro. It was found that in healthy persons the E-total rosettes count did not change under the influence of the thymic extract, whereas the E-helper rosettes count increased up to 21% in 4 of the 10 subjects. In thyroid cancer, Cushing's disease, and operated Graves' disease, the thymic extract induced a up to 23% increase in E-total rosettes count in 8 of 11 cases and an increase of up to 90% in the E-helper rosettes count in 9 of 12 cases. The thymic extract had no effect on the rat peritoneal macrophages phagocytosis in vitro.

Influence of the thymic extract (TP2) on some humoral and cell mediated immunity reactions in normal or irradiated animals.

The authors have studied the action of a thymic extract (TP2) containing thymic polypeptides with a molecular weight under 10,000 daltons, on humoral and cell-mediated immunity reactions in normal animals or in animals immunologically depressed by X-ray irradiation. The following were investigated: serum antibodies, such as antiflagelar agglutinins of TH Salmonella and anti-influenza antibodies in the rat, the plaque-forming hemolytic cells in the mouse spleen, delayed hypersensitivity reaction in guinea-pigs innoculated with BCG, the lymphocyte rosetting reaction in the mouse spleen, and the inhibition of macrophages migration in the rats innoculated with TH Salmonella typhi vaccine. The results showed that TP2 stimulates both the humoral and the cell-mediated immunity reactions and has a radioprotecting effect.

[Dynamics of the composition of lipids in human milk during lactation]. / La dynamique de la composition des lipides du lait humain au cours de la lactation.

The authors have studied the total lipids, triglycerides and cholesterol in the milk of 30 mothers over a lactation period of 4 days to 10 months. The total lipids showed diurnal oscillations with a minimal level in the morning and maximal level (P less than 0.001) at 1 p.m. and a slight decrease in the evening, without reaching the levels found in the morning. The lipid concentration in the milk decreases after 4 months of lactation. The oscillations of the lipids take place on the expense of the triglyceride content (r = 0.99). Cholesterol represented on the average 1.54% of the lipid content, showed a maximum level at a month and decreased after 6 months of lactation. The dynamics of lipid composition of the human milk suggests a physiologic significance in the development of the infant.

The effect of some thymic extracts on antibody formation in rats and mice.

The influence of some thymic extracts TP1 and TP2 on the number of hemolytic plaque-forming cells (PFC) in the mouse spleen, on the titre of serum antibodies, S-typhy antiflagelar agglutinins and anti-influenza antibodies, was investigated. The results have shown that the hemolytic plaque-forming cells in the mouse spleen increase significantly, 2.3 times under the influence of the TP2 thymic extract in RAP mice inoculated with sheep red cells. In Wistar rats, inoculated with a formol-inactivated suspension of S. typhy and treated with TP2, the antibody titre increases 3.3 times at most. The increase is in relation to the dose of extract and the thymus batch from which the extract was prepared. TP1 also stimulates serum antibody formation in Wistar rats inoculated with A2 influenza vaccine. The antiinfluenza antibody titre increases 2.7 times under the influence of the thymic extract. The results also depend on the dose of extract and the thymus batch. In irradiated animals, the thymic extract had a protective effect. X-ray exposure of Wistar rats caused a 2.5 times decrease in the antiinfluenza antibodies titre. Under the influence of the TP1 thymus extract, the antibody titre increases 2.9 times as against the irradiated controls.

Natrium, potassium, cholesterol and total free 11-hydroxycorticosteroids variations in thymectomized and thymic extract treated rats.

The authors investigated the effect of thymectomy and TP2 thymic polypeptide extract administration on total, esterified and free cholesterol in the plasma and the adrenals, as well as on plasma Na and K and plasma free total 11-hydroxycorticosteroids. The results showed that total, esterified and free cholesterol decrease in the adrenals by 23.20%, 28.57% and 17.70% maximum respectively, in the thymectomized rat and that under the influence of the TP2 extract the values increase by 14.81%, 15.38% and 12.67%, respectively. Plasma cholesterol did not change. Thymectomy caused an increase in the plasma 11-hydroxycorticosteroids value by 13.4% and administration of the TP2 extract lowered their value by 58.11%. The plasma Na and K values did not change.