Manifestations, complications, and treatment of neurobrucellosis: a systematic review and meta-analysis.

PURPOSE: Central nervous system involvement by Brucella species is the most morbid form of brucellosis disease. Studies on neurobrucellosis are scarce and limited to case reports and series. Brucella is unable to infect or harm neurons without the assistance of monocytes. This raises the question of whether ceftriaxone-based regimens are effective. METHODS: The primary aim of this study was to identify, evaluate, and summarize the findings of all relevant individual studies in the past 30 years to help better understand the disease. To achieve this, a broad systematic search was undertaken to identify all relevant records. Epidemiological and clinical features of the disease were assessed by the pooled analysis of descriptive studies. Through a meta-analysis, the treatment period duration was compared between the ceftriaxone-based and oral regimens using Standardized mean differences to measure effect size. RESULTS: 448 patients were included in the Meta-analyses from 5 studies. A moderate positive effect was found for ceftriaxone-based regimens over oral treatments, and there was a significant difference between these two groups (SMD 0.428, 95% CI -0.63 to -0.22, I 2 = 37.64). Neurobrucellosis has a different clinical picture in pediatric patients. The disease is less chronic in children. Fever, nausea and vomiting, fatigue, and abdominal pain were significantly more prevalent symptoms in children, and Convulsions, ascites, sensorineural hearing loss, and papilledema were significantly more prevalent signs in children than adults. CONCLUSION: It is recommended to initiate the treatment of neurobrucellosis with IV ceftriaxone therapy in combination with oral therapy.

SARS-CoV-2 Viral Shedding and Associated Factors among COVID-19 Inpatients and Outpatients.

Background: According to the contagious ability of the new virus, SARS-CoV-2, characterization of viral shedding duration in the period of infection is highly valuable in terms of providing quarantine guidelines and isolation policies. Therefore, we aimed at viral shedding determination in 58 COVID-19 confirmed Iranian subjects in different stages. Methods: 58 COVID-19 confirmed Iranian subjects including 21 outpatients and 37 inpatients were investigated. The analytical data and clinical properties were documented in the standard questionnaire. The RT-PCR tests were done two and three weeks after the symptoms initiation. Results: Viral eradication occurred in 44.8% two weeks after illness initiation whereas in 71% who achieved a negative PCR test in the third week. Moreover, prolonged viral shedding was observed in hospitalized cases in comparison to outpatients. Almost 30% of patients continued viral shedding three weeks after disease initiation. Conclusion: A longer duration of viral shedding in hospitalized cases rather than outpatients was observed in this study. The results similar to other investigations call into question if the current policies are enough to prevent the viral spread or not. This study should be done on a larger sample to provide an appropriate time in isolation policy.

Comparing Outcomes of Two Antiviral Therapy Combinations among COVID-19 Patients.

Several therapeutic regimens for COVID-19 have been studied, such as combination antiviral therapies. We aimed to compare outcome of two types of combination therapies atazanavir/ritonavir (ATV/r) or lopinavir/ritonavir (LPV/r) plus hydroxychloroquine among COVID-19 patients. 108 patients with moderate and severe forms of COVID-19 were divided into two groups (each group 54 patients). One group received ATV/r plus hydroxychloroquine, and the other group received hydroxychloroquine plus LPV/r. Then, both groups were evaluated and compared for clinical symptoms, recovery rates, and complications of treatment regimens. Our findings showed a significant increase in bilirubin in ATV/r-receiving group compared to LPV/r receivers. There was also a significant increase in arrhythmias in the LPV/r group compared to the ATV/r group during treatment. Other findings including length of hospital stay, outcome, and treatment complications were not statistically significant. There is no significant difference between protease inhibitor drugs including ATV/r and LPV/r in the treatment of COVID-19 regarding clinical outcomes. However, some side effects such as hyperbilirubinemia and arrhythmia were significantly different by application of atazanavir or lopinavir.

Age-standardized mortality rate and predictors of mortality among COVID-19 patients in Iran.

BACKGROUND: To have a thorough understanding of epidemic surveillance, it is essential to broaden our knowledge of death tolls worldwide. This study aimed to determine the age-standardized mortality rate (ASMR) and predictors of mortality among coronavirus disease 2019 (COVID-19) patients. MATERIALS AND METHODS: In this cross-sectional design, all COVID-19 patients with a positive polymerase chain reaction test in the population covered by Arak University of Medical Sciences (AUMS) were entered to the study. Data collection was conducted by phone interview. The study variables comprised age, sex, coronary heart diseases, diabetes, and some symptoms at admission. The adjusted odds ratio (OR) and 95% confidence intervals (CIs) were obtained by logistic regression. The direct method was applied to calculate ASMR (per 100,000) of COVID-19. The analysis was applied by STATA software 12.0. RESULTS: A total of 208 cases of COVID-19 (out of 3050 total infected cases) were dead and 2500 cases were recovered. The mean age of dead patients was 70 years. The COVID-19 fatality rate in the population equaled 6.8%; in those patients who were 70 years old or more, however, the case fatality rate was 16.4%. The ASMR of COVID-19 was 12.9 (CI 95%: 11.2, 14.8). The odds of COVID-19-related death in the age over 60 were 10.87 (CI 95%: 6.30, 18.75) times than lower 45 years old. Moreover, it was observed that COVID-19 significantly increased the odds of COVID-19-related death in diabetes patients (OR = 1.45, CI 95%: 1.02, 2.06, P = 0.036). CONCLUSION: The ASMR of COVID-19 was relatively higher in males than females. In general, the COVID-19 fatality rate was relatively high. We found that older age and diabetes can have impact on the death of COVID-19, but the headache was found to have a negative association with the COVID-19-related death.

SARS-CoV­2, a virus with many faces: a series of cases with prolonged persistence of COVID-19 symptoms.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as the causative agent of the ongoing pandemic, has spread into more than 200 countries to date. The disease which is caused by the virus is termed COVID-19. In most cases, it presents at first like common flu with cough and other respiratory symptoms. Nevertheless, other symptoms have been reported, such as a feeling of extreme fatigue, gastrointestinal symptoms, or acute onset of olfactory and gustatory dysfunction. Here we report a series of 10 cases (1 male, 9 females) observed between February and April 2020, with an undulating appearance and disappearance of symptoms. Weeks passed before the diagnosis was established. Symptoms resolved rapidly after treatment with hydroxychloroquine. It seems that the course of COVID-19 can be mild or moderate but with a long persistence of symptoms, and may therefore remain obscure. This may cause a public health issue because of the long infectivity of these patients.

Mucocutaneous Manifestations in HIV-Infected Patients and Their Relationship to CD4 Lymphocyte Counts.

BACKGROUND: More than 90% of human immunodeficiency virus- (HIV-) infected patients show at least one mucocutaneous manifestation during the course of their disease. The frequency, pattern, and associated factors of these complications vary among different populations. OBJECTIVE: This study was planned to evaluate the frequency of cutaneous presentations in HIV-infected patients and their association with the count of CD4 cells. METHODS: A cross-sectional study was conducted on eighty-four HIV-positive patients, who attended the Behavior Consultation Center of Arak University of Medical Sciences. All subjects had a complete physical examination by an expert dermatologist. Further diagnostic procedures were performed, if necessary. Counts of CD4 were determined using flow cytometry. RESULTS: From 84 patients who enrolled in this study, 95.2% manifested at least one type of mucocutaneous lesions. The most common presentation was xerosis, followed by seborrheic dermatitis, herpes simplex, and oral candidiasis. Oral candidiasis and furuncle were significantly associated with decrease in CD4 cell counts. CONCLUSIONS: Cutaneous manifestations are common in HIV-positive patients, some of which (oral candidiasis and furuncle) could be applicable as useful clinical indicators to predict the immune status of the patients. Therefore, regular skin examinations are recommended as routine HIV-infected patients' healthcare programs.

The combination of sofosbuvir and daclatasvir is effective and safe in treating patients with hepatitis C and severe renal impairment.

BACKGROUND AND AIM: Many of the treatment regimens available for hepatitis C include sofosbuvir. Unfortunately, sofosbuvir has not been recommended for use in patients with severe renal impairment leaving these group of patients with very few options. Nevertheless, there are many reports in which these patients have been treated with sofosbuvir-containing regiments without important adverse events. This study aims at determining the safety and effectiveness of a sofosbuvir-based treatment in patients with severe renal impairment, including those on hemodialysis. METHOD: We enrolled subjects with hepatitis C and estimated glomerular filtration rate under ml/min/1.73m2 from 13 centers in Iran. Patients were treated for 12 weeks with a single daily pill containing 400-mg sofosbuvir and 60-mg daclatasvir. Patients with cirrhosis were treated for 24 weeks. Response to treatment was evaluated 12 weeks after end of treatment (sustained viral response [SVR]). ClinicalTrials.gov identifier: NCT03063879. RESULTS: A total of 103 patients were enrolled from 13 centers. Seventy-five patients were on hemodialysis. Thirty-nine had cirrhosis and eight were decompensated. Fifty-three were Genotype 1, and 27 Genotype 3. Twenty-seven patients had history of previous failed interferon-based treatment. Three patients died in which cause of death was not related to treatment. Six patients were lost to follow-up. The remaining 94 patients all achieved SVR. No adverse events leading to discontinuation of medicine was observed. CONCLUSIONS: The combination of sofosbuvir and daclatasvir is an effective and safe treatment for patients infected with all genotypes of hepatitis C who have severe renal impairment, including patients on hemodialysis.

Interlukine-17 and TGF-ß levels in patients with acute brucellosisbefore and after treatment.

BACKGROUND/AIM: T-helper cell type 1 (Th1)/Th2 cytokine balance is involved in the resistance or susceptibility to Brucella infection. The analysis of cytokine levels is valuable to determine the role of the immune system in Brucella prognosis. The aim of this study was to investigate the levels of serum interleukin-17 (IL-17) and transforming growth factor beta (TGF-ß) and their alterations with treatment in patients with acute brucellosis. MATERIALS AND METHODS: TGF-ß was tested in 33 acute brucellosis patients and 19 controls and IL-17 was analyzed in 40 patients and 12 controls. Cytokine levels were tested in controls and patients before and after treatment by ELISA. RESULTS: TGF-ß levels were significantly lower in brucellosis cases compared to controls. At the end of the treatment, the serum levels of this cytokine had increased, but there was no significant difference between this cytokine level before and after treatment. The IL-17 level was significantly higher in the brucellosis group compared to controls and its value decreased in patients at the end of treatment without any significant difference. CONCLUSION: This study indicated that TGF-ß was lower and IL-17 was higher in brucellosis cases and, after treatment, the serum level of TGF-ß increased and that of IL-17 decreased in these patients.

Distribution of hepatitis C virus genotypes in Arak city, central province of Iran.

BACKGROUND AND OBJECTIVES: Hepatitis C virus (HCV) infection is a worldwide concern and it is the major cause of liver disease. Several genotypes of the HCV have been reported from different regions of the world. The determination of the HCV genotypes is important for the prediction of response to antiviral treatment and clinical outcomes. So, HCV genotyping in each region is of great importance. This investigation was performed to determine the distribution of HCV genotypes in Arak city, Central province of Iran. PATIENTS & METHODS: In this cross sectional study, 174 cases with chronic HCV infection from Arak city were enrolled. HCV infection was confirmed by positive results in HCV antibody (anti-HCV) and HCV-RNA tests. HCV genotypes were determined using a PCR based genotyping kit. RESULTS: A total of 174 HCV infected patients with mean age of 37.5±10.24 years were enrolled. 97.7% of cases were male and 2.3% were female. The main route of HCV transmission was injection drug use (IDU) which was observed in 59.8% of cases. Genotyping results demonstrated that subtype 3a (52.9%) was the most prevalent HCV type in Arak, followed by subtype 1a (22.9%) and subtype 1ab (17.8%). CONCLUSION: This study showed that HCV subtype 3a was the most prevalent HCV type, followed by subtype 1a and subtype 1ab in Arak, central province of Iran. Investigation of HCV genotypes in different parts of the country is needed to facilitate treatment options and preventive strategies.

Arginine adjunctive therapy in active tuberculosis.

Background. Dietary supplementation has been used as a mechanism to augment the immune system. Adjunctive therapy with L-arginine has the potential to improve outcomes in active tuberculosis. Methods. In a randomized clinical trial 63 participants with smear-positive pulmonary tuberculosis in Markazi Province of Iran were given arginine or placebo for 4 weeks in addition to conventional chemotherapy. The final treatment success, sputum conversion, weight gain, and clinical symptoms after one and two months were considered as primary outcomes and secondary outcomes were ESR, CRP, and Hg. Data were collected and analyzed with SPSS software (ver. 18). Results. Arginine supplementation reduced constitutional symptoms (P = 0.032) in patients with smear-positive TB at the end of the first month of treatment. Arginine treated patients had significantly increased BMI at the end of the first and second months of treatment (P = 0.032 and P = 0.04) and a reduced CRP at the end of the first month of treatment (P = 0.03) versus placebo group. Conclusion. Arginine is useful as an adjunctive therapy in patients with active tuberculosis, in which the effects are more likely mediated by the increased production of nitric oxide and improved constitutional symptoms and weight gain. This trial is registered with Clinical Trials Registry of Iran: IRCT201211179855N2.

Isolated anti-hbc and occult HBV infection in dialysis patients.

BACKGROUND: Occult Hepatitis B virus (HBV) infection (OBI) is defined as the presence of HBV-DNA in the liver or serum with undetectable hepatitis B surface antigen (HBsAg). Hemodialysis (HD) patients are at risk of acquiring parenterally transmitted infections. OBJECTIVES: The aim of this study was to assess the prevalence of OBI in HD patients. PATIENTS AND METHODS: A hundred HBsAg negative HD patients were included in this study from main dialysis units in Tehran, Iran. HBsAg, hepatitis B surface antibody (anti-HBs), hepatitis B core antibody (anti-HBc) and liver enzymes levels were examined in all subjects. The presence of HBV-DNA was determined in plasma samples using real-time PCR. RESULTS: A hundredpatients with a mean age of 58.5 ± 16.1 years were enrolled in this study. In total, 56.7% were male and 43.3% female. Anti-HBs, anti-HBc, anti-HCV and anti-HIV were detected in 56.7%, 2%, 5.2% and 1% of patients, respectively. Isolated anti-HBc was detected in 2% of cases. HBV-DNA was detected in 1% of HBsAg negative patients. CONCLUSIONS: This study showed a low rate of isolated anti-HBc and occult HBV infection in HD patients. It can be due to improvement of people's knowledge about HBV transmission routes, HBV vaccination of HD patients and regular surveillance of HBV infection.

Adverse reactions to antituberculosis drugs in Iranian tuberculosis patients.

Background. Antituberculosis multidrug regimens have been associated with increased incidence of adverse drug reactions (ADRs). This study aimed to determine the incidence and associated factors of ADRs due to antituberculosis therapy. Methods. This is a retrospective cross-sectional study on tuberculosis patients who were treated in tuberculosis clinics in Markazi province in Iran. The information contained in the medical files was extracted and entered into the questionnaire. Data was descriptively analyzed by using statistical package for social sciences (SPSS 18). Results. A total of 940 TB patients of 1240 patients' medical records available in 10 medical offices were included in this study. Of the 563 ADRs found in this study, 82.4% were considered minor reactions and 17.6% were major reactions. No death from antituberculosis ADR was observed. We found that the risk of major ADRs was higher in females (P value = 0.0241), age >50 y (P value = 0.0223), coinfection with HIV (P value = 0.0323), smoking (P value = 0.002), retreatment TB (P value = 0.0203), and comorbidities (P value = 0.0005). Conclusions. This study showed that severe side effects of anti-TB drugs are common in patients who have risk factors of ADRs and they should be followed up by close monitoring.

Serological response to one intradermal or intramuscular hepatitis B virus vaccine booster dose in human immunodeficiency virus-infected nonresponders to standard vaccination.

PURPOSE: Hepatitis B virus (HBV) vaccination is recommended for all human immunodeficiency virus (HIV)-infected patients without HBV immunity. However, serological response to standard HBV vaccination is frequently suboptimal in this population and the appropriate strategy for revaccination of HIV-infected nonresponders remained controversial. We aimed to determine the serological response to one booster dose of HBV vaccine given by intradermal (ID) or intramuscular (IM) route in HIV-positive nonresponders to standard HBV vaccination. MATERIALS AND METHODS: In this study, 42 HIV-infected nonresponders were enrolled. We randomized them to receive either 10 µg (0.5 mL) for ID (20 cases) or 20 µg (1 mL) for IM (22 cases) administration of HBV vaccine as a one booster dose. After 1 month, anti-HBs titer was checked in all cases. A protective antibody response (seroconversion) defined as an anti-HBs titer ≥10 IU/L. RESULTS: Seroconversion was observed in 47.6% of subjects after 1 ID dose. A total of 30% showed antibody titers above 100 IU/L. Except one case, all responders had CD4(+) >200 cells/mm(3). Mean anti-HBs titer was 146.5 ± 246 IU/L. After the one IM booster dose, seroconversion was observed in 50% of cases. A total of 36.3% of subjects had anti-HBs ≥100 IU/L. All responders had CD4(+) >200 cells/mm(3), except one case. Mean anti-HBs titer was 416.4 ± 765.6 IU/L. Responders showed significantly higher CD4(+) cell counts, in comparison to nonresponders (P < 0.001). CONCLUSIONS: One booster dose administered IM or ID to HIV-infected nonresponders resulted in similar rates of seroconversion, overall response rate 50%. However, higher anti-HBs titers observed more frequently in IM group.

Comparison of two durations of triple-drug therapy in patients with uncomplicated brucellosis: A randomized controlled trial.

BACKGROUND: Brucellosis remains the most common zoonotic disease throughout the world and especially in Iran. Several clinical trials have tested different therapeutic regimens for brucellosis, but few have assessed the optimal duration of treatment. METHODS: We performed a randomized controlled trial to compare a triple-drug regimen of doxycycline plus rifampicin for 6 weeks and streptomycin for the first 7 days with doxycycline plus rifampicin for 8 weeks and streptomycin for 7 days in patients with uncomplicated brucellosis in Arak, Iran. The primary outcome measure for the treatment groups was the relapse rate measured at 1, 3, 6, 12, and 24 months after cessation of therapy. RESULTS: Eligible patients were randomized to one of the 2 groups with 72 per arm. We found no significant difference in the relapse rate for the 8-week treatment group compared to the 6-week group (9.7% vs 13.9%). There were no significant differences between the 6-week and 8-week groups regarding the relapse rate, period between clinical presentation and beginning of treatment, and time of relapse. Symptom resolution was achieved in all cases at a median 9.5 days and no cases experienced continuing symptoms after treatment. CONCLUSIONS: Our trial found no significant difference between 6-week and 8-week regimens of doxycycline and rifampicin plus streptomycin for the first 7 days. Further comparative studies with a large sample size should be implemented to achieve a consistent therapeutic regimen for uncomplicated brucellosis, to help identify those who may benefit from longer treatment, and to minimize adverse effects and unnecessary continuation of treatment.

HCV, HBV, and HIV seroprevalence, coinfections, and related behaviors among male injection drug users in Arak, Iran.

This study explored the prevalence and related risk behaviors for hepatitis C (HCV), hepatitis B (HBV), and human immunodeficiency virus (HIV) among a sample of male injection drug users (IDUs) in Arak, Iran. One hundred male IDUs attending methadone maintenance clinics between April and September 2012 were enrolled and evaluated for HCV, HBV, and HIV infection. The majority of study participants (56%) had evidence of HCV exposure, 6% had evidence of HBV, and 19% were HIV-infected. Coinfections were frequent; 15% had evidence of HIV and HCV, 6% had evidence of HBV and HCV, and 5% had serologic markers for all three infections. Most (84%) were susceptible to HBV infection. A history of any syringe sharing (54%) and syringe sharing in prison (25%) were common. In bivariate analyses, a history of any syringe sharing and syringe sharing in prison were both associated with all three viral infections. The high prevalence of HCV, HBV, HIV, and coinfections among IDU in Arak is concerning and indicates rapid disease spread outside of Iran's main urban centers. Prevention efforts should expand vaccination for IDUs who are nonimmune to HBV and continue to target syringe sharing with efforts such as needle exchange programs, including inside prisons.

Coenzyme q10 administration in community-acquired pneumonia in the elderly.

BACKGROUND: Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. OBJECTIVES: This study aimed to assess the efficacy of adjunctive coenzyme Q10 (CoQ10) in the treatment of elderly CAP. PATIENTS AND METHODS: Hospitalized elderly patients with CAP (diagnosed by using defined clinical and radiological criteria) were randomized to receive oral CoQ10 (200 mg/d) or placebo for 14 days, along with antibiotics. Primary and secondary outcomes on days 3, 7, and 14 were measured. Disease severity was scored using CURB-65 index. Statistical analysis was performed using SPSS and P value < 0.05 was considered significant. RESULTS: We enrolled 150 patients for this research. Then, 141 patients, including 70 patients in the trial group and 71 patients in the control group were analyzed. Mean age of the trial and control groups were 67.6 ± 7.2 years and 68.7 ± 7.9 years, respectively. Clinical cure at days 3 and 7 were 24 (34.3%) and 62 (88.6%) in the trial group (P value = 0.6745) and 22 (31%) and 52 (73.2%) in the placebo group (P value = 0.0209). Patients on CoQ10 had faster defervescence (P value = 0.0206) and shorter hospital stay (P value = 0.0144) compared with the placebo group. The subgroup analysis of the patients with severe pneumonia showed differences in clinical cure at day 14. Treatment failure was less in CoQ10 group than in the placebo group (10% versus 22.5% and P value = 0.0440). Adverse events in two groups were few and similar. CONCLUSIONS: CoQ10 administration has no serious side effects and can improve outcome in hospitalized elderly CAP; therefore, we recommend it as an adjunctive treatment in elderly patients.

Immunity to diphtheria and tetanus among blood donors in Arak, central province of Iran.

BACKGROUND AND OBJECTIVES: Tetanus and diphtheria are vaccine-preventable, infectious diseases with significant morbidity and mortality. Immunization by the diphtheria and tetanus toxoid (DT) has been applied in Iran for almost 50 years. However, there are very few data about the rate of immunity to these diseases in the adult population. the humoral immunity to tetanus and diphtheria among blood donors in Arak city, central provice of Iran were investigated. PATIENTS & METHODS: A total of 530 consecutive blood donor samples were collected from Blood Transfusion Organization, Central province of Iran. All samples were tested for diphteria and tetanus IgG antibodies using enzyme-linked immunosorbent assay (ELISA). RESULTS: From 530 cases, 91.9% were male and 8.1% were female. 99.6% of cases had protective levels of diphtheria antibody. Protective levels of tetanus antibody were found in 96% of subjects. There was not any significant difference between diphtheria and tetanus antibodies levels and age and sex. CONCLUSION: The obtained data showed that high proportion of the adult population in Arak have sufficient protection against diphtheria and tetanus. The high protective level of immunity to diphtheria and tetanus in Iran can be due to widespread use of booster vaccines in Iranian high schools and during the military services or for pregnant women in their 3(rd) trimester.

Drug resistance pattern and associated risk factors of tuberculosis patients in the central province of Iran.

BACKGROUND: One of the fundamental issues of infectious disease treatment is drug resistance. The aim of the present study was to investigate the first-line anti-tuberculosis drug resistance rates and determine the risk factors related to multidrug resistant mycobacterium tuberculosis. METHODS: From March 2011 to September 2012, mycobacterial strains were collected from one hundred fifteen diagnosed smear positive patients in the central province of Iran and tested for drug susceptible against ethambutol, rifampicin, isoniazid and streptomycin and the risk factors influencing the development of drug resistance were determined. RESULTS: The mean age of patients was 52.23±19.75 years. The rate of multi-drug resistant tuberculosis (MDR-TB) was 7.8%. Our study revealed that there were significant associations between prior treatment, age < 45 years, positive smear result at the end of the second month and positive smear result at the end of the third month. However, there was no association found between gender, inhabitant, nationality, close contact with TB patient, HIV infection and size of mantoux test. CONCLUSION: The results show that about 8% of TB cases in Arak are MDR TB. The age under 45 years, previous TB treatment and positive smear at the end of the second and third months of treatment were the main factors in the development of MDR-TB.

No correlation between interleukin-10 gene promoter polymorphisms and hepatitis B virus infection outcome.

BACKGROUND: Single nucleotide polymorphisms (SNP) in the promoter region of the interleukin (IL)-10 genes have a role in determining hepatitis B virus (HBV) outcome. OBJECTIVES: This study evaluates the correlation between HBV infection and SNP in IL-10 gene promoter. PATIENTS AND METHODS: Ninety-six HBV-infected patients (32 chronic hepatitis B infection patients, 34 healthy carriers, 30 spontaneously recovered cases) and 31 healthy controls were enrolled. Three biallelic (-819,-592,-1082) regions in the IL-10 gene promoter were sequenced for all patients. RESULTS: Genotypes and haplotypes of IL-10 gene promoter region at position -1082, -819 and -592 were not significantly different among controls, HBV recovered cases, carriers and chronic HBV patients. Nevertheless, A/A genotype at position -592 and T/T genotype at position -819 were more frequently seen in the HBV clearance group, while frequency of G/G genotype at position -1082 was more prevalent in the persistence group. GCC/GCC and GCC/ACC haplotypes were significantly observed in anti-HBe positive individuals. CONCLUSIONS: Our findings showed that IL-10 promoter polymorphisms were not correlated with HBV infection prognosis. Nevertheless, individuals carrying high and intermediate producer of IL-10 haplotypes had a better ability to develop anti-HBe than low producer carriers.