Survival Rates among Co-infected Patients with Human Immunodeficiency Virus/Tuberculosis in Tehran, Iran.

BACKGROUND: The number of deaths related with co-infection of tuberculosis (TB) and HIV remains inappropriately high worldwide. TB is anticipated to be the major reason of HIV-related deaths globally. This study aimed to find out and evaluate the characteristics of the possible risk factors influencing the survival time of co-infected patients with HIV/TB in Tehran the capital of Iran. METHODS: This retrospective study was performed on the referred patients to the one of two Behavioral Diseases Counseling Centers, Imam Khomeini, and Zamzam Centers, Tehran, Iran, in 2004-2013. Data were analyzed by Cox PH model utilizing SPSS16 statistical software. RESULTS: Multivariate analysis confirmed that the age at diagnosis (P=0.014), gender (P=0.002), sexual transmission (P=0.01), cotrimoxazole preventive therapy (P<0.001), and onset to TB after post-HIV diagnosis (P=0.01) were the parameters which had significant effects on the death of HIV/TBco-infected patients. CONCLUSION: The results, recommend interplay between different risk factors and the risk of death in co-infected patients with HIV/TB. We presented the barriers to higher-level organizational and functional integration for commitment to interfere with the modifiable risk factors, which effect on the mortality of patients.

Individual Factors of Social Acceptance in Patients Infected With Human Immunodeficiency Virus (HIV) at the Yazd Behavioral Consultation Center in Iran.

BACKGROUND: A considerable number of patients infected with HIV also have mental health problems. Individual psychotherapy is an effective way to treat these issues. Lack of social acceptance is a barrier to patients receiving proper medication and emotional/psychological support. OBJECTIVES: The purpose of this study was to examine the individual factors of social acceptance in patients infected with human immunodeficiency virus. PATIENTS AND METHODS: Fifty HIV-infected patients who were registered in the Behavioral Consultation Center entered the study. Each of them filled out a questionnaire based on the Crown-Marlow social acceptance scale. Their answers were evaluated according to the questionnaire key. RESULTS: Forty-five patients (90%) were male and five (10%) were female. Their ages ranged between 28 and 52 years old. Other variables researched in this study include patients' age, sex, education, occupation, place of living, marital status, family history of HIV, and family history of psychological disorders. Employed patients experienced more social acceptance than housewives and people who were unemployed or retired. CONCLUSIONS: This study showed that HIV-infected patients with jobs enjoy a great deal of acceptance from the people around them and a higher quality of life in general. It also led to suggestions for further study with the purpose of finding more effective solutions for HIV prevention and better strategies for dealing with psychological disorders. Such research could also help in providing an enhanced understanding of the potential psychological impact that AIDS has on patients in Iran.

Molecular epidemiology of hepatitis C virus and its relation with persistence or clearance of infection in Hamadan, West-Iran.

BACKGROUND AND OBJECTIVES: Hepatitis C Virus genotyping appears to be vital for predicting the response to antiviral therapy. The present study aimed to analyze the HCV genotypes in relation to persistence or clearance of the virus in residents of Hamadan Province, West-Iran. MATERIAL AND METHODS: A total of 1159 recorded questionnaires of HCV infected people were evaluated in this prospective study. Several parameters including HCV genotypes, anti-HCV antibodies, viral load, drug treatment, response to therapy and amount of ALT and AST were analyzed. RESULTS: HCV genotyping in 637 samples revealed a predominance of type 1a (52.1%) followed by 3a (42.4%), type 1b (2.7%) and type 2 (0.2%) respectively. Mixed genotypes (3a-1a) were detected in 0.9%, and 1.7% had untypable genotype. High frequency of genotypes 1a and 3a were observed in drug-resistant (group-a) and drug-sensitive (group-b) patients respectively (P<0.0001). Additionally, duration of drug treatment was significantly higher in group-a than group-b (P<0.0001). During follow-up period, 92 cases showed spontaneous clearance of HCV infection and more importantly 86 of 92 cases were positive for anti-HCV antibodies compared with 59 of 455 antibody positive cases with treatment-induced clearance of HCV infection (P<0.0001). CONCLUSION: HCV genotyping and also antibody screening could be useful for proper therapeutic intervention in HCV infected subjects.

Survival rates of human immunodeficiency virus and tuberculosis co-infected patients.

BACKGROUND: At present, limited clinical data is available regarding survival rates of patients co-infected with human immunodeficiency virus (HIV)/tuberculosis (TB) in developing countries. OBJECTIVES: The present study aimed to evaluate the effect of HIV infection on the survival chances of active TB adults who disclosed their symptoms of TB in this part of Iran. PATIENTS AND METHODS: The records and data of 807 patients only infected with TB and 21 co-infected patients with HIV/TB, who were admitted to primary health care units in Iran, were evaluated. Their survival time was analyzed using the Kaplan-Meier Estimator, Log-rank test and SPSS version 16. RESULTS: Cox regression analysis showed that co-infection with HIV significantly affects the survival rate of TB patients so that the rate of death was 20.7 (8.1-53) times more than TB infected patients alone. Also, married patients with tuberculosis were 2.7 times more at risk of death than single subjects. We also confirmed that in HIV/TB positive patients, married individuals were more prone to death than single subjects (P value < 0.001). CONCLUSIONS: Our results denote the need to progress diagnostic and preventive measures in this part of Iran.

The assessment of affected factors on cytomegalovirus and rubella virus prevalence in females in Hamadan, Iran.

Cytomegalovirus (CMV) and rubella are considered as dangerous viral infections to the fetus. The findings of this research can clear the possible progress made thus far toward prevention in this part of the country. The data of all referees to genetic center of Shahid Beheshti Hospital in Hamadan, including the rubella and CMV tests were recorded in questionnaires and analyzed by logistic regression models. Univariate and multivariate logistic regression were utilized to assess the affected factors on CMV and Rubella separately. STATA and SPSS16 statistical software were used with setting P-value as 0.05. Logistic regression analysis indicates a statistically significant relationship between CMV IgM and on occupation (P=0.045), pregnancy (P=0.03) and years of referring the patients (P<0.001). The results of multivariate logistic regression analysis showed that job was significantly affected on the CMV infection [OR (95% C.I) = 1.71(1.1-2.83)]. Univariate logistic regression showed that age (P=0.001), the residential area (P=0.03), pregnancy (P=0.03), the marital status (P=0.022) and years of referring the patients (P<0.0001) has a significant effect on rubella IgG. However, multivariate logistic regression analysis also showed that residential status (OR=1.77) and age (OR=0.63) were significantly affected on the Rubella infection. The high level of IgG positivity against rubella in females may highlight the considerable impact of increasing public vaccination in this part of Iran. Also, the current data demonstrating frequency of primary infections with CMV in females which support the conclusion that regular prenatal screening tests is justified.

The Effect of Aqueous Extract of Glycyrrhiza glabra on Herpes Simplex Virus 1.

BACKGROUND: Herpes Simplex Virus 1 (HSV-1) resistance to drugs and the side effects of drugs have drawn the attention of investigators to herbal plants. OBJECTIVES: The main aim of the current research was to investigate the effects of Glycyrrhiza glabra (liquorice root) on HSV-1. One of the objectives of the current research was to determine the efficacy and the effect of the elapsed incubation time of treating the Vero cells infected with HSV-1 by G. glabra. In addition, the effect of cells pretreatment with licorice root extract, preincubation of virus with licorice root extract, and the antiviral activity were assessed. PATIENTS AND METHODS: Vero cells were incubated after adding different concentrations of aqueous extracts of G. glabra. The cells were incubated during various time courses. Cytotoxicity assay, determining the 50% tissue culture infectious dose (TCID50), and incubation of HSV-1 with licorice root extract prior to viral infection were performed. RESULTS: Internal association among different experiment groups showed the significant difference in the efficacy of the extract with regard to incubation period between one and four hours, one and eight hours, four and 12 hours, and eight and 12 hours. Moreover, there was a significant difference with regard to efficacy among the pretreatment of cells with extract for two hours, incubation of virus with extract for one hour, incubation of virus with extract for two hours. CONCLUSIONS: G. glabra showed the characteristics of a novel antiviral medication; however, more in vitro experiments are needed to determine the antiherpetic activities of the G. glabra.

Bacteriophage: time to re-evaluate the potential of phage therapy as a promising agent to control multidrug-resistant bacteria.

Nowadays the most difficult problem in treatment of bacterial infections is the appearance of resistant bacteria to the antimicrobial agents so that the attention is being drawn to other potential targets. In view of the positive findings of phage therapy, many advantages have been mentioned which utilizes phage therapy over chemotherapy and it seems to be a promising agent to replace the antibiotics. This review focuses on an understanding of phages for the treatment of bacterial infectious diseases as a new alternative treatment of infections caused by multiple antibiotic resistant bacteria. Therefore, utilizing bacteriophage may be accounted as an alternative therapy. It is appropriate time to re-evaluate the potential of phage therapy as an effective bactericidal and a promising agent to control multidrug-resistant bacteria.

An epidemiologic study of animal bites in Ilam Province, Iran.

BACKGROUND: In Iran, the number of stray dogs in cities and villages necessitates epidemiologic investigations. This study has undertaken an epidemiologic survey in Ilam, Iran with regard to animal bites during 1999-2009. METHODS: This was a cross-sectional descriptive study. The data due to animal bites was collected from patients and analyzed. RESULTS: The number of animal bites reported was 4420, which included 3032 men (68.3%) and 398 women (31.7%). Most animal bites were reported in the 10-19 year-old (1172, 26%) age group. The feet were the most commonly attacked body part, which was reported in 3177 cases (71.8%). Most bites were from dogs (3942 cases, 89.15%). Of cases, 3419 (77.3%) resided in rural areas while 1001 (22.7%) were urban residents. The number of patients with incomplete vaccinations was 3596 (81.3%) compared to 824 (18.7%) completely vaccinated patients. CONCLUSION: The present study showed a high incidence of animal bites in Ilam, which necessitates the importance of rabies prevention and control. It is recommended that the sanitation authorities provide for and implement measures to determine beneficial ways to avoid and control rabies infection in this part of Iran.

The Effect of GBV-C Infection on CD4 Count and Viral Loads in Patients Infected With HIV.

BACKGROUND: The picture that has emerged from studies investigating HIV infected people with GBV-C viremia is that they have lower plasma HIV viral loads in comparison with HIV-positive people who did not have the GBV-C viremia. OBJECTIVES: Since GBV-C HIV coinfection has not been studied in Iran, we have designed a survey to study the outcomes of GBV-C infection on HIV infected individuals. PATIENTS AND METHODS: We analyzed 78 serum samples from HIV-positive patients in Tehran. The HIV positive statue was confirmed by Western blot in our laboratory. Next we detected GBV-C RNA by RT nested-PCR and divided our patient into GBV-C positive and GBV-C negative groups. The final step was measuring the CD4 count and HIV viral load and comparing the means of the CD4 count and HIV viral load in HIV-infected individuals in the GBV-C positive and GBV-C negative groups. RESULTS: We detected GBV-C RNA in 15 patients out of 78. The mean CD4 count was 607.13 compared to 415.87 in the GBV-C negative group and the difference was significant (P = 0.005). In contrast to the CD4 count there was no significant difference in HIV viral loads between HIV infected individuals in the GBV-C positive and GBV-C negative groups. CONCLUSION: Although there was no significant difference in the mean of the HIV viral load between the GBV-C positive and GBV-C negative groups, the significantly higher CD4 mean in the GBV-C positive group compared with the GBV-C negative group suggests a beneficial effect of this coinfection.