Publications by authors named "Arezoo Aghakhani"

68 Publications

Importance of isolated anti-hbc in detection of occult hepatitis B virus infection in hemodialysis patients.

Ther Apher Dial 2013 Dec 12;17(6):644. Epub 2013 Sep 12.

Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.

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http://dx.doi.org/10.1111/1744-9987.12125DOI Listing
December 2013

Hepatitis E virus infection in patients infected with human immunodeficiency virus in an endemic area in Iran.

Int J STD AIDS 2013 Oct 10;24(10):769-74. Epub 2013 Jul 10.

Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.

Some studies have suggested that hepatitis E virus is more frequent in human immunodeficiency virus (HIV) patients and can progress to chronic infection. We aimed to determine the prevalence of hepatitis E virus antibodies and RNA in a series of 100 HIV-infected patients in Tehran, Iran, with comparison to 52 healthy HIV, hepatitis B and C-negative blood donors as controls. HIV-infected patients were also tested for hepatitis E virus-RNA. Among the HIV-infected patients, 10% had antibodies to hepatitis E virus - a finding not significantly different from the uninfected controls (11.5%). No HIV-infected patients had hepatitis E virus IgM antibodies nor did any have detectable hepatitis E virus-RNA. We found no associations between anti-hepatitis E virus IgG-seropositivity and age, sex, route of HIV acquisition, aminotransferases levels, CD4, antiretroviral therapy, hepatitis B virus and hepatitis C virus co-infection. Hepatitis E virus is relatively prevalent in our HIV-infected patients, although without evidence of chronic infection and no more common than among HIV-negative controls or the general population. For the present, we do not recommend routine screening for hepatitis E virus infection in HIV-infected patients in our moderately endemic region.
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http://dx.doi.org/10.1177/0956462413484457DOI Listing
October 2013

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

Hepat Mon 2013 May 19;13(5):e8803. Epub 2013 May 19.

Tuberculosis and Pediatric Infectious Research Center, Arak University of Medical Sciences, Arak, IR Iran.

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.
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http://dx.doi.org/10.5812/hepatmon.8803DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734898PMC
May 2013

Frequency and Genotype of Hepatitis D Virus Infection in Patients Infected with HIV and Those Undergoing Hemodialysis.

Hepat Mon 2013 May 11;13(5):e7481. Epub 2013 May 11.

Department of Hepatitis and AIDS, Pasteur Institute, Tehran, IR Iran.

Background: Hepatitis D virus (HDV) is a defective virus dependent on hepatitis B virus (HBV) for its replication. Due to HDV transmission routes, patients undergoing hemodialysis and those with HIV infection are at risk of acquiring HDV.

Objectives: This study was aimed to determine the frequency and genotype of HDV infection among patients with HIV infection and those undergoing hemodialysis.

Patients And Methods: 720 cases including 120 patients undergoing hemodialysis, and 600 patients with HIV infection were studied. All cases with positive results for HBsAg were evaluated for the presence of anti-HDV antibodies. Samples with Anti-HDV positive results were subjected to nested PCR for HDV-RNA confirmation, and sequenced for HDV genotype determination.

Results: HBsAg was found in 9 (7.5%) of 120 patients undergoing hemodialysis, and 9 (1.5%) of 600 patients with HIV infection. 3 (33.3%) of patients undergoing hemodialysis with positive results for HBsAg, and 5 (55.5%) of cases with HIV infection and positive results for HBsAg, had positive findings for anti-HDV which were then subjected to nested PCR. The amplification results confirmed that in 3 (37.5%) samples HDV-RNA was detected. Overall 2.5% of patients undergoing hemodialysis, and 0.8% of cases infected with HIV had positive results for anti-HDV and 1.7% and 0.2% of cases undergoing hemodialysis and patients infected with HIV had positive findings for HDV-RNA respectively. All of the HDV isolates were clustered in clade 1.

Conclusions: The survey showed that overall HDV frequency was not high in our high risk cases. Therefore, practitioners and health care managers should become aware of the risk of dual infection with HBV and HDV especially in high risk patients.
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http://dx.doi.org/10.5812/hepatmon.7481DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728973PMC
May 2013

Seroprevalence of Hepatitis E Virus infection among volunteer blood donors in central province of Iran in 2012.

Iran J Microbiol 2013 Jun;5(2):172-6

Department of Pathology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

Background And Objectives: Hepatitis E virus (HEV) is a major public health concern in developing countries. HEV transmission occurs primarily by the fecal-oral route. It has also been reported that blood donors are potentially able to cause transfusion-associated hepatitis E in endemic areas. This study aimed to determine the seroprevalence of HEV infection among volunteer blood donors in Central province of Iran in 2012.

Material And Methods: A total of 530 consecutive blood donor samples collected from Blood Transfusion Organization, Central Province of Iran. All samples were tested for the presence of IgG Hepatitis E antibody (anti-HEV) using enzyme-linked immunosorbent assay (ELISA).

Results: From 530 blood donors, 91.9% were male and 8.1% were female. Overall, anti-HEV was found in 76 of 530 samples (14.3%). There was no significant difference in HEV seropositivity between the subjects regarding gender and area of residence (urban vs. rural). Anti-HEV was distributed among all age groups. Although people aged 31-50 years had the highest prevalence, but there was no statistical difference between the age groups.

Conclusion: This study shows a relatively high prevalence of anti-HEV in the blood donors of Central province of Iran. More investigations are needed to assess the potential benefit of adding HEV screening of blood products to the current blood donor selection criteria.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3696855PMC
June 2013

Low Prevalence of Brucella agglutinins in Blood Donors in Central Province of Iran.

Iran J Microbiol 2013 Mar;5(1):24-7

Tuberculosis and Pediatric Infectious Research Center, Arak University of Medical Sciences, Arak, Iran.

Background And Objective: Brucellosis is a zoonotic disease of worldwide distribution and has great economic importance. Despite its control in many countries, it remains endemic in Iran. Brucellosis was investigated in many high risk occupational groups; however, few studies on the prevalence of brucellosis among blood donors are available. To determine the seroprevalence of brucellosis antibodies in blood donors, a serological study was carried out in central province of Iran.

Materials And Methods: A total of 897 healthy blood donors with mean age 37.23± 10.9 years were enrolled in the study. Laboratory tests including Standard Tube Agglutination Test (STA) and 2-mercaptoethanol (2ME) agglutination were checked in all samples. STA dilution ≥1:80, and in the presence of 2-mercaptoethanol (2ME) agglutination ≥ 20 was considered positive.

Results: Out of 897 cases, 11.9% were inhabitants of rural areas. 41.5% had history of consumption of unpasteurized dairy products and 9.3% had history of contact with domestic animals. A very low level of Brucella agglutinins was present in 3(0.33%) of the samples and only one sample (0.11%) was found to be truly positive for Brucella agglutinins. 2ME was negative in all samples. None of these 4 subjects showed signs and symptoms of brucellosis in 6 months follow-up.

Conclusion: On the basis of our data, brucellosis has no epidemiological and clinical importance in our blood donors; therefore, it is not recommended to perform screening tests such as, STA and 2ME to identify brucellosis antibodies in the sera of blood donors.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3577556PMC
March 2013

Serum profile of T helper 1 and T helper 2 cytokines in hepatitis C virus infected patients.

Hepat Mon 2012 Dec 29;12(12):e6156. Epub 2012 Dec 29.

Tuberculosis and Pediatric Infectious Research Center (TPIRC), Arak University of Medical Sciences, Arak, IR Iran.

Background: T-helper (Th) lymphocyte cytokine production may be important in the immune pathogenesis of hepatitis C virus (HCV) infections. Th1 cytokines such as; interleukin-2 (IL-2), and interferon gamma (IFN-gamma) are necessary for host antiviral immune responses, while Th2 cytokines (IL-4, IL-10) can inhibit the development of these effector mechanisms.

Objectives: The aim of the present study was to assess the serum profile of Th1 and Th2 cytokines in treated and non-treated HCV infected individuals.

Patients And Methods: This study was carried out in 63 HCV infected patients (31 under treatment and 32 untreated) and 32 matched HCV-sero negative healthy subjects. Serum samples were checked with an enzyme-linked immune sorbent assay (ELISA) for IL-2, IL-4, IL-10 and IFN-gamma.

Results: Levels of circulating IL-2, IL-4, IL-10 and IFN-gamma were significantly elevated in HCV patients versus normal controls (2 822.6 ± 1 259.92 vs. 950.8 ± 286.9 pg/mL; 1 987 ± 900.69 vs. 895.91 ± 332.33 pg/mL; 1 688.5 ± 1 405.1 vs. 519.03 ± 177.64 pg/mL and 1 501.9 ± 1 298 vs. 264.66 ± 71.59 pg/mL, respectively; P < 0.001). The serum levels of all cytokines were significantly lower in the patients under treatment than those of the untreated patients (P < 0.001).

Conclusions: On the basis of our data, the simultaneous increase of Th1 and Th2 related cytokines may indicate that both Thl and Th2 cytokines are involved in the pathogenesis of HCV infections. Moreover, this activated T-cell response in HCV infected patients may be regulated by treatment.
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http://dx.doi.org/10.5812/hepatmon.6156DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3575547PMC
December 2012

Occult hepatitis B infection in different high risk patients.

Hepat Mon 2012 Jul 30;12(7):467-8. Epub 2012 Jul 30.

Clinical Research Department, Pasteur Institute of Iran, Tehran, IR Iran ; Pediatric Infectious Disease Research Center, Tehran University of Medical sciences, Tehran, IR Iran.

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http://dx.doi.org/10.5812/hepatmon.7094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437461PMC
July 2012

Viral Hepatitis and HIV Infection in Hemodialysis Patients.

Hepat Mon 2012 Jul 30;12(7):463-4. Epub 2012 Jul 30.

Clinical Research Department, Pasteur Institute of Iran, Tehran, IR Iran.

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http://dx.doi.org/10.5812/hepatmon.6959DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437459PMC
July 2012

Viral hepatitis and HIV infection among injection drug users in a central Iranian City.

J Addict Med 2012 Dec;6(4):292-6

Arak University of Medical Sciences, Iran.

Objective: This study aimed to determine the prevalence of serological markers for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and occult HBV infection among injection drug users (IDUs) with isolated anti-hepatitis B core (anti-HBc).

Methods: A total of 153 male IDUs were tested for anti-hepatitis B surface (anti-HBs), hepatitis B surface antigen (HBsAg), anti-HBc, anti-HCV, and anti-HIV. The presence of HBV-DNA was determined in plasma samples of individuals with isolated anti-HBc (HBsAg negative, anti-HBs negative, and anti-HBc positive) by polymerase chain reaction (PCR).

Results: The prevalence of markers for viral hepatitis and HIV infections was 59.5% for anti-HCV, 44.4% for anti-HBs, 22.9% for anti-HBc, 7.2% for HBsAg, and 5.9% for anti-HIV. Several markers for coinfection, including HBV-HCV (5.9%), HCV-HIV (5.2%), HBV-HIV (2.0%), and HBV-HCV-HIV (1.3%), were present. Of the 7.2% of IDUs with isolated anti-HBc, all were anti-HCV positive and 18.2% were anti-HIV positive; however, no cases had detectable HBV-DNA as a marker of occult infection.

Conclusions: Markers for HCV, HBV, HIV, and combinations of these infections were common among IDUs in a city of central Iran. Isolated anti-HBc was associated with HCV but not with occult HBV infection in this sample. The 10-fold higher prevalence of HCV than HIV infection may be a harbinger of increasing HIV among IDUs in this area.
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http://dx.doi.org/10.1097/ADM.0b013e3182659928DOI Listing
December 2012

Occult hepatitis B virus infection in hemodialysis patients: a concept for consideration.

Ther Apher Dial 2012 Aug 11;16(4):328-33. Epub 2012 May 11.

Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.

Hemodialysis patients potentially have an increased risk of infection with parenterally transmitted viral agents due to an impaired host immune response and multiple transfusion requirements. Viral hepatitis is considered as a problem for hemodialysis patients because 1.9% of all deaths among this population are related to the consequence of viral hepatitis. Hepatitis B virus (HBV) is one of the most important causes of transmitted infections by the parenteral route in hemodialysis patients. Occult HBV infection is characterized by presence of HBV infection without detectable hepatitis B surface antigen (HBsAg), which harbors potential risk of HBV transmission through hemodialysis. There are conflicting reports on the prevalence of occult HBV infection (OBI) in hemodialysis patients. Considering the importance of occult HBV infection in hemodialysis patients and the growing evidence on this subject, the purpose of this review is to provide comprehensive information on OBI prevalence in hemodialysis patients and highlight the most important points in this issue.
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http://dx.doi.org/10.1111/j.1744-9987.2012.01072.xDOI Listing
August 2012

The influence of human leukocyte antigen and IL-10 gene polymorphisms on hepatitis B virus outcome.

Hepat Mon 2012 May 30;12(5):320-5. Epub 2012 May 30.

Clinical Research Department, Pasteur Institute of Iran, Tehran, IR Iran.

Context: The clinical outcome of hepatitis B virus (HBV) infection is variable, ranging from spontaneous recovery to an inactive carrier state, chronic hepatitis, occult HBV infection, liver cirrhosis, or hepatocellular carcinoma.

Evidence Acquisition: This variable pattern and clinical outcomes of the infection were mainly determined by virological and host genetic factors. Since the most of host genetic factors associated with HBV infection have currently focused on human leukocyte antigen (HLA) associations and interleukin (IL)-10 gene polymorphisms, this review focuses on the recent progresses in these issues to provide prognostic markers for the outcome of HBV infection.

Results: A study on serum levels of IL-10 in occult HBV infected patients reported that the higher level of IL-10 production may suppress function of the immune system against HBV in patients with occult HBV infection. IL-10 promoter polymorphism at position -592 is associated with susceptibility to occult HBV infection.

Conclusions: Findings of this study suggest that the host HLA polymorphism is an important factor in determining outcome of HBV infection but regarding IL-10 gene promoter polymorphisms, we are still have a long way to achieve a definite conclusion.
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http://dx.doi.org/10.5812/hepatmon.6094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3389357PMC
May 2012

Occult hepatitis B virus infection: A major concern in HIV-infected patients: Occult HBV in HIV.

Hepat Mon 2011 Jan;11(1):7-10

Department of Clinical Research, Pasteur Institute of Iran, Tehran, IR Iran.

Human immunodeficiency virus (HIV)- infected patients are at risk of acquiring viral hepatitis, due to common routes of transmission. As the introduction of highly active antiretroviral therapy (HAART) reduced the frequency of opportunistic infections and improved survival, viral hepatitis emerged as an important cause of morbidity and mortality in HIV-infected cases. Occult hepatitis B virus (HBV) infection is characterized by presence of HBV infection without detectable hepatitis B surface antigen (HBsAg). There are conflicting reports on the impact of occult HBV infection on the natural history of HIV disease. In this review, we described the findings of studies on HIV and hepatitis B co-infection with focus on the prevalence of occult HBV infection. The results of this review demonstrated the importance of prevention, diagnosis and treatment of occult HBV infection in HIV-positive patients.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206662PMC
January 2011

Persistence of antibody to hepatitis B surface antigen among vaccinated children in a low hepatitis B virus endemic area.

World J Pediatr 2011 Nov 27;7(4):358-60. Epub 2011 Aug 27.

Clinical Research Dept., Pasteur Institute of Iran, Tehran, Iran.

Background: A potential problem of hepatitis B immunization is that vaccine-induced antibody to hepatitis B surface antigen (anti-HBs) declines to low levels with age. This study investigated the persistence of anti-HBs in vaccinated children in a low hepatitis B virus (HBV) endemic area.

Methods: Plasma samples of 938 children between ages of 8 months and 15 years were tested for the presence of anti-HBs.

Results: The seroprotection rate was 60%. Protective antibody level was detected in 65% of children one year after vaccination, and in 30%, 29% and 24% 5, 10 and 15 years after vaccination, respectively. The mean anti-HBs titer declined with post-vaccination time (to 66 mIU/mL in 1 year, 60 mIU/mL in 5 years, 40 mIU/mL in 10 years to 37 mIU/mL in 15 years after vaccination).

Conclusions: Children vaccinated against HBV during infancy may show low levels of antibody during adolescence. Our data suggest that a booster dose of vaccine may be required in low HBV endemic areas.
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http://dx.doi.org/10.1007/s12519-011-0286-4DOI Listing
November 2011

Serological pattern of anti-HBc alone infers occult hepatitis B virus infection in high-risk individuals in Iran.

J Infect Dev Ctries 2010 Oct 28;4(10):658-61. Epub 2010 Oct 28.

Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.

Introduction: Anti-hepatitis B core antibody (Anti-HBc) alone is defined as the presence of anti-HBc in the absence of HBsAg and anti-HBs. The significance of this serological pattern as a predicting factor for occult hepatitis B virus (HBV) infection remains largely unknown. This study aimed to assess the significance of anti-HBc alone in predicting occult HBV infection in high-risk and low-risk individuals.

Methodology: A total of 926 individuals were enrolled in this study, including 289 hemodialysis (HD) and 106 HIV-infected patients who were considered as a high-risk group and 531 blood donors who were considered as low-risk. HBsAg, anti-HBs, anti-HBc were tested in all subjects. The presence of HBV-DNA was determined quantitatively in patients with anti-HBc alone by real-time PCR.

Results: Of the 395 high-risk patients, 40 cases (10.13%) had anti-HBc alone, while 11 subjects (2.07%) out of 531 blood donors had anti-HBc alone. HBV-DNA was detected in 12 out of 40 (30%) high-risk patients and none of the blood donors with anti-HBc alone.

Conclusion: Our study showed that the serological pattern of anti-HBc alone could reflect occult HBV infection in high risk cases but did not presume occult HBV infection in low-risk individuals.
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http://dx.doi.org/10.3855/jidc.728DOI Listing
October 2010

The role of human papillomavirus infection in prostate carcinoma.

Scand J Infect Dis 2011 Jan 22;43(1):64-9. Epub 2010 Jul 22.

Clinical Research Department, Pasteur Institute of Iran, Tehran.

Human papillomavirus (HPV) infections are associated with benign and malignant lesions of the female and male anogenital tract. Currently the possible role of HPV infections in prostate carcinogenesis is a subject of great controversy. In this study we aimed to investigate the role of HPV infection in prostate carcinoma (PCa). The study included formalin-fixed paraffin-embedded tissue samples of 104 primary prostate adenocarcinoma cases and 104 control tissues of benign prostatic hyperplasia (BPH). HPV-DNA was purified and amplified through MY09/MY11 and GP5(+)/GP6(+) primers and subsequently subjected to sequencing. HPV-DNA was found in 13 of 104 (12.5%) PCa and 8 of 104 (7.7%) BPH samples. High-risk HPVs were detected in 10 of 13 (76.9%) PCa and 5 of 8 (62.5%) BPH samples with positive HPV-DNA. Low-risk HPVs were detected in 3 of 13 (23.1%) PCa and 3 of 8 (37.5%) BPH specimens with positive HPV-DNA. There was no significant difference between PCa and BPH specimens regarding HPV-DNA presence or the detection of high-risk and low-risk types of HPV. Our data do not support the role of HPV infection in prostate carcinoma. Further studies are required to elucidate the role of HPV infection in human prostate carcinogenesis.
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http://dx.doi.org/10.3109/00365548.2010.502904DOI Listing
January 2011

Assessing subtype and drug-resistance-associated mutations among antiretroviral-treated HIV-infected patients.

AIDS 2010 Jul;24 Suppl 2:S85-91

Tehran University of Medical Sciences, Tehran, Iran.

Background: Several studies have reported an increasing number of therapeutic failures with antiretroviral drugs in HIV-infected patients. The emergence of viral-resistant strains is a major problem for the medical management of infected individuals. The aim of this study is to determine viral subtypes and drug-resistance mutations among antiretroviral-treated HIV-infected patients.

Methods: A total of 42 antiretroviral-treated but still viremic HIV-infected patients were enrolled. The HIV pol regions were amplified and sequenced to determine subtypes and antiretroviral-resistant mutations.

Results: The subtype distribution was 48% A/D recombinants, 43% subtype B, 5% subtype A and 5% CRF01-AE recombinants. Drug-resistant mutations were most common in subtype B (53%) and A/D recombinant strains (44%). Virus samples from 19% of participants had no drug-resistant mutations; 2, 2 and 76% of samples carried one, two and at least three drug-resistant mutations, respectively. The prevalence of nucleoside transcriptase inhibitor mutations was 76%, with M184V and L74V present in 60 and 38% of samples, respectively. The prevalence of nonnucleoside transcriptase inhibitor mutations was 74%, with P225H present in 55% of study specimens. The prevalence of protease inhibitor mutations was 45%, with major mutation L90M seen in 33% and minor mutation A71V in 36% of samples. Of note, the P225H and A71V are 'minor' drug-resistance mutations conferring only minimal drug-resistance phenotypes in the absence of major mutations.

Conclusion: Our study found a high prevalence of drug-resistant mutations in Iranian HIV-infected patients. Our data support the need for continued surveillance of resistance patterns to help guide therapeutic approaches and limit transmission of these variants.
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http://dx.doi.org/10.1097/01.aids.0000386738.32919.67DOI Listing
July 2010

Occult hepatitis B virus infection in hemodialysis patients with isolated hepatitis B core antibody: a multicenter study.

Ther Apher Dial 2010 Jun;14(3):349-53

Clinical Research Department., Pasteur Institute of Iran, Tehran, Iran.

Occult hepatitis B virus (HBV) infection is characterized by presence of HBV infection with undetectable hepatitis B surface antigen (HBsAg). Occult HBV infection harbors potential risk of HBV transmission through hemodialysis (HD). The aim of this study was to assess the occult HBV infection in hemodialysis patients with isolated hepatitis B core antibody (anti-HBc). A total of 289 HD patients from five dialysis units in Tehran, Iran, were included in this study. Hepatitis B surface antigen (HBsAg), Hepatitis B surface antibody (anti-HBs), anti-HBc, Hepatitis C antibody (anti-HCV), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were tested in all subjects. The presence of HBV-DNA was determined quantitatively in plasma samples of HD patients with isolated anti-HBc (HBsAg negative, anti-HBs negative and anti-HBc positive) by real-time PCR using the artus HBV RG PCR kit on the Rotor-Gene 3000 real-time thermal cycler. Of 289 patients enrolled in this study, 18 subjects (6.2%, 95% confidence interval (CI), 3.5%-8.9%) had isolated anti-HBc. HBV-DNA was detectable in 9 of 18 patients (50%, 95% CI, 27%-73%) who had isolated anti-HBc. Plasma HBV-DNA load was less than 50 IU/ml in all of these patients. Our study showed that detection of isolated anti-HBc could reflect unrecognized occult HBV infection in HD patients. The majority of these infections are associated with low viral loads.
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http://dx.doi.org/10.1111/j.1744-9987.2009.00798.xDOI Listing
June 2010

Seroepidemiology of hepatitis A virus in children of different age groups in Tehran, Iran: implications for health policy.

Travel Med Infect Dis 2010 May 11;8(3):176-9. Epub 2010 Mar 11.

Arak University of Medical Sciences, Arak, Iran.

Background: Hepatitis A is one of the most frequently reported vaccine-preventable diseases throughout the world and remains endemic in many areas. Studies in various communities have shown that Hepatitis A virus (HAV) prevalence rises with age. The current data regarding hepatitis A epidemiology in Iran is limited. The aim of this study was to determine the seroepidemiology of hepatitis A in children of different age groups in Tehran, Iran.

Methods: Plasma samples of 1065 children between ages of 6 months and 20 years were tested for the presence of total anti-HAV. The study population was stratified according to age.

Results: The prevalence of total anti-HAV was 61.6%. HAV prevalence rates according to age groups were as follows: 61.5% between 6 months and 1.9 years, 51.7% between 2 and 5.9 years, 52.9% between 6 and 10.9 years, 65.2% between 11 and 15.9 years, 85% between 16 and 20 years. Total anti-HAV seroprevalence was significantly different between age groups.

Conclusion: The study findings indicate that hepatitis A is prevalent in children in Tehran, Iran and HAV infection is an important public health problem in this region.
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http://dx.doi.org/10.1016/j.tmaid.2010.02.004DOI Listing
May 2010

Surface gene mutations of hepatitis B virus among high-risk patients with occult hepatitis B virus infection.

Diagn Microbiol Infect Dis 2010 Mar 10;66(3):285-91. Epub 2009 Nov 10.

Tehran University of Medical Sciences, Tehran 14155, Iran.

Surface gene mutants of hepatitis B virus (HBV) have been reported in a variety of patient groups. Because of limited data regarding these mutations in patients with occult HBV infections; we aimed to determine these mutations among high-risk patients with occult HBV infection. The presence of HBV-DNA was determined in patients with isolated anti-HBc by real-time polymerase chain reaction (PCR). Then, surface gene region was amplified by nested PCR and mutations were analyzed after sequencing. The mutations that resulted in nonfunctional hepatitis B surface antigen (HBsAg) were insertion of single nucleotide in 2 cases, which causes frameshift and single-nucleotide replacement, and premature stop codons at Leu15 and Gly10 in the other 2 cases. Amino acid substitution at amino acid position 207(S207N) was found in the other isolates. Our study suggested that "a" region mutations did not play a major role in HBsAg detection, and other genetic and nongenetic factors may be responsible for failure to detect HBsAg by routine laboratory tests.
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http://dx.doi.org/10.1016/j.diagmicrobio.2009.10.006DOI Listing
March 2010

Lack of occult hepatitis B virus infection among blood donors with isolated hepatitis B core antibody living in an HBV low prevalence region of Iran.

Int J Infect Dis 2010 Apr 4;14(4):e308-10. Epub 2009 Aug 4.

Arak University of Medical Sciences, Arak, Iran.

Background: Occult hepatitis B virus (HBV) infection in blood donors is considered a potential threat for the safety of the blood supply, however conclusive studies on this issue are lacking. The aim of this study was to assess the occult HBV infection in blood donors with isolated hepatitis B core antibody (anti-HBc) living in the city of Arak, in the Central Province of Iran, as a low prevalence region for HBV.

Methods: A total of 531 voluntary blood donors in Arak, Iran were included in this study. Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), anti-HBc, and hepatitis C antibody (anti-HCV) were tested in all subjects. The presence of HBV-DNA was determined quantitatively in plasma samples of cases with isolated anti-HBc (HBsAg-negative, anti-HBs-negative, and anti-HBc-positive) by real-time PCR using the artus HBV RG PCR kit on the Rotor-Gene 3000 real-time thermal cycler.

Results: Of 531 subjects enrolled in this study, 11 (2.1%, 95% confidence interval 0.8-3.2%) had isolated anti-HBc. HBV-DNA was not detected in any of the cases with isolated anti-HBc.

Conclusions: Our study showed that all the blood donors with isolated anti-HBc were negative for HBV-DNA, and occult HBV infection did not occur in the blood donors of this low prevalence region for HBV infection.
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http://dx.doi.org/10.1016/j.ijid.2009.05.011DOI Listing
April 2010

Comparison of QuantiFERON TB-G-test to TST for detecting latent tuberculosis infection in a high-incidence area containing BCG-vaccinated population.

J Eval Clin Pract 2009 Feb;15(1):148-51

Immunology Department Pasteur Institute of Iran, Tehran, Iran.

Objective: Until recently, the only tool for detection of latent tuberculosis infection (LTBI) was the tuberculin skin test (TST). QuantiFERON-TB Gold In-Tube test (QFT) is a promising in vitro diagnostic test for LTBI that has potential advantages over the TST. In this study we aimed to compare QFT with TST for diagnosis of LTBI.

Patients And Methods: A total of 186 BCG-vaccinated subjects enrolled in study. They underwent TST and QFT assay. They divided in two groups. Group 1 includes individuals who were at low risk for exposure to M. tuberculosis (LRG) and Group 2 includes individuals who were likely to have been exposed to M. tuberculosis infections (HRG).

Results: Overall agreement between QFT and TST was 89.3% (kappa = 0.052). In LRG, agreement between the two tests was 52.6% (95% confidence interval, 44-60%) with kappa-values of 0.019. In HRG agreement between the two tests was 63.2% (95% confidence interval, 42-84%) with kappa-values of 0.28.

Conclusion: In conclusion, the QFT assay showed acceptable results for determining latent M. tuberculosis infection in vaccinated population. The decision to select QFT over TST will depend on the population, purpose of testing and resource availability.
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http://dx.doi.org/10.1111/j.1365-2753.2008.00970.xDOI Listing
February 2009

Hepatitis B virus genotype in Iranian patients with hepatocellular carcinoma.

Int J Infect Dis 2009 Nov 9;13(6):685-9. Epub 2009 Jan 9.

Clinical Research Department, Pasteur Institute of Iran, No. 69, Pasteur Ave., Tehran 13164, Iran.

Objective: Chronic hepatitis B virus (HBV) infection is a major risk factor for the development of hepatocellular carcinoma (HCC). HBV appears to be the most common cause of HCC in Iran. To date, no study has been carried out on the HBV genotype in Iranian HCC patients. This study was undertaken to determine the HBV genotype in Iranian patients with HCC.

Methods: Paraffin-embedded tissue samples from 40 patients (31 males and nine females) with HBV-associated HCC were collected from different pathology centers during 2000-2007. Genotyping of HBV was performed by nested PCR-mediated amplification of the target sequence. PCR products were sequenced, and the genotype of each HBV sequence was determined by comparison with sequences of known genotypes in the GenBank. A phylogenetic tree was constructed.

Results: Phylogenetic analysis revealed that all of the HBV isolates were clustered in genotype D.

Conclusions: Our results concur with other reports from Iran, all showing that genotype D is the only detectable genotype in the different clinical forms of HBV infection in this country.
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http://dx.doi.org/10.1016/j.ijid.2008.10.009DOI Listing
November 2009

Occult hepatitis B virus infection in HIV-infected patients with isolated hepatitis B core antibody.

Intervirology 2008 7;51(4):270-4. Epub 2008 Oct 7.

Virology Department, Pasteur Institute of Iran, Tehran, Iran.

Objective: Detection of hepatitis B virus (HBV) DNA without detectable hepatitis B surfaceantigen (HBsAg) is defined as occult HBV infection. In patients co-infected with human immunodeficiency virus (HIV) and HBV, HIV interferes with the natural history of HBV infection by enhancing HBV replication, leading to more severe liver disease. The aim of this study was to assess occult HBV infection in Iranian HIV-positive patients with isolated hepatitis B core antibody (anti-HBc).

Methods: The presence of HBV-DNA was determined quantitatively in plasma samples of HIV-infected patients with isolated anti-HBc by real-time PCR using the artus HBV RG PCR kit on the Rotor-Gene 3000 real-time thermal cycler. Hepatitis C antibody (anti-HCV), alanine aminotransferase (ALT), aspartate aminotransferase (AST), HIV viral load and CD4+ count were also tested in all subjects.

Results: Of 106 patients enrolled in this study, 22 subjects (20.75%, 95% CI 13-28) had isolated anti-HBc. HBV-DNA was detectable in 3 of the 22 patients (13.6%, 95% CI 0.0-28) who had isolated anti-HBc.

Conclusion: A serological profile of isolated anti-HBc could be associated with occult HBV infection in Iranian HIV-infected patients. Therefore the risk of transmission of HBV is probable in these patients.
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http://dx.doi.org/10.1159/000160217DOI Listing
December 2008

Frequency of hepatitis G virus infection among HIV positive subjects with parenteral and sexual exposure.

J Gastrointestin Liver Dis 2008 Sep;17(3):269-72

Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.

Background: Epidemiological data indicate that Hepatitis G virus (HGV) is transmitted predominantly through parenteral routes, with a high seroprevalence among injection drug users (IDUs), although sexual transmission has also been reported. In this study our objective was to compare the frequency of HGV infection in two groups of HIV-positive patients including IDUs and those with sexual risk of exposure.

Methods: Presence of HGV-RNA was analyzed in serum samples from 82 HIV-infected patients including 52 IDUs and 30 cases with sexual (heterosexuals) risk of exposure by reverse transcriptase-nested polymerase chain reaction. Hepatitis B surface antigen (HBsAg), Hepatitis B surface antibody (anti-HBs), Hepatitis C antibody (anti-HCV), alanine aminotransferase (ALT) levels, HIV viral load and CD4 cells count were also tested in all subjects.

Results: The overall prevalence of HGV infection was 10.97% in HIV infected patients, with no statistically significant difference between the two groups (13.5% among IDUs vs. 6.7% among the sexual cases). We found a higher frequency of HGV co-infection with HCV in IDUs than in the sexual group (11.5% vs. 3.3%). There was no statistically significant difference between IDUs and the sexual group regarding age, viral load, CD4 cells count, ALT levels and the prevalence of HBV infection.

Conclusion: The overall prevalence of HGV infection was relatively high in HIV infected patients. HGV-RNA was found more frequently in patients with injection drug use than in those with sexual risk of exposure.
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September 2008

Frequency and genotype of GB virus C among Iranian patients infected with HIV.

J Med Virol 2008 Nov;80(11):1941-6

Hepatitis and AIDS Department, Pasteur Institute of Iran, Tehran, Iran.

GB virus C (GBV-C) infection is frequent in patients infected with the human immunodeficiency virus (HIV) due to similar transmission routes of these viruses. The aim of this study was to determine the rate of infection and genotypic characteristics of GBV-C in this population. The presence of GBV-C RNA was determined in serum samples of 106 patients infected with HIV by reverse transcriptase-nested polymerase chain reaction. GBV-C genotypes were determined by direct sequencing. Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis C antibody (anti-HCV), alanine aminotransferase (ALT) levels, HIV viral load and CD4(+) count were also tested in all patients. The overall prevalence of GBV-C infection was 11.3% in HIV patients. There was no significant difference between patients with and without GBV-C infection regarding age, sex, route of transmission, viral load, ALT levels, HBV and HCV co-infection and treatment with antiretroviral drugs. 66.7% of patients with GBV-C had a CD4(+) count > or = 200 and 33.3% had a CD4(+) count < 200 cells/mm(3). Phylogenetic analysis revealed that all GBV-C isolates were genotype 2, and classified as subtype 2a. GBV-C infection is relatively common in patients infected with HIV. The prevailing GBV-C genotype 2a in this study group concurred with reports from other parts of the Middle East.
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http://dx.doi.org/10.1002/jmv.21314DOI Listing
November 2008

Association of human leukocyte antigen polymorphism with outcomes of hepatitis B virus infection.

J Gastroenterol Hepatol 2008 Nov 28;23(11):1716-21. Epub 2008 Aug 28.

Clinical Research Department, Pasteur Institute of Iran, Tehran, Iran.

Background And Aim: Host genetic and environmental factors are viewed as a common basis of the different outcomes of hepatitis B virus (HBV) infection. Human leukocyte antigen (HLA) plays an important role in immunological reaction to HBV infection. In this study, we aimed to determine the association between HBV infection and HLA-A, B, and DRB1 alleles in northern Iran.

Methods: HLA-A, B, and DRB1 alleles in 33 patients with chronic hepatitis B (CHB) and 31 healthy carriers as the persistent group, and 30 subjects who had spontaneously recovered from HBV infection were analyzed by using the polymerase chain reaction (PCR)-sequence-specific primer (PCR-SSP) technique.

Results: The frequency of the HLA-A*33 allele was higher in the persistent group than in the recovered group (10.16% vs 0%, P < 0.008); the frequency of the DRB1*13 allele was lower in the persistent group than in the recovered group (3.13% vs 11.67%, P < 0.03). The frequency of the B*52 allele was higher in CHB patients than healthy carriers (7.58% vs 0%, P < 0.05). The logistic regression model showed that the presence of the HLA-DRB1*13 allele was the significant factor associated with protection against the persistency of HBV. There were significant differences between the HBV recovered group, CHB patients, and healthy carriers regarding age, hepatitis B e antigen, and anti-hepatitis B e positivity.

Conclusion: HLA-A*33 was closely related with susceptibility to persisting hepatitis B infection, and HLA-DRB1*13 was closely related with protection against persisting hepatitis B in an Iranian population. These findings emphasized that the host HLA polymorphism is an important factor in determining the outcome of HBV infection.
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http://dx.doi.org/10.1111/j.1440-1746.2008.05482.xDOI Listing
November 2008