Publications by authors named "Mehrnaz Rasoolinejad"

32 Publications

Genotyping and drug susceptibility patterns of M. tuberculosis isolated from HIV seropositive patients in Tehran Iran.

Curr HIV Res 2021 Feb 26. Epub 2021 Feb 26.

Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran. Iran.

Aim: to investigate the prevalence and drug-resistance M. tuberculosis isolated from HIV seropositive individuals in Tehran, Iran.

Background: Human immunodeficiency virus (HIV) is one of the most important risk factors for developing active tuberculosis (TB).

Objective: To determine the rate of transmission and drug resistant M. tuberculosis (MTB) strains isolated from HIV seropositive patients in Tehran province, Iran.

Methods: This study consecutively enrolled 217 TB/HIV coinfected patients from April 2018 to August 2019 at Emam Khomeini referral hospital and 5 other health centers in Tehran province. The isolates were genotyped using 15 loci Mycobacterial interspersed repetitive unit-variable number tandem repeats (MIRU-VNTR). Minimum inhibitory concentration (MIC) was determined for 6 drugs. In addition, mutations were assessed in rpoB, katG, inhA, and ahpC genes using Reverse Blot Hybridization Assay System.

Results: A 20 (9.2%) patients were culture-positive for M. tuberculosis and typed by MIRU-VNTR, 13 (65%) strains formed 5 clusters, but 6 (30%) isolates had a unique pattern. The total Hunter-Gaston discrimination index (HGDI) for all 15 loci was 0.846, and the cluster size was 2 to 4 patients. The estimated proportion of recent transmission was 45%. The mutation was identified in 1 isolate, lost inhAW1 and mutation in MT1 loci, which was resistant to isoniazid (INH). Moreover, 1 (5%) and 3 (15%) isolates were resistant to INH and ethambutol (EMB), respectively, of which 1 was resistant to INH and EMB.

Conclusion: The transmission rate of TB in HIV patients was relatively high; however, the prevalence of drug-resistant strains and TB infection in females was insignificant in this study (p < 0.05); none of the isolates was MDR strains.
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http://dx.doi.org/10.2174/1570162X19666210226125335DOI Listing
February 2021

CT-scan Findings of COVID-19 Pneumonia Based on the Time Elapsed from the Beginning of Symptoms to the CT Imaging Evaluation: A Descriptive Study in Iran.

Rom J Intern Med 2020 Jul 27. Epub 2020 Jul 27.

Department of Infectious Diseases, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Coronavirus disease 2019 (COVID-19) was initially detected in Wuhan city, China. Chest CT features of COVID-19 pneumonia have been investigated mostly in China, and there is very little information available on the radiological findings occurring in other populations. In this study, we aimed to describe the characteristics of chest CT findings in confirmed cases of COVID-19 pneumonia in an Iranian population, based on a time classification.

Methods: Eighty-nine patients with COVID-19 pneumonia, confirmed by a real-time RT-PCR test, who were admitted to non-ICU wards and underwent a chest CT scan were retrospectively enrolled. Descriptive evaluation of radiologic findings was performed using a classification based on the time interval between the initiation of the symptoms and chest CT-scan.

Results: The median age of patients was 58.0 years, and the median time interval from the onset of symptoms to CT scan evaluation was 7 days. Most patients had bilateral (94.4%) and multifocal (91.0%) lung involvement with peripheral distribution (60.7%). Also, most patients showed involvement of all five lobes (77.5%). Ground-glass opacities (GGO) (84.3%), and mixed GGO with consolidation (80.9%) were the most common identified patterns. We also found that as the time interval between symptoms and CT scan evaluation increased, the predominant pattern changed from GGO to mixed pattern and then to elongated-containing and band-like-opacities-containing pattern; on the other hand, the percentage of lung involvement increased.

Conclusions: Bilateral multifocal GGO, and mixed GGO with consolidation were the most common patterns of COVID-19 pneumonia in our study. However, these patterns might change according to the time interval from symptoms.
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http://dx.doi.org/10.2478/rjim-2020-0019DOI Listing
July 2020

Prevalence of COVID-19-like Symptoms among People Living with HIV, and Using Antiretroviral Therapy for Prevention and Treatment.

Curr HIV Res 2020 ;18(5):373-380

Liver Transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

Background: COVID-19 has spread globally with remarkable speed, and currently, there is limited data available exploring any aspect of the intersection between HIV and SARSCoV- 2 co-infection.

Objective: To estimate the prevalence of clinical symptoms associated with COVID-19 among people living with HIV (PLWH) in Tehran, Iran.

Design: Cross-sectional study.

Methods: A total of 200 PLWH were recruited through the positive club via sampling, and completed the symptom-based questionnaire for COVID-19, which was delivered by trained peers.

Results: Of 200 participants, respiratory symptoms, including cough, sputum, and shortness of breath, were the most prevalent among participants, but only one person developed symptoms collectively suggested COVID-19 and sought treatments.

Conclusion: It appears that existing infection with HIV or receiving antiretroviral treatment (ART) might reduce the susceptibility to the infection with SARS-CoV-2 or decrease the severity of the infection acquired. Further research is needed to understand causal mechanisms.
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http://dx.doi.org/10.2174/1570162X18666200712175535DOI Listing
October 2020

Bone Marrow Aspiration/Biopsy in the Evaluation of Fever of Unknown Origin in Patients with AIDS.

Infect Disord Drug Targets 2020 Jul 5. Epub 2020 Jul 5.

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran. Iran.

Background: HIV can interrupt the normal development of bone marrow cell lines. Bone marrow aspiration/biopsy (BMA/B) has been described as a diagnostic tool in AIDS patients with fever of unknown origin (FUO). In this study, we aimed to study patients with AIDS who had undergone a BMA/B to investigate FUO and describe the pathologies diagnosed in the biopsy.

Methods: Thirty-four BMA/B samples were collected from AIDS patients admitted for workup of FUO to the infectious disease ward of a tertiary referral HIV center in Tehran, Iran, between September 2014 and September 2015. Data including age, sex, duration of disease, CD4 cell counts, hepatitis B (HBV) and C (HCV) coinfection, the primary presentation of AIDS, and the treatment history were retrieved and analyzed. Patients underwent BMA/B. An expert pathologist reviewed the BMA/B specimens.

Results: The mean age of the patients was 37.5 years (range, 26-56), and 27 (79%) were men. Twenty-seven (79%) patients contracted HIV from injection drug use, and 7 (21%) via sexual transmission. Only 3 (9%) of the BMA/B examinations were normal. Hypocellular bone marrow was diagnosed in 22 (65%) patients. Other pathologies included granulomas in 6 (18%), hematologic malignancies in 2 (6%), and leishmaniasis Aspergillosis, each in 1 (3%) patient. Six (17%) of the specimens were found to have tuberculosis infections.

Conclusion: Hypocellular bone marrow was the most common pathology on BMA/B examinations, followed by the presence of granulomas. Tuberculosis, Aspergillosis, and Leishmaniasis were the opportunistic infections diagnosed on BMA/B specimens. Our results support BMA/B as an appropriate diagnostic tool for early diagnosis of opportunistic infections and malignancies in AIDS. BMA/B is indispensable in the armament of diagnostic tools of the physicians managing AIDS patients.
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http://dx.doi.org/10.2174/1871526520666200705212903DOI Listing
July 2020

Drug resistance patterns in HIV patients with virologic failure in Iran.

Arch Clin Infect Dis 2019 Dec 28;14(6). Epub 2019 Dec 28.

HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Kerman University of Medical Sciences, Kerman, Iran.

We reviewed the medical charts of 1,700 patients diagnosed with HIV who referred to a central HIV clinic in Tehran between 2004 and 2017. Participants who had a viral load of > 200 copies/mL after six months or more on antiretroviral therapy (ART) were grouped as virologic failure (VF). We assessed the demographic characteristics, diagnosis date, first ART regimen, and resistance to various ART drugs. Out of 1,700 patients, 72 (4.2%) had a treatment failure. Among those with treatment failure, 51.3% were on zidovudine + lamivudine + efavirenz, 13.9% were on tenofovir + lamivudine + lopinavir/ritonavir, and 12.5% were on tenofovir + emtricitabine + efavirenz. In patients with treatment failure, the highest resistance was to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) combination (44.4%). In these patients, resistance to tenofovir (one of the NRTIs) was 29.1%. The highest treatment failure was observed among patients treated with nevirapine (NVP) and efavirenz (EFV)-based regimen. Our findings suggest that protease inhibitors should be considered as first-line drugs in ART regimens in VF patients in Iran.
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http://dx.doi.org/10.5812/archcid.96531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7138207PMC
December 2019

The Relationship Between HIV Antibody Titer, HIV Viral Load, HIV p24 Antigen, and CD4 T-cell Count Among Iranian HIV-positive Patients.

Infect Disord Drug Targets 2020 ;20(5):752-757

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.

Objective: This study aimed to simultaneously measure and assess the correlation between the available HIV infection parameters including HIV antibody, p24 Antigen, CD4 cell count, and viral load at the different stages of HIV disease among HIV-positive individuals in Iran.

Materials And Methods: Fifty HIV-positive individuals were classified into three stages (1, 2, and 3) according to the HIV disease stages classification, available in Control of Disease and Prevention (CDC) guideline. 10 ml of the venous blood sample was collected to run the tests for HIV antibody and p24 Ag levels, CD4 cell counts, and viral load. Pearson's correlation test was employed to calculate the coefficients for the in-between correlation of different HIV parameters in each stage.

Results: Of 50 participants, 17 (34%), 25 (50%), and 8 (16%) patients belonged to stages 1, 2, and 3, respectively. Sexual relationship was the main route of HIV transmission among the patients (36%); however, injecting drug use (20%) was also reported frequently. There was no significant correlation between the parameters of HIV disease in different stages in the present study.

Conclusion: The findings showed no correlation between HIV parameters in the present study. Considering the fact that the association of HIV antibodies with HIV disease progression in infected individuals is independent of HIV-1 RNA levels, combined measurement of HIV-1 RNA and CD4 cell counts should be routinely carried out in HIV infected patients follow up.
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http://dx.doi.org/10.2174/1871526519666191104144721DOI Listing
January 2020

The effect of selenium and zinc on CD4(+) count and opportunistic infections in HIV/AIDS patients: a randomized double blind trial.

Acta Clin Belg 2020 Jun 19;75(3):170-176. Epub 2019 Mar 19.

Tehran University of Medical Sciences, Tehran, Iran.

: We assessed the effect of selenium and zinc supplementation on CD4 cell count and the risk of developing opportunistic infections.: In a double blind clinical trial, 146 HIV(+) patients receiving combination antiretroviral therapy with CD4(+) >200/cubic millimeter were screened for comorbidities and opportunistic infections, and randomized to receive daily selenium (200 µg), zinc (50 mg) or placebo for 6 months, before a 3-month follow-up period. CD4 cell counts were measured in the 3, 6 and 9 months. The serum selenium and zinc were measured in the 6 month. The incidence of opportunistic infection was assessed monthly for 6 months and at the end of the 9 month.: The final incidence of supplement deficiency for placebo, zinc and selenium were 46.7%, 44.7% and 50.0%, respectively. Overall compliance with supplementation was 99.42%. Although the changes from baseline were not statistically significant, zinc supplementation was significantly associated with reduced risk of opportunistic infections.: Development of the opportunistic infections after zinc supplementation significantly decreased; however, significant improvement in CD4 count was not observed in this group.
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http://dx.doi.org/10.1080/17843286.2019.1590023DOI Listing
June 2020

Zika Virus Infection, Basic and Clinical Aspects: A Review Article.

Iran J Public Health 2019 Jan;48(1):20-31

Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Background: Zika virus infection has recently attracted the attention of medical community. While clinical manifestations of the infection in adult cases are not severe and disease is not associated with high mortality rates, Zika virus infection can have an impact on fetal development and lead to severe neurodevelopmental abnormalities.

Methods: To gain insight into different aspects of Zika virus infection, a comprehensive literature review was performed. With regard to epidemiology and geographical distribution of Zika virus infection, relevant information was extracted from CDC and WHO websites.

Results: In this review, we discuss different basic and clinical aspects of Zika virus infection including virology, epidemiology and pathogenesis of disease. Laboratory methods required for the diagnosis of disease together with ethical issues associated with Zika virus infection will also be discussed in detail.

Conclusion: Herein, we have tried to provide a multi-faceted view of Zika virus infection, with greater emphasis on disease status in Eastern Mediterranean Region.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6401583PMC
January 2019

The Effect of Psycho-Social Problems on Risky Behaviors in People Living With HIV in Tehran, Iran.

J Family Reprod Health 2018 Jun;12(2):89-95

Department of Public Health, Faculty of Public Health, Flinders University, Flinders, Australia.

Over the past years, the prevalence and the progression rate of HIV infection in Iran especially through high-risk sexual relationships have regrettably been reported at very high levels. This cross-sectional study tries to analyze stigma, mental health, and coping skills on risky behaviors in HIV-positive adults in Tehran- Iran. This cross-sectional study was conducted on a sample of 450 HIV-positive adults. Participants completed a socio-demographic questionnaire, the General HealthQuestionnaire-28, the Berger HIV Stigma Scale as well as the Lazarus Ways of Coping Questionnaire (WOCQ). To analyze the data, the independent-samples t-test and Pearson Correlation were used. The findings of this study revealed that mental health, stigma, and avoidance-escape coping mechanisms were correlated with risky behaviors (p ˂ 0.05).Furthermore, the amount of stigma among female individuals compared to men was reported at higher levels and mental health status in the given group was lower than among male individuals. It seems that psychological treatment techniques could be effective in improving mental health and reducing risky behaviors.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391305PMC
June 2018

Stigma and Dissatisfaction of Health Care Personnel in HIV Response in Iran: A Qualitative Study.

J Int Assoc Provid AIDS Care 2019 Jan-Dec;18:2325958219829606

5 Washington, USA.

Background And Aims: With regard to the disease pandemics of HIV/AIDS, it is clear that there is need for prevention, treatment, care, and support of HIV positive patients in the health care system. In order to achieve these goals, job satisfaction should be a priority for health care staff. This study examined the problems of health care personnel and the behavior of patients undergoing HIV/AIDS counseling at Imam Khomeini Hospital in Tehran, Iran.

Methods: Interviews were conducted individually with 5 health care personnel who participated in this study. Participants had 30 to 45 minutes each per session at the clinic, during which they were able to discuss the problems they faced in their careers. All conversations were officially recorded.

Results: The most common problems mentioned by these health care workers included the lack of safety and standardization of work conditions, the lack of appropriate equipment, limited space, high numbers of patients, low staffing levels and financial and morale problems compounded by the lack of support by hospital authorities.

Conclusion: The authorities need to allocate more funds to provide facilities and appropriate working conditions for health care staff in order to increase job satisfaction and enable staff to provide the best services and care to HIV positive patients.
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http://dx.doi.org/10.1177/2325958219829606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748510PMC
April 2020

HIV Prevalence and Sexual Behaviors Among Transgender Women in Tehran, Iran.

AIDS Behav 2019 Jun;23(6):1590-1593

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.

To date, no study has looked at the prevalence of HIV and the high-risk behaviors among transgender women in Iran. Between May 2013 and February 2014, 104 transgender women were recruited for participation in this study. Inclusion criteria consisted of having an official letter from the Tehran Psychiatric Institute, or a well-known psychiatrist, that showed a diagnosis of gender dysphoria and/or completed Gender-Affirming Surgery at least 6 months prior to this study. Of the 104 participants, 2 were diagnosed with HIV, which translates to a HIV prevalence of 1.9%. Condom use with a non-paying partner, casual partner, and paying partner was respectively 39.7%, 34.6%, and 53.3%. A high percentage of transgender women in Tehran engage in high-risk sexual behaviors including condomless receptive anal sex, which is of particular concern given the low rates of HIV testing. Targeted public intervention programs and research are desperately needed for this high-risk group.
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http://dx.doi.org/10.1007/s10461-018-02380-wDOI Listing
June 2019

Prevalence and Associated Risk Factors of Hyperglycemia and Diabetes Mellitus Among HIV Positive Patients in Tehran, Iran.

Infect Disord Drug Targets 2019 ;19(3):304-309

Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.

Background: The introduction of Antiretroviral Therapy (ART) has resulted in the emergence of some metabolic complications including hyperglycemia and diabetes mellitus among HIV positive patients. The aim of this study was to investigate the prevalence of hyperglycemia, diabetes mellitus and their associated risk factors in HIV positive patients.

Methods: This cross-sectional study was conducted on HIV positive patients who visited Voluntary Counseling and Testing (VCT) center of Imam Khomeini Hospital, Tehran, Iran (2004-2013). Medical records of patients were reviewed retrospectively. A logistic regression model was applied for analysis of the association between glycemic status and relevant risk factors.

Results: Out of 480 patients who were included in this study, 267 (55.6%) had hyperglycemia, including 28 (5.8%) with diabetes mellitus and 239 (49.8%) with pre-diabetes. The higher frequency of hyperglycemia, was found to be significantly associated with older age (OR for patients ˃40 years old, 2.260; 95% CI, 1.491, 3.247), male gender (OR, 1.555; 95% CI, 1.047, 2.311), higher Body Mass Index (OR for patients with BMI˃25 Kg/m², 1.706; 95% CI, 1.149, 2.531) and prolonged duration of HIV infection (OR for patients with duration of HIV infection ≥60 months, 2.027; 95% CI, 1.372, 2.992).

Conclusion: Hyperglycemia, especially pre-diabetes, is highly frequent among Iranian people living with HIV. Male gender, older age, prolonged duration of HIV infection, and higher BMI were associated with a higher prevalence of hyperglycemia. Hence, it is important to screen all HIV infected patients at the time of diagnosis and then periodically for hyperglycemia.
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http://dx.doi.org/10.2174/1871526518666180723152715DOI Listing
February 2020

Prevalence of Adverse Drug Reactions to Highly Active Antiretroviral Therapy (HAART) among HIV Positive Patients in Imam Khomeini Hospital of Tehran, Iran.

Infect Disord Drug Targets 2017 ;17(2):116-119

Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Objective: The present study assessed the prevalence of adverse drug reactions (ADRs) among HIV positive patients taking antiretroviral therapy referred to Imam Khomeini Hospital in Tehran, Iran.

Methods: This is a cross sectional study regarding side effects of Highly Active Antiretroviral Therapy (HAART) in HIV positive patients referred to Voluntary Counseling and Testing (VCT) center in Imam Khomeini Hospital of Tehran, Iran during a period of the year 2009 to 2010. Two hundred patients under antiretroviral treatment evaluated for the side effects of drug based on available records, face to face interviews and written lab data.

Results: Data was collected from a sample of 200 HIV positive patients (72% male). Injection drug use was the most common route of HIV transmission. Co-Infections with Hepatitis C virus (HCV) found in the majority of patients (60.5%). Tuberculosis was the most prevalent opportunistic infection. One hundred eighty eight (94%) patients experienced at least one adverse drug reaction. The most frequent clinical and paraclinical findings were skin rash (28%) and abnormal liver function tests (36%).

Conclusion: Given the high prevalence of adverse drug reactions among HIV positive patients taking antiretroviral therapy (ART) in this study, clinicians should be aware of ADRs at the initiation of ART as complications can affect patients' adherence to the therapy.
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http://dx.doi.org/10.2174/1871526517666170117111350DOI Listing
May 2018

HBsAg mutations related to occult hepatitis B virus infection in HIV-positive patients result in a reduced secretion and conformational changes of HBsAg.

J Med Virol 2017 02 1;89(2):246-256. Epub 2016 Aug 1.

Hepatitis B Molecular Laboratory, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Background: Occult hepatitis B infection (OBI) is a frequent finding in human immunodeficiency virus (HIV)-infected patients. While several related mutations in the hepatitis B virus (HBV) genome have been reported, their distinct impact on HBsAg synthesis is largely obscure.

Methods: Thirty-one (18%) out of 172 HIV-infected patients, who were selected from HBsAg-negative patients, were positive for HBV-DNA assigned as being OBI-positive. We generated a series of expression constructs of variant HBsAg with "a" determinant amino acid substitutions including P127L, P127T, S136Y, and P127T + S136Y using site-directed mutagenesis. The expression of variant HBsAg was examined by transient transfection in hepatoma cells, followed by HBsAg immunoassay and immunofluorescence stained with specific anti-HBs antibodies. The potential impact of amino acid substitutions at different positions for conformational changes in the HBsAg was investigated using bioinformatics.

Results: All variants comprising either single or combined mutations resulted in significantly reduced HBsAg detection in supernatants and in cell lysates of hepatoma cells transfected with the constructs. Moreover, intracellular immunofluorescence staining of cytoblocks showed perinuclear and cytoplasmic fluorescence of HBsAg constructs with significantly diminished fluorescent intensity in comparison to the wild type. Altered protein conformations by predictive models, indicating an impaired detection by the host's immune response as well as by commercial antibody-based test assays.

Conclusion: Mutations in the "a" determinant region of HBV as often found in OBI remarkably impair the detection of HBsAg from serum and infected cells, emphasizing the relevance of alternative methods such as HBV-DNA quantification for high-risk groups like HIV-infected individuals. J. Med. Virol. 89:246-256, 2017. © 2016 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/jmv.24623DOI Listing
February 2017

Cytomegalovirus retinitis after initiation of antiretroviral therapy.

Acta Med Iran 2013 ;51(10):730-2

Department of Infectious Diseases, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Patients with human immunodeficiency virus (HIV) infection receiving antiretroviral therapy (ART), despite a reduced viral load and improved immune responses, may experience clinical deterioration. This so called "immune reconstitution inflammatory syndrome (IRIS)" is caused by inflammatory response to both intact subclinical pathogens and residual antigens. Cytomegalovirus retinitis is common in HIV-infected patients on ART with a cluster differentiation 4 (CD4+) counts less than 50 cells/mm3. We reported a patient with blurred vision while receiving ART. She had an unmasking classic CMV retinitis after ART.
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July 2014

Early loss to follow-up and mortality of HIV-infected patients diagnosed after the era of antiretroviral treatment scale up: a call for re-invigorating the response in Iran.

Int J STD AIDS 2013 Dec 6;24(12):926-30. Epub 2013 Aug 6.

Iranian Research Center for HIV/AIDS, Iran.

In Iran, the HIV/AIDS epidemic is growing during an era of scaling up the national surveillance system and antiretroviral therapy programs. We examined the early loss to follow-up and mortality rates in a retrospective cohort of 1495 HIV-infected patients by survival proportional hazard Cox model. We also conducted a data abstraction sub-study in a systematic random sample of 147 patients to assess the association between mortality and predictor factors. Overall, 17.3% patients were not seen after their first visit and 17.4% more were lost by 6 months. The overall mortality rate was 7.0 (95% CI 6.1-8.1) per 100 person-years. Moreover, crude mortality rate was higher in men (8.6) than in women (1.7), with an age-adjusted hazard ratio for men compared to women of 4.55 (95% CI 2.31-8.93). Lastly, history of tuberculosis and not being on antiretroviral therapy were significantly associated with higher mortality in the patient sub-sample.
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http://dx.doi.org/10.1177/0956462413491733DOI Listing
December 2013

Antibody responses to trivalent influenza vaccine in Iranian adults infected with human immunodeficiency virus.

Acta Med Iran 2013 Apr 6;51(3):148-52. Epub 2013 Apr 6.

Department of Infectious Disease, Imam Khomeini Medical Center, Tehran University of Medical Sciences, Tehran, Iran.

The serious influenza-associated complications among immunodeficient individuals such as those who are infected with human immunodeficiency virus (HIV), highlights the importance of influenza vaccination in these people. Therefore, the current study aimed to investigate the antibody responses to influenza vaccine in this group. Two hundred subjects were recruited, during autumn 2010 and 2011, to receive, trivalent inactivated influenza vaccine consisting of A (H1N1), A (H3N2), and B strains. Hemagglutination inhibition assay was used to measure the antibody titer against all strains of the vaccine prior and one month post vaccination. Seroconversion rate for A (H1N1), A (H3N2), and B were found to be 58.5%, 67% and 64.5%, respectively. No correlation was found between antibody titer and demographics factors such as age and gender; however, we found a significant correlation between antibody titer and CD4 cell count. Checking the local and systemic reactions after vaccination, the pain on the injection site and myalgia were the most common local and systemic reactions with 20% and 6.5%, respectively. As vaccination with influenza mount considerable antibody responses in HIV-infected patients, annual influenza vaccination seems to be rational in order to prevent or reduce the severe clinical complications induced by influenza virus.
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April 2013

What is the optimal test for diagnosis of latent tuberculosis?

Acta Med Iran 2012 ;50(6):361-2

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November 2012

Nosocomial Gram-positive antimicrobial susceptibility pattern at a referral teaching hospital in Tehran, Iran.

Future Microbiol 2012 Jul;7(7):903-10

Department of Clinical Pharmacy, School of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran.

Aims: The aim of the study was to evaluate epidemiology and susceptibility patterns of nosocomial Gram-positive infections in a referral teaching hospital.

Methods: Over a 1 year period, Gram-positive microorganisms isolated from specimens of hospitalized patients with documented nosocomial infection underwent antimicrobial susceptibility testing using the disk diffusion test. In addition, possible risk factors for developing multidrug-resistant bacteria were evaluated.

Results: During the study period, a total of 137 nosocomial infections were detected. Staphylococcus aureus was the most frequently isolated microorganism (56.2%), followed by Enterococcus spp. (21.9%) and Staphylococcus epidermidis (15.3%). All S. aureus strains were sensitive to vancomycin, teicoplanin, linezolid and chloramphenicol. More than 50% of enterococci strains were resistant to vancomycin and teicoplanin. Possible risk factors for multidrug resistance among isolated pathogens were history of antibiotic use and intubation of patient for mechanical ventilation.

Conclusion: This study showed high rates of antimicrobial resistance among nosocomial Gram-positive pathogens, complicating antibiotic therapy and its outcomes.
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http://dx.doi.org/10.2217/fmb.12.51DOI Listing
July 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

Incidence of isolation of Mycobacterium tuberculosis from blood samples in tuberculosis patients in Imam Khomeini Hospital, Tehran, Iran.

Acta Med Iran 2011 ;49(8):556-9

Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, Iran.

It is estimated that one third of the world's population is latently infected with tuberculosis (TB). The HIV epidemic fuels the TB epidemic by increasing the risk of reactivation of latent TB infection and by facilitating a more rapid progression of TB disease. Although the incidence of TB is constant or decreasing in many regions of the world, rates remain high in developing countries as a consequence of the HIV epidemic. This study was conducted as a collaboration of the Infectious Diseases department of Imam Khomeini Hospital with the Microbiology department of Tehran University of Medical Sciences. The hospital dataset of 94 patients admitted with TB during 2003-2005 was reviewed. We aimed to study factors correlating with positive blood culture including age, sex, immune deficiency status, HIV serology and SIRS (Systemic Inflammatory Response Syndrome) status. In this study, we found that positive blood cultures are more frequent in patients less than 45 years old. Positive blood cultures were also more frequent in HIV infected patients and there was a significant correlation between blood culture and SIRS status. Therefore, we recommend that we obtain blood cultures from these high-risk groups in order to increase early detection of TB.
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March 2012

Assessing the prevalence of HIV among Afghan immigrants in Iran through rapid HIV testing in the field.

Acta Med Iran 2011 ;49(7):478-9

Iranian Research Center for HIV/AIDS, Imam Khomeini Hospital, Tehran University of Medical Sciences, Iran.

Throughout the world, many migrant and mobile populations are at elevated risk for HIV. Iran has a large immigrant population from neighboring Afghanistan; however, few data exist on the prevalence of HIV in this community. In 2008, we conducted a study to assess the presence of HIV infection among 477 immigrants in a town to the northeast of Tehran using a rapid test in the field. HIV prevalence was 0.2% (95% CI 0.005-1.2) with one person HIV-positive. We recommend periodic HIV sero-surveillance with detailed behavioral measures for this population in the future.
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January 2012

FNA diagnostic value in patients with neck masses in two teaching hospitals in Iran.

Acta Med Iran 2011 ;49(2):85-8

Department of Pathology, Bu-Ali Hospital, School of Medicine, Azad University of Tehran, Iran.

The FNA (fine needle aspiration) procedure is simple, inexpensive, available and a safe method for the diagnosis of a neck mass. FNA has numerous advantages over open surgical biopsies as an initial diagnostic tool; therefore we decided to compare the accuracy of this method with open biopsy. This retrospective as well as descriptive study comparing preoperative FNA results with existing data in the Pathology Department in Bu-Ali and Amir Alam Hospitals. Our study included 100 patients with neck masses of which 22 were thyroid masses, 31 were salivary gland masses, and 47 were other masses. Age ranged from 3 years to 80 years with the mean age of 42.6 years. There were 59 men and 41 women. The Sensitivity was 72%, Specificity 87%, PPV 85%, NPV 75% and diagnostic Accuracy 79%. In this study we had also 26% false negative and 15% false positive. FNA is a valuable diagnostic tool in the management of neck masses; also it has been used for staging and planning of treatment for the wide and metastatic malignancy. This technique reduces the need for more invasive and costly procedures. According to the high sensitivity and high accuracy in this study, FNA can be used as the first step of diagnoses test in neck masses.
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September 2011

Frequency of HIV Infection among Sailors in South of Iran by Rapid HIV Test.

AIDS Res Treat 2011 10;2011:612475. Epub 2011 Apr 10.

Iranian Research Center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, Iran.

Information on the prevalence and risk factors for HIV infection among sailors is scarce. The aim of this seroprevalence study was to evaluate the frequency of HIV infection among sailors in south of Iran using rapid HIV test. The study included 400 consecutive participants in Lengeh, Shahid Rajaie, and Shahid Bahonar ports in south of Iran in May 2010. We observed only one case (0.25%) of HIV infection in this sample of sailors. While prevalence appears low at present, we recommend periodic HIV serosurveillance with detailed behavioral measures for this population in the future.
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http://dx.doi.org/10.1155/2011/612475DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085304PMC
July 2011

Cervical transverse myelitis after chickenpox in an immunocompetent patient.

Acta Med Iran 2010 Nov-Dec;48(6):417-8

Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran.

Varicella-zoster viruses complications involving the CNS are estimated to occur rarely, transverse myelitis after Varicella-zoster virus in most patients is characterized by an abrupt onset of progressive weakness and sensory disturbance in the lower extremities , like other viruses. We describe the case of 17 year-old boy who experienced cervical transverse myelitis after chickenpox with inability to walk and with urinary retention. He was not treated with any medication but complete recovery has been occurred.
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July 2011

Prevalence of hepatitis A virus infection in a HIV positive community.

Acta Med Iran 2010 May-Jun;48(3):192-5

Department of Infectious and Tropical Diseases, Iranian Research Center for HIV/AIDS, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Hepatitis A is acute and usually self-limiting disease, but sometimes it can be dangerous such as in immunosuppressed patients. Purpose of this study is to investigate the prevalence of hepatitis A serology in HIV/AIDS Patients. 247 HIV positive patients from March 2005 to September 2006 were entered in this study. Participants completed questionnaires to elicit demographic, drug and sex risk information, and were (tested for hepatitis A. They were all referred to Counseling center for behavioral diseases in Imam Khomeini Hospital. Cases were chosen from volunteers with no history of jaundice or acute hepatitis. Data were analyzed by SPSS version 13 and results were compared between seropositive and seronegative groups using T test and chi square. Statistical significance was accepted at a level of P < 0.05.200 (80.98%) were male and 47 (19.02) were female. The mean age was 36 +/- 9.3. 238 (96.3%) of patients were seropositive. One hundred percent and 96% who were born in rural and urban areas were seropositive, respectively. Also, 85.7% and 96.6% who reside in rural and urban areas were seropositive, respectively. Iran is an endemic country for hepatitis A in which most people has asymptomatic infectious during childhood. According to high prevalence of hepatitis A positive serology in HIV/AIDS patients, routine vaccination seems to be unnecessary. But special sub populations like HIV infected infants should be evaluated more precisely and different approaches may be needed for them.
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January 2011

Approach to Pandemic 2009 influenza: first report from a main referral hospital for Pandemic H1N1 influenza care in Iran.

J Infect Dev Ctries 2010 Oct 28;4(10):629-35. Epub 2010 Oct 28.

Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Pandemic H1N1 influenza A (pdmH1N1) was a major health threat worldwide.

Methodology:   A prospective cross-sectional study was conducted at Imam Khomeini Hospital in Iran. Cases of suspicious pdmH1N1 patients referred to the emergency ward of the hospital were enrolled in the study, regardless of whether the final location of treatment was the community, the hospital ward, or the intensive care unit.  Oseltamivir was administered within three hours of the patient's admission.  The median length of stay for hospitalized patients was 3 days.

Results: Gastrointestinal symptoms (nausea [164/434; 37.8%] and vomiting [98/434; 22.6%]) were the most common adverse reactions to oseltamivir in the study population, followed by dizziness (74/434; 17.1%). Out of 434 patients, 209 (48.2%) were treated in the community, 201 (46.3%) were admitted to the general ward in the hospital, and 24 (5.5%) were admitted to an ICU.

Conclusions: This study provided insight on the effectiveness of oseltamivir in treating pandemic influenza A, as well as possible adverse reactions to the drug.  The study further drew attention to a variety of pdmH1N1 complications, in particular secondary bacterial pneumonia. We also determined that 2009 influenza A (H1N1) infection-related critical illness and mortality affected fewer elderly than younger patients. Additionally, it was shown that our approach to patients with suspected Influenza A/H1N1 virus in our hospital was compatible with World Health Organization pandemic flu guidelines in our country.
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http://dx.doi.org/10.3855/jidc.1195DOI Listing
October 2010

Prevalence of cardiac manifestations in HIV-infected patients in Iran.

J Acquir Immune Defic Syndr 2010 Sep;55(1):e1-2

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http://dx.doi.org/10.1097/QAI.0b013e3181e6a609DOI Listing
September 2010

Evaluation of Tigecycline Activity Against Methicillin-Resistante Staphylococcus aureus Isolated from Biological Samples.

Iran J Pharm Res 2010 ;9(1):61-5

Department of Infectious Diseases, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Tigecycline is a new glycylcycline antibiotic structurally similar to minocycline antibiotic. It has broad spectrum activity, including Staphylococcus aureus infections. This is the first study that evaluated the activity of Tigecycline against Staphylococcus aureus isolated from biological samples in Iran. In vitro activity of tigecycline against 160 Staphylococcus aureus including 99 methicillin-resistant S. aureus and 61 methicillin-susceptible S. aureus from inpatients at Imam Khomeini Hospital, Tehran, Iran was assessed. Bacterial susceptibility tests were performed by the disk diffusion method and also E-test for methicillin-resistant S. aureus isolates. All isolated had inhibition zone of ≥ 19 mm, with the minimum inhibitory concentration 50 (MIC50) and MIC90 of 0.19 and 0.5 μg/mL, respectively. The study results indicated that all methicillin-resistant S. aureus and methicillin-susceptible S. aureus isolates were susceptible to tigecycline.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869553PMC
December 2013

Insights from a survey of sexual behavior among a group of at-risk women in Tehran, Iran, 2006.

AIDS Educ Prev 2007 Dec;19(6):519-30

Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Department of Infectious Diseases, Emam Khomeini Hospital, Tehran, Iran.

Despite high rates of HIV among male injection drug users, the sexual behaviors of at-risk women in Iran remain unknown. A questionnaire on HIV knowledge and risk behavior was administered in a Tehran nongovernmental organization targeting runaways and other women seeking safe haven. Half (total N = 50) were less than 24 years old; baseline HIV knowledge was high. The few who acknowledged using illicit substances said they used "frequently." Nonresponse rates to questions regarding sexual behavior were high (12 of 50). Half admitted a history of sexual activity; 40% of those reported their first sexual contact with someone other than their husband; three people had multiple partners. Three women reported a history of rape. Zero (97.5% one-sided confidence interval [CI] = 0, 0.17) of 35 women tested positive for HIV or syphilis. This study documents the existence of sexual behavior in a population of Iranian women, represents one of the first attempts at sexual research in the Iranian context, and highlights challenges in surveying this vulnerable group.
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http://dx.doi.org/10.1521/aeap.2007.19.6.519DOI Listing
December 2007