Human Immunodeficiency Virus Antibody Research Articles

Evaluation of a new human immunodeficiency virus antigen and antibody test using light-initiated chemiluminescent assay

Evaluation of a new human immunodeficiency virus antigen and antibody test using light-initiated chemiluminescent assay

Single-Cell Sequencing of Peripheral Blood Mononuclear Cells Reveals Immune Landscape of Monkeypox Patients with HIV

The monkeypox (MPXV) outbreak in 2022 is more prevalent among individuals with human immunodeficiency virus (HIV). While it is plausible that HIV-induced immunosuppression could result in a more severe progression, the exact mechanisms remain undetermined. To better understand the immunopathology of MPXV in patients with and without HIV infection, we employed single-cell RNA sequencing (scRNA-seq) to analyze peripheral blood mononuclear cells (PBMCs) from 6 patients hospitalized for MPXV, 3 of whom had HIV infection (HIV antibody positive & HIV RNA level below the detection limit), and 3 patients only infected with MPXV (HIV-). We map the peripheral immune response in both the acute phase and the recovery period, showing the reconfiguration of peripheral immune cell phenotypes in acute stage compared with recovery stage of 6 patients, characterized by disturbed cell subsets and intense cell interactions mediated by monocytes and neutrophils. Importantly, besides different Mono/DC dynamic between HIV + and HIV- patients, HIV + patients showed decreased NK cells subsets and expansion of some CD8 T cell subsets, we also found obviously dysregulated gene expression in B cells, thus proposing mechanism underlying serious condition underlying HIV + patients. In conclusion, our findings provide a comprehensive cell atlas of MPXV patients, shed light on the mechanisms underlying the severe disease progression and longer recovery time in HIV + individuals.

Unpredicted Protective Function of Fc-Mediated Inhibitory Antibodies for HIV and SARS-CoV-2 Vaccines.

Developing effective vaccines is necessary in combating new virus pandemics. For human immunodeficiency virus (HIV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the induction of neutralizing antibodies (NAb) is important for vaccine protection; however, the exact mechanisms underlying protection require further study. Recent data emphasize that even Abs that do not exhibit neutralizing activity may contribute to immune defense by Ab Fc-mediated inhibition. Abs exhibiting this function may counter virus mutations, which are acquired to escape from NAbs, and therefore broaden the protective Ab response induced by vaccination. The steps leading to inhibition are complex. How can these functions be measured in vitro? What inhibitory assay is physiologically relevant at mimicking effective in vivo protection? This review provides a comprehensive update on the current knowledge gaps on the Ab Fc-mediated functions involved in HIV and SARS-CoV-2 protection. Understanding the inhibitory effects of these Abs is vital for designing the next generation of protective HIV and SARS-CoV-2 vaccines.

High prevalence of hepatitis B and HIV among women survivors of sexual violence in South Kivu province, eastern Democratic Republic of Congo.

Limited data are available on the prevalence rates of hepatitis B and acquired immunodeficiency syndrome (AIDS) among women survivors of sexual violence (WSSV) in South Kivu province, in the eastern part of the Democratic Republic of Congo (DRC), where armed conflicts persist. Here, we aimed to assess the prevalence of these two infections in this vulnerable local population. A total of 1002 WSSV, aged from 18 to 70 years old were enrolled from May 2018 to May 2020 at three healthcare facilities (Panzi, Mulamba and Bulenga hospitals), which are called "The One-Stop Centre Care Model" for the management of sexual violence in South Kivu. Blood samples were collected and tested for hepatitis B virus (HBV) and human immunodeficiency virus (HIV) antigens and antibodies using enzyme-linked immunoassay (ELISA) methods. Subsequently, viral load quantification for HBV and HIV were performed using the GeneXpert. Univariate and multivariate logistic regression models were used to assess factors associated with HIV-positive and HBV-positive status. For HBV, overall prevalence was 8.9% (95% CI; 7.2-10.8%), 32.1% (95% CI; 29.3-35.0%), and 14.5% (95% CI; 12.3-16.8%) for HBsAg, anti-HBc and anti-HBs antibodies, respectively. Among the 89 HBsAg-positive patients, 17 (19.1%) were HBeAg-positive. The median age of individuals with a positive HBsAg test was higher than those with a negative test (median: 40 years (IQR 30-52) compared to 36 years (IQR 24-48)). Risk factors for HBV infection were age (≥35 years) (AOR = 1.83 [1.02-3.32]; p = 0.041), having no schooling (AOR = 4.14 [1.35-12.62]; p = 0.012) or only primary school-level (AOR = 4.88 [1.61-14.75]; p = 0.005), and multiple aggressors (AOR = 1.76 [1.09-2.84], p = 0.019). The prevalence of HIV was 4.3% [95% CI: 3.1-5.7%]. HIV/HBV co-infection occurred only in 5 individuals (0.5%). The HBV viral load was detectable (> 1 log10 UI/mL) in 61.8% of HBsAg-positive subjects and 64.8% HIV-positive subjects had a high viral load (≥ 3 log10 copies/mL). This study revealed a high prevalence of HBV and HIV infections among WSSV in South Kivu. The results generated highlight the urgent need for systematic screening of HBV and HIV by integrating fourth-generation ELISA tests in HIV and HBV control programs.

Real-world performance of HIV low viral load values in diagnosing acute HIV infection in a tertiary care hospital in Beijing, China

BackgroundEarly diagnosis of HIV infection decreases the time from HIV diagnosis to viral suppression and reduces further HIV transmission. The Chinese Guidelines for the Diagnosis and Treatment of HIV/AIDS (2021 edition) state that an HIV RNA level > 5,000 copies/mL is the threshold for diagnosing HIV infection. The impact of low viral load values on HIV diagnosis needs to be investigated.MethodsThere were 3455 human immunodeficiency virus (HIV1 + 2) antibody results (immunoblotting method) and 65,129 HIV viral load values at Beijing Youan Hospital from 2019 to 2022. A total of 2434 patients had both antibody confirmatory results and viral load results. The confirmatory antibody results and HIV viral load results of 2434 patients were analyzed to investigate the impact of low viral load values on HIV diagnosis.ResultsOf the 2434 patients who had both confirmatory antibody results and viral load results, the viral load values of 140 patients (5.8%) had viral loads ranging from 40 copies/mL to 5,000 copies/mL before positive confirmatory antibody result, and of these 140 patients, the sample receipt time for the viral load tests of 96 (66.7%) individuals was 1 to 6 days earlier than the corresponding sample receipt time for the confirmatory antibody test. In addition, 34 patients (1.4%) had low viral loads ranging from 40 copies/mL to 1,000 copies/mL before positive confirmatory antibody result.ConclusionThis study revealed that there is a risk of missed diagnosis if a threshold of 5000 copies/mL is used for the diagnosis of HIV infection. These data provide valuable information for the early diagnosis of HIV infection, and our findings have potential benefits for decreasing HIV transmission.

Diagnostic tests of HIV infection and AIDS

Background: Human immunodeficiency virus (HIV) infection presents a major global health challenge. According to the World Health Organization, approximately 39.0 million people have HIV, as of 2022, with 1.3 million new infections annually. In Korea, the first HIV cases were reported in 1985, and the number of cases has increased continuously since 1988. In 2022, 1,066 cases were newly diagnosed, increasing the total number of cases to approximately 15,880.Current Concepts: Diagnostics play a crucial role in the management of HIV, for early diagnosis and initiation of antiretroviral therapy. Approval of the first HIV antibody test in 1985 by the US Food and Drug Administration marked a notable advance in the ability to diagnose HIV infection. The screening test for HIV infection typically consists of a two-step approach, in which a fourth-generation combination HIV-1/2 immunoassay is followed by a confirmatory Western blot. Despite its high accuracy for chronic infections, the window period and the early-stage of HIV infections are problematic, and populations with low HIV prevalence show a low positive predictive value. A false positive result can occur from blood transfusions, vaccinations, and autoantibodies. Novel diagnostic tools, such as nucleic acid testing for viral RNA/DNA and antigen testing for p24 antigen have reduced the window period, allowing for earlier detection and differentiation between HIV-1 and HIV-2. Pointof-care tests are beneficial in resource-limited settings although their lower sensitivity and specificity require additional confirmatory follow-up testing.Discussion and Conclusion: In this review, we provide a historical perspective on the evolution of HIV diagnostics (serological and molecular) and describe the roles of conventional and point-of-care testing within the laboratory diagnostic network.

Analysis of the Value of ELISA in Screening Human Immunodeficiency Virus Antibodies

Analysis of the Value of ELISA in Screening Human Immunodeficiency Virus Antibodies

The Adaptation and Content Validity of an Instrument to Examine the Attitudes and Perceptions of HIV Self-Testing Among the Young Population in Nigeria

Background: The Human Immunodeficiency Virus (HIV) has been a stigmatized illness as well as a medical condition. Attitudes toward HIV/AIDS testing have been shown to suggest an individual’s predisposition to test for HIV. The objectives of this study were to develop an instrument examining the attitudes towards HIV/AIDS by adapting and validating the HIV Antibody Testing Attitude Scale for use in HIV self-testing among young people in Nigeria.

Diagnostic Efficacy of Photostimulated Chemiluminescence Assay for Detecting Anti-HIV Antibodies: A Retrospective Study.

The transmission of human immunodeficiency virus (HIV) through blood poses a slightly increased risk. As a result, patients requiring blood transfusions should be screened for HIV antibodies. This study examined the diagnostic effectiveness of the photostimulated chemiluminescence assay in detecting anti-HIV antibodies and determined the cut-off value for this method. The performance of the fully automated photostimulated chemiluminescence assay system was validated according to CNAS-GL038:2019 (2020) and CNAS-GL037:2019 (2019) guidelines. A retrospective study was conducted at the Department of Medical Laboratory, Nanjing Tongren Hospital, affiliated with Southeast University, from January 2020 to December 2022. A total of 77,386 cases were tested for anti-HIV antibodies using the photostimulated chemiluminescence assay, with 79 cases initially testing positive. The method's performance in detecting anti-HIV antibodies was evaluated using the Receiver Operating Characteristic (ROC) curve and the average Coefficient of Variation (CV) value of 3-year in-house quality control. The precision, detection limit, coincidence rate, and critical value of the performance verification results met the requirements. Using Western blotting (WB) as the reference method, positive cases were initially screened using the light-induced chemiluminescence method to determine the cut-off index (COI) value and draw the ROC curve. The maximum area under the ROC curve using the chemiluminescence method was 0.997, with a cutoff value of < 28.56, sensitivity of 98%, specificity of 100%, Jordan index of 0.98, and an average CV value of 3.55%. In conclusion, the photostimulated chemiluminescence assay has good diagnostic efficacy in detecting anti-HIV antibodies and is suitable for rapid screening before blood transfusion and surgery.

Factors Associated with HIV Testing among Male Students Who Have Engaged in Sexual Behaviour in Zhejiang Province, China.

This study aimed to estimate the prevalence of human immunodeficiency virus (HIV) testing, identify factors associated with HIV testing among male students who have engaged in sexual behaviour in Zhejiang province, and provide a scientific basis for the prevention and control of HIV infection on campus. Stratified cluster random sampling analysis was performed, which included general characteristics, sexual attitudes, sexual behaviours, information on HIV testing, and self-risk assessment for HIV infection. Univariate and multivariate logistic regression analyses were conducted to identify the influencing factors. Among 2734 male students who have engaged in sexual behaviour, 319 (11.7%) had undergone HIV antibody testing in the previous year. The results of multivariate analysis demonstrated that the participants who were in the junior grade level (adjusted odds ratio (AOR) = 1.59, 95% confidence interval (95% CI): 1.10-2.30) exhibited acceptance to male homosexual behaviour (AOR = 1.73, 95% CI: 1.19-2.52), had been exposed to testing publicity in the previous year (AOR = 1.51, 95% CI: 1.06-2.15), had been exposed to self-risk assessment for HIV infection (AOR = 2.66, 95% CI: 1.99-3.55), had male or bisexual partners (AOR = 1.60, 95% CI: 1.05-2.46), had a score for the scale indicating awareness of different testing methods between 2 and 5 (AOR = 2.19, 95% CI: 1.51-3.16) or greater than 6 (AOR = 1.49, 95% CI: 1.01-2.66), and had a score for the scale indicating knowledge of different testing facilities between 3 and 5 (AOR = 1.63, 95% CI: 1.00-2.66) were inclined to engage in HIV testing. In this study, the proportion of HIV-testing among male students who have engaged in sexual behaviour was low. This study revealed that students who exhibited acceptance to male homosexual behaviours had been exposed to publicity for HIV testing or a self-risk assessment for HIV infection which were more inclined to engage in HIV testing. Our study underscores the urgent need to enhance educational interventions concerning HIV risks and warnings as part of the health education curriculum on campus. The graveness of the AIDS epidemic among students necessitates this emphasis. Moreover, we recommend deploying condom-dispensing machines or HIV testing facilities across the campus for easy access to preventive and testing services for HIV.

Screening for latent infectious disease in patients with alopecia areata before initiating JAK inhibitors therapy: a single-center real-world retrospective study.

Although there is growing evidence supporting the effectiveness of Janus kinase (JAK) inhibitors in treating alopecia areata, the high rate of recurrence following drug discontinuation has led to prolonged treatment courses and raised concerns about long-term safety. In clinical practice, caution should be exercised while using JAK inhibitors for various indications, and a comprehensive pre-treatment screening. This study presents an analysis of screening data collected from real-world settings before the initiation of Janus kinase inhibitors in patients with alopecia areata. Investigators collected retrospective medical data characterizing patients' screening data. Data on demographic and clinical data, including age, sex, disease duration, severity of alopecia tool scale, history of prior treatment, and treatment regimen were recorded. In this cohort (N = 218), JAK inhibitors were initiated for 163 of 218 (74.8%) alopecia areata patients. The numbers of patients positive for antinuclear antibodies, hepatitis B surface antigen, hepatitis C virus antibodies, human immunodeficiency virus antibody, treponema pallidum hemagglutination assay, and thyroid-stimulating hormone were 32 (32/176), 10(10/218), 0 (0/218), 0 (0/218), 3 (3/218) and 9 (9/176), respectively. The number of patients with T-cell spot positive or imaging of the chest indicating tuberculosis was 37 (37/218). Our data provide additional information on the safety profile of JAK inhibitors in patients with alopecia areata. As such, it is necessary and crucial to screen for JAK inhibitors before it is used, particularly for individuals with a high risk of tuberculosis, hepatitis B, and other infections.

Seroprevalence of Human Immunodeficiency Virus, Hepatitis C Virus, and Hepatitis B Virus Among Blood Donors in Sidi Bel Abbes, West Algeria.

Introduction Blood transfusions can transmit various viruses. Among them, the most common are hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). These viruses can cause fatal and life-threatening diseases. Worldwide, many people are infected with these viruses. Blood safety has made majorprogress in recent years. Yet, blood-borne viruses continue to be a major concern for patients, physicians, and policymakers. The aim of this study was to assessthe prevalence of HIV, HBV, and HCV in blood donors. Methods A cross-sectional study was performed to assess HIV, HBV, and HCV seropositivity in blood donors. This research was carried out at the blood bank of Sidi Bel Abbes University Hospital. This was a retrospective study based on records of blood donors. All data of 10,386 donors were analyzed from January 2015 to December 2015. Biological screening was performed by enzyme-linked immunosorbent assay (ELISA) using antibodies and/or antigens. The combined HCV and HIV antigen and antibody ELISA test was utilized. To confirm the results, the blood bank and the virology laboratory used the same technique in duplicate. Results The overall seroprevalence of blood-borne viral infections (HIV, HBV, and HCV) in blood donors was 0.8%. The prevalence of HIV was found to be 0.1%, while the prevalence of HBV and HCV was 0.4%. Coinfection was rare with only one case of HBV with HIV.There was a significant difference in seroprevalence rates among blood donors compared to the general population. Significant variations were observed between the prevalence of this study and those conducted in West, East, Central, and South African countries but not with those of neighboringNorth African countries. The study found no association between seropositivity in blood donors and factors like age, gender, donor status, type of donation, or site. Besides, HIV, HBV, or HCV prevalence was not influenced by ABO and Rhesus blood group. Conclusion The study showed that blood donors in Algeria have a lower prevalence of blood-borne viral infections than the general population. The seropositivity rate of viral markers was similar throughout North African countries. This rate remained low compared to other African countries. Residual risk of infection persists. There is a need to increase blood safety for recipients. This report is the first comprehensive overview of blood-borne viruses among Algerian blood donors. There is a need for further nationwide studies to get a whole picture of the situation.

Correlations of intestinal microorganisms with liver and immune functions of patients with human immunodeficiency virus and hepatitis B virus coinfection.

Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection has threatened the survival of HIV-infected people. To explore the correlations of intestinal microorganisms with liver and immune functions of patients with HIV/HBV coinfection. Eighty-six patients positive for HIV antibody and HBV surface antigen diagnosed from January 2018 to June 2020 were selected as HIV/HBV coinfection group. Another 86 patients positive for HBV surface antigen and 86 healthy people were selected as HBV infection and control groups, respectively. The correlations of intestinal flora with liver function, inflammatory indices and immune cells were explored through Pearson's analysis. Compared with control group, the proportions and numbers of T lymphocytes (CD3+), helper T lymphocytes (CD4+), cytotoxic T lymphocytes (CD8+), CD4+/CD8+ and natural killer (NK) cells decreased in HIV/HBV coinfection group (P<0.05). IL-2, IL-6, IL-17, ALT, AST, GGT, DBiL and TDBi levels were correlated negatively with Bifidobacterium, Lactobacillus and Bacteroides numbers, but positively with Enterobacter and Enterococcus numbers (P<0.05). IL-10 level and proportions of CD3+, CD4+, CD8+, CD4+/CD8+ and NK cells were correlated positively with Bifidobacterium, Lactobacillus and Bacteroides numbers, but negatively with Enterobacter and Enterococcus numbers (P<0.05). HIV aggravates the liver damage and immuno-inflammatory response in HBV patients.

Serum Evaluation of Human T-lymphotropic Virus Type 1 and 2 (HTLV-I/II) and Human Immunodeficiency Virus (HIV) in Patients with Multiple Sclerosis (MS)

Background: Multiple Sclerosis (MS) is a multifactorial disease that causes neurological disability. Human retroviruses may have a role in the etiology of several acute and chronic neurological disorders. Objectives: We aimed to investigate the presence of HTLV-I/II and HIV antibodies in the sera of MS patients to assess the relationship between these infections and MS. Methods: This case-control study was conducted on serum samples of MS patients and individuals admitted to the same hospital with no symptoms of MS as the control group. Samples were examined for HIV and HTLV-I/II antibodies using ELISA kits. Results: A total of 79 people, including 38 MS patients and 41 healthy individuals, were evaluated. The frequency of HIV antibodies was 0.0% in both the case and control groups. The HTLV-I/II antibodies were detected in 1 patient in the control group and no patients in the MS group, with no statistically significant difference between the two groups (P: 0.999). Conclusions: This study could not establish a relationship between the presence of HTLV-I/II or HIV antibodies and MS.

Development of a Multiplex HIV/TB Diagnostic Assay Based on the Microarray Technology.

Currently there are diagnostic tests available for human immunodeficiency virus (HIV) and tuberculosis (TB); however, they are still diagnosed separately, which can delay treatment in cases of co-infection. Here we report on a multiplex microarray technology for the detection of HIV and TB antibodies using p24 as well as TB CFP10, ESAT6 and pstS1 antigens on epoxy-silane slides. To test this technology for antigen-antibody interactions, immobilized antigens were exposed to human sera spiked with physiological concentrations of primary antibodies, followed by secondary antibodies conjugated to a fluorescent reporter. HIV and TB antibodies were captured with no cross-reactivity observed. The sensitivity of the slides was compared to that of high-binding plates. We found that the slides were more sensitive, with the detection limit being 0.000954 µg/mL compared to 4.637 µg/mL for the plates. Furthermore, stability studies revealed that the immobilized antigens could be stored dry for at least 90 days and remained stable across all pH and temperatures assessed, with pH 7.4 and 25 °C being optimal. The data collectively suggested that the HIV/TB multiplex detection technology we developed has the potential for use to diagnose HIV and TB co-infection, and thus can be developed further for the purpose.

An increase of human immunodeficiency virus infection amongs blood donor during COVID-19 pandemic

Human immunodeficiency virus (HIV) is a one of crucial concern to blood safety because of their prolonged presence in the blood. Unsafe blood transfusion from infected donor contribute to spread the virus as well. Indonesia health ministry reported that HIV infection increase significantly in 2019 to 2021, and HIV case diagnose in population still way from the prediction in 2020, only 78.7% cases reported from 90% prediction case. A retrospective cross-sectional study was conducted and collected 51,351 blood donors during COVID-19 pandemic, 2020-2021. Blood sample analyzed using serological methods to detect the present of HIV antibodies. A reactive result of HIV screening from 21,260 donor in 2020 showed 12 donors reactive (0.00056%), while in 2021 from 30,091 donor showed 42 donors reactive (0.142899%) and showed a significant different from 2020 and 2021 (p-value &amp;lt;0.05). The number of reactive donors increase numerously from 2020 to 2021, while total donor also increased. The level of social restriction has contribution of HIV reactive case among blood donor and showed from two years of pandemic with p-value &amp;lt;0.05. A significant increase of HIV infection among blood donor and the effect of restriction level to prevent COVID-19 transmission are clearly show in this study.

Sero-Prevalence of Human Immunodeficiency Virus (HIV) Antibodies Among Pregnant Women Attending Primary Health Care Center (PHCC) Jajere

Sero-Prevalence of Human Immunodeficiency Virus (HIV) Antibodies Among Pregnant Women Attending Primary Health Care Center (PHCC) Jajere

Knowledge, attitude, practices, seroprevalence and vaccination status concerning hepatitis B, hepatitis C, human immunodeficiency virus among health care students

Aim: Students of all departments that serve patients during their education are in the risk group in terms of parenterally transmitted microorganisms. This study aims to evaluate the knowledge level and serologic status of healthcare students about viral hepatitis and Human Immunodeficiency Virus (HIV) infection.&#x0D; &#x0D; Methods: A sociodemographic questionnaire consisting of 29 questions was applied to 262 students who presented to the medico-social outpatient clinic between January 2015 and December 2020. Additionally, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (Anti HBs), hepatitis B core antibody (Anti HBc total), hepatitis C virus antibody (Anti HCV), HIV antibody (Anti-HIV) serum levels were investigated. The obtained information was evaluated with descriptive statistics and chi-square test in statistical package for the social sciences package program version 20. Results were given as frequency and percentage.&#x0D; &#x0D; Results: The mean age of the study group (230 female and 32 male) was 21.29 ± 2.2 years. According to the questionnaire, 43.9% of students stated that they had HBV vaccination, while 56.1% of the students stated that they were not vaccinated. The rate of the student who checked antibodies after vaccination was 14.1%. While 74% of students stated that they took lessons about hepatitis risk factors, 26% of students did not take any lessons. According to the laboratory results, Anti HBs positivity was found in 235 students (89.7%). Anti-HBc total positivity was found in 5 students (1.9%). HBsAg positivity was found in 2 students (0.8%). Anti-HCV and Anti-HIV were negative in all our students.&#x0D; &#x0D; Conclusion: Our results indicate that high prevalence of Anti HBs seropositivity among healthcare students. This result can be explained by our successful vaccination program in Turkey. As a preventive medicine perspective, it should be ensured that students studying at these schools should be trained, screened, and guided to become immune.

Trends in the Prevalence of Hepatitis B Virus, Hepatitis C Virus, and HIV Infections in Iranian Patients with Hereditary Bleeding Disorders.

Patients with hereditary bleeding disorders (HBDs) have always been vulnerable to transfusion-transmitted infections (TTIs) such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infections due to being regular recipients of blood and blood products. This study aimed to detect the trends in the prevalence of HBV, HCV, and HIV infections by birthyear in Iranian patients with HBDs to show the efficacy of national interventions implemented to administrate control and to prevent these infections, i.e., blood safety, newborn HBV vaccination, and safe replacement treatments. In this retrospective study, the trends in the prevalence of hepatitis B core antibody (HBcAb), HCV antibody (HCV-Ab), and HIV antibody (HIV-Ab) in Iranian patients with HBDs born before 2012 were assessed using patients' clinical archives. The determinants of HBV, HCV, and HIV infections were investigated in bivariable and multivariable logistic regression analyses. Out of 1475 patients with HBDs, most were male (87.7%) and diagnosed with hemophilia A (52.1%) and severe bleeding disorder (63.7%). The prevalence of HBcAb, HCV-Ab, and confirmed HIV-Ab was 22.9%, 59.8%, and 1.2%, respectively. The trends in HBcAb, HCV-Ab, and HIV-Ab were all decreasing by birthyear and reached a stable level of 0% for patients with birthyears in 1999, 2000, and 1984, respectively. In multivariable analysis, birthyear was significantly associated with HBcAb prevalence. In the multivariable analysis, type of HBD; birthyear; bleeding severity; histories of receiving packed cells, fresh frozen plasma, and cryoprecipitate before 1996; and history of receiving factor concentrate before 1997 were highly associated with the prevalence of HCV-Ab. Moreover, in the bivariable analysis, birthyear and type of HBD were associated with HIV-Ab prevalence. This study demonstrated the decreasing trends in HBV, HCV, and HIV seroprevalence in Iranian patients with HBDs following preventive interventions such as HBV vaccination, blood safety measures, and the provision of safe replacement treatments.

A severe manifestation of extensive multifocal epithelial hyperplasia (Heck's disease) and the role of CO2 laser as a treatment modality: A case report

AbstractHeck's disease or multifocal epithelial hyperplasia (MEH) is an uncommon asymptomatic contagious oral condition, usually attributed to human papillomavirus (HPV) infection. It manifests as several smooth papules and nodules in the oral mucosa. The disease has a good prognosis, as it is spontaneously regressing, but some cases persist and affect the quality of the patient's life, requiring therapeutic intervention. We present an unusual case of extensive multifocal epithelial hyperplasia. To the best of our knowledge, this is the first case to be reported with this severity and widespreadness of the lesions. A 14‐ year‐old girl was referred to the department of oral medicine at the faculty of dental medicine, with a chief complaint of numerous nodules and papules, appeared since she was 6 years old. The diagnosis of Heck's disease was confirmed depending on clinical characteristics, histopathological examination and immunohistochemical (IHC) staining. Human immunodeficiency virus (HIV) antibodies test and enzyme‐linked immunosorbent assay (ELISA) for human papillomavirus Immunoglobulin G (IgG) were performed. Depending on the extensive clinical situation, the decision was made to treat the patient using carbon dioxide (CO2) laser. Heck's disease is a human papillomavirus‐related oral condition. The diagnosis can be confirmed depending on both clinical and histopathological characteristics in addition to immunohistochemical staining. In this case, CO2 laser showed good functional and aesthetic results that reflected positively on the quality of the patient's life.