Serological Markers Of Infection Research Articles

Indicadores infecciosos e inflamatórios entre trabalhadores da limpeza urbana em São Paulo

O objetivo deste trabalho foi comparar agravos à saúde entre grupos funcionais de trabalhadores da limpeza urbana (TLU) decorrentes de exposição biológica do contato com os Resíduos Sólidos (RS) em São Paulo, 2007. Para tal, amostras dos grupos de TLU e um grupo Controle de servidores ferroviários realizaram entrevistas, contagens sanguíneas, provas de atividade inflamatória, marcadores sorológicos de infecção e exame protoparasitológico de fezes.Ao término, foram avaliados 217 indivíduos. O grupo Controle relatou menor cobertura vacinal para o tétano, enquanto os Varredores tiveram a menor proporção de cobertura para a hepatite B. Os Motoristas usaram mais antibióticos e apresentaram o número de leucócitos mais elevado quando comparados aos Controles. Os Motoristas apresentaram também maiores médias de neutrófilos e monócitos quando comparados aos Varredores. A presença de parasitas nas fezes foi mais frequente entre os Varredores e os Coletores quando comparados aos Controles. Os grupos de Coleta, Transbordo e Aterro apresentaram indicadores de infecções respiratórias e de atividade inflamatória sistêmica similares aos Controles. Não foram observadas diferenças entre episódios de sinusites, pneumonias, marcadores séricos de atividade inflamatória, contato com o vírus da hepatite B ou com a estreptolisina O entre os grupos estudados.

Human Borna Disease Virus Infection in Australia: Serological Markers of Infection in Multi‐transfused Patients

Borna disease virus (BDV) causes neurological disease in horses, however, there is no consensus as to the extent or significance of human infection. BDV antigen levels in plasma (BDVpAg) and anti-BDV were measured by ELISAs. Confirmation was by Western blot (WB), immunofluorescence assay (IFA) or BDV-peptide-epitope ELISA. For 42 volunteers psychiatrically-defined as non-depressed (82 samples) neither BDVpAg nor anti-BDV was detected. For 104 patients with diagnosed depression (290 samples) 1 was BDVpAg positive and 5 anti-BDV positive, one epitope-e8 positive and 4 IFA positive, with 96% concordance for repeat samples. No BDVpAg was detected in 214 pregnant women, 2 were anti-BDV positive, one WB-confirmed (p24/p40). For 219 donors 2 were BDVpAg positive with anti-BDV detected in 5 (2.3%) one IFA 1:10, another IFA 1:40/epitope-e8 positive. In multitransfused patients, 3/168 were BDV pAg positive, with 14/168 anti-BDV positive, 1 epitope-e8 positive, 2 WB positive and 1 IFA 1:10. In BDVpAg positive multi-transfused patients there was an elevated risk of transaminitis. In one case, a patient BDV-negative prior to transfusion was BDVpAg positive for several months posttransfusion (associated with transaminitis). These data provide serological evidence, supported by confirmatory assays and repeat-sample concordance, of BDV infection in Australia, particularly in multi-transfused patients.

Exophiala-Spezies — seltene Erreger einer Endokarditis mit zerebraler Abszedierung

Exophiala species belong to the dematiaceous fungi. Occurring worldwide, they are a rare cause of human infection. We present the case of a 75-year-old immunocompetent patient with a cardiogenic embolic anterior cerebral artery infarction. Echocardiography revealed endocarditis of the aortic valve. Antibiotic therapy was initiated after susceptibility testing (blood cultures were positive for Staphylococcus aureus, and liquor was normal), with a subsequent fall in serologic markers of infection and resolution of the signs of endocarditis on echocardiography. However, 6 weeks after initiation of antibiotic therapy, abscesses were seen in the infarct region on CT scan, although antimicrobial treatment was still continued. At this stage, the CSF showed an inflammatory process, and Exophiala species, susceptible to voriconazol, could be detected in liquor cultures. However, antifungal therapy with voriconazol could not prevent severe sepsis and death from multiorgan failure. Autopsy revealed the clinically supposed Exophiala endocarditis with metastatic cerebral abscesses. In accordance with other published case reports, a fatal outcome in disseminated Exophiala infection might only be prevented by aggressive therapy consisting of early surgical removal of the foci and combined antifungal agents.

Community‐based epidemiology of hepatitis B virus infection in West Bengal, India: Prevalence of hepatitis B e antigen‐negative infection and associated viral variants

There is a paucity of population-based epidemiological information regarding hepatitis B virus (HBV) infection in India. The present study was planned to outline the magnitude and pattern of HBV infection, hepatitis B e antigen (HBeAg)-negative infection and the associated viral mutants in India. A community-based epidemiological study of HBV infection was carried out in West Bengal, India. Serological markers of infection and potential risk factors for HBV transmission were determined. Among the infected individuals, HBV-DNA, genotypes and mutations in the precore (PC) stop codon and basal core promoter (BCP) regions were determined by DNA sequencing and polymerase chain reaction (PCR) restriction fragment length polymorphism methods. Of the 7653 people included in the study, 227 (2.97%) tested positive for hepatitis B surface antigen (HBsAg), of whom 204 (90%) were HBeAg-negative and hepatitis B e antibody (anti-HBe)-positive, and 78% had normal alanine aminotransferase (ALT) levels. HBV-DNA could be detected by PCR in only 32% of people. G1896A PC stop codon mutants were present in 12% of people, BCP mutants in 18% and the remainder (70%) of the HBeAg-negative infections were associated with wild type sequences in these regions. This first general population-based epidemiological study of HBV infection from India suggests that HBV acquisition starts in early childhood and peaks in adulthood. Most infections in the community are e-negative and inactive. The point prevalence of PC stop codon and BCP mutants is low in this primarily inactive and asymptomatic HBV-infected population sample in eastern India.

Interfaces between cardiovascular and kidney disease among Aboriginal Australians

Rates of kidney disease among several indigenous groups have been shown to be substantially higher than corresponding non-indigenous groups. This excess has been clearly shown among Aboriginal Australians with respect to both end-stage kidney disease and early kidney disease. Rates of cardiovascular disease among Aboriginal Australians are also very high, as are rates of diabetes, smoking, and possibly overweight and obesity. These factors have been traditionally linked with cardiovascular and renal disease as part of a broader "metabolic syndrome." However, the links and interfaces between cardiovascular and kidney disease in this environment extend beyond these "traditional" factors. The factors associated with atherosclerosis have expanded in recent years to include markers of inflammation, some infection, antioxidants, and other "non-traditional" risk factors. Given the high rates of acute infection and poor living conditions endured by many indigenous people, one might expect these "non-traditional" risk factors to be highly prevalent. In this review, we explore the relationships between markers of inflammation, some serological markers of infection, and other selected markers and both cardiovascular and renal disease. In doing so, we demonstrate links between kidney and cardiovascular disease at a number of levels, beyond the "traditional" cardiovascular/renal risk factors. Many of these factors are beyond the control of the individual or even community; addressing these issues a broader focus and biopsychosocial model.

Seroprevalence of markers of viral hepatitis in Yemeni healthcare workers.

The seroprevalence of viral hepatitis in healthcare workers has important public health implications. To assess the risk factors for the acquisition of viral hepatitis in an unvaccinated cohort from an hyperendemic region, 567 healthcare workers from a large hospital in the capital of the Republic of Yemen were interviewed and tested for serological markers of infection with viral hepatitis. 54/543 (9.9%) tested positive for hepatitis B surface antigen (HBsAg), 174/543 (32.0%) had positive hepatitis B core antibodies (anti-HBc), and 19/546 (3.5%) had hepatitis C antibodies (anti-HCV). Age (OR = 1.04, 95% CI 1.02-1.06), male sex (OR = 2.0, 1.32-3.03), and occupation (healthcare workers not carrying out exposure prone procedures, OR = 1.61, 1.06-2.44) were found to be independent predictors for the likelihood of detecting either HBsAg or anti-HBc by multivariate logistic regression analysis. No independent risk factors for anti-HCV positive status were identified. Our findings support the adoption of universal HBV immunisation programmes and infection control precautions. The absence of known risk factors predicting anti-HCV positive serostatus suggests the main mode of transmission of hepatitis C in this cohort in the Yemen remains undiscovered.

Seroepidemiology of hepatitis B infection among tribal school children in Andaman and Nicobar Islands, India.

A sero-survey to assess the prevalence of hepatitis B virus infection was carried out among the Nicobarese children attending different primary schools of Car Nicobar Island. A total of 1574 children were screened for different serological markers of infection. Overall, 44% of the children had evidence of HBV infection with 23% positive for HBsAg. The prevalence rates were found to increase linearly with age. The implications of these findings in relation to control of hepatitis B in the tribal population of these islands are discussed.

Serological detection of Gram-positive bacterial infection around prostheses.

Coagulase-negative staphylococci produce an exocellular glycolipid antigen which has potential as a serological marker of infection in bone. The value of this newly detected antigen was investigated by enzyme-linked immunosorbent assay (ELISA) in 15 patients with culture-proven infection of prostheses caused by Gram-positive bacteria. The antigen was purified by gel-permeation chromatography from the culture supernatants of coagulase-negative staphylococci grown in a chemically defined medium. There were significant differences (p < 0.0001) between the serum IgG and IgM levels in patients with infection due to Gram-positive staphylococci and those of a control group of 32 patients with no infection. The ELISA test, which has potential for the diagnosis of infection, may be valuable in distinguishing between staphylococcal infection around prostheses and aseptic loosening.

Serological detection of Gram-positive bacterial infection around prostheses

Coagulase-negative staphylococci produce an exocellular glycolipid antigen which has potential as a serological marker of infection in bone. The value of this newly detected antigen was investigated by enzyme-linked immunosorbent assay (ELISA) in 15 patients with culture-proven infection of prostheses caused by Gram-positive bacteria. The antigen was purified by gel-permeation chromatography from the culture supernatants of coagulase-negative staphylococci grown in a chemically defined medium. There were significant differences (p &lt; 0.0001) between the serum IgG and IgM levels in patients with infection due to Gram-positive staphylococci and those of a control group of 32 patients with no infection. The ELISA test, which has potential for the diagnosis of infection, may be valuable in distinguishing between staphylococcal infection around prostheses and aseptic loosening.

Active replication of hepatitis B virus (HBV) in HIV type 1 and in HIV type 2 infected patients.

To evaluate the effect of concurrent infection by HIV on HBV infection or immunity, we have studied a group of 66 HIV1+ symptomatic Caucasian patients and another of 38 African HIV2+ asymptomatic individuals, concerning their HBV status: serological markers of infection and presence of HBV-DNA in serum, the last taken as sign of hepatitis B virus active replication, were monitored. HIV+ groups were compared with seronegative controls, adequately matched for age, sex and ethnological background. HBV DNA was found in 7.6% of HIV1+ Caucasian patients and 3.2% of seronegative controls; in African HIV2+ individuals 2.6% were also HBV DNA+, a percentage close to that found in HIV2 seronegative controls (2.9%). No correlation was found between HIV infection and HBV active replication. Immunodepression that follows HIV infection over time may be compatible with a degree of T cell function capable of avoiding reinfection with or reactivation of HBV, even in symptomatic stages of acquired immunodeficiency syndrome. Our findings are relevant to the choice of preventive strategies in populations at risk for HIV and HBV infection.

Epidemiology of hepatitis C virus in western Venezuela: lack of specific antibody in Indian communities.

Hepatitis C virus (HCV) is transmitted mainly by the parenteral route after percutaneous exposure to virus-infected products or body fluids. Thus, HCV shares with hepatitis B and D (HBV, HDV) viruses this common transmission route. The prevalence of antibody against HCV (anti-HCV) was studied in 1155 serum samples from individuals at risk of infection by bloodborne or sexually transmitted agents, as well as from others lacking such risk factors, from the city of Maracaibo, Venezuela. Anti-HCV and serological markers of infection by HBV and HDV were also studied in further 550 samples taken from Bari Indians living in different communities in the Perijá mountains, State of Zulia, Venezuela. The results obtained showed that recipients of blood or blood products are at increased risk of HCV infection in Maracaibo, whereas sexual transmission plays only a minor role if any. Both HBV and HDV infections were highly prevalent among Bari Indians (64.4% positive for anti-HBc; 11.1% of HBsAg carriers; 15.3% positive for anti-HDV among HBsAg carriers). No anti-HCV positive samples were, however, detected among them, thus suggesting either that HCV has not still reached this population or that HBV and HDV are transmitted by routes unshared by HCV. Anti-HCV was also absent among samples from mentally retarded patients from Maracaibo, thus confirming similar findings from other countries and supporting the existence of specific transmission mechanisms for HBV and HDV which are not working for HCV.

Mortality trends in a cohort of homosexual men in New York City, 1978-1988.

Trends in mortality related to infection by human immunodeficiency virus type 1 (HIV-1) and to other causes were examined from 1978 to 1988 in a cohort of 8,906 homosexual men who participated in studies of hepatitis B virus infection in the late 1970s in New York City. HIV-related mortality rates increased from 1 per 10,000 person-years in 1980 to 181 per 10,000 person-years in 1986, followed by a plateau from 1986 to 1988. The standardized mortality ratio among white men in the cohort was 3.7 (95% confidence interval (Cl) 3.4-3.9) as compared with white men from across the United States. Higher HIV-related mortality rates were associated with a higher number of sexual partners, a history of gonorrhea and/or syphilis, and serologic markers of infection with hepatitis B virus. After adjustment for demographics and sexual behaviors, the relative risk of mortality for Hispanic men as compared with white men was 1.5 (95% Cl 1.1-1.9). This study illustrates the large excess in mortality among homosexual men over the last decade, with the excess accounted for by deaths from HIV-related diseases. The recent plateau in mortality may be due to the effect of new treatments and/or the decline in new HIV-1 infections among homosexual men. The excess in HIV-related mortality among Hispanic homosexual men was not explained by differences in demographics and factors associated with the sexual transmission of HIV-1.

Occurrence and distribution of hepatitis B infection in the aboriginal population of Western Australia.

In 1986, the prevalences of hepatitis B surface antigen (HBsAg), and other serological markers of infection with hepatitis B virus in the Western Australian adult Aboriginal population, were estimated using a stratified random sample of 1,150 subjects. When the estimates were standardised to the age and sex distribution of the total population of aborigines aged 12 years or over, the prevalence of HBsAg was 7% (95% confidence interval 6-9%). The prevalence of any marker, that is HBsAg and/or hepatitis surface antibody (anti-HBs), was 49% (44-54%). The follow-up blood specimens obtained from three-fifths of the antigenemic subjects indicated that 96% (88-99%) were hepatitis B carriers. Male subjects had twice the prevalence of HBsAg (10%; 7-13%) when compared with females (4%; 3-6%). However, there was only a modest elevation of the prevalence of any marker in men (53%) compared with women (46%). There was evidence that the prevalence of HBsAg increased with age, but this was not the case with any marker. Geographically, there was substantial variation in hepatitis B infection rates. The Eastern Goldfields region had the highest prevalence (HBsAg 12%; any marker 66%), followed by the Kimberley, Pilbara and Central regions (HBsAg 7-9%; any marker 56-59%). The lowest rates were evident in Perth and the South West (HBsAg 3-5%; any marker 23-25%). The highest prevalence of markers in any discrete community was observed in the desert people of Warburton (HBsAg 22%; any marker 85%). These data indicate that, according to World Health Organisation criteria, the aboriginal population of Western Australia has an intermediate to high risk of infection with hepatitis B.

Hepatitis B Vaccination and AIDS

To the Editor.— Articles about the relationship between hepatitis B vaccination and acquired immunodeficiency syndrome (AIDS)/human T-cell leukemia (lymphotropic) virus type III infection have often appeared inThe Journal. In LEADS FROM THE MMWR in the Jan 4, 1985, issue, 1 evidence confirming the absence of AIDS transmission by this hepatitis B vaccine was stated to be the following: (1) The AIDS virus is specifically inactivated by the inactivation procedures used in the vaccine's manufacture. (2) The vaccine contains no detectable AIDS virus nucleic acid sequence. (3) The serologic markers of infection with AIDS virus are not observed in vaccine recipients. Study.— In Japan, we studied Merck's Heptavax-B (lot 2374) in 74 health care workers who had no history of hepatitis B infection and determined, in addition to the safety and antigenic potential of the vaccine, the percentage of T-cell and B-cell subsets (OKT3, OKT4, and OKT8), the OKT4/OKT8 ratio,

Cirrhosis and hepatocellular carcinoma in a patient with heterozygous (MZ) alpha-1 -antitrypsin deficiency

A patient is described with micronodular cirrhosis, partial (heterozygous, MZ) deficiency of alpha-1-antitrypsin (AAT) and hepatocellular carcinoma. The patient did not drink alcohol and all serological markers of infection with hepatitis B virus were absent. Death was due to intra-peritoneal bleeding from a multifocal liver tumour. Histology revealed multiple intracytoplasmic AAT globules in hepatocytes at the periphery of the cirrhotic nodules. Copper granules, present in the same non-neoplastic liver cells may have resulted from minor cholestasis. Within the neoplastic hepatocytes AAT globules were sparse and copper deposits co-existed with the globular variant of Mallory bodies. The case is presented in support of the postulated association of partial deficiency of AAT, chronic liver disease and hepatic neoplasia.

Seroepidemiology of infection with hepatitis B virus in Fiji.

A batch of 984 sera obtained from a stratified sample of Melanesians and Indians living in rural and urban areas of Fiji in 1981 were for hepatitis B surface antigen (HBsAg) and antibody to hepatitis B core antigen (anti-HBc) by solid phase radioimmunoassay. The prevalence of hepatitis B infection (as measured by the sum of HBsAg and anti-HBc frequencies of HBsAg negative sera in the two groups) was 81.5% and 17.9%, respectively. No major differences were detected between urban and rural populations. While hepatitis B virus is endemic in Melanesians and Indians, the epidemiology of the infection shows certain differences. Among Melanesians, infection appears to be acquired early in life and peak prevalence of serologic markers of infection occurs during the second decade. Among the Indian population, the prevalence of markers increases steadily with age, presumably as a result of continuous exposure and infection throughout life. the high prevalence of infection and carriers among Melanesians is consistent with previous observations among Pacific populations. The lower prevalence of infection among Indians is remarkable, since they constitute almost half of the total population and live under similar conditions. Since the two populations remain largely separate in terms of housing and schooling, and intermarriage is uncommon, it is no possible to determine whether these differences merely represent different degrees of exposure to the virus or are the reflection of differences in susceptibility or response to infection.

Changes induced by hepatitis serum in cultured liver cells.

THE discovery of the relationship between the Australia (hepatitis-associated) antigen and serum hepatitis has provided a specific serological marker of infection for type B viral hepatitis. The precise biological nature of the Australia antigen remains uncertain and so far there has been no convincing demonstration of the successful infection of tissue culture preparations in spite of extensive efforts1. We now report the nuclear involvement of cultured primary human embryo liver cells inoculated with the serum of a well-documented former blood donor (P. J. G.) whose blood had been implicated in the transmission of serum hepatitis in transfused recipients and had induced serum hepatitis in human volunteers. Australia antigen has been repeatedly demonstrated in the serum of this blood donor1,2.