The relative frequency of Mycobacterium tuberculosis and Mycobacterium avium infections in HIV positive patients, Ahvaz, Iran

Epidemiology of HIV in Iran

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Iran has been one of the active countries fighting against HIV/AIDS in the Middle East during the last decades. Moreover, there is a strong push to strengthen the national health management system concerning HIV prevention and control. In Iran, HIV disease has its unique features, from changes in modes of transmission to improvement in treatment and care programs, which can make it a good case for closer scrutiny. The present review describes the HIV epidemic in Iran from the first case diagnosed until prevention among different groups at risk and co-infections. Not only we addressed the key populations and community-based attempts to overcome HIV-related issues in clinics, but we also elaborated on the efforts and trends in society and the actual behaviors related to HIV/AIDS. Being located in the Middle East and North Africa (MENA) region, given the countryspecific characteristics, and despite all the national efforts along with other countries in this region, Iran still needs to take extra measures to reduce HIV transmission, especially in health education. Although Iran is one of the pioneers in implementing applicable and appropriate policies in the MENA region, including harm reduction services to reduce HIV incidence, people with substance use disorder continue to be the majority of those living with HIV in the country. Similar to other countries in this region, the HIV prevention and control programs aim at 90-90-90 targets to eliminate HIV infection and reduce the transmission, especially the mother-to-child transmission and among other key populations.

Identification of Mycobacterium tuberculosis isolated from culture-negative pulmonary and extra-pulmonary samples in cases of suspected tuberculosis

Introduction:Mycobacterium tuberculosis is the cause of pulmonary and extra-pulmonary tuberculosis. Latent tuberculosis is asymptomatic and the results of mycobacterial culture in this case are negative. The purpose of this study was to determine the prevalence of M. tuberculosis in negative cultures of pulmonary and extra-pulmonary samples from suspected tuberculosis patients in Yazd city.

Methods: Specimens were collected from 44 patients with suspected pulmonary and extra-pulmonary tuberculosis. The culture result of all samples was negative and DNA was extracted from culture-negative samples. Then the IS6110 sequence of M. tuberculosis was determined by PCR, and the presence of 16S rRNA and rrnA-PCL1 was checked by real-time PCR. Data were analyzed using SPSS software.

Results: Of the 44 pulmonary and extra-pulmonary samples, M. tuberculosis DNA was detected in 12 cases (27%) by PCR. Of the 12 positive cases of M. tuberculosis, 9 were detected in lung samples and 3 in extra-pulmonary samples. For rrnA-PCL1 and 16S rRNA genes, 10 samples (23%) were confirmed positive by real-time PCR. The frequency distributions of M. tuberculosis according to PCR and real-time PCR were not significantly different (p=0.403).

Conclusion: Latent tuberculosis is characterized by the absence of clinical symptoms and the absence of bacilli in the culture. Regardless of the statistical analysis of results, PCR more effectively detects M. tuberculosis than does real-time PCR. According to the results, detection of M. tuberculosis in pulmonary and extra-pulmonary samples with culture-negative by PCR is reliable.

Mycobacterium avium complex infection in patients with human immunodeficiency virus: A systematic review and meta-analysis

BACKGROUND

Mycobacterium avium-intracellulare complex (MAC) is one of the leading causes of death among people living with human immunodeficiency virus (HIV). The current study was aimed to determine the frequency of MAC infection in patients infected with HIV.

METHODS

Embase, PubMed, and Web of Science were searched for relevant studies. All statistical analyses were performed by STATA version 14.

RESULTS

From 6,627 retrieved articles, 23 were included in the final analysis. A total of 18,463 patients with HIV were included in the analysis. The frequency of MAC infection in patients with HIV was found to be 10.6% (95% confidence interval, 6.9-14.2).

CONCLUSION

The relatively large fractions of HIV-infected patients were coinfected with MAC, which may poses significant public health problems. Continued progress in the development of rapid diagnostic methods and preventive therapy for MAC should lead to further improvements in survival and quality of life in patients with HIV.

Epidemiology of tuberculosis in Eastern Sudan

OBJECTIVE

To investigate the epidemiological factors of tuberculosis (TB) in eastern Sudan.

METHODS

The socio-demographic and clinical data was retrieved from the database at Kassala hospital during the year of 2011. The medical file of consequent patients who was discharged from the same ward in the hospital was reviewed to act as control for the TB patients.

RESULTS

A total of 670 patients were registered at Kassala hospital with clinical, laboratory and radiological evidence proven TB. Pulmonary TB accounted for 73.4% while extra-pulmonary TB was reported in 26.6% of all TB patients. The mean age (SD) was not significantly different between the cases and controls (670 in each arm). TB patients were those who had less education, and the infection more likely common among male patients.

CONCLUSIONS

Intervention from outside the health field in particular awareness of associated risk factors and improvement of the educational level potentially will strengthen TB control.