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Background&Objective: Consultation prior to blood donation and screening tests of common blood born diseases such as Hepatitis B,C and AIDS are very important issue in blood quality assurance, therefore we decided to compare frequency of such diseases in blood donors and outpatients admitted in the blood transfusion centers. Materials&Methods: For this purpose the initial tests including HBsAg, HCVAb, and HIVAb were performed on all blood donors and outpatients' blood samples in Gorgan transfusion center by ELIZA methods during 2003 and confirmatory tests including neutralization for HBsAg, RIBA for HCVAb and Western blot for HIVAb performed in condition where ELIZA report was positive. Results: The blood donor in this study had the following positive results: HbsAg 2.5%, HCVAb 3%, HIV 0.35%. The same indeces for the out patients were positive as follow: 13%, 8.3% and 2.04% respectively. The other finding from this investigation indicate that the blood donors positive cases with the ELISA technique were confirmed by Western blot 92%, 20.1% nad 0% for HBSAg, HCVAb, as HIV respectively. The confimatory results of the positive out patient's cases were as follow, 97%, 47% and 60% for HBSAg, HCVAb and HIV respectivley. Conclusion: This study reveals frequency of Hepatitis B and C and AIDS among outpatients which considered being high risk group are more than the blood donors. We conclude that the measurement of HBSAg by ELIAZ methodes in comparision to the HCV and HIV are more accurate.

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Background&Objective: Morphine is an opioid analgesic and has known effects on different organs. This study was done to determine the histopatological changes of liver due to morphine adminstration in adult mice. Materials&Methods: In this experimental study, 20 male Blab/c mice divided experiment and control groups. In experiment and control group, animals recived 15mg/kg/day morphine and salin normal interperitoneally, for 21 days respectively. Day 22 the livers were dissected under anaesthesiology. Specimens were processed for histological study and stanied with H&E. Results: In experimental group, small sites of necrosis with poly morphic inflammatory infiltration and debris formation of necrotized nucleus in death area, so hepatitis was suggested. Also accumulation of micro droplets of lipid inside the hepatocyte cytoplasm withont nucleus displacement (fatty damages with small vacuoles) observed in cases. In addition, microvesicular steatosis and mouth teeth necrosis in liver parenchyma with inflammation in the vein and portal space were seen in cases. Any changes was not seen in control group. Conclusion: The interperitoneal adminstration of morphine can cause histopatological changes in mice liver.

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Background&Objective: Hepatitis B, is a common kind of viral hepatitis. Vaccination is the most secure way of prevention for the health care worker. The present study was designed to survey the seropositivity of Gorgan teaching hospitals. Materials&Methods: This descriptive and cross-sectional study was done on 300 medical and official personals at 3 hospitals in Gorgan in 2003. with using 3ml of pripheral blood, sampling assay was performed to determine HBs-Ab and HBs Ag. Questionnaire form concerning demographic information, vaccination status and risk factors were compeleted for participants. Statistical analysis was done by means of SPSS soft ware with confidence interval equal to 95%. Results: 13% of individuals were not be vaccinated and 74.6% of them were vaccinated completely. There were statistically significant differences between HBs Ag and vaccination status ,individual’s age , the last vaccination time, occupation and use of glove (p<0.05). Furthermore, 1% of samples (one female, two males) were HBs Ag –positive. These three Persons has 10 years at service and were vaccinated compeletely were HBs –Ab neagtive. Conclusion: As a result of vaccination project, vaccination coverage of emplyees and immunologic status of them were satisfactory. Because of repetitive encountering of under considertion individuals with hepaptitis virus, 2% of unvaccinated subject had been infected but fortunately were be cured. Concomitant reduction in probability of immunity was being occurred after vaccination with the passing time and considering the importance of booster dose injection.

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Background & Objective: Vaccination is one of the most effective ways in preventing the hepatitis B viruse. This study was done to evaluate the response rate to hepatitis B vaccine in under one-year children in Gorgan, Iran. Materials & Methods: This cross-sectional descriptive study was carried out on 215, children of 7-12 month of age (55.3% male, 44.7% female), in Gorgan, northern Iran during 2006. These subjects already had received the three-time vaccination against hepatitis B. Anti-HBs, Anti-HBc and HBsAg level of these children serum were determined, using ELISA technique. Results: In 30 (14%) subject's serum, there was not detected any antibodies against the viruses. Out of 185 children positive for HBS, 4 cases belong to HBC viruses. As a whole, 86% of the samples, had more than ten international unit of HBS. The meanSD of the titred antibodies in male and female were 158.8412 and 187.5513.83 respectively. The response not to three-times vaccination in male and female were 84% and 89.9% respectively. Conclusion: This study showed that in spit of vaccination, there are cases with virus-contamination. The reasons for absence of any response to the vaccination in some of this children can be due to deficiency in the immune system, improper genetic background which can not be stimulated by that vaccination, inadequate proper conditions for the preservation of vaccine, and the type vaccine used. Also the procedure of vaccine inoculation, the vaccine preservation condition and transportation should be taken into considertion.

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Background and Objective: Noninvasive methods have been proposed as surrogate markers for liver biopsy in recent years. It was shown that serum laminin level increases with the development for liver fibrosis The aim of this work was to determine serum laminin level cutoff point for predicting liver fibrosis, highlighting its diagnostic value and determining the effect of treatment on its level. Materials and Methods: In this case-control study during 2008-09, serum laminin levels in chronic hepatitis patients (n=62) and controls (n=20) before the beginning of the treatment and three times in a 2 month's interval i.e. 2.4 and 6 months after the beginning of the treatment- were compared by ELISA and stages of fibrosis were assessed according to the liver biopsy. Results: Mean serum laminin concentration in patients (91.9±20.9 ng/ml) was greater than the control (46.2±10.2 ng/ml, P<0.05). Serum levels of laminin in all stages of hepatic fibrosis were significantly higher than those of the healthy controls (P<0.05). A cutoff point of 52.0 ng/ml of laminin serum was obtained for the discrimination of patients with liver fibrosis than the healthy control showed a good sensitivity (96.8%) and specificity (80%). After 6 months of treatment, a gradual decrease in serum laminin level was observed, however the level was still higher than that of the healthy group (P<0.05). Conclusion: The findings of this study suggest that serum laminin level is a useful non-invasive marker of liver fibrosis due to strong positive correlation between serum laminin level and the degree of liver fibrosis.

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Background and Objective: Occult hepatitis B infection is a form of hepatitis in which despite of absence of detectable HBsAg, HBV-DNA is present in peripheral blood of patients. The mechanisms which are responsible for progression of OBI yet to be clarified but some investigators believed that the genetics and immunological parameters may are different in resistant individuals and patients. Cytokine network system could be leading alteration in viral immune response. The aim of this study was to investigate the relation between polymorphisms +874 region of IFN-Gama with occult hepatitis B infection. Materials and Methods: In this study, the plasma samples of 3700 blood donors were tested for HBsAg and anti-HBs by ELISA. The HBsAg negative and anti-HBc positive samples were selected and screened for HBV-DNA by PCR. HBV-DNA positive samples assigned as occult hepatitis B infection cases and ARMS-PCR technique were performed to examine the present polymorphisms in +874 region of IFN-Gama genes of patients with occult hepatitis B infection. Results: 352 (9.51%) out of 3700 blood samples were negative for HBsAg and positive for anti-HBc antibody. HBV-DNA was detected in 57 (16.1%) of HBsAg negative and anti-HBc positive samples. Our results showed that there was not any significant difference between patients and control group in polymorphisms in +874 region of IFN-Gama genes. Conclusion: This study showed that there is not any significant difference between polymorphisms in +874 region with IFN-Gama occult hepatitis B infection.

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Background and Objective: The prevalence of hepatitis B infection is increasing worldwide. The main way to prevent hepatitis B transmission to newborns can be through accurate detection of HBsAg positive pregnant women and implementation of standard protocol for their infants. Therefore, this study carried out to determine the frequency of HBsAg in pregnant women in Gorgan, Iran. Materials and Methods: This cross sectional study was done on 1553 pregnant women whom attended to Dezyani hospital in Gorgan, North of Iran during 2008-09. Blood samples were taken and tested for HBsAg and HBeAg using ELISA method. Results: HBsAg was found positive in 15 (1%) pregnant women. However, HBeAg were negative in all cases. Seven of these cases (46.7%) were not diagnosed before admission to the hospital for delivery and therefore had not received any immunoprophylaxis or HBIG treatment for their newborns. In contrary, six mothers and their newborns received immunoprophylaxis due to falsely diagnosed HBsAg seropositive. Conclusion: This study showed that the current protocols for dealing with HBsAg seropositivity and case finding among pregnant women in this region should be thoroughly revised. Furthermore, it is suggested that pregnant women during third trimester should be screened for HBsAg.

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Background and Objective: The vaccination against hepatitis B is a front line defence for all at-risk groups. Conventional methods of hepatitis B vaccination (0, 1 and 6 months) is considered a long process. But vaccination at shorter intervals (0, 10 and 21 days) is suggested to achieve rapid immunity. This study was carried out to compare for the protective antibody level against hepatitis B in accelerated and conventional vaccination. Materials and Methods: In this descriptive and analytical study 160 health personnel of Imam Reza hospital of Kermanshah, Iran with no history of vaccination against hepatitis B were selected and divided into two groups during 2009. The volunteers were received vaccination according to accelerated (0, 10 and 21 days) and convetional (0, 1 and 6 months) methods. The antibody titer measured two years after the final dose of vaccination. The acceptable level of antibody was considered higher than 10 IU/ml. Results: After two years the acceptable level of antibody was observed in 94.5% and 97.9% of subjects in accelarated and conventional methods, respectivley. This difference was not significant. Conclusion: This study showed that there is not significant differences between accelerated and conventional methods in antibody production against hepatitis B antigen.

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Background and Objective: Infection with HBV is the most common chronic viral infection and mortality in children. Prevention of this infection with vaccination is vital. This study was done to compare the antibody level in post hepatitis B vaccination in children with 12-15 and 21-24 months age. Materials and Methods:This descriptive study was carreid out on 186 children with 12-15 (group I) and 21-24 (group II) months age who had not infected with hepatitis B infection in, Bandarabbas Iran during 2009. The parents were HbsAg negative, without immunodeficiency diseases and did not receive hepatitis vaccination, blood or blood products transfusion. Age, gender, birth weight, breast feeding duration and gestational age were recorded for each child. Hepatitis B antibody level was measured with ELISA method. Data were analyzed using SPSS-16 and student t-test. Results: Antibody level in group I (231 mIU/ml) was significantly higher than group II (142.9 mIU/ml) (P<0.05). There was not significant differences between males and females. Antibody level was not significantly corrolated with body weight, gestational age and breast feeding duration. Antibody level lower than 10 mIU/ml were observed in 4.34% of group I and 20.8% of group II. This differnce was significant (P<0.05). Conclusion: This study showed that the protective effect of vaccination reduced after six months of final dosage.

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Background and Objective: Hepatitis B vaccination has been conducted in neonates in the routine vaccination in Iran since 1993. This study was carried out to evaluate the serum hepatitis B antibody level in vaccinated children after 14 years in Kashan, Iran. Materials and Methods: This prospetive cohort study was conducted on 200 fourteen-year-old children which were selected via a simple random sampling method in Kashan, Iran drung 2008-09. This subjects were have been vaccined according to the govermental guildline at 0, 2 and 6 months old. Two ml blood specimens were obtained from children and serum hepatitis B surface antibody (anti-HBs) and hepatitis B core antibody (anti-HBc) were determined by ELISA method. Immunity was interpreted as anti-HBs≥10 IU/L. Data were analyzed using SPSS-13, Chi-Square and Fisher’s exat tests. Results: 92% girls and 95% boys, totally 187(93.5%) children had serum anti-HBs≥10 IU/L. Anti-HBc was positive in 3 (3%) girls and 5(5%) boys, totally 8(4%) which all of them had serum anti-HBS≤10 IU/L. No case of positive HBs Ag was detected. Immunity was detected in 11 of 18 (61.1%) children with birth weight<2.5 kg and in 176 of 182 (96.7%) children with birth weight≥2.5 kg (P<0.05). Conclusion: The immunity following the complete series (0, 2, 6 months old) of hepatitis B vaccination remained detectable after 14 years.

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Background and Objective: Chronic infection with Hepatitis B virus (HBV) is one of the main causes of cirrhosis and hepatocellular carcinoma (HCC). The pathogenicity of the virus is determined by the multi-functional protein x (HBx). Changing the sequence of the gene encoding this protein causes the regulation of transcription and pathogenicity factors. This study was done to analyze the genetic dynamics of the HBx coding gene in a person with chronic HBV.
Methods: In this descriptive laboratory study, an infected person with chronic hepatitis B virus infection was first amplified and cloned into complete sequence of HBx encoder. Then, the reference sequences of genotypes, serotypes and different virus subtypes of the GenBank database were matched by CLC Sequence Viewer software. The comparative result was used to plot the phylogenic tree by T-rex server and population genetic analysis using DnaSP software. Natural selection at the nucleotide and protein level was performed by the Tajima's D test.
Results: No known mutation at the level of the protein was found in the chronic sequence of the HBx encoder. The results of natural selection indicated neutral mutations in the HBx gene. The phylogenetic results showed that the HBx encoding sequences in the chronic infected individual had a genetic affinity with genotype D and ayw2 subtype.
Conclusion: Neutrality polymorphism takes place in HBx coding region. Also, the phylogenetic results of the present study are consistent with the previous findings of Golestan province and Iran which have reported the prevalence of genotype D and subspecies ayw2.

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Background and Objective: Prisoners are among the high risk population for contagious infections such as HIV (Human Immunodeficiency Virus), HBV (Hepatitis B Virus), HCV (Hepatitis C Virus), TB (Tuberculosis), and other dangerous diseases. In spite of other countries in the world, data about the prevalence and risk factors for infectious diseases among prisoners are spars in Iran. The aim of this study was to determine the prevalence of HBV, HCV and TB coinfections among male prisoners suffering from HIV.
Methods: In this descriptive-analytical study, 100 HIV patients were selected. Microscopic examination (acid fast staining) was applied on sputum specimens and serological (HBsAg, anti- HCV) and molecular (Real time PCR and DNA sequencing) investigations carried out on patient’s sera.
Results: Among 100 prisoners affected with HIV, the prevalence of HCV, HBV and TB infections were 45%, 3%, and 9%, respectively. All HBV positive cases were genotype D, subgenotype ayw2. Among the HCV positive subjects, 34 (75.5%) and 11 (24.5%) were genotype 1a and genotype 3a, respectively. There was no significant relation between age, CD4 and transmission route of HCV in male prisoners affected with HIV. Drug injection was the main route for the acquisition of HCV, HBV infections.
Conclusion: This study showed that a high prevalence of HCV and TB infections among male prisoners affected with HIV.