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Atnaf A, Kibret M, Tesfaye B, Abebaw D. Magnitude, predictors, and trends of multidrug-resistant tuberculosis among tuberculosis patients at Debre Markos, Northwest, Ethiopia: a five-year retrospective study. JAC Antimicrob Resist 2025; 7:dlaf086. [PMID: 40433447 PMCID: PMC12107240 DOI: 10.1093/jacamr/dlaf086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2025] [Accepted: 05/06/2025] [Indexed: 05/29/2025] Open
Abstract
Background The emergence of multidrug-resistant tuberculosis (MDR-TB) is a threat to the people of resource-limited countries, such as Ethiopia. This study aimed to assess the magnitude, predictors and trends of multidrug-resistant tuberculosis among patients with pulmonary tuberculosis (TB) at Debre Markos Comprehensive and Specialized Hospital (DMCSH), Northwest Ethiopia. Materials and Methods A retrospective cross-sectional study was conducted among patients with TB treated at the directly observed treatment short course (DOTS) clinic at DMCSH from 1 June 2016 to 1 June 2020. Data from 1509 patients with TB registered in the clinic were retrieved from medical records. Statistical analysis was performed using SPSS v.24. The frequency of variables is presented via tables and figures. Logistic regression was fitted to predictors of MDR-TB, and a P value < 0.05 was considered statistically significant. Results Overall, data from 1509 patients with pulmonary TB were retrieved during the study. The overall prevalence of MDR-TB was 4.1%. Variables such as sex, human immunodeficiency virus (HIV) status, lesion on chest X-ray, and a history of anti-TB treatment were significantly associated with MDR-TB. The trend of MDR-TB decreased by 40% in 2017, 29% in 2018, and 10% in 2019, but increased by 21% in 2020. Conclusions and recommendations The prevalence of MDR-TB among patients with pulmonary TB was comparable to the national rate. Key risk factors for MDR-TB included male sex, prior TB treatment, HIV infection, and chest X-ray abnormalities. The increasing trend in 2020 highlights the need for strengthened TB treatment adherence counselling and further prospective studies to explore additional predictors of MDR-TB.
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Affiliation(s)
- Aytenew Atnaf
- Department of Medical Laboratory Sciences, Debre Markos University, PO. Box 269, Debre Markos, Ethiopia
| | - Mekuanenit Kibret
- School of Medicine, Debre Markos University, PO. Box 269, Debre Markos, Ethiopia
| | - Bekele Tesfaye
- Department of Nursing, Debre Markos University, PO. Box 269, Debre Markos, Ethiopia
| | - Desalegn Abebaw
- Department of Medical Laboratory Sciences, Debre Markos University, PO. Box 269, Debre Markos, Ethiopia
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Mansoori N, Pahlavanzadeh B, Atarjalali M. Risk factors associated with multidrug-resistant tuberculosis in areas with a moderate tuberculosis burden. Int Health 2025; 17:186-194. [PMID: 38873833 PMCID: PMC11879555 DOI: 10.1093/inthealth/ihae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/09/2024] [Accepted: 06/11/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND The emergence of multidrug-resistant tuberculosis (MDR-TB) or rifampicin-resistant (RR) TB poses a significant challenge for TB control initiatives on a global scale. This study's aim was to estimate the incidence of MDR-/RR-TB and identify the risk factors associated with their incidence in four provinces in northern Iran. METHODS Drug susceptibility testing was conducted using the proportion method on Lowenstein-Jensen media. The demographic and clinical data were collected from the Iranian TB registry. RESULTS Among 1083 individuals diagnosed with TB, 27 (2.5%) were identified as having MDR-/RR-TB, while 73 cases (6.7%) were any drug resistant (ADR). The statistical analysis revealed a significant association between marital status and MDR-/RR-TB (p=0.003). In addition, significant associations were observed between ADR-TB and gender (p=0.035) and previous treatment for TB (p=0.02). CONCLUSIONS Our findings provide important information on the drug resistance pattern of Mycobacterium tuberculosis strains, as well as risk factors in northern Iran. Given the identified risk factors, creative approaches to promote treatment adherence in TB patients, particularly divorced/widowed women and individuals with a previous history of TB treatment, are required.
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Affiliation(s)
- Noormohamad Mansoori
- Infectious Diseases Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Bagher Pahlavanzadeh
- Research Center for Environmental Contaminants, Abadan University of Medical Sciences, Abadan, Iran
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Mostafavi E, Ebrahimi B, Doosti-Irani A, Mirzazadeh A. Prevalence of hepatitis B, hepatitis C, and tuberculosis among people living with HIV in Iran: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:777. [PMID: 39097724 PMCID: PMC11297631 DOI: 10.1186/s12879-024-09676-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 07/25/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND Up to now several studies estimate the prevalence of HBV, HCV, and TB among people living with HIV (PLWH) in Iran; however, their results are inconsistent. This study aimed to estimate the overall prevalence of HBV, HVC, and TB among Iranian PLWH. METHODS In this systematic review and meta-analysis six databases including Medline, Web of Science, Scopus, MagIran, Scientific Information Database (SID), and Barakat Knowledge network system were searched up to October 2023 with no language restriction. All studies estimated the prevalence of HBV, HCV, and TB among PLWH in Iran were included. The random-effects model was used to report the study estimates. Results were reported at a 95% confidence interval (CI). RESULTS Out of 1050 retrieved references, 58 articles met the eligibility criteria. Overall among PLWH, HBV prevalence was 13.0% (95% CI: 11.0, 15.0), HCV prevalence was 54% (95% CI: 45.0, 64.0), and TB prevalence was 19% (95% CI: 13.0, 24.0). The results from multivariate meta-regression analysis showed no statistically significant association between HBV and TB prevalence with the year of study, quality of studies, age, gender, and persons who inject drugs (PWID). HCV prevalence was significantly associated with PWID. CONCLUSION We found HBV, HCV, and TB infections are common among PLWH in Iran and required to be screened and treated with effective and timely services.
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Affiliation(s)
- Ehsan Mostafavi
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Bahram Ebrahimi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Science, Hamadan, Iran
| | - Amin Doosti-Irani
- Department of Epidemiology, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California, San Francisco, CA, USA
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Ghassabi F, Malekzadegan Y, Sedigh Ebrahim-Saraie H, Heidari H, Sabet M, Bagheri A, Bagheri N, Raeisi Shahraki H, Hasanabadi A, Motamedifar M. Gonorrhea and syphilis co-infection and related risk factors in HIV patients from Shiraz, South of Iran. CASPIAN JOURNAL OF INTERNAL MEDICINE 2018; 9:397-402. [PMID: 30510656 PMCID: PMC6230453 DOI: 10.22088/cjim.9.4.397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Neisseria gonorrhea and Treponema pallidum as an obligate human pathogen are two common causes of sexually transmitted diseases (STDs). The present study aimed to determine the prevalence of N. gonorrhoeae and T. pallidum among human immunodeficiency virus (HIV) patients in the southwest Iran. Methods: This retrospective study was performed from 2004 to 2013, on HIV patients who were tested for detection of gonorrhea and syphilis infection at Shiraz HIV/AIDS Research Center. ELISA technique was used for preliminary detection of HIV and confirmed by a Western Blotting test. Gonorrhea was routinely diagnosed using direct Gram-staining and culturing on selective agar. Syphilis was routinely diagnosed by RPR test. Results: Of the 806 HIV patients, 39 (2.6%) cases had co-infection with gonorrhea. Compared with mono-HIV infected patients, gonorrhea was significantly more likely among the males (69.4% vs. 92.3%, P=0.002). History of addiction and prison seems to be a significant risk factor for gonorrhea infection (P<0.05). Also, the mean of CD4+lymphocyte was higher among gonorrhea infected patients (368±238 vs. 415±328). Logistic regression analysis showed that sexual contact increased risk of gonococcal infection about 4 fold (OR: 4, CI: 1.7-9.39, P=0.001). None of the HIV patients had syphilis co-infection. Conclusions: As a preliminary survey, our findings provided unique information on the prevalence of gonorrhea and syphilis co-infections among HIV patients. Moreover, we introduced the main risk factors associated with gonorrhea co-infection in HIV patients in our region including gender, history of addiction and prison, CD4+lymphocyte count, and transmission routes for effective management of STDs.
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Affiliation(s)
- Farzaneh Ghassabi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yalda Malekzadegan
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Sedigh Ebrahim-Saraie
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Heidari
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Sabet
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdollatif Bagheri
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Narges Bagheri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Raeisi Shahraki
- Department of Biostatistics and Epidemiology, School of health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Alireza Hasanabadi
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Motamedifar
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Antimicrobial Susceptibility Pattern of Six Threatening Pathogens at Mofid Children’s Hospital, Tehran, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2018. [DOI: 10.5812/archcid.15576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ebrahim-Saraie HS, Nezhad NZ, Heidari H, Motamedifar A, Motamedifar M. Detection of Antimicrobial Susceptibility and Integrons Among Extended-spectrum β-lactamase Producing Uropathogenic Escherichia coli Isolates in Southwestern Iran. Oman Med J 2018; 33:218-223. [PMID: 29896329 DOI: 10.5001/omj.2018.40] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives Urinary tract infections (UTIs) are one of the most prevalent infectious diseases and can lead to a high rate of morbidity and mortality. The emergence of multiple-drug resistant strains, particularly extended-spectrum beta-lactamases (ESBLs) producing strains, has become a global healthcare concern. Our study sought to investigate the antimicrobial resistance pattern and presence of integrons and fimH determinants among uropathogenic Escherichia coli (UPEC) isolates obtained from hospitalized Iranian patients. Methods This cross-sectional study was performed on 121 E. coli isolates recovered from patients with clinical symptoms of UTIs, referred to Shiraz Nemazee Hospital, in 2016-17. The isolates were identified by standard microbiologic tests and confirmed by API 20E strip. Antimicrobial susceptibility testing was determined using the disk diffusion method. The presence of fimH and classes 1-3 integron encoding genes was determined using the polymerase chain reaction. Results Ampicillin (9.1%) and nalidixic acid (19.0%) showed the lowest level of antibiotic susceptibility. The highest level of susceptibility was toward imipenem (77.7%). The rate of ESBL-producing isolates was 42.1%. There was a significant association between production of ESBLs and higher antibiotic resistance in the tested isolates. Of the investigated virulence and resistance genes, fimH, intI1, and intI2 were positive in 98.3%, 59.5%, and 7.4% of isolates, respectively. Conclusions The remarkable rate of ESBL-producing UPEC isolates accompanied with the presence of integrons suggest the necessity of restricted infection control policies to prevent further dissemination of resistant strains.
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Affiliation(s)
- Hadi Sedigh Ebrahim-Saraie
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hamid Heidari
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ashkan Motamedifar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Motamedifar
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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Hoseini-Alfatemi SM, Karimi A, Armin S, Fakharzadeh S, Fallah F, Kalanaky S. Antibacterial and antibiofilm activity of nanochelating based silver nanoparticles against several nosocomial pathogens. Appl Organomet Chem 2018. [DOI: 10.1002/aoc.4327] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Seyedeh Mahsan Hoseini-Alfatemi
- Pediatric Infections Research Center, Research Institute for Children Health; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Abdollah Karimi
- Pediatric Infections Research Center, Research Institute for Children Health; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Shahnaz Armin
- Pediatric Infections Research Center, Research Institute for Children Health; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Saideh Fakharzadeh
- Department of Research and Development; SodourAhrarShargh Company; Tehran Iran
| | - Fatemeh Fallah
- Pediatric Infections Research Center, Research Institute for Children Health; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Somayeh Kalanaky
- Department of Research and Development; SodourAhrarShargh Company; Tehran Iran
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Talebi-Taher M, Abbasian L, Alavi-Niakou SN, Javad-Moosavi SA, Pahlavani S. Tuberculin Skin Test Conversion among Individuals with Human Immunodeficiency Virus Infection on Antiretroviral Therapy in a Referral Teaching Hospital, Tehran, Iran. TANAFFOS 2017; 16:201-206. [PMID: 29849673 PMCID: PMC5960224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 04/08/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND The risk of tuberculosis (TB) is greater for individuals with human immunodeficiency virus (HIV) who are on combined antiretroviral therapy (c-ART) than for the normal population. Therefore, the detection and treatment of latent tuberculosis infections is recommended for all HIV-positive persons with positive tuberculin skin tests (TSTs). MATERIALS AND METHODS This retrospective cohort study included all HIV-positive individuals with CD4 lymphocyte counts greater than 200 cells/μL and negative TST results, who were taking antiretroviral drugs and had been referred to Imam Khomeini Teaching Hospital Consultation Centre for Clients with Risky Behaviors in Tehran, Iran, from 2008 to 2013. TST conversion to positivity is defined as an induration increase of at least 5 mm compared with a previously negative TST result within a 1-year period. Conversion rates are expressed in person-years of observation. RESULTS A total of 113 patients were included in our study. At 1 year, 9 of the 113 TST-negative patients taking c-ART became TST-positive (8%; 8 males and 1 female). The TST conversion incidence rate was 10.09/100 person-years. TST conversion was only found to be associated with sex (odds ratio: 8.64; 95% confidence interval: 1.04-7.56, p = 0.032). CONCLUSION Our results suggest that TSTs should be administered to all HIV-positive patients before beginning isoniazid preventive therapy in Iran.
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Affiliation(s)
- Mahshid Talebi-Taher
- Antimicrobial Resistance Research Centre, Infectious Diseases Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ladan Abbasian
- Iranian Research Centre of HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Seiedeh Nina Alavi-Niakou
- Internal Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seied Ali Javad-Moosavi
- Internal Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyedmahdi Pahlavani
- Internal Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Edge CL, King EJ, Dolan K, McKee M. Prisoners co-infected with tuberculosis and HIV: a systematic review. J Int AIDS Soc 2016; 19:20960. [PMID: 27852420 PMCID: PMC5112354 DOI: 10.7448/ias.19.1.20960] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 10/01/2016] [Accepted: 10/24/2016] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Almost from the beginning of the HIV epidemic in 1981, an association with tuberculosis (TB) was recognized. This association between HIV and TB co-infection has been particularly evident amongst prisoners. However, despite this, few studies of TB in prisons have stratified results by HIV status. Given the high prevalence of HIV-positive persons and TB-infected persons in prisons and the documented risk of TB in those infected with HIV, it is of interest to determine how co-infection varies amongst prison populations worldwide. For this reason we have undertaken a systematic review of studies of co-infected prisoners to determine the incidence and/or prevalence of HIV/TB co-infection in prisons, as well as outcomes in this group, measured as treatment success or death. METHODS A literature search was undertaken using the online databases PubMed, Embase, IBSS, Scopus, Web of Science, Global Health and CINAHL Plus. No restrictions were set on language or publication date for article retrieval, with articles included if indexed up to 18 October 2015. A total of 1975 non-duplicate papers were identified. For treatment and outcome data all eligible papers were appraised for inclusion; for incidence/prevalence estimates papers published prior to 2000 were excluded from full text review. After full text appraisal, 46 papers were selected for inclusion in the review, 41 for incidence/prevalence estimates and nine for outcomes data, with four papers providing evidence for both outcomes and prevalence/incidence. RESULTS Very few studies estimated the incidence of TB in HIV positive prisoners, with most simply reporting prevalence of co-infection. Co-infection is rarely explicitly measured, with studies simply reporting HIV status in prisoners with TB, or a cross-sectional survey of TB prevalence amongst prisoners with HIV. Estimates of co-infection prevalence ranged from 2.4 to 73.1% and relative risks for one, given the other, ranged from 2.0 to 10.75, although some studies reported no significant association between HIV and TB. Few studies provided a comparison with the risk of co-infection in the general population. CONCLUSIONS Prisoners infected with HIV are at high risk of developing TB. However, the magnitude of risk varies between different prisons and countries. There is little evidence on treatment outcomes in co-infected prisoners, and the existing evidence is conflicting in regards to HIV status influence on prisoner treatment outcomes.PROSPERO Number: CRD42016034068.
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Affiliation(s)
- Chantal L Edge
- London School of Hygiene and Tropical Medicine, London, England;
| | - Emma J King
- Brighton and Hove City Council, Brighton and Hove, England
| | - Kate Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Martin McKee
- ECOHOST, London School of Hygiene and Tropical Medicine, London, England
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Rezaei E, Sedigh Ebrahim-Saraie H, Heidari H, Ghane P, Rezaei K, Manochehri J, Moghadami M, Afsar-Kazerooni P, Hassan Abadi AR, Motamedifar M. Impact of vitamin supplements on HAART related hematological abnormalities in HIV-infected patients. Med J Islam Repub Iran 2016; 30:350. [PMID: 27390719 PMCID: PMC4898844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 10/03/2015] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The human immunodeficiency virus (HIV) is one of the most life- threatening human infections. The advent of highly active antiretroviral therapy (HAART) has dramatically changed the course of HIV infection and patients' quality of life. In addition to the benefits, HAART can have numerous side effects and toxicities. Therefore, we aimed to assess the impact of short-term vitamins treatment on hematological parameters of HIV infected patients receiving HAART. METHODS This cross-sectional study was conducted on 100 confirmed HIV positive patients who referred to Shiraz HIV/AIDS research center in southwest of Iran. The first-line of HAART regimen contained Zidovudine, Lamivudine, and Efavirenz. The studied population received vitamin B12 weekly and folic acid daily for at least one month. RESULTS After receiving HAART for at least 6 months with adherence above 90%, significant differences (p<0.05) were observed in MCV, MCH, HCT, TLC and RBC status compared to the baseline parameters. After one month of treatment, vitamins in four hematological parameters including TLC, MCV, RBC, and WBC showed significant differences compared to HAART parameters. CONCLUSION Combined administration of B12 and folate supplements is a beneficial adjuster on hematologic status of HIV infected persons receiving HAART. However, future research with larger studied population and longer follow-up periods is required. Moreover, especial attention should be given to gender because the effect of vitamins was significantly different on some hematologic parameters between different genders.
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Affiliation(s)
- Esmaeil Rezaei
- 1 MSc, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hadi Sedigh Ebrahim-Saraie
- 2 PhD, Department of Bacteriology & Virology, School of Medicine, Shiraz University of Medical Sciences Shiraz, Iran.
| | - Hamid Heidari
- 3 PhD, Department of Bacteriology & Virology, School of Medicine, Shiraz University of Medical Sciences Shiraz, Iran.
| | - Parichehr Ghane
- 4 MSc, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Khadijeh Rezaei
- 5 MSc, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Science, Shiraz, Iran. m.rezaiee.gmail.com
| | - Jamal Manochehri
- 6 MSc, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohsen Moghadami
- 7 Associate Professor, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Parvin Afsar-Kazerooni
- 8 MD, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Science, Shiraz, Iran.
| | - Ali Reza Hassan Abadi
- 9 MD, Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Motamedifar
- 10 Professor, Shiraz HIV/AIDS Research Center (SHARC), Shiraz University of Medical Sciences, Shiraz, Iran. ,(Corresponding author) Professor, Shiraz HIV/AIDS Research Center (SHARC), Shiraz University of Medical Sciences, Shiraz, Iran.
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Associations Between Socio-Environmental Determinants and the Risk of Pulmonary Tuberculosis in Guilan, Iran. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2016. [DOI: 10.5812/archcid.30217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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