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Background: Occult hepatitis B infection (OBI) refers to the presence of hepatitis B virus (HBV) DNA in the serum or liver of individuals who tested negative for HBV surface antigen (HBsAg). This study aimed to determine seropositivity for antibodies against HBV core antigen (anti-HBc) and the frequency of OBI among the HBsAg non-reactive blood donors in Mashhad, northeastern Iran. Methods: In this cross-sectional study, serum samples of HBsAg-negative blood donors were examined for anti-HBc during June and August 2018. Anti-HBc-positive samples were tested for antibodies against HBsAg (anti-HBs), and those with negative results were classified as isolated anti-HBc cases. The presence of HBV DNA in the C, S, and X gene regions was assessed by a qualitative real-time polymerase chain reaction method in all HBsAg-negative samples. OBI subjects were detected by the presence of at least one HBV genomic region. Results: Of 540 HBsAg-negative donors, 29 (5.4%; 95% confidence interval: 3.6--7.6%) showed seroreactivity for anti-HBc, of whom 18 individuals were also seropositive for anti-HBs. All donors showed negative results for all three HBV genes regardless of their serum anti-HBc status. Conclusion: Based on our findings, we suggest routine screening of Iranian blood donation volunteers for serum anti-HBc and anti-HBs but not HBV DNA. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis C virus (HCV) infection affects 58 million people globally. The frequency of HCV infection in the general Iranian population is less than 0.5%; however, a concentrated epidemic was reported among people who use drugs, particularly those with a history of drug injection. Objectives: This cross-sectional study was performed to assess the prevalence of HCV infection among high-risk groups outside of prison in northeastern Iran. Methods: A total of 962 participants in Razavi Khorasan province were enrolled from 2018 to 2022. They included drug users referred to drug treatment and harm reduction centers and individuals with a history of crimes such as drug use or imprisonment who worked in a private industrial unit. Serum anti-HCV antibodies were assessed using a rapid or ELISA kit, and seroreactive samples were confirmed by single-step reverse transcriptase or qualitative real-time polymerase chain reactions. A P-value < 0.05 was considered statistically significant. Results: The mean age of 707 males and 255 females was 39.8 ± 10.2 years. Anti-HCV antibodies were detected from 129 samples (13.41%), of which 107 were available for polymerase chain reaction testing. HCV RNA was detected in 88 cases (75.2%); the total viremia rate was calculated as 9.26% (88/950). Logistic regression analysis revealed that HCV infection among drug users was significantly associated with older age (P = 0.002), being single (P = 0.009), and history of drug injection (P < 0.001) or incarceration (P = 0.04). Conclusions: The findings showed a considerably high prevalence of HCV infection among people who use drugs in northeastern Iran. To achieve the global goal of viral hepatitis elimination by 2030, we strongly recommend stricter screening and treatment of this infection among such hard-to-access populations in Iran. [ABSTRACT FROM AUTHOR]

Background: People who use drugs, particularly injection drug users (IDUs) are known as the major source of hepatitis C virus (HCV) infection. This study was performed to determine the prevalence of HCV infection using rapid point-of-care testing and to assess liver fibrosis by non-invasive lab tests among addict populations of Mashhad, Iran. Methods: In this cross-sectional study, drug users who referred to drug treatment and harm reduction centers of Mashhad were enrolled during March and December 2019. A rapid test kit was used to assess the presence of anti-HCV antibodies and a realtime PCR was performed to confirm the infection. The AST-platelet ratio index (APRI) and fibrosis-4 (FIB-4) score were used to investigate liver fibrosis in patients with positive HCV RNA. A P value <0.05 was considered as significant. Results: A total of 390 drug users aged 15-74 years were assessed. Sixty-four individuals showed positive results for anti-HCV (16.4%), of whom 58 blood samples were available for PCR test. The viremic rate among the latter group was calculated at 84.5% (49/58); the total viremia prevalence was 12.8% (49/384). Multivariate analysis revealed that being single (P = 0.040) or divorced/ widow (P = 0.011) and history of drug injection (P < 0.001) and tattoos (P = 0.021) were significantly associated with current HCV infection. Using APRI and FIB-4 indices, significant liver fibrosis was identified in 14.3% and 18.4% of cases, respectively. Conclusion: HCV infection screening using rapid tests and examining liver fibrosis by non-invasive lab tests appear to be practicable and useful among poor populations in settings such as drug treatment centers. [ABSTRACT FROM AUTHOR]

Context: Various frequency rates of occult hepatitis B virus infection (OBI) are reported from different parts of Iran. This systematic review and meta-analysis aimed to characterize the OBI epidemiology in Iran and estimate the pooled prevalence among different populations. Evidence Acquisition: Nine internationalandPersian electronic databases, as well assomeconference proceedings, were searched. Original cross-sectional studies up to December 2018 were included if they investigated the prevalence of OBI by the detection of serum hepatitis B virus surface antigen and hepatitis B virus nucleic acid in at least 30 samples selected with any sampling methods. Comprehensive meta-analysis software was used to analyze the data, and Cochran's Q-test and I-square statistics were applied to assess the heterogeneity. Meta-regression analysis was performed to assess the impact of the year of study on the OBI frequency. A P value < 0.05 was considered as the level of significance. Results: Of 412 citations found in electronic sources and 35 relevant citations added by searching the gray literature, 83 nonduplicated non-overlapping studies were evaluated. A total of 55 documents comprising 14,485 individuals from 16 provinces met the inclusion criteria and were used in the analysis. The prevalence of OBI considerably varied in different parts of the country with the highest prevalence (63.1%) reportedamongthe HIV-positive population in Fars province. The rates of the OBI prevalencewereestimatedat 0.06% (95% CI: 0.02 - 0.16%)amongblood donors (BDs) regardless of their anti-HBc status, 7.90% (95% CI: 4.33 - 13.99%)among anti-HBc positive BDs, 2.49% (95% CI: 1.2 - 4.81%) among hemodialysis (HD) patients, 4.44% (95% CI: 1.56 - 12.02%) among HIV-positive patients, and 7.76% (95% CI: 4.57 - 12.86%) among HCV-positive patients. No significant trends were observed in OBI prevalence rates among different groups over time (P > 0.05). Conclusions: This review revealed high rates of OBI prevalence among high-risk populations in Iran. It is strongly suggested that occult hepatitis B be investigated among populations with a high chance of its occurrence in our country. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Human T lymphotropic virus type 1 (HTLV‐1) infection with high prevalence in the north‐east of Iran, particularly in Mashhad, can lead to adult T‐cell leukemia (ATL) and HTLV‐1‐associated myelopathy/tropical spastic paraparesis (HAM/TSP) and a variety of autoimmune diseases. The aim of the study was to examine the presence of autoimmune markers in HTLV carries. Methods: Serum samples were obtained from blood donors in Mashhad, northeastern Iran. One hundred and five HTLV‐1 positive (cases) and 104 age‐ and sex‐matched HTLV‐1 negative donors (controls) were assessed for presence of serum autoimmune markers by enzyme‐linked immunosorbent assay. Results: The mean ages of cases and controls were 40.8 ± 9.4 and 41.5 ± 9.3 years, respectively (P = 0.5). In the case group, 81.9% and in the control group 83.7% were male (P = 0.74). The frequency of positive antinuclear antibodies and anticyclic citrullinated peptide antibodies in the serum of the two groups were not significantly different (P = 0.68 and P = 0.62, respectively). Only one antineutrophil cytoplasmic antibody‐positive case (1%) was observed in the group and no anti‐phospholipid immunoglobulin G positivity was observed. The frequency of rheumatoid factor (RF) was greater in case group than in the control group, although the difference was not significant (P = 0.08). The amount of RF in all 12 RF positive sera were higher than normal levels (33–37 IU/mL). Conclusion: Because we failed to detect any significant relation between serum autoimmune markers and HTLV‐1 infection, and because of the relatively low prevalence of autoimmune diseases, it could be concluded that healthy HTLV‐1 carriers do not produce rheumatologic‐related auto‐antibodies more than the healthy population. [ABSTRACT FROM AUTHOR]

Background: The incidence of sexual transmitted infections (STIs) and HIV/AIDS is globally higher in young people. This study evaluated the prevalence of sexual reproductive behaviors among undergraduate students of Mashhad, Iran. Methods: The study was conducted on 605 students in twelve non-medical faculties of a great university of Mashhad. A self-administered questionnaire was completed on demographic information, sexual contact in the lifetime and during the last three months, and age of first sex. Kaplan-Meier statistic was used to calculate the mean age of initiation of sex. A p<0.05 was considered statistically significant. Results: After exclusion of individuals over 25 years of age, among 590 students with a mean age of 20.8±1.5 years included in the analysis, 71.4% were female and 85.3% were single. Prevalence of at least one sexual contact in life was 15.1% and 35.3% of single sexually experienced students reported to have sex in the last three months. The lifetime prevalence of sexual relationship in males was significantly higher than females (32.9% vs. 7.6%, p<0.001). The mean age of first sexual experience was 23.7 years with a significant difference between both sexes (p<0.001). In single sexually experienced students, the mean age at first sex was 17.6±3.3 years, 24% started sexual activity at <15 years, 34.3% had at least 3 partners and only 40.6% stated using condom in their last sex. Conclusion: Although very small proportion of females reported premarital sex, a significant minority of male students experienced sexual and risky behaviors. Therefore, the use of educational programs on related issues to reduce the risk of STIs/ HIV among youth including university students seems to be a necessity. [ABSTRACT FROM AUTHOR]

Objective: High prevalence of human T-cell lymphotropic virus type 1 (HTLV-I) infection in the northeastern of Iran has been proven. However, there is no overall estimation of the infection in the country. This systematic review was conducted to make an accurate estimation of HTLV-I infection prevalence in the Iranian blood donors. Method: All cross-sectional studies which had reported the prevalence of HTLV-I infection in the Iranian blood donors in both English and Persian languages until August 2011 were adopted. The inclusion criteria were proper sampling methods, adequate sample size, and valid measurement methods. The overall prevalence rate was estimated using meta-analysis method as well as survey data analysis methods. Results: From 843 electronic searched citations, and 245 surveys found in gray literatures, 13 studies met the inclusion criteria. They were from seven provinces including Razavi Khorasan (0.38-1.16%), West Azarbaijan (0.34%), Ilam (0.21%), Hormozgan (0.18%), Alborz (0.11%), South Khorasan (0.04%), and Bushehr (0.01%). The overall estimation of the HTLV-I prevalence rate in Iranian blood donors was 0.119% (95% confidence interval (CI): 0.050-0.287 percent). Conclusion: It is concluded that HTLV-I infection in Iranian blood donors is considerably prevalent. It is highly recommended to continue prevention programs such as strict blood screening. [ABSTRACT FROM AUTHOR]

Abstract: Background: Mashhad, in the northeast of Iran has been suggested as an endemic area for human T cell lymphotropic virus type I (HTLV-I) infection since 1996. Objectives: We performed a community-based seroepidemiology study to examine the prevalence and risk factors for HTLV-I infection in the city of Mashhad. Study design: Between May and September 2009, overall 1678 subjects from all the 12 geographical area of Mashhad were selected randomly by multistage cluster sampling for HTLV antibody. The study population included 763 males and 915 females, with the mean age of 29.1±18.5 years. 1654 serum samples were assessed for HTLV antibody using ELISA and reactive samples were confirmed by Western blot and PCR. Results: The overall prevalence of HTLV-I infection in whole population was 2.12% (95% CI, 1.48–2.93) with no significant difference between males and females (p =0.093) and the prevalence of HTLV-II seropositivity was 0.12% (95% CI, 0.02–0.44). The HTLV-I Infection was associated with age (p <0.001), marital status (p <0.001), education (p =0.047), and history of blood transfusion (p =0.009), surgery (p <0.001), traditional cupping (p =0.002), and hospitalization (p =0.004). In logistic regression analysis, age was the only variable that had a significant relation with the infection (p =0.006, OR=4.33). Conclusions: Our results demonstrated that Mashhad still remains an endemic area for HTLV-I infection despite routine blood screening. Thus, further strategies are needed for prevention of the virus transmission in whole population. [Copyright &y& Elsevier]

Background: Hepatitis B virus (HBV) infection is a significant health problem throughout the world. Objectives: We aimed to evaluate the prevalence of hepatitis B antigen (HBsAg) seropositivity in the general population of Mashhad, northeast of Iran. Patients and Methods: One thousand six hundred fifty-two healthy individuals aged 1 to 90 (Mean; 29.1 ± 18.5) from all 12 municipalities of Mashad were selected randomly by multistage cluster sampling. Informed consent was obtained, and demographics and medical histories were collected. Twice-reactive samples were considered HBsAgpositive by ELISA. Chi-square test and logistic regression were applied to analyze the factors related to HBsAg positivity using SPSS 16.0. Results: The overall prevalence of HBsAg positivity was 1.39% (95% CI, 0.91% to 2.12%); 2.0% and 0.89% among men and women, respectively (p = 0.054). Infection was more prevalent in older (p = 0.019) and married persons (p = 0.001), Afghanis (p = 0.046), and those with a history of traditional cupping (p = 0.005). There was no association between HBV infection and gender; literacy; income; employment; family size; or history of blood transfusion, dental procedure, surgery, hospitalization, or tattooing. By logistic regression analysis, age was the only variable that had a significant association with infection (p = 0.026). Conclusion: It seems that the prevalence of HBV infection in Mashhad is slightly lower than that of the nation. [ABSTRACT FROM AUTHOR]