Our aim was to investigate the association between chronic hepatitis C virus (HCV) infection and B cell non-Hodgkin lymphoma (NHL) in the Greek population. We studied 120 patients (70 men and 50 women, mean age 59 years) diagnosed with NHL. One hundred and eight had B cell NHL (90%) and 12 had T cell NHL (10%). The presence of anti-HCV antibodies in patients and controls was investigated using the monoclonal enzymatic immunoassay (MEIA) method. The detection of HCV RNA and hepatitis G virus (HGV) RNA in patients with B cell NHL and anti-HCV-positive controls was performed using an RT-PCR technique. Anti-HCV antibodies were present in only 2 of the 108 patients with B cell NHL (1.9%), while the prevalence of HCV infection in the healthy population was 0.6%, and in patients with various solid tumors treated with chemotherapy, it was 0.99%. Ten of the 108 B cell NHL patients (9.26%) were diagnosed as HGV RNA positive, while the prevalence of HGV infection in 285 Greek blood donors was 0.7%. Our findings do not confirm a strong association between HCV infection and B cell NHL for Greek patients. The increased prevalence of HGV infection detected in patients with NHL could imply the potential participation of HGV in the pathogenesis of NHL.

The effects of mild physical training on the cellmediated and humoral immune responses were studied in 18 patients with end-stage renal disease (6.5±5.2 years on hemodialysis) participating in a six month exercise renal rehabilitation program. They were matched with 14 untrained patients for sex, age, years on hemodialysis and causes of renal disease. Serum immunoglobulins (IgA, IgM, IgG), IgG subclasses (IgG 1 , IgG 2 , IgG 3 , IgG 4 ), complement components (C 3 , C 4 ), interleukins IL-2, IL-4, IL-6, subpopulations of T lymphocytes and panel reactive lymphocytotoxic antibodies were determined on all patients. By the end of the study, peak aerobic capacity (VO 2 peak) was significantly improved by 42% in the trained group. This improvement was followed by a non-significant increase in IgE (by 13.8%) and in IgM (by 3%) and a decrease in IgA (by 17.5%, p<0.05), while the IgG levels remained constant. In the control group, there was no change in the levels of immunoglobulins. The values of interleukins, IgG subclasses, complement, lymphocytotoxic antibodies and T lymphocyte subsets remained almost unchanged in both groups. Finally, during the study, common upper respiratory infections were more often in the controls (58%), than in the trained patients (31%). The results suggest that physical training improves clinically the immune defense mechanisms in hemodialysis patients, although it does not significantly change cell-mediated and humoral immune responses.

The aim of the present study was: (a) to assess the effect of HBsAg on the survival of both renal grafts and patients, and (b) to determine the outcome of HBV chronic infection after renal transplantation. Fourteen patients seropositive for HBsAg but asymptomatic before renal transplantation (group A) were included in the study. The results were compared to those of 14 transplanted patients (group B) seronegative for HBsAg with similar age and immunosuppressive treatment. Four patients received a graft from a living-related donor and 10 patients from a cadaver donor in each group. Eight of 14 patients of group A showed, after renal transplantation, chronic hepatitis, which was not observed in any of the group B patients (p < 0.01). The rate of acute rejection episodes was significantly greater (p < 0.05) in group B than in group A. The graft survival was found to be similar in both groups at the 1st year, but significantly less (p < 0.01) in group B than in group A at the 5th year after transplantation. The survival of patients was found to be significantly less in group A than in group B at the 1st (p < 0.05) and 5th years (p < 0.0l) after transplantation. In 2 patients of group A and 1 of group B anti-HCV was found, while HDAg plus anti-HD was found in 1 patient of group B. The HBV-DNA was found in 4 of 8 alive patients of group A. It is suggested that HBsAg after renal transplantation is associated with the reduction of patient survival, despite the reduction of acute rejection episodes and better renal graft survival.

Since influenza increases the mortality of chronically ill patients we decided to study the effectiveness of influenza vaccination in hemodialysis (HD) patients. Nineteen HD patients aged from 20 to 60 years, on unrestricted diet and with no febrile episode, were studied. Blood samples were collected before the intramuscular injection of 0.5 mL multivalent influenza vaccine (Inflexal Berna) and every 2 weeks thereafter. At the end of 4th week a second vaccination was done and a dosage of 200 mg of zinc acetate (60 mg elemental zinc) was given daily to each patient for at least 4 weeks. Before vaccination the antibody titers to influenza virus ranged from 1:10 to 1:80 and after vaccination from 1:20 to 1:640. Four weeks after vaccination 6/19 (31.5%), 8/19 (42%), and 10/19 (52.5%) patients showed a fourfold or greater increase at serum antibody titers to antigens A/Singapore, A/Sichuan, and B/Beijing, respectively. The zinc supplementation after the second vaccination induced a similar increase of serum antibody titers to the A/Singapore but some even greater increase of the antibody titers to the A/Sichuan and B/Beijing. Serum immunoglobulins and complement components C3/C4 were not changed during this study. It is suggested that about 50% of uremic patients respond to the influenza vaccination and that zinc treatment does not increase this responsiveness.

Disturbances in testicular function develop in uraemic patients, but the effect of haemodialysis on them has not been determined definitively. Because of this, 22 patients with chronic renal failure who were receiving regular dialysis treatment underwent studies of the hypothalamo-pituitary-testicular axis before, during and after a dialysis. On all these occasions, serum testosterone concentrations were lower than the values found in 26 normal men. In contrast, serum concentrations of FSH and LH were higher than normal. 13 of these patients showed a normal response of the hypothalamo-pituitary system to the clomiphene stimulation test and a diminished response of Leydig’s cells to the human chorionic gonadotropin stimulation test. It is concluded that haemodialysis does not affect the impaired gonadal function of male uraemic patients.