No abstract

Objective HHV-6 is increasingly recognized as febrile agent in children, however, less is known in sub-Saharan African countries. In here, we aimed to investigate the involvement of HHV-6 in pediatric CNS infections in Khartoum, Sudan. This report is part of a larger study on the microbial aetiologies of CNS infections in this population. Results Out of 503, 13 (2.6%) CSF specimens were positive for HHV-6 DNA which constituted 33% (13/40) of cases with proven infectious meningitis. Median Ct for all HHV-6 positive specimens was 38 with range of 31.9 to 40.8. Median virus copy was 281.3/PCR run (1x105 virus copies/ml CSF) with range of 30 to 44x103 copies/PCR run (12x103 and 18x106 virus copies/ml CSF). All positive patients presented with fever, vomiting and 86% with seizures. Male to female ratio was 1:1; 50% were toddlers, 42% infants and 8% teenagers. Most (83%) were admitted in the dry season and 17% in the rainy season. CSF leukocytosis was seen in 33%. Normal and low CSF glucose levels were seen in 86% and 14%, respectively. CSF proteins levels were low in 14% and high in 43%. In conclusion, HHV-6 is common in CNS infections in children in Sudan.

Human Leucocyte Antigens (HLA) class II appears to play an important role in the individual's immune response to viral infection. The present study was aimed at assessment of the relationship between HLA DRB1 alleles and the response to HCV combined therapy in Chronic Hepatitis C patients (CHC). We enrolled a total of 44 chronically infected HCV patients without Hepatitis B Virus (HBV) or Human Immunodeficiency Virus (HIV). Their mean age was 36.45±11.18 years (21-63). HLA-DRB1 typing was done by real time Polymerase Chain Reaction (PCR). ALT and Hemoglobin (Hb) levels were assessed as well as viral genotype was taken from patients' reports (HCV genotypes were 1, 2, 3 and 4 representing 13.6, 13.6, 4.5 and 68.18%, respectively). The most frequent alleles demonstrated among patients were DRB1*13 and DRB1*07 (31.8 and 36.4%, respectively). Analysis of DRB1 frequency between sustained responders and non responders revealed that DRB1*13 allele was significantly higher among sustained responders (p<0.001), while DRB1*07 allele was significantly higher among non responders (p<0.01). Female sex, HCV genotype 2 and pretreatment low serum HCV RNA level were associated with Sustained Virological Response (SVR). Also, elevated Alanine aminotransferase (ALT) level at the 1st week of therapy followed by return to baseline level at the 4th week and a decrease of the mean hemoglobin concentration at 4th week and 12th week of therapy were significantly associated with SVR. We concluded that the virological and special HLA patterns may possibly predict the response to combination therapy in CHC patients.