Iron overload is reported to be associated with immune alterations and increased susceptibility to infections. HIV infection is characterized by progressive immunodeficiency leading to invasion by opportunistic pathogens. It was of interest to find out if disease course in HIV type-1 infection could have any relation with alteration in body iron status among individuals with history of oral iron intake. A follow-up study of immunologic and virologic markers in relation to disease progression was undertaken on asymptomatic HIV-1 positive blood donors with history of oral iron intake (subgroup I) compared to those without such history (subgroup II). High serum iron was associated with elevated levels of Th 2 category of cytokines, heightened immune activation, faster decline in CD4 + T lymphocyte count and higher viral set point. Pulmonary tuberculosis (PT) was the most common AIDS related illness (ARI) (>70%) recorded among subgroup I compared to non-PT category of ARI. Median ARI free duration (months) was shorter among those who developed PT compared to those developing non-PT category of ARI i.e. 30 (95% CI as 26,32) versus 67(95% CI as 60,71) in subgroup I and 47 (95% CI as 42,49) versus 80 (95% CI as 72,87) in subgroup II (P < 0.001 for PT versus non-PT in both subgroups). Median survival duration (months) in the PT versus non-PT categories of ARI was 47 (95% CI as 42,48) versus 95 (95% CI as 90,100) in subgroup I and 71 (95% CI as 65,76) versus 107 (95% CI as 102,112) in subgroup II (P < 0.001 for PT versus non-PT in both subgroups). The present study indicates that body iron overload resulting from excess intake of iron may be associated with qualitative defects in cell mediated im-

Increasing faecal carriage rate of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli (ESBL-EC) and Klebsiella pneumoniae (ESBL-KP) among livestock is responsible for abundance of these bacteria in livestock manure which is being extensively used as organic fertilizer in developing countries including India. Use of this manure can be a potential source for spread of these microorganisms to the human community, posing a serious public health threat especially, to manure handlers. There is paucity of data regarding the possible contamination of environment through use of livestock manure from rural India. Analysis of a total of 1080 manure sample pools from different segments of 40 manure heaps each year during the three years period (2015 to 2017) showed a total of 491(45.5%) E. coli and 85 (7.9%) K. pneumoniae to be detected as ESBL producers by double disc synergy test and 3 (0.6%) ESBL-EC and 3 (3.5%) ESBL-KP as carbapenemase producers by CarbaNP test. Among the ESBL producers, 436 (88.8%) ESBL-EC and 59 (69.4%) ESBL-KP were found to harbour bla CTX-M genes by PCR. The present study showed an alarmingly high prevalence of ESBL production and emerging evidence of carbapenemase production among E. coli and K. pneumoniae isolates in the manure samples from rural North India. The antibiotic resistance pattern of the ESBL producing isolates revealed high degree of co-resistance to cephalosporin and non-cephalosporin group of antibiotics.

Both HIV-1 infection and iron overload are independently associated with infection by Mycobacterium tuberculosis due to impaired macrophage function. A prospective study of in vitro assessment of macrophage function was undertaken in a group of asymptomatic HIV-1 infected remunerated (professional) blood donors with (n = 54) or without (n = 54) prevalent practice of oral iron intake (subgroups I and II respectively). The assessment was carried out at enrolment as well as at the point of development of AIDS related illness (ARI). The subgroup I showed higher levels of pro-inflammatory cytokines viz. IL-1β, IL-6 and IL-8 in serum, but lowered levels of IL-12p70 in serum as well as in supernatant of monocyte derived macrophage (MDM) cultures both at enrolment and at the point of development of ARI in the subset of cases that developed pulmonary tuberculosis (PT) on follow up compared to the subset that developed categories of ARI other than pulmonary tuberculosis (non-PT) on follow up. The subgroup II of HIV-1 positive donors did not show any such alterations at enrolment or at the point of development of PT or non-PT categories of ARI on follow up. There was significant depression of nitrite level in serum as well as that produced by MDM culture at enrolment in subgroup I regardless of category of ARI developed on follow up while in subgroup II there was significant elevation in these levels at enrolment, more among cases developing PT than those developing non-PT category of ARI. The subgroup I demonstrated increased production of superoxide at enrolment. The present study suggested that depressed production of nitrite and IL-12p70 by macrophages induced by iron overload may be responsible for greater susceptibility of HIV-1 positive donors to M. tuberculosis while superoxide may be a less powerful anti-mycobacterial tool. How to cite this paper: Chattopadhya, D.

The present study was taken up to evaluate the pattern of disease progression and survival in a group of HIV-1 positive children, coinfected with HCV infection (n=25) in comparison to those without such coinfection (n=23). There was a significant negative correlation between the rate of decline of the CD4 + T cell percentage and the duration of the AIDS-free interval in most (80.0 per cent) of the HCV seropositive children showing such decline (r=-0.588; p=0.005). The HCV seropositive children had twofold higher risk of progression to development of AIDS than HCV seronegatives (RR=2.51; 95 per cent CI:1.34-4.69; p=0.004). There was a significant negative correlation between the rate of decline of CD4 + T cell percentage and overall survival duration for HCV seropositive group (r=-0.609; p=0.003). Moreover, children coinfected with HCV had more than twofold higher risks of death than those without HCV (RR=2.39; 95 per cent CI:1.17-4.89; p<0.01). It appears that HCV infection may be an important contributor to the rapid disease progression and increase in mortality in HCV-HIV-1 coinfected children of thalassemia major.

Introduction: During dengue infection, cytokine levels may increase as various cytokines are released from infected inflammatory cells. This study was conducted to measure the levels of cytokines IL-8 and IL-10 in dengue patients and correlate them with dengue severity. Material & Methods: A prospective study was conducted on febrile patients suspected of dengue fever, seeking medical care in our institute. 107 cases confirmed to have dengue fever (by NS1/ IgM ELISA) and 100 healthy individuals with age and sex matched, were included in the study. The clinical features of all patients were recorded, and cytokine levels of IL-8 and IL-10 were estimated by ELISA in the dengue patients and healthy controls. Results: Out of 400 febrile patients suspected of having dengue fever, 107 (26.75%) cases were confirmed cases, of which 56 (52.3%), 20 (18.7%), and 31 (29%) were positive for only NS1 antigen, only IgM antibody, and both NS1 and IgM, respectively. Depending on the severity of the disease, 9 (8.5%) cases were classified as severe dengue cases while 98 (91.5%) as non-severe dengue fever. Mean levels (pg/ml) for IL-8 were 281.6 ± 76.6, 150.41 ± 55.9 and 75.4 ± 49.2 in severe dengue, dengue fever, and healthy controls respectively while for IL-10, the values were 219.4 ± 150.5, 38.9 ± 67.2, and 6.6 ± 0.65 among severe dengue cases, dengue cases, and healthy controls, respectively. Conclusion: Mean level of cytokines IL-8 and IL-10 were significantly raised in severe dengue patients as compared to non-severe dengue patients and healthy controls, suggesting their role in causing severe disease and as a potential predictor for disease severity and fatal outcome.