An important number of studies have been conducted on the potential association between human leukocyte antigen (HLA) genes and COVID-19 susceptibility and severity since the beginning of the pandemic. However, case–control and peptide-binding prediction methods tended to provide inconsistent conclusions on risk and protective HLA alleles, whereas some researchers suggested the importance of considering the overall capacity of an individual’s HLA Class I molecules to present SARS-CoV-2-derived peptides. To close the gap between these approaches, we explored the distributions of HLA-A, -B, -C, and -DRB1 1st-field alleles in 142 Iranian patients with COVID-19 and 143 ethnically matched healthy controls, and applied in silico predictions of bound viral peptides for each individual’s HLA molecules. Frequency comparison revealed the possible predisposing roles of HLA-A*03, B*35, and DRB1*16 alleles and the protective effect of HLA-A*32, B*58, B*55, and DRB1*14 alleles in the viral infection. None of these results remained significant after multiple testing corrections, except HLA-A*03, and no allele was associated with severity, either. Compared to peptide repertoires of individual HLA molecules that are more likely population-specific, the overall coverage of virus-derived peptides by one’s HLA Class I molecules seemed to be a more prominent factor associated with both COVID-19 susceptibility and severity, which was independent of affinity index and threshold chosen, especially for people under 60 years old. Our results highlight the effect of the binding capacity of different HLA Class I molecules as a whole, and the more essential role of HLA-A compared to HLA-B and -C genes in immune responses against SARS-CoV-2 infection.

Background:Previous studies have documented a high prevalence of hepatitis E among patients undergoing maintenance hemodialysis. Available studies reporting on the seroprevalence of hepatitis E in hemodialysis patients in Iran, an endemic region for the disease, are sparse.Objectives:The present study aimed to determine the prevalence rate of anti-hepatitis E antibody in hemodialysis patients in Hamadan, Iran.Patients and Methods:In this cross-sectional study, all 153 consecutive patients undergoing hemodialysis in two centers were enrolled. Patients’ demographic and clinical data were collected, using a standard questionnaire and from medical records. Serum immunoglobulin G concentrations against hepatitis E were determined using the enzyme linked immunosorbent assay method.Results:Thirty patients (19.2%), were seropositive. Seropositive patients were not significantly different from seronegative patients, with regard to age, sex, level of education, access to filtered water, and duration and frequency of hemodialysis. The proportions of patients with hepatitis B, C, and HIV infection were comparable between the two groups.Conclusions:One in five patients undergoing maintenance dialysis in Hamadan is seropositive for hepatitis E immunoglobulin G antibody. Future studies are needed to investigate the factors contributing to the observed high prevalence rate and the possibility of parenteral transmission of hepatitis E.

IL‐17is one of the most important inflammatory cytokines that stimulate immunity responses in humans infected with Brucella species, acting as a regulator that reduces release of γ‐IFN, thus increasing resistance to brucellosis. Gene polymorphisms in the regulatory regions of cytokine‐encoding genes affect the amountsof cytokines produced and play a fundamental role in infectious diseases. The aim of this study was to determine the association between IL‐17 gene polymorphisms and susceptibility to brucellosis. In this case‐control study, 86 patients with brucellosis and 86 healthy persons in Hamadan, western Iran, from September 2014 to September 2016, were included. IL‐17 genetic variants at positions rs4711998 A/G, rs8193036 C/T, rs3819024 A/G, rs2275913 A/G, rs3819025 A/G, rs8193038 A/G, rs3804513 A/T, rs1974226 A/G and rs3748067 A/G were analyzed by restriction fragment length polymorphism‐PCR. Serum IL‐17 titers were measured by sandwich ELISA. GG genotypes at positions rs4711998 and rs3748067 were present significantly more frequently in patients with brucellosis than in controls (P < 0.05). The AA genotype at positions rs4711998, rs2275913 and rs3748067 and GG genotype at position rs19744226 were present significantly more frequently in controls than in the patient group. These results suggest that the AA genotype at positions rs3748067, rs3819025 and rs4711998 and GG genotype at position rs3819024 are likely protective factors against brucellosis, whereas the GG genotype at positions rs3748067, rs3819025 and rs4711998 and AA genotype at position rs3819024 may be risk factors against the disease. No significant relationships were found between serum IL‐17 titers and genotypes of the single‐nucleotide polymorphisms.

Background: Hepatitis E virus (HEV) infection is a self-limited hepatitis and the most common cause of acute adult hepatitis in Asia. Young adults and middle-aged populations are more likely to be infected than other age groups. Objectives: The aim of this study was to determine the seroprevalence of anti-HEV among injection drug users (IDUs) compared to nonIDUs. Patients and Methods:This was a cross-sectional study performed on 131 IDUs referred to Farshchian Hospital, Hamadan, Iran and 131 nonIDUs selected from healthy visitors between March 2011 and March 2012. Anti-HEV IgG was measured in serum by ELISA method (DiaPro, Milan, Italy). Data including age, gender, education, location and duration of injection drug used were collected using a questionnaire. Results: In this study, the seroprevalence of hepatitis E virus antibody among IDUs group was 6.1%, and 1.5% among non-IDU group (Odds Ratio = 5.48; CI = 1/069-22/84), indicating that injection drug users were almost five and a half times more than non-IDUs at risk of HEV infection (P = 0.053). There was no significant association between seroprevalence of hepatitis E virus and education level (P = 0.46), duration of injection (P = 0.38) and location (P = 0.19). Conclusions: Seroprevalence of hepatitis E virus among IDUs group was higher than non-IDU group, which might be due to possible blood transmission of HEV among IDUs.

Introduction: Treatment failure in tuberculosis (defined as a positive sputum smear 5 months after the initiation of anti-TB treat-ment) is a major threat to the control over TB. This study aimed to investigate the association of smoking and drug abuse with treatment failure among individuals with TB. Material and methods: Out of 286 TB patients with available data registered by the health system of Hamadan Provinces in western Iran, 24 TB patients with treatment failure (positive sputum smear, 5 months after initiation of anti-TB treatment) and 262 patients without treatment failure (negative sputum smear, five months after initiation of anti-TB treatment) were selected as case and control groups, respectively. These two groups were compared to each other in terms of demographic status which include age, sex, job, residence, and risk factors such as smoking and drug abuse status. An odds ratio (OR) with a 95% confidence interval was used as a measure of association. The Bonferroni correction was used to counteract multiple comparisons, therefore, a p-value of less than 0.004 was statistically significant. Results: No significant association was found between treatment failure and age, residence, comorbidity, education level, job status, sex, smoking, and method of drug abuse (P > 0.004). However, a significant association was found between duration of smoking, number of cigarettes per day, and drug abuse with treatment failure in univariate analysis (P < 0.004). In multivariate analysis, only an association with drug abuse was significantly associated with treatment failure (P = 0.047). Conclusion: Drug abuse substantially increases the risk of treatment failure. Therefore, in order to control TB, it is suggested that preventive programs are designed in order to decrease drug abuse among TB patients before starting treatment.

Introduction Evaluation of cytokines such as interleukin‐4 (IL‐4) can be an important tool in examining immune responses to brucellosis. Also, determining the response rate to treatment is necessary for controlling and eradicating of disease. The review of previous studies reveals contradictory results that require further research in this regard. The aim of this study was to compare the serum level of IL‐4 in patients with brucellosis and healthy controls. Material and Methods In this descriptive‐analytical study for comparison of two groups, a total of 165 participants, including 83 patients with brucellosis and 82 non‐infected people, were evaluated after matching of sex and age in Hamadan (northwest of Iran) in 2017 and the serum level of IL‐4 was compared by ELISA method. The collected data were analyzed by SPSS software version 21 at 95% significant level. Results Mean of age in the case and control groups were 50.25 ± 16.01 and 43.26 ± 15.6 years, respectively. The serum levels of IL‐4 in the case and control groups were 1.42 ± 0.51 pg/mL and 1.31 ± 1.02 pg/mL, respectively. Based on the non‐parametric Mann‐Whitney test, the IL‐4 level was significantly higher in the case group, compared with the control ( P < .001), but no statistically significant relationship was found between serum levels of IL‐4 with age, sex, and serologic titers of Wright and 2ME. Conclusion In patients with brucellosis, the level of IL‐4 increases independently of the duration and severity of the disease, which indicates the role of this cytokine of immune system in this infectious disease.

Background Coronavirus disease 2019 (COVID-19) has spread widely throughout the world and become a pandemic disease. In this study we decided to investigate the chest computed tomography (CT) findings in COVID-19 patients in Hamadan, west of Iran. Methods This cross-sectional study was conducted on 101 patients with confirmed COVID-19 infection from February to March 2020. Demographic, clinical, laboratory and chest CT information of identified COVID-19 patients were assessed. Results Totally, 101 patients diagnosed with COVID-19 were included. The mean age of the patients was 55.21 ± 14.08 years and 54% (53.47%) of them were male. With regards to clinical manifestations, 82.18%, 72.28% and 54.46% of COVID-19 patients had dry cough, dyspnea and fever, respectively and 44.5% had lymphopenia. The right lower lobe was the most common (69%) and severe involved lobe followed by left lower lobe, right middle lobe, and lingual; however, anterior segment of upper lobes showed least involvement with abnormality in the late course of disease. The most common pattern is ground glass opacity, but atypical patterns such as round pneumonia, moderate to severe plural effusion and segmental lobar collapse consolidation was seen without evidence of mediastinal adenopathy, cavitation or nodule. Chest X ray (CXR) was not sensitive method as a first line imaging because 34.65% of them were normal. Conclusion CXR is not sensitive method as first line imaging too (34.65% normal first CXR), but Chest CT is very sensitive and nonspecific modality for diagnosis of COVID – 19. Lower lobe and posterior basal predominance involvements were seen in most cases. About 12% showed atypical chest CT features.

TB patients had a significantly higher serum L-selectin level, compared to the controls. Based on the findings, the incidence of TB and L-selectin polymorphism in the Phe206Leu gene had no significant association.