scholarly journals Immunoglobulin Sub-Typing and Quantification in Coombs Positive Hemolysis

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 19-20
Author(s):  
Thirosha Chetty ◽  
Nikki Bouwer ◽  
Yuen On Wan ◽  
Johnny Mahlangu
Keyword(s):  
Antibody Titre ◽  
False Positive ◽  
Intervention Strategy ◽  
Diagnostic Workup ◽  
Hiv Positive ◽  
Care Hospital ◽  
Coombs Test ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Positive Direct

Key words:immunoglobulin, coombs test, hemolysis, HIV, quantification Introduction A positive direct antiglobulin test (DAT, Coombs test) is valuable in identifying the etiology of autoimmune hemolysis and in guiding an immunomodulatory therapeutic intervention strategy. However, in HIV positive individuals with background polyclonal gammopathy, a false positive DAT is common. In this setting, immunoglobulin quantification and subtyping may be of value in characterizing the autoimmune hemolysis. There is paucity of published literature evaluating the diagnostic usefulness of IgG subtyping and quantification in HIV positive individuals who are investigated for possible autoimmune haemolysis (AIHA). The recently introduced gel card used for AIHA diagnosis can subtype and quantify the IgG antibody titre. This study evaluated the usefulness of IgG quantification and subtyping in the diagnostic workup of autoimmune hemolysis in patients who were DAT positive with and without HIV infection. Methods: This retrospective, cross sectional study was reviewed and approved by the institutional Ethics Committee. The study population included HIV positive and HIV negative patients who were investigated for autoimmune hemolysis in a quaternary care hospital as part of their diagnostic workup. Those with a positive DAT had their IgG subtyped and quantified using the ID -Card DAT IgG1/IgG3 and IgG-dilution cards (Bio-Rad©, Cressier, Switzerland). Results: From December 2019 to March 2020, 90 patients admitted in our hospital were investigated for AIHA. Forty four (49%) were found to be DAT positive. Of those who were DAT positive, 26 (59%) had biochemical evidence of haemolysis (raised LDH, raised unconjugated bilirubin). Of the total DAT positive population, 16 (36%) were HIV positive. Concurrent HIV and haemolysis was present in 8 patients. Four of the 8 had antibody titre≤1:30. Most patients had IgG 1 subtype. None of the HIV positive patients without features of haemolysis had IgG1 or IgG3 subtypes present and 2 of the 8 had antibody titres≤1:30. Conclusion: IgG quantification and subtyping was found to be of limited value in the diagnostic characterization of AIHA in HIV positive patients with false positive DAT. Disclosures Mahlangu: CSL Behring, Catalyst Biosciences, Freeline Therapeutics, Novo Nordisk, F. Hoffmann-La Roche Ltd, Sanofi, Spark and Takeda:Consultancy;CSL Behring, Catalyst Biosciences, Novo Nordisk, F. Hoffmann-La Roche Ltd, Sanofi, Spark and Takeda:Speakers Bureau;South Africa Medical Research Council, Wits Health Consortium, Colleges of Medicine of South Africa:Membership on an entity's Board of Directors or advisory committees;BioMarin, CSL Behring, Freeline Therapeutics, Novo Nordisk, Novartis, Pfizer, Sanofi, F. Hoffmann-La Roche Ltd, uniQure:Research Funding.

Immunoglobulin subtyping and quantification in direct antiglobulin test: positive haemolysis in an HIV-prevalent setting

2020 ◽  
pp. jclinpath-2020-207113
Author(s):  
Thirosha Chetty ◽  
Nikki Bouwer ◽  
Yuen On Wan ◽  
Johnny Mahlangu
Keyword(s):  
Cross Sectional Study ◽  
Hiv Positive ◽  
Care Hospital ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Antibody Titres ◽  
Diagnostic Usefulness ◽  
Polyclonal Gammopathy ◽  
Diagnostic Work ◽  
Positive Direct

AimsPositive direct antiglobulin tests (DATs) are valuable in identifying the aetiology of autoimmune haemolysis and in guiding therapeutic intervention. However, in HIV-positive individuals with background polyclonal gammopathy, a positive DAT in the absence of haemolysis is common. In this setting, IgG quantification and subtyping may be of value, as this is possible with the recently introduced gel cards. There is paucity of literature evaluating the diagnostic usefulness of IgG subtyping and quantification in HIV-positive individuals who are investigated for autoimmune haemolytic anaemia (AIHA). This study evaluated the usefulness of IgG quantification and subtyping in the diagnostic work-up of AIHA in patients with a positive DAT, with and without HIV infection.MethodsThis retrospective, cross-sectional study included patients investigated for AIHA in a quaternary care hospital. Those with a positive DAT had their IgG subtyped and quantified using the ID-Card DAT IgG1/IgG3 and IgG-dilution cards (Bio-Rad, Cressier, Switzerland).ResultsNinety patients admitted from December 2019 to March 2020 were investigated for AIHA. Forty-four (49%) patients had a positive DAT of whom 26 (59%) had evidence of haemolysis, and 16 (36%) were HIV positive. Concurrent HIV and haemolysis were present in eight patients, two of whom had IgG1 although none had an IgG antibody titre >1:30. None of the HIV-positive patients without features of haemolysis had IgG1/IgG3 or IgG antibody titres >1:30.ConclusionIn our clinical setting, IgG quantification and subtyping were found to be of limited value in the diagnostic characterisation of AIHA in HIV-positive patients with false-positive DAT.

scholarly journals Determination of ELISA reactive mumps IgG antibodies in MMR vaccine recipients in comparison with MMR vaccine naive children: A cross sectional study

2021 ◽  
Vol 52 (3) ◽  
pp. 174-180
Author(s):  
Riya Gupta ◽  
Naveen Saxena ◽  
Parul Gupta
Keyword(s):  
Antibody Titre ◽  
Effective Control ◽  
Healthy Children ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Mmr Vaccine ◽  
Igg Antibody ◽  
Cross Sectional ◽  
National Immunisation Programme ◽  
Mumps Vaccine

Background/Aim: Mumps is by vaccine preventable infectious disease characterised by parotitis. In India mumps vaccines are not currently used under National Immunisation Programme (NIP). Waning of vaccine-induced immunity is considered to play a central role in the re-emergence of mumps. The comprehensive data on the seroepidemiology of measles, mumps, and rubella (MMR) as well as studies which compare the antibody titre among mumps vaccine naiveand mumps vaccinated children are lacking. The aim of this study was to estimate and compare mumps specific antibody titre in children with and without MMR vaccine. Methods: In 2019/2020, blood samples were collected from 100 healthy children attending immunisation clinic in Government Medical College Kota and associated J K Lon Maternal and Child care hospital Kota. The samples were investigated for MMR IgG antibodies using ELISA. Results: Out of total 100 children included in the study, 32.27 % vaccinated and 4.83 % non-vaccinated children were positive for mumps IgG antibody in the age group of 6 months to 6 years of age. Children aged 6 to 12 years, vaccinated and non-vaccinated, had 31.57 % and 26.57 % positivity, respectively. The seroprevalence of measles, mumps and rubella antibodies among 50 MMR vaccinated children were 94 %, 64 %, and 96 %, respectively. A high measles and rubella seroprevalences were observed among all children age groups, suggesting an effective control program, while the mumps seroprevalence decreased significantly with age. Conclusion: The maximum vaccine effectiveness against mumps for 2 doses of MMR vaccine is ≈ 96 %. The herd immunity threshold to block mumps virus transmission is ≥ 86 %. In this study only 64 % of the vaccinated children were found to have IgG mumps antibodies. In view of morbidity following mumps infection there is a need to incorporate mumps vaccine along with measles and rubella vaccine in the NIP instead of Mr.

scholarly journals Neurocognitive dysfunction among HIV positive patients using International HIV dementia scale

2014 ◽  
Vol 5 (4) ◽  
pp. 61-64 ◽  
Author(s):  
Basavaprabhu Achappa ◽  
Shivani Priyadarshni ◽  
Deepak Madi ◽  
Unnikrishnan Bhaskaran ◽  
John T Ramapuram ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Care Hospital ◽  
Hiv Dementia ◽  
Cross Sectional ◽  
Asymptomatic Neurocognitive Impairment ◽  
Neurocognitive Dysfunction ◽  
Stage 1 ◽  
International Hiv Dementia Scale

Background: HIV associated neurocognitive dysfunction (HAND) ranges from asymptomatic neurocognitive impairment (ANI) to mild neurocognitive disorders (MND) to HIV associated dementia (HAD). Cognitive impairment may impact medication adherence which will ultimately affect morbidity and mortality. Aim: This study was undertaken to evaluate neurocognitive dysfunction among HIV positive patients using the International HIV Dementia scale(IHDS). Materials and Methods: This cross sectional study was conducted in a tertiary care hospital attached to a medical college that caters to a large number of HIV positive patients. The subjects for this study included HIV positive patients belonging to WHO stage 1 or 2. Data collection was done using a pre tested questionnaire. The International HIV Dementia scale(IHDS) was used to assess HAND. Results: Out of the 101 patients studied, 69(68.3%) were males and 32(31.7%) were females. Among these patients, 88 (87.1%) were receiving antiretroviral therapy (ART), 84 (83.2%) were in WHO stage 1. 91 (90.1%) patients had HAND. There were statistically significant differences in the gender and educational level between patients with or without HAND. As age advanced the percentage of patients having HAND also increased. Conclusion: There was high prevalence of HIV associated neurocognitive dysfunction among HIV positive individuals in our study. Also there was an increase in HIV associated neurocognitive dysfunction with increase in age. DOI: http://dx.doi.org/10.3126/ajms.v5i4.8724 Asian Journal of Medical Sciences 2014 Vol.5(4); 61-64

scholarly journals SCREENING OF PREGNANT WOMEN FOR PRESENCE OF IGG ANTIBODIES FOR RUBELLA, MUMPS, MEASLES AND VARICELLA VIRUSES IN TERTIARY CARE HOSPITAL , JAIPUR

2019 ◽  
pp. 1-6
Author(s):  
Seema Malav ◽  
Bharti Malhotr
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Immunosorbant Assay ◽  
Child Bearing ◽  
Education Status ◽  
Enzyme Linked Immunosorbant Assay

Background : The aim of this study were assess the susceptible pregnant women for vaccine preventable infection like rubella, mumps, measles and varicella viruses. Infection of mothers with these viruses during pregnancy can be serious. They can cause congenital infections, miscarriage, stillbirth and death of fetuses. Material and Method : This study is cross sectional. To determine the presence of IgG antibodies for rubella, mumps, measles and varicella viruses, blood samples were collected, stored at -700 c. Serum was separated for detection of IgG antibodies for these viruses by using enzyme linked immunosorbant assay. Results : Of 277 samples evaluated for IgG antibodies. Susceptibility Of pregnant women for rubella, mumps measles and varicella viruses were 7.6%, 17.6%,7.2% and 19.5% respectively. Susceptibility rates for rubella and mumps were higher in rural population as compares to urban while for varicella urban population was more susceptible, but it was not statistically signicant. No correlation could be observed in susceptibility to different to different viruses and their education status and age of patients, but youngest age group was most susceptible to varicella and oldest group to rubella. Primigravida were more susceptible to rubella and varicella while multigravida were more susceptible to mumps and measles. Conclusion : Majority of the pregnant women had protective levels of IgG antibody although susceptibility to rubella, mumps measles and varicella were low. Intensication of MMRV immunization of all females of child-bearing age is advocated.

scholarly journals A Cross-sectional Serological Study for Measles among Italian Medical Students in 2020

2020 ◽  
Vol 13 (1) ◽  
pp. 692-695
Author(s):  
Trabucco Aurilio Marco ◽  
I Iannuzzi ◽  
L Di Giampaolo ◽  
A Pietroiusti ◽  
C Ferrari ◽  
...  
Keyword(s):  
Medical Students ◽  
Antibody Titre ◽  
Vaccine Coverage ◽  
Health Concern ◽  
Age Group ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Care Workers ◽  
Protective Antibodies ◽  
Antibody Levels

Background: Measles is an infectious disease and a major health concern worldwide. Among individuals with a higher risk of exposure to measles, there are the Health Care Workers (HCWs), who may transmit the virus to other people. According to the Italian National Plan for Immunization and Prevention, all HCWs should have presumptive evidence of immunity to measles (documented two doses of MMR vaccination) or serological evidence of protective antibodies. Aim: The study aims to evaluate the immunological status, the vaccine coverage, and the protective IgG antibody titre for measles in medical students of the teaching hospital PoliclinicoTor Vergata (PTV). Methods: IgG measles antibodies titre was evaluated in a sample of 461 medical students undergoing annual health surveillance visits from January 1st to May 31th, 2020. Results: 73.7% of medical students showed protective measles IgG antibody levels. The immunization rate was higher among subjects aged less than 25 years with respect to students aged over 25 years (77.4% vs. 66.4%; P <0,001). Furthermore, average antibody titre showed a statistically significant association with the age group (124,2 AU/ml for the age group 18-25 and 133,2 AU/ml among subjects aged 25 or more; P<0.001). Conclusion: Our study shows a non-protective measles IgG antibody titre, especially among the older students. Therefore, it is essential to evaluate the serological levels, to vaccinate those subjects whose antibody level is not adequate, and promote the vaccination even in the general population.

SEROPREVALENCE OF HIV, HBV, AND HCV AMONG INDIVIDUALS ATTENDING ICTC OF A TERTIARY CARE HOSPITAL IN NORTHERN INDIA.

2021 ◽  
pp. 14-16
Author(s):  
Seema Aleem ◽  
Anjum Farhana ◽  
Humaira Bashir
Keyword(s):  
Tertiary Care ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Hcv Rna ◽  
Care Hospital ◽  
Cross Sectional ◽  
Treatment Services ◽  
Northern India ◽  
Relevant Variables ◽  
Hcv Coinfection

Introduction: Hepatitis B and Hepatitis C share common transmission routes with HIV and coinfection with either can lead to adverse clinical outcomes in patients. This study planned to estimate confections with HBV and HCV among HIV positive subjects at a single Integrated Testing and Counselling Center (ICTC) in Kashmir valley. Methods: The study employed a cross-sectional study design from 2017 to 2019. After pretest counselling all subjects underwent HIV testing as per National AIDS Control guidelines. HIV positive subjects were included in this study. Samples of HIV positive subjects were then tested for HBV by ELISA detecting HbsAg whereas HCV was diagnosed by Anti HCV antibodies and HCV-RNA. Data was entered in excel and analyzed using SPSS. Means and percentages were calculated for relevant variables. Results:Atotal of 20070 subjects were tested during the study period of which 34 (0.169%) were HIVpositive. Around 60% positive subjects were males. Co-infection with HBV was detected in 11.7% subjects whereas 8.8% had an HCV coinfection. One subject had coinfection with both HBV and HCV. There was no signicant association of coinfection with gender or age Conclusion:Considering the adverse impact of coinfection on disease course and outcome, screening for HBVand HCVshould be a component in diagnostic workup of all HIVpositive subjects followed by linkage with specialized treatment services

scholarly journals CROSS-REACTIVITY OF COVID-19 IGG ASSAY WITH KNOWN IMMUNE-MEDIATED AND INFECTIOUS DISORDERS

2021 ◽  
Vol 71 (6) ◽  
pp. 2053-56
Author(s):  
Nayab Zehra ◽  
Muhammad Dilawar Khan ◽  
Hijab Batool ◽  
Omar Rasheed Chughtai ◽  
Akhtar Sohail Chughtai ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
False Positive ◽  
Clinical Laboratory ◽  
Cross Reactivity ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Varicella Zoster ◽  
Barr Virus ◽  
Immune Mediated ◽  
Epstein Barr

Objective: To assess the cross-reactivity of COVID-19 IgG assay with known immune-mediated and infectious disorders and evaluate for any false-positive reactions to determine the specificity of the serological assay. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Chemical Pathology, Chughtai Institute of Pathology, Lahore Pakistan, from Sep to Oct 2020. Methodology: A total of 116 samples were included in the study of both males and females. Diagnosed cases of typhoid fever, viral hepatitis, systemic lupus erythematosus (SLE), syphilis, multiple connective tissue disorders (MCTD), varicella-zoster infection, rabies, toxoplasmosis, epstein-barr virus (EBV) infection, rubella, rheumatoid arthritis, AIDS, cytomegalovirus (CMV) infection and dengue fever were included in the study. Three samples of multiparous women aged more than 40 years were also included in the study. IgG antibody levels were measured against SARS-CoV-2 with a cut-off index of 1.4. Results: Out of 116, only 3 (2%) samples were reactive for IgG against SARS-CoV-2. The categories showing cross-reactivity were typhoid, hepatitis C, and CMV. All specimens showing cross-reactivity were of females. Assay under consideration showed a specificity of 97.4%. Conclusion: Cross-reactivity was seen in pre-pandemic cases of infectious diseases with COVID-19 IgG antibody assay. Medical lab professionals must verify the serological assays before use in the clinical laboratory to avoid false-positive results.

Sero-molecular evaluation of Toxoplasma gondii infection among HIV-positive patients

2019 ◽  
Vol 113 (12) ◽  
pp. 771-775 ◽  
Author(s):  
Ehsan Ahmadpour ◽  
Reza Pishkarie-Asl ◽  
Adel Spotin ◽  
Hossein Samadi Kafil ◽  
Hasan Didarlu ◽  
...  
Keyword(s):  
Toxoplasma Gondii ◽  
Mortality Rate ◽  
Hiv Positive ◽  
Igg Antibodies ◽  
Rt Pcr ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Igm Antibodies ◽  
Northwest Iran ◽  
Toxoplasma Gondii Infection

Abstract Background Toxoplasmosis is one of the most common comorbidities in HIV-positive patients with CD4+ T lymphocytes below 200 cells/μl. Early diagnosis and treatment of toxoplasmosis reduces the mortality rate in HIV-positive people. The aim of this study was to estimate the seroprevalence of Toxoplasma gondii infection in HIV-positive patients in northwest Iran using serological and molecular methods. Methods This prospective cross-sectional study included 124 HIV-positive outpatients and was conducted from January to May 2016. Anti-T. gondii IgM and IgG antibodies were detected from sera samples by chemiluminescence, while buffy coat samples were analyzed by RT-PCR for DNA detection. Patients’ socioepidemiological data were collected. Results Using chemiluminescence, 47/124 samples (37.9%) were positive for anti-Toxoplasma IgG antibodies, 2/124 samples (1.62%) were positive for IgM antibodies while 2/124 samples (1.62%) contained both IgM and IgG. There were no IgM-positive or IgG-negative patients. RT-PCR revealed four (3.22%) positive samples. On the basis of the results, a statistically significant relationship was found between anti-Toxoplasma IgG antibody seropositivity and residence (p=0.012). Conclusions The study showed a relatively low seroprevalence of anti-T. gondii IgG and IgM antibodies in HIV-positive patients in northwest Iran, while the prevalence was much higher in other regions of Iran. However, regular screening for T. gondii antibodies and early initiation of therapy are very important to decrease the mortality rate in HIV-positive patients.

scholarly journals Spectrum of disease in HIV-positive patients presenting to a tertiary care hospital: a retrospective, cross-sectional review in Kumasi, Ghana

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Richard Odame Phillips ◽  
Alexis Steinmetz ◽  
Justin Nichols ◽  
Emmanuel Adomako ◽  
Emmanuel Ofori ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Hiv Positive ◽  
Care Hospital ◽  
Cross Sectional

scholarly journals PROTEINURIA IN HIV POSITIVE PATIENTS;

2012 ◽  
Vol 19 (06) ◽  
pp. 816-821
Author(s):  
SYED ZEA-UL-ISLAM FARRUKH ◽  
Muhammad AURANGZEB ◽  
MUHAMMAD TANVEER ALAM ◽  
KHALID Imran ◽  
Muhammad Rehan ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hiv Positive ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Urine Dipstick ◽  
High Prevalence ◽  
Male Preponderance ◽  
Medical Wards

objective: To determine the frequency of proteinuria in HIV positive patients at a tertiary care hospital in Karachi. Studydesign: Cross-sectional. Place and duration of study: This study was carried out in Infectious diseases wards and all medical wards of CivilHospital Karachi, from Jan 2011 to the Dec 2011. Methodology: A total of 170 patients from infection diseases wards and all medical wards ofCivil Hospital Karachi. Age more >12 years of either sex who were newly diagnosed cases of HIV based on positive HIV serology by ELISA andWestern blot in Infection diseases ward were Included. Patients having known kidney disease. urinary tract infection, serum creatinine morethan 1.5 mg/dl, diabetes mellitus, high blood pressure and old diagnosed cases of HIV who have already taken or who are taking HIV infectiontreatment were excluded from this study. Spot urinary sample was taken to measure the proteinuria by urine dipstick. To minimize bias allspecimen sent to same laboratory of the hospital. Results: 170 newly diagnosed cases of HIV were included in this study. Gender distributionshowed male preponderance (Male: Female = 6.4:1). Majority of cases 120 (70.6%) had age between 26 – 50 years. Mean age of women was30.3 ±7.4 years (min – max = 18 – 45 years) and for males was 34.3 ±9.6 years (min – max = 15 – 56 years). Out of 170 HIV positive casesfrequency of > 1+ protein in urine on urine dipstick analysis was found in 27 (15.9%) cases. Out 27 cases, 16 (59.3%) cases had age between26-50 years (mean ±SD = 32 ±10.1 years, min – max = 18 – 55 years). Proteinuria was high in increasing age groups. Proportion of proteinuriawas high in married and depressed patients , out of 27 cases, 18 (66.7%) were married and 9 (33.3%) unmarried. Frequency of proteinuria washigh in labor class, 11 of 27 (40.7%) were labors followed by house wife 6 (22.3%), while 5 (18.5%) were private job holder. Conclusions: In thisstudy I found a high prevalence of proteinuria in HIV positive patients. Such subjects show male preponderance distribution. We conclude thatHIV positive patients should be screened for proteinuria and if they found to have proteinuria, they should be subjected to appropriate treatmentto retard the progression of nephropathy and associated complications.

Sign in / Sign up

Export Citation Format

Share Document