Brucella Infection in HIV Infected Patients
AbstractThe purpose of this study was to assess the possible correlation between Brucella and HIV infections. Iran is a country where HIV infection is expanding and Brucellosis is prevalent. In the present study, 184 HIV infected patients were assigned and for all of them HIV infection was confirmed by western blot test. In order to identify the prevalence rate of Brucella infection and systemic brucellosis in these subjects, sera samples were obtained and Brucella specific serological tests were performed to reveal antibody titers. Detailed history was taken and physical examination was carried out for all of patients. 11 (6%) subjects had high titers but only 3 of them were symptomatic. Most of these subjects were injection drug user (IDU) men and one was a rural woman. Considering both prevalence rates of Brucella infection (3%) and symptomatic brucellosis (0.1%) in Iran, our HIV positive patients show higher rates of Brucella infection and systemic brucellosis. Preserved cellular immunity of participants and retention of granulocytes activity may explain this poor association; whereas other explanations such as immunological state difference and non-overlapping geographical distribution of the 2 pathogens have been mentioned by various authors.
Rafiei A, Ardestani SK, Kariminia A, Keyhani A, Mohraz M, Amirkhani A. Dominant Th1 cytokine production in early onset of human brucellosis followed by switching towards Th2 along prolongation of disease. J Infect 2006;53(5):315-24.
Pappas G, Akritidis N, Tsianos E. Effective treatments in the management of brucellosis. Expert Opin Pharmacother 2005;6(2):201-9.
Ghaffarpour M, Khoshroo A, Harirchian MH, Siakroudi H, Pourmahmoodian H, Jafari S. Clinical, Epidemiological, Laboratory and imaging aspects of brucellosis with and without neurological involvement. Acta Med Iran 2007;45(1):63-8.
Carpenter CC, Flanigan TP, Lederman M. HIV Infection and Acquired Immunodeficiency Syndrome (AIDS). In: Andreoli TE, Carpenter CC, Griggs RC, Loscalzo J, editors. Cecil Essentials of Medicine. 6th ed. Philadelphia: WB Saunders; 2004. p. 917.
Fauci AS, Lane HC. Human immunodeficiency virus disease: AIDS and related disorders. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrisons Principles of Internal Medicine. 16th ed. New York, NY: McGraw-Hill; 2005. p. 1183-5.
Pantaleo G, Graziosi C, Fauci AS. New concepts in the immunopathogenesis of human immunodeficiency virus infection. N Engl J Med 1993;328(5):327-35.
Batchelor BI, Brindle RJ, Gilks GF, Selkon JB. Biochemical mis-identification of Brucella melitensis and subsequent laboratory-acquired infections. J Hosp Infect 1992;22(2):159-62.
Moreno S, Ariza J, Espinosa FJ, Podzamczer D, Miró JM, Rivero A, Rodríguez-Zapata M, Arrizabalaga J, Mateos R, Herrero F. Brucellosis in patients infected with the human immunodeficiency virus. Eur J Clin Microbiol Infect Dis 1998;17(5):319-26.
Paul J, Gilks C, Batchelor B, Ojoo J, Amir M, Selkon JB. Serological responses to brucellosis in HIV-seropositive patients. Trans R Soc Trop Med Hyg 1995;89(2):228-30.
Raziuddin S, Bilal N, Benjamin B. Transient T-cell abnormality in a selective IgM-immunodeficient patient with Brucella infection. Clin Immunol Immunopathol 1988;46(3):360-7.
Rubio Gutiérrez A, Portu Zapirain J, Zubizarreta García J, Ayensa Dean C. Brucella abortus meningitis in a patient with HIV infection. Med Clin (Barc) 1992;99(17):678.
Oksenhendler E, Morinière B, Rouveix E. Brucellosis in hairy cell leukaemia. Trans R Soc Trop Med Hyg 1988;82(2):336.
Sarguna P, Bilolikar AK, Rao A, Mathur DR. Brucellosis in association with HIV infection- a case report. Indian J Med Microbiol 2002;20(4):221-2.
Pedro-Botet J, Coll J, Auguet T, Rubiés-Prat J. Brucellosis and HIV infection: a casual association? AIDS 1992;6(9):1039-40.
Ibarra V, Blanco JR, Metola L, Oteo JA. Relapsing brucellosis in a patient infected with the human immunodeficiency virus (HIV). Clin Microbiol Infect 2003;9(12):1259-60.
Alsubaie S, Almuneef M, Alshaalan M, Balkhy H, Albanyan E, Alola S, Alotaibi B, Memish ZA. Acute brucellosis in Saudi families: relationship between brucella serology and clinical symptoms. Int J Infect Dis 2005;9(4):218-24.
Karp CL, Neva FA. Tropical infectious diseases in human immunodeficiency virus-infected patients. Clin Infect Dis 1999;28(5):947-63; quiz 964-5.
Abdollahi A, Morteza A, Khalilzadeh O, Rasoulinejad M. Brucellosis serology in HIV-infected patients. Int J Infect Dis 2010;14(10):e904-6.
Rasouli M, Kiany S. Association of interferon-gamma and interleukin-4 gene polymorphisms with susceptibility to brucellosis in Iranian patients. Cytokine 2007;38(1):49-53.
Araya LN, Elzer PH, Rowe GE, Enright FM, Winter AJ. Temporal development of protective cell-mediated and humoral immunity in BALB/c mice infected with Brucella abortus. J Immunol 1989;143(10):3330-7.
Serre A, Bascoul S, Vendrell JP, Cannat A. Human immune response to Brucella infection. Ann Inst Pasteur Microbiol 1987;138(1):113-7.
Zaknun JJ, Zangerle R, Gabriel M, Virgolini I. 18FDGPET for monitoring disease activity in an HIV-1 positive patient with disseminated chronic osteomyelitic brucellosis due to Brucella melitensis. Eur J Nucl Med Mol Imaging 2005;32(5):630.
Gür A, Geyik MF, Dikici B, Nas K, Cevik R, Sarac J, Hosoglu S. Complications of brucellosis in different age groups: a study of 283 cases in southeastern Anatolia of Turkey. Yonsei Med J 2003;44(1):33-44.
Geyik MF, Gür A, Nas K, Cevik R, Saraç J, Dikici B, Ayaz C. Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly 2002;132(7-8):98-105.
Andriopoulos P, Tsironi M, Deftereos S, Aessopos A, Assimakopoulos G. Acute brucellosis: presentation, diagnosis, and treatment of 144 cases. Int J Infect Dis 2007;11(1):52-7.