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Biomedical subjects

R Sher

Publications and source records attributed to R Sher.

At least 19 recordsLinked to original sources
PubMed1990

Transfusion-related human immunodeficiency virus in patients with haemophilia in Johannesburg.

Tests were carried out on 198 patients with inherited coagulation disorders attending haemophilia clinics of Johannesburg and Baragwanath Hospitals for the prevalence of antibodies to the human immunodeficiency virus (HIV). This cohort of patients has been treated with locally produced (South African) blood products from volunteer donors, except for a 15-month period in 1982-1984 when, owing to a shortage of locally produced material, an imported large donor-pool US factor VIII concentrate was used. Not all patients received this material. Of the haemophilia A patients who received the imported factor VIII concentrate, 85% were seropositive, while only 3% of the patients who received locally produced small donor-pool products were seropositive. No factor VIII-deficient patients have seroconverted while using small donor-pool products, since the introduction of routine screening of blood donations and strict exclusion criteria of donors. However, despite testing of blood products, 3 patients receiving locally produced factor IX concentrate (4,000 donors) seroconverted in 1988, having previously been HIV-negative. Factors influencing the choice of blood products to be used, especially in South Africa, are discussed.

Adolescent↗
PubMed1990

Dietary iron overload in southern African rural blacks.

A survey conducted in rural southern African black subjects indicated that dietary iron overload remains a major health problem. A full blood count, erythrocyte sedimentation rate, serum concentrations of iron, total iron-binding capacity, ferritin, C-reactive protein (CRP), gamma-glutamyltransferase (GGT) and serological screening for hepatitis B and human immunodeficiency virus (HIV) infections were carried out in 370 subjects (214 inpatients and 156 ambulatory Mozambican refugees). The fact that the geometric mean (SD range) serum ferritin concentration was much higher in the male hospital patients than in subjects living in the community [1,581 micrograms/l (421-5,944 micrograms/l) and 448 micrograms/l (103-1,945 micrograms/l) respectively] suggested that dietary iron overload was not the only factor raising the serum ferritin concentration. The major additional factor appeared to be inflammation, since the geometric mean (SD range) serum CRP was significantly higher in male hospital patients [21 mg/l (8-53 mg/l)] than in subjects in the community [3 mg/l (1-5 mg)]. Alcohol ingestion, as judged by history and by serum GGT concentrations, was also associated with significantly raised serum ferritin concentrations. This finding was ascribed to the fact that traditional brews are not only associated with alcohol-induced hepatic damage but are also a very rich source of highly bio-available iron. The role of iron overload in the genesis of the raised serum ferritin concentrations are confirmed in the diagnostic liver biopsy study. The majority of biopsies showed heavy siderosis, with varying degrees of hepatic damage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Prevalence of hepatitis C in South Africa: detection of anti-HCV in recent and stored serum.

The prevalence of anti-HCV was studied in a cohort of 2,072 South Africans. The results were compared in selected recently collected sera and in stored sera. The serum ALT and anti-HBc were also studied as surrogate markers in this population. The following groups were tested: (a) 498 urban, black blood donors (b) 500 white blood donors (c) 500 Asian blood donors (d) 216 rural hospitalized patients (e) 358 rural mineworkers. Sera found positive by the original ELISA were retested, and reproducibly positive tests in rural black men (group d) were confirmed both by recombinant immunoblot assay and by a second ELISA. An anti-HCV prevalence of 1.2%, 0.8%, and 0.6% in urban blacks, Asians, and whites was found. Antibodies to hepatitis B core antigen were found in 42.9%, 3.4%, and 1.2% of black, Asian, and white donors, respectively; 76% of donors positive for anti-HCV were anti-HBc negative. In rural African men, 17% of stored serum samples and 9.2% of recently collected serum samples were positive for anti-HCV. In this cohort 3.84% were positive by all three assays. These results suggest that the prevalence of anti-HCV in low and high-risk South African urban blood donors is comparable to high and low prevalence areas in Europe, the United States, and Japan, but indicates a relatively high degree of exposure to hepatitis C in rural African men. The reactivity of stored, frozen sera in this population requires further investigation. In South African urban blood donors, surrogate marker testing will not expedite HCV screening.

Adult↗
PubMed1990

A study of autoantibodies in chronic mycobacterial infections.

Infections can cause autoantibody production. The purpose of this study was to determine the prevalence of autoantibodies in patients with chronic mycobacterial infections. Sera from 41 leprosy patients and from 49 untreated and 73 treated tuberculosis (TB) patients were tested for the presence of rheumatoid factor, antinuclear factor, and several other autoantibodies. The rheumatoid factor, measured by the Rheuma Tec RF latex test, was positive in 2.4% of the leprosy patients and 2.7% of the treated TB patients but absent in the untreated TB group. The titers ranged from 40 to 160 international units. Positivity was dependent upon the technique utilized, and existed in 21% of untreated TB group and 4% of the treated TB patients when using the Rheuma-Wellcotest technique. The antinuclear antibody was positive in 7.3% of the leprosy group, 6.1% of the untreated TB group, and 15% of the treated TB patients (p = 0.0125). Antinuclear antibody positivity correlated with the duration of treatment of the TB patients (p = 0.025). The antinuclear antibody titers were low and gave no specific pattern on staining. No patient had antibodies against native deoxyribonucleic acid, ribonuclear protein, Ro (SS-A) or La (SS-B) antigens. Due to their low prevalence and frequency in these chronic infections, these autoantibodies should not lead to confusion in distinguishing these conditions from the connective tissue diseases.

Adult↗
PubMed1989

HIV infection in South Africa, 1982-1988--a review.

A review of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) in South Africa between 1982 -1988 is presented. One hundred and sixty-six cases of AIDS have been seen in South Africa so far, with a mortality rate of 59.2%. There has been a predicted and alarming increase in the number of cases of AIDS in the black population. A total of 1857 HIV antibody-positive sera have been tested by various laboratories in the RSA, but this figure excludes sera found to be positive in the mining industry. The HIV-positive and AIDS cases include members of all population groups. A number of surveillance studies are presented. These revealed that beyond the groups at high risk for HIV infection the prevalence of this infection is still very low. Of an estimated 710,000 blood donors tested, 244 were positive for HIV-1 antibodies. Although 1 case of HIV-2 infection was detected in South Africa, this does not constitute a problem at present. No evidence of infection with HIV-1 was detected in southern and central African sera taken between 1970 and 1974. In the absence of a vaccine and specific treatment a change of sexual behavior to one of safer sex practices through education is the only means we have of containing the spread of the epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Evaluation of the effectiveness of AIDS training and information courses.

Acquired immunodeficiency syndrome (AIDS) is considered to be the major health threat of the 20th century. The only way to contain the spread of AIDS is by prevention of infection in the first place. This task is essentially one of education. Because the South African Institute for Medical Research is traditionally associated with the prevention of infectious diseases, an AIDS Centre was established to promote education. As part of the launching of the Centre in January 1988, a series of four 1-day courses was held for different target groups. Attendance rates were high and all participants completed a pre- and post-test questionnaire designed to evaluate the effectiveness of the courses and identify existing level of knowledge, present needs and possible future demands. Collected data were examined by correlation analysis, the chi-square test and the t-test. Results generally showed improved changes in knowledge and attitudes about AIDS, and pointed the way forward for future education interventions in the community.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Differences in the regional prevalence of chronic hepatitis B in southern Africa--implications for vaccination.

Chronic hepatitis B infection is an important cause of cirrhosis and subsequent hepatocellular carcinoma in South Africa. The disease can now be prevented by vaccination, but second-generation genetically engineered vaccines still necessitate planned allotment. We have tested 29,312 black southern African mineworkers for hepatitis B surface antigen (HBsAg) to indirectly ascertain the relative prevalence of hepatitis B infection in diverse linguistic and ethnic groups. The overall prevalence of HBsAg in this cohort of predominantly rural men was 9.9%, but the prevalence in men from different regions varied from 5.5% to 14%. The relative prevalence in 200 magisterial districts was ranked; these percentage prevalences ranged from 0% to 17%. A significantly lower mean prevalence was detected in Southern Sotho subjects than in those from coastal districts (Nguni). Based on these data, we believe that there are perhaps 2 million hepatitis B carriers in South Africa. The collected data in this report could provide a basis for a broad-based vaccine campaign whereby hepatitis B vaccine could be targeted to high-priority districts initially. This strategy could rapidly reduce the critical mass of carriers, and hasten control of the disease.

Adolescent↗
PubMed1989

Regional prevalence of hepatitis B, delta, and human immunodeficiency virus infection in southern Africa: a large population survey.

Although hepatitis B infection is endemic in southern Africa, a changing epidemiology of the disease has recently been documented in the region. The authors surveyed migrant southern African male mineworkers during 1986 to establish the prevalence of chronic hepatitis B and D (delta) infection in their areas of origin. Hepatitis B surface antigen (HBsAg) was tested in 29,312 adult male mineworkers from 18 geographic regions, encompassing the diverse tribal and linguistic groups in the region, as well as in expatriate mineworkers from neighboring southern African countries. The same cohort was also tested for antibody to human immunodeficiency virus (HIV). Selected hepatitis B carriers were also tested for hepatitis B virus deoxyribonucleic acid (DNA), antibody to hepatitis D (anti-HD), and alpha-fetoprotein. The overall prevalence of HBsAg in this survey was 9.9%. However, the prevalence varied from 5.5% to 14% in different ethnic groups. A minority of carriers (4.9%) had replicative hepatitis B infection and were hepatitis B virus DNA-positive. Only 0.6% of tested carriers were anti-HD-positive. Alpha-fetoprotein determinations were abnormal in 1.2% of hepatitis B-positive men. These data show that although chronic hepatitis B infection remains widespread in southern Africa, carrier rates vary significantly from region to region. In contrast, hepatitis D co-infection remains extremely uncommon. These baseline seroprevalence data also establish that HIV infection was, in 1986, a rare infection in the indigenous population of South Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Photosensitivity and anti-Ro (SS-A) antibodies in black patients with systemic lupus erythematosus (SLE).

Ninety-two patients with SLE, 36 black and 56 white, were studied prospectively for photosensitivity and anti-Ro (SS-A) and anti-La (SS-B) antibodies. Photosensitivity was found in 19% of black patients, compared to 71% of white patients (p = 0.001). Anti-Ro antibodies were found in 69% of black and 54% of white patients (p = 0.013). Photosensitivity was present in 87% of Ro-positive white patients and in 54% of Ro-negative white patients (p = 0.007). However, in black patients with SLE there was a strong negative association: 4% of Ro-positive patients were photosensitive while 55% of Ro-negatives were photosensitive (p = 0.001). This suggests that black SLE patients may possess a factor which 'blocks' photosensitivity, perhaps by preventing local tissue damage caused by the interaction of Ro antibodies and ultraviolet light.

Antibodies, Antinuclear↗
PubMed1988

AIDS--overview.

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Acquired Immunodeficiency Syndrome↗
PubMed1987

Kaposi's sarcoma in different populations in South Africa.

Patients with Kaposi's sarcoma (13 black and 5 white heterosexuals and 2 homosexuals with the acquired immunodeficiency syndrome (AIDS)) were investigated clinically, histologically, serologically and immunologically. Clinically, lymph node involvement was present in 9 of the 13 black heterosexuals, but was not seen in the other two groups. Oedema, which was seen in 13 of the 14 black patients, was only present in 1 white patient. The lesions were of the nodular cutaneous type except in the AIDS patients who presented with plaque-like lesions. Whereas all non-AIDS patients were negative for HTLV-III antibodies, both AIDS patients were positive and showed a marked cell-mediated immune (CMI) deficiency. Only 1 heterosexual white and 4 heterosexual black patients had some degree of CMI deficiency. South Africans with Kaposi's sarcoma do not have significant underlying immunodeficiency or associated opportunistic infections. No serological or electron microscopic evidence was found to support the aetiological role of cytomegalovirus in Kaposi's sarcoma. The findings suggest that the cell of origin of this tumour is the vascular endothelial cell.

Acquired Immunodeficiency Syndrome↗
PubMed1985

AIDS and related conditions--infection control. Guidelines for health care workers involved in patient management and investigation.

The aetiology, transmission, clinical spectrum, complicating opportunistic infections and neoplasias (such as Kaposi's sarcoma) and the diagnosis of acquired immune deficiency syndrome (AIDS) are described. Precautions to be observed by health care workers with regard to the handling of patients with AIDS and AIDS-related conditions are detailed, as are instructions relating to the handling of blood, secretions, excretions and tissues for laboratory and health care workers. These include the use of protective clothing and sterilization of instruments, and the correct disposal of infected fomites, needles, syringes and other disposable hardware. The need for counselling patients infected with the AIDS virus is stressed.

Acquired Immunodeficiency Syndrome↗
PubMed1985

AIDS in Johannesburg.

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Acquired Immunodeficiency Syndrome↗
PubMed1985

Sero-epidemiology of HTLV-III antibody in southern Africa.

A preliminary survey has demonstrated that antibodies directed against human T-cell leukaemia virus type III (HTLV-III), the virus implicated as the agent causing the acquired immunodeficiency syndrome, are not present in the low-risk population groups studied. The survey, in which an indirect immunofluorescence assay was used, has indicated that HTLV-III is not endemic in southern Africa (as opposed to central Africa, where it has been suggested that the virus is endemic). Anti-HTLV-III antibodies were, however, found in sera from male homosexuals, the one high-risk population group studied.

Acquired Immunodeficiency Syndrome↗