Many studies have shown that viruses after they enter the host cell can interact with mitochondria and disrupt their function; particularly some studies have determined that these effects can alter the mitochondrial structure as well as changes in the pathway for energy production. The effect of virus or VIRAL protein on the electron transport chain, sometimes following entry of divert viruses to the host cell, will result in a sharp decrease in cellular energy at the end of the electron transport process. In addition, nowadays new data indicate that a number of viruses may affect the mitochondrial pathway of apoptosis and thus affect the respiratory chain in the mitochondria. Such effects can lead to clinical outcomes, particularly in the context of sustained INFECTIONs, which can ultimately be considered as a possible cause of chronic fatigue syndrome (CFS). Therefore, as a hypothesis, it may be concluded that VIRAL INFECTIONs may be one of the main potential etiology for this syndrome.

Dear Editor: We greatly enjoyed reading the article by Zahediet al. (1) about the prevalence of VIRAL hepatitis and human immunodeficiency virus (HIV) INFECTION in hemodialysis (HD) patients in South-East of Iran. They reported that hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) were found in 7% of cases individually. Anti-HIV and hepatitis D antibody (anti-HDV) were negative in all cases (1). Patients on maintenance hemodialysis, potentially are prone to INFECTION with parentally transmitted VIRAL agents especially hepatitis B (HBV) and hepatitis C virus (HCV) due to impaired host immune response and multiple transfusion requirements.VIRAL hepatitis considered as a problem for HD patients because 1.9% of all deaths among this population were related to the consequence of VIRAL hepatitis (2, 3). The prevalence of HCV and HBV INFECTION in hemodialysis patients is quite variable among different HD units in varying countries (4).

Vitamin A is fat-soluble compounds of retinoid derivate, consisting of retinol, retinal, and retinyl esters. Vitamin A also affects cell growth and differentiation, playing a critical role in the normal formation and function of the heart, lungs, kidneys, and other organs. According to the role of vitamin A in enhancing immune function, it is known as an anti-inflammatory agent. Also, vitamin A supplementation by reducing morbidity and mortality in different infectious diseases, such as measles, diarrheal disease, measles-related pneumonia, human immunodeficiency virus INFECTION, and malaria considered as a crucial factor against INFECTION. So vitamin A deficiency can be life-threatening, because of impairing the response to INFECTION and significant risk of development of severe respiratory INFECTIONs in infants and young children. In this paper, we have discussed the effects of vitamin A in modulating immune responses in VIRAL INFECTIONs and the direct effects of this vitamin on VIRAL replication by comparing its role during different types of VIRAL INFECTIONs.

Dear Editor: Leonardi and Rosa’s (2010) research on the link between celiac disease and VIRAL hepatitis (1) is well designed and fo­cuses on a very interesting topic. Several de novo or latent autoimmune disorders or diseases have been reported in cases of chronic VIRAL hepatitis INFECTIONs, especially Hepati­tis C (2). In this paper, we report 5 cases of established perni­cious anemia during chronic VIRAL hepatitis INFECTION. These cases were extracted from a retrospective (1996 to 2010) study of 82 cases of pernicious anemia in the University Hospital of Strasbourg, France, a tertiary reference center (personal communication in the French Congress of He­matology, Paris, December, 2010)…

Background: Rotavirus is a common INFECTION causing 450, 000 deaths annually primarily in children 5 years and below. Despite the high burden of disease, little is known about the epidemiology of rotavirus in Libya. The aim of this study was to estimate the rotavirus disease burden among Libyan children.Methods: A cross-sectional study was carried out prospectively among children 5 years old and below between August 2012 and April 2013. Stool samples of children with diarrhea attending the outpatient department or admitted to the pediatric wards, at three public hospitals within the northwestern region of Libya were tested for rotavirus. The seasonality, symptomology demographics and outcomes of rotavirus cases were determined and compared to other diarrhea illnesses. An estimated incidence rate per 100, 000 children aged 5 years and below was determined.Results: A total of 545 children with diarrhea were identified for participation. Results of rotavirus immunoassays determined 57% of cases were caused by rotavirus. Inpatients were more likely to be rotavirus positive than outpatients (58% vs.53%, P<0.05), Most rotavirus positive cases (86%) were found among children below 2 years of age. RotaVIRAL cases peaked in the winter, constituting 76% of diarrheal illness in February and very few rotavirus cases in the summer months. The incidence rate of rotavirus diarrhea was estimated at 640/100, 000 children aged 5 years and below.Conclusion: Rotavirus INFECTION poses a significant disease burden in Libya. Preventive measures such as proper hygiene should be emphasized. Introduction of vaccination against rotavirus into the national immunization program should be examined, as it would likely be a cost-effective investment.