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Gluvic Z, Tomasevic R, Bojovic K, Obradovic M, Isenovic ER. Non-alcoholic fatty liver disease: a multidisciplinary clinical practice approach—the institutional adaptation to existing Clinical Practice Guidelines. Emergency and Critical Care Medicine 2021; 2:12-22. [DOI: 10.1097/ec9.0000000000000016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Abstract
Non-alcoholic fatty liver disease (NAFLD) is among the most frequently encountered chronic liver diseases in everyday clinical practice. It is considered the hepatic manifestation of metabolic syndrome. Today, liver biopsy is still the gold standard for NAFLD confirmation and assessing NAFLD's possible progression to non-alcoholic steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Because of the high prevalence of NAFLD and potential associated risks of invasive diagnostic procedures, it is of great interest to recruit the patients for liver biopsy. However, as the presence of liver fibrosis determines the further clinical course, liver biopsy is expectedly reserved for those with increased fibrosis risk. The quality of liver biopsy recruitment and patient monitoring could be significantly improved by using non-invasive tools to assess liver fibrosis presence and interactive collaboration between general practitioners, gastroenterologists, and endocrinologists. As a result, the quality of liver biopsy recruitment and patients monitoring could be significantly improved. Here, we proposed clinical practice guidelines that could be implemented for everyday clinical practice in NAFLD patients.
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Affiliation(s)
- Zoran Gluvic
- University Clinical-Hospital Centre Zemun-Belgrade, Clinic of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ratko Tomasevic
- University Clinical-Hospital Centre Zemun-Belgrade, Clinic of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ksenija Bojovic
- Clinical Centre of Serbia, Clinic of Infectious and Tropical Diseases, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Obradovic
- Department of Radiobiology and Molecular Genetics, “VINČA” Institute of Nuclear Sciences – National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Esma R. Isenovic
- Department of Radiobiology and Molecular Genetics, “VINČA” Institute of Nuclear Sciences – National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
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Bojovic K, Simonovic-Babic J, Mijailovic Z, Milosevic I, Jovanovic M, Ruzic M, Cvejic Pasic T, Svorcan P, Petrovic M, Jordovic J. Micro-elimination of HCV as a possible therapeutic strategy: our experience and a review of literature. J Infect Dev Ctries 2020; 14:117-124. [PMID: 32146444 DOI: 10.3855/jidc.11785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 09/03/2019] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Serbia has an intermediate estimated prevalence of chronic hepatitis C (CHC) infection, approximately 1.13%, with hepatitis C remaining one of the leading causes of liver-related morbidity and mortality in Serbia with impaired quality of life and overwhelming cost of treating its complications As the availability of new treatment options and resources for screening remains limited, micro-elimination of CHC becomes a top priority. METHODS Review of the available published data related to the clinical and epidemiological situation of the hepatitis C infection in Serbia, including the unpublished data from the databases of four major reference centres in Serbia (Clinical Center Serbia, Clinical Center Niš, Clinical Center Vojvodina and Clinical Center Kragujevac). RESULTS Currently in Serbia, micro-elimination appears to be realistic in the patients with haemophilia, who represent a small, well-defined subpopulation, under constant monitoring by the healthcare system. Other feasible targets for micro-elimination of CHC infection in Serbia are patients on hemodialysis, prisoners and people who inject drugs. CONCLUSIONS Micro-elimination is feasible in Serbia, especially in the subpopulation of patients with haemophilia. This may represent an initial step towards achieving the WHO objective to eliminate hepatitis C infection by 2030.
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Affiliation(s)
- Ksenija Bojovic
- Clinic for Infectious and tropical diseases, Clinical Center Serbia, Belgrade, Serbia.
| | | | - Zeljko Mijailovic
- Department of Infectious disease, Clinical Center Kragujevac, Kragujevac, Serbia.
| | - Ivana Milosevic
- Clinic for Infectious and tropical diseases, Clinical Center Serbia, Belgrade, Serbia.
| | - Maja Jovanovic
- Department of Infectious disease, Clinical Center Niš, Niš, Serbia.
| | - Maja Ruzic
- Department of Infectious disease, Clinical Center Vojvodina, Novi Sad, Serbia.
| | | | | | | | - Jelena Jordovic
- Clinic for Infectious and tropical diseases, Clinical Center Serbia, Belgrade, Serbia.
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Jordovic J, Simonovic-Babic J, Gasic V, Kotur N, Zukic B, Pavlovic S, Lazarevic I, Karalic D, Katanic N, Nikolic N, Urosevic A, Nestorov J, Delic D, Bojovic K. IL-28B genotypes as predictors of long-term outcome in patients with hepatitis C-related severe liver injury. J Infect Dev Ctries 2019; 13:526-535. [PMID: 32058988 DOI: 10.3855/jidc.11351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 03/03/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Patients with severe fibrosis or cirrhosis are at high risk for liver-related complications, even after successful antiviral treatment and/or regression of fibrosis. These are the first published results concerning the role of IL-28B genotypes as predictors of the durability of sustained virological response (SVR) and long-term outcome, in patients with baseline severe fibrosis and cirrhosis caused by hepatitis C (HCV) infection. METHODOLOGY Genetic testing for three different single nucleotide polymorphisms (SNP) near the IL28B gene, rs12979860, rs12980275 and rs8099917, was performed in 42 patients with HCV-related advanced fibrosis and cirrhosis, who achieved SVR after successful interferon-based treatment. Baseline clinical and laboratory parameters were analysed, as well as IL28B genotype association with late virological relapse, fibrosis progression and clinical outcomes. RESULTS The most prevalent genotypes in all three tested SNP positions were: CCrs12979860 genotype in 69% of patients, GTrs8099917 in 78.6% and GGrs12980275 in 47.6% of patients. The presence of IL28B CCrs12979860 genotype was identified as a negative predictor of late virological relapse. Further analysis did not confirm the association of other IL28B genotypes with the progression of fibrosis and clinical outcomes. CONCLUSIONS Varying long-term prognosis in patients with HCV-related severe fibrosis and cirrhosis is due to multiple interactions between host genetic factors, virus and environment. These are first published results demonstrating the significance of IL28B CCrs12979860 genotype as a negative predictor of late virological relapse. A further investigation concerning genetic factors is necessary to identify patients under risk for late relapse, complications and unfavorable outcomes, so that they can be reevaluated and offered new treatment options.
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Affiliation(s)
- Jelena Jordovic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia.
| | | | - Vladimir Gasic
- Laboratory for Molecular Biomedicine, Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia.
| | - Nikola Kotur
- Laboratory for Molecular Biomedicine, Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade.
| | - Branka Zukic
- Laboratory for Molecular Biomedicine, Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade.
| | - Sonja Pavlovic
- Medical Faculty, University of Belgrade, Belgrade, Serbia.
| | | | | | - Natasa Katanic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia.
| | - Natasa Nikolic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia.
| | - Aleksandar Urosevic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia.
| | | | - Dragan Delic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia.
| | - Ksenija Bojovic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia.
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Pribakovic JA, Katanic N, Radevic T, Tasic MS, Kostic M, Stolic B, Radulovic A, Minic V, Bojovic K, Katanic R. Serological status of childbearing-aged women for Toxoplasma gondii and cytomegalovirus in northern Kosovo and Metohija. Rev Soc Bras Med Trop 2019; 52:e20170313. [PMID: 30652782 DOI: 10.1590/0037-8682-0313-2017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 06/21/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Toxoplasma gondii and cytomegalovirus (CMV) are pathogens associated with congenital anomalies. METHODS Serum was collected from 79 reproductive-age women and tested for IgM and IgG antibodies to T. gondii and CMV. RESULTS Seropositivity for T. gondii was detected in 24.1% of women and CMV in 96.2%. High seropositivity for CMV was found for all ages. The highest seropositivity for T. gondii was observed among older participants. CONCLUSIONS T. gondii remains an important pathogen owing to low seropositivity.
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Affiliation(s)
- Jelena Aritonovic Pribakovic
- Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Natasa Katanic
- Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Tatjana Radevic
- Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Mirjana Stojanovic Tasic
- Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Mirjana Kostic
- Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Boban Stolic
- Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | | | - Verica Minic
- Institute for Public Health, Pristina, Kosovska Mitrovica, Serbia
| | - Ksenija Bojovic
- Clinic for Infectious Diseases, Clinical Center of Serbia, Belgrade, Serbia
| | - Radoslav Katanic
- Faculty of Medicine, University of Pristina temporarily seated in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
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Mitrovic N, Delic D, Markovic Denic L, Nikolic N, Bojovic K, Simonovic Babic J, Brmbolic B, Milosevic I, Katanic N, Barac A. The prevalence and the risk factors for hepatitis C virus infection in Serbia. J Infect Dev Ctries 2018; 12:171-177. [PMID: 31829992 DOI: 10.3855/jidc.10172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 02/22/2018] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION The epidemiological characteristics of the hepatitis C virus (HCV) infection in Republic of Serbia have not been studied sufficiently so far. The aim of this study was to estimate the prevalence of anti-HCV positivity in the general population of Serbia and determine the risk factors for this infection. METHODOLOGY Estimation of the prevalence was done using the median ratio method with data from several regional countries to a previously determined prevalence of anti-HCV positivity among volunteer blood donors of 0.19%. In order to determine the risk factors a matched case-control study was conducted of 106 subjects with confirmed HCV infection from the Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia and the same number of hospital controls matched by sex and age. RESULTS The estimated prevalence of anti-HCV positivity in the general population of Serbia was 1.13% (95% CI: 1.0-1.26%). The most important predictive risk factors of HCV infection were: intravenous drug use (OR = 31.0; 95% CI: 3.7-259.6), blood transfusions (OR = 3.7; 95% CI: 1.6-8.7), invasive dental treatment (OR = 3.1; 95% CI: 1.4-6.8), and low level of education (OR = 2.2; 95% CI:1.1-4.7). A total of 91.5% of the persons with hepatitis C had at least one of the significant risk factors. CONCLUSION The prevalence of anti-HCV positivity ranks Serbia in the range of mid-endemic European countries. Preventive measures should be directed at preventing drug use, on education about getting the infection, creating safe conditions for blood transfusions, and strict adherence to adopted practices in dentistry.
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Zec S, Popovic D, Matovic V, Nikolic V, Bojovic K, Jovic J, Markovic Denic L, Milosavljevic T, Alempijevic T. Translation and validation of the Serbian primary biliary cholangitis-40 questionnaire. PLoS One 2017; 12:e0175697. [PMID: 28406960 PMCID: PMC5391097 DOI: 10.1371/journal.pone.0175697] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 03/29/2017] [Indexed: 02/07/2023] Open
Abstract
Background and aims To translate into Serbian and validate the Primary Biliary Cholangitis–40 (PBC-40) and PBC-27 questionnaires. Materials and methods Ninety-four consecutive outpatients with the diagnosis of PBC from three departments across two tertiary care institutions in Belgrade were enrolled from February to October 2016. Standard methodology for cultural adaption of healthcare related quality of life questionnaires was used, and included: a forward translation, backward translation and a pilot test of the Serbian PBC-40 on five patients who gave suggestions and comments. For evaluation of the questionnaires, acceptance was shown by the proportion of missing items and the internal consistency was assessed using Cronbach’s α coefficient. The PBC-40 was self-administered under the supervision of an experienced hepatologist. The PBC-27 is a shorter version of the PBC-40. Results A total of 92 (97.9%) of the patients were females. The mean age was 59.26 ± 1.05 years and the average length of disease was 60.45 ± 48.314 months. The average PBC-40 score was 85.62 ± 30.46. The total time needed to complete the questionnaire ranged from 7 to 16 minutes. The proportion of missing items was 5.45% (205/3760). Cronbach’s α for the entire scale was 0.93. Reliability for all of the domains of the PBC-40 was above 0.70, except for the domain “Symptoms” (α = 0.52). Overall reliability of the PBC-27 was α = 0.90. Domains “Dryness”, “Symptoms” and “Fatigue” demonstrated reliability below α = 0.70. Conclusions The Serbian PBC-40 is a valid and reasonably adequate for use in Serbian PBC patients. The PBC-40 is preferred over the PBC-27.
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Affiliation(s)
- Simon Zec
- Department of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
- * E-mail:
| | - Dusan Popovic
- Department of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
| | - Vera Matovic
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
| | - Vladimir Nikolic
- Department of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ksenija Bojovic
- Department of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
- Department of Gastroenterology and Hepatology, Clinic for Tropical and Infectious Diseases, Clinical Center of Serbia, Belgrade, Serbia
| | - Jasna Jovic
- Department of Gastroenterology and Hepatology, Military Medical Academy, Belgrade, Serbia
| | - Ljiljana Markovic Denic
- Department of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
- Institute of Epidemiology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tomica Milosavljevic
- Department of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
| | - Tamara Alempijevic
- Department of Internal Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
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Salemovic D, Pesic-Pavlovic I, Jevtovic D, Bojovic K, Ranin J, Brmbolic B, Stanojevic M. Intravenous drug use - an independent predictor for HCV genotypes 3 and 4 infection among HIV/HCV co-infected patients. Arch Med Sci 2017; 13:652-658. [PMID: 28507583 PMCID: PMC5420631 DOI: 10.5114/aoms.2017.66022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 07/02/2015] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION About one quarter of human immunodeficiency virus (HIV) infected persons in Serbia have also been found to be hepatitis C virus (HCV) co-infected. In the general population, HCV genotype 1 has been shown to be the most prevalent one. Here, we present the first study on the distribution of HCV genotypes among HIV/HCV co-infected patients in Serbia, in relation to epidemiological and clinical features. MATERIAL AND METHODS The study included HIV/HCV co-infected and a group of HCV mono-infected patients in the period 1998-2012, with collection of epidemiological, clinical, and behavioral data using a standardized questionnaire. The HCV genotyping to the level of pure genotype was performed by reverse hybridization. RESULTS Intravenous drug use (IDU) was found to be significantly more prevalent among the co-infected patients (p < 0.01). HCV genotype 1 was detected in 87% of patients with mono-infection, compared to 46.3% of patients with co-infection (p < 0.01); genotypes 3 and 4 were significantly more common among co-infected patients (6% and 5%, vs. 27% and 25%, respectively). Multivariate logistic regression confirmed IDU, infection with non-1 HCV genotype and HCV viral load over 5 log to be predictors of HIV co-infection. CONCLUSIONS The HCV genotypes 3 and 4 were found to be significantly more prevalent among HIV/HCV co-infected patients in Serbia, compared to HCV mono-infected patients, but also more prevalent compared to the European HIV/HCV co-infected cohort. History of IDU represents an independent predictor of HCV genotypes 3 and 4 infection, with important implications for treatment.
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Affiliation(s)
- Dubravka Salemovic
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
| | | | - Djordje Jevtovic
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
- University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Ksenija Bojovic
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
| | - Jovan Ranin
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
- University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Branko Brmbolic
- Infectious and Tropical Diseases University Hospital, Clinical Center Serbia, HIV/AIDS Unit, Belgrade, Serbia
- University of Belgrade Faculty of Medicine, Belgrade, Serbia
| | - Maja Stanojevic
- Institute of Microbiology and Immunology, NRL HIV/AIDS, University of Belgrade School of Medicine, Belgrade, Serbia
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Mitrovic N, Delic D, Markovic-Denic L, Jovicic M, Popovic N, Bojovic K, Simonovic Babic J, Svirtlih N. Seroprevalence and risk factors for hepatitis C virus infection among blood donors in Serbia: A multicentre study. Dig Liver Dis 2015; 47:572-6. [PMID: 25882212 DOI: 10.1016/j.dld.2015.03.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 03/10/2015] [Accepted: 03/19/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND The epidemiological characteristics of hepatitis C virus (HCV) infection have not yet been described in Serbia. AIMS To determine the prevalence of anti-HCV-positive individuals among first-time blood donors and the risk factors for hepatitis C transmission. METHODS A multicentre case-control study nested within a prospective cohort study was conducted at 10 main transfusion centres in Serbia in 2013 and 27,160 blood donors who gave blood for the first time were included. Blood donors with confirmed anti-HCV positivity and seronegative controls were enrolled to determine the risk factors. RESULTS Of 27,160 blood donors 52 were anti-HCV-positive; seroprevalence was 0.19%. By univariate analysis, marital status, educational level, drug use, previous transfusion, tattooing, non-use of condoms and number of sexual partners, were risk factors for hepatitis C. In the final multivariate analysis, three factors remained independently predictive: drug use, tattooing and previous blood transfusion. In total, 87.5% of cases had at least one of the risk factors for HCV transmission; 20.9% presumed that they knew when the infection occurred. CONCLUSION HCV seroprevalence in Serbia is higher than in developed European countries. Preventive measures need to be directed towards drug use and tattooing facilities. The admission questionnaire for blood donors should be improved.
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Affiliation(s)
- Nikola Mitrovic
- Clinic for Infectious and Tropical Disease, Belgrade, Serbia.
| | - Dragan Delic
- Clinic for Infectious and Tropical Disease, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Ljiljana Markovic-Denic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia; Institute of Epidemiology, Belgrade, Serbia
| | | | - Natasa Popovic
- Clinic for Infectious and Tropical Disease, Belgrade, Serbia
| | - Ksenija Bojovic
- Clinic for Infectious and Tropical Disease, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Jasmina Simonovic Babic
- Clinic for Infectious and Tropical Disease, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Neda Svirtlih
- Clinic for Infectious and Tropical Disease, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
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Katanic N, Bojovic K, Delic D, Simonovic J, Malinic J, Milosevic I. Efficacy and safety on tenofovire therapy in patients with hepatitis B viral infections resistent to lamivudin. Praxis Med 2015. [DOI: 10.5937/pramed1501061k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Katanic N, Bojovic K, Milosevic I, Lavadinovic L, Aritonovic J, Odalovic A, Malinic J. Abdominal actinomycosis 'imitator' of colon cancer. Praxis Med 2014. [DOI: 10.5937/pramed1403083k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Milosevic I, Delic D, Lazarevic I, Pavlovic IP, Korac M, Bojovic K, Jevtovic D. The significance of hepatitis B virus (HBV) genotypes for the disease and treatment outcome among patients with chronic hepatitis B in Serbia. J Clin Virol 2013; 58:54-8. [PMID: 23838671 DOI: 10.1016/j.jcv.2013.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Revised: 04/29/2013] [Accepted: 06/10/2013] [Indexed: 12/23/2022]
Abstract
BACKGROUND Hepatitis B virus (HBV) genotypes influence disease progression and treatment outcome. OBJECTIVES To determine natural history and treatment outcome in patient chronically infected with HBV. STUDY DESIGN A cohort study included 162 treatment naive patients with chronic HBV infection in order to analyze factors influencing natural history of infection and survival. RESULTS Genotype A was far less prevalent, detected in 14.2%. The prevalence of HbeAg+ serology of 60.8% among patients infected with genotype A was significantly higher then 30.9% recorded among those with genotype D (P=0.02). Even though patients from two genotypes subgroups had significantly different prevalence of HBeAg serology, their viral loads were similar at the time of diagnosis (2.90 log10 and 3.31 log10 HBV DNK IU/μl plasma, for genotypes A and D, respectively). The analyses of viral loads across three serologic patterns of chronic HBV infection were: for HBeAg+/HBeAb-, HbeAg-/HBAb+, and both "e" antigen and antibodies negative: 4.24, 2.67 and 2.69 log10 IU/ml of HBV DNA IU/μl, respectively (P=0.01). Mean time to liver cirrhosis was 23.2±3.4 years and 15.1±8.4 years, for genotypes A and D, respectively (P=0.02). The overall estimated mean survival of patients with chronic HBV infection was 28.4 years, and was influenced by the stage of liver disease, but not by gender, age above 40, viral genotype and lamivudine therapy. CONCLUSIONS Patients infected with genotype D had more rapid progression to ESLD regardless of levels of viral replication. All clinical and laboratory differences between genotypes did not affect survival of patients with chronic hepatitis B, regardless of lamivudine therapy.
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Affiliation(s)
- Ivana Milosevic
- Belgrade University School of Medicine Infectious and Tropical Diseases Hospital, Clinical Centre of Serbia, Belgrade, Serbia
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Bojovic K, Simonovic J, Katanic N, Milosevic I, Pesic I, Delic D, Svirtlih N, Jevtovic DJ. The comparison of chronic hepatitis C treatment outcome between intravenous drug users and non-intravenous drug users. Biomed Pharmacother 2013; 67:517-20. [PMID: 23639229 DOI: 10.1016/j.biopha.2013.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 03/10/2013] [Indexed: 01/06/2023] Open
Abstract
UNLABELLED Despite the fact that the majority of prevalent and incident cases of HCV are associated with intravenous drug use (IVDU), these patients have largely been excluded from HCV care. The aim of this study was to examine the treatment outcome of chronic hepatitis C in IVDUs compared to non-IVDUs. PATIENTS AND METHODS Patients with chronic hepatitis C (CHC) who initiated and completed combination antiviral therapy with pegilated interferon and ribavirin, at the Hepatology Department of the University Hospital for Infectious and Tropical Diseases in Belgrade, were retrospectively analyzed. The study included a series of 254 patients of which 100 (39.4%) were former IVDU. RESULTS Sustained virological response (SVR) was recorded in a total of 172 patients (67.7%). The analyses of the favorable treatment outcome, regarding particular viral genotypes, revealed that among those with genotype 1 and/or 4, including patients with genotype 1 recombinants with genotype 3, SVR was achieved in 114 (63.3%), while it was almost equally distributed between subgroups of former IVDU and all others (P=0.079). Among patients infected with HCV genotypes 2 and/or 3 the SVR rate was as high as 86.6%. CONCLUSION IVDU with CHC infection should be treated with standard combination antiviral therapy for CHC, since the success rate is equal or even better than in non-IVDU patients.
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Affiliation(s)
- K Bojovic
- Belgrade University School of Medicine, Clinics for Infectious and Tropical Disease, Belgrade, Serbia.
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