1
|
Piekarska A, Jabłonowska E, Garlicki A, Sitko M, Mazur W, Jaroszewicz J, Czauz-Andrzejuk A, Buczyńska I, Simon K, Lorenc B, Dybowska D, Halota W, Pawłowska M, Dobracka B, Berak H, Horban A, Tudrujek-Zdunek M, Tomasiewicz K, Janczewska E, Socha Ł, Laurans Ł, Parczewski M, Zarębska-Michaluk D, Pabjan P, Belica-Wdowik T, Baka-Ćwierz B, Deroń Z, Krygier R, Klapaczyński J, Citko J, Berkan-Kawińska A, Flisiak R. Real life results of direct acting antiviral therapy for HCV infection in HIV-HCV-coinfected patients: Epi-Ter2 study. AIDS Care 2019; 32:762-769. [PMID: 31345052 DOI: 10.1080/09540121.2019.1645808] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The aim of this study was to evaluate the baseline demographics and real-life efficacy of direct acting antivirals (DAAs) in HIV-HCV-positive patients as compared to patients with HCV monoinfection. The analysis included 5690 subjects who were treated with DAAs: 5533 were HCV-positive and 157 were HIV-HCV-positive. Patients with HCV-monoinfection were older (p < .0001) and in HIV-HCV group there were more men (p < .0001). Prevalence of genotype 1a (p = .002), as well as of genotypes 3 and 4 (p < .0001) was higher in HIV-HCV-coinfected patients. Genotype 1b was more frequent (p < .0001) in the HCV-mono-infection group. Patients with HCV-monoinfection had a higher proportion of fibrosis F4 (p = .0004) and lower proportion of fibrosis F2 (p < .0001). HIV-HCV-coinfected individuals were more often treatment-naïve (p < .0001). Rates of sustained viral response after 12 weeks did not differ significantly between both groups (95.9% versus 97.3% in coinfection and monoinfection group, respectively; p > .05). They were, however, influenced by HCV genotype (p < .0001), stage of hepatic fibrosis (p < .0001), male sex (p < .0001), BMI (p = .0001) and treatment regimen modifications (p < .0001). Although factors associated with worse response to therapy (male sex, genotype 3) occurred more often in the HIV coinfection group, real-life results of DAAs did not differ significantly between both populations.
Collapse
Affiliation(s)
- A Piekarska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland
| | - E Jabłonowska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland
| | - A Garlicki
- Department of Infectious and Tropical Diseases, Collegium Medicum, Jagiellonian University, Kraków, Poland
| | - M Sitko
- Department of Infectious and Tropical Diseases, Collegium Medicum, Jagiellonian University, Kraków, Poland
| | - W Mazur
- Clinical Department of Infectious Diseases, Medical University of Silesia, Chorzów, Poland
| | - J Jaroszewicz
- Department of Infectious Diseases and Hepatology, Medical University of Silesia in Katowice, Bytom, Poland
| | - A Czauz-Andrzejuk
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
| | - I Buczyńska
- Department of Infectious Diseases and Hepatology, Wrocław University of Medicine, Wrocław, Poland
| | - K Simon
- Department of Infectious Diseases and Hepatology, Wrocław University of Medicine, Wrocław, Poland
| | - B Lorenc
- Department of Infectious Diseases, Pomeranian Center of Infectious Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - D Dybowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - W Halota
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - M Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - H Berak
- Hospital for Infectious Diseases, Warsaw Medical University, Warszawa, Poland
| | - A Horban
- Hospital for Infectious Diseases, Warsaw Medical University, Warszawa, Poland
| | - M Tudrujek-Zdunek
- Department of Infectious Diseases, Medical University of Lublin, Lublin, Poland
| | - K Tomasiewicz
- Department of Infectious Diseases, Medical University of Lublin, Lublin, Poland
| | - E Janczewska
- School of Public Health in Bytom, Department of Basic Medical Sciences, Bytom; ID Clinic, Hepatology Outpatient Department, Medical University of Silesia, Mysłowice, Poland
| | - Ł Socha
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - Ł Laurans
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - M Parczewski
- Department of Infectious, Tropical Diseases and Acquired Immunodeficiency, Pomeranian Medical University, Szczecin, Poland
| | - D Zarębska-Michaluk
- Department of Infectious Disease, Voivodeship Hospital, Jan Kochanowski University, Kielce, Poland
| | - P Pabjan
- Department of Infectious Disease, Voivodeship Hospital, Jan Kochanowski University, Kielce, Poland
| | - T Belica-Wdowik
- Regional Center for Diagnosis and Treatment of Viral Hepatitis and Hepatology, John Paul II Hospital, Kraków, Poland
| | - B Baka-Ćwierz
- Regional Center for Diagnosis and Treatment of Viral Hepatitis and Hepatology, John Paul II Hospital, Kraków, Poland
| | - Z Deroń
- Ward of Infectious Diseases and Hepatology, Bieganski Regional Specialist Hospital, Łódź, Poland
| | - R Krygier
- NZOZ Gemini, Infectious Diseases and Hepatology Outpatient Clinic, Żychlin, Poland
| | - J Klapaczyński
- Department of Internal Medicine and Hepatology, Central Clinical Hospital of Internal Affairs and Administration, Warszawa, Poland
| | - J Citko
- Regional Hospital, Olsztyn, Poland
| | - A Berkan-Kawińska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland
| | - R Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
| |
Collapse
|
2
|
Chałas R, Szlązak K, Wójcik-Chęcińska I, Jaroszewicz J, Molak R, Czechowicz K, Paris S, Święszkowski W, Kurzydłowski KJ. Observations of mineralised tissues of teeth in X-ray micro-computed tomography. Folia Morphol (Warsz) 2019; 76:143-148. [PMID: 27813625 DOI: 10.5603/fm.a2016.0070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 09/05/2016] [Revised: 09/29/2016] [Accepted: 09/29/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND The one of the most recent imaging technology is X-ray microtomography which allows non-invasive three-dimensional visualisation of structures. It also offers the opportunity to conduct a comprehensive quantitative analysis of the tested objects such as measuring the shares of the various phases, determining the material density and distribution of the size of pores and particles. The aim of the paper was to present an overview on the applicability and relevance of X-ray microtomography in the study of mineralised tissues of the teeth. MATERIALS AND METHODS The article is based on the most recent and significant literature and own observations. RESULTS The use of X-ray microtomography in dentistry has recently increased and includes, inter alia, the assessment of the density of minerals in enamel and dentin, the detection of demineralisation in an artificially and a naturally induced caries, the automatic measurement of the depth of cavities in dentin, the measurement of the amount of removed dentin in preparation of carious lesions by various methods, the assessment of microleakage around fillings and fissure sealants, cortical bone density measurement, evaluation of root canal morphology, comparison of the accuracy of root canal working and filling by various methods. CONCLUSIONS X-ray microtomography offers within the analysis of mineralised tissues - complex structures of bone, teeth and biomedical materials, turn out to be indispensable since it opens new opportunities for cognitive and implementation research.
Collapse
Affiliation(s)
- R Chałas
- Department of Conservative Dentistry and Endodontics, Medical University of Lublin, Poland, Poland.
| | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Flisiak R, Zarębska-Michaluk D, Janczewska E, Staniaszek A, Gietka A, Mazur W, Tudrujek M, Tomasiewicz K, Belica-Wdowik T, Baka-Ćwierz B, Dybowska D, Halota W, Lorenc B, Sitko M, Garlicki A, Berak H, Horban A, Orłowska I, Simon K, Socha Ł, Wawrzynowicz-Syczewska M, Jaroszewicz J, Deroń Z, Czauż-Andrzejuk A, Citko J, Krygier R, Piekarska A, Laurans Ł, Dobracki W, Białkowska J, Tronina O, Pawłowska M. Treatment of HCV infection in Poland at the beginning of the interferon-free era-the EpiTer-2 study. J Viral Hepat 2018; 25:661-669. [PMID: 29316039 DOI: 10.1111/jvh.12861] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 08/30/2017] [Accepted: 11/21/2017] [Indexed: 02/06/2023]
Abstract
The aim of the EpiTer-2 study was to analyse patient characteristics and their medication for HCV infection in Poland at the beginning of the interferon-free era. Analysis of data of HCV infected patients treated during the initial period of availability of interferon-free regimens in Poland, who started therapy after 1 July 2015 and had available an efficacy evaluation report before 30 June 2017 was undertaken. A total of 2879 patients with chronic hepatitis C were entered, including 46% with liver cirrhosis. The most common was genotype 1b (86.8%). The study population was gender balanced, the majority of patients were overweight or obese and 69% presented comorbidities, with the highest prevalence that for hypertension. More than half of patients were retreated due to failure of previous therapy with pegylated interferon and ribavirin. Almost two-third of patients received current therapy with ombitasvir/paritaprevir/ritonavir±dasabuvir (OPrD) ±ribavirin. Other patients received mostly sofosbuvir-based regimens including combination with ledipasvir and pegylated interferon and ribavirin for genotype 3-infected patients. Efficacy of treatment in the whole study population measured as intent-to-treat analysis was 95%. The most frequent regimen, administered for patients infected with genotype 1b, was 12 weeks of OPrD, resulting in an SVR rate of 98%. At least one adverse event was reported in 38% of patients, and the death rate was 0.8%. In conclusion, data from the EpiTer-2 study confirmed the excellent efficacy and safety profile of the real-world experience with recently introduced therapeutic options for genotype 1 HCV infection, but demonstrated weakness of the current therapeutic programme regarding genotype 3 infections.
Collapse
Affiliation(s)
- R Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
| | - D Zarębska-Michaluk
- Department of Infectious Diseases, Voivodship Hospital and Jan Kochanowski University, Kielce, Poland
| | - E Janczewska
- Hepatology Outpatient Clinic, ID Clinic, Mysłowice, Poland
| | - A Staniaszek
- Department of Internal Medicine and Hepatology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland
| | - A Gietka
- Department of Internal Medicine and Hepatology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland
| | - W Mazur
- Clinical Department of Infectious Diseases, Specialist Hospital in Chorzów, Medical University of Silesia, Katowice, Poland
| | - M Tudrujek
- Department of Infectious Diseases and Hepatology, Medical University of Lublin, Lublin, Poland
| | - K Tomasiewicz
- Department of Infectious Diseases and Hepatology, Medical University of Lublin, Lublin, Poland
| | - T Belica-Wdowik
- Regional Center for Diagnosis and Treatment of Viral Hepatitis and Hepatology, John Paul II Hospital, Kraków, Poland
| | - B Baka-Ćwierz
- Regional Center for Diagnosis and Treatment of Viral Hepatitis and Hepatology, John Paul II Hospital, Kraków, Poland
| | - D Dybowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, Toruń, Poland
| | - W Halota
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, Toruń, Poland
| | - B Lorenc
- Pomeranian Center of Infectious Diseases, Department of Infectious Diseases, Medical University of Gdańsk, Gdańsk, Poland
| | - M Sitko
- Department of Infectious and Tropical Diseases, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - A Garlicki
- Department of Infectious and Tropical Diseases, Jagiellonian University Collegium Medicum, Kraków, Poland
| | - H Berak
- Hospital for Infectious Diseases in Warsaw, Medical University in Warsaw, Warsaw, Poland
| | - A Horban
- Hospital for Infectious Diseases in Warsaw, Medical University in Warsaw, Warsaw, Poland
| | - I Orłowska
- Department of Infectious Diseases and Hepatology, Wrocław Medical University, Warsaw, Poland
| | - K Simon
- Department of Infectious Diseases and Hepatology, Wrocław Medical University, Warsaw, Poland
| | - Ł Socha
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - M Wawrzynowicz-Syczewska
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - J Jaroszewicz
- Department of Infectious Diseases, Medical University of Silesia in Katowice, Bytom, Poland
| | - Z Deroń
- Ward of Infectious Diseases and Hepatology, Biegański Regional Specialist Hospital, Łódź, Poland
| | - A Czauż-Andrzejuk
- Department of Infectious Diseases and Hepatology, Medical University of Białystok, Białystok, Poland
| | - J Citko
- Medical Practice of Infections, Regional Hospital, Olsztyn, Poland
| | - R Krygier
- Infectious Diseases and Hepatology Outpatient Clinic NZOZ "Gemini", Żychlin, Poland
| | - A Piekarska
- Department of Infectious Diseases and Hepatology, Medical University of Łódź, Łódź, Poland
| | - Ł Laurans
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland.,Multidisciplinary Regional Hospital in Gorzów Wielkopolski, Gorzów Wielkopolski, Poland
| | | | - J Białkowska
- Department of Infectious and Liver Diseases, Medical University of Łódź, Łódź, Poland
| | - O Tronina
- Department of Transplantation Medicine, Nephrology, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - M Pawłowska
- Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum Bydgoszcz, Nicolaus Copernicus University Toruń, Toruń, Poland
| |
Collapse
|
4
|
Ho PH, Ambrosetti M, Groppi G, Tronconi E, Jaroszewicz J, Ospitali F, Rodríguez-Castellón E, Fornasari G, Vaccari A, Benito P. One-step electrodeposition of Pd–CeO2 on high pore density foams for environmental catalytic processes. Catal Sci Technol 2018. [DOI: 10.1039/c8cy01388h] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Electrodeposited Pd–CeO2 on high pore density foams shows high activity and stability for environmental processes and outstanding mass transport properties.
Collapse
Affiliation(s)
- P. H. Ho
- Dipartimento di Chimica Industriale “Toso Montanari”
- ALMA MATER STUDIORUM - Università di Bologna
- Bologna
- Italy
- Institut für Technische und Makromolekulare Chemie
| | - M. Ambrosetti
- Laboratory of Catalysis and Catalytic Processes
- Dipartimento di Energia
- Politecnico di Milano
- Milano
- Italy
| | - G. Groppi
- Laboratory of Catalysis and Catalytic Processes
- Dipartimento di Energia
- Politecnico di Milano
- Milano
- Italy
| | - E. Tronconi
- Laboratory of Catalysis and Catalytic Processes
- Dipartimento di Energia
- Politecnico di Milano
- Milano
- Italy
| | - J. Jaroszewicz
- Faculty of Materials Science and Engineering
- Warsaw University of Technology
- 02-507 Warsaw
- Poland
| | - F. Ospitali
- Dipartimento di Chimica Industriale “Toso Montanari”
- ALMA MATER STUDIORUM - Università di Bologna
- Bologna
- Italy
| | - E. Rodríguez-Castellón
- Departamento de Química Inorgánica
- Facultad de Ciencias
- Universidad de Málaga
- 29071 Málaga
- Spain
| | - G. Fornasari
- Dipartimento di Chimica Industriale “Toso Montanari”
- ALMA MATER STUDIORUM - Università di Bologna
- Bologna
- Italy
| | - A. Vaccari
- Dipartimento di Chimica Industriale “Toso Montanari”
- ALMA MATER STUDIORUM - Università di Bologna
- Bologna
- Italy
| | - P. Benito
- Dipartimento di Chimica Industriale “Toso Montanari”
- ALMA MATER STUDIORUM - Università di Bologna
- Bologna
- Italy
| |
Collapse
|
5
|
Flisiak R, Janczewska E, Wawrzynowicz-Syczewska M, Jaroszewicz J, Zarębska-Michaluk D, Nazzal K, Bolewska B, Bialkowska J, Berak H, Fleischer-Stępniewska K, Tomasiewicz K, Karwowska K, Rostkowska K, Piekarska A, Tronina O, Madej G, Garlicki A, Lucejko M, Pisula A, Karpińska E, Kryczka W, Wiercińska-Drapało A, Mozer-Lisewska I, Jabłkowski M, Horban A, Knysz B, Tudrujek M, Halota W, Simon K. Real-world effectiveness and safety of ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin in hepatitis C: AMBER study. Aliment Pharmacol Ther 2016; 44:946-956. [PMID: 27611776 DOI: 10.1111/apt.13790] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 07/16/2016] [Accepted: 08/12/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Virologic and safety outcomes of ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin (OBV/PTV/r ± DSV ± RBV) therapy have shown high sustained virologic response (SVR) rates and good tolerability in most patient populations in pre-registration studies. AIM To confirm these clinical trial findings in the treatment of genotype 1 and 4 hepatitis C under real-world conditions. METHODS Patients enrolled for treatment with OBV/PTV/r ± DSV ± RBV based on therapeutic guidelines were included, and the regimen was administered according to product characteristics. Clinical and laboratory data, including virologic response, were collected at baseline, end of treatment (EOT) and 12 weeks after EOT. RESULTS A total of 209 patients with chronic hepatitis C were enrolled, most were genotype 1b-infected (84.2%) and 119 (56.9%) had liver cirrhosis. Among these, 150 (71.7%) had failed previous anti-viral therapies and 84 (40.2%) were null-responders. At 12 weeks after EOT, SVR was achieved by 207 (99.0%) patients, ranging from 96.4% to 100.0% across subgroups. All Child-Pugh B and post-orthotopic liver transplantation patients achieved SVR. Adverse events occurred in 151 (72.2%) patients and were mostly mild and associated with the use of RBV. Serious adverse events, including hepatic decompensation, renal insufficiency, anaemia, hepatotoxicity and diarrhoea, were reported in eight (3.8%) patients. In five (2.4%) patients, adverse events led to treatment discontinuation. On-treatment decompensation was experienced by seven (3.3%) patients. CONCLUSIONS The results of our study confirm previous findings. They demonstrate excellent effectiveness and a good safety profile of OBV/PTV/r± DSV±RBV in HCV genotype 1-infected patients treated in the real-world setting.
Collapse
|
6
|
Brauner C, Lankisch TO, Fytili P, Jaroszewicz J, Lehner F, Barg-Hock H, Klempnauer J, Jaeckel E, Manns MP, Wedemeyer H, Negm AA. Clinical value and safety of liver biopsies in patients transplanted for hepatitis C virus-related end-stage liver disease. Transpl Infect Dis 2014; 16:958-67. [PMID: 25393916 DOI: 10.1111/tid.12310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/20/2014] [Revised: 06/28/2014] [Accepted: 08/07/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hepatitis C is the leading indication for liver transplantation. Differentiation between recurrent graft hepatitis C (RGH-C) and graft rejection (GR) is challenging. Liver biopsy is standard to diagnose both conditions; however, little information is available regarding this procedure in hepatitis C virus (HCV)-infected liver transplant recipients. METHODS Liver biopsies (n = 211) from all consecutive patients (n = 138) transplanted for hepatitis C at Hannover Medical School between January 2000 and October 2011 were screened, and a final cohort of 96 patients with 196 biopsies was included. Indications, histopathological findings, and biopsy-related complications were documented. Modifications in the treatment based on the biopsy result and the biochemical outcome were analyzed. RESULTS Most biopsies (196/211, 93%) were representative. Five patients (2.5%) developed non-fatal biopsy-related complications. Biopsy results were GR (35%), RGH-C (31%), and other diagnoses (34%). GR was independently associated with lower albumin (P = 0.025) and higher bilirubin levels (P = 0.011). Treatment was modified based on the biopsy result in 25% of cases. Alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), and bilirubin levels improved in 41%, 25%, and 31% of cases 4 weeks post biopsy respectively. ALT improvements were more significant in patients with GR than in those with RGH-C. CONCLUSION Liver biopsy in HCV-infected liver transplant recipients is safe and representative in >90% of cases. GR is independently associated with lower albumin and higher bilirubin levels.
Collapse
Affiliation(s)
- C Brauner
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Calle Serrano B, Großhennig A, Homs M, Heidrich B, Erhardt A, Deterding K, Jaroszewicz J, Bremer B, Koch A, Cornberg M, Manns MP, Buti M, Wedemeyer H. Development and evaluation of a baseline-event-anticipation score for hepatitis delta. J Viral Hepat 2014; 21:e154-63. [PMID: 24673975 PMCID: PMC4263246 DOI: 10.1111/jvh.12251] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [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: 10/06/2013] [Accepted: 01/02/2014] [Indexed: 12/13/2022]
Abstract
Hepatitis delta is considered the most severe form of viral hepatitis, but variables associated with disease progression are poorly defined. This study aimed to identify risk factors associated with worse clinical outcome in patients with hepatitis delta and to develop a clinical score to determine their risk of experiencing liver-related morbidity or mortality. We followed 75 HBsAg-anti-HDV-positive patients with hepatitis delta for up to 16 years (median 5 years). The baseline-event-anticipation score (BEA score) was developed based on variables associated with the development of liver-related clinical complications. Age, region of origin, presence of cirrhosis, albumin, INR, hyperbilirubinemia and thrombocytopenia were all associated with the development of an event in the training cohort. The BEA score included age, sex, region of origin, bilirubin, platelets and INR. Points were allocated according to hazard ratios, and three risk groups were defined: BEA-A mild risk, BEA-B moderate risk and BEA-C high risk. Hazard ratios of BEA-B and BEA-C patients for liver-related clinical endpoints were 9.01 and 25.27 vs BEA-A with an area under curve of the receiving operating characteristic curve of 0.88. The accuracy of the BEA score was confirmed in two independent validation cohorts followed in Barcelona (n = 77) and Düsseldorf (n = 62). Delta hepatitis is associated with a very severe long-term outcome. The BEA score is easy to apply and predicts with a very high accuracy the development of liver-related complications in patients with hepatitis delta.
Collapse
Affiliation(s)
- B Calle Serrano
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,German Center for Infection Research (DZIF), Partner Side HepNet Study-HouseHannover, Germany
| | - A Großhennig
- Institute for Biostatistics Hannover Medical SchoolHannover, Germany
| | - M Homs
- Liver Unit, Hospital General Universitario Vall d'Hebron and CIBERehd of Instituto Carlos IIIBarcelona, Spain
| | - B Heidrich
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical SchoolHannover, Germany
| | - A Erhardt
- Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine-UniversityDusseldorf, Germany
| | - K Deterding
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany
| | - J Jaroszewicz
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,Department of Infectious Diseases and Hepatology, Medical University of BialystokBialystok, Poland
| | - B Bremer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany
| | - A Koch
- Institute for Biostatistics Hannover Medical SchoolHannover, Germany
| | - M Cornberg
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany
| | - M P Manns
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,Liver Unit, Hospital General Universitario Vall d'Hebron and CIBERehd of Instituto Carlos IIIBarcelona, Spain
| | - M Buti
- Institute for Biostatistics Hannover Medical SchoolHannover, Germany
| | - H Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical SchoolHannover, Germany,German Center for Infection Research (DZIF), Partner Side HepNet Study-HouseHannover, Germany,Liver Unit, Hospital General Universitario Vall d'Hebron and CIBERehd of Instituto Carlos IIIBarcelona, Spain
| |
Collapse
|
8
|
Abstract
OBJECTIVES Psoriasis has been considered as a systemic disease associated with obesity, cardiovascular diseases and metabolic syndrome. Adipokines have influence on many metabolic processes. Aim of this study was to evaluate the effect of conventional topical treatment on serum adiponectin and leptin levels in patients with psoriasis. METHODS Forty-nine patients with relapse of plaque-type psoriasis and 16 healthy controls were examined. Blood samples were collected before therapy and after 14 days of application. Serum adiponectin and leptin concentrations were examined by enzyme-linked immunosorbent assay for correlations with effectiveness of topical treatment. RESULTS Adiponectin and leptin serum levels were significantly decreased in psoriatic patients in comparison to the controls. As a result of the topical treatment, serum adiponectin level did not significantly change. Serum leptin level increased significantly, still remaining lower than in the controls. CONCLUSIONS Leptin might be a useful marker in assessing the efficacy of the treatment for psoriasis.
Collapse
Affiliation(s)
- A Baran
- Department of Dermatology and Venereology and
| | | | | | | |
Collapse
|
9
|
Wursthorn K, Zacher BJ, Jaroszewicz J, Darnedde M, Manns M, Wedemeyer H. Development of a protocol for the quantitative determination of HBeAg using the Elecsys® HBeAg immunoassay. J Viral Hepat 2011; 18:e179-83. [PMID: 21199189 DOI: 10.1111/j.1365-2893.2010.01419.x] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Loss of hepatitis 'e' antigen (HBeAg) in patients with HBeAg-positive chronic hepatitis B is associated with improved long-term clinical outcome and is defined as a goal of antiviral treatment by clinical practice guidelines. Recent studies suggest that baseline levels and on-treatment monitoring of HBeAg levels may identify patients most likely to respond to therapy. The aim of this study was the development of a protocol for the quantitative determination of HBeAg using the Elecsys® HBeAg immunoassay. The linear range of the Elecsys® HBeAg immunoassay was established using recombinant HBeAg and five different diluents. The assay was validated against the Paul Ehrlich Institute (PEI) international standard serum. Linearity was demonstrated up to a cut-off index (COI) of 1000, independent of the diluent used. Optimal linearity was obtained using the Elecsys® Universal Diluent. Using the PEI reference standard, conversion factors were established as 4.50 COI for 1 PEIU/mL corresponding to 0.222 PEIU/mL for a COI of 1. Based on the results from these analyses, a simple algorithm for the quantitative measurement of HBeAg using the Elecsys® HBeAg immunoassay was developed. Using a simple algorithm with an initial 1:40 dilution, the Elecsys® HBeAg assay provides robust quantification of serum HBeAg in an easy-to-use and rapid system. The use of a commercially available, standardized diluent improves comparability between laboratories.
Collapse
Affiliation(s)
- K Wursthorn
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
| | | | | | | | | | | |
Collapse
|
10
|
Cornberg M, Jaroszewicz J, Manns MP, Wedemeyer H. Treatment of chronic hepatitis B. MINERVA GASTROENTERO 2010; 56:451-465. [PMID: 21139543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Approximately 350-420 million people worldwide are chronically infected with hepatitis B virus (HBV). Chronic hepatitis B can result in liver cirrhosis, hepatic decompensation, and hepatocellular carcinoma. Reactivation of hepatitis B is possible in patients with inactive or resolved hepatitis B often leading to liver failure. Those sequelae may be prevented by effective antiviral therapy. Interferon alfa, pegylated interferon alfa and five direct antiviral nucleoside and nucleotide analogues are approved for the treatment of chronic hepatitis B. Still, whom to treat, which therapy regimen to use, and when to begin treatment remain the challenges in the management HBV-infected patients. This review focuses on the current treatment concepts for chronic hepatitis B.
Collapse
Affiliation(s)
- M Cornberg
- Department of Gastroenterology, Medizinische Hochschule Hannover, Germany.
| | | | | | | |
Collapse
|
11
|
Lind OC, Salbu B, Skipperud L, Janssens K, Jaroszewicz J, De Nolf W. Solid state speciation and potential bioavailability of depleted uranium particles from Kosovo and Kuwait. J Environ Radioact 2009; 100:301-307. [PMID: 19216013 DOI: 10.1016/j.jenvrad.2008.12.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A combination of synchrotron radiation based X-ray microscopic techniques (mu-XRF, mu-XANES, mu-XRD) applied on single depleted uranium (DU) particles and semi-bulk leaching experiments has been employed to link the potential bioavailability of DU particles to site-specific particle characteristics. The oxidation states and crystallographic forms of U in DU particles have been determined for individual particles isolated from selected samples collected at different sites in Kosovo and Kuwait that were contaminated by DU ammunition during the 1999 Balkan conflict and the 1991 Gulf war. Furthermore, small soil or sand samples heavily contaminated with DU particles were subjected to simulated gastrointestinal fluid (0.16 M HCl) extractions. Characteristics of DU particles in Kosovo soils collected in 2000 and in Kuwait soils collected in 2002 varied significantly depending on the release scenario and to some extent on weathering conditions. Oxidized U (+6) was determined in large, fragile and bright yellow DU particles released during fire at a DU ammunition storage facility and crystalline phases such as schoepite (UO(3).2.25H(2)O), dehydrated schoepite (UO(3).0.75H(2)O) and metaschoepite (UO(3).2.0H(2)O) were identified. As expected, these DU particles were rapidly dissolved in 0.16 M HCl (84 +/- 3% extracted after 2 h) indicating a high degree of potential mobility and bioavailability. In contrast, the 2 h extraction of samples contaminated with DU particles originating either from corrosion of unspent DU penetrators or from impacted DU ammunition appeared to be much slower (20-30%) as uranium was less oxidized (+4 to +6). Crystalline phases such as UO(2), UC and metallic U or U-Ti alloy were determined in impacted DU particles from Kosovo and Kuwait, while the UO(2,34) phase, only determined in particles from Kosovo, could reflect a more corrosive environment. Although the results are based on a limited number of DU particles, they indicate that the structure and extractability of DU particles released from similar sources (metallic U penetrators) will depend on the release scenarios (fire, impact) and to some extent environmental conditions. However, most of the DU particles (73-96%) in all investigated samples were dissolved in 0.16 M HCl after one week indicating that a majority of the DU material is bioaccessible.
Collapse
Affiliation(s)
- O C Lind
- Department of Plant and Environmental Sciences, Norwegian University of Life Sciences, As, Norway.
| | | | | | | | | | | |
Collapse
|
12
|
Wiercinska-Drapalo A, Jaroszewicz J, Tarasow E, Siergiejczyk L, Prokopowicz D. The possible association between serum cholesterol concentration and decreased bone mineral density as well as intravertebral marrow fat in HIV-1 infected patients. Infection 2007; 35:46-8. [PMID: 17297592 DOI: 10.1007/s15010-007-5033-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2005] [Accepted: 11/13/2006] [Indexed: 10/23/2022]
|
13
|
Wiercinska-Drapalo A, Jaroszewicz J, Tarasow E, Flisiak R, Prokopowicz D. Transforming growth factor beta1 and prostaglandin E2 concentrations are associated with bone formation markers in ulcerative colitis patients. Prostaglandins Other Lipid Mediat 2005; 78:160-8. [PMID: 16303613 DOI: 10.1016/j.prostaglandins.2005.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2005] [Revised: 05/25/2005] [Accepted: 06/23/2005] [Indexed: 01/05/2023]
Abstract
Osteoporosis is a significant complication of a multifactoral etiology associated with inflammatory bowel disease. The aim of study was to evaluate the relationships between bone mineral density as well as bone turnover markers and inflammatory activity modulators (i.e., PGE2 and TGFbeta1) in ulcerative colitis (UC). Twenty-one active ulcerative colitis subjects and 14 healthy individuals were included into the study. We observed no significant differences in serum concentrations of osteoprotegerin and osteocalcin, as well as bone mineral density between UC patients and healthy individuals. Plasma concentrations of PGE2, TGFbeta1 and TNF-alpha were significantly higher in UC patients than in controls. Serum osteocalcin demonstrated a positive correlation with both serum PGE2 and plasma TGFbeta1. Moreover there was significant correlation between osteoprotegerin and TGFbeta1 as well as serum TNF-alpha concentrations. In conclusion a positive association between PGE2 and TGFbeta1 and bone formation markers-osteoprotegerin and osteocalcin, as well as a comparable BMD in UC patients and healthy individuals was shown. Our results may indicate that increase of PGE2 as well as TGFbeta1 concentrations may play a protective role against bone loss in ulcerative colitis patients.
Collapse
Affiliation(s)
- A Wiercinska-Drapalo
- Department of Infectious Diseases, Medical University of Bialystok, Zurawia 14 Str., 15-540 Bialystok, Poland.
| | | | | | | | | |
Collapse
|
14
|
Lapiński TW, Kowalczuk O, Prokopowicz D, Chyczewski L, Jaroszewicz J. HBV-DNA and sFas, sFasL concentrations in serum of healthy HBsAg carriers. Rocz Akad Med Bialymst 2005; 50:179-82. [PMID: 16358961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE Increased HBV-DNA concentration is a prognostic factor of disease progression in chronic hepatitis B patients. Moreover, active hepatic inflammation during HBV replication influences apoptosis intensification. The aim of this study was to estimate occurrence of HBV replication among carriers of HBsAg. Furthermore, we analysed the correlation between HBV replication and HBeAg or anti-HBe presence as well as known apoptosis indicators--sFas and sFasL concentration. MATERIAL AND METHODS The study included 34 HBV infected patients, aged 20-43 yrs defined as HBsAg healthy carriers. HBV-DNA was extracted from patients' serum using two different DNA isolation kits: the QIAamp DNA Mini Kit (QIAGEN Ltd, USA) and the Gene Elute Mammalian Genomic DNA Miniprep Kit (Sigma, USA). HBV-DNA concentration in serum was measured by RT-PCR based on TaqMan Universal Master Mix (Applied Biosystems). The detection limit of this system was as few as 10 HBV-DNA copies/mL of serum. HBV-DNA concentration was calculated from a linear standard curve obtained between 10 and 10(8) DNA copies/reaction. HBeAg and anti-HBe in serum were detected by MEIA method (ABBOTT, Germany). The concentration of sFas and sFasL in serum was-estimated by ELISA method (Bender MedSystems, Austria). RESULTS HBV active replication was detected in 79% HBsAg carriers. The HBV-DNA levels exceeding 10(5) copies/mL were observed in 64% patients. Among HBsAg carriers presenting HBeAg, HBV replication occurred more often and was more intensify than in HBsAg carriers presenting anti-HBe antibodies. The sFasL occurrence in serum of 56% HBsAg carriers shows an active apoptosis, independent from ALT and AST activity within normal ranges.
Collapse
Affiliation(s)
- T W Lapiński
- Department of Infectious Diseases, Medical University of Białystok, Poland.
| | | | | | | | | |
Collapse
|
15
|
Tarasów E, Wiercińska-Drapało A, Jaroszewicz J, Siergiejczyk L, Orzechowska-Bobkiewicz A, Prokopowicz D, Walecki J. Metabolic disturbances in liver 1H MR spectroscopy in HIV and HCV co-infected patients as a potential marker of hepatocyte activation. Acta Radiol 2004; 45:803-9. [PMID: 15690608 DOI: 10.1080/02841850410008711] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate proton magnetic resonance spectroscopy (1H MRS) features in order to assess hepatocellular activation in chronic hepatitis C and human immunodeficiency virus/hepatitis C (HIV/HCV) co-infected patients. MATERIAL AND METHODS Liver in vivo 1H MR spectra were obtained in 14 patients with hepatitis C virus infection (HCV), 20 HIV/HCV co-infected individuals, and 24 healthy volunteers. Resonances of lipids, glutamine/glutamate (Glx), phosphomonoesters (PME), glycogen/glucose (Glc) were assessed and metabolite ratios to total lipids (TL) were calculated. RESULTS A significant increase in Glx/TL and PME/TL was observed in the HCV group as compared to healthy individuals. Patients with HIV and HCV co-infection had a further increase of all metabolite ratios. Changes in metabolite ratios were due to both the increase in particular metabolite contents and to the decrease in lipid levels. HIV/HCV-infected patients treated with highly active anti-retroviral therapy (HAART) showed elevated PME and Glx levels and significantly decreased TL compared to patients not undergoing anti-retroviral treatment. CONCLUSIONS Our findings suggest clinical usefulness of liver 1H MR spectroscopy in detecting even slight disturbances in liver metabolism.
Collapse
Affiliation(s)
- E Tarasów
- Department of Radiology, Medical University Hospital, Bialystok, Poland.
| | | | | | | | | | | | | |
Collapse
|
16
|
Jaroszewicz J, Flisiak R. [Primary biliary cirrhosis]. Pol Merkur Lekarski 2000; 8:369-72. [PMID: 10967908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Primary biliary cirrhosis is a chronic, progressive cholestatic liver disease characterised by the destruction of small intrahepatic bile ducts. Although known for many years its etiology and pathogenesis still remains uncertain. Alterations of humoral and cellular immune functions suggests an autoimmune pathogenesis. Primary biliary cirrhosis typically affects middle-aged women who reports fatigue and itching. Diagnosis is usually based on abnormal biochemical tests of liver function, presence of antimitochodrial antibodies (especially anti-M2) and histologic evaluation of liver biopsy specimens. Relatively small number of diagnosed cases in Poland may be due to insufficient knowledge on this disease in our country.
Collapse
|
17
|
Jaroszewicz J, Flisiak R. [Diagnosis of autoimmune hepatitis]. Pol Arch Med Wewn 2000; 103:301-6. [PMID: 11291613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|