Differences in Clinical Presentation of COVID-19 in Children Hospitalized During Domination of Early (BA.1, BA.2) and Late (BA.5, BA.2.75, BQ.1 and XBB.1.5) SARS-CoV-2 Omicron Subvariants.

This study analyzed data for 1098 children: 575 diagnosed with COVID-19 between January and June 2022 (early Omicron) and 523 hospitalized from July 2022 to April 2023 (late Omicron). New Omicron subvariants lead to similar recovery rates without deaths and acute respiratory distress syndrome in children as BA.1 and BA.2, however, they more often cause fever and croup. Children suffering from comorbidities, presenting with pulmonary lesions and older, may be prone to a more severe consequences of COVID-19 in terms of the currently dominating Omicron subvariants.

Clinical Course and Severity of COVID-19 in 940 Infants with and without Comorbidities Hospitalized in 2020 and 2021: The Results of the National Multicenter Database SARSTer-PED.

This study aimed to analyze the differences in severity and clinical characteristics of COVID-19 in infants hospitalized in Poland in 2021, when the dominance of variants of concern (VOCs) alpha and delta was reported, compared to 2020, when original (wild) SARS-CoV-2 was dominant (III-IV vs. I-II waves of the pandemic, respectively). In addition, the influence of the presence of comorbidities on the clinical course of COVID-19 in infants was studied. This multicenter study, based on the pediatric part of the national SARSTer database (SARSTer-PED), included 940 infants with COVID-19 diagnosed between March 1, 2020, and December 31, 2021, from 13 Polish inpatient centers. An electronic questionnaire, which addressed epidemiological and clinical data, was used. The number of hospitalized infants was significantly higher in 2021 than in 2020 (651 vs. 289, respectively). The analysis showed similar lengths of infant hospitalization in 2020 and 2021, but significantly more children were hospitalized for more than 7 days in 2020 (p < 0.009). In both analyzed periods, the most common route of infection for infants was household contact. There was an increase in the percentage of comorbidities, especially prematurity, in children hospitalized in 2021 compared to 2020. Among the clinical manifestations, fever was predominant among children hospitalized in 2021 and 2020. Cough, runny nose, and loss of appetite were significantly more frequently observed in 2021 (p < 0.0001). Severe and critical conditions were significantly more common among children with comorbidities. More infants were hospitalized during the period of VOCs dominance, especially the delta variant, compared to the period of wild strain dominance, even though indications for hospitalization did not include asymptomatic patients during that period. The course of COVID-19 was mostly mild, characterized mainly by fever and respiratory symptoms. Comorbidities, particularly from the cardiovascular system and prematurity, were associated with a more severe course of the disease in infants.

The Influence of SARS-CoV-2 Variants B.1.1.7 and B.1.617.2 on a Different Clinical Course and Severity of COVID-19 in Children Hospitalized in 2021 Compared With 2020.

BACKGROUND: This study aimed to analyze the differences in the epidemiologic and clinical characteristics of coronavirus disease 2019 (COVID-19) in children hospitalized in 2021, when the severe acute respiratory syndrome coronavirus 2 variants B.1.1.7 (alpha) and B.1.617.2 (delta) dominated, compared with 2020. METHODS: In this multicenter study based on the pediatric part of the national SARSTer register (SARSTer-PED), we included 2771 children (0-18 years) with COVID-19 diagnosed between March 1, 2020, and December 31, 2021, from 14 Polish inpatient centers. An electronic questionnaire, which addressed epidemiologic and clinical data, was used. RESULTS: Children hospitalized in 2021 were younger compared with those reported in 2020 (mean 4.1 vs. 6.8 years, P = 0 .01). Underlying comorbidities were reported in 22% of the patients. The clinical course was usually mild (70%). A significant difference in the clinical course assessment between 2020 and 2021 was found, with more asymptomatic patients in 2020 and more severely ill children in 2021. In total, 5% of patients were severely or critically ill, including <3% of the participants in 2020 and 7% in 2021. The calculated mortality rate was 0.1% in general and 0.2% in 2021. CONCLUSION: Infections with severe acute respiratory syndrome coronavirus 2 variants alpha and delta lead to a more severe course of COVID-19 with more pronounced clinical presentation and higher fatality rates than infection with an original strain. Most of the children requiring hospitalization due to COVID-19 do not have underlying comorbidities.

Remdesivir Decreases Mortality in COVID-19 Patients with Active Malignancy.

Data on the use of remdesivir, the first antiviral agent against SARS-CoV-2, are limited in oncologic patients. We aimed to analyze contributing factors for mortality in patients with malignancies in the real-world CSOVID-19 study. In total, 222 patients with active oncological disorders were selected from a nationwide COVID-19 study of 4890 subjects. The main endpoint of the current study was the 28-day in-hospital mortality. Approximately half of the patients were male, and the majority had multimorbidity (69.8%), with a median age of 70 years. Baseline SpO2 < 85% was observed in 25%. Overall, 59 (26.6%) patients died before day 28 of hospitalization: 29% due to hematological, and 20% due to other forms of cancers. The only factor increasing the odds of death in the multivariable model was eGFR < 60 mL/min/m2 (4.621, p = 0.02), whereas SpO2 decreased the odds of death at baseline (0.479 per 5%, p = 0.002) and the use of remdesivir (0.425, p = 0.03). This study shows that patients with COVID-19 and malignancy benefit from early remdesivir therapy, resulting in a decrease in early mortality by 80%. The prognosis was worsened by low glomerular filtration rate and low peripheral oxygen saturation at baseline underlying the role of kidney protection and early hospitalization.

COVID-19 infections in infants.

The study aimed to analyse the clinical course of COVID-19 in 300 infants, selected from 1283 children diagnosed with COVID-19 between March and December 2020, registered in the SARSTerPED multicenter database. Most of the infants were registered in October and November 2020. 44% of the group were girls, and 56% were boys. At diagnosis, the most common symptoms were fever in 77% of the children, cough in 40%, catarrh in 37%. Pneumonia associated with COVID-19 was diagnosed in 23% of the children, and gastrointestinal symptoms in 31.3%. In 52% of the infants, elevated levels of D-dimers were observed, and in 40%, elevated levels of IL-6 serum concentration were observed. During the second wave of the pandemic, 6 times more infants were hospitalized, and the children were statistically significantly younger compared to the patients during the first wave (3 months vs 8 months, p < 0.0001 respectively). During the second wave, the infants were hospitalized for longer. COVID-19 in infants usually manifests as a mild gastrointestinal or respiratory infection, but pneumonia is also observed with falls in oxygen saturation, requiring oxygen therapy. Gastrointestinal symptoms are common in infants infected with SARS-CoV-2, and infant appetite disorders may lead to hospitalization. The clinical course of the disease differed significantly between the first and second wave of the pandemic. It seems that infants may play a role in the transmission of SARS-COV-2 infections in households, despite mild or asymptomatic courses; eating disorders in infants should be an indication for COVID-19 testing.

Air pollution might affect the clinical course of COVID-19 in pediatric patients.

Air pollution, to which children are more susceptible than adults, can promote airway inflammation, potentially exaggerating the effects of respiratory viral infection. This study examined the association between the clinical manifestation of COVID-19 in unvaccinated pediatric patients hospitalized in Poland (n = 766) and levels of particulate matter 2.5 (PM2.5) and benzo(a)pyrene (B(a)P) within a week before hospitalization. Children aged ≤ 12 years exposed to mean and max 24 h B(a)P levels > 1 ng/m3 revealed higher odds of cough, dyspnea, fever, and increased concentrations of inflammatory markers (C-reactive protein, interleukin-6, procalcitonin, white blood cell count). In older patients (13-17 years), elevated mean 24 h B(a)P levels increased odds of dyspnea, fever, and diarrhea, and higher concentrations of C-reactive protein and procalcitonin. Exposure to max 24 h PM2.5 levels > 20 µg/m3 was associated with higher odds of cough, increased concentrations of C-reactive protein (group ≤12 years), and increased procalcitonin concentration (groups ≤12 years and 13-17 years). In both age groups, length of stay was extended in patients exposed to elevated levels of max 24 h PM2.5, mean and max 24 h B(a)P. This study suggests that worse air quality, particularly reflected in increased B(a)P levels, might affect the clinical course of COVID-19 in pediatric patients and adds to the disease burden during a pandemic.

Pneumonia, gastrointestinal symptoms, comorbidities, and coinfections as factors related to a lengthier hospital stay in children with COVID-19-analysis of a paediatric part of Polish register SARSTer.

BACKGROUND: Although COVID-19 is associated with a mild course in children, a certain proportion requires admission to hospital due to SARS-CoV-2 infection and coexisting diseases. The prospective multicenter study aimed to analyze clinical factors influencing the length of the hospital stay (LoHS) in children with COVID-19. METHODS: The study included 1283 children from 14 paediatric infectious diseases departments with diagnosed SARS-CoV-2 infection. Children were assessed in respective centres regarding indications for admission to hospital and clinical condition. History data, clinical findings, laboratory parameters, treatment, and outcome, were collected in the paediatric SARSTer register. The group of children with a hospital stays longer than seven days was compared to the remaining patients. Parameters with a statistically significant difference were included in further logistic regression analysis. RESULTS: One thousand one hundred and ten children were admitted to the hospital, 763 children were hospitalized >24 h and 173 children >7 days. 268 children had comorbidities. Two hundred and eleven children had an additional diagnosis with coinfections present in 135 children (11%). Factors increasing the risk of higher LoHS included pneumonia [odds ratio-OR 3.028; 95% confidence interval-CI (1.878-4.884)], gastrointestinal symptoms [OR = 1.556; 95%CI (1.049-2.322)], or rash [OR = 2.318; 95%CI (1.216-4.418)] in initial clinical findings. Comorbidities [OR = 2.433; 95%CI (1.662-3.563)], an additional diagnosis [OR = 2.594; 95%CI (1.679-4.007)] and the necessity of the empirical antibiotic treatment [OR = 2.834; 95%CI (2.834-6.713)] were further factors related to higher LoHS. CONCLUSIONS: The clinical course of COVID-19 was mild to moderate in most children. Factors increasing the risk of higher LoHS included pneumonia, gastrointestinal symptoms, comorbidities, an additional diagnosis, and the empirical antibiotic treatment.

Clinical and Epidemiological Characteristics of 1283 Pediatric Patients with Coronavirus Disease 2019 during the First and Second Waves of the Pandemic-Results of the Pediatric Part of a Multicenter Polish Register SARSTer.

This prospective multicenter cohort study aimed to analyze the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) in children. The study, based on the pediatric part of the Polish SARSTer register, included 1283 children (0 to 18 years) who were diagnosed with COVID-19 between 1 March 2020 and 31 December 2020. Household contact was reported in 56% of cases, more frequently in younger children. Fever was the most common symptom (46%). The youngest children (0-5 years) more frequently presented with fever, rhinitis and diarrhea. Teenagers more often complained of headache, sore throat, anosmia/ageusia and weakness. One fifth of patients were reported to be asymptomatic. Pneumonia was diagnosed in 12% of patients, more frequently in younger children. During the second wave patients were younger than during the first wave (median age 53 vs. 102 months, p < 0.0001) and required longer hospitalization (p < 0.0001). Significantly fewer asymptomatic patients were noted and pneumonia as well as gastrointestinal symptoms were more common. The epidemiological characteristics of pediatric patients and the clinical presentation of COVID-19 are age-related. Younger children were more frequently infected by close relatives, more often suffered from pneumonia and gastrointestinal symptoms and required hospitalization. Clinical courses differed significantly during the first two waves of the pandemic.

Demographic and Clinical Overview of Hospitalized COVID-19 Patients during the First 17 Months of the Pandemic in Poland.

Long-term analyses of demographical and clinical characteristics of COVID-19 patients can provide a better overview of the clinical course of the disease. They can also help understand whether changes in infection symptomatology, disease severity, and outcome occur over time. We aimed to analyze the demographics, early symptoms of infection, laboratory parameters, and clinical manifestation of COVID-19 patients hospitalized during the first 17 months of the pandemic in Poland (March 2020-June 2021). The patients' demographical and clinical data (n = 5199) were extracted from the national SARSTer database encompassing 30 medical centers in Poland and statistically assessed. Patients aged 50-64 were most commonly hospitalized due to COVID-19 regardless of the pandemic period. There was no shift in the age of admitted patients and patients who died throughout the studied period. Men had higher C-reactive protein and interleukin-6 levels and required oxygenation and mechanical ventilation more often. No gender difference in fatality rate was seen, although the age of males who died was significantly lower. A share of patients with baseline SpO2 < 91%, presenting respiratory, systemic and gastrointestinal symptoms was higher in the later phase of a pandemic than in the first three months. Cough, dyspnea and fever were more often presented in men, while women had a higher frequency of anosmia, diarrhea, nausea and vomiting. This study shows some shifts in SARS-CoV-2 pathogenicity between March 2020 and July 2021 in the Polish cohort of hospitalized patients and documents various gender-differences in this regard. The results represent a reference point for further analyses conducted under the dominance of different SARS-CoV-2 variants.

Convalescent Plasma Transfusion for the Treatment of COVID-19-Experience from Poland: A Multicenter Study.

Because the optimal treatment for COVID-19 is still unknown, it is important to explore every potential way of improving the chances of survival for COVID-19 patients. The aim of the study was to analyze the effectiveness of convalescent plasma on COVID-19 patients. The study population consisted of 78 patients diagnosed with COVID-19, selected from the SARSTer national database, who received convalescent plasma. The impact on clinical and laboratory parameters was assessed. A clinical improvement was observed in 62 (79%) patients, and 10 (13%) patients died from COVID-19. No side effects of the convalescent plasma treatment were observed. When plasma was administered earlier than 7 days from diagnosis, the total hospitalization time was shorter (p < 0.05). Plasma efficacy was inferior to remdesivir in endpoints such as the necessity and duration of oxygen therapy, the duration of hospitalization, and mortality rate, and inferior to other drugs in the case of the duration of hospitalization and the necessity of constant oxygen therapy, but comparable in most other measured endpoints. A comparison of a 30-day mortality rate in patients who received plasma and remdesivir (4/25, 16%) and who received only plasma (6/53, 11%) showed no significant difference. Convalescent plasma efficacy is inferior to remdesivir when treating COVID-19 patients but the addition of remdesivir to plasma does not improve the treatment effectiveness. In most endpoints, plasma was comparable to other treatment options. In our opinion, convalescent plasma may be used as a supportive treatment in COVID-19 patients because of the low frequency of adverse effects and availability, but must be given as early from the diagnosis as possible.

Diode Laser 805 Hair Removal Side Effects in Groups of Various Ethnicities - Cohort Study Results.

Introduction: As hair removal has become most popular in aesthetics, the management of its side effects is crucial for every practitioner. Available studies describe the effectiveness of the diode laser hair removal for all skin types according to the Fitzpatrick scale independently, but the question of the occurrence of side effects and adverse effects remains unanswered. This study aims to illustrate aspects of side effects for patients of various ethnicities and the impact of those on the effectiveness of the treatment. Methods: The research was carried out in Poland and the United Kingdom from March 2016 to March 2019. 217 people of various ethnic origins were qualified for the study, 206 sessions were completed and statistical analysis was performed. The procedure was performed in the pubic area with diode lasers with a wavelength of 805 nm, minimum peak power of 2100 W and pulse duration between 15 and 400 ms. ET sapphire cooling assisted handle 9 x 9 mm large and pulse energy density between 10 and 100 J/cm2 were used for all treatments. In addition, in order to illustrate the effectiveness of treatments, the subjective and objective analyses of hair loss percentages were indicated. In statistical analysis, the chi-square test for independence was used to evaluate the correlation between the type and severity of side effects and the ethnic origin of patients, the number of treatments, the Fitzpatrick scale and the level of satisfaction. Results: The occurrence of sensitivity depended statistically significantly (PP=0.002) on ethnicity. Ethnicity had no significant effect on the occurrence of erythema. The occurrence of hyperpigmentation statistically significantly depended (P<0.001) on ethnicity. The occurrence of burns depended statistically significantly (P=0.001) on ethnicity. The number of treatments had a significant (P P=0.012) effect on the severity of side effects occurrence. Among participants who had 6 treatments, only half had side effects, including multiple effects occurring in 9.79% of cases. The occurrence of side effects such as sensitivity and hyperpigmentation did not depend on the number of treatments. However, the number of treatments had a significant impact on the incidence of erythema (P<0.001) and burns (P=0.005). More than half of the respondents (58.33%) had erythema after more than six procedures, whereas in the 6 treatments the erythema occurred only in 6.7% of cases. Conclusion: The treatment with the use of diode lasers for all subjects with different ethnicity and thus the recognized scale according to Fitzpatrick is effective and safe. The occurring side effects are transient and do not impact the effect of the whole therapy.

The results of the diode laser hair reduction treatments after the IPL hair reduction treatments.

Introduction: Lasers and IPL action are similarly based on the selective photo thermolysis principle, where the melanin acts as chromatophore. There are, however, fundamental differences in the way they are built and in the light they emit.The goal of this paper is to compare the results of epilation treatments by a laser and by an IPL and to rate the effectiveness of a diode laser epilation following a non-coherent light therapy.Methods: 45 healthy females, 21-23 years old, skin type II-III took part in the study.805 nm diode laser and the IPL device with a wavelength of 640-1200 nm, was used. The informed consent for participation and treatment was obtained during a consultation. The participants were randomly divided into three groups of 15: I - one IPL treatment was followed by three diode laser treatments, II - two IPL treatments followed by three diode laser treatments, III- three IPL treatments followed by three diode laser treatments.Results: A percentage average of hair loss among patients treated with a diode laser as a control group is higher which indicates the laser's higher effectiveness.Conclusion: The IPL has been shown to negatively impact the effectiveness of a diode laser. This is linked with the way non-coherent light weakens and thins the hair that impedes the absorption of laser light by the melanin and adversely affects the treatment results.

Aspects of Diode Laser (805 nm) Hair Removal Safety in a Mixed-Race Group of Patients.

Introduction: Laser hair removal (LHR) has become one of the most popular treatments in aesthetics. Side effects are an inevitable part of laser therapy, therefore managing them is crucial for every laser practitioner to ensure patients' safety along with achieving the best results. The available references describe the effectiveness of the diode LHR for all skin types according to the Fitzpatrick scale, but the question of patient safety and minimization of side effects and postoperative complications in mixed-race patients remains unanswered. This study aims to illustrate aspects of specific side effects in patients of mixed ethnicity and the impact of those effects on the results of the treatment. Methods: The study was conducted in Poland and the United Kingdom on 216 patients of various ethnic backgrounds. This study analyses the frequency of side effects in a mixed-race group of 32 participants, taking into account their skin type according to the Fitzpatrick scale. The patients received a course of 6 treatments using diode laser 805 nm. An objective and a subjective method were used to analyse treatment results and side effects, with adverse effects documented, if observed. Treatment settings were adjusted to skin reaction during the patch test. Results: Objective analysis was different from the subjective analysis of the treatment's effectiveness. No adverse effects were observed. Side effects such as hyperpigmentation, skin irritation, skin burns, and skin hypersensitivity were found. Conclusion: 805 nm diode laser is effective and efficient at hair removal in mixed-race patients. It is a safe treatment in terms of skin reaction as only short-term side effects were observed in the treated area and no adverse effects were noted. To achieve the best results and to avoid adverse effects it is necessary to adjust treatment settings according to the individual patient's skin reaction.

Diet and Physical Activity as Determinants of Lifestyle Chosen by Women from Southern Poland.

The aim of the study was to assess the relationship between the lifestyle of Polish women (characterized by the quality of diets and levels of reported physical activity) and their characteristics such as age, place of residence, physical activity at work or school, reported health status, and BMI. The sample consisted of 882 women from Southern Poland. Diet quality and the level of physical activity were evaluated by the Nutrition Beliefs Questionnaire established by the Polish Academy of Sciences. The lifestyle category (healthy, moderate, or unhealthy) was based on "Prohealthy Diet Index-10" and participant's self-assessed physical activity during their leisure-time. The lifestyle category was significantly associated with age, BMI, physical activity at work/school, and health. Moderate lifestyle (high or moderate levels of physical activity combined with low prohealthy diet) was the most commonly found classification in examined women. Age (>35 years old) and overweight are the main factors determining unhealthy lifestyle behavior. Healthy lifestyle is more often chosen by the women from big cities. More intensive efforts should be undertaken to increase the knowledge and awareness of the health benefits of a healthy lifestyle. The main goal should be concentrated on increasing the level of physical activity, especially in leisure time, and promoting the tenets of a well-balanced diet.

Distribution of HCV genotypes in Poland.

UNLABELLED: Available data on prevalence of HCV genotypes in Poland are insufficient. The aim of the study was the analysis of distribution of HCV genotypes in Poland over the period of recent 10 years regarding the age of patients and the regions of the country. MATERIAL AND METHODS: Analysis of HCV genotypes in Poland was carried out between 2003 and 2012, and included 14 651 patients from 22 centers where patients with chronic viral hepatitis C are diagnosed and treated. Genotypes were analyzed in age groups (< 20 years of age, 20-40 years of age, > 40 years of age) as well as in populations of HBV and HIV co-infections. RESULTS: Genotype (G) 1 infection was demonstrated in 79.4%, G2 -0.1%, G3- 13.8%, G4- 4.9%, G6-0.09% and mixed infections in 1.6%. There was no infection with genotype 5. The highest prevalence of G1 was observed in the Lódzkie voivodship (89.2%) and the Slaskie voivodship (86.7%) while the lowest one in the Warminsko-mazurskie (62.0%) and the Podlaskie voivodships (68.2%). Genotype 3 most commonly occurs in the Warminsko-mazurskie (28.1%), and the Podlaskie voivodships (23.0%) and is least common in the Malopolskie (7.9%) and the Lódzkie voivodships (9.0%). Genotype 4 is more common in the Kujawsko-pomorskie (11.7%) and the Podlaskie voivodships (8.6%) and relatively less common in the Lubelskie (1.1%) and the Lódzkie voivodships (1.8%). Prevalence of G1 infection in 2003-2004 was 72% and increased up to 85.6% in 2011-2012, that was accompanied by decrease of G3 prevalence from 17% to 8% in this period. In HBV co-infected (n = 83), G1 infection was demonstrated in 85.5%, G3 - in 7.2%, G4 -4.8%, and mixed genotypes in 6%. Among HIV co-infected (n = 391), a much lower prevalence of G1 (33.0%) and a high of G3 (40.4%) as well as G4 (24.0%) were observed. CONCLUSIONS: There is a geographic variability of HCV genotypes prevalence in Poland. Increase of HCV G1 infections and decrease of G3 and G4 were observed in the last 10 years. Genotypes G3 and G4 occur more often in HCV/HIV co-infected than in HCV mono-infected patients.

[The treatment of HCV infection with interferon alpha and ribavirin in a child with diabetes I type]. / Przebieg leczenia rebetronem dziecka z przewleklym zapaleniem watroby wywolanym hcv i z cukrzyca typu I.

UNLABELLED: HCV is a leading cause of chronic hepatitis in worldwide and diabetes is thought to be a risk factor of HCV infection. Interferon treatment may induce the autoimmune reactions. We report a case of 10 year old girl with diabetes since 4 th year of life and HCV infection since 9 year of life, treated with alpha-interferon and ribavirin for 12 months. Interferon was administered in doses of 3 MU 3 times a week, ribavirin 200 mg 3 times daily. Liver function (ALT, AST, GGT, prothrombin) and morphology was monitored every 6 weeks. Autoantibodies (ANA, ASMA, AMA, ATG, TPO) were tested before the treatment, after 6 and 12 months of the treatment. We have observed the adverse reactions typical for interferon and ribavirin treatment, such as: loss of appetite, muscle and joint pains, hair loss, emotional lability, concentration disturbance, irritability, somnolence and mental depression, which subsided after the end of the treatment. The transitional ALT, AST elevation in 6th month of the treatment was observed. During the therapy hypothyreosis was diagnosed in the 7th month, and thyroid autoantibodies (ATG and TPO) appeared in the 12th month. ANA antibodies were present before therapy and its titer increased after 6 month of treatment. During the therapy pneumonia, thrombocytopaenia and anaemia were observed in 6th month. CONCLUSIONS: diabetes is not contraindication to interferon and ribavirin treatment. Interferon treatment in the patients with genetic predisposition to thyroid gland diseases and in the patients with present autoantibodies ought to be applied with special caution.

[Influence of chronic HBV infection and interferon therapy on somatic development of children]. / Wplyw przewleklego zakazenia wirusem zapalenia watroby typu B i leczenia interferonem alfa na rozwój dzieci.

UNLABELLED: Interferon alpha (IFN) is the most common treatment in chronic hepatitis B in children. Its impact on the development of children is still discussed. AIM OF THIS STUDY: The assessment of body mass and body height of children after interferon therapy and the influence of chronic HBV infection on these parameters. MATERIALS AND METHODS: The study concerned 64 children who suffered chronic hepatitis B. Among them 36 boys and 12 girls were treated with interferon alpha and 18 boys and 4 girls not treated. They were compared with a control group (416 boys and 457 girls). Scatter plots and chi-square test were used in analysis. RESULTS: Treated and not treated children were found in 3 distinguish zones: middle zone M+/- 1/2 SD, above and below it. Body mass: in the middle zone about 30% boys and 25% girls were found. In the high zone 20% boys and 40% girls. In low zone 45% boys and 30% girls. Body height: in the middle zone there were 30% boys as well as 40% girls. In high zone 35% boys and 30% girls. In low zone 30% boys and 25% girls were found. The comparison of frequency of treated and not treated children represented in the three zones was not statistically significant. Among sick children (treated and not treated together) about 60% boys and about 43% girls were characterized by lower weight than arithmetic mean of a population study. According to height about 40% boys and about 37% girls were found to be under mean of control group. CONCLUSIONS: 1. Interferon alpha can be used in chronic hepatitis B in children as a drug which does not cause permanent disturbances of body mass and body height 2. Children with chronic hepatitis B infection must be treated early to stop growth retardation.

[Measles antibodies concentration in vaccinated children and adolescents with autoimmune hepatitis]. / Stezenie przeciwcial odrowych u zaszczepionych dzieci i mlodziezy chorej na autoimmunologiczne zapalenie watroby.

UNLABELLED: Etiology and pathogenesis of autoimmune hepatitis (AIH) is still unknown. In several studies significantly increased antibody titers to measles virus in the sera of patients with AIH and chronic active hepatitis as compared to healthy people were observed. Aim of the study was to evaluate the humoral immunity against measles in children and adolescent with AIH after measles vaccination. MATERIAL AND METHODS: 110 subjects of both sexes aged 6-22 year (19 patients with AIH, 41 children with chronic hepatitis B and C (CH) and 50 healthy persons (HP) were tested to measles antibodies. Moreover mumps antibodies were examined for humoral immunity defects exclusion. All subjects were vaccinated against measles but none of them with mumps vaccine. Antibody were tested by enzyme immunoassays (EIA) and standardized by calibration against the International Standard. Geometrical mean concentration (GMC) of antibodies and the number of seropositive patients were calculated. RESULTS: Measles antibodies were found in all AIH patients (GMC 1.33 IU/ml (range 0.5-21.1 IU/ml)), in 85.4% of patients with CH (GMC 1.68 IU/ml (0.5-4.9 IU/ml)) and in 78% of HP (GMC 1.62 IU/ml (0.41-10 IU/ml)). The differences between the number of seropositive patients and between antibody concentrations in three groups were not significant. Mumps antibodies were detected in 82% AIH patients, 70% patients with CH and 76% HP. In AIH group higher antibody titer was observed than in patients with CH (p=0.047). CONCLUSIONS: The vaccination with measles vaccine does not lead to immunoregulation disturbances in AIH patients in contrary to natural measles infection.

A longitudinal study of the efficacy of interferon therapy in children with chronic hepatitis B.

BACKGROUND: Interferon alpha (IFN) is the most effective drug in the treatment of chronic hepatitis B. This article presents the results of IFN therapy and 28-month follow-up. MATERIAL/METHODS: 193 Caucasian children (130 boys and 63 girls) aged 1.5-17 years were treated with IFN for 20 weeks (3.0 MIU 3 times a week). They were examined at baseline (period 0), after 6 weeks (period 1), 12 weeks (period 2), 20 weeks (period 3), 6 months (period 4), 12 months (period 5), 18 months (period 6), and 24 months (period 7). RESULTS: HBcAg elimination drom period 3 was: 29.6%, 35.2%, 45.4%, 58.3%, in period 7 63.9% (significantly higher in girls). Significant positive correlations were found in several periods between IFN/m2 and HBeAg, HBsAg elimination, HBeAb, HBsAb presence and negatie correlations between IFN/m2 and ALT activity. ALT activity significantly decreased in girls between periods 0-3, in boys between 0-3 and 4-6. Significant positive correlations between ALT-0 and HBeAg, HBsAg elimination, HBeAb, HBsAb presence was seen in several periods, more frequently in girls. IFN transiently decreased Hb, leukocytes, and thrombocytes, especially in boys. No relationship was found between IFN therapy and bilirubin, protein, albumin and gammaglobulin concentrations. The prothrombin index increased after 6 months of IFN therapy in girls. CONCLUSIONS: The efficacy of IFN therapy is clearer with longer observation, especially in girls. A relationship was found between IFN dose and HBeAg/HbeAb and HBsAg/HBsAb seroconversion. IFN had a transient negative effect on the peripheral blood picture.

Autoantibodies in children with chronic hepatitis B undergoing interferon therapy.

BACKGROUND: The occurrence of various side effects in patients treated with interferon alpha has attracted more attention to the manifestation of autoantibodies. The purpose of our study was to evaluate the side effects of interferon in children suffering from chronic hepatitis B by detecting six autoantibodies. MATERIAL/METHODS: Autoantibodies were examined in 76 children (55 boys and 21 girls) aged 2-16 years, treated with interferon-alpha 3 MU 3 times weekly for 20 weeks. They were tested before treatment (exam I) and after its conclusion (exam II). SMAs were determined by indirect immunofluorescence (Euroimmuno reagents), while ANA, AMA M2, GPC, TPO and ATG were measured by EIA (Biomedica reagents). RESULTS: No statistically significant differences were found between the total number of patients with autoantibodies in examination I and examination II. A comparison of the frequency of presence or absence of autoantibodies in the same patients in exams I and II showed significantly more frequent disappearance of GPC in exam II than appearance (p<0.00005). This was also observed in the case of TPO (p=0.320). In relation to ANA, SMA, AMA M2 and ATG these differences were not significant. CONCLUSIONS: INF-alpha does not induce autoantibody formation in children with chronic hepatitis B. Our results suggest that IFN-alpha may inhibit the formation of some autoantibodies.