Analysis of patients with acute hepatitis E treated at the Clinic of Infectology and Travel Medicine in Kosice. / Analýza pacientov s akútnou hepatitídou E na Klinike infektológie a cestovnej medicíny v Kosiciach.

AIM: To analyse clinical, laboratory, and epidemiological data of a cohort of patients with acute hepatitis E treated at the Clinic of Infectology and Travel Medicine (CITM) in Kosice. MATERIAL AND METHODS: Retrospective analysis of hospital information system data on patients diagnosed with acute hepatitis E who were examined or hospitalized at CITM in 2015-2023. Statistical evaluation of the available data with a focus on epidemiology, course, and complications. RESULTS: The cohort consisted of 62 patients. Fifty-eight percent were male. The mean age was 56 years. Seventy-four percent of patients were hospitalized, with a mean length of hospital stay of 10 days. The most common clinical manifestation was jaundice (in 40% of patients). Six patients had stool HEV RNA testing and all were confirmed to have genotype 3. In 5% of patients, the infection was classified as imported (they did not have HEV RNA tested), and 95% of cases were autochthonous. A history of contact with an HEV infected person was reported by 26% of patients. A history of preexisting liver disease was noted in 13% of patients who were confirmed with higher bilirubin, GMT, and ammonia levels. No statistically significant differences were found for patients with a history of immune deficiency. One patient with preexisting liver disease developed fulminant infection resulting in death. Four hepatitis E patients with neurological symptoms had lower bilirubin levels. CONCLUSIONS: The study cohort included predominantly older men. Genotype 3 was confirmed in all patients who underwent HEV RNA testing. Higher bilirubin, ammonia, and GMT levels were confirmed in patients with preexisting liver disease. Patients with neurological complications had lower bilirubin levels. One patient with preexisting liver disease died.

[Invasive pulmonary aspergillosis and esophageal candidiasis in a patient with decompensated liver cirrhosis due to chronic hepatitis C and alcohol]. / Invazívna pl'úcna aspergilóza a kandidová ezofagitída u pacienta s dekompenzáciou cirhózy pecene na podklade chronickej hepatitídy C a alkoholu.

We present a rare case of combined fungal infection in a critically ill 47 year-old patient with chronic hepatitis C at the stage of liver cirrhosis. The patient was admitted for signs of decompensated cirrhosis caused by hepatitis C and increased alcohol consumption. After 2 week hospital stay, his condition was complicated by a pulmonary infiltrate and rapid deterioration followed. Despite intensive care, the patient died. Autopsy findings showed invasive pulmonary aspergillosis. The aim of this case report is to point to a broad differential diagnosis of jaundice and pulmonary infiltrates, thus stressing the value of interdisciplinary cooperation and the need to consider the possibility of invasive fungal infections when caring for liver cirrhosis patients. In addition, several risk factors contributing to the development of fungal diseases in these patients are discussed in the article.

Impact of TTV and SENV infection in chronic hepatitis B or C on liver histology and therapy outcome.

AIM: To determine the influence of TTV and SENV on histological findings and viral response in patients with chronic viral hepatitis B and C. BACKGROUND: The clinical impact of TTV or SENV coinfections in these patients remains unclear. METHODS: Serum and liver biopsy specimens from chronic hepatitis B and C patients, 107 with liver biopsy and 105 who had finished complete antiviral therapy, were investigated for the presence of TTV and SENV. RESULTS: The Ishak score determined from 107 liver biopsy samples compared according to TTV or SENV coinfection was similar. Among 39 chronic hepatitis C patients with and 43 without virological response, we have found 9 and 3 SENV positive (p < 0.05) and 18 and 28 TTV positive patients, respectively (not significant). However 11 of 32 biopsy samples obtained in the responder's group and 19 of 31 in non-responders were TTV positive (p < 0.05). No similar differences were observed among 23 chronic hepatitis B patients. TTV clearance after interferon therapy exceeded 80%, clearance of SENV 90%. CONCLUSION: TTV or SENV infections did not negatively influence the severity of histological features or the antiviral response in patients with chronic hepatitis B and C. Both viruses were highly sensitive to interferon therapy (Tab. 5, Ref. 29).

[Epidemiological survey of hepatitis C at the Clinic of Infectology and Travel Medicine in Kosice]. / Epidemiologický prehl'ad hepatitidy C na Klinike infektológie a cestovnej medicíny v Kosiciach.

INTRODUCTION: The study objective was to evaluate epidemiological aspects in patients with hepatitis C treated at the Clinic of Infectology and Travel Medicine in Kosice. MATERIAL AND METHODS: A retrospective analysis was performed of 232 patients (132 males and 100 females, mean age 43.8 years) followed up and treated with the diagnosis of hepatitis C (HC) in 2003 through 2007. RESULTS: The probable sources of infection were most often blood transfusion (in 31% of patients), injecting drug use (9%) and invasive medical procedures (6%). Tattooing and piercing procedures were a potential route of infection in 4% of HC cases, while other risk factors were less common. None of the HC risk factors was identified in 41% of HC patients. HCV genotype was determined in 198 patients. HCV genotype 1 was detected in nearly 90% of the tested HC patients, HCV genotype 3 in 36.6%, HCV genotype 2 in 3 patients and HCV genotypes 4 and 6 in one patient each. Two HC cases were coinfections with HCV genotypes 1 and 3 or 1 and 4. The mean time interval from the first detection of elevated aminotransferase activity to the diagnosis and therapy institution was 6.3 years. CONCLUSION: The most common source of infection was blood transfusion, followed by injecting drug use and surgery. The prevailing HCV genotype is 1. In the future, it would be necessary to reduce the time interval from the detection of liver damage to the etiological diagnosis of HC, which has been too long.