Epidemiology of hepatitis C virus infections in children.

BACKGROUND: Epidemiological analysis of hepatitis C virus infections in children diagnosed and treated in the Hepatology Outpatient Clinic in Bytom between 1996 and 1999. MATERIAL AND METHODS: The study comprised 62 children with detected serum presence of anti-HCV antibodies (ELISA method) and/or HCV-RNA (RT-PCR method). Risk factors for the infection were thoroughly analysed on the base of questionnaires. RESULTS: It was established that in 55 (88.7%) children high probability of infection existed in connection with past hospitalization and applied diagnostic and therapeutic procedures, such as: transfusion of blood and its preparations (24.19%), surgical procedures (22.58%), hospital treatment without invasive procedures and blood transfusions (19.35%). Familial exposure was a risk factor in 4.84% of cases, while in 6.45% of cases there were no burdens in the history. CONCLUSIONS: 1. In the evaluated group of children HCV infection was iatrogenic in character in majority of cases. 2. Hospitalization, even without invasive procedures, may be an important risk factor for HCV infection. 3. Familial exposure seems to be of secondary importance in transmission of HCV infection.

Bcl-2 antigen expression in patients with chronic hepatitis C and advanced fibrosis.

Bcl-2 antigen is a proto-oncogene responsible for the inhibition of the death of cells in the mechanism of apoptosis. The expression of bcl-2 antigen was analysed in liver bioptates obtained from patients with chronic hepatitis C. Thirty-five patients with advanced fibrosis (bridging fibrosis or cirrhosis) and various inflammatory activity were investigated. Control group was formed of the subjects with minimum or non-existent fibrosis. Histological and immunohistochemical assessments were performed with the use of widely-acceptable methods. The expression of bcl-2 antigen within portal spaces and lobules was evaluated. The values of lobular index declined as the fibrosis increased. As far as portal space index is concerned, no significant changes in correlation with fibrosis advancement were noticed. Additionally, the expression of bcl-2 antigen was recorded within lymphocyte infiltrations in lobules and portal spaces, in the epithelium of bile ducts in portal spaces and proliferating bile ductules in lobules as well as in perisinusoid cells. In hepatocytes, bcl-2 expression was detected more often among controls than in the analysed patients. The expression of bcl-2 antigen is directly proportional to the degree of inflammatory activity and it is inversely proportional to the degree of fibrosis. It seems that positive colour reaction with bcl-2 antigen in lobules may be of prognostic value for the prediction of collagen fibroplasia development. Bcl-2 expression in portal spaces has a limited diagnostic value for the prediction of the scope of fibrosis in patients with chronic hepatitis C.

[Hepatocytes growth factor (HGF), leptin, neopterin serum concentrations in patients with chronic hepatitis C]. / Stezenie czynnika wzrostu hepatocytów (HGF), leptyny i neopteryny w surowicy chorych na przewlekle wzw typu C.

UNLABELLED: In 18 patients with chronic hepatitis C we evaluated leptin (with IRMA method) and HGF and neopterin (with ELISA method) serum concentrations. Concentrations of leptin, HGF and neopterin were higher than in the control group. Leptin serum concentrations correlated with liver biopsy inflammatory grading, but higher HGF concentrations were connected with fibrosis staging. Neopterin correlated with both parameters and GGTP activity. IN CONCLUSION: increased neopterin concentrations could inform about liver inflammation activity; leptin and HGF serum concentrations could reflect the liver damage intensity.

[Effectiveness of antiviral treatment of patients with chronic hepatitis C (a Polish multicenter study)]. / Efektywnosc leczenia przeciwwirusowego przewleklego zapalenia watroby typu C (wieloosrodkowe badania pòlskie).

Interferon alpha (INF) is routine treatment in patients with chronic hepatitis C. Many controlled investigations were evaluated to establish the optimal schedule of treatment with sustained virological and biochemical response. Recently, multicentre meta-analyses suggest that combination therapy (INF + Ribavirin) was more effective than treatment with interferon alone. The aim of this study was to compare the efficacy of four schedules of antiviral treatment in 445 patients with chronic hepatitis C. Combination therapy (INF + Ribavirin) given for 6 mo. and monotherapy (INF) for 18 mo. were more effective than interferon alone given for 6 mo. Treatment with INF alone for 6 mo. was demonstrated to be insufficient.

[The HLA-I and HLA-II expression evaluation in liver biopsy specimens of patients with chronic viral hepatitis]. / Ocena ekspresji antygenów HLA-I i II w bioptatach watroby chorych z przewleklym zapaleniem watroby o etiologii wirusowej.

The main an etiological agents of chronic hepatitis are viral infections. The viral infection course and outcome depend mostly on the immunological response. Infected hepatocytes are damaged by appropriately viral antigen-specific cytolytic T lymphocytes. Those sensitised T cells react only with those hepatocytes which express viral antigen and antigen HLA on membrane surface. The aim of this study was to evaluate the expression of selected histocompatibility antigens HLA in liver biopsy specimens of patients with chronic viral hepatitis. Seventeen patients with chronic persistent hepatitis (inflammatory activity 1-4 points according to Scheuer scale modified by Gabriel) and 27 patients with chronic active hepatitis (5-10 points) were studied. In these groups of patients the intensity of HLA-I (A, B, C), HLA-II (DR) expression in liver biopsy specimens, alanine aminotransferase activity, markers of HBV and HCV in serum were examined. The monoclonal mouse anti-human antibodies and streptavidin-biotin with alkaline phosphatase method for estimation of HLA-I, HLA-II was used. Results were statistically analysed using Mann-Whitney's U test and Spearman's rank correlation test. Generally, the expression of HLA-I and HLA-II on hepatocyte membrane was shown. Significant differences in expression of HLA-II among studied groups were observed, moreover the highest degree of HLA-II intensity in the group of patients with greater inflammation activity was significantly more frequently observed. The expression of HLA-I, HLA-II was regardless of the viral a etiology and serological markers of HBV replication. The degree of studied parameters expression was positively correlated with biochemical activity of inflammation.

[Rare case of endogenous hepatic coma in a patient during the course of viral hepatitis A with a good outcome after arterialization of portal blood]. / Rzadki przypadek endogennej spiaczki watrobowej u chorej w przebiegu ostrego wirusowego zapalenia watroby typu A leczonej z dobrym wynikiem arterializacja krwi wrotnej.

A case of endogenous hepatic coma during acute virus hepatitis A is reported. Arterialization of portal blood gave a good result.

[Endogenic hepatic coma in the course of acute hepatitis treated with arterialization of portal blood]. / Endogenna spiaczka watrobowa w przebiegu wirusowego zapalenia watroby leczona arterializacja krwi wrotnej.

Symptoms of endogenic hepatic coma were observed in the course of acute hepatitis in 17 patients admitted to the I Clinic of Infectious Diseases of Silesian Medical School between 1987 and 1992. Five of them were treated with the arterialization of portal blood. At least one exchange transfusion preceded the arterialization in four cases. Recovery was obtained in 3 patients. Two patients died because of complications which occurred during the twenty-four hours after the intervention. In the first case the reason of the death was the extensive myocardial infarction, in the second one-DIC and ARDS. As it has been observed, the prothrombin rate should not be lower than 30% in these patients who are to undergo the arterialization of portal blood. This value of the prothrombin rate is provided by at least one exchange transfusion.

[Food poisoning caused by Salmonella rods]. / Zatrucia pokarmowe spowodowane przez paleczki z rodzaju Salmonella.

Epidemiologic and clinical analysis concerned the cases of acute gastroenteritis caused by Salmonella rods. It has proved that the most frequent etiologic factor was Salmonella enteritidis. Also a clinical process of salmonellosis was analysed. It proved that septic forms of the disease made up 2.2% of cases. Examining antibiotic-sensitivity of Salmonella strains proved that the biggest group of them was sensitive to Biseptol.