Acquired immune deficiency syndrome (AIDS) and late presentation in Poland - data from Test and Keep in Care (TAK) Polska project.

OBJECTIVES: Late presentation (LP) at HIV diagnosis is associated with worse prognosis and an increase in the number of new infections. We analyse the proportion of patients diagnosed late and factors related to LP in Poland in 2016-2017. METHODS: Data were obtained from 13 out of 17 HIV centres in Poland from 2016 and 2017, including date of diagnosis, age, sex, transmission route, anti-hepatitis C virus (anti-HCV), Venereal Diseases Research Laboratory (VDRL) antibodies, AIDS diagnosis, baseline HIV viral load and CD4 count. RESULTS: Out of 1522 patients, 88.9% were male with median age of 33.6 years. Men who have sex with men (MSM) comprised 69.4% of all new infections, heterosexual route of transmission (HTX) 18.2% and injecting drug use (IDU) 4.7%. Late presenters comprised 44.8% of the study group. Factors associated with LP were female sex [odds ratio (OR) = 1.5, 95% confidence interval (95% CI): 1.09-2.08], older age (OR = 1.59, 95% CI: 1.42-1.79 per decade), route of transmission (HTX: OR = 1.96, 95% CI: 1.50-2.56; IDU: OR = 3.17, 95% CI: 1.92-5.37), positive HCV results (OR = 1.90, 95% CI: 1.23-2.95) and syphilis diagnosis (OR = 2.06, 95% CI: 2.29-3.31). Adjusting for these factors, the only independent factors associated with LP were age (OR = 1.52, 95% CI: 1.35-1.71) and route of transmission (HTX: OR = 1.73, 95% CI: 1.23-2.44; IDU: OR = 2.24, 95% CI: 1.25-4.10). CONCLUSIONS: Late presentation in Poland follows European trends. A total of 44.8% of all newly diagnosed patients in Poland continue to present late or at the AIDS stage. Independent factors associated with LP/AIDS were older age, IDU and HTX. Patients from these groups should be targeted to improve early diagnosis and medical care.

Long-term trends in HIV care entry: over 15 years of clinical experience from Poland.

INTRODUCTION: Delay in HIV diagnosis and consequently late care entry with low CD4 counts remain a major challenge for the control of the HIV/AIDS epidemic. The aim of this study was to analyse the evolution of characteristics of the HIV epidemic in Poland. METHODS: Cross-sectional data were collected for 3972 HIV-infected patients followed up in 14 of 17 Polish HIV treatment centres in the years 2000-2015. Clinical data were analysed and factors associated with late presentation (baseline CD4 count < 350 cells/µL or history of AIDS-defining illness) and advanced HIV disease (baseline CD4 count < 200 cells/µL or history of AIDS) were identified. RESULTS: The majority (57.6%) of patients entered care late, while 35.6% presented with advanced HIV disease. The odds of being linked to care late or with advanced HIV disease increased consistently across age categories, increasing from 2.55 [95% confidence interval (CI) 1.46-4.47] for late presentation and 3.13 (95% CI 1.49-6.58) for advanced disease for the 21-30-year-old category to 5.2 (95% CI 1.94-14.04) and 8.15 (95% CI 2.88-23.01), respectively, for individuals > 60 years of age. Increased risks of late entry and advanced HIV disease were also observed for injecting drug users [adjusted odds ratio (aOR) 1.74 (95% CI 1.16-2.60) and 1.55 (95% CI 1.05-2.30), respectively], with lower aOR associated with the men who have sex with men transmission route [aOR 0.3 (95% CI 0.31-0.59) and 0.39 (95% CI 0.29-0.53), respectively]. The frequencies of cases in which patients were linked to care late and with advanced HIV disease decreased over time from 67.6% (2000) to 53.5% (2015) (P < 0.0001) and from 43.5% (2000) to 28.4% (2015) (P = 0.001), respectively. CONCLUSIONS: Despite improvements over time, most patients diagnosed with HIV infection entered care late, with a third presenting with advanced HIV disease. Late care entry remains common among people who inject drugs and heterosexual groups.

[The case of mumps complicated by one-sided hearing loss]. / Przypadek nagminnego zapalenia przyusznic powiklanego jednostronna gluchota.

We presented the case of mumps complicated by left ear's hearing loss in 32-year-old man. Audiological examinations performed after one, two and three months since the date of discharge from hospital showed the maintenance of hearing loss.

[Plasma levels of interferon gamma and interleukin 10 in patients with lymphonodular toxoplasmosis]. / Stezenie interferonu gamma i interleukiny 10 w osoczu chorych na toksoplazmoze wezlowa.

The concentrations of IFN gamma and IL 10 in plasma of sixteen patients with toxoplasmic lymphadenopathy were measured. These examinations were carried out two times in the interval of a month. We found increased level of IFN gamma and normal concentrations of IL 10 in both of these terms.

[Awareness of AIDS in selected population groups from the province of Lublin]. / Wiedza na temat AIDS w wybranych grupach ludnosci wojewodztwa lubelskiego.

The poll carried out among selected community groups in the Lublin Voivodship has shown that the problem of AIDS is looked upon multifariously depending on age. The paper is an attempt to compare opinions of the 18-25 age group (118 people) with those of the 40-60 age group (100 people). The poll, which consisted of 8 questions, has indicated that the knowledge of epidemiology and preventive measures in reference to AIDS is incomplete, the younger group revealing greater awareness of the problem. It has also been determined that the need for information on the HIV virus is high. It has been agreed that television and radio programmes constitute the best methods to convey information on AIDS; the press comes second followed by various publications and open lectures. The poll has also shown that the young tend to accept HIV carriers more than the 40-60 age group.

PIP: Investigations were carried out in 1991 in 218 persons in Lublin county who were divided into 2 groups: Group I comprised 118 persons 18-25 years old, who had completed primary school, basic level trade school, or secondary school, and Group II consisted of 100 persons 40-60 years old, who had completed primary, secondary, or higher level schooling. A questionnaire asked about the probability of HIV infection in Poland, the routes and time of transmission, prevention methods, and knowledge about AIDS. Responses to the questions concerning the route of transmission were similar in both groups: sexual intercourse, use of narcotics, needle prick conveying blood of infected person, blood transfusion, maternal-fetal exchange, childbirth, and breast-feeding. Group II more frequently indicated the possibility of infection through sharing food, kisses, working together, riding the bus, and shaking hands with an infected person. Transmission of HIV by insects was asserted by 26.3% of Group I and 38% of Group II. Regarding transmission from persons with negative test results, 7.6% of respondents in Group I and 9.0% in Group II stated that it was possible to get infected from them, while 59.3% and 79.0%, respectively said it was not. As to prevention of HIV infection, 76.2% in Group I and 42% in Group II advocated the use of condoms, 59.3% and 44%, respectively, stated the need for a steady partner and avoidance a casual partners, 33.1% and 24.0%, respectively, mentioned single uses of medical instruments, but only 3.4% and 0%, respectively, referred to avoiding contact with blood. Familiarity with the topic of AIDS before filling out the questionnaires was reported by 61.9% in Group I and 59.0% in Group II. Basic sources of knowledge were derived from television, radio, press, specialist brochures, lectures, and acquaintances. The topic of AIDS was of interest to 83.1% in Group I and 71.0% in Group II. Regarding acceptance of an HIV-infected person in their vicinity, 40.7% in Group I said yes vs. 30.0% in Group II; while 44.1% and 63.0%, respectively, said no.

[Dynamics of the Paul Bunnel-Davidsohn test during infectious mononucleosis]. / Dynamika odczynu Paul-Bunnel-Davidsohna w przebiegu mononukleozy zakaznej.

The study was aimed at establishment whether dependence exists between severity of clinical course of infectious mononucleosis and the level of heterophilic antibodies in the PBD test. Antibody titers were measured three times during illness in 34 persons with infectious mononucleosis, divided into two groups: I--patients with moderate course of the disease and II--patients with moderate-severe course. In five persons out of 34 tested negative PBD test result was obtained, although these patients exhibited symptoms on mononucleosis confirmed by other laboratory methods. Positive result of the PBD test was occurring more frequently and mean titer of heterophilic antibodies was higher in patients with moderate clinical course than in persons with moderate-serious course of the disease. Decrease of PBD test titer was observed between first and third determination in both groups of patients.

[Alpha-fetoprotein in acute viral hepatitis type A]. / Alfa-fetoproteina w ostrym wirusowym zapaleniu watroby typu A.

Serum AFP levels were estimated by radioimmunoassay (RIA) at the first and the last but one day of hospitalization of 25 patients with acute viral hepatitis of type A. The observed group consisted of 11 women and 9 men. A significant increase in the serum AFP levels was found in the group of patients on the first day of hospitalization. Besides, a rise in the aminotransferases (ALT and AST) activity and in the serum total bilirubin level were observed. On the last but one day of hospitalization the mean value of serum AFP level and the activity of the investigated enzymes were diminished. Mean value of serum AFP level the and activity of aminotransferases were higher in patients than those in the control group. Only serum total bilirubin level was similar to the mean value of control group.

[Level of prolactin, gonadotrophin, testosterone, and alpha fetoprotein in serum of blood donors with antibodies to hepatitis c virus (anti-HCV)]. / Poziom prolaktyny, gonadotropin, testosteronu i alfa-fetoproteiny w surowicy krwi krwiodawców, nosicieli przeciwcial przeciwko wirusowemu zapaleniu watroby typu-C (anty-HCV).

The study was aimed at the determination of serum levels of the investigated hormones (prolactin, gonadotrophins, testosterone and alpha-fetoprotein) in blood donors with antibodies to hepatitis C virus. The observed group consisted of 50 men of age between 22 and 47 years. The blood serum concentrations of hormones were determined by RIA method using the ready made reagent kits. No characteristic changes were observed in the serum hormones levels except for prolactin. Mean value of serum prolactin concentration was higher in blood donors than those in the control group.