OBJECTIVE: Hepatitis C virus (HCV) genotyping is an important part of pre-treatment diagnostic algorithms as it guides the choice of therapeutic regimens. The aim of this study was to analyse the distribution of HCV genotypes in patients with chronic hepatitis C from Croatia in the period 2008-2015. METHODS: The study enrolled 3,655 anti-HCV positive patients with available results of HCV genotyping from the three largest national HCV genotyping laboratories. RESULTS: The majority of HCV-infected individuals enrolled in the study were male (70.7%). Analysis of age distribution in a subset of 2,164 individuals showed a mean age of 40.9 years (SD 11.77 years). Croatian patients were mostly infected with HCV genotype 1 (56.6%), followed by genotype 3 (37.3%), genotype 4 (4.2%) and genotype 2 (1.8%). Genotype 1 subtyping in a subset of 1,488 patients showed 54% (803/1,488) of 1b infections and 46% (685/1,488) of 1a infections. Percentages of genotype 1 were the highest in Central/Northwestern and Eastern Croatia and the lowest in the Central/Southern Adriatic Region. Genotype 3 was most frequently found in the Central/Southern Adriatic Region (49.1%) but represented only 17.5% of infections in Eastern Croatia (p < 0.001). CONCLUSIONS: The results of this nine-year retrospective analysis on the distribution of HCV genotypes and subtypes in 3,655 HCV-infected individuals from Croatia showed that the majority of infections can be attributed to genotypes 1 and 3 with absence of major changes in the molecular epidemiology of the two most frequent HCV genotypes infection in Croatia in the past 20 years.

• Klíčová slova
• Croatia, genotypes, hepatitis C virus, subtypes,
• MeSH
• chronická hepatitida C epidemiologie   virologie   MeSH
• dospělí MeSH
• genotyp MeSH
• Hepacivirus genetika   MeSH
• lidé MeSH
• retrospektivní studie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Chorvatsko epidemiologie   MeSH

UNLABELLED: Chronic hepatitis C is a global health problem. The virus of hepatitis C (HCV) was discovered 15 years ago. According to the Centre for Disease Control in Antlanta the epidemiology of HCV infections has changed in recent years. Simultaneously with a substantial increase in the number of infected i.v. drug addicts (from 35 % to 60 %) and in the number of sexually transmitted infections (from 7 % to 20 %), there has been a drop in the number of patients without a patent risk factor of an HCV infection (from 40 % to 10 %). Localities with a marked increase in local anti-HCV prevalence, significantly higher than the prevalence in blood donors, were identified in Italy, China and Japan. The most probable source of infection in these localities seem to be inadequately sterilized glass injection syringes and needles, which were in use until about 1975. Since adulthood anti-HCV reactivity rises almost linearly with the patients' age: in the group of patients aged 60-69 years it can be as high as 30-40 %. This is usually explained by the use, in previous times, of inadequately sterilized glass syringes and injection needles in i.v. treatment and i.v. blood sampling, by hospital stays exceeding seven days and surgery. The remaining 10 % of as yet unexplained risk factors of HCV infections are most probably the consequence of low socio-economic standards. KEYWORDS: chronic hepatitis C, epidemiology, risk factors.

• MeSH
• chronická hepatitida C MeSH
• Hepacivirus * MeSH
• hepatitida C * epidemiologie   MeSH
• lidé MeSH
• prevalence MeSH
• rizikové faktory MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Hepatitis C virus (HCV) infection is still a major cause of chronic liver diseases, with approximately 71 million chronically infected persons worldwide. People who inject drugs currently or in the past (PWID), mostly intravenously, are the main risk group among HCV chronically infected persons. The efficacy of therapy with direct acting antivirals (DAA) is almost 100 %. Currently, the main mission is to diagnose HCV infection in the most possible number of infected persons; it is in collision with poor adherence of PWID in particular.

• Klíčová slova
• HCV elimination, chronic hepatitis C, direct acting antivirals (DAA),
• MeSH
• antivirové látky terapeutické užití   MeSH
• chronická hepatitida C * diagnóza   farmakoterapie   MeSH
• Hepacivirus MeSH
• hepatitida C * diagnóza   farmakoterapie   MeSH
• intravenózní abúzus drog * farmakoterapie   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antivirové látky MeSH

UNLABELLED: Hepatitis C virus (HCV) is an important human pathogen that causes hepatitis, advanced liver fibrosis, cirrhosis (CIH), and hepatocellular carcinoma (HCC). Especially the chronic form of hepatitis C (HC), with 55-85% of acute cases progressing to it, is a serious problem worldwide. HCV is a cause of the significant morbidity and mortality that are only expected to peak. An ongoing research of new therapeutic molecules for the treatment of HCV infection is a promise for a better future. The costs incurred are, however, high. KEY WORDS: hepatitis C - genotypes - prevalence - risk groups - HCV-associated diseases.

• MeSH
• Hepacivirus * MeSH
• hepatitida C * komplikace   epidemiologie   MeSH
• lidé MeSH
• nemoci jater epidemiologie   etiologie   MeSH
• pandemie * MeSH
• prevalence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

The Roche Cobas TaqScreen MPX Test v1 - multiplex reverse transcription-real time (MPX RT-Real Time) PCR, performed on Cobas s201 for HCV RNA, HBV DNA, HIV-1 RNA /group M and O/, and HIV-2 RNA was introduced as a supplement to the currently used imunoanalysis method for blood donor´s testing (Abbott CMIA - chemiluminescent microparticle imunoassay, performed on Architect i2000 for anti-HCV, hepatitis B surface antigen (HBsAg)), anti-HIV-1 /group M and O/, anti-HIV-2 and p24 HIV). The results of study could provide valuable arguments to support the discussion about the NAT implementation into the standards of blood donor´s testing in the Czech Republic. Two groups of samples were tested. In the first one, 5074 samples from consecutive blood donors, and in the second one, 5 repository preseroconverted samples from repeat blood donors, who were subsequently confirmed positive for Viral Hepatitis and/or HIV/AIDS by the National Reference Laboratory (NRL), were tested. One sample was found reactive by chemiluminescent microparticle immuno assay (CMIA) and nucleic acid test (NAT) (confirmed HBV-positive in NRL), 31 samples were CMIA-only reactive (15 anti-HCV, 4 HBsAg, 12 anti-HIV/p24, all confirmed negative in NRL) and one pool (6 samples) was found reactive (further individual NAT was negative for all samples) in the first group of samples. One sample was NAT-only reactive (confirmed HCV-positive in NRL) in the second group of samples. Our study confirmed that screening of infectious markers using NAT can reduce the risk of transmitting the monitored infections by blood transfusion in the Czech Republic, even as a country with currently good epidemiological situation.

• MeSH
• Hepacivirus genetika   izolace a purifikace   MeSH
• hepatitida B diagnóza   epidemiologie   virologie   MeSH
• hepatitida C diagnóza   epidemiologie   virologie   MeSH
• HIV infekce diagnóza   epidemiologie   virologie   MeSH
• HIV-1 genetika   izolace a purifikace   MeSH
• HIV-2 genetika   izolace a purifikace   MeSH
• lidé MeSH
• virus hepatitidy B genetika   izolace a purifikace   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

BACKGROUND: Controlling hepatitis C virus (HCV) transmission among people who inject drugs (PWID) has focused on preventing sharing syringes and drug preparation paraphernalia, but it is unclear whether HCV incidence linked to sharing paraphernalia reflects contamination of the paraphernalia or syringe-mediated contamination when drugs are shared. METHODS: In experiments designed to replicate real-world injection practices when drugs are shared, the residual contents of HCV-contaminated syringes with detachable or fixed needled were passed through the "cookers" and filters used by PWID in preparing drugs for injection and then introduced into a second syringe. All items were tested for the presence of infectious HCV using a chimeric HCV with a luciferase gene. RESULTS: Hepatitis C virus could not be recovered from cookers regardless of input syringe type or cooker design. Recovery was higher when comparing detachable needles to fixed needles for residue in input syringes (73.8% vs 0%), filters (15.4% vs 1.4%), and receptive syringes (93.8% vs 45.7%). CONCLUSIONS: Our results, consistent with the hypothesis that sharing paraphernalia does not directly result in HCV transmission but is a surrogate for transmissions resulting from sharing drugs, have important implications for HCV prevention efforts and programs that provide education and safe injection supplies for PWID populations.

• Klíčová slova
• drug paraphernalia, harm reduction, hepatitis C virus, injection drug use, syringes,
• MeSH
• Hepacivirus izolace a purifikace   fyziologie   MeSH
• hepatitida C přenos   MeSH
• injekční stříkačky virologie   MeSH
• intravenózní abúzus drog komplikace   MeSH
• lidé MeSH
• mikrobiální viabilita * MeSH
• mikrobiologie životního prostředí * MeSH
• přenos infekční nemoci MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Research Support, N.I.H., Extramural MeSH

The pathogenesis of hepatitis C virus (HCV) infection is regulated by the host immunity and several metabolic factors affecting liver metabolism, including oxidative stress, insulin resistance, and hepatic steatosis. Both innate and adaptive immunity play an important role in HCV infection. Cytotoxic lymphocytes have a crucial role in viral eradication or viral persistence. Major cause of viral persistence during HCV infection could be the development of a weak antiviral immune response to the viral antigens, with corresponding inability to eradicate infected cells.

• Klíčová slova
• hepatitis C virus - pathogenesis - immunity - Th1 immune response - Th2 immune response - regulatory T cells - Tregs/Th17 ratio - IFN-γ - TNF-α - IL-2 - IL-10 - TGF-β.,
• MeSH
• cytotoxické T-lymfocyty imunologie   MeSH
• Hepacivirus genetika   imunologie   patogenita   MeSH
• hepatitida C imunologie   virologie   MeSH
• lidé MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

The treatment of chronic hepatitis C is currently based exclusively on the use of drugs from the direct-acting anti-viral class. They are substances that inhibit one of the 3 most important enzymes of the virus replication cycle. Anti-viral drugs are divided according to the target structure into 3 basic classes, further division is mainly based on the chemical structure of individual antivirals. A common feature of all the regimens is high efficiency and safety. Pangenotypic efficacy regimens are those that utilize a combination of 2 or 3 antiviral agents of different classes, and are effective for all HCV genotypes. Currently there are 3 such regimens available. Pangenotypic regimens probably represent the latest stage of development of treatment for chronic hepatitis C. The review discusses in detail the efficiency of different pangenotypic regimens in individual subgroups of patients with HCV infection. Atten-tion is primarily paid to the data bases for their use.

• Klíčová slova
• antiviral agent, chronic hepatitis C, treatment,
• MeSH
• antivirové látky * terapeutické užití   MeSH
• chronická hepatitida C * farmakoterapie   genetika   MeSH
• Hepacivirus * genetika   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antivirové látky * MeSH

OBJECTIVE: To assess the prevalence of hepatitis C in the general Slovak population without any further evaluation or risk group stratification. MATERIAL AND METHODS: A total of 3,608 remnant serum specimens from epidemiological surveys in 1997 (1,484 specimens) and 2002 (2,124) were analyzed. These were from randomly selected persons over 15 years of age from all over Slovakia. The anti-HCV antibodies were detected using the 4th generation ELISA test. In case of positive or borderline results, the presence of HCV RNA was determined qualitatively. RESULTS: Of the 3,608 analyzed specimens, 55 (1.52 %) were anti-HCV-positive and 10 (0.28 %) were borderline positive. HCV RNA was detected in 24 cases (0.67 %). A comparison of the 1997 and 2002 results showed a statistically significant (p < 0.01) increase of anti-HCV-positive specimens. A similar--but not significant--increase was noted in HCV RNA-positive cases. Despite a slightly higher prevalence of HCV infection in females, no statistically significant gender differences were found. Whereas anti-HCV positivity increased slightly with age, most HCV RNA patients were from the middle age group, i.e. between 36 and 45 years of age. The geographic distribution of HCV cases across Slovakia was relatively even. CONCLUSIONS: The prevalence of anti-HCV antibodies in subjects representing the general population of Slovakia older than 15 years was 1.52 %; chronic HCV infection was confirmed in 0.67 % of cases.

• MeSH
• dospělí MeSH
• Hepacivirus izolace a purifikace   MeSH
• hepatitida C - protilátky krev   MeSH
• hepatitida C epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• prevalence MeSH
• RNA virová analýza   MeSH
• senioři MeSH
• séroepidemiologické studie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Geografické názvy
• Slovenská republika epidemiologie   MeSH
• Názvy látek
• hepatitida C - protilátky MeSH
• RNA virová MeSH

BACKGROUND: Hepatitis C virus (HCV) infection has been associated with increased risk of chronic kidney disease (CKD). We investigated the impact of HCV cure on CKD in HIV-positive persons in the EuroSIDA study. METHODS: HIV-positive persons with known HCV status and at least three serum creatinine measurements after 1/1/2004 were compared based on time-updated HCV-RNA and HCV treatment: anti-HCV-negative, spontaneously cleared HCV, chronic untreated HCV, successfully treated HCV, and HCV-RNA positive after HCV treatment. Poisson regression compared incidence rates of CKD [confirmed (>3 months apart) eGFR <60 ml/min per 1.73 m] between HCV strata. RESULTS: Fourteen thousand, seven hundred and fifty-four persons were included; at baseline 9273 (62.9%) were HCV-Ab negative, 696 (4.7%) spontaneous clearers, 3021 (20.5%) chronically infected, 922 (6.2%) successfully treated and 842 (5.7%) HCV-RNA positive after treatment. During 115 335 person-years of follow-up (PYFU), 1128 (7.6%) developed CKD; crude incidence 9.8/1000 PYFU (95% CI 9.2-10.4). After adjustment, persons anti-HCV negative [adjusted incidence rate ratio (aIRR) 0.59; 95% CI 0.46-0.75] and spontaneous clearers (aIRR 0.67; 95% CI 0.47-0.97) had significantly lower rates of CKD compared with those cured whereas persons chronically infected (aIRR 0.85; 95% CI 0.65-1.12) and HCV-RNA positive after treatment (aIRR 0.71; 95% CI 0.49-1.04) had similar rates. Analysis in those without F3/F4 liver fibrosis using a more rigorous definition of CKD showed similar results. CONCLUSION: This large study found no evidence that successful HCV treatment reduced CKD incidence. Confounding by indication, where those with highest risk of CKD were prioritized for HCV treatment in the DAA era, may contribute to these findings.

• MeSH
• antivirové látky * terapeutické užití   MeSH
• chronická hepatitida C * komplikace   farmakoterapie   MeSH
• chronická renální insuficience * komplikace   epidemiologie   MeSH
• Hepacivirus MeSH
• HIV infekce * komplikace   farmakoterapie   MeSH
• koinfekce * farmakoterapie   MeSH
• lidé MeSH
• prospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• antivirové látky * MeSH