Biomedical subjects

Małgorzata Pawłowska

Publications and source records attributed to Małgorzata Pawłowska.

At least 19 recordsLinked to original sources

PubMed2006

[Early virologic response in retherapy with pegylated interferon alpha-2B plus ribavirin in children with chronic hepatitis C].

UNLABELLED: The aim of the study was evaluation of EVR in children with chronic hepatitis C retreated with PegIFN and ribavirin. We enrolled 13 children (11 boys and 2 girls) with CHC, median age 13,9 years, previously treated with IFN monotherapy (n-4) or combined IFN+ RBV (n-9) during 12 months, mean interval for previous therapy 2,7 years, infected with HCV genotypes 1 (n-6) and type 4 (n-7), mean baseline ALT activity 65,3 U/l, HCV-RNA 488.315 IU/ml. HCV RNA was evaluated with PCR method (Amplicor Roche test), HCV genotypes with InnoLipa test. All children received pegylated IFN-alpha 2b 1,5 mcg/kg/week and ribavirin 15 mg/kg/day. EVR was defined as decrease of HCV RNA > 2 log10 to baseline or serum undetectable in 12 week of treatment. RESULTS: EVR was observed in 6/12 (50%) of children. EVR was more common in children < 13 years old and with shorter interval for end of previous therapy, higher baseline ALT activity (p<0,05) and lower HCV viral load. In patients with EVR more common leucopenia <3.000/ml was observed. 1 patient discontinued therapy because of depression. CONCLUSIONS: 1. Pegylated IFN alpha-2b with RBV seems to be effective in children with chronic hepatitis C previously non responded to therapy. 2. Factors associated with favorable treatment prognosis include high baseline ALT activity, lower viral load, shorter interval for end of previous treatment and younger age.

Adolescent↗

PubMed2006

[Pegylated interferon alpha in the treatment of chronic hepatitis B in HBe negative patients].

Among patients with chronic hepatitis B 30% there are HbeAg negative. In Europe the most of these patients are infected with genotype D HBV and live on The Mediterrane Basen. Molecular investigations were revealed presence of mutant HBV infection in this group of patients. The most common type of mutationts there are "precore stop codon" and dual mutation "basal core promoter". In clinical trials was revealed that treatment with interferon-alfa decreases staging, esspecially in treatment responders. On the base of the results of multicenter, randomized trial it was revealed that biochemical treatment response assessed as ALT activity normalisation was higer in patients receiving pegylated interferon. Similar in these groups of patients virologic response measured as HBV viral load <20.000 copies/ml was higher. Pegylated interferon seems to be the first drug for treatment of chronic hepatitis B.

Antiviral Agents↗

PubMed2006

[Chronic hepatitis C--patients "difficult to treat"].

Among "patients difficult to treat" there are infected with genotypes 1,4 HCV, patients with liver cirrhosis, blacks, immunocompromised, hemodialyzed and non-responders to previous treatment. Multicenter, randomized trials were confirmed lower sustained virologic response (SVR) in patients infected with genotype 1 HCV. To improve the response longer therapy during 72 weeks was suggested. In genotype 4 HCV infected relationship of therapeutic efficacy with patients ethnicity was shown. The standard of HCV therapy in HIV infected patients is combined therapy with pegylated interferon and ribavirin. This therapy depends of the advance of HIV infection and administered antiretroviral therapy. Pharmacokinetic examination of safety and tolerability of pegylated interferon in patients with renal insufficiency was revealed the base to administering it in these patients. Controversial in this group is administering of ribavirin. Relationships between body weight, body mass index, obesity, liver steatosis, insulin resistance and therapeutic response in patients with chronic hepatitius C are analyzed. Trials assessed the efficacy of retherapy with pegylated interferon and ribavirin patients, who non responded to previous therapy revealed positive results.

Antiviral Agents↗

PubMed2006

[Entecavir--close perspective for using it].

There are 3 drugs registered to treatment of chronic hepatitis B: interferon, lamivudine and adefovir. Many other nucleoside and nucleotide analougs are examined. In experiments on the animals: woodchucks infected with WHBV and ducks infected with DHBV beneficial influence of entecavir on viral DNA and cccDNA supression. In these examination no resistance was present. In clinical studies resistanse to entecavir conserned only patients with resistance to lamivudine. Entecavir is safety and effective in the treatment of chronic hepatits B in patients HBeAg positive and negative and in patients with resistance to lamivudine.

Animals↗

PubMed2005

[Serum IL-2 and sIL-2R concentration in children with chronic hepatitis B].

UNLABELLED: The aim of the study was evaluation of serum IL-2 and sIL-2R concentration in children with chronic hepatitis B without previous treatment. MATERIAL AND METHODS: Investigations were performed on sera from 27 children, 13 HBsAg and HBeAg positive (group I) and 14 HBsAg positive, HBeAg negative, anti-HBe positive (group II). Serum IL-2 and sIL-2R concentrations were detected with ELISA method. RESULTS: In all examined children serum IL-2 concentrations were decreased. The mean values of sIL-2R in group I was 4,40 (from 1,78 to 15,74) and in group II was 2,60 ( from 1,59 to 4,81) ng/ ml and were statistically significant higher in HBeAg positive children (group I, p < 0.005). The mean ALT activity in this group of children was increased (mean 74 U/I) . The positive correlation between sIL-2R and ALT activity was observed in group I. CONCLUSIONS: In children with chronic hepatitis B a deficiency of Th1 mediated immunological response was observed. HBeAg/anti-HBe seroconversion seems to change the IL-2/sIL-2R balance.

Adolescent↗

PubMed2005

[Tropical malaria in a 9 years old girl. A case report].

Malaria occurs in Poland sporadically. It is imported from endemic regions, exceptionally by children. Lack of knowledge of the clinical course may result in false diagnosis and fatal outcome of the disease. We present the case of falciparum malaria in the 9-years old girl during infection of Plasmodium falciparum.

Antimalarials↗

PubMed2005

[The adherence in the treatment of chronic hepatitis C].

The most effective therapy for patients with chronic hepatitis C is combined therapy with pegylated interferon plus ribavirin. Adherence has been shown to enhance the sustained viral response (SVR) in patients receiving standard or pegylated interferon plus ribavirin. Treatment - related side effects affects on treatment quality of life and impact upon the ability of a patient to adhere to treatment. It is essential that they are managed quickly and effectively. In the work authors presented side effect of the therapy of chronic hepatitis C and management of this side effects providing to reduction them.

Antiviral Agents↗

PubMed2005

[Morphological liver changes of chronic hepatitis C in antiretroviral-naive HIV-infected patients].

UNLABELLED: The aim of the study was evaluation of morphological exponents of chronic hepatitis C in naive HIV/HCV co-infected patients. MATERIAL AND METHODS: Investigation were performed in 61 patients with chronic hepatitis C, 21 HIV co-infected. HIV-HCV co-infected patients were included to group I. There were 7 females and 14 males (mean age 31.5 years). In group II there were 40 patients with chronic hepatitis C HIV-seronegatives. There were 22 females and 18 males (mean age 40.1 years). In all patients medical history, physical examination, some laboratory tests (ALT activity, HCV viral load) and histological examination of liver biopsy specimens were performed. In patients from group I HIV viral load and CD4 count were assessed. RESULTS: Among HCV infected (group II) higher biochemical activity of the disease and more intense inflammatory changes and fibrosis in the liver were detected. In group HIV/HCV co-infected 2-times higher values of HCV viral load were detected. There were no connections with morphological liver picture and HCV viral load in these patients. There were no connections between the grade of immunodeficiency and advancing of morphological changes in the liver. So grading as staging were similar, independent on lymphocyte CD4 count. CONCLUSION: In the light of performed investigations it was revealed that HIV not accelerate the natural history of chronic hepatitis C. The grade of immunodeficiency measured by CD4 count seems to no influence on advancing of morphological changes in the liver in naive patients.

Adult↗

PubMed2005

[HCV: immune response and its modifiers in clinical development].

Host immunological response is one of the major factors determining natural history of HCV infection. Disturbances of cellular immune response, especially dynamic Th1/Th2 balance and Th2 response domination seems to be the reason of HCV persistence. Recent therapeutic strategies based on immunomodulatory agents like interferon and ribavirin. Interferon action is regulated by many factors including immunological. In the work the results of experimental and clinical trials evaluating safety, tolerance and efficacy of interferon others as alpha were described. While the mechanism of immune modifiers is not clearly understood, various immunomodulatory agents are being studied for HCV-infected patients.

Antiviral Agents↗

PubMed2005

[Retreatment strategies for the patients with HCV infection].

Despite recent advances in the treatment of chronic hepatitis C, especially introduction of combined therapy with pegylated interferons with ribavirin, significant number of patients fails to achieve sustained virologic response. Such patients may be divided into relapsers and non-responders.. Pegylated interferon-based retherapy appear to induce sustained response in 40-68% of relapsers and only in 11% of non responders. New therapeutic approaches are needed for treatment of these group of patients. Current retreatment strategies includes administration of pegylated interferon and ribavirin, maintenance therapy with pegylated interferon for prevention of liver fibrosis and daily administration of consensus interferon and ribavirin. In the work the initial results of 3 clinical investigation (HALT-C, EPIC 3 and COPILOT) are presented, in which beneficial efficacy of pegylated interferon in non responders was observed.

Antiviral Agents↗

PubMed2004

[Peginterferon alpha-2b in patients with chronic hepatitis C].

150 adult patients were assigned pegylated interferon alpha-2b (once weekly 1.5 microg/kg) plus ribavirin (800-1200 mg depending on bodyweight). The treatment lasted 52 weeks and was completed by 139 persons (92.7%). Because of adverse events the treatment was interrupted in 7 persons, 4 other persons resigned. Periodical reduction of pegylated interferon doses was necessary in 19% and the reduction of ribavirin in 21% of patients. Six months after the completion of treatment HCV-RNA was negative in 82 (59%) patients. Neither hepatitis C virus genotype, nor viremia was marked in the study. The negative correlation between the degree of fibrosis in the liver tissue and the results of sustained virological response was stated. Degree of inflammation at liver tissue, sex, age over and less than 40 years did not correlate with the final virological results. The recurrence of infection happened at 7% of the treated persons (negative HCV-RNA directly after the treatment--positive 6 months after the completion). During the treatment period, and comparison with the results obtained before its implementation, statistically significantly decreased: hemoglobin concentration, the number of leukocytes, granulocytes and thrombocytes. They returned to the referential values half a year after the completion of treatment. The activity of enzymes (AIAT, AspAT, GGTP) was decreasing statistically significantly since the first weeks of the treatment till the end and remained significantly lower after 6 months. In both sexes statistically significant reduction of bodyweight was stated, while it increased during the six months after the completion of treatment. Adverse events, which mostly were mild and were not the cause of interruption of treatment, were numerous and occurred at different frequency, in the range from over 50% (flu-like) to 0.7%.

Adult↗

PubMed2004

[Interferons alpha in the treatment of chronic HCV infections].

Interferons play the main role in the treatment of chronic hepatitis C. In the clinical practice recombined forms of these cytokines dominate. Most recent obligatory standard of the treatment is combined therapy with pegylated interferon and ribavirin during 24 or 48 weeks dependent of HCV genotype. In some clinical cases, in which contraindications to these forms of drugs or adverse events appear, administration of natural interferon (alphaferon) is possible. Treatment with this form of interferon in these cases is safe and efficient.

Antiviral Agents↗

PubMed2004

[CMV infections].

Infections with cytomegalovirus are widespread among populations. The frequency of anti-CMV bodies occurrence in healthy adults is from 40% in Europe to 100% in the Third World countries. The research carried out in Poland on two thousand healthy women at productive age showed in more than half of them the presence of anti-CMV bodies before pregnancy. It is especially significant in the context of the possibility of primary CMV infection in gravidas and the transmission into the fetus. Confirmation of the primary CMV infection in women at an early stage of pregnancy requires further prenatal diagnosis. CMV is asymptomatic in 99% of cases. It is especially dangerous for neonates, in whom heavy cytomegalovirus disease is connected with immaturity of the immunological system, and for people with immunological system disorders (after transplantations or HIV infections). Clinical forms of CMV infections have been presented here, with some of them being illustrated with descriptions of cases observed at the Clinic; methods of CMV infection treatment in various groups of patients, as well as the state of knowledge about anti-CMV vaccine are also presented.

Adult↗

PubMed2004

[Combined vaccine against hepatitis A and B].

Among the infectious virus hepatitis diseases, types A and B can be successfully prevented with vaccinations. WHO recommend effective control of hepatitis A through immunisation, especially among populations with indirect or high endemicity. Since 1991 WHO has been recommending vaccinations against hepatitis B. It is planned to introduce it in all countries by the year 2007. Vaccinations against hepatitis A & B are recommended for people travelling to the regions endemic for these infections or for those with high professional risk of HAV and HBV. Presented here are the characteristic features of the vaccine, the analysis concerning the evaluation of its effectiveness, comparison of this effectiveness with monovalent vaccine effectiveness, as well as evaluation of the tolerance and safety.

Endemic Diseases↗

PubMed2004

[HIV and HCV infections--clinical implications].

Coexisting HIV and HCV infection involves approx. 10 million people in the world. It is most common in drug addicts taking drug injections as well as in haemophiliacs. In the research we have confronted the existing views on natural history progression in hepatitis C in HIV infected, with our own study. The existing recommendations for hepatitis C treatment have also been presented. It was pointed out that there is a possibility of interaction between the drugs applied in the treatment and the antiretrovirus therapy and what is connected with it, the possibility of potentially adverse actions. It was also shown that early treatment of hepatitis C in HIV infected slows down the progress of liver fibrosis, prevents liver failure, improves HA-Art tolerance, increases immunological reconstruction and improves the quality of the patients' lives.

AIDS-Related Opportunistic Infections↗

PubMed2003

[HBV and HCV coinfections in children--own investigations].

Problem of HBV and HCV coinfection is controversial. HCV superinfection seems to be the co-factor of HBV infection, so as factor inhibiting HBV replication. According to some authors in HBV, HCV co-infection more advanced morphological liver changes and progression to hepatocellular carcinoma were observed. It concerns so patients with active as an "occult" hepatitis B. In this work the results of our own investigations were presented in which beneficial influence of HCV superinfection on chronic B hepatitis in children was revealed. Our study confirmed opinions of both viruses interference.

Carcinoma, Hepatocellular↗

PubMed2002

Hepatitis B virus serologic markers and anti-hepatitis B vaccination in patients with diabetes.

BACKGROUND: In Poland HBV infections are mainly the result of nosocomial infections or risky behavior. Active prevention plays a crucial role in limiting such infections. Patients suffering from insulin-dependent diabetes (type 1) incur high risk of infection with hepatotropic viruses because of frequent hospitalization and blood tests. The aim of our study was to determine the frequency of occurrence of serological markers of HBV infection among patients with diabetes type 1, to evaluate the humoral response to HBV vaccine depending on dosage, and to evaluate the influence of past HBV infections on vaccination response. MATERIAL/METHODS: 299 diabetic patients were vaccinated against hepatitis B with Engerix B in two doses (20 mg or 40 mg), on a 0-1-6 month schedule. The humoral response to the vaccination was evaluated in the 5th and 8th months after the first dose of vaccine according to sex, dose and previous detection of anti-HBc in serum. Serologic markers of HBV infection were detected with the immunoenzymatic-fluorescent ELFA method, with bioMerieux tests using the VIDAS system. RESULTS: 98.7% of patients achieved protective anti-HBs titer after vaccination. Women responded better than men. There were no differences in mean anti-HBs concentration by vaccine dose. Patients with previous serum anti-HBc achieved anti-HBs titers (p<0.00001). CONCLUSIONS: The frequency of anti-HBc among patients with diabetes confirms the widespread risk of HBV infection in the Polish population. Diabetics should be vaccinated against hepatitis B with standard doses. Diabetics with anti-HBc in serum can be vaccinated with a single dose.

Adolescent↗

PubMed2002

[Serum neopterin and beta2-microglobulin concentration as "prognostic markers" of AIDS].

UNLABELLED: The aim of the study was evaluation of serum neopterin and beta 2-microglobulin concentrations as "prognostic markers" of AIDS natural history. MATERIAL AND METHODS: Investigations was performed in 68 patients (48 hiv-infected and 20 without hiv-infection), who were divided into 3 groups according to HIV CDC classification. RESULTS: The highest serum concentrations of neopterin and beta 2-microglobulin were detected in patients with AIDS. In a non-symptomatic HIV-infected patients p24 Ag was absent. It was detected in patients with AIDS. Negative correlation between neopterin and beta 2-microglobulin serum concentration and CD4 count was detected in sera from all patients. Positive correlation was observed between p24 Ag, serum neopterin and beta 2-microglobulin concentration in patients with AIDS. CONCLUSIONS: Progression of HIV infection was connected with an increase of serum neopterin and beta 2-microglobulin serum concentrations. Neopterin serum concentration seems to be a more sensitive marker of HIV infection than beta 2-microglobulin.

Acquired Immunodeficiency Syndrome↗