It is unclear whether the current antiviral treatment for chronic hepatitis C virus (HCV) infection results in complete elimination of the virus, or whether small quantities of virus persist. Our study group comprised 17 patients with chronic HCV who had sustained virological response (SVR) after interferon/ribavirin treatment. Serum and peripheral blood mononuclear cells were collected 2 to 3 times at 3-to 6-month intervals starting 40 to 109 months (mean, 64.2 ؎ 18.5 months) after the end of therapy. In addition, lymphocyte and macrophage cultures were established at each point. In 11 patients, frozen liver tissue samples were available from follow-up biopsies performed 41 to 98 months (mean, 63.6 ؎ 16.7 months) after therapy. Presence of HCV RNA was determined by sensitive reversetranscriptase polymerase chain reaction, and concentration of positive and negative strands was determined by a novel quantitative real-time reverse transcriptase polymerase chain reaction. Only 2 of 17 patients remained consistently HCV RNA negative in all analyzed compartments. HCV RNA was detected in macrophages from 11 patients (65%) and in lymphocytes from 7 patients (41%). Viral sequences were also detected in 3 of 11 livers and in sera from 4 patients. Viral replicative forms were found in lymphocytes from 2 and in macrophages from 4 patients. In conclusion, our results suggest that in patients with SVR after therapy, small quantities of HCV RNA may persist in liver or macrophages and lymphocytes for up to 9 years. This continuous viral presence could result in persistence of humoral and cellular immunity for many years after therapy and could present a potential risk for infection reactivation. (HEPATOLOGY 2005;41:106 -114.)

The aim of this study was to evaluate the efficacy and safety of interferon-a (IFN-a) therapy of chronic hepatitis B, C and D (HBV, HCV and HDV, respectively) in renal transplant recipients. A group of 42 patients (30 males, 12 females, mean age 38 years) with documented viraemia and chronic active hepatitis (CAH) were studied, of whom 1 had HBV infection alone, 11 had HCV infection alone, 3 had HBV and HDV infection concomitantly, 12 had HBV and HCV infection concomitantly, and 2 had HBV, HCV and HDV infection concomitantly. Patients received 3 MU IFNa three times weekly for 6 months. After IFN-a therapy, 18 patients (43 %) achieved normal alanine aminotransferase (ALT) activity and a partial response was observed in 12 (29%) patients. Two patients relapsed (one with HCV and one with HBV + HCV infection) immediately after the cessation of IFN-a therapy. Repeated liver biopsy was performed in 16 patients after 6-24 months of therapy and revealed progression to cirrhosis in five patients, remission in two and stable disease in nine. None o f the patients cleared HCV RNA, four patients cleared HBeAg (two also HDV), and one both HBV and HCV Five patients died during IFN-a therapy (one as a consequence of liver failure), and four died during the 6 months after therapy (two as a consequence of liver failure). During IFN-a therapy renal allograft function remained stable in 31 patients and acute rejection episodes occurred in 7, of whom 5 lost their graft and all had experienced rejection episodes before. In 16 patients normalization of ALT continued during long-term follow-up (median 22 months, range 0-84 months). IFN-a seemed to be moderately effective in the treatment of chronic HBV or HCV infections, but cannot be recommended for recipients infected with both HBV and HCV.

IntroductionEvery year more than 15,000 newly diagnosed cases of colorectal carcinoma are recorded in Poland.AimThe objective of the study was an assessment of coping strategies and pain management, acceptance of illness, and adjustment to cancer in patients diagnosed with colorectal carcinoma. The analysis was extended to include the effect of socioeconomic variables on the above-mentioned issues.Material and methodsThe study included 238 colorectal cancer patients treated on an outpatient basis at the Centre of Oncology, the Maria Skłodowska-Curie Institute in Warsaw in the year 2013. The questionnaire interview comprised demographic questions (socioeconomic variables) and the following four psychometric tests: BPCQ (Beliefs about Pain Control Questionnaire), CSQ (Coping Strategies Questionnaire), AIS questionnaire (Acceptance of Illness Scale), and the Mini-Mac scale (Mental Adjustment to Cancer).ResultsThe source of pain control depends on the respondent's level of education. An increase in patient income was associated with a lower mean result in the “power of doctors” subscale. The coping self-statements and increased behavioural activity are the two most frequently selected strategies of coping with pain. The most commonly followed ways of mental adjustment to cancer in the study group were a fighting spirit (23.42) and positive re-evaluation (22.31).ConclusionsColorectal cancer patients believe that the greatest role in pain management is played by internal factors. The locus of pain control depends on the level of education. The study patients feature a constructive way of struggling with disease differentiated by the place of residence, professional status, and income.

Hepatitis C virus (HCV) infection is considered by the World Health Organization (WHO) to be a serious public health concern and one of the major public health priorities. In 2005, it was estimated that there are 185 million anti-HCV positive people in the world, which constitutes 2.8% of the global population. Our study estimates the anti-HCV seroprevalence in the working age population (15–64 years-old), mostly urban and suburban residents, in Poland from 2004 to 2014. The studied group consisted of 61,805 working-age population representatives whose data were obtained from electronic medical records of an outpatient clinic network operating on a countrywide level. Positive anti-HCV test results were obtained in 957 patients, representing 1.5% of the whole population studied throughout the analysed period. The average age of all anti-HCV positive patients was 36.8 years. Analysis of the data suggests that the proportion of anti-HCV positive patients decreased over the study period (mean positive anti-HCV = -0.0017 × year + 3.3715; R2 = 0.7558). In 2004, positive results were noted among 3.2% of patients undergoing HCV antibody tests, but in 2014, the percentage of patients with a positive result stood at 1.1%. The apparent decrease affected men and women similarly. Our study also provides evidence that screening people born before 1965 could be beneficial.

One of the main questions regarding nonalcoholic fatty liver disease is the molecular background of the transition from simple steatosis (SS) to the inflammatory and fibrogenic condition of steatohepatitis (NASH). We examined the gene expression changes during progression from histologically normal liver to SS and NASH in models of obesity caused by hyperphagia or a high-fat diet. Microarray-based analysis revealed that the expression of 1445 and 264 probe sets was changed exclusively in SS and NASH samples, respectively, and 1577 probe sets were commonly altered in SS and NASH samples. Functional annotations indicated that transcriptome alterations that were common for NASH and SS, as well as exclusive for NASH, involved extracellular matrix (ECM)-related processes, although they differed in the type of matrix structure change. The expression of 80 genes was significantly changed in all three comparisons: SS versus control, NASH versus control and NASH versus SS. Of these genes, epithelial membrane protein 1, IKBKB interacting protein and decorin were progressively up-regulated in both SS and NASH compared to normal tissue. The molecular context of interactions of encoded 80 proteins revealed that they are highly interconnected and significantly enriched for processes involving metabolism by cytochrome P450. Validation of 10 selected mRNAs encoding genes related to ECM and cytochrome P450 with quantitative RT-PCR analysis showed consistent changes in their expression during NASH development. The expression profile of these genes has the potential to distinguish NASH from SS and normal tissue and may possibly be beneficial in the clinical diagnosis of NASH.