Background & aimsThere is a considerable burden of hepatitis C in Europe related to the lack of prompt diagnosis. We aimed to estimate the prevalence and related risk factors of HCV infections by the stages of liver fibrosis, using non-invasive methods, to understand testing needs in Poland.MethodsA cross-sectional study was conducted in 2012–2016 adopting a stratified random sampling of primary health care units followed by systematic sampling of patients within each unit. Study participants filled a questionnaire and donated blood for laboratory HCV testing. Additionally, the results of liver function tests and platelet count were collected to calculate APRI and FIB-4 scores. Cases were classified according to the level of fibrosis: ‘significant fibrosis’ (APRI≥0.7 or FIB4≥1.45) and ‘no significant fibrosis’ (APRI<0.7 and FIB4<1.45).ResultsOf 21 875 study participants, 102 were HCV-RNA positive. Prevalence of HCV infections and significant fibrosis was estimated at 0.47% (95% CI 0.38% - 0.57%) and 0.12% (0.08% - 0.17%), respectively. Cases with significant fibrosis accounted for 51.6% (33.4%-69.9%) in men and 34.4% (17.3%-51.4%) in women. There was no correlation between the HCV prevalence and age. Blood transfusion prior to 1992 strongly predicted significant fibrosis as did the history of injecting drug use (IDU) and ever having an HCV-infected sexual partner in men and caesarean sections in women. Factors associated with HCV infection without significant fibrosis were tattooing in men and younger age in women. We acknowledge limited possibility to study the associations between IDU and ever having HCV-infected sexual partner, given small sample sizes for these exposures.ConclusionsAs no clear birth cohort affected by HCV could be identified, risk factor-based screening in the general population should be considered, taking into account the association between the increased risk of liver fibrosis and the history of transfusion prior to 1992 and caesarean sections.

Cytomegaloviruses are common worldwide, with variable frequency of infections. The infection in pregnancy may lead to pregnancy loss or serious sequelae for the child. To understand the risk posed by CMV in Poland we conducted cross-sectional study on women aged 15-49 basing on existing serum bank. Age dependent incidence, the rates of congenital infection and sequelae were modelled from sero-prevalence, literature and demographic data. The overall anti-CMV IgG prevalence was 81.9% increasing from 74.3% in <30 years old to 94.3% in subjects 45+ years old. The lowest incidence was estimated at the age of 15 and the highest at the age 34 (3.8 and 8.95 respectively/100 women/year). The estimated rate of cCMV varies from 22.4 to 37.2 per 1000 live birth depending on the assumptions made. The proportion of cases due to secondary infection ranged from 34.8% to 49.9% accordingly.

Objective. The aim of the study was to review available data on HCV in Poland and Switzerland, in order to compare the two European countries with respect to epidemiological situation and efficiency of the response systems. Materials and method. A search of registries, published and grey literature was performed to assemble data on prevalence, rate of detection of new cases, identified risk factors for transmission, mortality due to HCV, prevalence of HCC and the consequent liver transplantations, as well as data on treatment in Poland and Switzerland. Results. Overall, the prevalence of anti-HCV antibodies was similar, not exceeding 1%. However, the major transmission routes of HCV infections were different: medical procedures in Poland and drug injections in Switzerland. By combining the available information it was also possible to demonstrate important differences in efficiency of the response systems. There was approximately 1 new diagnosis per 100 estimated undiagnosed cases in the population in Poland per year, compared to 6 in Switzerland, and the treatment rate per 100 estimated active infections was 2 and 4, respectively. Conclusions. Scaling up of the diagnosis and treatment is necessary in both countries; however, the means to achieve this might differ, taking into account the higher concentration of the infections in risk groups in Switzerland than in Poland.

of HBsAg expression in hepatocytes. Inflammatory infiltrates accompanied the focal expression of HCV antigens. A direct correlation between antigen expression and inflammatory reaction in situ was noted more often in hepatitis C than B. CONCLUSION: Irrespective of the etiology and activity of hepatitis, components of the inflammatory infiltrate in liver were similar. Overall inflammatory activity did not correlate with the expression of HBsAg and HCVAg; HBcAg expression, however, accompanied chronic hepatitis B of moderate and severe activity. INTRODUCTIONA cytopathic effect is absent in hepatocytes during viral replication, which is a characteristic feature of infection with hepatotropic viruses. Necrosis of hepatocytes is considered to be a result of cellular immunity reactions directed against viral antigens on the surface of these cells [1,2] . It is assumed that immunological mechanisms, insufficient for the full eradication of viruses, are responsible for liver damage and extrahepatic manifestations of infection [3] . Extrahepatic manifestations of hepatitis B virus (HBV) and hepatitis C virus (HCV) Bozena Walewska-Zielecka, Kazimierz Madalinski, Paulina Godzik, Joanna Cielecka-Kuszyk, Bogumila Litwinska, Department of Virology, National Institute of Public Health, National Institute of Hygiene, Warsaw 00-791, Poland Joanna Jablonska, Department of Hepatology and AIDS, Warsaw Medical University, Warsaw 01-201, Poland Author contributions: Walewska-Zielecka B designed and performed research; Madalinski K and Godzik P equally contributed to write the paper; Jablonska J collected the patient data; Cielecka-Kuszyk J contributed to data interpretation and wrote parts of the paper; Litwinska B contributed to data interpretation and collection of funds. Abstract AIM: To study the composition of liver inflammatory infiltrate in biopsy material from patients chronically infected with hepatotropic viruses and to evaluate the correlation of inflammatory infiltrate with hepatitis B virus (HBV) and hepatitis C virus (HCV) viral antigen expression in chronic B and C hepatitis. METHODS: The phenotype of inflammatory cells was evaluated by the EnVision system, using a panel of monoclonal antibodies. HBV and HCV antigens were detected with the use of monoclonal anti-HBs, polyclonal anti-HBc and anti-HCV antibodies, respectively. RESULTS: The cellular composition of liver inflammatory infiltrate was similar in the patients with B and C hepatitis: ~50%-60% of cells were T helper lymphocytes. Approximately 25% were T cytotoxic lymphocytes; B lymphocytes comprised 15% of inflammatory infiltrate; other cells, including NK, totalled 10%. Expression of HLA antigens paralleled inflammatory activity. Portal lymphadenoplasia was found more often in hepatitis C (54.5%) than in hepatitis B (30.6%). Expression of HBcAg was found more often in chronic B hepatitis of moderate or severe activity. Overall inflammatory activity in HBV-infected cases did not correlate with the intensity

The serum levels of all proinflammatory cytokines, especially IL-8, were significantly higher in the patients with cryoglobulinemia in comparison with the patients without cryoglobulinemia and healthy persons. All microscopic features did not correlate with the level of any investigated proinflammatory cytokines.