Common and distinct BOLD correlates of Simon and flanker conflicts which can(not) be reduced to time-on-task effects.

The ability to identify and resolve conflicts between standard, well-trained behaviors and behaviors required by the current context is an essential feature of cognitive control. To date, no consensus has been reached on the brain mechanisms involved in exerting such control: while some studies identified diverse patterns of activity across different conflicts, other studies reported common resources across conflict tasks or even across simple tasks devoid of the conflict component. The latter reports attributed the entire activity observed in the presence of conflict to longer time spent on the task (i.e., to the so-called time-on-task effects). Here, we used an extended Multi-Source Interference Task (MSIT) which combines Simon and flanker types of interference to determine shared and conflict-specific mechanisms of conflict resolution in fMRI and their separability from the time-on-task effects. Large portions of the activity in the dorsal attention network and decreases of activity in the default mode network were shared across the tasks and scaled in parallel with increasing reaction times. Importantly, the activity in the sensory and sensorimotor cortices, as well as in the posterior medial frontal cortex (pMFC) - a key region implicated in conflict processing - could not be exhaustively explained by the time-on-task effects.

Dietary supplements, nutraceuticals and functional foods use after myocardial infarction depend on the age, sex, BMI and professional activity - a pilot study.

OBJECTIVES: To assess dietary supplements, functional foods and nutraceuticals use among the patients after myocardial infarction (MI). MATERIAL AND METHODS: The authors prospectively enrolled 100 consecutive patients hospitalized due to MI and remaining under coordinated outpatient care after MI in the authors' cardiology department. RESULTS: The authors showed that patients within median (interquartile range) 12.30 (10.18-14.57) months after MI use dietary supplements, nutraceuticals and functional foods in their everyday diet. Vitamins (53% patients), especially vitamin D (35%), were the most frequently used dietary supplements. In contrary to common usage of dietary supplements (59%), smaller proportion of patients use functional foods (21%) and nutraceuticals (5%), especially phytosterols. The authors found that the use of over-the-counter (OTC) drugs and dietary supplements is associated with age (participants <60 years old vs. participants ≥60 years old: OTC drugs: N = 8 [20.0%] vs. N = 32 [53.3%], p < 0.001; herbals: N = 3 [7.5%] vs. N = 16 [26.7%], p = 0.019), sex of the patients following MI (females vs. males: vitamins: N = 17 [70.8%] vs. N = 36 [47,4%], p = 0.045; vitamin D: N = 13 [54.2%] vs. N = 22 [28.9%], p = 0.024; omega-3 fatty acids: N = 3 [12.5%] vs. N = 1 [1.3%], p = 0.042; herbals: N = 8 [33.3%] vs. N = 11[14.5%], p = 0.040), as well as the BMI of the participants (BMI < 24.9 vs. BMI ≥ 25.0: multivitamin/ multimineral dietary supplements: N = 3 [15.0%] vs. N = 31 [42.5%], p = 0.035; vitamin B6: N = 1 [5.0%] vs. N = 21 [28.8%], p = 0.035). In the study group all participants with the age above retirement age have already withdrawn from professional activity and they more often used OTC drugs (N = 14 [25.9%] before retirement age vs. N = 26 [56.5%] above retirement age, p = 0.002). CONCLUSIONS: The patients following MI use supplements, functional foods and nutraceuticals. Their use depends on sex, age, BMI and professional activity. The authors believe that their potential beneficial effects require further evaluation in clinical longitudinal studies. Int J Occup Med Environ Health. 2023;36(6):732-43.

The relationship between body mass index and food preoccupation in women: A moderated mediation of body-related self-conscious emotions and self-esteem.

OBJECTIVE: Individuals who are preoccupied with food are more likely to develop maladaptive eating behaviours and eating disorders. Thus, it is advisable to investigate the factors that increase vulnerability to food preoccupation (FP) to prevent its harmful impact on physical and mental health. Our objective in this study was to investigate the relationship between body mass index (BMI) and FP in Polish women (N = 407) and examine a possible pathway through body-related shame and body-related guilt and self-esteem. METHOD: Participants completed an abbreviated version of the Eating Attitudes Test-26, the Body and Appearance Self-Conscious Emotions Scale, and the Rosenberg Self-Esteem Scale. RESULTS: The findings demonstrated a positive indirect effect of BMI on FP through body-related shame and body-related guilt. However, this effect was moderated by self-esteem only for body-related shame; namely, in women with a low or average level of self-esteem, higher BMI was related to higher body-related shame, which, in turn, was associated with higher levels of FP. These associations were not observed in women with a high level of self-esteem. DISCUSSION: Body-related shame may help explain the relationship between BMI and FP. Moreover, self-esteem serves as a protective factor against body-related shame related to higher BMI and, as a result, against FP.

Pylabianca: comprehensive and user­friendly Python package for single­neuron data analysis.

In the area of electrophysiology, the availability of comprehensive and user­friendly tools for single-neuron data processing, statistical analysis, and fast, intuitive data visualization is limited. To address this gap, we introduce pylabianca, a Python library tailored for robust single and multi­unit data processing. Pylabianca leverages the power of standard Python packages and adopts the application programming interface of MNE­Python, one of the most widely used electrophysiology packages. One of pylabianca's primary objectives is to provide a low entry threshold for scientists, requiring only basic Python programming skills. Pylabianca was designed to streamline most common analyses of single neuron data, and provide convenient data structures to serve as a foundation for building custom analysis pipelines. We believe that pylabianca will contribute to enhancing researchers' capabilities and efficiency in the field of single-neuron electrophysiology.

Power and Intimacy Motives in Narratives About Closeness Presented by People Staying in a Penitentiary Institution.

The world of people imprisoned in penitentiary institutions may never be understood by those who enjoy their freedom. The present study investigated the narratives about close relations, produced by inmates, with the analyses focusing specifically on the motive of power and the motive of intimacy, as described by McAdams. It was hypothesized that, depending on the length of prison sentence, the inmates would differ significantly regarding these motives and secondly that the motive of intimacy and the subjects' age would be significant predictors for the duration of the prison sentence. The study involved 356 male inmates (M = 28.80; SD = 10.91) who were asked to write stories about close relations with their partners. The findings show that individuals with longer prison sentence present a higher level of the power motive focused on building a stronger self, compared to the inmates sentenced to prison for a shorter duration. A multivariate regression analysis showed that the duration of imprisonment is positively predicted by the subjects' age and negatively by the motive of intimacy.

Are There Still Difficult-to-Treat Patients with Chronic Hepatitis C in the Era of Direct-Acting Antivirals?

Difficult-to-treat populations with chronic hepatitis C (CHC), in the era of interferon treatment, included patients with liver cirrhosis, kidney impairment, treatment-experienced individuals, and those coinfected with the human immunodeficiency virus. The current study aimed to determine whether, in the era of direct-acting antivirals (DAA), there are still patients that are difficult-to-treat. The study included all consecutive patients chronically infected with hepatitis C virus (HCV) who started interferon-free therapy between July 2015 and December 2020 in the Department of Infectious Diseases in Kielce. The analyzed real-world population consisted of 963 patients, and most of them were infected with genotype 1 (87.6%) with the predominance of subtype 1b and were treatment-naïve (78.8%). Liver cirrhosis was determined in 207 individuals (21.5%), of whom 82.6% were compensated. The overall sustained virologic response, after exclusion of non-virologic failures, was achieved in 98.4%. The univariable analysis demonstrated the significantly lower response rates in males, patients with liver cirrhosis, decompensation of hepatic function at baseline, documented esophageal varices, concomitant diabetes, body mass index ≥25, and previous ineffective antiviral treatment. Despite an overall very high effectiveness, some unfavorable factors, including male gender, genotype 3 infection, liver cirrhosis, and treatment experience, significantly reduce the chances for a virologic response were identified.

Genotype-specific versus pangenotypic regimens in patients infected with hepatitis C virus genotype 1b in real-world settings.

Introduction: The introduction of direct-acting antivirals (DAAs) has provided us with hope to eliminate hepatitis C virus (HCV) infection as a significant public health problem in the coming years. Objective: Our study aimed to compare the effectiveness and safety of genotype-specific and pangenotypic regimens in genotype 1b­infected patients treated in real-world settings. Patients and methods: Patients were selected from 990 HCV-infected individuals treated with DAAs in the Department of Infectious Diseases in Kielce, Poland, who had the therapy initiated between July 1, 2015 and December 31, 2020. Results: A total of 795 genotype 1b­infected patients with a median age of 51 years, female predominance (55%), and a 21.1% rate of cirrhosis were included in the analysis. A total of 69.9% of patients were treated with genotype-specific regimens. Those patients were significantly older, more often were treatment experienced, and had advanced liver fibrosis and cirrhosis compared with patients assigned to pangenotypic regimens. An overall sustained virologic response rate of 97.9% in the intention-to-treat (ITT) analysis and 99% after excluding nonvirologic nonresponders was achieved, with no significant difference between patients in the 2 treatment arms. Significantly higher proportions of men (P = 0.001) and DAA-experienced patients (P = 0.049) were documented among virologic nonresponders. Conclusions: We confirmed very high effectiveness and a good safety profile of both genotype-specific and pangenotypic regimens used in patients with genotype 1b HCV infection, and we found no differences between these 2 generations of medications. Male sex and previous treatment with DAAs were identified as negative predictors for therapy effectiveness.

Beyond Difference in Reaction Time: Understanding Neuronal Activity during the Preparatory Period of the Decision Process.

Even the simplest perceptual tasks are executed with significant interindividual differences in accuracy and RT. In this work, we used the diffusion decision model and multi-electrode EEG signals to study the impact of neuronal activity during the preparatory period on the following decision process in an attention task. Two groups were defined by fast and slow responses during the performance of control trials. A third, control group performed the same experiment but with instructions defining signal for response execution. We observed that the fast-responding group had a shorter duration of nondecision processes (describing both stimulus encoding and response preparation) preceded by lower power of the frontal upper alpha (10-15 Hz) and central beta (21-26 Hz) activities during the preparatory period. To determine whether these differences were followed by a shortening of the early perceptual or late motor process, we analyzed lateralized readiness potential (LRP). The time from LRP onset until response execution (LRP-RT interval) was similar in all three groups, enabling us to interpret shortening of nondecision time as reflecting faster stimulus encoding.

Large-scale brain networks underlying non-spatial attention updating: Towards understanding the function of the temporoparietal junction.

The temporoparietal junction (TPJ) and related areas are activated when a target stimulus appears at unexpected locations in Posner's spatial-cueing paradigm, and also when deviant stimuli are presented within a series of standard events in oddball paradigms. This type of activation corresponds to the ventral attention network (VAN), for regions defined on the basis of the spatial task. However, involvement of the VAN in object-based updating of attention has rarely been examined. In the present study, we used functional magnetic resonance imaging to investigate brain responses to (i) invalid targets after category-cueing and (ii) neutrally cued targets deviating in category from the background series of pictures. Bilateral TPJ activation was observed in response to invalidly cued targets, as compared to neutrally cued targets. Reference to the main large-scale brain networks showed that peaks of this activation located in the angular gyrus and inferior parietal lobule belonged to the default mode (DMN) and fronto-parietal networks (FPN), respectively. We found that VAN regions were involved only for simple detection activity. We conclude that spatial and non-spatial reorienting of attention rely on different network underpinnings. Our data suggest that DMN and FPN activity may support the ability to disengage from contextually irrelevant information.

Low risk of HBV reactivation in a large European cohort of HCV/HBV coinfected patients treated with DAA.

OBJECTIVES: The aim of the study was to analyze the prevalence and clinical characteristics of HCV/HBV coinfection and to evaluate the rate of HBV-reactivation during anti-HCV therapy in a large real-world study. METHODS: Analyzed population consisted of 10,152 chronic hepatitis C patients treated with DAA between 2015 and 2019 in a nationwide study. Prior to the DAA all subjects had HBsAg and 60% anti-HBc testing. RESULTS: 111 of 10,152 patients (1.1%) had detectable HBsAg and 1239 of 6139 (20.2%) anti-HBcAb. The prevalence of occult hepatitis B was 0.48%. HCV/HBV patients were younger with a higher proportion of males, HIV-coinfected, and advanced fibrosis. They were less often diagnosed with diabetes but more often with chronic kidney disease. In HBsAg(+) subjects with baseline HBV-DNA available 6/102 (5.9%) HBV-reactivations during or after DAA therapy were observed, and in two (1.9%) significant hepatic flares were noted. In HBsAg(-)/anti-HBc(+) group 2 (0.16%) reactivations were observed only in patients undergoing immunosuppressive therapy. DISCUSSION: Data from a large European cohort suggest a relatively low risk of HBV-reactivation during DAA-therapy for HCV infection in HBsAg(+) patients. In HBsAg(-)/anti-HBc(+) HBV-reactivation seems to be limited to subjects with immunodeficiency. Importantly, previous exposure to HBV and occult hepatitis B is present in a significant proportion of HCV-infected.

Retreatment of symptomatic hepatitis C virus genotype 3 associated mixed cryoglobulinemia with sofosbuvir and ribavirin: a case report.

A 52-year-old woman with chronic hepatitis C virus genotype 3 infection developed clinically symptomatic mixed cryoglobulinemia. She started pegylated interferon and ribavirin therapy and in week 12 became negative for HCV RNA with resolution of clinical signs of cryoglobulinemia. The dual treatment was discontinued due to interferon-related bilateral retinopathy. After therapy cessation, relapse of HCV RNA and recurrence of symptomatic cryoglobulinemia were observed. While waiting for the antiviral retreatment option she developed glomerulonephritis with renal impairment. Successful HCV eradication was achieved with 24-week treatment of sofosbuvir and ribavirin despite this regimen being considered as suboptimal therapy for genotype 3 HCV infection. A sustained virological response resulted in lasting resolution of clinical symptoms of mixed cryoglobulinemia.

EEG-neurofeedback training of beta band (12-22Hz) affects alpha and beta frequencies - A controlled study of a healthy population.

The frequency-function relation of various EEG bands has inspired EEG-neurofeedback procedures intending to improve cognitive abilities in numerous clinical groups. In this study, we administered EEG-neurofeedback (EEG-NFB) to a healthy population to determine the efficacy of this procedure. We evaluated feedback manipulation in the beta band (12-22Hz), known to be involved in visual attention processing. Two groups of healthy adults were trained to either up- or down-regulate beta band activity, thus providing mutual control. Up-regulation training induced increases in beta and alpha band (8-12Hz) amplitudes during the first three sessions. Group-independent increases in the activity of both bands were observed in the later phase of training. EEG changes were not matched by measured behavioural indices of attention. Parallel changes in the two bands challenge the idea of frequency-specific EEG-NFB protocols and suggest their interdependence. Our study exposes the possibility (i) that the alpha band is more prone to manipulation, and (ii) that changes in the bands' amplitudes are independent from specified training. We therefore encourage a more comprehensive approach to EEG-neurofeedback training embracing physiological and/or operational relations among various EEG bands.

Beware: Recruitment of Muscle Activity by the EEG-Neurofeedback Trainings of High Frequencies.

EEG-neurofeedback (NFB) became a very popular method aimed at improving cognitive and behavioral performance. However, the EMG frequency spectrum overlies the higher EEG oscillations and the NFB trainings focusing on these frequencies is hindered by the problem of EMG load in the information fed back to the subjects. In such a complex signal, it is highly probable that the most controllable component will form the basis for operant conditioning. This might cause different effects in the case of various training protocols and therefore needs to be carefully assessed before designing training protocols and algorithms. In the current experiment a group of healthy adults (n = 14) was trained by professional trainers to up-regulate their beta1 (15-22 Hz) band for eight sessions. The control group (n = 18) underwent the same training regime but without rewards for increasing beta. In half of the participants trained to up-regulate beta1 band (n = 7) a systematic increase in tonic EMG activity was identified offline, implying that muscle activity became a foundation for reinforcement in the trainings. The remaining participants did not present any specific increase of the trained beta1 band amplitude. The training was perceived effective by both trainers and the trainees in all groups. These results indicate the necessity of proper control of muscle activity as a requirement for the genuine EEG-NFB training, especially in protocols that do not aim at the participants' relaxation. The specificity of the information fed back to the participants should be of highest interest to all therapists and researchers, as it might irreversibly alter the results of the training.

The Do's and Don'ts of Neurofeedback Training: A Review of the Controlled Studies Using Healthy Adults.

The goal of EEG neurofeedback (EEG-NFB) training is to induce changes in the power of targeted EEG bands to produce beneficial changes in cognitive or motor function. The effectiveness of different EEG-NFB protocols can be measured using two dependent variables: (1) changes in EEG activity and (2) behavioral changes of a targeted function (for therapeutic applications the desired changes should be long-lasting). To firmly establish a causal link between these variables and the selected protocol, similar changes should not be observed when appropriate control paradigms are used. The main objective of this review is to evaluate the evidence, reported in the scientific literature, which supports the validity of various EEG-NFB protocols. Our primary concern is to highlight the role that uncontrolled nonspecific factors can play in the results generated from EEG-NFB studies. Nonspecific factors are often ignored in EEG-NFB designs or the data are not presented, which means conclusions should be interpreted cautiously. As an outcome of this review we present a do's and don'ts list, which can be used to develop future EEG-NFB methodologies, based on the small set of experiments in which the proper control groups have excluded non-EEG-NFB related effects. We found two features which positively correlated with the expected changes in power of the trained EEG band(s): (1) protocols which focused on training a smaller number of frequency bands and (2) a bigger number of electrodes used for neurofeedback training. However, we did not find evidence in support of the positive relationship between power changes of a trained frequency band(s) and specific behavioral effects.

Predictors of sustained virological response in patients with hepatitis C virus genotype 3 infection.

AIM OF THE STUDY: To assess predictors of sustained virological response (SVR) in patients with chronic hepatitis C virus (HCV) genotype 3 treated with standard therapy. MATERIAL AND METHODS: We retrospectively investigated data of 116 consecutive treatment-naïve patients chronically infected with HCV genotype 3, treated with pegylated interferon alpha (PegIFNα) and ribavirin (RBV) for 24 weeks. HCV RNA at week 4 (rapid virological response - RVR) and week 12 (early virological response - EVR) were measured in 85 and 105 patients respectively. Liver biopsy data were available for 103 patients. The variables were compared between patients with an SVR and those without. RESULTS: Overall 70.7% of patients achieved an SVR. Pretreatment factors including younger age, mild liver fibrosis as well as normal values of gamma-glutamyl transferase (GGT) and platelet count were significantly associated with higher SVR rate in univariate analysis. In the multivariate analysis only baseline platelet count > 140 000/µl and normal GGT activity were correlated with higher SVR rate. At weeks 4 and 12 HCV RNA was undetectable in 34.1% and 84.8% of patients respectively. The SVR rate was significantly higher in patients with an RVR compared to those without (p = 0.002). Only 2 patients with a rapid and early virological response did not achieve an SVR; both had negative pretreatment prognostic factors. CONCLUSIONS: In treatment-naïve patients with genotype 3 HCV infection, low baseline platelet count and elevated GGT activity were significantly associated with poor response to PegIFNα and RBV. Achieving a rapid and early virological response was associated with higher likelihood of an SVR.

[Changes in blood pressure and heart rate by an increase in serum estradiol in women undergoing controlled ovarian hyperstimulation]. / Zmiany cisnienia tetniczego i czestosci serca pod wplywem wzrostu stezenia estradiolu w surowicy u pacjentek poddanych kontrolowanej stymulacji jajeczkowania.

UNLABELLED: The aim of the study was to evaluate changes in blood pressure and heart rate in women undergoing controlled ovarian stimulation (COH) in preparation for assisted reproduction techniques. Material and method: The comparison of blood pressure and heart rate measurements obtained from 5 women (age 35.3 +/- 9.4 years) was performed. The data were collected during the 24-hour ambulatory blood pressure monitoring (ABPM) using Holcard sphygmomanometer CR-07 Aspel S.A. at the beginning and in the last day of short protocol of COH with the use of triptorelin (Decapeptyl 0.1 mg/day--Ferring GmbH) and the total supply of Gonalu F 225 U/day--Merck Serono) and Menotropiny 75j FSH + LH 75 U/day (Merional Imed/lBSA). RESULTS: During COH the increase in the serum estradiol level was detected (54.03 +/- 9.4 pg/ml at baseline vs. 1128.7 +/- 208.6 pg/ml after COH, p < 0.001). However, there were no differences in SBP and DBP values before stimulation and on the day of its completion. Only the decrease of mean arterial pressure measured by oscillometric method was observed during the study (95.1 +/- 25.3 mmHg vs. 87.6 +/- 27.8 mmHg, p<0.02). Mean arterial pressure measured by oscillometric method decreased in the daytime measurements (98 +/- 27.3 mmHg vs. 92.8 +/- 26.5 mmHg, p<0.05) as well as in the nighttime measurements (84.4 +/- 17.4 mmHg vs. 78.8 +/- 14, 4 mmHg, p <0.05). After COH, the higher heart rate (HR) was measured (in overall ABPM statistics: baseline HR 68.5 +/- 12.8/min vs. 73.6 +/- 13.7/ min after COH, p<0.002 and also in daytime statistics: baseline HR70.8 +/- 13.6 / min vs. 76.3 +/- 15.5 / min after COH, p<0.002). CONCLUSIONS: The increase in serum estradiol level caused by COH leads to increase in heart rate and reduction in mean arterial pressure measured by oscillometric method. However, short-term increase in serum estradiol during COH is not associated with significant changes in systolic and diastolic blood pressure in women preparing for the in vitro procedure.

Brain-training for physical performance: a study of EEG-neurofeedback and alpha relaxation training in athletes.

In recent years, EEG-neurofeedback training (EEG-NFB) has been increasingly used to optimize various brain functions. Better performance in various activities was also reported after relaxation trainings, another popular method in therapeutic practice. Both these methods are used as a part of professional coaching in sports training centers. In the present study, we aimed to evaluate the impact of such holistic training on physiological (EEG) and behavioral measures on semi-professional athletes. EEG-NFB paradigm was intended for amplification of the amplitudes of SMR (12-15 Hz) and beta1 (13-20 Hz) bands and simultaneous reduction of the amplitude of theta (4-7.5 Hz) and beta2 (20-30 Hz). Participation in NFB sessions was accompanied with self-administration of relaxing, audio-visual stimulation after each daily athletic training session. The training program resulted in the increase of alpha and beta1 power of trained participants when assessed in rest with eyes-closed. In eyes - open state, participants of the trained group maintained the same level in all frequency bands, in opposite to the control subjects, whose power decreased in the second measurement in beta1 band when compared to the first one. The trained group exhibited greater reduction of reaction times in a test of visual attention than the control group and showed improvement in several performance measures of Kraepelin's work-curve, used to evaluate speed, effectiveness and work accuracy. Together, these results present initial support for the use of holistic, neurophysiological training in sports workout.

[Rate of liver fibrosis progression among patients with chronic hepatitis C in Poland]. / Tempo postepu wlóknienia watroby u chorych z przewleklym zapaleniem watroby typu C w Polsce.

AIM: To assess the rate of liver fibrosis (RLF) among previously untreated patients with chronic hepatitis C (CHC) and to identify predictors of rapid progression to cirrhosis in this group. PATIENTS AND METHODS: Medical records of 337 consecutive patients with biopsy proven CHC (anti-HCV and HCVRNA positive; F/M: 153/184; mean age at biopsy: 43 +/- 14 years) and with known probable age at infection have been analysed. There were no intravenous drug users among the patients. HBsAg--and HIV-positive subjects as well as those with other concomitant liver disease were excluded from the analysis. The RLF was defined as the ratio between fibrosis stage (scored 0-6 units [U] according to Ishak's criteria, with 6 representing established cirrhosis) and the duration of HCV infection (in years). The RLF was analysed in relation to the age at infection, sex, route of transmission, alcohol abuse, past HBV infection, acute hepatitis history, HCV genotype and hepatic steatosis. Based on published data, a patient with RLF > or = 0.3 U/yr (cirrhosis up to 20 years after HCV infection) was arbitrarily defined as a rapid progressor. Both uni- and multivariate statistical analyses were performed. RESULTS: The mean RLF was 0.14 +/- 0.17 U/yr (range 0-0.83) and the expected mean duration from infection to cirrhosis was 43 years. In multivariate analysis the only independent factors associated with an increase in RLF were the older age at infection and alcohol abuse (both with p < 0.0001). 58 [17.2%] patients were rapid progressors and the same factors as mentioned above have been independent predictors of cirrhosis up to 20 years after infection. There were as much as 55.5% of rapid progressors among alcohol abusers infected in the age over 30 and only 1.9% among non-alcoholic patients infected in the age up to 30 years. CONCLUSIONS: Our study showed that natural course of CHC in Poland is similar to other regions of the world. HCV-related liver disease progression is accelerated among alcohol abusers and infected in older age. In contrast, risk of cirrhosis seems to be minimal among non-alcoholic patients infected before the age of 30.

Progress of liver disease in chronic hepatitis C patients who failed antiviral therapy.

BACKGROUND: The natural history of chronic hepatitis C (CHC) is characterized by gradual progression of hepatic fibrosis, which can lead to cirrhosis. The aim of our study is to examine the influence of ineffective antiviral therapy on progress of the liver disease in CHC patients. MATERIAL/METHODS: Seventy-seven treated and non-treated CHC patients with two liver biopsies: baseline (BLB) and control (CLB) performed at least 12 months after treatment and at least 18 months from BLB in non-treated patients were studied. Twenty-eight CHC patients (age: 40.3 +/- 9.2 yrs; 22M), non-responding to interferon therapy (all with pretreatment fibrosis), were compared with non-treated patients divided into subgroups NT1 (21 patients [age: 45.1 +/- 11.2 yrs; 10M] with fibrosis in BLB) and NT2 (28 patients [age: 34.7 +/- 12.6; 17M] without fibrosis in BLB). The baseline clinical data between study groups as well as activity grade and fibrosis staging scores of the paired biopsy samples were compared. RESULTS: All three groups were comparable in terms of mean duration of the disease and interval between biopsies. There were no significant differences of clinical features in T and NT1 groups. In CLB, the patients from NT1 group presented non-significant worsening of staging and grading and in NT2 group a slight but statistically significant increase in grading was observed. In contrast, the treated patients had a slight, but significant improvement in liver histology. CONCLUSIONS: Antiviral treatment stopped the progression of liver disease in CHC despite the lack of biochemical and virological response. In non-treated patients a slight tendency to worsening of morphological parameters was observed.