Injecting drug users, MSM and people at the older age should be routinely tested for HCV in Poland - data derived from a post-exposure prophylaxis population.

OBJECTIVE: The aim of the study was to identify risk factors for HCV infection and thus identify groups for routine HCV testing in the group of people consulted for post-exposure prophylaxis (PEP). MATERIAL AND METHODS: A retrospective analysis was performed of cross-sectional data available from consultations due to post-exposure prophylaxis in HIV Out-patient Clinic and Emergency Department (ED) of Hospital for Infectious Diseases in Warsaw, Poland. Data were obtained from the electronic database, from 2008-o 2016. For statistical analysis, χ2 and t-tests were used for group comparisons, as appropriate. A total of 3,593 persons were included in the study, 60 (1.7%) were anti-HCV positive. In the first step, univariate models were estimated for each of predictors separately. RESULTS: The results showed that odds of infection are significantly higher in males (OR = 1.92), people after non-professional exposure (OR = 3.82), and increase with age (OR = 1.03). In the next step, a multivariate logistic model was fitted in the group of participants after non-professional exposure with gender, age, and route of exposure as predictors. Obtained results revealed significantly higher odds of infection, both in IDU (OR = 162.6) and gender exposure (OR = 3.59) groups. After including routes of exposure, effects of age remained significant (OR = 1.05), while the effects of gender did not (OR = 1.12). CONCLUSIONS: Based on the study results, it is recommended that routine testing for HCV should be provided for people at older age, and for individual with behavioural risk factors, such as history of injecting drus use or sexual exposure, particularly among men having sex with men (MSM).

Missed opportunities for diagnosing viral hepatitis C in Poland. Results from routine HCV testing at the Emergency Department in the Hospital for Infectious Diseases in Warsaw.

AIM OF THE STUDY: Current statistics indicate that approximately 150,000 (0.5%) people in Poland suffer from active hepatitis C virus (HCV) infection, but only 20% among them are aware of their status. This project is based on the concept that screening based on the presence of HCV-related risks (a patient's individual history and behavioural risk factors) is more effective than obligatory testing of the whole population. This study investigates prevalence of serological markers for HCV among patients with a risk of exposure to HCV infection. MATERIAL AND METHODS: The prospective study concerning patients of 18 years and older was conducted at the Emergency Department (ED) of the Hospital for Infectious Diseases in Warsaw (from 15 September 2016 until 23 July 2018). The inclusion criteria were: a blood transfusion before 1992, more than three hospitalizations in the lifetime, suspected liver disease, elevated aminotransferase activity, imprisonment, patient's own initiative, history of injecting drug use. The rapid HCV test was performed on all patients who fulfilled inclusion criteria. The statistical analyses included calculating serological positivity rate and comparing risk-group characteristics. RESULTS: Among 1502 patients consulted at the emergency department with risk factors for HCV infection during the study period, the HCV test was performed in 1487 cases. New diagnoses were confirmed in 25 cases, HCV seroprevalence was 1.68%, all patients were linked to care, 21/25 (84.0%) were HCV RNA positive. CONCLUSIONS: The study confirms that routine rapid testing in certain risk groups constitutes an essential tool for identifying new HCV infections and might have an important role for public health.

The Spectrum of Malignancies among Adult HIV Cohort in Poland between 1995 and 2012: A Retrospective Analysis of 288 Cases.

THE AIM OF THE STUDY: The aim of the study was to evaluate the spectrum of AIDS-defining malignancies (ADMs) and non-AIDS-defining malignancies (NADMs) in HIV-infected patients in Poland. MATERIAL AND METHODS: A retrospective observational study was conducted among HIV-infected adult patients who developed a malignancy between 1995 and 2012 in a Polish cohort. Malignancies were divided into ADMs and NADMs. Non-AIDS-defining malignancies were further categorised as virus-related (NADMs-VR) and unrelated (NADMs-VUR). Epidemiological data was analysed according to demographic data, medical history, and HIV-related information. Results were analysed by OR, EPITools package parameters and Fisher's exact test. RESULTS: In this study 288 malignancies were discovered. The mean age at diagnosis was 41.25 years (IQR20-81); for ADMs 38.05 years, and for NADMs-VURs 46.42 years; 72.22% were male, 40.28% were co-infected with HCV. The risk behaviours were: 37.85% IDU, 33.33% MSM, and 24.31% heterosexual. Mean CD4+ at the diagnosis was 282 cells/mm(3) (for ADMs 232 and for NADMs-VUR 395). Average duration of HIV infection at diagnosis was 5.69 years. There were 159 (55.2%) ADMs and 129 (44.8%) NADMs, among whom 58 (44.96%) NADMs-VR and 71 (55.04%) NADMs-VUR. The most frequent malignancies were: NHL (n = 76; 26.39%), KS (n = 49; 17.01%), ICC (n = 34; 11.81%), HD (n = 23; 7.99%), lung cancer (n = 18; 6.25%) and HCC (n = 14; 4.86%). The amount of NADMs, NADMs-VURs in particular, is increasing at present. Male gender (OR = 1.889; 95% CI: 1.104-3.233; p = 0.024), advanced age: 50-60 years (OR = 3.022; 95% CI: 1.359-6.720; p = 0.01) and ≥ 60 years (OR = 15.111; 95% CI: 3.122-73.151; p < 0.001), longer duration of HIV-infection and successful HAART (OR = 2.769; 95% CI: 1.675-4.577; p = 0) were independent predictors of NADMs overall, respectively. CONCLUSIONS: In a Polish cohort NHL was the most frequent malignancy among ADMs, whereas HD was the most frequent among NADMs. Increased incidence of NADMs appearing in elderly men with longer duration of HIV-infection and with better virological and immunological control was confirmed. As HIV-infected individuals live longer, better screening strategies, especially for NADMs-VUR, are needed. The spectrum of cancer diagnoses in Poland currently does not appear dissimilar to that observed in other European populations.