[Efficacy of combined antiviral therapy with pegylated interferon alpha-2a and ribavirin for chronic hepatitis C infection in intravenous drug users].

INTRODUCTION: Hepatitis C Virus infection represents not just a medical, but also a socio-economic problem. It is estimated that among 170 million infected, 60% belongs to the category of intravenous drug users (IDUs). OBJECTIVE: The aim of this paper was to compare the response to the combined therapy of pegylated interferon alfa 2a and ribavirin, in the group of patients with HCV infection who were intravenous drug users (IDUs) and in patients who were identified in the other way of transmission of HCV. Also to identify the influence of the therapy on diseases of addiction, during the course of HCV infection and on the effects of the combined therapy of pegylated interferon alfa 2a and ribavirin. METHODS: We conducted a retrospective-prospective study, on 60 patients, treated with combined antiviral therapy--pegylated interferon alfa 2a and ribavirin. 30 patients were from the group of IDUs, and 30 patients from other epidemiological groups. RESULTS: There were significant differences between the age of the patients (30.2 +/- 7.1 vs. 39.3 +/- 11.2 years; p = 0.002), but no significant difference in the duration of the HCV infection between the two groups of patients (8.9 +/- 7.4 vs. 13.1 +/- 7.0 years; p > 0.05). A large number of the patients in the group of IDUs had a problem with the abstinence of the drug abuse. In this group, there was the influence of alcohol (30%) and other substances with potential hepatotoxicity: marihuana (23.3%) and psychoactive drugs (73.6%). Staging of the liver fibrosis was not influenced by those two parameters and was similar in both groups (p > 0.05). The genotype 3a was dominant in intravenous drug users (50.0%) and genotype 1b in the control group of the patients (76.6%). In both groups, SVR was achieved at a higher percentage (86% vs. 70.00%; p > 0.05), but among the intravenous drug users the relapses of HCV infection were at a lower percentage (3.3% vs. 20.0%; p = 0.044). Side effects were noticed in solitary cases in both of the examined groups, but severe side effects were found only in the control group of the patients. Relapse of drug abuse was noticed in 6.66% of cases. CONCLUSION: We have registered that the group of intravenous drug users has the same or even better response to the antiviral therapy than other epidemiological groups and that the use of drugs does not change the course of HCV infection.

[On the development of the infectology service in Novi Sad].

INTRODUCTION: Infectious diseases are a part of the history of this region. Devastating epidemics of plague, smallpox, and cholera were frequent during the 18th and the 19th centuries. Other infectious diseases were a serious problem as well: alimentary tract infections, scarlet fever, diphtheria, whooping cough. Geographic position, climate, migrations, as well as the tradition and lack of medical staff and medications, affected the frequency and outcome of infections. THE HISTORY OF THE TREATMENT OF INFECTIOUS DISEASES: Patients with infectious diseases were first treated at home. Later, a hospital in Visarion street was opened as an isolation facility and a hospital for homeless patients. The development of science and the education of medical personnel exerted the greatest influence on the control and later treatment of infectious diseases. These measures resulted in the establishment of the first specialized medical institutions in Novi Sad during the cholera outbreak in 1884. After that, temporary pediatric units were organized for the treatment of scarlet fever, diphtheria and smallpox. A ward for infectious diseases was founded in the The Great City Hospital in the second half of the 19th century (1892). The 20th century was a period of control and eradication of infectious diseases in Vojvodina (smallpox, malaria, diphtheria, polio). MODERN INFECTIOUS DISEASES: Nowdays, major infectious deseases include respiratory, alimentary and parasitic infections. However, new diseases are being registered as well - hemorrhagic fevers, Lyme disease, HIV infection. The Infectologic Service in Novi Sad was developed from an Infectology Departement as part of the Departement of Internal Diseases in the new Provincial Hospital (1909) to the independent Departement for Infectious Diseases (1945). Today, Clinic of lnfectious Diseases is an integral part of the Clinical Center of Vojvodina. DEPARTMENT OF INFECTIOUS DISEASES: The Department of Infectious Diseases of the Faculty of Medicine in Novi Sad was founded in 1960. Undergraduate studies started in 1963/64 for students of medicine and in 1978/79 jor dentistry students. Today. the faculty of the Department takes part in undergraduate studies of medicine, dentistry, health care, as well as in graduate programs. The faculty members are also taking part in specialization programs at the Faculty of Medicine. Infectious disease physicians are involved in the activities of the Infectology Section (founded in 1979) of the Society of Physicians of Vojvodine of the Medical Society of Serbia. The first president of the Infectology Section was Dr. Vera Mudric, professor, infectologists, whereas Dr. Grozdana Canak, professor, was the vice-president from 2000-2004. The Infectology Section collaborates with various national and international societies for infectious diseases.