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Article ; Online: The prevalence of smoking cigarettes among HIV-infected patients after a decade. Single-center analysis.

Tochman, Pola / Mikuła, Tomasz / Lembas, Agnieszka / Wiercińska-Drapało, Alicja

International journal of adolescent medicine and health

2023 Volume 35, Issue 3, Page(s) 277–281

Abstract: Objectives: Smoking habit is known to be a risk factor for the development of multiple diseases and conditions, premature death, and worse quality of life. The prevalence of smoking in PLWH is 2-3 times higher than in the general population. The study ... ...

Abstract	Objectives: Smoking habit is known to be a risk factor for the development of multiple diseases and conditions, premature death, and worse quality of life. The prevalence of smoking in PLWH is 2-3 times higher than in the general population. The study aimed to evaluate how the prevalence of smoking has changed among PLWH over the past decade. Methods: The data of n=204 PLWH hospitalized from November 2018 to November 2019 was analyzed. All patients filled out the survey including age, gender, the number of cigarettes smoked, the number of years as a smoker, and the impact of HIV diagnosis on the number of cigarettes smoked. The data was compared to a similar analysis performed in our department in 2009. Results: The study showed a decrease in the prevalence of smoking among PLWH over the past decade. In comparison to 2009, a statistically significant (p<0.05) reduction in the number of smoking individuals among ever and never smokers was observed both in males and in females. Conclusions: The prevalence of smoking cigarettes among PLWH in our department has significantly decreased since 2009 but remains much higher than in the general population. Smoking cessation interventions provided by HIV care professionals are necessary and should be continued among PLWH.
MeSH term(s)	Male ; Female ; Humans ; Smoking Cessation ; Prevalence ; Quality of Life ; Smoking/epidemiology ; HIV Infections/epidemiology ; Tobacco Products
Language	English
Publishing date	2023-05-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639287-8
ISSN	2191-0278 ; 0334-0139
ISSN (online)	2191-0278
ISSN	0334-0139
DOI	10.1515/ijamh-2023-0001
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Article ; Online: Rapid-progressing progressive multifocal leukoencephalopathy in two patients newly diagnosed with HIV: case series and review of literature.

Badura, Barbara / Barczak, Szymon / Mikuła, Tomasz / Wiercińska-Drapało, Alicja

Journal of neurovirology

2023 Volume 29, Issue 1, Page(s) 8–14

Abstract: The JC Polyomavirus (JCPyV) is a virus of global distribution and is usually kept under control by the immune system. In patients with AIDS, a latent JCPyV infection can reactivate and develop into progressive multifocal leukoencephalopathy (PML). Around ...

Abstract	The JC Polyomavirus (JCPyV) is a virus of global distribution and is usually kept under control by the immune system. In patients with AIDS, a latent JCPyV infection can reactivate and develop into progressive multifocal leukoencephalopathy (PML). Around half of the patients with PML die within 2 years since the diagnosis, yet in rare cases, the disease advances significantly quicker and seems to be insusceptible to any medical actions. In our clinic, we observed two cases of such course in HIV-positive patients in the AIDS stage. On admission, both patients had mild neurological symptoms such as dizziness, vision disturbances, and muscle weakness. Both had extremely low CD4 lymphocyte count (7 cells/μL, 40 cells/μL) and high HIV-1 viral load (VL) (50,324 copies/ml, 78,334 copies/ml). PML was confirmed by PCR for JCPyV DNA in cerebrospinal fluid (CSF) coupled with clinical and radiological features. Despite receiving though antiretroviral (ARV) treatment paired with intra-venous (IV) steroids, the disease progressed rapidly with neurological manifestations exacerbating throughout the few weeks following the admission. Eventually, both patients developed respiratory failure and died within less than 3 months after the onset of the neurological symptoms. Even though such curse of the disease is not common, it should be a warning to all how deadly both PML and AIDS can be and remind doctors to offer testing even to asymptomatic patients.
MeSH term(s)	Humans ; Leukoencephalopathy, Progressive Multifocal ; Acquired Immunodeficiency Syndrome ; JC Virus/genetics ; Polyomavirus Infections ; CD4 Lymphocyte Count
Language	English
Publishing date	2023-02-11
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1283265-0
ISSN	1538-2443 ; 1355-0284
ISSN (online)	1538-2443
ISSN	1355-0284
DOI	10.1007/s13365-023-01115-5
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Article: Hepatocellular carcinoma after direct-acting antivirals: an unresolved problem. Review of five cases.

Bartosiewicz, Agnieszka Joanna / Mikuła, Tomasz

Clinical and experimental hepatology

2019 Volume 5, Issue 1, Page(s) 88–92

Abstract: Aim of the study: To present the problem of hepatocellular carcinoma (HCC) occurring in patients treated with direct-acting antiviral (DAA) agents and to draw attention to the fact that HCC may develop even after successful therapy and in patients who ... ...

Abstract	Aim of the study: To present the problem of hepatocellular carcinoma (HCC) occurring in patients treated with direct-acting antiviral (DAA) agents and to draw attention to the fact that HCC may develop even after successful therapy and in patients who were not previously diagnosed with it. Material and methods: The inclusion criterion was confirmation of successful DAA treatment prior to HCC among hepatitis C virus (HCV)-infected patients with liver cirrhosis. The analysed group consisted of 5 patients. Results: In three patients the emergence of hepatocellular carcinoma was very rapid. They developed sudden decompensation of liver function with its symptoms - ascites, oedema, coagulation dysfunction. Furthermore, they had liver encephalopathy and renal failure. One of the patients had cancer cell thrombosis. Two patients' status was stable, but they were disqualified from liver surgery due to large size of the focal lesions and their plurality. Conclusions: DAAs, despite their high effectiveness in HCV treatment, still bear the risk of developing HCC. Patients after the therapy should remain under medical control for the early detection and treatment of the presumptive cancer.
Language	English
Publishing date	2019-02-20
Publishing country	Poland
Document type	Case Reports
ZDB-ID	2937940-4
ISSN	2449-8238 ; 2392-1099
ISSN (online)	2449-8238
ISSN	2392-1099
DOI	10.5114/ceh.2019.83162
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Article: Significance of Vascular Cell Adhesion Molecule-1 and Tumor Necrosis Factor-Alpha in HIV-Infected Patients.

Mikuła, Tomasz / Suchacz, Magdalena / Sapuła, Mariusz / Wiercińska-Drapało, Alicja

Journal of clinical medicine

2022 Volume 11, Issue 3

Abstract: Background: The aim of this study was the evaluation of the correlation between VCAM-1 and TNF-alpha serum concentrations and various clinical and laboratory parameters in HIV-infected patients.: Methods: All included subjects were patients of the ... ...

Abstract	Background: The aim of this study was the evaluation of the correlation between VCAM-1 and TNF-alpha serum concentrations and various clinical and laboratory parameters in HIV-infected patients. Methods: All included subjects were patients of the Department of Infectious and Tropical Diseases and Hepatology of the Medical University of Warsaw in Poland in the years 2014-2016. The inclusion criteria were: confirmed HIV infection, Caucasian origin, and age > 18 years old. PCT, CRP, serum HIV-1 RNA, CD4/CD8 T cell count, PCR HCV RNA, HBsAg, VCAM-1, and TNF-alpha were measured. The VCAM-1 and TNF-alpha serum levels were evaluated by ELISA. Results: Seventy-two HIV-infected patients were included (16 women and 56 men: mean age 38.7 years, 66.6% cigarette smokers, 34.7% HCV co-infected HCV, and 27.8% ART-naïve). VCAM-1 concentrations were significantly higher in HIV/HCV co-infected patients than in HIV mono-infected patients (125.6 ± 85.4 vs. 78.4 ± 58.6 ng/mL, Conclusions: Successful cART and HCV eradication seemed to play an important role in the reduction of endothelial dysfunction and persistent inflammation in HIV-infected patients. CD8 T cell count seemed to be one of the markers of the pro-inflammatory state in HIV-infection patients.
Language	English
Publishing date	2022-01-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11030514
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Article ; Online: Human Immunodeficiency Virus as a Risk Factor for Cardiovascular Disease.

Lembas, Agnieszka / Załęski, Andrzej / Peller, Michał / Mikuła, Tomasz / Wiercińska-Drapało, Alicja

Cardiovascular toxicology

2023 Volume 24, Issue 1, Page(s) 1–14

Abstract: The developments in HIV treatments have increased the life expectancy of people living with HIV (PLWH), a situation that makes cardiovascular disease (CVD) in that population as relevant as ever. PLWH are at increased risk of CVD, and our understanding ... ...

Abstract	The developments in HIV treatments have increased the life expectancy of people living with HIV (PLWH), a situation that makes cardiovascular disease (CVD) in that population as relevant as ever. PLWH are at increased risk of CVD, and our understanding of the underlying mechanisms is continually increasing. HIV infection is associated with elevated levels of multiple proinflammatory molecules, including IL-6, IL-1β, VCAM-1, ICAM-1, TNF-α, TGF-β, osteopontin, sCD14, hs-CRP, and D-dimer. Other currently examined mechanisms include CD4 + lymphocyte depletion, increased intestinal permeability, microbial translocation, and altered cholesterol metabolism. Antiretroviral therapy (ART) leads to decreases in the concentrations of the majority of proinflammatory molecules, although most remain higher than in the general population. Moreover, adverse effects of ART also play an important role in increased CVD risk, especially in the era of rapid advancement of new therapeutical options. Nevertheless, it is currently believed that HIV plays a more significant role in the development of metabolic syndromes than treatment-associated factors. PLWH being more prone to develop CVD is also due to the higher prevalence of smoking and chronic coinfections with viruses such as HCV and HBV. For these reasons, it is crucial to consider HIV a possible causal factor in CVD occurrence, especially among young patients or individuals without common CVD risk factors.
MeSH term(s)	Humans ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; HIV ; Risk Factors ; Smoking
Language	English
Publishing date	2023-11-20
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2036765-X
ISSN	1559-0259 ; 1530-7905
ISSN (online)	1559-0259
ISSN	1530-7905
DOI	10.1007/s12012-023-09815-4
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Zs.A 5817: Show issues

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Article ; Online: VCAM-1 as a Biomarker of Endothelial Function among HIV-Infected Patients Receiving and Not Receiving Antiretroviral Therapy

Lembas, Agnieszka / Zawartko, Katarzyna / Sapuła, Mariusz / Mikuła, Tomasz / Kozłowska, Joanna / Wiercińska-Drapało, Alicja

Viruses. 2022 Mar. 11, v. 14, no. 3

2022

Abstract: The Human Immunodeficiency Virus and retroviral therapy are both known risk factors for cardiovascular disease. It remains an open question whether HIV or ARV leads to increased arterial inflammation. The objective of this study was to investigate the ... ...

Abstract	The Human Immunodeficiency Virus and retroviral therapy are both known risk factors for cardiovascular disease. It remains an open question whether HIV or ARV leads to increased arterial inflammation. The objective of this study was to investigate the changes in endothelial activation by measuring VCAM-1 levels among HIV-infected patients who were and were not treated with antiretroviral therapy. It is a retrospective study that included 68 HIV-infected patients, 23 of whom were never antiretroviral-treated, 15 who were ART-treated for no longer than a year, and 30 who were ART-treated for longer than a year. Blood samples were collected for biochemical analysis of the concentration of VCAM-1. The results show a statistically lower VCAM-1 level (p = 0.007) in patients treated with ART longer than a year (1442 ng/mL) in comparison to treatment-naïve patients (2392 ng/mL). The average VCAM-1 level in patients treated no longer than a year (1552 ng/mL) was also lower than in treatment-naïve patients, but with no statistical significance (p = 0.096). Long-term antiretroviral therapy was associated with the decline of VCAM-1 concentration. That may suggest the lowering of endothelial activation and the decreased risk of the development of cardiovascular disease among ARV-treated patients. However, VCAM-1 may not be a sufficient factor itself to assess this, since simultaneously there are a lot of well-known cardiovascular-adverse effects of ART.
Keywords	HIV infections ; Human immunodeficiency virus ; antiretroviral agents ; biomarkers ; blood ; cardiovascular diseases ; inflammation ; retrospective studies ; risk reduction ; therapeutics ; vascular cell adhesion molecules
Language	English
Dates of publication	2022-0311
Publishing place	Multidisciplinary Digital Publishing Institute
Document type	Article ; Online
ZDB-ID	2516098-9
ISSN	1999-4915
ISSN	1999-4915
DOI	10.3390/v14030578
Database	NAL-Catalogue (AGRICOLA)

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Article: Cerebral Toxoplasmosis, CMV and Bacterial Pneumonia with Decreasing CD4+ T-Cell Count as Results of Antiretroviral Therapy Discontinuation-A Case Report.

Piwowarek, Marta / Siennicka, Katarzyna / Mikuła, Tomasz / Wiercińska-Drapało, Alicja

Pathogens (Basel, Switzerland)

2021 Volume 10, Issue 4

Abstract: Cerebral toxoplasmosis occurs mainly in immunocompromised hosts as a reactivation of ... ...

Abstract	Cerebral toxoplasmosis occurs mainly in immunocompromised hosts as a reactivation of latent
Language	English
Publishing date	2021-04-20
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2695572-6
ISSN	2076-0817
ISSN	2076-0817
DOI	10.3390/pathogens10040497
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Article ; Online: Weight and body mass index increase after switch from tenofovir disoproxil fumarate to tenofovir alafenamide fumarate-containing treatment in an antiretroviral therapy-experienced group.

Łomiak, Michał / Stępnicki, Jan / Mikuła, Tomasz / Wiercińska-Drapało, Alicja

International journal of STD & AIDS

2021 Volume 32, Issue 6, Page(s) 570–577

Abstract: Tenofovir alafenamide fumarate (TAF) is an alternative to tenofovir disoproxil fumarate (TDF). Currently, TAF is increasingly being used because of its non-inferior antiviral properties, lower risk of nephrotoxicity, and lower decrease in bone mineral ... ...

Abstract	Tenofovir alafenamide fumarate (TAF) is an alternative to tenofovir disoproxil fumarate (TDF). Currently, TAF is increasingly being used because of its non-inferior antiviral properties, lower risk of nephrotoxicity, and lower decrease in bone mineral density than TDF. There is growing evidence of unfavorable effects of TAF on weight and body mass index (BMI) in antiretroviral therapy (ART)-experienced patients treated with TAF-based ART. The aim of this study was to evaluate whether switching from TDF-containing to TAF-containing ART is associated with an increase in BMI and body weight in ART-experienced patients. Two study groups were established: 32 patients who switched from TDF to TAF only and 68 patients who switched from TDF to TAF along with changes to other components of the ART regimen. Significant weight gain and BMI increase was observed during the first year after initiation of TAF-containing ART regimens in both groups (mean change +1.91 kg and +0.61 kg/m2 in the first group and +1.50 kg and +0.49 kg/m
MeSH term(s)	Aged ; Alanine ; Anti-HIV Agents/adverse effects ; Body Mass Index ; Fumarates/therapeutic use ; HIV Infections/drug therapy ; Humans ; Tenofovir/adverse effects ; Tenofovir/analogs & derivatives
Chemical Substances	Anti-HIV Agents ; Fumarates ; Tenofovir (99YXE507IL) ; tenofovir alafenamide (EL9943AG5J) ; Alanine (OF5P57N2ZX)
Language	English
Publishing date	2021-02-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1018089-8
ISSN	1758-1052 ; 0956-4624
ISSN (online)	1758-1052
ISSN	0956-4624
DOI	10.1177/0956462420983699
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Article: Challenges in diagnosing fever in traveler returning from tropical ares - is it dengue or chikungunya? Case report.

Bętkowska, Aleksandra / Hanke, Julia / Krankowska, Dagny / Mikuła, Tomasz / Wiercińska-Drapało, Alicja

Przeglad epidemiologiczny

2022 Volume 76, Issue 4, Page(s) 450–457

Abstract: Arthropod-borne viral infections caused by dengue virus (DENV) and chikungunya virus (CHIKV) are prevalent in the same regions and are spread by the same mosquito type (Aedes) and have similar clinical manifestations. This study emphasized the challenges ...

Abstract	Arthropod-borne viral infections caused by dengue virus (DENV) and chikungunya virus (CHIKV) are prevalent in the same regions and are spread by the same mosquito type (Aedes) and have similar clinical manifestations. This study emphasized the challenges of diagnosing fever in a patient returning from a tropical area. We report a case of a 52-year-old patient who presented with fever, myalgia, and headache after travelling to Laos and Thailand. After ten days of the disease, the diagnosis of chikungunya was made. Recent travel history should be a standard part of assessment when consulting febrile patients and is essential for further diagnosis. Malaria should permanently be excluded from travellers returning from tropical regions with fever. In the differential diagnosis, dengue, chikungunya, and other mosquito-borne infections should be considered. Patients wishing to travel to such areas need to be educated beforehand on the necessary preventative measures.
MeSH term(s)	Animals ; Humans ; Middle Aged ; Chikungunya Fever/diagnosis ; Dengue/complications ; Dengue/diagnosis ; Poland ; Chikungunya virus ; Fever/etiology
Language	English
Publishing date	2022-09-17
Publishing country	Poland
Document type	Case Reports ; Journal Article
ZDB-ID	421782-2
ISSN	0033-2100
ISSN	0033-2100
DOI	10.32394/pe.76.42
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Article ; Online: Evaluation of Clinical Biomarkers Related to CD4 Recovery in HIV-Infected Patients-5-Year Observation.

Lembas, Agnieszka / Załęski, Andrzej / Mikuła, Tomasz / Dyda, Tomasz / Stańczak, Wojciech / Wiercińska-Drapało, Alicja

Viruses

2022 Volume 14, Issue 10

Abstract: Human Immunodeficiency Virus infection leads to the impairment of immune system function. Even long-term antiretroviral therapy uncommonly leads to the normalization of CD4 count and CD4:CD8 ratio. The aim of this study was to evaluate possible clinical ... ...

Abstract	Human Immunodeficiency Virus infection leads to the impairment of immune system function. Even long-term antiretroviral therapy uncommonly leads to the normalization of CD4 count and CD4:CD8 ratio. The aim of this study was to evaluate possible clinical biomarkers which may be related to CD4 and CD4:CD8 ratio recovery among HIV-infected patients with long-term antiretroviral therapy. The study included 68 HIV-infected patients undergoing sustained antiretroviral treatment for a minimum of 5 years. Clinical biomarkers such as age, gender, advancement of HIV infection, coinfections, comorbidities and applied ART regimens were analyzed in relation to the rates of CD4 and CD4:CD8 increase and normalization rates. The results showed that higher rates of CD4 normalization are associated with younger age (
MeSH term(s)	Humans ; HIV Infections ; Viral Load ; Coinfection/drug therapy ; CD4 Lymphocyte Count ; Biomarkers ; Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active/methods
Chemical Substances	Biomarkers ; Anti-HIV Agents
Language	English
Publishing date	2022-10-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2516098-9
ISSN	1999-4915 ; 1999-4915
ISSN (online)	1999-4915
ISSN	1999-4915
DOI	10.3390/v14102287
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