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Selected genetic factors modifying the natural course of viral infections in organ transplant settings
Chmelová, Klára ; Šperl, Jan (advisor) ; Husa, Petr (referee) ; Brůha, Radan (referee)
Solid organ transplantation (SOT) represents a life-saving procedure and a future perspective for patients suffering from organ failure. On the other hand, SOT recipients are burdened with numerous complications, including infections or lifelong administration of immunosuppressive medication. There are several well-known factors related to graft and patient survival, including general health status, age at the time of SOT, diagnosis leading to SOT, acute or antibody-mediated rejection, development of the metabolic syndrome and complications including viral diseases. Viral infections in SOT recipients may present with a very distinct natural history compared with the healthy population. Several can cause immune activation leading to graft rejection; others can be associated more likely with immune tolerance. We aimed to identify the impact of variants of selected genes on the natural history of various viral diseases in SOT recipients and thus their overall outcome, morbidity and graft survival. Cytomegalovirus (CMV) infection is the most common viral infection in SOT recipients. We focused on the role of the IL28B rs12979860 locus genotype in the risk of CMV disease occurrence. We proved the T allele is associated with a more frequent occurrence of CMV disease in liver transplant (LTx) recipients...
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Prevention of hepatitis C virus infection among injecting drug users - hepatitis C virus infection treatment rate among injecting drug users, treatment efficacy and related factors on the side of treatment system
Mravčík, Viktor ; Bencko, Vladimír (advisor) ; Němeček, Vratislav (referee) ; Husa, Petr (referee)
Background: Injecting drug users (IDUs) represent considerable group of patients infected with hepatitis C virus (HCV). HCV treatment is an effective tool for reduction of HCV transmissions among IDUs. Nevertheless treatment rate among IDUs is rather insufficient. Treatment uptake, provision and adherence as well as its efficacy in IDUs are determined by number of specific factors. Aims: Mapping an extent of the provision of HCV treatment to IDUs in the Czech Republic, rules and practices for the admission of IDUs into HCV treatment and its provision, describing relevant factors related to drug use. Material and methods: From January to March 2011, a questionnaire survey among centres for treatment of viral hepatitis in the Czech Republic was conducted. 76 identified centres were addressed, of which 45 (59%) responded, and 40 (53%) filled in an online questionnaire. Results: Estimated number of centres treated HCV with combination of pegylated interferon α and ribavirin in the Czech Republic in 2010 was 61, 39 of them treated IDUs. Estimated 780 persons were treated, of whom 370 were (mostly ex-) IDUs. Reported treatment uptake in IDUs was 60% on average (range 0-90%). Treatment is completed by 80% of IDUs on average (0-100%) according to clinicians. Most clinicians reported no difference in the treatment...
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