Browsing by Author "Katanić, Nataša (57190964860)"

Background/Aim. In Serbia, pegylated interferon (PEG-IFN) alpha-2a has been registered since 2013 for the treatment of patients with chronic hepatitis B (CHB). Numerous advantages, new experiences during the past five years and lack of any published data in our specific population, have initiated this study, with the aim to examine efficacy and safety of PEG-IFN in patients in a Serbian referral center. Methods. This prospective study included 36 patients with CHB who were treated in the Hepatology Department of the Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia in Belgrade, during 2012–2017. Patients had a standard 48-week treatment protocol with PEG-IFN, with measurements of liver enzymes, serology and viraemia before, during, at the end of the treatment and follow-up 6 months afterwards. Treatment outcome was determined using serology (clearance of HBeAg), biochemical [normalization of alanine aminotransferase (ALT)] and virological response [hepatitis B virus (HBV) DNA < 2,000 IU/mL]. Results. Virological success in patients with HBeAg positive CHB was achieved in 50% of patients, HBeAg clearance in 62.5%, and normalization of ALT in 37.5% of patients. In patients with HBeAg negative CHB, 38% of the patients achieved virologic success, biochemical success was obtained in 47.6% of the patients and only one (4.7%) patient had HBsAg clearance. Conclusion. PEG-IFN is important for treatment of patients with CHB in well-defined situations, and in our population success rates are similar to other published studies. Although safety and tolerability are satisfactory, there is a possibility of more serious side-effects so it is necessary to monitor patients regularly during the treatment. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

People who inject drugs (PWIDs) experience high rates of hepatitis C virus (HCV) infection, primarily due to needle sharing and limited healthcare access, resulting in a disproportionate disease burden within this population. This prospective study evaluated treatment outcomes in 432 adult patients with chronic hepatitis C (CHC) treated with direct-acting antivirals (DAAs) at the University Clinical Center of Serbia. Patients were categorized into two groups based on a history of drug addiction: PWIDs (163, 37.7%) and non-PWIDs (269, 62.3%). The PWID group was further categorized into subpopulations of problematic PWIDs (39, 23.9%), ex-PWIDs (124, 76.1%), and PWIDs on OST (96, 58.9%). The PWID group demonstrated significantly lower treatment adherence, with an intention-to-treat (ITT) rate of 82.8%, compared to 96.3% in the control group (p < 0.001). In contrast, no significant differences were observed in per-protocol (PP) outcomes between the two groups. Additionally, PWIDs were significantly younger (p < 0.001) and had higher rates of psychiatric disorders (p < 0.001), alcohol abuse (p < 0.001), and HCV genotype 1a (p < 0.001). Advanced fibrosis was predictor of PP treatment failure among PWIDs, while mood disorders and alcohol use disorder were associated with interruptions before the scheduled completion time. For non-PWIDs, older age and advanced fibrosis emerged as key predictors of PP treatment failure. The loss to follow-up was most commonly observed in the problematic PWID subgroup (p = 0.001). These findings highlight the importance of addressing barriers in PWIDs through integrated care strategies that concurrently manage addiction and HCV. © 2024 by the authors.

People who inject drugs (PWIDs) experience high rates of hepatitis C virus (HCV) infection, primarily due to needle sharing and limited healthcare access, resulting in a disproportionate disease burden within this population. This prospective study evaluated treatment outcomes in 432 adult patients with chronic hepatitis C (CHC) treated with direct-acting antivirals (DAAs) at the University Clinical Center of Serbia. Patients were categorized into two groups based on a history of drug addiction: PWIDs (163, 37.7%) and non-PWIDs (269, 62.3%). The PWID group was further categorized into subpopulations of problematic PWIDs (39, 23.9%), ex-PWIDs (124, 76.1%), and PWIDs on OST (96, 58.9%). The PWID group demonstrated significantly lower treatment adherence, with an intention-to-treat (ITT) rate of 82.8%, compared to 96.3% in the control group (p < 0.001). In contrast, no significant differences were observed in per-protocol (PP) outcomes between the two groups. Additionally, PWIDs were significantly younger (p < 0.001) and had higher rates of psychiatric disorders (p < 0.001), alcohol abuse (p < 0.001), and HCV genotype 1a (p < 0.001). Advanced fibrosis was predictor of PP treatment failure among PWIDs, while mood disorders and alcohol use disorder were associated with interruptions before the scheduled completion time. For non-PWIDs, older age and advanced fibrosis emerged as key predictors of PP treatment failure. The loss to follow-up was most commonly observed in the problematic PWID subgroup (p = 0.001). These findings highlight the importance of addressing barriers in PWIDs through integrated care strategies that concurrently manage addiction and HCV. © 2024 by the authors.

Background/Aim. The reactivation of the varicella zoster virus results in herpes zoster. Acyclovir is currently recommended over 7 to 10 days for herpes zoster treatment and should be started within 72 hours of rash eruption. This study analyses whether a therapy delay and/or shorter courses of treatment are associated with adverse outcomes. Methods. We identified 292 patients treated at the Clinic for Infectious and Tropical Diseases in Belgrade for herpes zoster in a five-years period. The data on these patients were analyzed using the descriptive statistics, the χ2 test, the Mann-Whitney U-test and the multiple logistic regression analysis. Results. The average time from rash eruption to the first dose of acyclovir was 4.07 ± 2.64 days. The patients received acyclovir for 6.83 ± 2.45 days. Seventy-one patients had disseminated herpes zoster, 100 had cranial nerve involvement, 86 had complications other than postherpetic neuralgia and one patient died. In cases where therapy was delayed there was no significant association with complications (χ2 = 0.031; p = 0.86). Our logistic regression model was not able to predict who was treated less than 7 days. An association between the HZ complications and abbreviated acyclovir regimens was not demonstrated (χ2 = 1.109; p = 0.326). We conducted the PubMed search on February 1st, 2017 and found no proof for the need to apply at least 7 days of acyclovir therapy for herpes zoster in the studies that have been published so far. Conclusion. We were unable to prove an association between therapy delay and unfavorable outcomes. The same was true for shorter than recommended acyclovir courses. © 2019 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Introduction: The region of Serbia is characterised by a high prevalence and diversity of Borrelia species, with Borrelia lusitaniae dominating, followed by Borrelia afzelii. Before this report, there were no data on Borrelia species causing Lyme borreliosis (LB) in Serbia. Case presentation: We report the case of a 10-year-old boy with a clinical presentation of disseminated erythema migrans (EM). His results showed IgM antibodies at 6.27 (negative < 0.20; positive > 0.32) against Borrelia burgdorferi sensu lato, which was confirmed via ELFA. Except for skin lesions, the patient did not show any other clinical signs of systemic infection. His blood was taken to isolate and cultivate spirochetes and for molecular analysis. Antimicrobial therapy was prescribed according to the recommended treatment for patients with LB. A follow-up examination was conducted after nine days. The EMs on the skin had disappeared, and antibiotic therapy was continued for 14 days. A second follow-up was conducted one month after the end of therapy. The boy's health condition was normal. After 16 days of incubation in BSK-H medium, viable, motile, and spiral-shaped spirochetes were observed in the culture tube, and cultivation was prolonged for 29 days. PCR and sequencing were successful in both the blood sample and the culture and confirmed the presence of B. lusitaniae. Conclusions: The results presented here is the first Borrelia isolate from the blood of a patient with the clinical manifestation of LB-disseminated EM. The presented results confirm the potential of B. lusitaniae for dissemination via the hematogenous route. Copyright © 2025 Veinović et al.

Introduction: The region of Serbia is characterised by a high prevalence and diversity of Borrelia species, with Borrelia lusitaniae dominating, followed by Borrelia afzelii. Before this report, there were no data on Borrelia species causing Lyme borreliosis (LB) in Serbia. Case presentation: We report the case of a 10-year-old boy with a clinical presentation of disseminated erythema migrans (EM). His results showed IgM antibodies at 6.27 (negative < 0.20; positive > 0.32) against Borrelia burgdorferi sensu lato, which was confirmed via ELFA. Except for skin lesions, the patient did not show any other clinical signs of systemic infection. His blood was taken to isolate and cultivate spirochetes and for molecular analysis. Antimicrobial therapy was prescribed according to the recommended treatment for patients with LB. A follow-up examination was conducted after nine days. The EMs on the skin had disappeared, and antibiotic therapy was continued for 14 days. A second follow-up was conducted one month after the end of therapy. The boy's health condition was normal. After 16 days of incubation in BSK-H medium, viable, motile, and spiral-shaped spirochetes were observed in the culture tube, and cultivation was prolonged for 29 days. PCR and sequencing were successful in both the blood sample and the culture and confirmed the presence of B. lusitaniae. Conclusions: The results presented here is the first Borrelia isolate from the blood of a patient with the clinical manifestation of LB-disseminated EM. The presented results confirm the potential of B. lusitaniae for dissemination via the hematogenous route. Copyright © 2025 Veinović et al.

Introduction: In addition to known systemic manifestations, coronavirus disease (COVID-19) can cause serious neurological manifestations as a result of damage to the central and peripheral nervous system. Case report: A 62-year-old male with medical history of arterial hypertension and type 2 diabetes mellitus was admitted to the hospital, complaining of high fever, fatigue, cough, and disturbed mental state. He was diagnosed with COVID-19, had fever of up to 38 °C 7 days before admission, dry cough, and became disoriented and psychotic after 5 days. The chest X-ray and computed tomography (CT) of the head were normal. Following a lumbar puncture, the patient was diagnosed with encephalitis based on clinical and laboratory findings (pleocytosis and hyperproteinorachia in cerebrospinal fluid (CSF)). CSF was checked with the polymerase chain reaction meningitis-encephalitis panel which excludes the more common viral or bacterial causes of encephalitis. Anti-edematous, anti-inflammatory, anticoagulant, gastroprotective, and other symptomatic medications were administered. Ataxic gait was the only focal neurological abnormality identified during neurological assessment. The chest CT did not reveal COVID-19 pneumonia and brain magnetic resonance imaging revealed only cortical reductive brain alterations. The COVID-19 swab test after 10 days was negative. The patient was recovered and released from hospital treatment with normal physical findings and without neurological abnormalities. Conclusions: The diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encephalitis can be challenging, and it is usually based on the exclusion of other etiological agents of brain infections. Copyright © 2025 Poluga et al.

Background/Aim. The World Health Organization estimates that 3.2 billion people are at a risk of being infected with malaria. Thus, the adequate diagnostic protocols for malaria, especially those aimed at determining disease severity, are paramount both in endemic and non-endemic setting. The aim of this study was to identify the demographic, parositological, clinical and laboratory characteristics associated with severe malaria in a non-endemic settings. Methods. We analyzed 22 patients with severe malaria and compared their clinical and laboratory findings with those of the patients with non-severe malaria in a search of predictors of disease severity. All patients were treated at the Infectious and Tropical Diseases University Hospital, Clinical Centre of Serbia in Belgrade, Serbia from 2000 to 2010. Results. The average age of patients with with severe malaria was 44.86 ± 12.33 years and men predominated (95.45%). The patients with severe malaria were infected Plasmodium falciparum (P. falciparum) significantly more frequently compared with those with non-severe disease (p =0.047). Jaundice was the most commonly observed feature of severe malaria, followed by anemia and renal failure. The multifactor analysis of variance showed that thrombocytopenia (p = 0.05) and high serum tumor necrosis factor-alpha levels (p = 0.02) were significantly associated with the disease severity. Conclusion. A high index of suspicion for malaria should be maintained when evaluating febrile patients returning from the malaria endemic regions. The elevated serum tumor necrosis factor-alpha levels and thrombocytopenia are associated with severe malaria in non-endemic settings. © 2019, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.