Klinicka mikrobiologie a infekcni lekarstvi最新文献

{"title":"[Epidemiological data on HIV/AIDS and the surveillance system in the Czech Republic].","authors":"Marek Malý, Vratislav Němeček","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Human immunodeficiency virus (HIV) progressively impairs immune function. If the infection is detected late or left untreated, it leads to the development of AIDS. Therefore, from a public health perspective, it is necessary to monitor the occurrence of infection in the population, as well as trends overall and in specific subgroups. This is achieved through a national HIV surveillance system, whose outputs can be used not only to describe the epidemiological situation but also to guide preventive activities. The text outlines the organizational components of the surveillance system developed since 1986 and presents the key epidemiological data describing the HIV epidemic in the Czech Republic. Between 1985 and 2024, a total of 4888 cases of HIV infection were detected among Czech citizens and foreigners with long-term or permanent residence. Of those, 926 were diagnosed with AIDS, and 654 died. The basic characteristics of the HIV epidemic in the Czech Republic are the predominance of sexual transmission, especially among men who have sex with men, but with increasing numbers of heterosexually transmitted infections, a low proportion of women (approximately 15%), and an increasing proportion of foreigners (48% in the last five years). The annual number of new cases initially hovered around a few dozen, then steadily increased from 2003 until reaching 286 in 2016. After a slight decline, the numbers peaked at 292 in 2022. Recent trends have been affected by the COVID-19 pandemic and the war in Ukraine. In addition to the above figures, 856 HIV-positive refugees from Ukraine were registered in 2022-2024. Despite these facts, the Czech Republic continues to be classified as a low-prevalence country in both the European and global contexts. However, the trend in recent years has not been favorable, with the number of new cases showing a slight increase. Keywords: HIV, AIDS, surveillance, HIV transmission, foreigners.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 4","pages":"142-150"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Assessing the nutritional status of treated HIV-positive individuals].","authors":"Michaela Tomanová, Hanuš Rozsypal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The article focuses on the role of nutrition as a risk factor for the development of lifestyle diseases in people living with HIV. Among these individuals, an increase in obesity and the progression of metabolic syndrome, cardiovascular diseases, hypertension, and type 2 diabetes occur faster and appear earlier than in the HIV-negative population. A combination of an unhealthy lifestyle, chronic HIV-related inflammation, and long-term antiretroviral therapy increases the risk of these comorbidities. Regularly takings patients' medical history, including substance abuse, is important for monitoring their nutritional status. It is also crucial to regularly monitor body weight and fat distribution (e.g., using the waist-hip ratio). Patients' social and work conditions are key to establishing effective nutritional interventions as they can affect their ability to adhere to regular diets and physical activity. Laboratory tests are also used to assess nutritional status by monitoring parameters such as lipid profiles, blood glucose levels, and immune function. In a general practitioner's office, the emphasis is placed on preventing and diagnosing the aforementioned comorbidities early and initiating long-term, sustainable nutritional interventions. Overall, infectious disease doctors and general practitioners také a comprehensive approach to monitoring and adjusting the lifestyle of HIV-positive individuals, thereby significantly contributing to prolonging and improving their quality of life. Keywords: human immunodeficiency virus (HIV) infection, nutritional status, lifestyle diseases.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 4","pages":"167-171"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current state of HIV treatment].","authors":"Hanuš Rozsypal","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Antiretroviral therapy (ART) is the most important part of treatment for HIV-positive individuals. Antiretroviral drugs are divided into groups according to their mechanism of action and chemical structure. Most of them block the function of three viral enzymes, others prevent the virus from entering the cell through three different mechanisms, and one drug disrupts the function of the capsid. In most patients, viral replication is suppressed, which is a prerequisite for the restoration or maintenance of adequate immune system function. Treatment is also important for restricting the transmission of infection to other people. Although treatment prevents the typical health complications of HIV infection associated with immunodeficiency, it does not completely suppress the activation of the immune system and thus the risk of non-AIDS complications. Antiretrovirals are administered in combinations, typically in a triple combination, but thanks to the resilience of new integrase inhibitors to the development of resistance, dual combinations are also sufficiently effective. A novel treatment for virologically suppressed patients is a long-acting dual regimen administered parenterally with a pair of intramuscular injections once every two months. Patients who have failed multiple ART regimens have the option of rescue therapy, which includes the latest antiretroviral drugs fostemsavir and lenacapavir. The elimination of viral reservoirs in cells and the cure of HIV infection remain unattainable goals. Therefore, treatment remains long-term and indefinite. Keywords: human immunodeficiency virus infection, HIV, antiretroviral therapy (ART).</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 4","pages":"156-166"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Laboratory diagnostics of HIV infection in the Czech Republic].","authors":"Andrea Pavlíková, Marek Linka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the Czech Republic, laboratory diagnostics of HIV is designed as a multi-level system that integrates clearly defined legislative requirements, modern diagnostic technologies, and close interdisciplinary collaboration among specialists. Reliable and early detection of HIV infection is a key factor for the timely initiation of treatment, which not only benefits the patient, but also serves as the most effective tool for preventing further spread of the infection. The diagnostic algorithm includes highly sensitive screening tests followed by mandatory confirmatory testing at the National Reference Laboratory for HIV/AIDS at the National Institute of Public Health. Molecular biological methods are primarily applied in monitoring therapy for HIV-positive patients. However, they also serve as a tool for molecular epidemiology, enabling the tracking of infection dynamics in the population and, based on these insights, the optimization of preventive interventions and evaluation of their effectiveness. Keywords: HIV, NRL for HIV/AIDS, laboratory diagnostics, screening test, confirmatory test, viral load, drug resistance monitoring.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 4","pages":"151-155"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[COVID-19 pandemic in a cohort of lung transplant recipients: Insights into immune system status].","authors":"Jiří Kufa, Samuel Genzor, Jan Mizera, Petr Jakubec, Petra Schneiderová, Eva Kriegová, Jana Zapletalová","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Lung transplant recipients represent a high-risk population for COVID-19, primarily due to long-term immunosuppressive therapy. The study aimed to describe the impact of COVID-19 in a cohort of lung transplant recipients during the pandemic and to identify selected risk factors associated with an unfavorable disease course.</p><p><strong>Material and methods: </strong>This retrospective analysis included patients followed at a specialized post-transplant outpatient clinic of the Department of Respiratory Medicine, University Hospital Olomouc. All patients had undergone lung transplantation at the 3rd Department of Surgery, Motol University Hospital, and were followed within an inter-institutional collaborative care program. Data were obtained from the national infectious diseases information system (ISIN), outpatient and inpatient medical records, and were statistically analyzed with a focus on clinical and genetic risk factors.</p><p><strong>Results: </strong>A total of 87 patients (29 women, 58 men) were included in the study and followed from the beginning of the pandemic in 2020 through December 2023. COVID-19 was diagnosed in 65 patients (74.7%), while 22 patients (25.3%) remained uninfected. The overall mortality was 15.4% (10 patients), with the highest fatality rates observed during the early pandemic waves dominated by the original SARS-CoV-2 variants. Over time, the prognosis improved in association with the availability of vaccination, antiviral prophylaxis, and the emergence of the less pathogenic Omicron variant. Older age was identified as a significant risk factor for severe disease and mortality. Time since transplantation and the presence of a single native lung did not have a significant impact on disease severity. Genetic risk factors associated with severe COVID-19 included the polymorphisms rs16944G (IL1B), rs2069763A (IL2), and rs2076295*G (DSP).</p><p><strong>Conclusions: </strong>COVID-19 had substantial clinical consequences in the evaluated cohort of lung transplant recipients, with an overall mortality of approximately 15%. Independent risk factors for an unfavorable course included older age and insufficient prophylaxis. Selected genetic polymorphisms may represent additional risk factors. These findings may contribute to improved risk stratification for viral infections and to a better understanding of immune status in lung transplant recipients.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 4","pages":"132-141"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Antiviral treatment for chronic viral hepatitis B and C in children in Ostrava].","authors":"Luděk Rožnovský, Libuše Kabieszová, Irena Orságová, Lenka Petroušová, Martina Konečná, Jakub Mrázek, Alena Kloudová","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Retrospective evaluation of the frequency, efficacy, and tolerance of antiviral treatment for chronic viral hepatitis B and C (VHB, VHC) in children in Ostrava.</p><p><strong>Material and methods: </strong>The sample included 17 children with chronic VHB, aged 3-15 years, treated with conventional interferon alpha in 1993-2008, and 11 children with chronic VHC, aged 5-17 years, of whom six were treated with interferon regimens in 1995-2016 and five used direct-acting antivirals since 2020.</p><p><strong>Results: </strong>In the 1990s, children with chronic VHB prevailed; 12 of them were infected vertically. In the last decade, children with chronic VHC dominated, with vertical transmission found in seven children. All 17 children with chronic VHB, 15 of whom were HBeAg (hepatitis B virus e-antigen-positive), were treated with interferon alpha (IFN). HBeAg positivity disappeared in seven children during treatment or within a year after treatment and in another six patients within 15 years after treatment. Treatment tolerance was good, except for psychological problems in two children. Thirteen patients continued to be observed into adulthood, six of whom were treated with interferons or oral antivirals. HBsAg (hepatitis B virus s-antigen) disappeared in four patients aged 7-38 years. Six children with chronic VHC were treated with IFN or pegylated IFN; four received ribavirin. The virus was permanently cleared in five children, the last of whom after treatment with elbasvir and grazoprevir at the age of 18. The tolerance of IFN treatment was good, except for a 5-year-old boy who developed hypothyroidism. Direct-acting antivirals were administered to five children; the first received glecaprevir with pibrentasvir, and the other four received sofosbuvir with velpatasvir. All treatments were successful. Long-term follow-up after treatment was recommended for only three patients.</p><p><strong>Conclusions: </strong>Antiviral treatment for chronic VHB in children has become a thing of the past thanks to VHB vaccination. However, chronic VHB persists into adulthood after infection in childhood. Currently, chronic VHC dominates in children. After successful treatment with direct-acting antivirals, further follow-up in adulthood is usually unnecessary.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 3","pages":"76-82"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Organization and operation of the National Center for Isolation and Treatment of Highly Dangerous Diseases - practical experiences].","authors":"Hana Roháčová","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The article focuses on the organization of care for patients with, or suspected of having, highly dangerous infectious diseases in the Czech Republic. It describes the activities of the National Center for Isolation and Treatment of Highly Dangerous Diseases, including its activation, patient admission, and isolation measures. The article also mentions experiences with activating the center over the past 10 years. Keywords: National Center for Isolation and Treatment of Highly Dangerous Diseases, Bulovka University Hospital, viral hemorrhagic fevers, isolation measures, bioboxes.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 3","pages":"96-100"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Viral hemorrhagic fevers: Pathogenesis, epidemiology and clinical manifestations].","authors":"Samuel Martišík, Milan Trojánek","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Viral hemorrhagic fevers are severe infections caused by selected enveloped RNA viruses from the families Filoviridae, Arenaviridae, Flaviviridae, and the order Bunyavirales. Their pathogenesis is characterized by early failure of antiviral immunity, high viremia, endothelial dysfunction, capillary leak, and coagulopathy. Clinically, they initially present as non-specific febrile illnesses, but may progress to organ dysfunction, hemorrhagic manifestations, or shock. Laboratory findings commonly include early leukopenia, thrombocytopenia, and elevated liver enzymes. The current epidemiological situation shows considerable regional variability. For many of these infections, transmission via vectors, zoonotic spread, or nosocomial transmission plays a significant role. In Europe, the risk of most hemorrhagic fevers remains low but, not negligible. Continuous surveillance of imported cases, together with access to high-quality laboratory testing, effective infection control including prevention of nosocomial spread, and vigilance in febrile patients with relevant epidemiological exposure, are essential. Limited therapeutic and vaccination options highlight the need for further research and international collaboration, as well as preparedness for the potential importation of these infections.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 3","pages":"83-89"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A brief history and significance of the Czechoslovak army's Antiviral Serum Bank].","authors":"Michal Holub, Lubomír Mankovecký, Hana Kubátová, Oto Pavliš, Petr Pajer","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Virology Department of the Czechoslovak army, established in response to the need for a specific approach to biological threats, was initially subordinated to the Military Institute of Hygiene and Epidemiology (founded in 1957), and later to the Central Military Medical Institute. Within this department, a systematic Virus Strain Bank was established that contained highly contagious viruses and bacteria used for diagnostic purposes and to develop defensive methods against biological threats. The preserved strains included viruses causing hemorrhagic fevers, encephalitis, yellow fever, and Rocky Mountain spotted fever, as well as the variola minor virus. The Virus Strain Bank enabled testing of the capabilities to detect and identify dangerous agents, as well as the development of specific and neutralizing antibodies against them. It was therefore essential for defensive and diagnostic purposes in the context of protection against the use of biological weapons. Keywords: virus strains; viral infection diagnosis, biological threat.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 3","pages":"101-104"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Procedure in case of suspicion of a high consequence infectious disease].","authors":"Luděk Rožnovský, Stanislav Plíšek","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>High consequence infectious diseases (HCIDs) are feared for their high lethality and easy interpersonal transmission, posing a particular threat to healthcare workers. This article provides a brief history and characteristics of HCIDs, the procedure for healthcare workers in the event of suspecting an HCID, the coordinating function of an epidemiologist, and the gradual involvement of all components of the integrated rescue system, leading to transporting the patient to the Department of Infectious Diseases of the Bulovka University Hospital in Prague. Activation of the Ministry of Health and the National Institute of Public Health aims to arrange HCID diagnosis in a laboratory abroad. An integral part of the measures is carrying out proper disinfection at the outbreak site and treating contacts with the HCID. Keywords: high consequence infectious diseases, outbreak, contact.</p>","PeriodicalId":17909,"journal":{"name":"Klinicka mikrobiologie a infekcni lekarstvi","volume":"31 3","pages":"90-95"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}