Difficult-to-treat populations with chronic hepatitis C (CHC), in the era of interferon treatment, included patients with liver cirrhosis, kidney impairment, treatment-experienced individuals, and those coinfected with the human immunodeficiency virus. The current study aimed to determine whether, in the era of direct-acting antivirals (DAA), there are still patients that are difficult-to-treat. The study included all consecutive patients chronically infected with hepatitis C virus (HCV) who started interferon-free therapy between July 2015 and December 2020 in the Department of Infectious Diseases in Kielce. The analyzed real-world population consisted of 963 patients, and most of them were infected with genotype 1 (87.6%) with the predominance of subtype 1b and were treatment-naïve (78.8%). Liver cirrhosis was determined in 207 individuals (21.5%), of whom 82.6% were compensated. The overall sustained virologic response, after exclusion of non-virologic failures, was achieved in 98.4%. The univariable analysis demonstrated the significantly lower response rates in males, patients with liver cirrhosis, decompensation of hepatic function at baseline, documented esophageal varices, concomitant diabetes, body mass index ≥25, and previous ineffective antiviral treatment. Despite an overall very high effectiveness, some unfavorable factors, including male gender, genotype 3 infection, liver cirrhosis, and treatment experience, significantly reduce the chances for a virologic response were identified.

The introduction of direct-acting antivirals (DAA) has provided us with hope to eliminate the hepatitis C virus (HCV) infection as a significant public problem in upcoming years. This study compares genotype-specific and pangenotypic regimens in patients with genotype (GT) 1b infection, being the most common GT in Poland. We have confirmed the very high effectiveness and a good safety profile with no significant differences between these two generations of the drug. Male sex and previous treatment with DAA were identified as negative predictors of therapy efficacy. To the best of our knowledge, the presented results of our research have been so far the only study of this type comparing the effectiveness and safety of both generations of drugs within one protocol carried out by the same researchers.

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was discovered in Wuhan, China at the end of 2019 and is believed to be the cause of COVID-19 (coronavirus disease 2019). There is some evidence that SARS-CoV-2 infection can be complicated by pulmonary embolism. However, the pathomechanism of this relation is not fully understood, and data are still limited. The real incidence of this condition is not known, and available papers in the literature on this issue comprise case presentations and one report from a prospective multicentre study published very recently. Pulmonary angiography computed tomography seems to play a crucial role, allowing early and proper diagnosis of this condition. The timely recognition of pulmonary embolism is essential for the implementation of anticoagulant treatment. Streszczenie Wirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) odkryty pod koniec 2019 r. w chińskim mieście Wuhan jest czynnikiem etiologicznym COVID-19 (coronavirus disease 2019). Zgodnie z doniesieniami piśmiennictwa przebieg kliniczny zakażenia SARS-CoV-2 może być powikłany zatorowością płucną. Patomechanizm występowania tego powikłania w przebiegu COVID-19 nie jest do końca poznany, a dane kliniczne dotyczące jego ryzyka i częstości występowania są bardzo skąpe. Dostępne prace na ten temat ograniczają się do opisów przypadków i jednego nowo opublikowanego raportu z wieloośrodkowego badania prospektywnego. Decydującą rolę w rozpoznaniu zatorowości płucnej odgrywa tomografia komputerowa naczyń krwionośnych klatki piersiowej. Wczesne rozpoznanie zatorowości płucnej jest kluczowe dla wdrożenia terapii przeciwkrzepliwej.