The Central and Eastern Europe (CEE) region differs in access to HIV and co-infections care and treatment. The aim of the study was to analyze the relation between the severity of the COVID-19 disease and HIV specific factors in the European Union (EU) Countries and in non-European Union (non-EU) Countries.The study was conducted between November 2020 and May 2021. Euroguidelines in Central and Eastern Europe (ECEE) Network Group was collecting observational data on HIV-positive patients diagnosed with COVID-19. In total, 16 countries from CEE (Poland, Czech Republic, Ukraine, Croatia, Turkey, Romania, Belarus, Estonia, Lithuania, Greece, Georgia, Albania, Hungary, Serbia, Bosnia and Herzegovina, and Bulgaria) submitted data on HIV-positive patients using an electronic case report form (eCRF). Chi-Square test was used for group comparisons.In total 557 patients were included into the analyses: 361 from EU and 196 from non-EU countries. Access to remdesivir was 1.5% in non-EU countries vs 3.9% in EU-countries (p= 0.1952) . Symptoms of COVID-19 occurred more often in non-EU countries (93.3%) vs non-EU countries (83.6%) [p=0.0009], as well as hospitalization 32.8% vs. 20.8% respectively [0.0027]. Death/ICU was 4.8% in non-EU countries vs 3.4% in EU-countries (p=0.4877). In total 18 (3.23%) patients found out about HIV diagnosis during COVID-19, which was comparable in two groups (11 [3.0%] in UE countries vs. 7 [3.6%] in non-UE countries; p=0.8029).Patients from non- EU countries were more likely to be COVID-19 symptomatic and hospitalized. Access to antiviral therapy for SARS-CoV-2 was very low for all CEE countries.

Introduction The implementation of nationwide viral hepatitis C elimination programs is challenging in Central and Eastern European countries (CEEC). It is reasonable to start by targeting specific populations, such as people living with HIV (PLWH), who are at higher risk of acquiring HCV or developing HCV-related complications. Methods Euroguidelines in Central and Eastern Europe Network Group consists of experts in the field of infectious diseases from 26 countries in the region. Between April 26th and June 23rd 2023, the group performed an on-line survey consisting of 32 questions. The questionnaire assessed the status of HCV micro-elimination in 2022. Results Twelve HIV centers from 11 countries responded: Albania, Bosnia and Herzegovina, Croatia, Czech Republic, Estonia, Greece, Hungary, Macedonia, Moldova, Serbia and Ukraine. All centers screen for HCV antibody all PLWH at entry into care. The seroprevalence of anti-HCV was <5% in 5 centers (Albania, Croatia, Serbia, North Macedonia and Hungary), 30.2% in Estonia and 29% in Ukraine, Greece and Moldova had high seroprevalence as well, 15.3% and 15.6% respectively. The prevalence of HCV viremia in antibody-positive PLWH was very high in Greece (85%), while in most other treatment centers it ranged from 4.2% to 38.2%. There is also a screening policy of annual HCV-testing of HCV-antibody negative persons in all centers by either testing all PLWH or those considered at risk. Direct-acting antiviral agents (DAA) were not available in one country (Albania). Among PLWH who entered care in 2022, nine out of 12 ECEE centers reported cases of HCV/HIV coinfection, with five centers indicating that at least 50% of these individuals were HCV-viremic. Conclusions HCV screening in PLWH followed by access to DAA treatments were available in all but one center. Microelimination of HCV in PLWH in the majority of surveyed HIV treatment centers in CEEC has not been achieved and efforts to reach this goal need to be strengthened.

The aim of this study was to analyze the clinical course and outcome of the disease in patients with chronic obstructive pulmonary disease (COPD) who were hospitalized at the Clinic for Infectious Diseases of the University Clinical Center of the Republic of Srpska (UCCRS), in the period from November 30, 2024 to April 1, 2025, due to confirmed influenza. The study included 125 hospitalized patients with microbiologically confirmed influenza. Among them, 20.8% had COPD, of which 48% were male and 52% female, with an average age of 68.6 years and the majority had influenza A (76%), while 24% had influenza B. The mortality rate among patients with COPD was 8%, compared to 32% in patients without COPD. Laboratory findings showed higher levels of C-reactive protein and procalcitonin in patients with COPD, indicating a more pronounced inflammatory response. Additionally, COPD patients had higher levels of D-dimer, suggesting an increased tendency toward thrombosis. Radiological analyses revealed various forms of pneumonia, with 48% of COPD patients showing negative radiological findings despite elevated CRP levels. Oxygen therapy and de-obstructive treatments were more frequently administered in COPD patients, while antibiotics were included in the treatment of all COPD patients. The results suggest the need for a specific therapeutic approach in this group of patients patient group. Also, vaccination against influenza is a key preventive measure that can prevent influenza, reduce the severity of the disease if it occurs, and improve the outcome, especially in patients with COPD, who are more susceptible to more serious complications.

Background: Seasonal flu represents a significant public health challenge and cause of morbidity and mortality, especially among vulnerable populations. The aim of our study is to describe demographic and clinical characteristics of patients hospitalized for laboratory of confirmed influenza during the 2024/2025. season.Methods: The data of patients hospitalized in the Clinic for infectious diseas of the University Clinical Center of the Republic of Srpska from December 2024 to March 2025 were restrospectively analyzed. The diagnosis of influenza was confirmed by PCR testing from a nasopharyngeal swab. Data were collected on age, sex, comorbidities, laboratory findings, therapy, the need for oxygen support and mechanical ventilation, the outcome of treatment.Results: A total of 175 patients, average age 63, were hospitalized. Influenza A was confirmed by PCR test in 78 (44.6%), and Influenza B in 20 patients (11.4%). The most common symptoms on admission were fever, cough and muscle pain. Chronic diseases were present in 155 patients (88.6%), while only 12 patients (6.9%) were vaccinated against influenza. Pneumonia was radiographically diagnosed in 102 patients (58%). Antiviral therapy was used in 160 patients (91.4%). 54 patients (30.9%) required oxygen support, while 7 patients (4%) were on mechanical ventilation. A fatal outcome was recorded in 8 patients (4.6%).Conclusion: Low vaccination rate and high proportion of chronic diseases among the hospitalized indicates to patients the need for stronger vaccination promotion and early intervention in risk groups. Timely diagnosis and adequate therapy remain key factors in prevention of severe forms of disease and reduction of mortality.

<p><strong>Introduction. </strong>Lyme neuroborreliosis (LNB) can manifest during the early and late stages of Lyme disease (LD). The aim of this study is to determine epidemiology and clinical findings in patients with LNB.&nbsp;<br /><strong>Methods.</strong> The research was conducted in Banja Luka at the University Clinical Center of Republic of Srpska (UCC RS) during a four-year period from 10/2017 to 10/2021. The research included 51 patients admitted to the hospital with some neurological symptoms that could lead to the LNB diagnosis. Patients had lumbar puncture with cytochemical analysis of cerebrospinal fluid (CSF), ELISA anti-Borrelia IgM/IgG in serum and CSF, Immunoblot anti-Borrelia IgM/IgG in serum, and other documentation about epidemiology and clinical findings in LNB. &nbsp;<br /><strong>Results.</strong> A statistically significant (p=0.017) higher proportion of female patients was observed. Most patients were between 50 and 60 years old. Most of them were retirees (31.37%), farmers, medical technicians followed with forestry workers, students etc. Most of examinees did not have information on previous tick bite (64.71%). The largest number (72.55%) did not have data on previous skin changes. The largest number of neurological symptoms at admission related to the feeling of tingling and weakness in the extremities, headache, dizziness and some ophthalmological symptoms. Patients also suffered from consciousness and speech disorder, anxiety, paresis n.VII. The largest number of examinees had some neurological symptoms up to three months prior the admission to the hospital. &nbsp;<br /><strong>Conclusion. </strong>Symptoms of LNB can be quite non-specific or possibly even mimic other neurological diseases. Involvement&nbsp;<br />of peripheral nervous system is dominant in adult patients. It is necessary to work on early diagnosis of LD and it is mandatory to report it to the national epidemiological service.&nbsp;</p>

Objectives: Lamivudin has been approved for the treatment of chronic hepatitis B but experience with lamivudin treatment for acute severe hepatitis B is still limited. Fulminant hepatitis develops in 1% of patients with acute hepatitis B. Severe acute hepatitis B in immunocompetent patients may progress to fulminant hepatitis and death. Aim: To evaluate the efficasy of lamivudine for the treatment of acute severe hepatitis B virus infection in imunocompetent adults in Clinic for infectious diseases Banja Luka. Patients and methods: In the period of 2006-2024 years, 12 immunocompetent patients (4 women, 8 men, age 24-77 years) with severe acute hepatitis B were treated with lamivudin. All 12 patients fulfil at least two of the criteria for severe acute hepatitis B infection: 1. hepatic encephalopathy; 2. total bilirubin 210 micromole per litre; and severe coagulopathy (international normalized ratio-INR was 4.5 ± 6.4 or prothrombin time-PT < 40%). All patients had evidence of severe hepatocyte lysis. Nine patients had rapid increase of total bilirubin and contemporary decrease of alanine aminotransferase level, which escalate risk of development of fulminant hepatitis B. All patients received lamivudin at a dose 100 mg per day. Results: Ten patients responded well to the treatment and their biochemical parameters improved rapidly. Within 1-6 months, the HBsAg was undetectable in 10 out of 12 investigated patients. Protective anti-HBs antibodies developed in 10 of them in 1-6 months. The corticosteroid therapy was short-term in 2 of 12 patients. Two patient developed fulminant hepatitis B and died after the lamivudine therapy was initiated. Lamivudine treatment was well tolerated in all patients. Conclusion: Lamivudin induces a prompt clinical, biochemical and serological response in immunocompetent patients with severe acute hepatitis B. Early treatment with lamivudine probably decreases the risk of progression to fulminant hepatitis in patients with severe acute hepatitis B.

Background and aims: Hepatitis C virus (HCV) infection is common among patients on haemodialysis (HD) therapy and is an important cause of morbidity and mortality. In patients with chronic kidney disease (CKD), the risks for negative outcomes are significantly higher in HCV-infected patients than in those without HCV infection, including progression to cirrhosis, hepatocellular carcinoma and liver-related mortality. Micro-elimination of hepatitis C in renal patients is crucial. This study aims to assess the efficacy and safety of directly acting antivirals in chronic kidney disease patients and the effect of treatment on kidney functions. Methods: The course of treatment with antiviral therapy in patients on chronic hemodialysis program was analyzed. Pre-treatment evaluation of HCV infection included HCV RNA, genotype, and liver fibrosis assed by transient fibroelastography (FibroScan). The stage 5 CKD was defined as an eGFR of <15 mL/min/1.73 m2, respectively; those on haemodialysis were considered to have stage 5 CKD or end-stage renal disease (ESRD). Demographic data and concomitant medication were retrieved from patients’ records. The primary endpoint was sustained virologic response at post-treatment week 12 (SVR12). We collected data on on-treatment adverse events (AEs), serious AEs, and laboratory abnormalities. Results: From 2008 until now, a total of 25 patients were treated for chronic HCV infection on a chronic hemodialysis program with three therapeutic antiviral modalities. Treatment with pegylated interferon (PEG-IFN) alfa 2a with or without ribavirin (RBV) was performed in 16 patients. This treatment showed the least effectiveness and great intolerability. Seven patients were treated with a 3D regimen - Paritaprevir/Ritonavir/ Ombitasvir and Dasabuvir with or without Ribavirin. Among the 7 treated patients, 6 were male and 1 female, all were infected with genotype 1 (5 GT1b, 2 GT1a). The patient had compensated liver cirrhosis, and six patients did not have liver cirrhosis, none were transplanted. All seven patients completed 12 weeks of treatment and achieved SVR12. One patient had significant decreases in hemoglobin, white blood cell, and platelet counts during the treatment period. The most common adverse events were nausea, diarrhea. Adverse events were generally mild and no patient discontinued due to an AE. Two patients were treated with the pangenotypic drug glecaprevir/pibrentasvir, the shortest therapeutic regimen of 8 weeks, with excellent efficacy and safety. This was the most comfortable therapy regimen. Due to implementation of HCV infection control procedures within dialysis units and elimination of HCV from the bloodstream, the frequency of HCV infection is gradually decreasing in many dialysis centers. Conclusions: Treatment with OBV/PTV/r + DSV ± RBV and pangenotypic glecaprevir/ pibrentasvir was well tolerated and resulted in high SVR12 rates (100%) in hemodialysis patients. DAA treatment provided significant improvement in patients with HHC, compared to PEG-IFN/RBV in patients with ESRD.

To date there remains much ambiguity in the literature regarding the immunological interplay between SARS‐CoV‐2 and HIV and the true risk posed to coinfected individuals. There has been little conclusive data regarding the use of CD4 cell count and HIV viral load stratification as predictors of COVID‐19 severity in this cohort.

The COVID-19 pandemic, since SARS-CoV2 was discovered in December 2019, has resulted in significant morbidity and mortality. Since then, several countries have witnessed the collapse of the health care system due to the great need to treat patients with COVID-19. At the global level, drastic measures have been taken to combat the spread of the virus. However, these measures have led to disruptions in other aspects of health care, diagnosis and treatment of other diseases and conditions. There is also a stalemate in achieving the ambitious goal set by the World Health Organization to eliminate viral hepatitis as a threat to public health by 2030. Hepatitis B and C are chronic conditions with a significant global burden, and COVID-19 has slowed or stopped many hepatitis elimination programs.

Abdominal actinomycosis remains an uncommon condition that mimics a wide range of intra-abdominal conditions ranging from acute inflammatory pathologies such as appendicitis to colonic or gynecological malignancies. Any abdominal organ can be affected. Preoperative diagnosis is often difficult and radiological imaging is unlikely to provide a definitive diagnosis. Surgical resection is often required in combination with long-term high-dose antibiotic therapy.