Brygida Knysz’s research while affiliated with Wroclaw Medical University and other places

Introduction Human Immunodeficiency Virus (HIV) remains a major global health issue. In Poland, men represent 79% of the HIV-infected population, but the proportion of women diagnosed has been increasing. This study examines the clinical condition of newly diagnosed HIV-1 patients in Lower Silesia at three key points: 2010, 2016, and 2020, to understand infection dynamics and improve regional screening and prevention efforts. Objective The objective of the study is to compare the clinical condition of newly diagnosed women and men with HIV-1 in Lower Silesia at three time points in order to identify trends and differences that can inform targeted public health strategies. Methods A retrospective analysis of medical records from the HIV clinic in Wroclaw was conducted for the years mentioned. The dataset included demographic information, transmission routes, clinical status, and co-infections. Results The study included 202 patients, of whom 27 were women. Heterosexual transmission was the primary route among women (2010/2016/2020 – 44.44%/57.14%/90.91%), while men predominantly acquired HIV-1 through homosexual contact (2010/2016/2020 – 52.94%/80.82%/75%). A significant decrease in infections from intravenous drug use was observed among men (Chi² = 24.85, df = 2, p < 0.001). Women consistently had lower CD4+ T cell counts, with a median (Q1, Q3) of 250 (108–288), significantly lower than men’s 431 (280–550) (Mann–Whitney U-test: z = 4.23, p < 0.001). Women were also more frequently diagnosed as late presenters (OR: 6.07, 95% CI (2.34–15.82)). Conclusion This study identifies significant gender disparities in HIV-1 diagnosis in Lower Silesia, with women being six times more likely to be diagnosed as late presenters. This highlights the necessity for enhanced and targeted public health interventions, particularly within the context of antenatal care.

Background/Objectives: A late HIV diagnosis represents a significant public health concern in Poland, with approximately 50% of patients being identified as late presenters (LPs), resulting in the delayed initiation of treatment. This study assesses the potential of HIV self-testing (HIVST) to enhance early detection, particularly among heterosexual individuals, and evaluates its advantages and limitations within the Polish context. Methods: This study examines the advantages and disadvantages of HIVST by analyzing data from various studies. It focuses on the acceptability, sensitivity, and specificity of HIVST, comparing blood-based and oral fluid-based tests. Moreover, the economic impact and potential public health benefits of HIVST in Poland are evaluated. Results: HIVST is well-accepted, especially among key populations; it can reduce stigma and enhance privacy. The results of studies conducted in Poland indicate that heterosexuals are more inclined to use self-testing methods than traditional diagnostic procedures. On the other hand, HIVST has the potential for false-negative results due to the serological window and the possibility of missed diagnoses of other sexually transmitted infections (STIs). Moreover, the cost of HIVST remains a significant barrier, as it is not publicly funded in Poland. Conclusions: Despite its limitations, HIVST offers a number of significant benefits, including increased rates of testing and earlier detection, which could prove vital in reducing the transmission of HIV in Poland. This study proposes that increased funding, the integration of HIVST into public health strategies, and further research to enhance its implementation, alongside education and support for its effective use, should be prioritized.

Streptococcus pyogenes is responsible for 20–30% of pharyngitis in children and 5–15% in adults. The ineffective treatment of group A Streptococcus (GAS) infections can result in postinfectious sequelae. This study aims to evaluate the frequency of GAS pharyngitis and assess the management of patients with pharyngitis and antibiotic use. We conducted a multicenter, retrospective analysis of medical records from nine primary care centers in Poland. The study enrolled 1949 medical records of patients (children 67.4%, adults 32.6%). An infection of Streptococcus pyogenes, based on a rapid strep test, was diagnosed in 830 patients (42.6%). In the comprehensive study group of 1949 patients, 1054 (54.1%) were given antibiotics. Notably, 224 patients had a negative rapid strep test result but still received antibiotic treatment, underscoring the complexity of treatment decisions. The most commonly used antibiotics were oral penicillin V in 431 cases (41%) and amoxicillin in 219 cases (20.8%). We observed no significant difference between positive rapid strep test results and patients’ sociodemographic data and comorbidities. The prevalence of GAS was 42.6% in the analyzed records of patients with pharyngitis, and 54.1% were prescribed antibiotics. Antibiotics were overprescribed for sore throats. Strategies are needed to promote rational antibiotic use.

The HIV (Human Immunodeficiency Virus) epidemic remains a significant public health issue, requiring ongoing access to preventive methods. This study aimed to analyze the evolution of the HIV epidemic in Lower Silesia from 2010 to 2020, focusing on the key populations. A retrospective analysis of the medical records from newly diagnosed HIV patients at a major HIV clinic in Wroclaw was conducted, examining demographic data, infection routes, and laboratory results. An 84% increase in newly diagnosed HIV cases was observed over the decade, with the most common route of infection being sex between men (70% among those with a known infection route). These patients were generally in better clinical condition compared to their heterosexual counterparts, as indicated by a higher median CD4+ T cell count (465/μL vs. 250/μL). The changes in clinical status and infection routes were statistically significant. The HIV epidemic in Lower Silesia has shifted, with a notable rise in new infections among men who have sex with men. Heterosexual patients were often diagnosed at more advanced stages. Prevention strategies should adapt to these changing trends, with education and testing accessibility remaining priorities nationwide.

Background/Objectives: People living with HIV (PLWH) treated with combined antiretroviral therapy (cART) show a greater predisposition to metabolic and inflammatory disturbances compared to the general population. This study aimed to assess the effect of five years of cART use on the level of selected parameters related to carbohydrate and lipid metabolism and inflammation in PLWH compared to the uninfected. Methods: The levels of sirtuins (-1, -3, -6); irisin (IRS); myostatin (MSTN); peptide YY (PYY); glucagon-like peptide-1 (GLP-1); dipeptidyl peptidase IV (DPP-4); fetuin-A (FETU-A); pentraxin 3 (PTX3); chemokine stromal cell-derived factor 1 (SDF-1); regulated on activation, normal T cell expressed and presumably secreted (RANTES); and interleukins (-4, -7, -15) in the plasma of PLWH and a control group were evaluated by immunoassay methods. The results obtained after five years of antiretroviral therapy were compared with the levels obtained before and one year after cART. Results: Analysis of the parameters after five years of cART showed significantly higher levels in PLWH compared to the control group for SIRT-6, IRS, and IL-4 and significantly lower levels for RANTES and IL-7. There were significantly higher levels of SIRT-6, PYY, GLP-1, and PTX3 obtained after five years of cART compared to the results before therapy and after one year of cART. Conclusions: The results indicated changes occur in the expression of selected parameters during cART use in PLWH. Further research on the clinical usefulness of selected parameters and obtaining new information on the development of HIV-related comorbidities needs to be conducted.

The introduction of protective vaccination against COVID-19 was a turning point in the fight against the pandemic. Expectations also concerned the effectiveness of vaccines in inducing a strong immune response against the SARS-CoV-2 virus and the length of post-vaccination immunity. This topic seems to be especially important in the case of immunocompromised people such as those living with HIV (PLWH). The aim of the study was to examine the concentration of anti-SARS-CoV-2 IgG antibodies against the S1 subunit of the virus’spike protein as a marker of humoral response and the concentration of interferon-gamma (IFN-γ) as an indicator of cellular response in PLWH undergoing combination antiretroviral therapy (cART) and uninfected people (control group) several months after the COVID-19 booster. Concentrations of selected enzymes from the group of sirtuins (SIRT1,-3,-6) that participate in the course of HIV infection were also examined. Concentrations of IgG and IFN-γ were statistically significantly lower in PLWH compared to the control group. Correlations between IgG and IFN-γ concentrations were found both in PLWH and in the control group. Only the concentration of SIRT-6 was significantly lower in PLWH compared to the control group. Vaccination for COVID-19 enabled good long-term humoral and cellular immunity in both HIV positive and uninfected people. The CD4/CD8 ratio and T CD8+ T lymphocytes count played a role in the long-term immune response to booster vaccination. The introduction of optimal cART stabilized the immune status of PLWH and had a positive effect on the humoral and cellular response against infection SARS-CoV- 2.

Introduction Despite vaccinations available worldwide, patients and healthcare workers still struggle with COVID-19. Previously we observed in some convalescents surprisingly lower antibody levels after a second dose of SARS-CoV-2 vaccine compared to the first dose. Six months after full vaccination we obtained follow-up results of 87 patients divided into 3 groups: (A) convalescents with higher antibody levels after second dose of vaccine compared to first dose, (B) naïve patients, (C) convalescents with decreasing antibody level after second dose compared to first dose. Materials and Methods Patients’ anti-SARS-CoV-2 antibody levels were checked by the anti-SARS-CoV-2 QuantiVac ELISA (IgG) (EUROIMMUN MedicinischeLabordiagnostica AG, Luebeck, Germany) test, as before, and prior to the blood sampling patients completed a questionnaire regarding, inter alia, general condition, smoking, flu vaccination. Results Thanks to this follow-up we concluded that none of the patients suffered from symptomatic SARS-CoV-2 infection within 6 months after vaccination. Decline of antibody levels 6 months after vaccination was observed in all groups. Convalescent group A lost more antibodies in the mentioned period of time than group B or C. Group C presented still high results, higher than in group B (p = 0.007), but lower than in group A (p = 0.048). Conclusions Temporary decrease of antibody levels in convalescents after the second dose of SARS-CoV-2 vaccination did not imply further consequences in the form of important antibody level differences 6 months after vaccination. Patients’ overweight could have an impact on antibody production but only after natural infection. It did not affect obtained results after vaccinations.

Cutaneous larva migrans (CLM) is a dermatosis caused by accidental infestation with animal hookworms and is widely distributed in tropical and subtropical regions. Humans become infected when their skin comes into contact with soil contaminated with dog faeces. The filariform larvae penetrate and burrow into human skin, causing a condition known as “creeping eruption”. We describe a case, well-documented by photos, of CLM infection in a family of three who returned from Thailand.

Introduction: Inflammation and injury within reproductive organs, including artificial vagina, can facilitate human immunodeficiency virus (HIV) transmission. However, HIV infection in a patient with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome has been rarely described. Both MRKH and HIV diagnoses are linked to psychological distress in patients.

Background: Since the beginning of the coronavirus disease (COVID-19) pandemic, numerous infections have been observed with various symptoms and degrees of severity. Not all patients have had a confirmation of infection made using reverse transcription polymerase chain reaction (RT-PCR) or antigen tests. It has been observed that some people, including convalescents or those without knowledge of a past infection, perform serological tests to detect anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. Objectives: We aimed to evaluate the levels of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies in a cohort of convalescents and in individuals not previously infected, who were willing to get vaccinated. We also aimed to assess several socio-clinical factors associated with participants' humoral responses. Material and methods: We recruited 298 individuals from the region of Lower Silesia who were willing to get vaccinated for SARS-CoV-2. The participants were divided into 2 groups: convalescents (group I) and participants without a past infection (group II). Several seropositive individuals in group II were identified, and they were transferred to group I, resulting in a final distribution of 171 individuals in group I and 127 individuals in group II. For serological testing, the QuantiVac anti-SARS-CoV-2 (IgG) enzyme-linked immunosorbent assay (ELISA) was used. Results: The results showed the presence of anti-SARS-CoV-2 IgG antibodies in participants from group I, with an average number of 190.3 IU/mL. Twenty-three participants (13.45%) did not have a detectable level of antibodies despite a previous SARS-CoV-2 infection. In 21 participants (12.28%), antibodies were detected despite no previous symptoms of infection (average level: 145.0 IU/mL). Conclusion: Older participants were more likely to experience a symptomatic SARS-CoV-2 infection, and the severity of the symptoms was related to higher antibody titers seen later after COVID-19. Numerous individuals from group II were unaware of past SARS-CoV-2 infections. In several participants, antibodies were not detected despite a previous infection.