Papers by Camelia Sultana
Journal of the International AIDS Society, 2010
Roumanian archives of microbiology and immunology
Accurate genotyping of hepatitis C virus (HCV) has clinical implications for treatment orientatio... more Accurate genotyping of hepatitis C virus (HCV) has clinical implications for treatment orientation and epidemiological impact in tracing the contamination sources. The aim of the study was to compare a genotyping assay by restriction fragment length polymorphism (RFLP) in the HCV 5'untranslated region (5'UTR) with sequencing in the 5'untranslated and NS5B regions. One hundred and three samples, collected between 2004 and 2006 from chronically infected patients with HCV, were tested with the 5'UTR and NS5B protocols. Of the total number of the samples tested by the 5'UTR-RFLP assay (n=103) the HCV subtype could be inferred by this method for 92 samples, by 5'UTR sequencing for 16 samples out of 23 tested (n=23) and by using the NS5B sequencing for all the samples tested (n=34). Our results showed that the HCV genotype distribution in Romania is: 1b--86.4%, 1a--10.7% and 4a--2.9%. In conclusion, RFLP screening in the 5'UTR is a convenient method for HCV gen...
Roumanian archives of microbiology and immunology
Accurate genotyping of hepatitis C virus (HCV) has clinical implications for treatment orientatio... more Accurate genotyping of hepatitis C virus (HCV) has clinical implications for treatment orientation and epidemiological impact in tracing the contamination sources. The aim of the study was to compare a genotyping assay by restriction fragment length polymorphism (RFLP) in the HCV 5'untranslated region (5'UTR) with sequencing in the 5'untranslated and NS5B regions. One hundred and three samples, collected between 2004 and 2006 from chronically infected patients with HCV, were tested with the 5'UTR and NS5B protocols. Of the total number of the samples tested by the 5'UTR-RFLP assay (n=103) the HCV subtype could be inferred by this method for 92 samples, by 5'UTR sequencing for 16 samples out of 23 tested (n=23) and by using the NS5B sequencing for all the samples tested (n=34). Our results showed that the HCV genotype distribution in Romania is: 1b--86.4%, 1a--10.7% and 4a--2.9%. In conclusion, RFLP screening in the 5'UTR is a convenient method for HCV gen...
Roumanian archives of microbiology and immunology
Serum alpha fetoprotein (AFP) is a commonly used marker in the screening for hepatocellular carci... more Serum alpha fetoprotein (AFP) is a commonly used marker in the screening for hepatocellular carcinoma. This study aims to evaluate the value of AFP as an early predictor of the evolution of chronic hepatitis C. In a retrospective study on 116 HCV-infected patients (62.9% females, mean age 49.13 ± 1.73 years), increased levels of serum AFP (> 7 ng/mL) were found in 39.7% of cases. High serum AFP levels were more frequently detected in older patients and in those with severe fibrosis and cirrhosis (62.2% and 76.9% respectively vs. 11.6% in those without significant fibrosis, p = 0.0001). Increased AFP levels were significantly associated with markers of hepatic cytolysis (ALT- r = 0.245, p = 0.009 and AST r = 0.441, p = 0.0001) and cholestasis (GGT level-r = 0.947, p = 0.000 1), but not with HCV viral load. A predictive model based on AFP level and routinely monitored biochemical markers of liver fibrosis and necroinflammatory activity can be a useful clinical tool in chronic HCV infection.
Roumanian archives of microbiology and immunology
Improved understanding of the HCV viral life cycle has led to the identification of numerous pote... more Improved understanding of the HCV viral life cycle has led to the identification of numerous potential molecular targets for the development of new drugs. Direct acting antivirals -DAAs specifically target a viral encoded protein: the NS3-4A protease, involved in the posttranslational viral protein processing; the NS5B encoded viral polymerase, that conducts the nucleic acid replication and the NS5A encoded phosphoprotein, that participates in both replication and virus assembly. Host-targeted agents, both directed to the early steps of viral replication (receptors and coreceptors antagonists) or to the development of a functional viral replication complex (host cyclophilins) are also developed, to strengthen the antiviral efficacy of these drugs. The newly approved NS3-4A protease inhibitors (telaprevir and boceprevir), administered in combination with pegylated interferon and ribavirin for patients with HCV genotype I infection, determined a significant enhancement in the sustained virologic response rates (towards 66-75% in treatment-naive patients and 59-66% in treatment-experienced ones). Improved antiviral efficacy was shown in clinical trials by second generation protease inhibitors, while valuable alternatives are represented by nucleoside/nucleotide analogues and non-nucleoside inhibitors directed to the HCV RNA-dependent RNA polymerase, as well as by NS5A inhibitors (both direct acting or directed to the host cofactors). More recently, combinations of different drugs are tested as a potential cure for chronic hepatitis C.
Background: The transmission of drug-resistant HIV-1 has important implicationsfor the successful... more Background: The transmission of drug-resistant HIV-1 has important implicationsfor the successful management of antiretroviral therapy amonginfected individuals, restricting drug options and increasingthe risk of suboptimal treatment outcomes. Considering the fact that data on non-B subtypes are limited, and subtype F is predominant in Romania, our goal is to analyze resistance mutations in the pol gene of HIV-1 isolates from drug-naive patients. Methods: Twenty HIV-1 strains from untreated individuals, newly diagnosed (n = 10) and chronically infected (n = 10), with detectable HIV RNA viral load were included in this study. Among newly diagnosed patients, recent infections (acquired in the previous 6 months) were detected by BED-CEIA in 2/10 cases. Resistance genotyping was performed using the ViroSeq HIV-1 Genotyping System (Celera Diagnostics, Alameda, USA). For subtyping purposes and drug resistance interpretation all sequences were submitted to the Stanford University HIVdataba...
Journal of gastrointestinal and liver diseases : JGLD, 2012
Journal of gastrointestinal and liver diseases : JGLD, 2011
A high seroprevalence of Hepatitis C Virus (HCV) infection has been reported in Romania, with lim... more A high seroprevalence of Hepatitis C Virus (HCV) infection has been reported in Romania, with limited data on the viral subtypes' distribution. In order to detect any changes in the genetic composition of the epidemic, a survey on the recent profile of circulating HCV genotypes was conducted. 241 hepatitis C infected patients with active viral replication diagnosed between September 2004 - October 2008 were included in a retrospective study. Genotyping using commercial Line Probe Assay (Innogenetics) was confirmed by sequencing of Core PCR products followed by phylogenetic analysis. HCV subtype 1b was found in 92.6% of the samples, subtype 1a in 5.4 % of the samples, subtype 4a in 1.2%, and subtype 3a in 0.8% of the samples. Chronic hepatitis C infections with subtype 1b were found in women aged 40-60 years old with a history of blood transfusions received during surgical/obstetrical interventions. No geographical clustering was evident for HCV 1b sequences. The new emerging non...
Hepatitis Monthly, 2013
Background: Patients with chronic hepatitis C (CHC) often have elevated serum iron markers, which... more Background: Patients with chronic hepatitis C (CHC) often have elevated serum iron markers, which may worsen liver injury. Objectives: The aim of this study was to investigate the possible correlations between iron metabolism serum markers, HCV viral load, and liver disease severity in treatment-naive patients with chronic hepatitis C infection. Patients and Methods: Eighty five patients with untreated hepatitis C chronic infection were investigated. Results: Twenty one patients (24.7%) had elevated serum iron levels, and 29 subjects (34.1%) had severe liver fibrosis. Significantly elevated levels of serum iron (P < 0.05) and ferritin (P < 0.001), associated with lower levels of TIBC (P < 0.05) were detected in patients with severe fibrosis compared to no/mild fibrosis. Severe necroinflammatory activity was also significantly correlated with serum iron (P < 0.001), TIBC (P < 0.05), and ferritin levels (P < 0.001). Using multiple linear regression analysis, serum levels of ferritin and transferrin were the independent variables selected as being good predictors for advanced fibrosis and severe necroinflammatory activity. No significant correlations were detected between HCV viral load and iron markers. Conclusions: This study revealed that serum iron markers (especially ferritin and transferrin) might be used as surrogate markers for both liver fibrosis and necroinflammatory activity.Patients with chronic hepatitis C (CHC) often have elevated serum iron markers, which may worsen liver injury.
Central European Journal of Medicine, 2007
... Mihaela Chivu1∗ , Serban Nastasia2, Camelia Sultana1, Coralia Bleotu1, Irina Alexiu1, Decebal... more ... Mihaela Chivu1∗ , Serban Nastasia2, Camelia Sultana1, Coralia Bleotu1, Irina Alexiu1, Decebal Hudita2 1 Stefan S. Nicolau Institute of Virology, 285 Mihai Bravu Ave., Bucharest, Romania 2 Dr. I. Cantacuzino Hospital, 5-7 Ion Movila Ave., Bucharest, Romania ...
Central European Journal of Medicine, 2011
Due to the increasing number of infections related to injecting drug use, both the pattern of hep... more Due to the increasing number of infections related to injecting drug use, both the pattern of hepatitis C virus (HCV) transmission, and the circulating genotypes in Europe have changed. As there are little available data in this respect for Romania, the aim of our study was a preliminary analysis of the distribution of HCV genotypes circulating among injecting drug users (IDUs). Of the 45 IDUs evaluated (86.7% men, mean age - 27.6±3.7 years, mean age at first drug use - 17.5±3.9 years), 88.9% presented anti-HCV antibodies, with higher rates in those with an injecting history of more than 10 years; 57.8% of the subjects had detectable HCV viral load. Only 6.7% had markers of chronic hepatitis B infection, and none had anti-HIV antibodies. While HCV subtype 1b is still prevalent (in 50% of the viraemic subjects), other subtypes begin to emerge, especially in younger patients (1a - in 23.1%, 4 - in 11.5%, 3a - in 7.7% of the cases). These data indicate the possibility of major shifts in the distribution of the dominant subtype, underlining the need for close surveillance of HCV infections in IDUs, who can act as a bridging group toward the general population.
Hepatitis Monthly, 2013
Background: Due to a recent alarming increase in the number of HIV-HCV co-infected patients in Ro... more Background: Due to a recent alarming increase in the number of HIV-HCV co-infected patients in Romania. Objectives: A cross sectional study was conducted to assess the baseline predictors of liver disease evolution. Patients and Methods: 83 HIV-HCV co-infected patients, untreated for HCV infection, were evaluated for viral replication, liver fibrosis (estimated by a noninvasive marker -FIB4), and plasma levels of IP-10 (interferon-gamma inducible protein 10) -a cytokine associated with an unfavorable outcome of HCV infection. Results: The median value for HCV viral load was high (6.3 log10 IU/mL), 98.8% of the patients were infected with HCV genotype 1. Although 53% of the patients received antiretroviral therapy (cART), only 31.8% of these achieved undetectable HIV levels. HCV viral load was significantly higher in patients with AIDS (6.4 vs. 6.1 log10IU/mL; P = 0.04), and in those naïve for cART (6.5 vs. 5.9 log10 IU/mL; P = 0.04). Severe fibrosis was directly correlated with immunosupression (56% vs. 17.4%, P = 0.03), HCV replication (6.1 vs. 4.9 log10IU/mL P = 0.008), and IP-10 median values (312 vs. 139 pg/ml, P=0.008). A serum IP-10 level higher than 400 pg/mL was significantly associated with FIB-4 median values (4.09 vs. 1.7, P = 0.004), HCV viral load (6.4 vs. 6.1 log10 IU/mL, P = 0.02) and ALT level (206.8 vs. 112.4 IU/L, P = 0.05). Conclusions: An important part of the HIV-HCV co-infected patients had negative baseline predictors for the evolution of HCV infection; their therapeutical management must be conducted with special attention towards adherence and potential overlapping drug toxicities. High concentrations of plasma IP-10 are reliable markers for the severity of liver disease.
Journal of the International AIDS Society, 2005
Background. : We evaluated the frequency of hepatitis coinfection in Romanian adolescents who wer... more Background. : We evaluated the frequency of hepatitis coinfection in Romanian adolescents who were diagnosed with human immunodeficiency virus (HIV) infection prior to 1995.
Journal of the International AIDS Society, 2008
International Journal of Infectious Diseases, 2008
International Journal of Infectious Diseases, 2008
minor surgery (ORad,10.9; CI,3.6-32.6). A lower but significant risk (from 3,7 to 4,7 times highe... more minor surgery (ORad,10.9; CI,3.6-32.6). A lower but significant risk (from 3,7 to 4,7 times higher respect to no intervention) was found for oral surgery, Gynaecological, cardiovascular, abdominal interventions and for biopsy or endoscopy. Only minor (ORad,3.0; CI, 1.3-7.1), oral (ORad, 2.6; CI,1.5-4.6) and dermatological surgery (ORad, 2.9; CI, 1.1-7.5) were associated with AHB instead, instead.
International Journal of Antimicrobial Agents, 2007
Accurate genotyping of hepatitis C virus (HCV) has clinical implications for treatment orientatio... more Accurate genotyping of hepatitis C virus (HCV) has clinical implications for treatment orientation and epidemiological impact in tracing the contamination sources. The aim of the study was to compare a genotyping assay by restriction fragment length polymorphism (RFLP) in the HCV 5'untranslated region (5'UTR) with sequencing in the 5'untranslated and NS5B regions. One hundred and three samples, collected between 2004 and 2006 from chronically infected patients with HCV, were tested with the 5'UTR and NS5B protocols. Of the total number of the samples tested by the 5'UTR-RFLP assay (n=103) the HCV subtype could be inferred by this method for 92 samples, by 5'UTR sequencing for 16 samples out of 23 tested (n=23) and by using the NS5B sequencing for all the samples tested (n=34). Our results showed that the HCV genotype distribution in Romania is: 1b -86.4%, 1a -10.7% and 4a -2.9%. In conclusion, RFLP screening in the 5'UTR is a convenient method for HCV genotyping and discrimination between 1b and non-1b genotypes but has a poor resolving power for subtyping and evaluation of the transmission routes. Sequencing in NS5B region is more adapted than RFLP and sequencing in 5'UTR for subtyping and epidemiological investigation.
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Papers by Camelia Sultana