Liliya Pekova - Academia.edu (original) (raw)

Papers by Liliya Pekova

Future Virology, 2019

Aim: To evaluate hepatitis B virus (HBV) and hepatitis C virus (HCV) among individuals with HIV/A... more Aim: To evaluate hepatitis B virus (HBV) and hepatitis C virus (HCV) among individuals with HIV/AIDS in Bulgaria diagnosed between 2010 and 2015. Materials & methods: A total of 1158 individuals were diagnosed with HIV/AIDS during the study period. Different transmission groups were tested with ELISA and real-time PCR for HBV and HCV markers. Results: Hepatitis B surface antigen and hepatitis C virus antiboby were found in 9.3 and 23.2% of the tested. HBV DNA and HCV RNA has been found in 47.4 and 69.6%. Hepatitis B and C co-infections were predominant in multiple risk behavior groups, including people who inject drugs, men who have sex with men, prisoners and Roma individuals. Conclusion: HIV prevalence in Bulgaria is low but the rates of hepatitis B and C co-infections among these patients fall within the upper range reported in Europe.

International journal of clinical case reports and reviews, Feb 29, 2024

Before the Covid 19 pandemic, the incidence of community-acquired Clostridium difficile infection... more Before the Covid 19 pandemic, the incidence of community-acquired Clostridium difficile infection (CDI) was 35-50%. SARS-CoV-2 created favorable conditions for its increase. Aim: To identify the factors responsible for the severe course and adverse outcome in CDI post-Covid 19. Materials and methods: 121 patients aged from 23 to 90 years-53 women and 68 men-with CDI and a recent Covid-19 were included in a prospective study. Clinical, epidemiological, laboratorial and molecular-genetic investigations were used. Results: All patients were on long-term treatment with broad-spectrum antibiotics for SARS-CoV-2 infection. The most common symptoms of CDI were diarrhea, fever and loss of weight. The majority of patients were discharged in an improved condition. There were 12 lethal outcomes (9,91%). Conclusion: Age over 65 years, presence of accompanying chronic diseases, as well as late hospitalization can be indicated as poor prognostic factors for the clinical course and outcome of CDI.

International Journal of Infectious Diseases, Dec 1, 2016

Conclusion: The commercially prepared vaccine did not induce a robust, measurable humoral respons... more Conclusion: The commercially prepared vaccine did not induce a robust, measurable humoral response in captive deer. Killed virus vaccines have previously been shown to provide effective protection from BTV in sheep. Efficacy of autogenous vaccines depends on multiple factors including the similarity of viruses in the vaccine to the wild-type strain, the use of a proper adjuvant to induce immune response, and purity of the vaccine. Vaccine makers must conduct proper testing of purity and efficacy of vaccine prior to offering its project to the market, and cervid owners are advised to test for antibody production if they are going to use autogenous vaccines.

Viruses

Transmitted HIV drug resistance in Bulgaria was first reported in 2015 using data from 1988–2011.... more Transmitted HIV drug resistance in Bulgaria was first reported in 2015 using data from 1988–2011. We determined the prevalence of surveillance drug resistance mutations (SDRMs) and HIV-1 genetic diversity in Bulgaria during 2012–2020 using polymerase sequences from 1053 of 2010 (52.4%) antiretroviral therapy (ART)-naive individuals. Sequences were analyzed for DRM using the WHO HIV SDRM list implemented in the calculated population resistance tool at Stanford University. Genetic diversity was inferred using automated subtyping tools and phylogenetics. Cluster detection and characterization was performed using MicrobeTrace. The overall rate of SDRMs was 5.7% (60/1053), with 2.2% having resistance to nucleoside reverse transcriptase inhibitors (NRTIs), 1.8% to non-nucleoside reverse transcriptase inhibitors (NNRTIs), 2.1% to protease inhibitors (PIs), and 0.4% with dual-class SDRMs. We found high HIV-1 diversity, with the majority being subtype B (60.4%), followed by F1 (6.9%), CRF02_...

Obsha Meditsina / General Medicine, 2019

IDCases, 2021

Cerebral toxoplasmosis is a common opportunistic infection that causes expansive brain lesions in... more Cerebral toxoplasmosis is a common opportunistic infection that causes expansive brain lesions in people living with HIV/AIDS. But it is extremely rarely associated with HIV negative patients. This study presents a case of a 23-year-old male with non HIV-relative cerebral toxoplasmosis. There was an acute onset of the disease. The first symptoms included fever and signs of meningoradicular irritation. Neurological abnormalities progressed in cranial nerves disorders and pyramidal syndrome. The cerebrospinal fluid (CSF) changes were consistent with those of viral meningoencephalitis. CT and MRI showed multiple ring-enhancing lesions with high-intensity signals in cerebrum brain stem and cerebellum. The tests for HIV (ELISA and Western blot) were negative. Serological detection of Toxoplasma gondii (T. gondii) IgM and IgG antibodies in the CSF confirmed the diagnosis. Parasitic, bacterial, viral encephalitis and meningoencephalitis, as well as neoplastic metastatic process and other neurological diseases were discussed in the differential diagnosis. The intensity of the disease activity fluctuated during the hospital stay regardless of the adequate therapy.

Trakia Journal of Sciences, 2020

Infections of the nervous system and its belonging structures have often been reported as life-th... more Infections of the nervous system and its belonging structures have often been reported as life-threatening conditions. Purpose: the results of dynamic follow-up and proving of changes in secondary meningoencephalitis from suppurative left maxillary sinusitis are presented using the imaging methods - CT and MRI. Methods: diagnostic imaging (CT, MRI), of acute disease in a 13-year-old child with progressive development and proving of secondary bacterial meningoencephalitis. Result: the control CT after two days showed dynamics in the imaging CT finding with the appearance of changes in the type of brain oedema and development of pansinusitis. The MRI data described corresponded to changes as at meningoencephalitis in progress.Conclusion: The extension of the diagnostic algorithm with MRI, with the administration of intravenous contrast medium, clearly demonstrated changes characteristic of meningoencephalitis.

European Journal of Internal Medicine, 2011

E-health includes a number of tools based on information and communication technologies (ICT). It... more E-health includes a number of tools based on information and communication technologies (ICT). Its introduction in the practice of medical specialists helps them for more effective work. PURPOSE The aim is to analyze the adjustment and the efficiency of the usage in the practice of medical specialists. METHODS: A representative scientific survey among medical specialists working in 8 hospitals from 5 cities in Bulgaria - 3 university (2 MHAT and 1 SHAT), 4 private (MHAT) and 1 complex oncology center (COC). RESULTS: The present article analyzes the answers of questions relevant to using information systems (IS) of medical specialists' practice. The success of e-health depends on the understanding of its current role and proficiency in its usage from medical specialists. CONCLUSIONS: Time to review the patient is not enough for large part of medical specialists. They enter corresponding data consecutively in using information system (IS) after the review.

Global Vaccines and Immunology, 2017

S. pneumoniae is one of the leading causes of bacterial meningitis. In children under 2-year-old ... more S. pneumoniae is one of the leading causes of bacterial meningitis. In children under 2-year-old it appears as the second bacterial agent who is responsible for neuroinfections. Pneumococcal meningitis is an important clinical condition which progresses rapidly and can result in death or significant morbidity if it is not treated as a medical emergency. Aim: The purpose of this study is to describe a case of S. pneumoniae meningoencephalitis as a primary localization in a 50-day-old breast fed child and to discuss the possibilities to escape such illness in this young age. Methodology: Clinical, epidemiological, laboratorial, microbiological and instrumental investigations were completed. Findings: The illness began with high temperature and mild catarrh. Three days later convulsions without meningeal signs were demonstrated. Diagnosis was based on cerebral fluid changes and microbiological verification. In spite of triple antibacterial starting suitable to microbial sensitivity neuroinfection completed with lethal outcome. Laboratorial data-low levels of natrium, severe acidosis in conjunction with high level of protein, cells and low glucosis were considered as prognostic signs for unfavourable outcome. The baby had not been vaccinated with Sinflorix because his insufficient age. Conclusion: Using vaccine against S. pneumoniae for adults is the right solution for prevention pneumococcal diseases at babies at very young under-vaccinating age.

PROBLEMS of Infectious and Parasitic Diseases, Feb 25, 2022

Background. In Bulgaria the second most predominant HIV-1 strain after subtype B is CRF01_AE. Mat... more Background. In Bulgaria the second most predominant HIV-1 strain after subtype B is CRF01_AE. Material and Methods. 270 HIV-1 polymerase (pol) CRF01_AE sequences collected between 1995-2019 were analyzed with the phylogenetic approach. To identify transmission clusters, we used two different genetic distance thresholds (d), i. e. 1.5% and 0.5%. Results. Genetic distance d=1.5% defined more distant infections in a huge cluster of 154 sequences composed mostly of people, who inject drugs (PWID), whereas when (d) was reduced to 0.5%, we determined more recent transmissions and the large cluster disintegrated into smaller ones. Different drug resistance mutations (DRM) were detected in patient's HIV-1 pol sequences and were most common in male heterosexual (HET) single sequences. Conclusions. Our data showed repeated introduction of CRF01_AE in Bulgaria and rapid spread of the infection among PWID groups. Molecular monitoring of the epidemic among PWID communities could help reduce the spread of HIV-1 infection.

The clinical course of trichinosis in 18 patients aged between 6 and 59 years is analysed. The pa... more The clinical course of trichinosis in 18 patients aged between 6 and 59 years is analysed. The patients were 7 men and 11 women. All of them had consumed pork of domestic pig origin, reared in a yard in the Gurkovo region and had not had trichinoscopy. The onset of disease was after an incubation period of 7 to 12 days and presented high fever, severe muscle pain, swellings, especially of the face, diarrhoea and maculopapular rash. Hepatomegaly was present in 17 of the 18 patients. The laboratory studies showed leukocytosis with eosinophilia, increased activity of liver transaminases and creatine phosphokinase (CPK). The diagnosis was confirmed using Parasitological Morpho-Diagnostics. The treatment of hospital patients was done with Vermox, as well as with corticosteroids, antihistamine drugs, non-steroid anti-inflammatory drugs, and vitamins. All patients, subject of our study, were treated succsessfully.

Journal of Hepatology, 2013

Clinical Infectious Diseases, 1995

Aim: Enteroviruses target various organs and systems of the human body, including the central ner... more Aim: Enteroviruses target various organs and systems of the human body, including the central nervous system (CNS). The aim of the present study was to better understand the clinical features of enteroviral infections of the CNS and the factors influencing the clinical course of disease.Material and methods: A total of 39 patients, aged 3-16 years, admitted to the Clinic of Infectious Diseases, University Hospital in Stara Zagora, Bulgaria, between 2012-2017 with confirmed enteroviral neuroinfection were enrolled in the study. Diagnosis was confirmed by laboratory and virological tests. Instrumental investigation was performed if needed. Results: In all cases the disease began suddenly and severely followed by hospitalization within 24 hours. Meningo-radicular syndrome was observed in 25 patients and sustained for average 4,1±1,9 days. Cerebrospinal fluid (CSF) showed pleocytosis in all cases ranging from 57 to 843.106/L, in 9 patients segmented cells predominated at the first lumbar puncture. Mild proteinorachie (0,50 to 0,76 g/L) was found in 17 of the patients. Virological tests revealed echovirus 30 and coxsackievirus B in 24 and 4 patients, respectively. Discussion: All cases in the study fulfill the criteria for a confirmed enteroviralinduced disease. Echovirus 30 was the predominant causative agent, affecting mainly children between 3 and 9 years old. All patients have gone as meningitis. The majority of them had moderate clinical course. Predominance of plymorphonuclear cells in the first lumbar punctate was found in 23% of the patients. All cases had a favorable outcome.

Vaccines & vaccination open access, 2018

Acute influenza-associated encephalopathy/encephalitis (IAE) in children and adults is not so com... more Acute influenza-associated encephalopathy/encephalitis (IAE) in children and adults is not so common but very serious and sometimes fatal neurological complication. The purpose was to show clinical and laboratorial peculiarities in this condition and to indicate some prognostic factors. Materials and methods: In a period of three years (2014-2017) through the Clinic of Infectious diseases at the University Hospital in Stara Zagora, Bulgaria 7 patients with this neuroinfection were passed. They were aged between 3 and 42 years. Clinical, epidemiological, laboratorial and instrumental investigations were accomplished in all patients. The results were processed with statistical program SPSS for Windows, v. 14. Results and discussion: Clinical manifestations appeared in 5 patients with an initial convulsion usually within 24-72 hours after the acute onset of the disease and quantitative changes in consciousness to coma in 3. Clinical manifestations of meningeal irritation were detected in only two patients Laboratory blood tests showed in 3 patients' elevated levels of leucocytes and amino transferases, high urea, glucose and creatinin. The findings of cerebrospinal fluid in them indicated albumin values from 1,0 to 6,0 g/l and increased glucose from 4,5 to 21 mmol/l. All of these three patients ended up with a fatal outcome. Their pathological outcomes detected necrotizing encephalopathy. The remaining 4 patients were fully recovered except for one in which there is a 7 cranial-brain nerve paresis as a residual symptom. The diagnosis was confirmed by clinical and epidemiological data, but also by serological (ELISA) in blood investigations and virological (PCR) in nasal swabs and also in autopsy material. In all but one influenza A virus was detected. Influenza virus B strain

Vaccines & Vaccination Open Access

This case report is about a 13-year-old male patient who had spina bifida oculta at L5-S1, combin... more This case report is about a 13-year-old male patient who had spina bifida oculta at L5-S1, combined with dermal sinus. He was admitted in the Clinic of Infectious Diseases of a University Hospital in Stara Zagora with typical clinical signs of acute meningitis. Based on the anamnestic, clinical, laboratory, microbiological, virological and imaging methods, bacterial meningitis caused by Morganella morganii was diagnosed. The disease had a prolonged, severe course requiring rehospitalisation and prolonged treatment. The causative agent was only cultivated in CSF, while blood, urine and copro cultures were negative. Antibacterial treatment, despite the wide range of susceptibility of the causative agent, did not result in a favorable response. The combination of conservative and operative therapy lead to eradication of the infection and recovery.

PROBLEMS of Infectious and Parasitic Diseases, May 12, 2020