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    Cure in Chronic Hepatitis C! Does it Prevent the Risk of Hepatocellular Carcinoma?
    (Bilimsel Tip Yayinevi, 2018) Celen, Mustafa Kemal; Akdemir, Irem; Bayan, Kadim
    In 5%-20% of chronic HCV patients, cirrhosis or other complications like liver cancer may be seen and these may be directly or undirectly related. The development of a sustained viral response (SVR) does not change this fact. In the case of a 52-year-old female diabetic patient whose Anti-HCV was positive, HCV-RNA 2.230.000 IU/mL was decided to be followed up due to an ALT 68 UI/L, AST 55 UI/L. As a result of the biopsy (ISHAK, fibrozis= 2, HAI= 8), Pegile interferon alfa 2a 180 mu g/week + ribavirin 1000 mg/day was started. The patient was put under treatment for 48 weeks and as a result, SVR was obtained and the patient accepted as cure. The patient was told to come for check-up every six months. This patient who had actually started getting better stopped coming to our center in 2015 and did not return for a long time. The patient came back in 2016 with a fatigue complaint. As a result of the examination, AFP was 38.6 and all other parameters were found normal. Although there was no sign of a mass image in her liver ultrasound, there was a hepatocellular carcinoma (HCC) compatible lesion which was 190 x 150 x 90 mm in segment 6-7 in her contrasted MR result. The patient was urgently referred to a transplant center. However, it was determined at the center that since the tumor had made a vein invasion, there was no chance for a transplant. The patient died in June 2017. The cure in HCV treatment does not exclude the reality of HCC, which shows that patients who get the treatment must be followed up very closely. Routine clinical follow up, AFP level screening, effective ultrasound and dynamic imagination are of utmost importance.
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    Elbasvir/Grazoprevir Experience - A New Glance at HCV Treatment: Case Report
    (Galenos Yayincilik, 2017) Celen, Mustafa Kemal; Akdemir, Irem; Tekin, Recep; Bayan, Kadim; Ayaz, Celal
    Hepatitis C is a viral disease having a worldwide importance and posing a risk for liver complications. With the new treatment options, it is easy to manage with higher rates of success. Among them, one of the most recent one is elbasvir/grazoprevir option. This study presents the results of two treatment-naive patients treated with elbasvir/grazoprevir. The first case was a male non-cirrhotic patient and the second one was a female who suffered from compensated hepatic cirrhosis. Both patients received elbasvir/grazoprevir 50/100 mg in a single tablet for 12 weeks. Persistent viral response was achieved in both patients and no side effect was observed during the treatment. Elbasvir/grazoprevir combination, one of the recent treatments, was considered effective and tolerable.
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    OMBITASVIR/PARITAPREVIR/RITONAVIR PLUS DASABUVIR TREATMENT EXPERIENCE IN HCV PATIENTS
    (Carbone Editore, 2018) Bayan, Kadim; Celen, Mustafa Kemal; Dal, Tuba; Ayaz, Celal; Tekin, Recep; Akdemir, Irem; Sari, Tugba
    Introduction: Achieving sustained virologic response (SVR) is critical in HCV patients. In current study, we aimed to investigate the efficacy and safety of DAA (OBV/PTV/r + DSV +/- RBV) treatment regimen in patients with HCV. Materials and method: A total of 57 adults with HCV infection who initiated treatment DAA were included in this study. Baseline, 4 weeks and 12 weeks data including clinical characteristics, laboratory results and adverse events (AEs) were recorded. Results: One patient left treatment at the second week. The majority of patients were female 33 (57.9 %) and HCV GT1b (80.7%). Of the patients, 43 (75.4 %) patients were treatment experienced with pegylated interferon +/- RBV and 14 (25.6%) patients were naive. Ten (17.5%) patients had liver cirrhosis, 3 patients renal insufficiency, 7 patients diabetes mellitus, and 6 patients hypertension. Mean baseline ALT and HCV RNA levels was 48.58 +/- 25.8 U/L and 2857661 +/- 7231938 IU/ml, respectively. At the end of the week 4, one patient had >15 IU/mL HCVRNA level, HCVRNA was negative in remaining patients and mean ALT levels was 34.7 +/- 17.01 U/L. Three (5.3%) patient had AEs. At the end of the week 12, HCVRNA was negative in all patients, mean ALT levels was 29.3 +/- 12.2 U/L, 8 (14%) patients had AEs. Conclusion: DAA was a safe and effective therapy with 100% SVR rate and low treatment discontinuation rate (1.7 %) in patients with HCV GT1, GT1a and GT1b. This was well tolerated and efficient treatment aproach in patients with liver cirrhosis, renal insufficiency, diabetes mellitus, and hypertension.