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Öğe Alanin aminotransferaz düzeyi normal kronik hepatit C infeksiyonlu hastaların karaciğer histolojileri(2012) Çelen, Mustafa Kemal; Aygen, Bilgehan; Yıldız, Orhan; Gökahmetoğlu, Selma; Patıroğlu, Tahir Ercan; Erten, Siraç; Deniz, KemalAmaç: Bu çalışmada alanin aminotransferaz (ALT) düzeyi normal kronik hepatit C (KHC)li hastalarda karaciğerdeki histolojik değişikliklerin değerlendirilmesi amaçlanmıştır. Yöntemler: Çok merkezli retrospektif çalışmamızda >16 yaş, ALT düzeyi normal, KHCli 72 hasta değerlendirildi. ALTnin en az 6 ay süresince ve en az birer ay arayla 2 veya 3 kez normal sınırlar içinde olması normal ALT düzeyi kabul edildi. Demografik veriler, tanı konulan yıl, 6 ay içindeki en az 2 ALT değeri, hepatit göstergeleri, hepatit C virusu (HCV) RNA ve karaciğer biyopsisi sonuçları kaydedildi. Hepatit göstergeleri farklı kitlerle test edildi. HCV RNA, ölçüm aralığı ve duyarlılığı farklı polimeraz zincir reaksiyonu kitleriyle çalışıldı. Biyopsi preparatları aynı patologca tekrar değerlendirildi. Bulgular: Hastaların yaş ortalaması 44±13 yıldı ve %61.1i kadındı. HCV RNA değerleri 1.53x102-1.13x108 İÜ/ml arasındaydı. ALT değerleri ortalaması 30.3±9.6 İÜ/lt bulundu. Histopatolojik olarak ortalama nekroinflamasyon derecesi 4.67±1.96 ve ortalama fibroz evresi 1.03±1.13 idi. Biyopsilerin %48.6sında minimal aktivite, %45.8inde hafif aktivite ve %2.8inde orta aktivite saptandı. Portal-periportal fibroz oranı %51.4, köprüleşen fibroz oranı %6.9 ve inkomplet-komplet siroz oranı %1.4 idi. Sonuçlar: KHCli hastalarda ALT düzeyleri hastalığın aktivitesini belirlemede zayıf bir göstergedir. Tedavi indikasyonu olan hastalar karaciğer biyopsisi açısından değerlendirilmelidir.Öğe Epidemiology and Risk Factors of Hepatitis Delta Infection in Turkey(Dr M N Khan, 2013) Ayaz, Celal; Koruk, Suda Tekin; Yalci, Aysun; Yamazhan, Tansu; Aygen, Bilgehan; Tosun, Selma; Dal, TubaThis study is aimed to investigate the prevalence and risk factors of HDV co-infection in patients with chronic HBV infection in Turkey, where HBV infection is endemic. The date of this study was obtained from Turk-Hep-Net project. The project includes real-life cohort of HBV patients from 15 centers in Turkey and is supported by Viral Hepatitis Society. Of the 7366 HBsAg positive individuals tested for the presence of anti-HDV antibodies, 63,6 were male and 36.4 % were female. Of the 7366 HBsAg positif patients, 206 (2.8%) contained anti-HDV. Southeastern Anatolia Region of the country's anti-HDV positivity rate was found to be 4.5%. The risk factors in anti-HDV positivity patient were; male gender, long-term (>5 year) HBsAg positivity and living in Southeastern Anatolia. Our study revealed that recognizing the risk factors associated with HBV and HDV co-infection will be beneficial to control of these infections.Öğe Hepatit B ve Hepatit C Virüs Koenfeksiyonu: Seksen İki Hastanın Değerlendirilmesi(2017) Yıldız, Orhan; Ayaz, Celal; Çelen, Mustafa Kemal; Akhan, Sıla; Aygen, Bilgehan; Günal, Özgür; Barut, Hüseyin ŞenerAmaç: Bu çalışmada, 82 hepatit B virüs (HBV)/hepatit C virüs (HCV) ko-enfekte hastanın özelliklerini ve tedavi sonuçlarını araştırmayı amaçladık.Gereç ve Yöntemler: Dört farklı üniversite hastanesinde HBV/HCV ko-enfeksiyonu olan hastalar retrospektif olarak incelendi. HBV/HCV ko-enfeksiyonu olan hastaların epidemiyolojik, virolojik, klinik, histopatolojik verileri ve tedavi sonuçları analiz edildi. HCV enfeksiyonu dominansı olan hastalara pegile interferon (peg IFN) ve ribavirin tedavisi verildi. HBV enfeksiyonu için farklı tedaviler alan hastaların sonuçlarıda değerlendirildi. Bulgular: Hastaların yaş ortalaması 44,3±14,7 idi ve %52,4'ü kadın hasta idi. HCV enfeksiyonu için major risk aktörleri; diş tedavisi, cerrahi girişim, hemodiyaliz ve kan transfüzyonu idi. Ortalama HCV RNA seviyesi 1,36x106±3,06x106 IU/mL, ortalama HBV DNA seviyesi 1,55x107±4,83x107 IU/mL olarak saptandı. Biyopsi yapılan 39 hastanın histopatolojik incelemesinde nekroenflamatuvar aktivitesi ortalama 4,9±2,6 iken, fibrozis evresi otalama 1,7±1,5 olarak saptandı. Hastaların %8,5'inde hem HCV-RNA hem de HBV-DNA pozitifti ve bu hastaların %85,7'sinde HCV enfeksiyonu dominant olarak bulundu. Hastalardan 24 tanesine peg IFN + ribavirin tedavisi başlandı ve bu hastalarda kalıcı viral yanıt oranı %70,8 olarak saptandı. Hastalarının %33,3'ünde HBV reaktivasyon gelişti. Oral antiviral tedavi başlanan hastaların tümünde HBV DNA negatifleşti.Sonuç: Hem HCV RNA hem de HBV DNA'nın pozitif olduğu durumlarda, HCV baskıntı. Bu durum özellikle hemodiyaliz alan hastalarda belirgindiÖğe Hepatitis B Virus and Hepatitis C Virus Co-infection: An Evaluation of Eighty-Two Patients(Galenos Yayincilik, 2017) Aygen, Bilgehan; Gunal, Ozgur; Yildiz, Orhan; Celen, Mustafa Kemal; Akhan, Sila; Barut, Sener; Ayaz, CelalObjective: In this study, we aimed to investigate the characteristics and treatment results of 82 co-infected patients with hepatitis B virus (HBV)/hepatitis C virus (HCV). Materials and Methods: Four university hospitals evaluated HBV/HCV co-infection cases retrospectively. We analyzed the epidemiological, virological, clinical, and histopathological data and the results of treatment in patients co-infected with HBV and HCV. Pegylated interferon (peg IFN) plus ribavirin treatment was given to patients with HCV dominance. The results of patients receiving different treatment for HBV were evaluated. Results: The mean age of the patients was 44.3 +/- 14.7 years and 52.4% were female. The major risk factors were dental therapy, any surgical procedure, hemodialysis, and blood transfusion. The average HCV RNA level and HBV DNA level were found to be 1.36x10(6)+/- 3.06x10(6) IU/mL, and 1.55x10(7)+/- 4.83x10(7) IU/mL, respectively. On histopathology, the mean grade of necroinflammation was found to be 4.9 +/- 2.6 while the mean stage of fibrosis was 1.7 +/- 1.5 in 39 patients. 8.5% of patients were positive for both HCV-RNA and HBV-DNA positive and in 85.7% of cases, HCV infection was found to be dominant. The rate of sustained virologic response was 70.8% in 24 patients receiving peg IFN plus ribavirin therapy. Reactivation of HBV was found in 33.3% of cases. HBV DNA was negative in all patients who received oral antiviral therapy. Conclusion: In cases where both HCV RNA and HBV DNA were positive, HCV was predominant. This is especially noticeable in hemodialysis patientsÖğe İmmünosüpresif tedavi veren hekimlerin hepatit b virusu reaktivasyonuyla ilgili farkındalıklarının ve klinik pratiklerinin değerlendirilmesi(AVES, 2019) Korkmaz, Pınar; Demirtürk, Neşe; Aydın, Güle Ç.; Çeken, Sabahat; Aygen, Bilgehan; Toka, Onur; Gündoğdu, Kıymet; Çelikbaş, Aysel Kocagül; İnan, Dilara; Kuruüzüm, Ziya; Kutsoylu, Oya Özlem Eren; Batırel, Ayşe; Sırmatel, Fatma; Ersöz, Gülden Munis; Hakyemez, İsmail Necati; Aşçı, Zerrin; Yeşilbaǧ, Zuhal; Sönmezer, Meliha Çaǧla; Tulek, N.; Örmen, Bahar Kopraman; Karadağ, Fatma Yılmaz; Yörük, Gülşen; Türker, Nesrin Akbaş; Özkaya, Hacer Deniz; Kalkan, İrem Akdemir; Süer, Hüseyin Kaya; Tekin, Süda; Saltoǧlu, Neşe; Şener, Alper; Yenilmez, Ercan; Çetinkaya, Rıza Aytaç; Özel, Selcan Arslan; Ayaz, Celal; Karagöz, Ergenekon; Aydın, Mehtap; Acar, Ali; Arslan, Eyüp; Ceylan, Mehmet Reşat; Demir, Nazlım Aktuǧ; Çaylak, Selmin Dirgen; Günal, Özgür; Solay, Aslı Haykır; Öztürk, Sinan; Ural, Önur; Sümer, Şua; Kadanalı, Ayten; Altıparmak, Vuslat Ecem Güneş; Akhan, Sıla Çetin; Sayan, Murat; Köse, ŞükranObjective: This study aimed to evaluate the awareness and knowledge levels of all physicians administering immunosuppressive treatment concerning hepatitis B virus (HBV) reactivation, and draw attention to the importance of the subject through evaluation. Methods: The study was carried out by infectious diseases and clinical microbiology specialists in 37 health centers, and it was performed in Turkey between January and March 2017. All specialists providing a written consent and working in the departments of Medical Oncology, Hematology, Dermatology and Venereology, Physical Medicine and Rehabilitation, and Rheumatology of each study center were included in the study. Results: A total of 430 physicians participated in the study. Their mean age was 39.87±7.42 years, and 47.9% of them were males. During their career, 39.3% of these physicians had encountered patients developing HBV reactivation while receiving immunosuppressive treatment. The rate of encountering patients who died due to HBV reactivation was 6.5%. 97% of physicians who participated, considered the risk of HBV reactivation to be important. 70.2% of physicians stated that guidelines related to HBV reactivation and antiviral treatment for these patients were discussed in the congresses they participated, regarding their specialties. The rate of performing hepatitis screening among physicians whose patients developed HBV reactivation was statistically significantly higher than those physicians who had no patients with HBV reactivation (p<0.05). Physicians who used the guidelines related to HBV reactivation in their specialties performed screening for the HBV infection much more often than physicians who did not use the guidelines (p=0.002). Conclusions: According to the results obtained in our study, the rates of conducting screening and awareness of HBV reactivation among physicians administering immunosuppressive treatment were higher compared with similar studies; however, their awareness that HBV DNA and anti-HBc should be utilized much more frequently among the serological tests they use for screening of HBV infection, should be increased.Öğe Liver Histology of Patients with Hepatitis C Virus Infection and Normal Alanine Aminotransferase Levels(Aves, 2012) Aygen, Bilgehan; Deniz, Kemal; Akhan, Sila; Celen, Mustafa Kemal; Yildiz, Orhan; Ayaz, Celal; Dogan, Suat AliObjective: In this study, our objective is to evaluate histological changes in livers of hepatitis C virus (HCV)-infected patients with normal alanine aminotransferase (ALT) levels. Methods: 72 patients over 16 years old, with chronic hepatitis C (CHC) and normal ALT levels were evaluated in this multicenter retrospective study. Persistently normal ALT level was defined as 2 or 3 normal ALT levels at intervals of at least 1 month during 6 months. Demographic data, year of diagnosis, at least 2 ALT values within 6 months, hepatitis markers, results of HCV RNA and the liver biopsy were all evaluated. Serological markers have been tested with different kits. HCV RNA has been studied by RT-PCR with dynamic range and sensitivity of different kits. All biopsies were evaluated again by the same pathologist. Results: The mean age was 44 +/- 13 years and 61.1% were female. HCV RNA levels were between 1.53x10(2)-1.13x10(8) IU/ml. The mean ALT levels were 30.3 +/- 9.6 IU/lt. The mean grade of necro-inflammation was 4.67 +/- 1.96 and mean staging of fibrosis was 1.03 +/- 1.13. The ratios of minimal, mild and moderate activity in the liver biopsies were 48.6%, 45.3% and, 2.8%, respectively. Rate of portal-periportal fibrosis, bridging fibrosis and incomplete cirrhosis were 51.4%, 6.9%, and 1.4%, respectively. Conclusions: ALT level is a poor indicator of liver disease activity in patients with CHC. Patients with indication for treatment should be evaluated for liver biopsy.Öğe Protease Inhibitors Drug Resistance Mutations in Turkish Patients with Chronic Hepatitis C(Elsevier Sci Ltd, 2016) Altunok, Elif Sargin; Sayan, Murat; Akhan, Sila; Aygen, Bilgehan; Yildiz, Orhan; Koruk, Suda Tekin; Mistik, ResitBackground: Drug resistance development is an expected problem during treatment with protease inhibitors (PIs), this is largely due to the fact that Pls are low-genetic barrier drugs. Resistance-associated variants (RAVs) however may also occur naturally, and prior to treatment with Pls, the clinical impact of this basal resistance remains unknown. In Turkey, there is yet to be an investigation into the hepatitis C (HCV) drug associated resistance to oral antivirals. Materials and methods: 178 antiviral-naive patients infected with HCV genotype 1 were selected from 27 clinical centers of various geographical regions in Turkey and included in the current study. The basal NS3 Pls resistance mutations of these patients were analyzed. Results: In 33 (18.5%) of the patients included in the study, at least one mutation pattern that can cause drug resistance was identified. The most frequently detected mutation pattern was T54S while R109K was the second most frequently detected. Following a more general examination of the patients studied, telaprevir (TVR) resistance in 27 patients (15.2%), boceprevir (BOC) resistance in 26 (14.6%) patients, simeprevir (SMV) resistance in 11 (6.2%) patients and faldaprevir resistance in 13 (7.3%) patients were detected. Our investigation also revealed that rebound developed in the presence of a Q80K mutation and amongst two V55A mutations following treatment with TVR, while no response to treatment was detected in a patient with a R55K mutation. Conclusion: We are of the opinion that drug resistance analyses can be beneficial and necessary in revealing which variants are responsible for pre-treatment natural resistance and which mutations are responsible for the viral breakthrough that may develop during the treatment. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.Öğe Real-world data from Turkey: Is sofosbuvir/ledipasvir with or without ribavirin treatment for chronic Hepatitis C really effective?(Aves, 2021) Demirtürk, Neşe; Aygen, Bilgehan; Çelik, İlhami; Mistik, Reşit; Akhan, Sıla; Barut, Şener; Ural, Onur; Batırel, Ayşe; Şimsek, Funda; Ersöz, Gülden; İnan, Dilara; Kınıklı, Sami; Türker, Nesrin; Bilgin, Hüseyin; Gürbüz, Yunus; Tülek, Necla; Tarakçı, Hüseyin; Yıldız, Orhan; Türkoğlu, Emine; Güzel, Deniz Kamalak; Şimsek, Sümeyra; Tuna, Nazan; Demir, Nazlım Aktuğ; Çağatay, Atahan; Çetinkaya, Rıza Aytaç; Karakeçili, Faruk; Hakyemez, İsmail Necati; Ertem, Günay Tuncer; Örmen, Bahar; Korkmaz, Pınar; Sili, Uluhan; Kuruüzüm, Ziya; Şener, Alper; Özel, Selcan Arslan; Öztürk, Sinan; Süer, Kaya; Çelen, Mustafa Kemal; Konya, Petek; Asan, Ali; Saltoğlu, Neşe; Doğan, NurhanBackground: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice. Methods: Data from patients with chronic hepatitis C treated with SOF/LDV +/- RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed. Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 +/- 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV +/- RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect. Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV +/- RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.Öğe Real-world efficacy, safety, and clinical outcomes of ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin combination therapy in patients with hepatitis C virus genotype 1 or 4 infection: The Turkey experience experience(AVES, 2020) Aygen, Bilgehan; Demirtürk, Neşe; Yıldız, Orhan; Çelen, Mustafa Kemal; Çelik, İlhami; Barut, Şener; Ural, Önur; Batırel, Ayşe; Mıstık, Reşit; Şi̇mşek, Funda; Asan, Ali; Ersöz, Gülden Munis; Türker, Nesrin Akbaş; Bilgin, Hüseyin; Kınıklı, Sami; Karakeçili, Faruk; Zararsız, Gökmen; Günal, Özgür; Akhan, Sıla Cetin; Tulek, N.; İnan, Dilara; Çaǧatay, Arif Atahan; Gürbüz, Yunus; Şener, Alper; Çelikbaş, Aysel Kocagül; Çetinkaya, Rıza Aytaç; Kadanalı, Ayten; Hakyemez, İsmail Necati; Kuruüzüm, Ziya; Özel, Selcan Arslan; Korkmaz, Pınar Yagiz; Tuna, Nazan; Saltoǧlu, Neşe; Tarakçı, Hüseyin; Uysal, Burcu; Karagöz, Ergenekon; Koçulu, Safiye; Ayaz, Celal; Güzel, Deniz Kamalak; Türkoğlu, Emine; Demir, Nazlım Aktuğ; Şimşek, Sümeyra; Kantürk, Arzu; Akça, Mustafa Özgür; Evik, Güliz; Örmen, Bahar Kopraman; Sili, Uluhan; Hatipoǧlu, Çiǧdem Ataman; Binay, Umut Devrim; Kılıç, Sırrı; Arslan, Kader; Yenilmez, Ercan; Çomoǧlu, Şenol; Koç, Meliha Meriç; Gökgöz, Altan; Dursun, Zehra Beştepe; Sümer, Şua; Heper, Yasemin; Yíldírmak, Taner T.; Öztürk, Sinan; Güğül, Tuğba Demirel; Yüce, Zeynep TüreBackground/Aims: mbitasvir/paritaprevir/ritonavir (OMV/PTV/r) ± dasabuvir (DSV) ± ribavirin (RBV) combination has demonstrated excellent rates of sustained virologic response (SVR) and a very good safety profile in patients with the chronic hepatitis C virus (HCV) genotype 1 or 4 infections. We aimed to investigate the effectiveness and safety of OMV/PTV/r ± DSV ± RBV combination regimen in a real-world clinical practice. Materials and Methods: Data from HCV genotype 1 and 4 patients treated with OMV/PTV/r ± DSV ± RBV (n=862) in 34 centers across Turkey between April 1, 2017 and August 31, 2018 were recorded in a large national database. Demographic, clinical, and virologic data were analyzed. Results: The mean age of the patients was 55.63, and 430 patients (49.9%) were male. The majority had HCV genotype 1b infection (77.3%), and 66.2% were treatment-naïve. Non-cirrhosis was present at baseline in 789 patients (91.5%). SVR12 rate was 99.1% in all patients. Seven patients had virologic failure. No significant differences were observed in SVR12 according to HCV genotypes. HCV RNA was undetectable at treatment week 4 in 90.9%, at treatment week 8 in 98.5%, and at the end of treatment (EOT) in 98.9%. SVR12 ratio was significantly higher in the non-cirrhotic patients compared to that in the compensated cirrhotic patients. Rates of adverse events (AEs) in the patients was 59.7%. Conclusion: The present real-life data of Turkey for the OBV/PTV/r ± DSV ± RBV treatment of patients with HCV genotype 1b, 1a, or 4 infection from 862 patients demonstrated high efficacy and a safety profile. © Copyright 2020 by The Turkish Society of GastroenterologyÖğe Retreatment of Chronic Hepatitis C Infection with Telaprevir: Preliminary Results in Turkey(Galenos Publ House, 2015) Aygen, Bilgehan; Yildiz, Orhan; Akhan, Sila; Celen, Mustafa Kemal; Ural, Onur; Koruk, Suda Tekin; Kose, SukranBackground: The use of pegylated interferon alpha and ribavirin (PegIFN/RBV) for the retreatment of chronic hepatitis C virus (HCV) infection without a sustained virological response (SVR) prior to PegIFN/RBV treatment has resulted in low success rates. Aims: To investigate the efficacy and safety of telaprevir (TVR) in combination with PegIFN/RBV in patients infected with HCV genotypes 1 and 4 who were previously treated with PegIFN/RBV and failed to achieve SVR. Study Design: Multi-center, retrospective, cross-sectional study. Methods: The study included 111 patients: 80 prior relapsers, 25 prior null responders, and six prior partial responders to PegIFN/RBV treatment. The patients were given TVR/PegIFN/RBV for 12 weeks, followed by a 12-week PegIFN/RBV treatment; virological response results were assessed at weeks 4, 12, and 24. Treatment was discontinued in patients with HCV RNA >1000 IU/mL at week 4 or with negative RNA results at week 4 but >1000 IU/mL at week 12. Rapid virological response (RVR), early virological response (EVR), extended rapid virological response (eRVR), and virological response at 24th week of treatment were evaluated. The side effects of combination therapy and the rates of treatment discontinuation were investigated. Results: The mean age of the patients was 56.02 +/- 9.96 years and 45.9% were male. Ninety-one percent of the patients were infected with viral genotype 1, 69.6% with the interleukin (IL) 28B genotype CT and 20.2% were cirrhotic. The RVR rate was 86.3% in prior relapsers, 56% in prior null responders, and 50% in prior partial responders (p=0.002). EVR rates in those groups were 91.3%, 56%, and 83.3%, respectively (p<0.001). eRVR rates were 83.8% in prior relapsers, 48% in prior null responders, and 50% in prior partial responders (<0.001). The virological response at the 24th week of treatment was found to be the highest in prior relapsers (88.8%); it was 56% in prior null responders and 66.7% in prior partial responders (p<0.001). Common side effects were fatigue, headache, anorexia, malaise, anemia, pruritus, dry skin, rash, dyspepsia, nausea, pyrexia, stomachache, and anorectal discomfort. All treatments were discontinued due to side effects in 9.9% of patients. Conclusion: High virological response rates were obtained with TVR/PegIFN/RBV treatment. Although side effects were frequently observed, the discontinuation rate of combination therapy was low.Öğe Tuberculous meningits in adults in Turkey: Epidemiology, diagnosis, clinic and laboratory(2003) Hoşoǧlu, Salih; Geyik, Mehmet Faruk; Balık, İsmail; Aygen, Bilgehan; Erol, Serpil; Aygencel, Gülbin; Mert, Ali A.; 0000-0002-0906-0902; 0000-0003-3630-8851; 0000-0002-8856-5019A retrospective study was performed to assess the epidemiology, diagnosis, clinic, and laboratory of the patients with tuberculous meningitis (TBM) in a multicentral study. The medical records of adult cases with TBM treated at 12 university hospitals throughout Turkey, between 1985 and 1998 were reviewed using a standardized protocol. The diagnosis of TMB was established with the clinical and laboratory findings and/or microbiological confirmation in cerebrospinal fluid (CSF). The non-microbiologically confirmed cases were diagnosed with five diagnostic sub-criteria which CSF findings, radiological findings, extra-neural tuberculosis, epidemiological findings and response to antituberculous therapy. A total of 469 patients were included in this study. Majority of the patients were from Southeast Anatolia (164 patients, 35.0%) and (108 patients, 23.0%) from East Anatolia regions. There was a close contact with a tuberculous patient in 88 of 341 patients (25.8%) and with a tuberculous family member in 53 of 288 patients (18.4%). BCG scar was positive in 161 of 392 patients (41.1%). Tuberculin skin test was done in 233 patients and was found to be negative in 75. Totally 115 patients died (24.5%) of whom 23 died in 24 hour after admittance. The diagnosis was confirmed with clinical findings and CSF culture and/or Ziehl-Nelson staining in 88 patients (18.8%). Besides clinical criteria, there were three or more diagnostic sub-criteria in 252 cases (53.7%), two diagnostic sub-criteria in 99 cases (21.1%), and any diagnostic sub-criteria in 30 patients (6.4%). Since TBM is a very critical disease, early diagnosis and treatment may reduce fatal outcome and morbidity.