Yazar "Degertekin, H" seçeneğine göre listele
Listeleniyor 1 - 20 / 20
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe A 12 months course of interferon and lamivudine combination therapy versus interferon monotherapy for untreated chronic hepatitis B infection(Elsevier Science Bv, 2002) Yalcin, K; Yildiz, F; Degertekin, H; Celik, Y[Abstract Not Available]Öğe A 12-month course of combination therapy with interferon-? and ribavirin in chronic hepatitis due to coinfection with hepatitis B and C viruses(Adis International Ltd, 2002) Yalcin, K; Degertekin, H[Abstract Not Available]Öğe A 12-month course of combination therapy with interferon-alfa and lamivudine in patients with chronic hepatitis delta virus: A single-center, prospective, open-label, uncontrolled study(Excerpta Medica Inc, 2002) Yalcin, K; Degertekin, H; Yildiz, F; Akkus, ZBackground: Chronic hepatitis delta virus (HDV) is a severe and rapidly progressive liver disease for which no therapy has been proved to be effective. Objective: The aim of this study was to investigate the efficacy and tolerability of long-term therapy with a combination of recombinant interferon (IFN)-alfa. and lamivudine. Methods: In this single-center, prospective, open-label, uncontrolled study, patients aged 18 to 60 years with chronic HDV were eligible. Patients were treated with a combination of 10 million units of IFN-alfa-2b subcutaneously 3 times weekly and lamivudine 100 mg once daily for 12 months. The primary outcome measures were biochemical and histologic response at the end of treatment and at least 12 months thereafter. Results: Twelve patients (10 men, 2 women; mean age, 33.9 years [range, 19-49 years]) were enrolled (6 treatment-naive patients, 6 previously treated patients). Normalization or decrease of >50% from baseline in serum alanine aminotransferase (ALT) level occurred in 8 (66.7%) of 12 patients at month 12 of treatment. Of the 12 patients, 10 (83.3%) completed the trial; 1 (8.3%) was withdrawn because of severe leukopenia. and 1 (8.3%) was lost to follow-up. Relapses occurred in 5 of 8 (63.3%) initial responders shortly after the cessation of therapy. In 3 (25%) patients whose ALT levels became normal at the end of the therapy, the complete biochemical responses persisted for up to 3 years (mean, 31 months). The treatment was associated with a marked improvement in histologic activity. Conclusions: In this study, combination therapy with IFN-alfa and lamivudine was well tolerated and reduced hepatic inflammation was found. Further controlled trials are needed to show possible beneficial effects of this model of therapy and to determine the optimal dose and duration of therapy for chronic HDV.Öğe The age and sex distribution of colorectal carcinoma cases in Turkey(H G E Update Medical Publ Ltd., 2000) Degertekin, H; Sari, Y; Yalcan, K; Akgun, Y[Abstract Not Available]Öğe Asbestosis and gastrointestinal cancer in Southeast Turkey.(W B Saunders Co-Elsevier Inc, 1997) Goral, V; Degertekin, H; Canoruc, F[Abstract Not Available]Öğe Clinical and demographic characteristics of patients with non-alcoholic steatohepatitis: A multicenter study(Elsevier Science Bv, 2003) Sarioglu, M; Akarca, U; Sonsuz, A; Duman, D; Tankut, E; Degertekin, H; Suleymanlar, I[Abstract Not Available]Öğe Comparison of 12-month courses of interferon-?-2b-lamivudine combination therapy and interferon-?-2b monotherapy among patients with untreated chronic hepatitis B(Oxford Univ Press Inc, 2003) Yalcin, K; Degertekin, H; Yildiz, F; Celik, YWe compared the use of prolonged synchronous combination therapy with interferon (IFN)-alpha-2b and lamivudine with the use of IFN-alpha-2b monotherapy in patients with untreated hepatitis B e antigen (HBeAg)-positive chronic hepatitis B virus (HBV) infection. Thirty-three patients received therapy with lamivudine (100 mg daily) and IFN-alpha-2b (10 million U 3 times per week) for 12 months; 16 patients received IFN-alpha-2b alone (10 million U 3 times per week for 12 months). The primary end point was sustained suppression of HBV DNA and HBeAg seroconversion, which was observed in 15 (45%) of 33 patients treated with combination therapy and in 3 (19%) of 16 patients treated with monotherapy (P = .133). Both therapeutic regimens were well tolerated. Combination therapy increased the rate of sustained suppression of HBeAg and resulted in significant improvement in Knodell histologic activity index scores, compared with monotherapy. However, there was no significant difference in rates of sustained suppression between the 2 groups at the end of follow-up.Öğe Hepatitis B virus genotype D prevails in patients with persistently elevated or normal ALT levels in Turkey(Springer Heidelberg, 2004) Yalcin, K; Degertekin, H; Bahcecioglu, IH; Demir, A; Aladag, M; Yildirim, B; Horasanli, SBackground: The clinical relevance of hepatits B virus (HBV) genotypes are poorly understood and it is unclear if the prevalence of HBV genotypes differs with the various clinical features of HBV carriers. The aim of our study was to examine the prevalence of the HBV genotype in a group of patients with chronic hepatitis B, compared to a group with chronic inactive hepatits B surface antigen (HbsAg) carriers. Patients and Methods: HBV genotypes were determined in 32 patients with chronic hepatitis B and in 12 chronic inactive HBsAg carriers. 35 males and nine females with a mean age of 33.95 +/- 13.04 were studied. Serum samples were examined for the presence of HBV DNA by polymerase chain reaction (PIER). Samples negative in first round PCR were further amplified with nested PCR. The PCR product was sequenced with the Cy5/5.5 dye primer kit on a Long Read Tower automated DNA sequencer. Results: HBV DNA was detectable in 29 (66%) and 44 (100%) patients by the PCR with universal primers and nested-PCR, respectively. All patients were found to be infected with HBV genotype D. Genotype D was the only detected type found in different clinical forms of chronic HBV infection, in all hepatitis B e antigen (HbeAg)-positive and negative patients, in at[ patients who had elevated or normal alanine transaminase (ALT) Levels and in all ages. Conclusion: In the present study we could not find any association between genotype D and distinct clinical phenotypes. Genotype D is the predominant type among hepatitis B carriers residing in our region and is not associated with more severe liver diseases. This genotype did not influence clinical manifestations in carriers with chronic hepatitis B virus infection. However, additional Large-scale longitudinal studies are needed to find the relationship of HBV genotypes to liver disease severity and clinical outcomes.Öğe Horizontal transmission of HBV infection among students in Turkey(Nature Publishing Group, 2000) Degertekin, H; Tuzcu, A; Yalçin, KIn this study, the HBsAg carrier state and the role of horizontal transmission were investigated among primary and high school students in southeastern Anatolia where HBsAg seropositivity is remarkably high. In total, 350 students from primary school first grade, 350 students from fifth grade, 400 students from high school eleventh grade and 400 healthy adults as a control group were studied. In all cases HBsAg and anti-HBs were screened by ELISA. HBsAg positivity was 2.4% in first grade, 6.1% in fifth and 6.7% in eleventh grade students. Anti-HBs positivity was 14% in first grade, 20% in fifth and 21% in eleventh grade students. HBsAg positivity was 9% and anti-HBs, 49% in the control group. There is a significant difference between first and fifth grade students for HBsAS positivity (2.1% vs 6.1% and P < 0.05). This difference decreased during the high school years (6.2% and P > 0.05). There is also a similar statistically significant difference for anti-HBs positivity during the primary school years (14% vs 20%, P < 0.05). These findings show that the risk of horizontal transmission of HBV is especially important during elementary school years between the ages of 7 and 11 y. All infants or at least elementary school first grade students in Turkey should have HBV vaccinations.Öğe The lack of effect of therapeutic vaccination with a pre-S2/S HBV vaccine in the immune tolerant phase of chronic HBV infection(Lippincott Williams & Wilkins, 2003) Yalcin, K; Danis, R; Degertekin, H; Alp, N; Tekes, S; Budak, TBackground/Aims: Even if the results are controversial and preliminary, several reports suggest that the HBV vaccine might be effective in treating HBV infection. In this study, we aimed to evaluate the efficacy and safety of specific anti-HBV vaccination for the immune tolerance phase of chronic HBV infection in a randomized, controlled study. Patients and Methods: The 47 subjects included patients that were treatment-naive with hepatitis B e antigen positivity, active hepatitis B virus replication as measured by hepatitis B virus DNA levels, persistently normal alanine transaminase levels, and with minimal or absent disease activity by liver biopsy. Thirty patients were given three intramuscular injections of 20 mug of a pre-S2/S vaccine (GenHevac-B) on days 0, 30, and 60, and the remaining 17 patients were included in the control group. The efficacy of vaccination was evaluated by testing for loss of serum HBV DNA or decrease in its level and for HBeAg seroconversion. A significant decrease in HBV DNA levels was accepted as a decrease of >50% of initial values. The complete response was defined as loss of HBV DNA in serum with HBeAg seroconversion. Postvaccination follow-up lasted 12 months after the first dose. Results: No significant effects were observed in the vaccination population in the reduction of HBV DNA to undetectable levels, or to <50% of prevaccination levels, in HBeAg/anti-HBe seroconversion, or in transaminase levels. There was an early clearance/decrease in HBV DNA levels in five vaccinated patients by 3 months, and none in controls (P = 0.143), and two of them had sustained responses later. At the end of follow-up, complete response is almost similar in study as well as control group (13% vs. 12%, P > 0.05). Disappearance of serum HBV DNA was more frequently observed in those patients who had pretreatment viremia of <100 pg/mL in both groups. The median levels of HBV DNA and alanine transaminase activity be-tween baseline and 12 months did not differ significantly in both groups. All patients remained HBsAg positive and none developed anti-HBs. No serious adverse event was encountered in vaccinated patients, and the therapy was well tolerated. Follow-up lasted a median of 16 months (range 12-30 months) for the study group and 18 months (range 12-31 months) for the control group. Conclusions: Immunotherapy with specific anti-HBV vaccine in the immune tolerance phase of chronic HBV infection did not offer additional benefit. New immunotherapeutic strategies to control HBV infection by specific HBV vaccines in chronically infected subjects are needed.Öğe Late failure of combined recombinant hepatitis B vaccine and lamivudine in treatment of a patient with chronic hepatitis B(Lippincott Williams & Wilkins, 2004) Yalcin, K; Degertekin, H; Bozdayi, MWe report the first case of a woman having chronic hepatitis B treated with a combination therapy of recombinant hepatitis B vaccine and lamivudine for 18 months. The main aims of such a combined therapy were to assess whether the concomitant anti-hepatitis B virus (HBV) vaccination might prevent the emergence of a mutant HBV and lead to sustained hepatitis B e antigen seroconversion with undetectable serum HBV DNA. The data from the present case demonstrated that combination of anti-HBV vaccine and lamivudine did not eliminate viral DNA despite prolonged treatment and did not have any effect on preventing resistant-type HBV. Although the combined therapy failed to reach the therapeutic endpoints, it concerned a single and unique patient. Hepatitis B vaccine and lamivudine for HBV treatment should be further investigated in randomized controlled trials.Öğe Markers of disease activity in chronic hepatitis B virus infection(Canadian Medical Association, 2003) Yalcin, K; Degertekin, H; Yildiz, F; Celik, YBackground: Assessment of disease activity is important in the management of chronic hepatitis B virus (HBV) infection. Our objective was to study the correlation between serum HBV DNA levels and HBV e antigen (HBeAg) status, alanine aminotransferase (ALT) levels, histologic activity, age and sex in patients who had chronic HBV, with emphasis on those who were HBeAg negative with high replication but had normal or below-normal liver enzyme levels and mild liver disease. Method: At our university-affiliated tertiary care medical centre in Turkey, we studied prospectively 179 consecutive patients who were long-term hepatitis B surface antigen carriers. These patients were first separated into 2 groups according to HBeAg positivity and then subdivided into 4 groups according to the presence of HBV DNA, HBeAg status and ALT levels. The clinical, virologic and histologic differences in these patients were evaluated with respect to the HBeAg status. Results: Of the 179 patients, 120 (67%) were HBeAg positive and 59 (33%) were HBeAg negative. The mean (and standard deviation) age in the former group was 24.8 (7.60) and in the latter group was 32.2 (11.2) years (p < 0.001). HBeAg-negative patients had significantly more severe liver disease, more male predominance and lower serum HBV DNA levels than HBeAg-positive patients (p < 0.05). HBeAg status had a close correlation with age. There was a significant correlation between age and serum HBV DNA levels but not between HBV DNA levels and disease activity in study groups. We found that some of anti-HBe-positive patients had below-normal ALT levels with minimal or absent histologic changes despite high viral replication. Conclusions: Monitoring of ALT is of value in assessing hepatocellular damage in patients with chronic hepatitis B virus infection. HBeAg-negative patients with elevated ALT levels and some with normal ALT levels should be considered highly infectious in the course of chronic HBV infection.Öğe Peritoneal mesothelioma associated with exposure to asbestos in Southeastern Turkey(Lippincott Williams & Wilkins, 2002) Degertekin, H; Yalçin, K; Isik, R[Abstract Not Available]Öğe rHB vaccination in replicative chronic asymptomatic HBsAg carriers(Elsevier, 2000) Yalcin, K; Degertekin, H; Tekes, S[Abstract Not Available]Öğe Risk factors, clinical and virological characteristics of hepatitis delta virus infection in Turkey(Elsevier Science Bv, 2003) Yalcin, K; Degertekin, H; Bahcecioglu, IH; Demir, A[Abstract Not Available]Öğe The role of HBeAg seroconversion in acute exacerbation of liver disease with termination of hepatitis B and D virus infection in a chronic hepatitis D patient during ?-interferon therapy(Lippincott Williams & Wilkins, 2003) Yalcin, K; Degertekin, H; Yurdaydin, C; Bozdayi, M; Bozkaya, H[Abstract Not Available]Öğe A severe hepatitis flare in an HBV-HCV coinfected patient during combination therapy with ?-interferon and ribavirin(Springer-Verlag Tokyo, 2003) Yalcin, K; Degertekin, H; Yildiz, F; Kilinc, NWe report a reactivation of hepatitis B virus infection and a severe hepatitis flare in a patient with chronic hepatitis due to dual infection with hepatitis B and C viruses during combination therapy with alpha-interferon and ribavirin. Pretreatment, HCV was the dominant virus, with detectable serum HCV-RNA but undetectable HBV-DNA. The patient responded to therapy, with the disappearance of HCV-RNA and normalization of serum alanine aminotransferase (ALT) at months 1 and 6. In the seventh month of therapy, an ALT flare was observed, and serum HBV-DNA became detectable. The patient had a severe hepatitis flare leading to impending hepatic failure. Treatment was discontinued and the patient had marked clinical and biochemical improvement and recovered with normalization of liver function test results within 1 month. Two months later, serum HBV-DNA was again undetectable, both by hybridization and polymerase chain reaction (PCR) assays. The patient had a rapid progression to cirrhosis in a year. At month 24, 17 months after the end of therapy, serum HCV-RNA reappeared, with a level of 2.4 X 10(5) copies/ml. In conclusion, severe HBV reactivation may occur during interferon plus ribavirin therapy in patients with chronic hepatitis C who are also hepatitis B surface antigen (HBsAg)-positive, and thus more careful monitoring than usual should be considered. Longterm follow-up is recommended, because very late HCV relapses may occur in coinfected patients. These data exemplify the complexity of viral dominance in patients infected with multiple hepatitis viruses, and this has significant importance for treatment decisions. Lamivudine may be administered early in HCV-RNA/HBsAg-positive patients who ate at high risk of liver failure once reactivation of HBV occurs during interferon therapy.Öğe Specific hepatitis B vaccine therapy in inactive HBsAg carriers: a randomized controlled trial(Mmv Medien & Medizin Verlagsgesellschaft Mbh, 2003) Yalcin, K; Acar, M; Degertekin, HBackground: Hepatitis B virus (HBV) vaccine therapy has two major areas of application: for preventive purposes and for treating patients with chronic hepatitis B. This study aimed to investigate the effect of therapeutic vaccination of inactive hepatitis B surface antigen (HbsAg) carriers using a recombinant hepatitis B vaccine in a randomized-controlled study. Patients and Methods: The 71 studied patients had never received prior antiviral therapies, were anti-HBe positive, had undetectable HBV-DNA and persistently normal alanine transaminase levels. 31 patients were given three 20 mg intramuscular injections of a preS2/S vaccine (GenHevac-B) on days 0, 30 and 60 and the remaining 40 patients were included in the control group. The efficacy of vaccination was evaluated by testing for HBsAg seroconversion to anti-HBs. Post-vaccination follow-up was for 12 months after the first dose. Results: At the end of the follow-up, three out of 31 patients (10%) who received vaccine therapy were able to clear HBsAg from their sera and concomitantly develop anti-HBs antibodies. In contrast, none of the 40 control patients who did not received vaccine therapy had decreased their levels of HBsAg or elicited anti-HBs antibodies (p = 0.079). In three vaccinated patients serum HBsAg became undetectable approximately by the 3rd month of vaccine therapy and HBsAg seroconversion was seen to be durable in all patients in the follow-up period. Conclusion: This study offers the first direct evidence, based on a controlled study, that the recombinant HBV vaccine has no great effect in enhancing the rate of HBsAg seroconversion in inactive HBsAg carriers. More efficient strategies, such as an increase in the dose and number of immunizations, should be evaluated further in large controlled trials.Öğe Specific vaccine therapy in inactive HBsAg carriers by recombinant hepatitis B vaccine: A randomised controlled trial(Elsevier Science Bv, 2003) Yalcin, K; Acar, M; Degertekin, H[Abstract Not Available]Öğe Treatment of chronic hepatitis D with famciclovir(Elsevier, 2000) Yurdaydin, C; Bozkaya, H; Gürel, S; Erkan, Ö; Erden, E; Memik, F; Degertekin, H[Abstract Not Available]
