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    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 Şener
    Amaç: 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 belirgindi
  • Küçük Resim
    Öğe
    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, Şükran
    Objective: 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.
  • Küçük Resim
    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 Türe
    Background/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 Gastroenterology