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  • Küçük Resim
    Öğe
    Comparison of two different regimens of combined interferon-?2A and lamivudine therapy in children with chronic hepatitis B infection
    (International Medical Press, 2006) Kansu, Aydan; Doğancı, Tumay; Akman, Sezin A.; Artan, Reha; Kuyucu, Necdet; Kalaycı, Ayhan Gazi; Dikici, Bünyamin; Dalgıç, Buket; Selimoğlu, Ayşe; Kasırga, Erhun; Özkan, Tanju B.; Kuloğlu, Zarife; Aydoğdu, Sema; Boşnak, Mehmet; Ertekin, Vildan; Tanır, Gönül; Haspolat, Yusuf Kenan; Girgin, Nurten; Yağcı, Raşit Vural
    Aim: To evaluate the efficacy of two regimens of combined interferon-alpha2a (IFN-alpha2a) and lamivudine (3TC) therapy in childhood chronic hepatitis B. Methods: A total of 177 patients received IFN-alpha2a, 9 million units (MU)/m2 for 6 months. In group I (112 patients, 8.7 +/- 3.5 years), 3TC (4 mg/kg/day, max 100 mg) was started simultaneously with IFN-alpha2a, in group II (65 patients, 9.6 +/- 3.8 years) 3TC was started 2 months prior to IFN-alpha2a. 3TC was continued for 6 months after antiHBe seroconversion or stopped at 24 months in nonresponders. Results: Baseline alanine aminotransferase (ALT) was 134.2 +/- 34.1 and 147.0 +/- 45.3; histological activity index (HAI) was 7.4 +/- 2.7 and 7.1 +/- 2.3; and HBV DNA levels were above 2,000 pg/ml in 76% and 66% of patients in groups I and II, respectively (P > 0.005). Complete response was 55.3% and 27.6% in groups I and II, respectively (P < 0.01). AntiHBe seroconversion was higher and earlier, and HBV DNA clearance was earlier in group I (P < 0.05). HBsAg clearance was 12.5% and 4.6% and antiHBs seroconversion was 9.8% and 6.2% in groups I and II, respectively (P > 0.05). Breakthrough occurred in 17.9% and 24.6%; breakthrough times were 15.9 +/- 4.6 and 14.1 +/- 5.1 months; and relapse rates were 6.8% and none in groups I and II, respectively (P > 0.05, P > 0.05, P > 0.05). Responders had higher HAI (HAI > 6) and higher pre-treatment ALT than non-responders. Conclusion: Simultaneous 3TC+IFN-alpha2a yields a higher response and earlier antiHBe seroconversion and viral clearance than consecutive combined therapy. Relapse rate is low. Predictors of response are high basal ALT and high HAI scores. 3TC can be administered for 24 months without any side effect and breakthrough rate is comparable with previous studies.
  • Küçük Resim
    Öğe
    Multicenter hospital-based prospective surveillance study of bacterial agents causing meningitis and seroprevalence of different serogroups of Neisseria meningitidis, Haemophilus influenzae Type B, and Streptococcus pneumoniae during 2015 to 2018 in Turkey
    (American Society for Microbiology, 2020) Ceyhan, Mehmet; Özsürekçi, Yasemin; Başaranoglu, Sevgen Tanır; Gürler, Nezahat G.; Salı, Enes; Emiroglu, Melike; Öz, Fatma Nur; Belet, Nurşen M.; Duman, Murat; Ulusoy, Emel; Kurugöl, Zafer; Tezer, Hasan; Parlakay, Aslınur Özkaya; Dinleyici, Ener Cagri; Çelik, Ümit Sizmaz; Çelebi, Solmaz; Öner, Ahmet Faik; Solmaz, Mehmet Ali; Karbuz, Adem; Hatipoglu, Nevin; Devrim, İlker; Caglar, İlknur; Bozdemir, Şefika Elmas; Kocabaş, Emine; Gündeşli·oğlu, Özlem Özgür; Sütçü, Murat; Akcan, Özge Metin; Kuyucu, Necdet; Aktar, Fesih; Kara, Soner Sertan; Akışoğlu, Havva Özlem Altay; Tuygun, Nilden; Uslu, Zeynep Diyar Tamburaci; Öncel, Eda Karadag; Bayhan, Cihangül; Cengiz, Ali Bülent
    The etiology of bacterial meningitis in Turkey changed after the implementation of conjugated vaccines against Streptococcus pneumoniae and Haemophilus influenzae type b (Hib) in the Turkish National Immunization Program (NIP). Administration of Hib vaccine and PCV-7 (7-valent pneumococcal conjugate vaccine) was implemented in NIP in 2006 and 2009, respectively. In 2011, PCV-7 was replaced with PCV-13. Meningococcal vaccines have not yet been included in Turkish NIP. This prospective study comprised 27 hospitals located in seven regions of Turkey and represented 45% of the population. Children aged between 1 month and 18 years who were hospitalized with suspected meningitis were included. Cerebrospinal fluid (CSF) samples were collected, and bacterial identification was made according to the multiplex PCR assay results. During the study period, 994 children were hospitalized for suspected meningitis, and Hib (n = 3, 2.4%), S. pneumoniae (n = 33, 26.4%), and Neisseria meningitidis (n = 89, 71%) were detected in 125 samples. The most common meningococcal serogroup was MenB. Serogroup W comprised 13.9% (n = 5) and 7.5% (n = 4) of the meningococci in 2015 to 2016 and 2017 to 2018, respectively. Serogroup C was not detected. There were four deaths in the study; one was a pneumococcus case, and the others were serogroup B meningococcus cases. The epidemiology of meningococcal diseases has varied over time in Turkey. Differing from the previous surveillance periods, MenB was the most common serogroup in the 2015-to-2018 period. Meningococcal epidemiology is so dynamic that, for vaccination policies, close monitoring is crucial.