Objectives: Human immunodeficiency virus (HIV) may adversely affect the course of viral hepatitis infections that share similar routes of transmission. This study aimed to evaluate the seroprevalence of hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among individuals infected with HIV. Materials and Methods: This retrospective study included HIV-infected patients aged ≥18 years who were followed at the outpatient clinic between October 1, 2020, and September 1, 2024. Demographic characteristics and viral hepatitis serological markers [anti-HAV immunoglobulin G (IgG), hepatitis B surface antigen (HBsAg), anti-HBs, total anti-HBc, anti-HCV] were recorded for these patients. Results: A total of 210 HIV-infected patients were included in the study; 86.7% were male, and the median age was 35 (18-73) years. HBV and HCV serological data were available for 196 patients. Positivity rates for anti-HBs, total anti-HBc, HBsAg, and anti-HCV were 51%, 18.4%, 2.6%, and 0.5%, respectively. Concomitant positivity for anti-HBs and total anti-HBc was observed in 15.3% of patients, whereas isolated total anti-HBc positivity was detected in only one patient (0.5%). Among 152 patients with available anti-HAV IgG data, 68.4% were seropositive. Anti-HAV IgG negativity was significantly associated with younger age, higher educational level, and men who have sex with men status (p<0.05). Conclusion: This study indicates that HBV and HCV coinfections occur at a low frequency among individuals living with HIV, whereas susceptibility to HAV and HBV remains an important clinical concern. It also emphasizes the necessity of routine serological screening and vaccination against viral hepatitis during HIV follow-up.
Objectives: The aim of this study is to document the increase in hepatitis B surface antigen (HBsAg) seroclearance that we observed during the coronavirus disease-2019 (COVID-19) pandemic. Materials and Methods: Patients with chronic hepatitis B aged 18 years and older who were followed between 2010 and 2023 at three hospitals in Türkiye were included in this study. Rates of HBsAg seroclearance, seroconversion, and serological response among the patients were determined. Data from patients other than those who developed HBsAg seroclearance before the COVID-19 pandemic (before 2020) were analyzed. Results: A total of 188 patients were included in the study. In total, 26 (13.8%) patients developed HBsAg seroclearance, 28 (15%) developed HBsAg seroconversion, and 21 (11.2%) developed a serological response. Of the patients who developed HBsAg seroclearance, 22 (84.6%) occurred in 2020 or later, and 4 (15.4%) occurred before 2020. The annual incidence rates of HBsAg seroclearance were 0.78% in 2014, 0.6% in 2017, 1.15% in 2019, 1.71% in 2020, 2.23% in 2021, 7.4% in 2022, and 1.2% in 2023. 95% of the patients were vaccinated with Pfizer-BioNTech and/or Sinovac-CoronaVac vaccines, and 36.4% had a COVID-19 infection. Conclusion: In this study, the annual incidence rate of HBsAg seroclearance in the pre-pandemic period was consistent with the literature (0-1.15%), but this rate tended to increase during the pandemic (7.4%). We suggest that this increase may be related to COVID-19 infection and vaccination.
Transient hepatitis B surface antigen (HBsAg) positivity following hepatitis B (HB) vaccination is a rare occurrence and, particularly in hemodialysis patients, may lead to unnecessary clinical interventions if misinterpreted. A 42-year-old male with a history of myasthenia gravis, nephrotic syndrome, and thymic carcinoma was admitted to the clinic to initiate chronic hemodialysis for steroid-resistant focal segmental glomerulosclerosis. Since baseline serology was negative for HBsAg and anti-HBs, the patient was administered a double dose of recombinant HB vaccine. One day after vaccination, HBsAg positivity was detected, and the patient was dialyzed using an isolated dialysis machine. The positivity persisted on the second day but completely resolved by day 12. The final test was negative for HBsAg, with an anti-HBs titer of 10.85 IU/L. Additional vaccine doses were administered, and HBsAg remained negative on follow-up evaluations. To prevent misdiagnosis and unnecessary isolation or interventions, accurate interpretation of serological findings and effective interdisciplinary communication in dialysis centers are critically important.
Objectives: This study aimed to evaluate biochemical response, sustained virological response (SVR) rates, and changes in non-invasive fibrosis markers [aspartate aminotransferase (AST) to platelet ratio index (APRI) and fibrosis-4 index (FIB-4)] using real-world data in patients with chronic hepatitis Cvirus (HCV) treated with direct-acting antivirals (DAAs). Materials and Methods: Patients aged >= 18 years with chronic HCV who were followed between January 2018 and December 2024 and treated with glecaprevir/pibrentasvir, sofosbuvir/velpatasvir/voxilaprevir, or ledipasvir/sofosbuvir were retrospectively analyzed. Alanine aminotransferase (ALT), AST, platelet count, and HCV-RNA levels were recorded at baseline, at treatment week 4, at end of treatment, and at 12 and 24 weeks after treatment completion. APRI and FIB-4 scores were calculated at each time point. Results: A total of 43 patients were included; the median age was 57 years (interquartile range: 43-65), and 58% were male. ALT and AST levels decreased significantly from treatment week 4 onward (p<0.001). APRI scores showed a significant early decline that persisted throughout the follow-up period (p<0.001). FIB-4 scores decreased significantly at week 4; however, this reduction was not sustained during follow-up. A strong correlation was observed between changes in APRI and ALT, whereas the association between FIB-4 and ALT was weak and limited. SVR12 and SVR24 rates were 100% among patients with available HCV-RNA data. Conclusion: In real-world settings, DAA therapy achieves high SVR rates and rapid biochemical improvement. The early and persistent decline in APRI reflects regression of inflammatory activity, while the limited change in FIB-4 suggests that longer follow-up may be required to adequately assess fibrosis regression.
