Herpes zoster (HZ) results from the reactivation of varicella-zoster virus (VZV) in dorsal root ganglia, often triggered by immune decline. This multicenter study aimed to describe the frequency, clinical and demographic characteristics, and risk factors of HZ in Türkiye to inform clinical management and prevention strategies. This retrospective analysis was conducted on 503 patients diagnosed with HZ between 2014 and 2024 across 17 hospitals in nine Turkish provinces. Data included demographics, comorbidities, immunosuppressive therapy, dermatomal involvement, rash duration, antiviral treatment, and vaccination status. Descriptive statistics were applied. A total of 503 patients were included in the study. Of these, 281 (55.9

INTRODUCTION/OBJECTIVE:HIV infection has transitioned from a fatal disease to a manageable chronic condition due to effective antiretroviral therapy (ART). While life expectancy has increased, there is a growing need to assess health-related quality of life (HRQoL) as part of comprehensive HIV care. This study evaluated changes in HRQoL during the first six months after diagnosis among individuals newly diagnosed with HIV. METHODS:This prospective observational study was conducted at a tertiary care hospital in Türkiye and included 81 newly diagnosed adults living with HIV. HRQoL was assessed using the WHOQOL-HIV Bref scale at baseline (n = 81), month 3 (n = 70), and month 6 (n = 81). Longitudinal changes were analysed using repeated-measures ANOVA or Friedman tests, with paired t-tests or Wilcoxon signed-rank tests for pairwise comparisons, as appropriate. The Minimal Clinically Important Difference (MCID) was calculated using anchor-based and distribution-based methods, and logistic regression was used to examine factors associated with anchor-defined perceived clinical improvement. RESULTS:The overall HRQoL score increased from 14.12 at baseline to 14.80 at month 3 and 14.90 at month 6. Significant improvements over the six-month period were observed in physical health (p = 0.006), environment (p = 0.011), and overall HRQoL (p = 0.021). Higher overall HRQoL scores were associated with greater odds of anchor-defined perceived clinical improvement (CI+) at month 3 (OR = 2.34, 95% CI: 1.56-4.03, p < 0.001) and month 6 (OR = 2.39, 95% CI: 1.52-4.60, p = 0.002). DISCUSSION:These findings suggest that HRQoL may improve during early follow-up after HIV diagnosis and initiation of ART, particularly in physical health. Early HRQoL assessment may also complement virological monitoring by capturing patient-centred information during the first months after HIV diagnosis. CONCLUSION:Beyond treatment access and virological suppression, improving HRQoL should be considered an important goal in HIV care. Strengthening social support systems, reducing stigma, and integrating multidisciplinary approaches may help support progress towards the Fourth 90 targets.

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.

INTRODUCTION:Cancers remain a major cause of mortality among individuals with HIV infection. This study aimed to determine the incidence, prevalence, and mortality of AIDS-defining cancers (ADCs) and non-AIDS-defining cancers (NADCs) in people living with HIV (PLWH). METHODS:This retrospective, cross-sectional study was conducted in Istanbul. Among patients diagnosed with HIV/AIDS between January 2011 and December 2019, those who developed cancer were analyzed. To assess changes in cancer types over time, the study period was divided into three-year intervals. RESULTS:Cancer was diagnosed in 57 (3.9%) of the 1,438 patients. The mean CD4 count was 272.3/mm³. Patients in the cancer group had significantly higher mean age at HIV diagnosis, higher HIV RNA levels, and lower CD4+ T lymphocyte counts. A notably high rate (72%) of simultaneous diagnosis of cancer and HIV was observed in the ADCs group. Kaposi sarcoma was identified in 23 (71.8%) patients, and non-Hodgkin lymphoma (NHL) in 9 patients. Hodgkin lymphoma and lung cancer were the most common cancers in the NADCs group. DISCUSSION:People living with HIV are experiencing longer life expectancy due to ART; however, this also increases cancer risk, emphasizing the need for national screening guidelines that consider age, gender, and immune status. A multidisciplinary approach is essential for effective prevention and treatment strategies. Since cancer risk is multifactorial, larger prospective and multicenter studies are needed to strengthen and expand these findings. CONCLUSIONS:These findings highlight that AIDS-defining cancers continue to be a significant clinical concern in Turkey. Cancer screening should be integrated both at the time of HIV diagnosis and during routine follow-up of PLWH.

Objective:This study aimed to evaluate the clinical, microbiological, and sociodemographic characteristics of patients diagnosed with cellulitis and to identify risk factors associated with the development of recurrence. Material and Methods: This retrospective, single-center observational study included 120 adult patients (aged ≥18 years) treated for cellulitis as inpatients or outpatients over a one-year period. Demographic, clinical, and laboratory data were extracted from electronic medical records. Predisposing factors, infection sites, treatment characteristics, and variables associated with recurrence were evaluated. Recurrence was defined as a history of at least two episodes of lower extremity cellulitis. Univariable and multivariable logistic regression analyses were performed to identify factors associated with recurrence. Statistical significance was set at a p value <0.05. Results: Among the 120 patients diagnosed with cellulitis, the mean age was 56.4±15.7 years; 51% were male. The most commonly affected site was the lower extremity (91%). Although all patients presented with edema and erythema, increased local temperature (96%) and pain (80%) were also frequent findings, whereas fever was less common (15%). The most prevalent predisposing factors were tinea pedis (64.2%), obesity (56.7%), and onychomycosis (47.5%). The recurrence rate was 36.7%. Statistically significant associations were found between recurrence and advanced age, lymphedema, peripheral arterial disease, higher body mass index (BMI), and living alone or being homeless (p<0.05). In multivariable logistic regression analysis, living alone or being homeless [odds ratio (OR): 6.27, 95% confidence interval (CI): 1.36-28.87, p=0.018], older age (OR: 1.03 per year, 95% CI: 1.001-1.06, p=0.045), and the presence of lymphedema (OR: 3.08, 95% CI: 1.17-8.14, p=0.023) were independently associated with recurrence, while BMI showed a borderline association (OR: 1.06, 95% CI: 0.99-1.14, p=0.084). Additionally, C-reactive protein levels were positively correlated with duration of antibiotic treatment and length of hospital stay. Conclusion: The findings suggest that cellulitis recurrence is closely associated not only with the treatment of the acute infection but also with the comprehensive management of underlying chronic conditions. In particular, controlling modifiable risk factors such as lymphedema, peripheral arterial disease, and higher BMI may play a crucial role in reducing recurrence rates. These results highlight the importance of risk-based and individualized approaches in clinical management.

Introduction: Community-acquired central nervous system infections (CA-CNSIs) are associated with substantial morbidity and mortality, and early differentiation between purulent and aseptic meningitis remains a major clinical challenge. Readily available admission biomarkers may facilitate timely clinical differentiation. Materials and Methods: We conducted a retrospective cohort study including adult patients (≥18 years) hospitalized with CA-CNSIs at Şişli Hamidiye Etfal Training and Research Hospital over a 5-year period. Epidemiological, clinical, and laboratory characteristics were evaluated. The diagnostic performance of routinely available biomarkers was assessed using receiver operating characteristic analysis. Multivariable Firth penalized logistic regression was applied, with internal validation performed using bootstrap resampling. Results: Seventy patients were included (median age, 45 years; 63% male). Purulent meningitis accounted for 46% of cases, whereas aseptic meningoencephalitis comprised 24%. Patients with purulent meningitis had significantly higher leukocyte counts and C-reactive protein (CRP) and procalcitonin levels, as well as a lower cerebrospinal fluid (CSF)-to-serum glucose ratio. The CSF-to-serum glucose ratio demonstrated the highest discriminative ability for differentiating purulent from aseptic meningitis [area under the curve (AUC), 0.97], followed by CRP (AUC, 0.89). In the multivariable analysis, the CSF-to-serum glucose ratio remained independently associated with purulent meningitis, with CRP providing additional discriminatory value. Conclusion: In this real-world cohort, the CSF-to-serum glucose ratio was the most robust admission biomarker for differentiating purulent from aseptic meningitis. CRP provided additional discriminatory value, supporting the combined use of routinely available biomarkers to improve early clinical decision-making in patients with suspected CA-CNSIs.

Introduction: Serum cryptococcal antigen (CrAg) screening is crucial for early diagnosis of cryptococcal meningitis. This study presents the results of CrAg screening among people living with HIV (PLWH) followed in our clinic over the past six years. Methodology: Patients with a CD4+ T cell count below 200 cells/µL who were tested for CrAg were included in the study. Data regarding age, gender, comorbidities, CD4+ T cell count, HIV RNA level, blood culture results, and cerebrospinal fluid (CSF) findings—including CrAg, microscopy, culture, and PCR—were retrospectively collected. Descriptive statistical methods were used for the analysis. Results: Serum CrAg testing was performed on 99 patients, nine of whom tested positive. Among the patients with positive antigenemia, four were diagnosed with cryptococcal meningitis. In two cases, serum CrAg positivity was interpreted as false-positive due to the absence of clinical or laboratory findings consistent with cryptococcal infection. One patient died shortly after the CrAg test and could not be further evaluated. Two patients were lost to follow-up; however, one of them presented with symptoms two months later and was diagnosed with cryptococcal meningitis. Additionally, there was one patient with confirmed cryptococcal meningitis despite an initial negative serum CrAg result. Conclusions: CrAg positivity may be detected during the asymptomatic phase of cryptococcal infection. Although current guidelines recommend serum CrAg screening for individuals with CD4+ T cell counts below 100 cells/µL, the detection of positive results in those with CD4+ T cell counts above this threshold should also be carefully evaluated, considering the possibility of false-positive or false-negative results.

BACKGROUND:Aging people living with HIV (PLWH) are at higher risk of multimorbidity and polypharmacy, complicating care. OBJECTIVE:To assess the prevalence and risk factors of multimorbidity and polypharmacy in elderly PLWH on antiretroviral therapy (ART). METHOD:In this cross-sectional study, PLWH aged ≥50 were compared with age- and sex-matched people without HIV. Logistic regression was used to identify predictors of polypharmacy. RESULTS:Multimorbidity (≥2 chronic conditions) was seen in 29% of PLWH and 22% of controls. Osteoporosis (9.5% vs. 2.3%) and psychiatric disorders (9.5% vs. 2.8%) were significantly more common in PLWH (p < 0.001). Polypharmacy (≥5 non-ART medications) was more frequent in PLWH (20.4% vs. 11.8%, p = 0.014). In multivariable analysis, being in the PLWH group (aOR 2.41), increasing age (aOR per 1-year 1.05), and having no formal education (aOR 4.59) were independent predictors of polypharmacy. Potential drug-drug interactions were present in 19.4% of PLWH and were present in those with polypharmacy (33% vs. 16%, p < 0.001). CONCLUSION:Older PLWH experience greater multimorbidity and polypharmacy than people without HIV. Tailored strategies - such as medication review, drug interaction monitoring, and preventive care - are essential to optimize outcomes in this growing and vulnerable population.

Background: Managing Pseudomonas aeruginosa bloodstream infections (BSIs) is challenging due to increasing antimicrobial resistance, limited therapeutic options, and high mortality rates. In this study, we aimed to identify 30-day mortality risk factors and assess infectious diseases consultants' preferences for combination or monotherapy. Methods: The study was conducted in four hospitals in Istanbul, Turkey, involving 140 adult ICU beds and 336,780 ICU-bed-days between 1 January 2014, and 31 December 2021. A total of 157 patients were included in the study. Cox proportional hazard regression was performed to assess the factors on 30-day mortality. Results: The 30-day mortality rate was 44.6% (70/157). Higher Charlson Comorbidity Index (CCI) score, severe sepsis, primary bloodstream infection, being in COVID-19 pandemic period, and infection caused by MDR strain were associated with higher hazard of 30-day mortality. Combination therapy was more commonly used in patients with BSIs with MDR or DTR (difficult-to-treat) strains but did not significantly improve the hazard of 30-day mortality. Conclusions: Targeted interventions and vigilant management strategies are crucial for patients with defined risk factors. While infectious disease consultants tended to favor combination therapy, particularly for drug-resistant strains, our analysis revealed no significant impact on 30-day mortality hazard. The increased incidence of P. aeruginosa BSIs during the pandemic emphasizes the need for infection control measures and appropriate antibiotic prescribing practices.

Objectives: The role of hematologic, inflammatory and biochemical parameters as biomarkers, their role in identifying risky pa-tients in the early stage and their role in prognosis in COVID-19 Coronavirus disease 2019 (COVID-19) were investigated. Methods: The study included patients who were hospitalized and followed up with a prediagnosis of COVID-19 in the first wave in our country at the University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital Demographic and clinical characteristics as well as complete blood count, C reactive protein (CRP), procalcitonin (PCT), fibrinogen (FIB), ferritin, albumin (ALB), lactate dehydrogenase (LDH) levels on admission, third, seventh and 14th days were analyzed. Patients were grouped and compared according to the occurrence of death during hospital follow-up. Variables considered significant on mortality were analyzed with univariate and multivariate logistic regression models. Results: The study was conducted with 485 patients, 273 (56.3%) males and 212 (43.72%) females. The mean age of the patients was 58 +/- 16.2 years, and 71% were in the mild-moderate and 29% in the severe-critical disease group. Disease severity, the need for intensive care unit (ICU) follow-up, and the development of death were positively correlated with age, comorbidity, neutrophil (NE), leukocyte, neutrophil-lymphocyte ratio (NLR), PCT, CRP, ferritin, LDH values, and negatively correlated with lymphocyte (LE), ALB and hemoglobin (HGB) values. In multivariate analysis, elevated PCT at hospital admission (OR: 6.96 [1.63;39.65]), LDH >= 352U/L (OR: 4.35 [1.23;16.61]), LE<0.810 x 109/L (OR: 3.0 [1.16;7.85]) and advanced age (OR: 1.08 [1.03;1.14]) were independently associated with in-hospital death. In hemogram and acute phase reactant monitoring, PCT, CRP and LDH were the most valuable markers for predicting death, respectively (third-day AUC: 0.90;0.83;0.83 and seventh-day AUC: 0.95;0.90;0.89, respectively). Conclusion: In our study, leukocytes, lymphocytes, NLR, CRP, PCT, ferritin, albumin and LDH at admission were valuable in predicting poor prognosis. In addition, it was determined that increases in PCT, LDH and CRP during follow-up could be used to predict in-hospital death and to identify patients requiring close follow-up

Objective: We aimed to determine the frequency, type, and mortality rate of central nervous system infections (CNSI) in patients infected with the human immune deficiency virus (HIV). Methods: A total of 353 HIV/AIDS cases hospitalized in our clinic between January 2014 and March 2020 were retrospectively analyzed. Patients diagnosed with CNSI were included in the study. Epidemiological data, diagnoses, clinical, and laboratory information, and clinical progress data of the cases were collected from patient files and recorded. Variables were analyzed. Results: Thirty-four (9.6%) of 353 inpatients diagnosed with HIV/AIDS were followed with CNSI diagnosis. 88.2% of the cases were male, and the median age was 43.5 [interquartile range (IQR)= 26-62) ]. Toxoplasma encephalitis (n=7, 20.6% ), neurosyphilis (n=7, 20.6%), tuberculous meningitis (n=4, 11.8%), cryptococcal meningitis (n=4, 11.8%), HIV encephalopathy (n =3, 8.8%), progressive multifocal leukoencephalopathy (PML) (n=3, 8.8%), and bacterial meningitis (n=2, 5.9%), and 1 case of herpes simplex virus (HSV) encephalitis, varicella zoster virus (VZV) encephalitis, chronic encephalitis, cytomegalovirus (CMV) meningoencephalitis were seen. The median CD4+ T lymphocyte count of the cases was 44.5 /uL (IQR=5-627), HIV RNA level was 215 000 copies/mL (IQR=20-617 000) in patients under antiretroviral therapy (ART), 227 500 (IQR=32 000-4 500 000) copies/ml in patients not receiving ART. CD4+ T lymphocyte count of 25 (73.4%) patients was <200/uL. Twenty-one patients (61.8% ) were simultaneously diagnosed with HIV/AIDS and CNSI, and 14 were in the AIDS stage. The mortality rate was 32.4 % (n=11), and all fatal cases had CD4+ T lymphocyte counts below 200/uL. Conclusion: Central nervous system infections continue to cause severe mortality and morbidity in HIV-infected individuals. We observed that the frequency and mortality rate of CNSI is higher in patients who do not know their HIV status, late-presenters, and those who are not under treatment and/or do not adhere to treatment. Facilitating access to diagnostic tests, rapid treatment initiation, and counseling on treatment compliance is essential to prevent CNSI and, thus, reduce mortality.

Human monkeypox (MPX) disease is a re-emerging zoonotic infection caused by the monkeypox virus belonging to the same family as vaccinia and variola. The European Center for Disease Prevention and Control (ECDC) has documented an outbreak of MPX with atypical transmission paths throughout Europe. In this report, male-to-male sexual intercourse was first defined as a means of close humanto-human contact. The Ministry of Health of the Republic of Turkey announced via social media on June 30, 2022 that the first case confirmed by polymerase chain reaction (PCR) for the MPX virus in Turkey was admitted and isolated in a hospital. Four days after this statement, a 24-year-old Turkish man was hospitalized in our clinic with a bacterial infection of the penis and scrotum following local radiofrequency ablation therapy. A week ago, lesions resembling warts were noted in his medical history, for which a local radiofrequency ablation procedure was conducted at an external center. One day after his hospitalization, skin lesions of different stages (from macules, papules to umbilical papules) and several eruptions were detected on his face, nose tip, body, arms, and fingers, which gradually became more evident. After evaluating the risk factors, the patient was isolated with a preliminary diagnosis of MPX disease and samples were collected and sent for MPX virus detection to the reference laboratory according to the Ministry of Health guidelines. MPX virus nucleic acid was detected by PCR in samples taken from the lesion. The patient was discharged after 21 days of isolation and treatment for a secondary bacterial infection. In this case report the significance of differential diagnosis and screening tests for sexually transmitted infections (STI), a previously unreported case of MPX disease in Turkey, and a soft tissue infection that developed after local ablation treatment which was administered to a patient with MPX disease were presented. To be prepared for new and re-emerging infectious diseases, it was emphasized that well-structured continuing education based on current epidemiological data is required. Sexual contact has recently been identified as a new mode of transmission for MPX disease, and symptoms and signs may resemble those of other ulcerative sexually transmitted infections (STIs), such as "molluscum contagiousum" or syphilis. ORF disease is also in the differential diagnosis of MPX disease in Turkey. In addition, patients admitted with unreported STIs are permitted to receive health services without additional screenings. For this reason, easily accessible sexually transmitted disease centers with a high diagnostic efficiency can provide greater control over these diseases.

Human monkeypox (MPX) disease is a re-emerging zoonotic infection caused by the monkeypox virus belonging to the same family as vaccinia and variola. The European Center for Disease Prevention and Control (ECDC) has documented an outbreak of MPX with atypical transmission paths throughout Europe. In this report, male-to-male sexual intercourse was first defined as a means of close humanto-human contact. The Ministry of Health of the Republic of Turkey announced via social media on June 30, 2022 that the first case confirmed by polymerase chain reaction (PCR) for the MPX virus in Turkey was admitted and isolated in a hospital. Four days after this statement, a 24-year-old Turkish man was hospitalized in our clinic with a bacterial infection of the penis and scrotum following local radiofrequency ablation therapy. A week ago, lesions resembling warts were noted in his medical history, for which a local radiofrequency ablation procedure was conducted at an external center. One day after his hospitalization, skin lesions of different stages (from macules, papules to umbilical papules) and several eruptions were detected on his face, nose tip, body, arms, and fingers, which gradually became more evident. After evaluating the risk factors, the patient was isolated with a preliminary diagnosis of MPX disease and samples were collected and sent for MPX virus detection to the reference laboratory according to the Ministry of Health guidelines. MPX virus nucleic acid was detected by PCR in samples taken from the lesion. The patient was discharged after 21 days of isolation and treatment for a secondary bacterial infection. In this case report the significance of differential diagnosis and screening tests for sexually transmitted infections (STI), a previously unreported case of MPX disease in Turkey, and a soft tissue infection that developed after local ablation treatment which was administered to a patient with MPX disease were presented. To be prepared for new and re-emerging infectious diseases, it was emphasized that well-structured continuing education based on current epidemiological data is required. Sexual contact has recently been identified as a new mode of transmission for MPX disease, and symptoms and signs may resemble those of other ulcerative sexually transmitted infections (STIs), such as "molluscum contagiousum" or syphilis. ORF disease is also in the differential diagnosis of MPX disease in Turkey. In addition, patients admitted with unreported STIs are permitted to receive health services without additional screenings. For this reason, easily accessible sexually transmitted disease centers with a high diagnostic efficiency can provide greater control over these diseases.

To identify the frequency of late presentation and late presentation with advanced disease, and associated factors in people living with HIV (PLHIV). Data from PLHIV diagnosed between 2008 and 2021 were retrospectively analyzed. Time of diagnosis (categorized based on key events affecting HIV care continuum e.g., national strategies, HIV guidelines, COVID-19 pandemic) and characteristics of late presenters (LP: CD4 ≤350 cells/mm³ or an AIDS defining event) and late presenters with advanced disease (LPAD: CD4 <200 cells/mm³) were describe. Associations between dependent (LP, LPAD) and independent variables were assessed using univariate/multivariate regression tests and presented as odds ratios (95% confidential interval). Of 1585 individuals (93.7% men), 42.5% were LPs and 19.3% were LPADs. Most common route of transmission was sex between men (54.3%). Non-LPs were younger (30 vs. 34 and 36 years; p < 0.001) and included more men who have sex with men (60.3% vs. 46.3% and 39.5%; p < 0.001). Factors associated with being LP and LPAD were age >30 years, heterosexual/unknown route of transmission (vs. sex between men), diagnosis in 2008-2013 or 2020-2021, (vs. 2014-2019). With reference to Turkish subjects, migrants from Africa had higher odds of being LPAD. LP is still an important health issue in HIV care. Heterosexuality, older age (>30 years), migration from Africa, and the COVID-19 pandemic are associated with delays in HIV presentation in Turkey. These factors need to be considered when developing and implementing policies to enable earlier diagnosis and treatment of PLHIV to achieve UNAIDS 95-95-95 targets.

Introduction: Sustained virologic response in the treatment of chronic hepatitis C can be achieved with direct-acting antivirals (DAA) in recent years. Monitoring virologic and histologic response to treatment is essential and noninvasive methods are preferred. In our study, we aimed to determine the regression of fibrosis following DAA treatment with serum fibrosis indices constituting a noninvasive method. Method: Patients with chronic hepatitis C to whom DAA treatment is started between January 2016 and January 2018 in our clinic are evaluated retrospectively. The fibrosis scores [fibrosis 4 index (FIB-4), aminotransferase platelet ratio (APRI), Fibro QKing score, age platelet index, Goteburg University Cirrhosis Index (GUCI), aspartate transaminase/alanine transaminase ratio (AAR)] are calculated with routine biochemical and hematologic tests of DAA-treated patients before treatment, at the end of treatment, and in the 12th and 24th weeks of treatment. In total, the course of seven scores calculated at four separate times including baseline was recorded and compared.ResultsIn total 91 patients are included in the study. The average age was 51.16 +/- 13.78 and 59.3% (n = 54) of patients were women. According to the baseline FIB-4 values, the patients were grouped as cirrhotic or noncirrhotic, and 11 of them were cirrhotic (12.1%). Statistically significant regression in APRI, FIB-4, GUCI and King scores is seen in all groups regardless of their cirrhotic status, treatment experience or genotype (P < 0.001). Specified scores had a positive, significant correlation with pretreatment biopsy results [area under curve (AUC): 0.800, 0.782, 0.749 and 0.746].Conclusion:APRI, FIB-4, GUCI and King scores that have a positive correlation with biopsy can also be used for fibrosis recovery follow-up after treatment with DAAs.

Objectives: Adherence to antiviral treatment is important for treatment success and prevention of resistance. It was aimed to determine treatment adherence to nucleoside/nucleotide analogs and factors influencing on adherence. Methods: The study included 168 patients who received oral nucleoside/nucleotide analog with diagnosis of chronic hepatitis for at least 1 year. Data regarding demographic characteristics and missed drug were collected using a survey, while list of medication within prior year were extracted from pharmacy registry and Medication Possession Rate (MPR) was calculated. Results: There were 60 women (35.7%) and 108 men (64.3%) in the study. Mean age was calculated as 43.61±10.35 years. It was found that 29.2% of patients were non-adherent based on MPR (MPR<0.90). It was observed that adherence was improved on middle age. Treatment adherence was found to be higher in patients receiving medication due to disorders other than hepatitis B. It was found that there was no significant difference in adherence according to age, gender, occupation status, marital status, smoking or alcohol consumption habits, type of antiviral treatment, time and mode of drug intake, and biopsy finding at time of drug prescription. The most common cause was identified as forgetfulness for missed drug. Other common causes were inoccupation and alteration in daily routine. Conclusion: In our study, the treatment adherence determined by MPR was 70.8%. This rate was lower than those reported for chronic hepatitis B in the literature. It is important to monitor and encourage treatment adherence in patients with chronic hepatitis B by clinicians.

Aims: The COVID-19 pandemic has substantially changed lives and presented several barriers to health services. HIV care continuum needs a high rate of diagnosis, effective treatment, and sustained suppression of viral replication. The COVID-19 pandemic has affected these three steps of HIV care. This study investigated the characteristics of newly diagnosed patients living with HIV/AIDS (PLWH) during the COVID pandemic and compared them with those before the pandemic. Methods: All newly diagnosed patients in three HIV healthcare centers, in Istanbul, Turkey, were included in the study. The pandemic period included April 1, 2020, to April 1, 2021, and the pre-pandemic period included March 1, 2019, to March 1, 2020. Results: 756 patients were diagnosed with HIV/AIDS. In the pandemic period, this figure was 58% less: 315. Patients in the pre-pandemic and pandemic period had comparable age and gender distributions. PLWH diagnosed in the pandemic period had higher rates of low CD4 cells: low CD4 (<350 cells /mm(3)) was measured in 243 (36.4%) patients in the pre-pandemic period, while it was done in 126 (47.9%) in the pandemic period (p<0.01). Also, the distribution of CD4 cells was significantly different between periods: In the pandemic period, CD4 cell distribution significantly skewed to lower CD4 categories. Symptomatic patient rates and AIDS-defining disorder rates among symptomatic patients were comparable. Viral loads were not significantly different in the two periods. Conclusion: A low number of newly diagnosed PLWH can be explained by less HIV testing, less admission to health care, or an actual decrease of HIV prevalence during the pandemic. Sexual behaviors may have changed during the COVID-19 pandemic, leading to HIV transmission restriction. Lower CD4 counts among the newly diagnosed PLWH suggest that admittance to health care is late and a significant portion of PLWH remain undiagnosed.

Objectives: Our aim is to determine prevalence, severity, duration of otorhinolaryngologic symptoms related to coronavirus disease 2019 (COVID-19), and correlation between the test results obtained by oronasopharyngeal swab and the symptoms of these regions by evaluating differences in ear, nose, and throat (ENT) symptoms between laboratory- confirmed COVID-19 patients and clinically and computed tomography (CT)-diagnosed COVID-19 patients. Methods: The study enrolled patients with a positive polymerase chain reaction (PCR) test diagnosed with COVID-19 that grouped as PCR (+), and those with repeated negative PCR tests but COVID-19 Reporting and Data System (CO-RADS) chest CT findings with high (CO-RADS 5) or very high (CO-RADS 6) similarity to COVID-19 that grouped as PCR(-)/CT(+). Demographic features, general symptoms, and otorhinolaryngological symptoms and severity of disease were evaluated and compared. Results: The most common ENT symptoms in the PCR(+) group were loss of taste (n=77), loss of smell, and sore throat with respective frequencies of 34.5%, 31.8%, 26.0%, and in PCR(-) CT (+) group loss of taste, loss of smell, and sore throat with respective frequencies 24.6%, 21.1%, and 18.4%. ENT symptom rates were found higher in PCR (+) group (65.0%) according to PCR(-)/CT(+) group (49.1%) with statistically significant difference (p=0.008). Loss of smell rates were found higher in PCR (+) group according to PCR(-)/CT(+) group with statistically significant difference (p=0.037). Conclusion: Loss of smell and taste were most common ENT symptoms in laboratory-confirmed COVID-19 cases. The presence of COVID-19 should definitely be considered in patients presenting with sudden loss of smell or taste. In addition, loss of smell and otolaryngologic symptoms were more common in laboratory-confirmed COVID-19 according to clinically and computed tomograpy diagnosed COVID-19 cases. There can be a correlation between positive sample region and symptom region. Location of symptoms must be considered for decision of sampling location.

Objective:In the determination and monitoring of neurocognitive disorders in human immunodeficiency virus (HIV)-positive individuals, there is a need for significantly more practical methods which provide results in a shorter time than the tests that require challenging and specialized expertise. This study aimed to evaluate cognitive functions and the factors affecting them in naïve HIV-positive patients using by Montreal Cognitive Assessment (MoCA) test before and after the initiation of combination antiretroviral therapy.Materials and Methods:HIV-positive, treatment-naïve patients monitored between January-June 2017 were included in the study. The MoCA test was performed at the beginning and the sixth month of the treatment.Results:Forty male patients were included in the study. The mean age was calculated as 29.1±4.0. When the factors affecting the MoCA score were examined, there was a significant relationship between the education level and the MoCA score. Smoking, using alcohol, and substance did not have a significant impact on baseline MoCA values. A significant correlation was found between cluster differentiation 4 (CD4) count and HIV RNA level and attention function. There was a significant increase in the total MoCA score and the MoCA subgroup scores at the end of the sixth month of the treatment.Conclusion:MoCA test is one of the most practical tests that can be applied in a short time period, and it was found useful in evaluating the changes in the cognitive functions of HIV-positive patients during antiretroviral treatment.