BACKGROUND:Entecavir (ETV), tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF) are widely used in the treatment of chronic hepatitis B (CHB). This study aimed to investigate the blood lipid profile of CHB patients using these three drugs. METHODS:This Türkiye-wide retrospective cohort study included individuals who were older than 18 years of age, treatment-naive and were diagnosed with CHB for at least 1 year after 2010. The study aimed to evaluate the 48-month lipid profile changes of patients taking antivirals. RESULTS:In total, 1912 cases (ETV 756 [39.3%], TDF 1082 [56.3%] and TAF 74 [3.8%]) diagnosed with CHB and receiving antiviral treatment were included. There was no difference between the three drug groups in terms of age and comorbidities (P>0.05). While there was no difference in the initial total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides (TG) values between the three groups, all values were significantly lower in the TDF group in the first year (P<0.05). While TG, LDL and TC values were significantly lower in the TDF group in the second year (P<0.05), there was no difference in HDL and HDL/CHOL (P>0.05). CONCLUSIONS:TDF causes a decrease in LDL levels, TC and total cholesterol/HDL ratio. However, use of ETV and TAF did not significantly affect the lipid profile. It should not be forgotten that lipid profile changes may cause metabolic health problems in individuals receiving hepatitis B treatment and appropriate treatment should be planned by regular monitoring according to treatment groups.

Background/Aims:Despite the widespread use of direct-acting antivirals (DAAs), real-world data on treatment outcomes and predictors of response in hepatitis C virus (HCV) genotypes 2 and 3 remain limited, particularly in countries with heterogeneous patient populations such as Türkiye. This study evaluates the efficacy and safety of direct-acting antivirals (DAAs) in treating hepatitis C virus (HCV) genotype 2 (GT-2) and genotype 3 (GT-3) in Türkiye. Materials and Methods:This cohort is a multicenter, retrospective, and observational study. Data from 267 GT-2 or GT-3 patients treated with a DAA were analyzed. Treatment efficacy was assessed by sustained virological response at 12 weeks after the end of treatment (SVR), and baseline demographic, clinical, and laboratory parameters were evaluated to identify factors associated with treatment response. Results:An overall sustained virological response (SVR) rate of 95.9%, with no significant difference between GTs. The SVR rates were relatively lower in patients with cirrhosis. Prior pegylated interferon and ribavirin reduced SVR rates, particularly in males and patients with cirrhosis. The most common treatments were sofosbuvir-based regimens, which demonstrated comparable efficacy. No significant drug interactions were observed. The most commonly reported adverse events were fatigue and mild anemia, particularly in cirrhotic patients; however, these did not lead to treatment discontinuation. Conclusion:This study supports the efficacy and tolerability of DAA regimens for these HCV GTs, thereby reinforcing their role in HCV eradication.

Objectives: This study aimed to investigate the seroprevalence of hepatitis E virus (HEV) and chronic HEV infection in patients with confirmed human immunodeficiency virus (HIV)-1 infection. Materials and Methods: This prospective single-center study included a sample of 101 patients aged 18-84 years who were admitted to Hatay Mustafa Kemal University Hospital between May 2022 and December 2022 with a confirmed diagnosis of HIV-1 infection. From the blood samples collected for the study, anti-HEV immunoglobulin M (IgM) [HEV IgM enzyme-linked immunosorbent assay (ELISA), DiaPro, Italy] and anti-HEV immunoglobulin G (IgG) (HEV IgG ELISA, DiaPro, Italy) were evaluated using the microplate ELISA method. Ribonucleic acid (RNA) was extracted from plasma samples using a Qiagen virus kit (Qiagen EZ1 automated system, Germany). HEV-RNA was tested using an in-house reverse transcription polymerase chain reaction for all samples included in the study. In addition, HIV-RNA, CD4+T cell count, hepatitis B surface antigen (HbsAg), anti-hepatitis C virus (HCV), antihepatitis A virus (HAV) IgG, aspartate transaminase (AST), alanine transaminase (ALT), total bilirubin (TBIL), and venereal disease research laboratory (VDRL) parameters were obtained from the hospital automation system. Results: Anti-HEV IgG seropositivity was 3.96% (n=4). HEV-RNA was analyzed from all samples, but no HEV-RNA positivity was detected. There was no significant difference between the antiHEV IgG (+) and anti-HEV IgG (-) group in terms of HIV-RNA level, CD4+T cell count, ALT, AST, alkaline phosphatase, gamma-glutamyl transpeptidase, and TBIL levels. Anti-HAV IgG seropositivity was observed in 89.1% (n=90) of the patients included in our study, HbsAg seropositivity was observed in 1.0% (n=1), and HCV seropositivity was not observed. VDRL seropositivity was observed in 11.9% (n=12) of the patients. Conclusion: Although our findings showed that HEV seroprevalence was not high in HIV-positive patients and did not develop into chronic infection, we believe that multicenter studies with a larger number of patients are needed to investigate the relationship between HIV and HEV in our country.

Objective: Parasitic infections are more frequently observed in immunosuppressed cases, such as those infected with human immunodeficiency virus (HIV). Furthermore, compared to immunocompetent cases, a more severe clinical course is observed in the immunosuppressed patient group. HIV-positive individuals have increased pathogenicity of parasites and may exhibit a wide range of clinical symptoms of varying severity that may result in mortality. Visceral leishmaniasis (VL) is a vector-borne disease and an important opportunistic infection seen in HIV/Acquired Immune Deficiency Syndrome (AIDS) cases, most notably in Southern Europe and Africa, where both infections are endemic. Several parasites namely toxoplasmosis, cryptosporidiosis, isosporiasis, cyclosporiasis, amebiasis, giardiasis, plasmodium, and strongyloidiasis are infections posing significant risk factors for these patient groups. Materials and Methods: In this study, visceral leishmaniasis was investigated serologically in serum samples and parasitic infections were analyzed by conventional methods in fecal samples from HIV-positive cases. Results: 5 of the 42 cases included in the study were female. The mean age of these cases was 38.7 years (19-66). Blastocystis spp was detected in 5 fecal samples obtained from HIV-positive cases. The rK39 dipstick test with serum samples yielded a very weak band in one case, while none of the other tests yielded a positive band. Conclusion: The regional prevalence of these latent infections, which can be subclinical in HIV-positive patients, is important to know. However, the literature lacks sufficient data on the situation in Turkey. In this study, the prevalence of enteric parasitic infections in people with HIV infection in our region was found to be low and VL was not detected.

Amaç: Bu çalışma ile COVID-19 enfeksiyonu olan ve olmayan olgular arasında Hepatit A virüsüne karşı kazanılmış immün yanıt düzeyi açısından fark bulunup bulunmadığının irdelenmesi amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif, kesitsel, tek merkez çalışmasına kliniğimizde 1 Haziran 2020-1 Eylül 2020 tarihleri arasında COVID-19 hastalığı (PCR pozitifliği ile doğrulanmış) nedeniyle takip edilmiş 50 olgu dahil edildi. Benzer demografik özelliklere sahip olan, salgın öncesindeki son iki yılda (1 Kasım 2017–1 Kasım 2019) kliniğimize başvuruları sırasında Anti HAV IgG düzeyleri belirlenmiş olgular arasından rastlantısal olarak seçilen toplam 150 olgu ise kontrol grubu olarak alındı. Bu iki grup arasında Anti-HAV IgG seropozitiflik oranları ile serum antikor titreleri karşılaştırıldı. Bulgular: Çalışmaya dahil edilen toplam 200 olgunun ortanca yaşı 48.5 (IQR=43.0-59.0) yıl olup, 108’i (%54) erkek, 92’si (%46) kadındı. Olguların 142’si (%71) 60 yaş ve üzerinde idi, ancak hasta grupları içerisindeki 60 yaş ve üzeri olguların oranı benzerdi (p=0.105). COVID-19 olgularındaki Anti-HAV IgG seropozitifliği oranları kontrol grubundaki olgularla benzer olmakla birlikte (p=0.062), COVID-19 olgularındaki anti HAV IgG titrelerinin, kontrol olgularındakine göre anlamlı oranda daha düşük olduğu görüldü (p<0.001). Anti-HAV IgG titrelerinin kritik seyirli COVID-19 olgularında (n=7), diğer COVID-19 olgularına (n=43) göre anlamlı oranda daha düşük olduğu görüldü (p=0.049). Buna ek olarak anti-HAV titresi ile kritik COVID-19 hastalığı varlığı arasında anlamlı ve güçlü düzeyde bir ilişki olduğu (η=0.988) görüldü. Sonuç: Sonuçlarımız HAV aşısı veya geçirilmiş HAV enfeksiyonu varlığının COVID-19 enfeksiyonunda, özellikle kritik hastalık seyrinin önlenmesi açısından, koruyucu olabileceğini göstermektedir.

Chickenpox is an infectious disease caused by the varicella zoster virus (VZV). VZV causes two different clinical pictures, chickenpox and shingles. Chickenpox is a preventable, benign disease with a vesicular rash, but it can cause life-threatening organ involvement such as pneumonia. Pneumonia is more common and dangerous in pregnant women. The importance of history and clinical findings in diagnosis is indisputable. Isolation of VZV from vesicular fluid is the gold standard in laboratory diagnosis. From body fluids, detection of VZV nucleic acid by Polymerase Chain Reaction (PCR) and antigen by Direct Immunofluorescent antibody (DFA) is sensitive and specific. Detection of IgM and IgG by serological methods such as Enzyme-Linked Immunosorbet Assay (ELISA), Enzyme Linked Florencent assay (ELFA) is used for diagnosis. In severe and atypical cases, RT-PCR is the appropriate method to rapid demonstration of VZV. Demonstrating VZV IgM and IgG positivity with serological methods such as ELISA and ELFA is also important for the diagnosis of acute chickenpox. Reducing complications, antiviral treatment and supportive treatment are the cornerstones of chickenpox management. Here, we wanted to share a pregnant case who had not had chickenpox/shingles before, had no history of contact with chickenpox, had not been vaccinated against chickenpox, and developed pneumonia due to varicella without skin and mucous membrane involvement.

Denguefever is a viral disease seen as imported cases in Turkiye. Mosquitoes of the genus Aedes (A. aegytiand, A. alboptticus) serve as vectors. The flaviviridea a family is a RNA virus in the genus flavivirus. The incubation period is 3-14 days. There are four different serotypes: DENV-1, DENV-2, DENV-3, and DENV-4. Infection with any serotype can occur. It is the most important step for diagnosis, especially, in cases traveling to endemic regions in Turkiye. Warning symptoms such as fever, headache, retrobulbar pain, myalgia, jointpain, rash (macular, papular, petechiae, purpura) are important in early diagnosis. RT-PCR from serum makes a definitive diagnosis. DENV IgM positivity and four-fold increase in DENV IgG also make the diagnosis. The main treatment is supportive treatment. There is no specific antiviral treatment. There is a vaccine licensed as Dengvaxia for people in the risk group. In our study, we wanted to share our two cases of Dengue fever, which is likely to be confused with malaria, in the Hatay region, where imported malaria cases are common.

Parasitic infections are more frequently observed in immunosuppressed cases, such as those infected with human immunodeficiency virus (HIV). Furthermore, compared to immunocompetent cases, a more severe clinical course is observed in the immunosuppressed patient group. HIV-positive individuals have increased pathogenicity of parasites and may exhibit a wide range of clinical symptoms of varying severity that may result in mortality. Visceral leishmaisis (VL) is a vector-borne disease and an important opportunistic infection seen in HIV/AIDS cases, most notably in Southern Europe and Africa, where both infections are endemic. Several parasites namely toxoplasmosis, cryptosporidiosis, isosporiasis, cyclosporiasis, amebiasis, giardiasis, plasmodium, and strongyloidiasis are infections posing significant risk factors for these patient groups. In this study, visceral leishmaniasis was investigated serologically in serum samples and parasitic infections were analyzed by conventional methods in fecal samples from HIV-positive cases. 5 of the 42 cases included in the study were female. The mean age of these cases was 38.7 years (19-66). Blastocystis spp was detected in 5 fecal samples obtained from HIV-positive cases. The rK39 dipstick test with serum samples yielded a very weak band in one case, while none of the other tests yielded a positive band. As a result, the regional prevalence of these latent infections, which can be subclinical in HIV-positive patients, is important to know. However, the literature lacks sufficient data on the situation in Turkey. In this study, the prevalence of enteric parasitic infections in people with HIV infection in our region was found to be low and VL was not detected.

Nötropenik enterokolit çoğunlukla akut lösemili hastalar gibi mukozal hasarı indükleme potansiyeli yüksek hastalığı olanları ve yoğun kemoterapötik rejimleri alan hastaları etkilemektedir. Burada kemoterapi devamında ateş, karın ağrısı, bulantı, kusma, karında şişkinlik, ishal, ağız içinde yara şikayetleri ile başvuran, batın BT’ de diffüz duodenum duvar kalınlaşması saptanan 34 yaşında akut lenfoblastik lösemi tanılı nötropenik enterokolit olgusu sunulmuştur. Olgumuzu sunmaya değer kılan duodenal bölge tutulumu ile seyreden nötropenik enterokolit olmasıdır.

Nötropenik enterokolit çoğunlukla akut lösemili hastalar gibi mukozal hasarı indükleme potansiyeli yüksek hastalığı olanları ve yoğun kemoterapötik rejimleri alan hastaları etkilemektedir. Burada kemoterapi devamında ateş, karın ağrısı, bulantı, kusma, karında şişkinlik, ishal, ağız içinde yara şikayetleri ile başvuran, batın BT' de diffüz duodenum duvar kalınlaşması saptanan 34 yaşında akut lenfoblastik lösemi tanılı nötropenik enterokolit olgusu sunulmuştur. Olgumuzu sunmaya değer kılan duodenal bölge tutulumu ile seyreden nötropenik enterokolit olmasıdır.

Abstract Objectives The aim of this study was to evaluate the relationship between systemic oxidative balance, and the severity of the disease in patients with COVID 19. Methods Sixty-four patients were divided into three groups according to the severity of the disease: mild (n=28), moderate (n=11) and severe (n=25). Twenty-four healthy controls included to the study. Proinflammatory cytokines (IL-6 and TNF-α), D-dimer, fibrinogen, total oxidative status (TOS), total antioxidant status (TAS) were measured and oxidative stress index (OSI) was calculated. Results The mean age of severe group was significantly higher than the other groups (p=0.001). TAS levels were significantly decreased in all patient groups compared to controls, while serum TOS and OSI levels were significantly different in all three stages of the disease. Serum IL-6 and TNF- α levels were significantly elevated in severe group compared to other groups. TOS and OSI levels were also significantly correlated with IL-6, CRP, ferritin, fibrinogen, LDH and D-dimer. Conclusions TOS and OSI levels are an indicator of systemic oxidative balance in COVID-19 and related to the disease severity. They can be an important marker for evaluating the disease severity and used in the management of patients with COVID-19.