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Arslan E, Yildiz Y, Karaşahin Ö, Demir Y, Tümbül Mermutluoğlu Ç, Ünlü G, Kuşçu F, Kaya Ş, Akgül F, Damar Çakirca T, Yilmaz Karadağ F, Altunişik Toplu S, Nazik S, Akdemir İ, Özer Balin Ş, Kandemir FÖ, İnan D, Bayindir Y, Taşova Y, Çelen MK. Evaluation of chronic hepatitis B patients who voluntarily discontinued oral antiviral therapy: is there an answer to the controversial topic? Eur J Gastroenterol Hepatol 2024; 36:438-444. [PMID: 38407855 DOI: 10.1097/meg.0000000000002722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
OBJECTIVE The uncertain treatment duration for nucleos(t)ide analogues (NA) used in the treatment of chronic hepatitis B (CHB) is an important problem for both patients and physicians. The aim of this study was to evaluate the determinants of virologic relapse (VR) and the optimum time of treatment discontinuation in the follow-up of CHB patients who voluntarily discontinued treatment after virological suppression was achieved under NA use. METHODS Data from 138 patients from 11 centers were included in this registry-based study. Factors associated with VR were investigated using multivariate Cox regression analysis. RESULTS Ninety-nine (71.7%) of the patients were HBeAg (Hepatitis B e antigen) negative. During the 24-month follow-up period after treatment discontinuation, VR occurred in 58.7% (n = 81) of all patients and 57.6% (n = 57) of HBeAg-negative patients. The duration of NA treatment was significantly shorter (cutoff 60 months) in HBeAg-negative patients who later developed VR. In addition, the duration of virologic remission achieved under NA treatment was significantly shorter (cutoff 52 months) in those who later developed VR. In the Cox multivariate regression model of HBeAg-negative patients, having less than 60 months of NA treatment (HR = 2.568; CI:1.280-5.148; P = 0.008) and the levels of alanine aminotransferase being equal to or higher than twice the upper level of normal at the beginning of treatment (HR = 3.753; CI:1.551-9.081; P = 0.003) were found to be statistically significant and independently associated with VR. CONCLUSION The findings of this study may provide clinical guidance in terms of determining the most appropriate discontinuation time for NA.
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Affiliation(s)
- Eyüp Arslan
- Department of Infectious Diseases and Clinical Microbiology, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul
| | - Yeşim Yildiz
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Faculty of Medicine, Ankara
| | - Ömer Karaşahin
- Department of Infectious Diseases and Clinical Microbiology, Erzurum Regional Training and Research Hospital, Erzurum
| | - Yakup Demir
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakir
| | - Çiğdem Tümbül Mermutluoğlu
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakir
| | - Gülten Ünlü
- Department of Infectious Diseases and Clinical Microbiology, Derince Training and Research Hospital, Kocaeli
| | - Ferit Kuşçu
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana
| | - Şafak Kaya
- Department of Infectious Diseases and Clinical Microbiology, Gazi Yasargil Training and Research Hospital, Diyarbakir
| | - Fethiye Akgül
- Department of Infectious Diseases and Clinical Microbiology, Batman Regional State Hospital, Batman, Turkey
| | - Tuba Damar Çakirca
- Department of Infectious Diseases and Clinical Microbiology, Şanliurfa Training and Research Hospital, Şanliurfa
| | - Fatma Yilmaz Karadağ
- Department of Infectious Diseases and Clinical Microbiology, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul
| | - Sibel Altunişik Toplu
- Department of Infectious Diseases and Clinical Microbiology, Inonu University Faculty of Medicine, Malatya
| | - Selçuk Nazik
- Department of Infectious Diseases and Clinical Microbiology, Sütçü İmam University Faculty of Medicine, Kahramanmaraş
| | - İrem Akdemir
- Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara
| | - Şafak Özer Balin
- Department of Infectious Diseases and Clinical Microbiology, Fırat University Faculty of Medicine, Elazığ
| | - Fatma Özlem Kandemir
- Department of Infectious Diseases and Clinical Microbiology, Mersin University Faculty of Medicine, Mersin
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Yaşar Bayindir
- Department of Infectious Diseases and Clinical Microbiology, Inonu University Faculty of Medicine, Malatya
| | - Yeşim Taşova
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana
| | - Mustafa Kemal Çelen
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakir
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Çelen MK, Ertürk Şengel B, Kaya Ş, Demirtürk N, Azap A, Pullukçu H, Eroğlu E, Yıldırım F, Barut HŞ, Zerdali E, Sağmak Tartar A, Mete AÖ, Şahin AM, Mutay Suntur B, Sarı ND, Yılmaz E, Candevir A, Şimşek F, İnan D, Akhan S, Asan A, Günal Ö, Ural O, Parlak M, Çabalak M, Nazik S, Hızel K, Kınıklı S, Beştepe Dursun Z, Batırel A, Mermutluoğlu Ç. Treatment initiation rates of patients with positive anti-hepatitis C virus results in tertiary hospitals in Turkey. J Infect Dev Ctries 2024; 18:441-449. [PMID: 38635621 DOI: 10.3855/jidc.17910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/31/2023] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION The aim of this national, multicenter, cross-sectional, retrospective chart review study was to determine the proportion of patients in Turkey who received hepatitis C virus (HCV) treatment after receiving positive anti-HCV results during HCV screening. METHODOLOGY Data related to patients' demographics, laboratory results, time interval from obtaining a positive anti-HCV result to treatment initiation, specialty of the physician requesting anti-HCV screening, and type of hospital were analyzed. RESULTS Among 1,000 patients who received a positive anti-HCV result, 50.3% were male and 78.5% were screened for HCV-RNA. Among HCV-RNA screened patients, 54.8% (n = 430) had a positive result. Among patients who tested positive for HCV-RNA, 72.8% received HCV treatment in line with their positive anti-HCV results. The median time from obtaining a positive anti-HCV result to initiation of HCV treatment was 91.0 days (interquartile range 42.0 to 178.5). Non-surgical branches requested HCV-RNA testing more frequently than surgical branches (p < 0.001). The rate of access to HCV treatment was higher among patients screened in university hospitals than among patients screened in training and research hospitals (p < 0.001). CONCLUSIONS Our results indicate a higher rate of treatment initiation among patients with HCV infection than is described in the published literature. Furthermore, the time from screening to treatment initiation was considerably shorter compared with other international studies. However, since HCV-RNA testing was not requested in a significant portion of patients with a positive anti-HCV test result, there might be a large patient population with HCV who do not receive treatment.
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Affiliation(s)
- Mustafa K Çelen
- Department of Infectious Diseases, Dicle University Medical Faculty, Diyarbakır, Turkey
| | - Buket Ertürk Şengel
- Department of Infectious Diseases, Pendik Training and Research Hospital, İstanbul, Turkey
| | - Şafak Kaya
- Department of Infectious Diseases, Sağlık Bilimleri University Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - Neşe Demirtürk
- Department of Infectious Diseases, Afyonkarahisar Sağlık Bilimleri University Medical Faculty, Afyonkarahisar, Turkey
| | - Alpay Azap
- Department of Infectious Diseases and Clinical Microbiology, İbn-i Sina Research and Application Hospital, Ankara University Medical Faculty, Ankara, Turkey
| | - Hüsnü Pullukçu
- Department of Infectious Diseases and Clinical Microbiology, Ege University Medical Faculty, İzmir, Turkey
| | - Esma Eroğlu
- Department of Infectious Diseases, Konya Meram State Hospital, Konya, Turkey
| | - Figen Yıldırım
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Hüseyin Ş Barut
- Department of Infectious Diseases, Gaziosmanpaşa University Research and Application Hospital, Tokat, Turkey
| | - Esra Zerdali
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Ayşe Sağmak Tartar
- Department of Infectious Diseases, Fırat University Medical Faculty, Elazığ, Turkey
| | - Ayşe Ö Mete
- Department of Infectious Diseases, Gaziantep University Şahinbey Research and Application Hospital, Gaziantep, Turkey
| | - Ahmet M Şahin
- Department of Infectious Diseases, Giresun University Prof. Dr. A. İlhan Özdemir Training and Research Hospital, Giresun, Turkey
| | - Bedia Mutay Suntur
- Department of Infectious Diseases, Adana City Training and Research Hospital, Adana, Turkey
| | - Nagehan D Sarı
- Department of Infectious Diseases and Clinical Microbiology, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Emel Yılmaz
- Department of Infectious Diseases and Clinical Microbiology, Bursa Uludağ University Medical Faculty, Bursa, Turkey
| | - Aslıhan Candevir
- Department of Infectious Diseases and Clinical Microbiology, Adana Çukurova University Hospital, Adana, Turkey
| | - Funda Şimşek
- Department of Infectious Diseases and Clinical Microbiology, Prof. Dr. Cemil Taşcıoğlu City Hospital, İstanbul, Turkey
| | - Dilara İnan
- Department of Infectious Diseases, Akdeniz University Hospital, Antalya, Turkey
| | - Sıla Akhan
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University Research and Application Hospital, Kocaeli, Turkey
| | - Ali Asan
- Department of Infectious Diseases, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Özgür Günal
- Department of Infectious Diseases and Clinical Microbiology, Sağlık Bilimleri University Samsun Training and Research Hospital, Samsun, Turkey
| | - Onur Ural
- Department of Infectious Diseases, Selçuk University Medical Faculty, Konya, Turkey
| | - Mehmet Parlak
- Department of Infectious Diseases and Clinical Microbiology, Atatürk University Medical Faculty Hospital, Erzurum, Turkey
| | - Mehmet Çabalak
- Department of Infectious Diseases, Mustafa Kemal University Research and Application Hospital, Hatay, Turkey
| | - Selçuk Nazik
- Department of Infectious Diseases, Kahramanmaraş Sütçü İmam University Research and Application Hospital, Kahramanmaraş, Turkey
| | - Kenan Hızel
- Department of Infectious Diseases, Gazi University Medical Faculty Hospital, Ankara, Turkey
| | - Sami Kınıklı
- Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Zehra Beştepe Dursun
- Department of Infectious Diseases and Clinical Microbiology, Kayseri City Training and Research Hospital, Kayseri, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases, Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Çiğdem Mermutluoğlu
- Department of Infectious Diseases, Dicle University Medical Faculty, Diyarbakır, Turkey
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Büyüktuna SA, Öksüz C, Tahmaz A, Sarıgül Yıldırım F, Türken M, Günal Ö, Topal Ş, Baran Aİ, Sarıkaya B, Çelik Ekinci S, Kaya S, Alkan Çeviker S, Aypak A, Yürük Atasoy P, İnan D, Köse A, Koç İnce N, Şenbayrak S, Kaya Ş, Özgüler M, Dindar Demiray EK, Köse Ş. [Distribution of the Prevalence of Human Leukocyte Antigen (HLA)-B*57:01 Positivity in HIV-1 Infected Individuals and Its Effects on Treatment: Türkiye Map-Buhasder Working Group]. MIKROBIYOL BUL 2024; 58:29-38. [PMID: 38263938 DOI: 10.5578/mb.20249903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Human immunodeficiency virus (HIV)/acquired immundeficiency syndrome (AIDS) is a critical global public health problem that significantly affects both life expectancy and the overall quality of life of individuals in all age groups. The landscape of HIV infection has changed significantly in recent years due to the introduction of effective combination antiretroviral therapies (ART). A key component of first-line ART regimens for HIV treatment is abacavir, a nucleoside HIV reverse transcriptase inhibitor. Although abacavir is effective in suppressing viral replication and managing disease, its clinical utility is overshadowed by the potential for life-threatening hypersensitivity reactions in HLA-B*57:01-positive patients. In our country, local data obtained from various centers regarding the prevalence of HLA-B*57:01 in HIV-1-infected patients are available. In this study, it was aimed to determine the prevalence of the HLA-B*57:01 genotype in HIV-infected patients who were followed up and treated in many regions of our country. This retrospective study consists of the data of the patients aged 18 years and over diagnosed with HIV-1 infection between 01.01.2019 and 31.07.2022. Age, gender, place of birth, mode of transmission of the disease, death status, CD4+ T cell count and HIV RNA levels at the first clinical presentation, HLA-B*57:01 positivity, and the method used, clinical stage of the disease, virological response time with the treatment they received were recorded from the patient files. Data were collected from 16 centers and each center used different methods to detect HLA-B*57:01. These methods were sequence-specific oligonucleotide probe hybridization (SSOP), DNA sequence-based typing (SBT), single-specific primer-polymerase chain reaction (SSP-PCR), allele-specific PCR (AS-PCR) and quantitative PCR (Q-PCR). A total of 608 HIV-infected individuals, 523 males (86%) and 85 females (14%), were included in the study. The mean age of the patients was 36.9 ± 11.9 (18-73) years. The prevalence of HLA-B*57:01 allele was found to be 3.6% (22 patients). The number of CD4+ T lymphocytes in HLA-B*57:01 allele-positive patients was > 500/ mm3 in 10 patients (45.5%), while the number of CD4+ T lymphocytes in HLA-B*57:01 negative patients was > 500/mm3 in 216 patients (36.9%) (p> 0.05). Viral load at the time of diagnosis was found to be lower in patients with positive HLA-B*57:01 allele but it was not statistically significant (p> 0.05). Although different treatment algorithms were used in the centers following the patients, it was observed that the duration of virological response was shorter in HLA-B*57:01 positive patients (p= 0.006). Although the presence of the HLA-B*57:01 allele has a negative impact due to its association with hypersensitivity, it is likely to continue to attract interest due to its association with slower progression of HIV infection and reduced risk of developing AIDS. In addition, although the answer to the question of whether it is cost-effective to screen patients for HLA-B*57:01 before starting an abacavir-containing ART regimen for the treatment of HIV infection is being sought, it seems that HIV treatment guidelines will continue to recommend screening to identify patients at risk in this regard.
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Affiliation(s)
- Seyit Ali Büyüktuna
- Sivas Cumhuriyet University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Sivas, Türkiye
| | - Caner Öksüz
- Sivas State Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Sivas, Türkiye
| | - Alper Tahmaz
- University of Health Sciences, Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Figen Sarıgül Yıldırım
- Antalya Life Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Melda Türken
- University of Health Sciences İzmir Faculty of Medicine, İzmir City Hospital, Clinic of Infectious Disease and Clinical Microbiology, İzmir, Türkiye
| | - Özgür Günal
- Samsun University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Samsun, Türkiye
| | - Şeyma Topal
- Samsun University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Samsun, Türkiye
| | - Ali İrfan Baran
- Van Yüzüncü Yıl University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Van, Türkiye
| | - Burak Sarıkaya
- University of Health Sciences, Sultan 2nd Abdulhamid Khan Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Semiha Çelik Ekinci
- University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Selçuk Kaya
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Türkiye
| | - Sevil Alkan Çeviker
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Türkiye
| | - Adalet Aypak
- University of Health Sciences, Ankara City Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Ankara, Türkiye
| | - Pınar Yürük Atasoy
- University of Health Sciences, Ankara City Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Ankara, Türkiye
| | - Dilara İnan
- Akdeniz University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Adem Köse
- İnönü University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Malatya, Türkiye
| | - Nevind Koç İnce
- Düzce University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Düzce, Türkiye
| | - Seniha Şenbayrak
- University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İstanbul, Türkiye
| | - Şafak Kaya
- University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Diyarbakır, Türkiye
| | - Müge Özgüler
- University of Health Sciences Hamidiye Faculty of Medicine, Elazığ Fethi Sekin City Health Practice and Research Center, Clinic of Infectious Diseases and Clinical Microbiology, Elazığ, Türkiye
| | | | - Şükran Köse
- Dokuz Eylül University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İzmir, Türkiye
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Sarıgül Yıldırım F, Candevir A, Akhan S, Kaya S, Çabalak M, Ersöz G, İnan D, Ceren N, Karaoğlan İ, Damar Çakırca T, Özer Balin Ş, Alkan S, Kandemir Ö, Üser Ü, Karabay O, Çelen MK. Comparison of Immunological and Virological Recovery with Rapid, Early, and Late Start of Antiretroviral Treatment in Naive Plwh: Real-World Data. Int J Gen Med 2023; 16:1867-1877. [PMID: 37213471 PMCID: PMC10195690 DOI: 10.2147/ijgm.s393370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/01/2023] [Indexed: 05/23/2023] Open
Abstract
Background Rapid initiation of antiretroviral therapy (ART) reduces the transmission of HIV infection in the community. This study aimed to determine whether rapid ART initiation is effective compared to standard ART treatment in our country. Methods Patients were grouped based on time to treatment initiation. HIV RNA levels, CD+4 T cell count, CD4/CD8 ratio, and ART regimens were recorded at baseline and follow-up visits for 12 months. Results There were 368-ART naive adults (treatment initiated at the time of HIV diagnosis; 143 on the first day, 48 on the second-seventh day, and 177 after the seventh day). Although virological suppression rates at 12th months were higher in all groups, over 90% on average, there were no statistically significant differences in HIV-1 RNA suppression rates, CD+4 T cell count, and CD4/CD8 ratio normalization in the studied months but in multivariate logistic regression analysis; showed a significant correlation between both virological and immunological response and those with CD4+ T <350 cells/mL at 12th month in total patients. Conclusion Our findings support the broader application of recommendations for rapid ART initiation in HIV patients.
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Affiliation(s)
- Figen Sarıgül Yıldırım
- Antalya Life Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
- Correspondence: Figen Sarıgül Yıldırım, Antalya Life Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey, Tel +90 532 473 44 46, Email
| | - Aslıhan Candevir
- Cukurova University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Adana, Turkey
| | - Sıla Akhan
- Kocaeli Üniversity, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Kocaeli, Turkey
| | - Selçuk Kaya
- Karadeniz Teknik University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Trabzon, Turkey
| | - Mehmet Çabalak
- Mustafa Kemal University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Hatay, Turkey
| | - Gülden Ersöz
- Mersin University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Mersin, Turkey
| | - Dilara İnan
- Akdeniz University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Nurgül Ceren
- Health Science University, Haydarpaşa Numune Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, İstanbul, Turkey
| | - İlkay Karaoğlan
- Gaziantep University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Gaziantep, Turkey
| | - Tuba Damar Çakırca
- Health Science University, Şanlıurfa Numune Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Şanlıurfa, Turkey
| | - Şafak Özer Balin
- Fırat University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Elazığ, Turkey
| | - Sevil Alkan
- Çanakkale 18 Mart University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Çanakkale, Turkey
| | - Özlem Kandemir
- Mersin University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Mersin, Turkey
| | - Ülkü Üser
- Health Science University, Antalya Education and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Oğuz Karabay
- Sakarya University Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Hatay, Turkey
| | - Mustafa Kemal Çelen
- Dicle University, Medical Faculty, Department of Infectious Diseases and Clinical Microbiology, Diyarbakır, Turkey
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5
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Sarıgül Yıldırım F, Üser Ü, Didem Sarı N, Kurtaran B, Önlen Y, Şenateş E, Gündüz A, Zerdali E, Karsen H, Batırel A, Karaali R, Güner R, Yamazhan T, Köse Ş, Erben N, İnce N, Köksal İ, Çuvalcı Öztoprak N, Yörük G, Kömür S, Bal T, Kaya S, Bozkurt İ, Günal Ö, Esen Yıldız İ, İnan D, Barut Ş, Namıduru M, Tosun S, Türker K, Şener A, Hızel K, Baykam N, Duygu F, Bodur H, Can G, Gül HC, Sağmak Tartar A, Çelebi G, Sünnetçioğlu M, Karabay O, Kumbasar Karaosmanoğlu H, Sırmatel F, Tabak F. In a Real-Life Setting, Direct-Acting Antivirals to People Who Inject Drugs with Chronic Hepatitis C in Turkey. Turk J Gastroenterol 2022; 33:971-978. [PMID: 36415900 PMCID: PMC9797763 DOI: 10.5152/tjg.2022.21834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/12/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. METHODS We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. RESULTS Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). CONCLUSION Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization's objective of eliminating viral hepatitis.
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Affiliation(s)
- Figen Sarıgül Yıldırım
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ülkü Üser
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Nagehan Didem Sarı
- Department of Infectious Diseases, İstanbul Education Research Hospital, İstanbul, Turkey
| | - Behice Kurtaran
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Yusuf Önlen
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Ebubekir Şenateş
- Department of Gastroenterology, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Alper Gündüz
- Department of Infectious Diseases, İstanbul Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Esra Zerdali
- Department of Infectious Diseases, Haseki Education Research Hospital, İstanbul, Turkey
| | - Hasan Karsen
- Department of Infectious Diseases and Clinical Microbiology, Harran University Faculty of Medicine, Şanlıurfa, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases, İstanbul Doctor Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey
| | - Rıdvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Şükran Köse
- Department of Infectious Diseases, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Nevin İnce
- Department of Infectious Diseases and Clinical Microbiology, Düzce University Medical School, Düzce, Turkey
| | - İftihar Köksal
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Teknik University Faculty of Medicine, Trabzon, Turkey
| | - Nefise Çuvalcı Öztoprak
- Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gülşen Yörük
- Department of Infectious Diseases, İstanbul Education Research Hospital, İstanbul, Turkey
| | - Süheyla Kömür
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University Faculty of Medicine, Hatay, Turkey
| | - Tayibe Bal
- Department of Gastroenterology, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Sibel Kaya
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - İlkay Bozkurt
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Özgür Günal
- Department of Infectious Diseases, Samsun Education Research Hospital, Samsun, Turkey
| | - İlknur Esen Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Medical School, Antalya, Turkey
| | - Şener Barut
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Medical Faculty, Tokat, Turkey
| | - Mustafa Namıduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University Medical Faculty, Gaziantep, Turkey
| | - Selma Tosun
- Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Kamuran Türker
- Department of Infectious Diseases, İstanbul Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Kenan Hızel
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Fazilet Duygu
- Department of Infectious Diseases, Ankara Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Hürrem Bodur
- Department of Infectious Diseases, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Güray Can
- Department of Gastroenterology, Bolu İzzet Baysal University Medical Faculty, Bolu, Turkey
| | - Hanefi Cem Gül
- Department of Infectious Diseases, Health Science University Gülhane Faculty of Medicine, Ankara, Turkey
| | - Ayşe Sağmak Tartar
- Department of Infectious Diseases and Clinical Microbiology, Fırat University School of Medicine, Elazığ, Turkey
| | - Güven Çelebi
- Department of Infectious Diseases and Clinical Microbiology, Zonguldak Bülent Ecevit University Training and Research Hospital, Zonguldak, Turkey
| | - Mahmut Sünnetçioğlu
- Department of Infectious Diseases and Clinical Microbiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Oğuz Karabay
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Hayat Kumbasar Karaosmanoğlu
- Department of Infectious Diseases, İstanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Fatma Sırmatel
- Department of Infectious Diseases and Clinical Microbiology, Bolu İzzet Baysal University Medical Faculty, Bolu, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Medical Faculty, Tokat, Turkey
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6
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Önlen Y, Bal T, Çabalak M, Çuvalcı Öztoprak N, Didem Sarı N, Kurtaran B, Şenateş E, Gündüz A, Zerdali E, Karsen H, Batırel A, Karaali R, Güner R, Yamazhan T, Köse Ş, Erben N, İnce N, Köksal İ, Sarıgül Yıldırım F, Yörük G, Kömür S, Kaya S, Esen Ş, Günal Ö, Esen Yıldız İ, İnan D, Barut Ş, Namıduru M, Tosun S, Türker K, Şener A, Hızel K, Baykam N, Duygu F, Akıncı E, Can G, User Ü, Cem Gül H, Akbulut A, Çelebi G, Sünnetçioğlu M, Karabay O, Kumbasar Karaosmanoğlu H, Sırmatel F, Tabak F. Efficacy and Safety of Direct-Acting Antivirals in Elderly Patients with Chronic Hepatitis C: A Nationwide Real-Life, Observational, Multicenter Study from Turkey. Turk J Gastroenterol 2022; 33:862-873. [PMID: 35946896 PMCID: PMC9623221 DOI: 10.5152/tjg.2022.21271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 01/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C. METHODS In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (≥65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups. RESULTS The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P = .879, P = .508 for modified evaluable population and P = .058, P = .788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir+ribavirin had a significantly lower sustained virological response 12 rates (P < .001, P = .047, P = .013, and P = .025, respectively). CONCLUSION Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.
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Affiliation(s)
- Yusuf Önlen
- Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | - Tayibe Bal
- Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | - Mehmet Çabalak
- Mustafa Kemal University Faculty of Medicine, Antakya, Turkey
| | | | | | | | - Ebubekir Şenateş
- Department of Gastroenterology, Medeniyet University Faculty of Medicine, İstanbul, Turkey
| | - Alper Gündüz
- Department of Infectious Diseases, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Esra Zerdali
- Department of Infectious Diseases, Haseki Training and Research Hospital, İstanbul, Turkey
| | - Hasan Karsen
- Department of Infectious Diseases and Clinical Microbiology, Harran University Faculty of Medicine, Urfa, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases, Kartal Training and Research Hospital, İstanbul, Turkey
| | - Rıdvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Rahmet Güner
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Tansu Yamazhan
- Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Şükran Köse
- Department of Infectious Diseases, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Eskişehir Osman Gazi University, Eskişehir, Turkey
| | - Nevin İnce
- Department of Infectious Diseases and Clinical Microbiology, Düzce University Faculty of Medicine, Düzce, Turkey
| | - İftihar Köksal
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Figen Sarıgül Yıldırım
- Department of Infectious Diseases, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gülşen Yörük
- Department of Infectious Diseases, İstanbul Training and Research Hospital, İstanbul, Turkey
| | - Süheyla Kömür
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Sibel Kaya
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Şaban Esen
- Department of Infectious Diseases and Clinical Microbiology, Samsun 19 Mayıs University Faculty of Medicine, Samsun, Turkey
| | - Özgür Günal
- Department of Infectious Diseases, Samsun Training and Research Hospital, Samsun, Turkey
| | - İlknur Esen Yıldız
- Department of Infectious Diseases and Clinical Microbiology, RTE University Faculty of Medicine, Rize, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Şener Barut
- Department of Infectious Diseases and Clinical Microbiology, Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey
| | - Mustafa Namıduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Selma Tosun
- Department of Infectious Diseases, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Kamuran Türker
- Department of Infectious Diseases, Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Çanakkale 18 Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Kenan Hızel
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Fazilet Duygu
- Department of Infectious Diseases, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Esragül Akıncı
- Department of Infectious Diseases, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Güray Can
- Department of Gastroenterology, Bolu İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Ülkü User
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Hanefi Cem Gül
- Department of Infectious Diseases, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Ayhan Akbulut
- Department of Infectious Diseases and Clinical Microbiology, Fırat University Faculty of Medicine, Elazığ, Turkey
| | - Güven Çelebi
- Department of Infectious Diseases and Clinical Microbiology, Bülent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Mahmut Sünnetçioğlu
- Department of Infectious Diseases and Clinical Microbiology, Yüzüncü Yıl University Faculty of Medicine, Van, Turkey
| | - Oğuz Karabay
- Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, Hatay, Turkey
| | | | - Fatma Sırmatel
- Department of Infectious Diseases and Clinical Microbiology, Bolu İzzet Baysal University Faculty of Medicine, Bolu, Turkey
| | - Fehmi Tabak
- İstanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty of Medicine, İstanbul, Turkey
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7
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Özel T, Erdem N, Ünal A, Yalçın A, İnan D, Ilhanli N, Uysal H. Neurological manifestations and mortality in hospitalized coronavirus disease 2019 patients. NEUROL SCI NEUROPHYS 2022. [DOI: 10.4103/nsn.nsn_117_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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8
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Tabak F, Şirin G, Demir M, Aladağ M, Sümer Ş, Kurtaran B, Tosun S, Yamazhan T, Bozkurt İ, Gürbüz Y, Batırel A, Şenateş E, Kandemir FÖ, Topal F, Doğanay HL, Sezgin O, Mıstık R, Köse Ş, Yılmaz Y, İnan D, Köksal İ, Parlak E, Akdoğan M, Güner R. Demographic Characteristics and Transmission Risk Factors of Patients with Hepatitis C Virus in Turkey: The EPI-C, A Multicenter and Cross-sectional Trial. Egypt J Immunol 2021. [DOI: 10.4274/vhd.galenos.2021.2021-1-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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9
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Ünlü G, Yıldız Y, Ören MM, Çabalak M, Mete Ö, Kömür S, Yıldırım F, İnan D, Altunışık Toplu S, Akhan S, Karaşahin Ö, Akdemir Kalkan İ, Demir Y, Ayhan M, Karaoğlan İ, Taşova Y, Bayındır Y, Dal T, Çelen MK. Occult hepatitis B infection in Turkish HIV-infected patients: A multicentre, retrospective, cross-sectional study, Schindler study. Int J Clin Pract 2021; 75:e14358. [PMID: 33977603 DOI: 10.1111/ijcp.14358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/07/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Occult hepatitis B infection (OHBI) appears to have a higher prevalence in populations at high risk for hepatitis B virus (HBV) infection with concomitant liver disease. The aim was to assess the prevalence of OHBI in a sample of human immunodeficiency virus -1 positive and HBV surface antigen-negative (HIV-1+/HBsAg-) Turkish patients. METHODS Ten centres in Turkey were included in the study. Patients were selected on the basis of a power calculation with a known population size of HIV-positive patients and a reported prevalence of OHBI. Gender, age, occupation, place of residence, treatment and clinical status, and laboratory results, including immunodeficiency panel, antibody tests, hemogram, biochemistry, and coagulation studies were evaluated retrospectively. RESULTS The number of HIV-infected patients followed in these centres was 3172 and the sample population numbered 278. All 278 were HBsAg negative. The mean age of the sample was 37.2 ± 13.1 years and 235 (84.5%) were male. All but one patient (99.6%) had been treated with antiretroviral therapy. Of the 278 patients, 169 (60.6%) were positive for Anti-HBs and 125 (44.8%) were positive for Anti-HBc IgG. HIV RNA was detected in 203/278 (73%) of the patients. Four HBV DNA (1.4%) were diagnosed with OHBI. There was no significant difference in hemogram, hemoglobin or bilirubin concentrations in those with OHBI compared with the other patients. CONCLUSION In a representative sample of HIV+ patients from 10 Turkish centres, the prevalence of OHBI was found to be 1.4%. In HIV positive patients, it is important to identify those with OHBI for optimal clinical management and prognosis.
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Affiliation(s)
- Gülten Ünlü
- Infectious Diseases and Clinical Microbiology Clinic, Kocaeli Derince Training and Research Hospital University of Health Science, Kocaeli, Turkey
| | - Yeşim Yıldız
- Department of Infectious Diseases and Clinical Microbiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Meryem Merve Ören
- Department of Public Health, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Çabalak
- Department of Infectious Diseases and Clinical Microbiology, Mustafa Kemal University Medical Faculty, Hatay, Turkey
| | - Özlem Mete
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Süheyla Kömür
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Medical Faculty, Adana, Turkey
| | - Figen Yıldırım
- Clinic of Infectious Diseases and Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Sibel Altunışık Toplu
- Department of Infectious Diseases and Clinical Microbiology, İnönü University Medical Faculty, Malatya, Turkey
| | - Sıla Akhan
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Ömer Karaşahin
- Department of Infectious Diseases and Clinical Microbiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - İrem Akdemir Kalkan
- Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Yakup Demir
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Merve Ayhan
- Self-Employed Pharmacists, Ela Pharmacy, Batman, Turkey
| | - İlkay Karaoğlan
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Yeşim Taşova
- Department of Infectious Diseases and Clinical Microbiology, Çukurova University Medical Faculty, Adana, Turkey
| | - Yaşar Bayındır
- Department of Infectious Diseases and Clinical Microbiology, İnönü University Medical Faculty, Malatya, Turkey
| | - Tuba Dal
- Medical Microbiology Department, Ankara Yıldırım Beyazıt University Medical Faculty, Ankara, Turkey
| | - Mustafa Kemal Çelen
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
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10
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Erdoğan A, Yalnız Dilcen H, Cinemre B, Kulaksızoğlu B, İnan D, Kuloğlu MM. Sociodemographic and clinical characteristics of patients admitted to an addiction center. Journal of Substance Use 2021. [DOI: 10.1080/14659891.2021.1941352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ali Erdoğan
- Department of Psychiatry, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Hacer Yalnız Dilcen
- Department of Midwifery, Bartin University Faculty of Health Sciences, Bartın, Turkey
| | - Buket Cinemre
- Department of Psychiatry, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Burak Kulaksızoğlu
- Department of Psychiatry, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Mehmet Murat Kuloğlu
- Department of Psychiatry, Akdeniz University Faculty of Medicine, Antalya, Turkey
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11
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Demirtürk N, Aygen B, Çelik İ, Mıstık R, Akhan S, Barut Ş, Ural O, Batırel A, Şimşek F, Ersöz G, İnan D, Kınıklı S, Türker N, Bilgin H, Gürbüz Y, Tülek N, Tarakçı H, Yıldız O, Türkoğlu E, Kamalak Güzel D, Şimşek S, Tuna N, Aktuğ Demir N, Çağatay A, Çetinkaya RA, Karakeçili F, Hakyemez İN, Tuncer Ertem G, Örmen B, Korkmaz P, Yıldız U, Kuruüzüm Z, Şener A, Arslan Özel S, Öztürk S, Suer K, Çelen MK, Konya P, Asan A, Saltoğlu N, Doğan N. Real-World Data from Turkey: Is Sofosbuvir/Ledipasvir With or Without Ribavirin Treatment for Chronic Hepatitis C Really Effective? Turk J Gastroenterol 2021; 32:155-163. [PMID: 33960939 DOI: 10.5152/tjg.2020.19569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice. METHODS Data from patients with chronic hepatitis C treated with SOF/LDV ± RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed. RESULTS A total of 552 patients were included in the study. The mean age of the patients was 51.28 ± 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV ± RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect. CONCLUSION The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV ± RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.
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Affiliation(s)
- Neşe Demirtürk
- Department of Infectious Disease and Clinical Microbiology, Afyon Saglik Bilimleri University Medical Faculty, Afyonkarahisar, Turkey
| | - Bilgehan Aygen
- Department of Infectious Disease and Clinical Microbiology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - İlhami Çelik
- Department of Infectious Diseases and Clinical Microbiology, Kayseri Education and Research Hospital, Saglik Bilimleri University, Kayseri, Turkey
| | - Reşit Mıstık
- Infectious Disease Clinic, Medicana Hospital, Bursa, Turkey
| | - Sıla Akhan
- Department of Infectious Disease and Clinical Microbiology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Şener Barut
- Department of Infectious Disease and Clinical Microbiology, Gaziosmanpasa University Medical Faculty, Tokat, Turkey
| | - Onur Ural
- Department of Infectious Disease and Clinical Microbiology, Selcuk University Medical Faculty, Konya, Turkey
| | - Ayşe Batırel
- Department of Infectious Diseases and Clinical Microbiology, Kartal Lütfi Kırdar Education and Research Hospital, Saglik Bilimleri University, İstanbul, Turkey
| | - Funda Şimşek
- Department of Infectious Diseases and Clinical Microbiology, Ok Meydanı Education and Research Hospital, Saglik Bilimleri University, İstanbul, Turkey
| | - Gülden Ersöz
- Department of Infectious Disease and Clinical Microbiology, Mersin University Medical Faculty, Mersin, Turkey
| | - Dilara İnan
- Department of Infectious Disease and Clinical Microbiology, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Sami Kınıklı
- Department of Infectious Diseases and Clinical Microbiology, Ankara Education and Research Hospital, Saglik Bilimleri University, Ankara, Turkey
| | - Nesrin Türker
- Department of Infectious Disease and Clinical Microbiology, Atatürk Education and Research Hospital, Katip Çelebi University, İzmir, Turkey
| | - Hüseyin Bilgin
- Department of Infectious Disease and Clinical Microbiology, Marmara University Medical Faculty, İstanbul, Turkey
| | - Yunus Gürbüz
- Department of Infectious Disease and Clinical Microbiology, Dışkapı Education and Research Hospital University Medical Faculty, Saglik Bilimleri University, Antalya, Turkey
| | - Necla Tülek
- Department of Infectious Disease and Clinical Microbiology, Atılım University Medical Faculty, Ankara, Turkey
| | - Hüseyin Tarakçı
- Department of Infectious Diseases and Clinical Microbiology, Eşrefpaşa Education and Research Hospital, Saglik Bilimleri University, İzmir, Turkey
| | - Orhan Yıldız
- Department of Infectious Disease and Clinical Microbiology, Erciyes University Medical Faculty, Kayseri, Turkey
| | - Emine Türkoğlu
- Department of Infectious Disease and Clinical Microbiology, Afyon Saglik Bilimleri University Medical Faculty, Afyonkarahisar, Turkey
| | - Deniz Kamalak Güzel
- Department of Infectious Diseases and Clinical Microbiology, Kayseri Education and Research Hospital, Saglik Bilimleri University, Kayseri, Turkey
| | - Sümeyra Şimşek
- Department of Infectious Disease and Clinical Microbiology, Uludağ University Medical Faculty, Bursa, Turkey
| | - Nazan Tuna
- Department of Infectious Diseases and Clinical Microbiology, Sakarya Education and Research Hospital, Saglik Bilimleri University, Sakarya, Turkey
| | - Nazlım Aktuğ Demir
- Department of Infectious Disease and Clinical Microbiology, Selcuk University Medical Faculty, Konya, Turkey
| | - Atahan Çağatay
- Department of Infectious Disease and Clinical Microbiology, İstanbul University İstanbul Medical Faculty, İstanbul, Turkey
| | - Rıza Aytaç Çetinkaya
- Department of Infectious Diseases and Clinical Microbiology, Sultan Abdülhamid Han Education and Research Hospital, Saglik Bilimleri University, İstanbul, Turkey
| | - Faruk Karakeçili
- Department of Infectious Diseases and Clinical Microbiology, Erzincan University of Faculty of Medicine, Erzincan, Turkey
| | - İsmail Necati Hakyemez
- Department of Infectious Diseases and Clinical Microbiology, Bezmiâlem University of Faculty of Medicine, İstanbul, Turkey
| | - Günay Tuncer Ertem
- Department of Infectious Diseases and Clinical Microbiology, Ankara Education and Research Hospital, Saglik Bilimleri University, Ankara, Turkey
| | - Bahar Örmen
- Department of Infectious Disease and Clinical Microbiology, Atatürk Education and Research Hospital, Katip Çelebi University, İzmir, Turkey
| | - Pınar Korkmaz
- Department of Infectious Diseases and Clinical Microbiology, Kütahya Health Sciences University Faculty of Medicine, Kütahya, Turkey
| | - Uluhan Yıldız
- Department of Infectious Disease and Clinical Microbiology, Marmara University Medical Faculty, İstanbul, Turkey
| | - Ziya Kuruüzüm
- Department of Infectious Disease and Clinical Microbiology, Dokuz Eylül University Faculty, İzmir, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey
| | - Selcan Arslan Özel
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli Training and Research Hospital, Saglik Bilimleri University, Kocaeli, Turkey
| | - Sinan Öztürk
- Department of Infectious Diseases and Clinical Microbiology, Ümraniye Education and Research Hospital, Saglik Bilimleri University, Kocaeli, Turkey
| | - Kaya Suer
- Department of Infectious Diseases and Clinical Microbiology, Yakın Doğu University of Faculty of Medicine, Nicosia, Turkey
| | - Mustafa Kemal Çelen
- Department of Infectious Diseases and Clinical Microbiology, Dicle University Faculty of Medicine, Diyarbakır, Turkey
| | - Petek Konya
- Department of Infectious Disease and Clinical Microbiology, Afyon Saglik Bilimleri University Medical Faculty, Afyonkarahisar, Turkey
| | - Ali Asan
- Department of Infectious Diseases and Clinical Microbiology, Bursa Yüksek İhtisas Training and Research Hospital, Saglik Bilimleri University, Bursa, Turkey
| | - Neşe Saltoğlu
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University of Cerrahpaşa Faculty of Medicine, İstanbul, Turkey
| | - Nurhan Doğan
- Department of Biostatistics and Medical Informatics, Afyon Saglik Bilimleri University Medical Faculty, Afyonkarahisar, Turkey
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12
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Kara H, İnan D, Özçelik Ö, Erdoğan A, Çolak D, Öngüt G. Frequency of HBV, HCV and HIV Infections and Determination of HCV Genotype Distribution in People who Inject Drugs. Egypt J Immunol 2021. [DOI: 10.4274/vhd.galenos.2021.2020-12-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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13
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Erman Daloğlu A, Parkan ÖM, Erdoğan A, Peker BO, Can Sarınoğlu R, Sağlık İ, İnan D, Kuloğlu MM, Mutlu D, Öngüt G, Çolak D. [Distribution of Hepatitis C Virus (HCV) Genotypes Among Intravenous Drug and Non-Drug User Patients]. MIKROBIYOL BUL 2021; 55:30-40. [PMID: 33590979 DOI: 10.5578/mb.20108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Genotype distribution of hepatitis C virus (HCV) can vary over the years between different patient groups and regions. The prevalence of intravenous drug users (IVDU) is known to increase in our country, yet there are a limited number of studies investigating the distribution of HCV genotypes in this group. These data are essential for monitorization of the changes in HCV epidemiology. The present study aimed to evaluate the five-year results of HCV genotyping among patients infected with HCV related to IVDU and unrelated to drug use. Plasma samples of 720 patients (HCV antibody, HCV RNA positive), which were sent to our laboratory for HCV genotyping between January 2014-March 2019 were analyzed. HCV RNA extraction from plasma samples was performed in the automated-extraction system of EZ1 advanced (Qiagen, Germany) using the EZ1 virus mini kit v2.0 (Qiagen, Germany). Amplicons were obtained by amplifying the 5'NCR and core gene region in the Rotorgene 6000 real-time PCR (Qiagen, Germany) device with the HCV RNA real-time quantitative 2.0 (NLM, Italy) kit. For the genotyping, a commercial line probe assay (LIPA) based on in vitro reverse hybridization GEN-C2.0 kit (NLM, Italy) which can distinguish 1, 2, 3, 4, 6 genotypes and 1a, 1b, 2a/c, 2b, 3a, 3b, 3c, 3k, 4a, 4b, 4c/d, 4e, 4f, 4h, 5a, 6a/b, 6g, 6f/q, 6m, 7a subtypes of HCV, based on variations in the 5'-NCR and core regions was used. HCV genotype distribution of 266 IVDU (93.2%: male; median age: 25 ± 6.82) and 454 non-drug users (51.3%: male; median age: 56.5 ± 16.06) were examined. In order of frequency in the group with IVDU; genotype 1a, 3a, 1b, 4c/d, 2b, 4, 3 were observed and genotype 1, 2a/c and mixed genotype (1+3a) were detected in one patient. In the group without IVDU, in order of frequency; genotype 1b, 1a, 3a, 1, 2a/c, 4 were observed and genotype 2b, 4c/d, 5a, 6a/b, 6 and mixed genotype (3+4) were detected in one patient. Genotypes 1a and 3a were significantly higher in the IVDU group (p< 0.00001, p< 0.00001), while 1b was significantly higher in patients without IVDU (p< 0.00001). Genotypes 1a and 3a were more common in young men (p< 0.00001, p= 0.000163), while 1b was higher in middleaged women (p< 0.00001). The incidence of genotypes 1b (p= 0.021) and 3a (p= 0.012) was higher in foreign nationals than the Turkish patients. When the HCV genotype distribution was examined by years, it was observed that the percentages of genotype 1b and 1a were decreasing, while the percentage of genotype 3a was increasing. As a result, in this study, HCV genotype distribution among IVDU was observed to be different from the general population without IVDU. It was found that genotypes 1a and 3a were more common in the IVDU group. As in the other regions of our country, genotype 1b was found most frequently in the general population. Genotype 3a increases significantly compared to years. In our study, the determination of genotypes existing in different parts of the world may be due to the foreign nationals living in our city and our region is a tourism center. It is also necessary to investigate whether there is an increase in IVDU over the years.
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Affiliation(s)
- Aylin Erman Daloğlu
- University of Health Sciences Antalya Training and Research Hospital, Medical Microbiology Laboratory, Antalya, Turkey
| | - Ömür Mustafa Parkan
- Erciyes University Faculty of Medicine, Department of Medical Microbiology, Kayseri, Turkey
| | - Ali Erdoğan
- Akdeniz University Faculty of Medicine, Department of Psychiatry, Antalya, Turkey
| | - Bilal Olcay Peker
- İzmir Katip Çelebi University Atatürk Training and Research Hospital, Medical Microbiology Laboratory, Izmir, Turkey
| | - Rabia Can Sarınoğlu
- Marmara University Pendik Training and Research Hospital, Medical Microbiology Laboratory, Istanbul, Turkey
| | - İmran Sağlık
- Uludağ University Faculty of Medicine, Department of Medical Microbiology, Bursa, Turkey
| | - Dilara İnan
- Akdeniz University Faculty of Medicine, Department of Infectious Diseases Antalya, Turkey
| | - Mehmet Murat Kuloğlu
- Akdeniz University Faculty of Medicine, Department of Psychiatry, Antalya, Turkey
| | - Derya Mutlu
- Akdeniz University Faculty of Medicine, Department of Medical Microbiology, Division of Virology, Antalya, Turkey
| | - Gözde Öngüt
- Akdeniz University Faculty of Medicine, Department of Medical Microbiology, Division of Basic Immunology, Antalya, Turkey
| | - Dilek Çolak
- Akdeniz University Faculty of Medicine, Department of Medical Microbiology, Division of Virology, Antalya, Turkey
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14
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Sayan M, Özgüler M, Sarıgül Yıldırım F, Yıldırmak T, Gündüz A, Dokuzoğuz B, Çelen MK, İnan D, Heper Y, Ersöz G, Karaoğlan İ, Ceran N, Deveci A, Öztürk S, Sayın Kutlu S, Özkan Özdemir H, Akbulut A, Yazıcı S, Şener A, Çağatay A, Ünal S. Molecular Identification of HIV-1 in the Presence of Hepatitis B Virus and Hepatitis C Virus Co-infections. Balkan Med J 2020; 37:125-130. [PMID: 32106666 PMCID: PMC7161615 DOI: 10.4274/balkanmedj.galenos.2020.2019.5.89] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 02/24/2020] [Indexed: 01/20/2023] Open
Abstract
Background Because of their similar modes of transmission, the simultaneous infection of viral hepatitis and human immunodeficiency virus are increasingly seen as a big problem related to human health. Aims To determine the drug mutations in hepatitis B virus and/or hepatitis C virus co-infected human immunodeficiency virus-1 patients in Turkey. Study Design Retrospective cross-sectional study. Methods The present study was conducted between 2010 and 2017. HBsAg, anti-hepatitis C virus, and anti-human immunodeficiency virus were tested with ELISA. All anti-human immunodeficiency virus positive results by ELISA were verified for anti-human immunodeficiency virus positivity by a Western blot test, and Anti-human immunodeficiency virus positive patients with HBsAg and/or anti-hepatitis C virus positivity were included in the study. Subtyping and genotypic resistance analyses were performed by population sequencing of the viral protease and reverse transcriptase regions of the human immunodeficiency virus-1 pol gene. Results We detected 3896 human immunodeficiency virus-1 positive patients whose sera were sent from numerous hospitals across the country to our polymerase chain reaction unit for detection of drug resistance mutations and whose molecular laboratory tests were completed. Viral hepatitis co-infections were detected in 4.3% (n=170) of patients. Hepatitis B virus and hepatitis C virus co-infection were observed in 3.2% and 0.5% of all human immunodeficiency virus-1 infected patients, respectively. The major human immunodeficiency virus-1 subtype detected was group M, subtype B (62.9%). However, 13.5% of drug resistance mutation motifs were found in human immunodeficiency virus-1 genomes of patients included in the study. Conclusion Due to similar transmission routes, HIV1 patients are at risk of hepatitis B and C virus co-infection. However, antiretroviral drug resistance mutation model is similar to patients with hepatitis negative.
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Affiliation(s)
- Murat Sayan
- Clinical Laboratory, PCR Unit, Kocaeli University School of Medicine, Kocaeli, Turkey
- Research Center of Experimental, Health Sciences Near East University, Northern Cyprus
| | - Müge Özgüler
- Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Figen Sarıgül Yıldırım
- Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey
| | - Taner Yıldırmak
- Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Okmeydanı Training and Research Hospital, İstanbul, Turkey
| | - Alper Gündüz
- Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Şişli Etfal Training and Research Hospital, İstanbul, Turkey
| | - Başak Dokuzoğuz
- Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
| | - Mustafa Kemal Çelen
- Department of Infectious Diseases and Clinical Microbiology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Dilara İnan
- Department of Infectious Diseases and Clinical Microbiology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Yasemin Heper
- Department of Infectious Diseases and Clinical Microbiology, Uludağ University School of Medicine, Bursa, Turkey
| | - Gülden Ersöz
- Department of Infectious Diseases and Clinical Microbiology, Mersin University School of Medicine, Mersin Turkey
| | - İlkay Karaoğlan
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Nurgül Ceran
- Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Aydın Deveci
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Servet Öztürk
- Clinic of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Selda Sayın Kutlu
- Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Hülya Özkan Özdemir
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Ayhan Akbulut
- Department of Infectious Diseases and Clinical Microbiology, Fırat University School of Medicine, Elazığ, Turkey
| | - Saadet Yazıcı
- Clinic of Infectious Diseases and Clinical Microbiology, Medeniyet University, Göztepe Training and Research Hospital, İstanbul, Turkey
| | - Alper Şener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Çanakkale, Turkey
| | - Atahan Çağatay
- Department of Infectious Diseases and Clinical Microbiology, İstanbul University School of Medicine, İstanbul, Turkey
| | - Serhat Ünal
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University School of Medicine, Ankara, Turkey
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15
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Sarınoğlu RC, Sağlık İ, Mutlu D, Öngüt G, İnan D, Çolak D. [Evaluation of Enzyme Immunoassay (EIA), Immunoblot and HIV RNA Polymerase Chain Reaction Test Results in the Diagnosis of Human Immunodeficiency Virus (HIV) Infection]. MIKROBIYOL BUL 2019; 53:401-407. [PMID: 31709937 DOI: 10.5578/mb.68323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Acquired Immunodeficiency syndrome (AIDS) is an important global public health issue. Increasing HIV/AIDS cases reported each year has become a serious health problem for our country. The fourth generation enzyme immunoassay (EIA) test is the first step in the laboratory diagnosis of human immunodeficiency virus (HIV) infection. When the EIA test is repeatedly reactive, antibody-based tests such as immuno blot (IB), line immunoassay (LIA), HIV 1-2 antibody differentiation immunoassay, and HIV RNA tests for the early period of infection are used as confirmatory tests. The aim of this study was to evaluate the results of three different methods for the diagnosis of HIV infection. HIV 1-2 IB and quantitative HIV-1 RNA PCR tests were performed in 199 patient samples. These samples were detected as the reactive or gray zone with HIV 1-2 Ab+Ag EIA test between 2010 and 2015 at Akdeniz University Hospital, Microbiology Laboratory. HIV 1-2 Ab+Ag determination in serum samples was performed with the EIA method (Elecsys HIV combi PT test, Roche Diagnostics, Germany). A commercial kit (INNO-LIA HIV I-II Score, Innogenetics, Belgium) was used for HIV 1-2 IB method. The presence of HIV-1 RNA was investigated by automated nucleic acid extraction and real-time PCR method (Ampliprep/COBAS Tagman HIV-1 Test, Roche Diagnostics, Germany) in plasma samples. For statistical analysis, SPSS, Mann Whitney U test was used, ROC analysis was performed and p<0.05 value was considered statistically significant. HIV 1-2 Ab+Ag EIA COI (cut-off index) median value was higher with positive HIV 1-2 IB and HIV-1 RNA results than negative HIV 1-2 IB and HIV-1 RNA results. These values were 394 (range: 11.5-2272) and 1.79 (range: 1.01-83.3) respectively and this difference was statistically significant (p< 0.001). HIV-1 RNA test results were positive in one patient with gray zone and two patients with negative HIV 1-2 IB result (viral loads were > 10.000.000, > 10.000.000 and 5.040.000 copies/ml, respectively). For the kit that we used for HIV 1-2 Ab+Ag EIA COI ratio of >16.45 had a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 97.6%, 98.1%, 97.6% and 98.1%, respectively for the detection of HIV infection (r= 0.994, p< 0.001). HIV 1-2 Ab+Ag EIA S/CO ratio of < 9.26 had a sensitivity, specificity, PPV and NPV of 100%, 92.5%, 91.1% and 100% (p< 0.001). HIV infection is diagnosed if HIV 1-2 Ab+Ag EIA test result is repeatedly reactive and HIV 1-2 IB test and HIV-1 RNA tests are positive. In our study, HIV 1-2 Ab+Ag EIA COI median value was 394 (range: 11.5-2272) in this group of patients (p< 0.001). HIV-1 RNA PCR test was positive in three patients with > 10.000.000, 5.040.000 and > 10.000.000 copies/ml whose EIA tests were repeatedly reactive. HIV IB test was detected as the gray zone in one of them and as negative in the remaining two (HIV EIA S/CO values were 265, 9.5 and 131.8, respectively). These patients were diagnosed as acute HIV infection with clinical and laboratory findings. In conclusion, HIV RNA should also be performed and included in the diagnostic algorithm for acute HIV infection.
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Affiliation(s)
- Rabia Can Sarınoğlu
- T.C. Ministry of Health Marmara University, İstanbul Pendik Training and Research Hospital, Department of Medical Microbiology, İstanbul, Turkey
| | - İmran Sağlık
- Uludağ University Faculty of Medicine, Department of Medical Microbiology, Bursa, Turkey
| | - Derya Mutlu
- Akdeniz University Faculty of Medicine, Department of Medical Microbiology, Antalya, Turkey
| | - Gözde Öngüt
- Akdeniz University Faculty of Medicine, Department of Medical Microbiology, Antalya, Turkey
| | - Dilara İnan
- Akdeniz University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Dilek Çolak
- Akdeniz University Faculty of Medicine, Department of Medical Microbiology, Antalya, Turkey
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16
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Sarigül F, Sayan M, İnan D, Deveci A, Ceran N, Çelen MK, Çağatay A, Özdemir HÖ, Kuşcu F, Karagöz G, Heper Y, Karabay O, Dokuzoğuz B, Kaya S, Erben N, Karaoğlan İ, Ersöz GM, Günal Ö, Hatipoğlu Ç, Kutlu SS, Akbulut A, Saba R, Şener A, Büyüktuna SA. Current status of HIV/AIDS-syphilis co-infections: a retrospective multicentre study. Cent Eur J Public Health 2019; 27:223-228. [PMID: 31580558 DOI: 10.21101/cejph.a5467] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/22/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities co-infect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases. METHODS A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases. RESULTS Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm3 reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%. CONCLUSION Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future.
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Affiliation(s)
- Figen Sarigül
- Infectious Disease and Clinical Microbiology Department, Antalya and Research Hospital, Health Sciences University, Antalya, Turkey
| | - Murat Sayan
- PCR Unit, Clinical Laboratory, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.,Research Centre of Experiment Health Sciences, Near East University, Nicosia, Northern Cyprus
| | - Dilara İnan
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Aydin Deveci
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Samsun 19 Mayis University, Samsun, Turkey
| | - Nurgül Ceran
- Infectious Disease and Clinical Microbiology Department, Istanbul Haydarpasa Numune Education and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Mustafa Kemal Çelen
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Diyarbakir University, Diyarbakir, Turkey
| | - Atahan Çağatay
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hülya Özkan Özdemir
- Infectious Disease and Clinical Microbiology Department, Bozyaka Education and Research Hospital, Health Sciences University, Izmir, Turkey
| | - Ferit Kuşcu
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Gül Karagöz
- Infectious Disease and Clinical Microbiology Department, Istanbul Umraniye Education and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Yasemin Heper
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Bursa University, Bursa, Turkey
| | - Oğuz Karabay
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Başak Dokuzoğuz
- Infectious Disease and Clinical Microbiology Department, Ankara Numune Education and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Selçuk Kaya
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Nurettin Erben
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Eskisehir University, Eskisehir, Turkey
| | - İlkay Karaoğlan
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Gülden Munis Ersöz
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Özgür Günal
- Infectious Disease and Clinical Microbiology Department, Samsun Education and Research Hospital, Health Sciences University, Samsun, Turkey
| | - Çiğdem Hatipoğlu
- Infectious Disease and Clinical Microbiology Department, Ankara Education and Research Hospital, Health Sciences University, Ankara, Turkey
| | - Selda Sayin Kutlu
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Ayhan Akbulut
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Rabin Saba
- Infectious Disease and Clinical Microbiology Department, Private Medstar Antalya Hospital, Antalya, Turkey
| | - Alper Şener
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Onsekiz Mart University, Canakkale, Turkey
| | - Seyit Ali Büyüktuna
- Infectious Disease and Clinical Microbiology Department, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
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17
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Idilman R, Baykam N, Kaymakoğlu S, Tabak F, Bahçecioğlu HI, Bektaş A, Bulut C, Günşar F, İnan D, Karaosmanoğlu HK, Karasu Z, Kuşçu F, Mete B, Özbakır Ö, Özdoğan OC, Parlak M, Sırmatel F, Topalak Ö, Ünsal B, Guidelines Study Group VH. Turkey 2017 Clinical Practice Guidelines on recommendations for screening diagnosing and managing hepatitis C virus. Turk J Gastroenterol 2018; 28:90-93. [PMID: 29303105 DOI: 10.5152/tjg.2017.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The present guideline updates the Turkish recommendations for the screening, diagnosis and management of Hepatitis
C virus (HCV) infection prepared by the Turkish Association for the Study of the Liver (TASL) and Viral Hepatitis
Society (VHS). The aim of this guidance was to provide updates recommendations to physicians, who are interested
in HCV care on the optimal screening, diagnosis and pre-treatment management for patients with HCV infection
in Turkey. These recommendations, produced by panel experts, were aimed to addresses the management issues
ranging from diagnosis and linkage to care, to the optimal treatment regimen in patients with HCV infection. Recommendations
are based on evidence and opinions of more than 70% of the panelists. This guidance is supported by
the memberships of two societies and not by pharmaceutical companies. This guidance will be updated frequently
as new data become available.
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Affiliation(s)
- Ramazan Idilman
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Nurcan Baykam
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Sabahattin Kaymakoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fehmi Tabak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Halil I Bahçecioğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ahmet Bektaş
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Cemal Bulut
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fulya Günşar
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Dilara İnan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Hayat K Karaosmanoğlu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Zeki Karasu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ferit Kuşçu
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Birgül Mete
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Özbakır
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Osman C Özdoğan
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Mehmet Parlak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Fatma Sırmatel
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Ömer Topalak
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
| | - Belkis Ünsal
- Turkish Association for the Study of the Liver, İstanbul, Turkey; Viral Hepatitis Society, Ankara, Turkey
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18
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Gürbüz HGA, Turhan L, Şendil N, Kaşıkçı HÖ, Salepçi B, Ipekcioglu D, Karcı CK, Ray PÇ, Tahiroğlu AY, Avcı A, Çelik GG, Cekin N, Evliyaoğlu N, Alkanat M, Özdemir H, Akgün E, Demirkol ME, Tamam L, Esnafoglu E, Sevinçok D, Memiş ÇÖ, Doğan B, Çakaloz B, Kutlu A, Sevinçok L, Demirkol ME, Dikmen SNT, Şafak Y, Gökçer Tulacı R, Özdemir İ, Baykara S, Alban K, Aydın N, Aytaç HM, Yılmaz D, Aydın PÇ, Yalçın GY, Canbay C, Terzioğlu M, Özer A, Altintas E, Kütük MÖ, Tufan AE, Bağ HG, Şenormancı G, Güçlü O, Çelik C, Bolu A, Öznur T, Aydın MS, Tokgöz Y, Uzun Ö, Gıca S, Poyraz BÇ, Fidan YS, Güleç H, Akça E, Yıldız M, Akça ZND, Öztürk Y, Özyurt G, Özdel K, Özyurt G, Öztürk Y, Özdel K, Elboga G, Ozyurek MB, Bolu A, Aydın MS, Akgün A, Coşkun A, Çelik C, Uzun Ö, Öznur T, Bilgiç A, Sivri RÇ, Kılınç İ, İnal A, Eray U, Memiş ÇÖ, Doğan B, Acat M, Sevinçok L, Önder A, Adanır AS, Kavurma C, Bilaç Ö, Doğan Y, Ay R, Uğur Ç, Alıç BG, Gündüz M, Ünal Ö, Uçur Ö, Özcan Ö, Gül HK, Aykut DS, Tiryaki A, Arslan FC, Adanır AS, Önder A, Bülbül GA, Yolcu Ö, Uysal A, Özatalay E, Esnafoglu E, Cırrık S, Erdogan E, Delibas DH, Bozkurt HT, Tekdemir R, Erbasan V, İmre O, Aydın M, Altınbaş K, Karabucak B, Esen HTÇ, Kültür SEÇ, Karaokur R, Uysal SA, Erbil N, Kirazlı MÇ, Kara T, Mıhçıoğlu AM, Yılmaz S, Akaltun İ, Atli A, Can Z, Çim EFA, İbiloğlu AO, Şahin N, Ertekin H, Kocagöz ZB, Özçetin A, Ataoğlu A, Cangür Ş, Ölmez SB, Yazar N, Uçar HN, Murat D, Eray Ş, Tanır Y, Altun H, Tanyeri MH, Büyükokuroğlu ME, Tanyeri P, Mutlu O, Akar FY, Ulak G, Erden BF, Sevgen FH, Altun H, Arıcı A, Kılıçaslan F, Erbay MF, Darılmaz C, Çökmüş FP, Yüzeren S, Dikici DS, Aydın O, Aydın PÜ, Akdeniz F, Öztekin S, Çöldür EÖ, Balıkçı K, Köroğlu E, Aydemir Ö, Kara H, Özçelik Ö, Balcı MM, Kuloğlu MM, Tomar T, Öztekin S, Akdeniz F, Taneli F, Oran A, Ovalı GY, Aydemir Ö, Kaypaklı GY, Metin Ö, Ray PÇ, Çelik GG, Karcı CK, Tahiroğlu AY, Karaş H, Çetingök H, İlişer R, Çarpar E, Kaşer M, Can GŞ, Ulaş G, Ildız A, Emiroğlu N, Ada E, Özerdem A, Tekdemir R, Bozkurt HT, Imre O, Erbasan V, Aydın M, Altınbaş K, Tanyeri MH, Büyükokuroğlu ME, Tanyeri P, Mutlu O, Akar FY, Ulak G, Erden BF, Tekin U, Satar A, Aydın AN, Erermiş HS, Kocaman O, Çetin NY, Akay A, Karagöz YS, Doğan Ö, Ülkar S, Kılıç BG, Ceyhun HA, Aydın EF, Ülkevan T, Gürbüzer N, Aykutlu HC, Görker I, Özen E, Aktepe E, Aydın MA, Yavuz DD, Karaaslan U, Altun H, Karataş A, Sancak Z, Çetin NY, Dikici DS, Çökmüş FP, Eser E, Demet MM, Karadere ME, Asafov EY, Ölçüm Hİ, Algül A, Gündoğmuş İ, Cetin FH, Guler HA, Turkoglu S, Çolpan BK, Tanır Y, Bayram E, Ateş FSÖ, Teber ST, Kılıç BG, Duman NS, Gökten ES, Sungur EN, Şengül MCB, Kardeşler AÇ, Enli Y, Kurtul N, Altun H, Aslan C, Konuşkan B, Şener B, Anlar B, Ünal F, Akçay BD, Koç G, Yetkin S, Bayad S, Elbir M, Topbaş ÖA, Kocabaş T, Aydemir Ö, Çim EFA, Aydın A, Atli A, Atli A, Avcu Çelik P, İbiloğlu AO, Çıldır DA, Özbek A, Mustan AT, Karadağ AS, Kalenderoğlu A, Örüm MH, Özen ME, Eğilmez OB, Kalenderoğlu A, Karadağ AS, Hamdi Örüm M, Özen ME, Aydın DB, Elmas B, Nasıroğlu S, Aydın E, Özdemir Ö, Erel Ö, Altun H, Fedai Ü, Asoğlu M, Elbay RY, Karatepe HT, Ulaşoğlu C, Ayaydın H, Kılıçaslan F, Asoğlu M, Şahin B, Karabekiroğlu K, Bozkurt A, Usta MB, Aydın M, Çobanoğlu C, Kara H, Kahya Y, Özçelik Ö, İnan D, Kuloğlu MM, Altınöz AE, Köşger F, Eşsizoğlu A, Arslan M, Çalışkan AM, Göktaş D, İnanlı İ, Çalışır S, Eren İ, Tatar ZB, Kurt E, Unal G, Aricioglu F, Cetin FH, Guler HA, Tezcan ME, Turkoglu S, Kalyoncu T, Çıldır DA, Ergüvendi F, Yektaş Ç, Eroz R, Yurdakul G, Cakır M, Tasmektepligil MY, Baykal S, Usta MB, Karakurt MN, Karabekiroglu K, Yulaf Y, Gümştaş F, Gökçe S, Yazgan Y, Memiş ÇÖ, Sevincok D, Doğan B, Kutlu A, Çakaloz B, Sevinçok L, Çıldır DA, Kalyoncu T, Ergüvendi FA, Uğur Ç, Yağcı İ, Avcı S, Kıvrak Y, Yaşar AB, Sayman C, Taycan SE, Çetinkaya Y, Gündüz A, Tireli H, Yazici KU, Yazici IP, Kıvrak Y, Kılıçle PA, Gül S, Yağcı İ, Yazici IP, Yazici KU, Çıldır DA, Özbek A, Sümer AD, Çöp E, Bilgili D, Şahin M, Dinç GŞ, Hekim Ö, Mısırlıoğlu ED, Kurt F, Göker Z, Üneri Ö, Kıvrak Y, Kıvrak Y, Yağcı İ, Kıvrak Y, Atalay E, Yıldırım İ, Yağcı İ, İnaltekin A, Yücens B, Kotan VO, Özkayar N, Dede F, Yüksel RN, Bayram Ş, Kotan Z, Göka E, Bozkurt A, Say GN, Şahin B, Usta MB, Kalyoncu M, Aydın M, Çobanoğlu C, Beğinoğlu Ö, Asoğlu M, Basgoz BB, Ince S, Safer U, Tasci İ. Oral Research Presentations. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1464273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
| | - Levent Turhan
- Kartal Dr. Lutfi Kirdar Research and Training Hospital, Istanbul, Turkey
| | - Nilgun Şendil
- Kartal Suleyman Demirel Anatolian High School, Istanbul, Turkey
| | | | | | - Derya Ipekcioglu
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Canan Kuygun Karcı
- Dr. Ekrem Tok Psychiatry Hospital, Department of Child and Adolescent Psychiatry, Adana, Turkey
| | - Perihan Çam Ray
- Cukurova University School of Medicine, Department of Child and Adolescent Psychiatry, Adana, Turkey
| | - Ayşegül Yolga Tahiroğlu
- Cukurova University School of Medicine, Department of Child and Adolescent Psychiatry, Adana, Turkey
| | - Ayşe Avcı
- Cukurova University School of Medicine, Department of Child and Adolescent Psychiatry, Adana, Turkey
| | - Gonca Gül Çelik
- Cukurova University School of Medicine, Department of Child and Adolescent Psychiatry, Adana, Turkey
| | - Necmi Cekin
- Cukurova University School of Medicine, Department of forensic Medicine, Adana, Turkey
| | - Nurdan Evliyaoğlu
- Cukurova University School of Medicine, Department of Pediatrics, Adana, Turkey
| | - Mehmet Alkanat
- Departmant of Physiology, Giresun University School of Medicine, Giresun, Turkey
| | - Hafize Özdemir
- Departmant of Internal Medicine Nursing, School of Health Sciences, Giresun University, Giresun, Turkey
| | - Egemen Akgün
- Departmant of Medical Biology, Giresun University School of Medicine, Giresun, Turkey
| | | | - Lut Tamam
- Cukurova University School of Medicine, Department of Psychiatry, Adana
| | | | - Doğa Sevinçok
- Dr. Behcet Uz Child Diseases and Pediatric Surgery Training and Research Hospital, Department of Child and Adolescent Psychiatry, Izmir, Turkey
| | | | - Bilge Doğan
- Adnan Menderes University, Department of Psychiatry, Aydin, Turkey
| | - Burcu Çakaloz
- Pamukkale University, Department of Child and Adolescent Psychiatry, Denizli, Turkey
| | - Ayşe Kutlu
- Dr. Behcet Uz Child Diseases and Pediatric Surgery Training and Research Hospital, Department of Child and Adolescent Psychiatry, Izmir, Turkey
| | - Levent Sevinçok
- Adnan Menderes University, Department of Psychiatry, Aydin, Turkey
| | | | | | - Yasir Şafak
- Dışkapı Yıldırım Beyazıt Education and Training Hospital, Ankara, Turkey
| | | | - İlker Özdemir
- Kütahya Dr. Mustafa Kalemli Tavşanlı Government Hospital, Kütahya, Turkey
| | - Sema Baykara
- Firat University, School of Medicine, Department of Psychiatry, Elazig, Turkey
| | - Kübra Alban
- Elazig Mental Health Hospital, Elazig, Turkey
| | - Nazan Aydın
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Hasan Mervan Aytaç
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Doğan Yılmaz
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Pınar Çetinay Aydın
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Gökşen Yüksel Yalçın
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Cana Canbay
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Merve Terzioğlu
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Aysel Özer
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Ebru Altintas
- Baskent University School of Medicine, Department of Psychiatry, Adana, Turkey
| | - Meryem Özlem Kütük
- Baskent University School of Medicine, Department of Child and adolescent Psychiatry, Adana, Turkey
| | - Ali Evren Tufan
- Abant İzzet Baysal University, School of Medicine, Department of Child and adolescent Psychiatry, Bolu, Turkey
| | - Harika Gözükara Bağ
- Inonu University, Department of Biostatistics and Medical Informatics, Malatya, Turkey
| | - Güliz Şenormancı
- Health Sciences University Bursa Yüksek İhtisas Training and Research Hospital, Department of Psychiatry, Bursa, Turkey
| | - Oya Güçlü
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Cemil Çelik
- Gulhane Medical Faculty, Department of Psychiatry, Ankara, Turkey
| | - Abdullah Bolu
- Gulhane Medical Faculty, Department of Psychiatry, Ankara, Turkey
| | - Taner Öznur
- Gulhane Medical Faculty, Department of Psychiatry, Ankara, Turkey
| | | | - Yusuf Tokgöz
- Gulhane Medical Faculty, Department of Psychiatry, Ankara, Turkey
| | - Özcan Uzun
- Gulhane Medical Faculty, Department of Psychiatry, Ankara, Turkey
| | - Sakır Gıca
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Burç Çağrı Poyraz
- Istanbul University Cerrahpasa School of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Yağmur Sever Fidan
- Erenkoy Research and Training Hospital for Psychiatric and Neurological Disorders, Department of Psychiatry, Istanbul, Turkey
| | - Hüseyin Güleç
- Erenkoy Research and Training Hospital for Psychiatric and Neurological Disorders, Department of Psychiatry, Istanbul, Turkey
| | - Erdoğdu Akça
- Psychiatry, Marmara University School of Medicine, İstanbul, Turkey
| | - Mesut Yıldız
- Psychiatry, Marmara University School of Medicine, İstanbul, Turkey
| | | | - Yusuf Öztürk
- Abant Izzet Baysal University, Department of Child and Adolescent Psychiatry, Bolu, Turkey
| | - Gonca Özyurt
- İzmir Katip Celebi University, Department of Child and Adolescent Psychiatry, Izmir, Turkey
| | - Kadir Özdel
- Dıskapi Training and Research Hospital, Department of Psychiatry, Ankara, Turkey
| | - Gonca Özyurt
- İzmir Katip Celebi University, Department of Child and Adolescent Psychiatry, Izmir, Turkey
| | - Yusuf Öztürk
- Abant Izzet Baysal University, Department of Child and Adolescent Psychiatry, Bolu, Turkey
| | - Kadir Özdel
- Dıskapi Training and Research Hospital, Department of Psychiatry, Ankara, Turkey
| | - Gulcin Elboga
- Gaziantep University School of Medicine Department of Psychiatry
| | | | - Abdullah Bolu
- Gülhane Medical School; Dept. of Psychiatry. Ankara/Turkey
| | | | - Abdullah Akgün
- Gülhane Medical School; Dept. of Psychiatry. Ankara/Turkey
| | - Ali Coşkun
- Gülhane Medical School; Dept. of Pathology. Ankara/Turkey
| | - Cemil Çelik
- Gülhane Medical School; Dept. of Psychiatry. Ankara/Turkey
| | - Özcan Uzun
- Gülhane Medical School; Dept. of Psychiatry. Ankara/Turkey
| | - Taner Öznur
- Gülhane Medical School; Dept. of Psychiatry. Ankara/Turkey
| | - Ayhan Bilgiç
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Rukiye Çolak Sivri
- Department of Child and Adolescent Psychiatry, Ankara Education and Research Hospital, Ankara, Turkey
| | - İbrahim Kılınç
- Department of Biochemistry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ahmet İnal
- Erciyes University School of Medicine, Department of Pharmacology, Hakan Çetinsaya Good Clinical Practice and Research Center, Kayseri, Turkey
| | - Uğur Eray
- Adnan Menderes University School of Medicine, Department of Psychiatry, Aydın, Turkey
| | - Çağdaş Öykü Memiş
- Adnan Menderes University School of Medicine, Department of Psychiatry, Aydın, Turkey
| | - Bilge Doğan
- Adnan Menderes University School of Medicine, Department of Psychiatry, Aydın, Turkey
| | - Murat Acat
- Karabük University School of Medicine, Department of Pulmonary Diseases, Karabük, Turkey
| | - Levent Sevinçok
- Adnan Menderes University School of Medicine, Department of Psychiatry, Aydın, Turkey
| | - Arif Önder
- Manisa Mental Health Hospital, Department of Child and Adolescent Psychiatry, Manisa, Turkey
| | - Aslı Sürer Adanır
- Akdeniz University School of Medicine, Department of Child and Adolescent Psychiatry, Antalya, Turkey
| | - Canem Kavurma
- Manisa Mental Health Hospital, Department of Child and Adolescent Psychiatry, Manisa, Turkey
| | - Öznur Bilaç
- Manisa Mental Health Hospital, Department of Child and Adolescent Psychiatry, Manisa, Turkey
| | - Yakup Doğan
- Manisa Mental Health Hospital, Department of Child and Adolescent Psychiatry, Manisa, Turkey
| | - Rukiye Ay
- Malatya Training and Research Hospital
| | - Çağatay Uğur
- Health Sciences University, Ankara Child Health and Diseases Hematology Oncology Research and Training Hospital, Child and Adolescent Psychiatry Department, Ankara, Turkey
| | - Betül Gül Alıç
- Health Sciences University, Ankara Child Health and Diseases Hematology Oncology Research and Training Hospital, Child and Adolescent Psychiatry Department, Ankara, Turkey
| | - Mehmet Gündüz
- Health Sciences University, Ankara Child Health and Diseases Hematology Oncology Research and Training Hospital, Department of Child Metabolism and Nutrition, Ankara, Turkey
| | - Özlem Ünal
- Health Sciences University, Ankara Child Health and Diseases Hematology Oncology Research and Training Hospital, Department of Child Metabolism and Nutrition, Ankara, Turkey
| | - Ömer Uçur
- Inonu University School of Medicine, Department of Child and Adolescent Psychiatry, Malatya, Turkey
| | - Özlem Özcan
- Inonu University School of Medicine, Department of Child and Adolescent Psychiatry, Malatya, Turkey
| | - Hasret Karabulut Gül
- Karadeniz Technical University School of Medicine, Department of Psychiatry, Trabzon, Turkey
| | - Demet Sağlam Aykut
- Karadeniz Technical University School of Medicine, Department of Psychiatry, Trabzon, Turkey
| | - Ahmet Tiryaki
- Istanbul Aydın University School of Medicine, Department of Psychiatry, Istanbul, Turkey
| | - Filiz Civil Arslan
- Karadeniz Technical University School of Medicine, Department of Psychiatry, Trabzon, Turkey
| | - Aslı Sürer Adanır
- Akdeniz University School of Medicine, Department of Child and Adolescent Psychiatry, Antalya, Turkey
| | - Arif Önder
- Manisa Psychiatry Hospital, Department of Child and Adolescent Psychiatry, Manisa, Turkey
| | - Gül Alkan Bülbül
- Antalya Training and Research Hospital, Department of Gynecology and Obstetrics, Antalya, Turkey
| | - Ömer Yolcu
- Akdeniz University School of Medicine, Department of Child and Adolescent Psychiatry, Antalya, Turkey
| | - Aysel Uysal
- Antalya Training and Research Hospital, Department of Gynecology and Obstetrics, Antalya, Turkey
| | - Esin Özatalay
- Akdeniz University School of Medicine, Department of Child and Adolescent Psychiatry, Antalya, Turkey
| | - Erman Esnafoglu
- Department of Child and Adolescent Psychiatry, School of Medicine, Ordu University, Ordu, Turkey
| | - Selma Cırrık
- Department of Physiology, School of Medicine, Ordu University, Ordu, Turkey
| | - Esin Erdogan
- University of Health Sciences, Izmir Bozyaka Research and Training Hospital, Department of Psychiatry, Izmir
| | - Dursun Hakan Delibas
- University of Health Sciences, Izmir Bozyaka Research and Training Hospital, Department of Psychiatry, Izmir
| | - Hazan Tomar Bozkurt
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Rukiye Tekdemir
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Vefa Erbasan
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Okan İmre
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Memduha Aydın
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Kürşat Altınbaş
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Başak Karabucak
- Department of Child and Adolescent Psychiatry, Karaman State Hospital, Karaman, Turkey
| | - Halime Tuna Çak Esen
- Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | | | - Remzi Karaokur
- Department of Child and Adolescent Psychiatry, Sincan State Hospital, Ankara, Turkey
| | - Songül Atasavun Uysal
- Department of Physical Therapy and Rehabilitation, Institute of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Nurhan Erbil
- Department of Biophysics, Hacettepe University, Ankara, Turkey
| | | | - Tayfun Kara
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
| | - Ajda Mutlu Mıhçıoğlu
- Health Sciences University, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Pediatric Cardiology, Istanbul, Turkey
| | - Semra Yılmaz
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
| | - İsmail Akaltun
- Gaziantep Dr. Ersin Arslan Training and Research Hospital, Department of Child and Adolescent Psychiatry Gaziantep, Turkey
| | - Abdullah Atli
- Dicle University School of Medicine, Department of Psychiatry, Diyarbakir, Turkey
| | - Zübeyir Can
- Batman Regional State Hospital, Batman, Turkey
| | | | | | - Nilfer Şahin
- Muğla Sıtkı Koçman University School of Medicine, Department of Child and Adolescent Psychiatry, Muğla, Turkey
| | - Hülya Ertekin
- Çanakkale 18 Mart University, School of Medicine, Çanakkale, Turkey
| | | | - Adnan Özçetin
- Duzce University School of Medicine, Department of Psychiatry, Duzce Turkey
| | - Ahmet Ataoğlu
- Duzce University School of Medicine, Department of Psychiatry, Duzce Turkey
| | - Şengül Cangür
- Duzce University School of Medicine, Department of Psychiatry, Duzce Turkey
| | - Safiye Bahar Ölmez
- Duzce University School of Medicine, Department of Psychiatry, Duzce Turkey
| | - Neslihan Yazar
- Duzce University School of Medicine, Department of Psychiatry, Duzce Turkey
| | - Halit Necmi Uçar
- Department of Child and Adolescent Psychiatry, Van Training and Research Hospital, Van, Turkey
| | - Duygu Murat
- Department of Child and Adolescent Psychiatry, Avcılar Hospital, İstanbul, Turkey
| | - Şafak Eray
- Department of Child and Adolescent Psychiatry, Van Training and Research Hospital, Van, Turkey
| | - Yaşar Tanır
- Department of Child and Adolescent Psychiatry, Kutahya Dumlupınar University Evliya Celebi Training and Research Hospital, Kütahya, Turkey
| | - Hatice Altun
- Department of Child and Adolescent Psychiatry, Kahramanmaras Sutcu Imam University School of Medicine, Kahramanmaras, Turkey
| | | | | | - Pelin Tanyeri
- Sakarya University School of Medicine, Department of Pharmacology, Sakarya, Turkey
| | - Oguz Mutlu
- Kocaeli University School of Medicine, Department of Pharmacology, Kocaeli, Turkey
| | - Füruzan Yıldız Akar
- Kocaeli University School of Medicine, Department of Pharmacology, Kocaeli, Turkey
| | - Güner Ulak
- Kocaeli University School of Medicine, Department of Pharmacology, Kocaeli, Turkey
| | - Bekir Faruk Erden
- Kocaeli University School of Medicine, Department of Pharmacology, Kocaeli, Turkey
| | - Feyza Hatice Sevgen
- Department of Child and Adolescent Psychiatry, Sutcu Imam University School of Medicine, Kahramanmaras, Turkey
| | - Hatice Altun
- Department of Child and Adolescent Psychiatry, Sutcu Imam University School of Medicine, Kahramanmaras, Turkey
| | - Asiye Arıcı
- Department of Child and Adolescent Psychiatry, Sutcu Imam University School of Medicine, Kahramanmaras, Turkey
| | - Fethiye Kılıçaslan
- Department of Child and Adolescent Psychiatry, Harran University School of Medicine, Sanlıurfa, Turkey
| | - Mehmet Fatih Erbay
- Inonu University School of Medicine, Department of Radiology, Malatya, Turkey
| | - Cengiz Darılmaz
- Inonu University School of Medicine, Department of Psychiatry, Malatya, Turkey
| | | | - Serra Yüzeren
- Departmant of Psychiatry, Manisa Celal Bayar University, Manisa, Turkey
| | | | - Orkun Aydın
- Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Pınar Ünal Aydın
- Department of Psychology, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Fatma Akdeniz
- Psychiatry Clinic, Bolvadin Halil İbrahim Özsoy State Hospital, Afyon, Turkey
| | - Siğnem Öztekin
- Psychiatry Clinic, Viranşehir State Hospital, Şanlıurfa, Turkey
| | - Emine Özge Çöldür
- Departmant of Psychiatry, Manisa Celal Bayar University, Manisa, Turkey
| | - Kuzeymen Balıkçı
- Department of Psychiatry, Near East University, Lefkoşa, North Cyprus
| | | | - Ömer Aydemir
- Departmant of Psychiatry, Manisa Celal Bayar University, Manisa, Turkey
| | - Hüseyin Kara
- Department of Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Özgen Özçelik
- Department of Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Mehmet Murat Balcı
- Department of Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Mehmet Murat Kuloğlu
- Department of Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Talya Tomar
- Medical School, Akdeniz University School of Medicine, Antalya, Turkey
| | - Siğnem Öztekin
- Viransehir State Hospital, Department of Psychiatry, Viransehir, Sanliurfa, Turkey
| | - Fatma Akdeniz
- Bolvadin Halil Ibrahim Ozsoy State Hospital, Department of Psychiatry, Bolvadin, Afyonkarahisar, Turkey
| | - Fatma Taneli
- Celal Bayar University School of Medicine, Department of Biochemistry, Manisa, Turkey
| | - Arzu Oran
- Manisa State Hospital, Department of Biochemistry, Manisa, Turkey
| | - Gülgün Yılmaz Ovalı
- Celal Bayar University School of Medicine, Department of Radiology, Manisa, Turkey
| | - Ömer Aydemir
- Celal Bayar University School of Medicine, Department of Psychiatry, Manisa, Turkey
| | - Gamze Yapça Kaypaklı
- Cukurova University School of Medicine, Child and Adolescent Psychiatry Department, Adana, Turkey
| | - Özge Metin
- Cukurova University School of Medicine, Child and Adolescent Psychiatry Department, Adana, Turkey
| | - Perihan Çam Ray
- Cukurova University School of Medicine, Child and Adolescent Psychiatry Department, Adana, Turkey
| | - Gonca Gül Çelik
- Cukurova University School of Medicine, Child and Adolescent Psychiatry Department, Adana, Turkey
| | - Canan Kuygun Karcı
- Cukurova University School of Medicine, Child and Adolescent Psychiatry Department, Adana, Turkey
| | - Ayşegül Yolga Tahiroğlu
- Cukurova University School of Medicine, Child and Adolescent Psychiatry Department, Adana, Turkey
| | - Hakan Karaş
- Beykent University, Department of Psychology, Istanbul, Turkey
| | - Halil Çetingök
- Bağcılar Education and Research Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey
| | - Reşat İlişer
- Genesis Hospital, Department of Physical Therapy and Rehabilitation, Diyarbakır, Turkey
| | - Elif Çarpar
- Hınıs State Hospital, Department of Psychiatry, Erzurum, Turkey
| | - Muzaffer Kaşer
- University of Cambridge, Department of Psychiatry, Cambridge, UK; Bahçeşehir University, Department of Psychiatry, Istanbul, Turkey
| | - Güneş Şayan Can
- Mardin State Hospital, Department of Psychiatry, Mardin, Turkey
| | - Gözde Ulaş
- Dokuz Eylul University School of Medicine, Child and Adult Psychiatry, Izmır, Turkey
| | - Ayşegül Ildız
- Dokuz Eylul University Health Sciences Institute, Neuroscience, Izmır, Turkey
| | - Neslihan Emiroğlu
- Dokuz Eylul University School of Medicine, Child and Adult Psychiatry, Izmır, Turkey
| | - Emel Ada
- Dokuz Eylül University School of Medicine, Department of Radiology, Izmır, Turkey
| | - Ayşegül Özerdem
- Dokuz Eylul University School of Medicine, Department of Psychiatry, Izmir, Turkey
| | - Rukiye Tekdemir
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Hazan Tomar Bozkurt
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Okan Imre
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Vefa Erbasan
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Memduha Aydın
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | - Kürşat Altınbaş
- Selcuk University School of Medicine, Department of Psychiatry, Konya, Turkey
| | | | | | - Pelin Tanyeri
- Sakarya University, School of Medicine, Department of Pharmacology, 54100-Sakarya/Turkey
| | - Oğuz Mutlu
- Kocaeli University, School of Medicine, Department of Pharmacology, 41380-Kocaeli/Turkey
| | - Furuzan Yıldız Akar
- Kocaeli University, School of Medicine, Department of Pharmacology, 41380-Kocaeli/Turkey
| | - Güner Ulak
- Kocaeli University, School of Medicine, Department of Pharmacology, 41380-Kocaeli/Turkey
| | - Bekir Faruk Erden
- Kocaeli University, School of Medicine, Department of Pharmacology, 41380-Kocaeli/Turkey
| | - Uğur Tekin
- Health Sciences University Van Research and Training Hospital, Van, Turkey
| | - Ayşegül Satar
- Ege University School of Medicine, Department of Child and Adolescent Psychiatry, Izmir, Turkey
| | - Ayşe Nur Aydın
- Ege University School of Medicine, Department of Child and Adolescent Psychiatry, Izmir, Turkey
| | - Hatice Serpil Erermiş
- Ege University School of Medicine, Department of Child and Adolescent Psychiatry, Izmir, Turkey
| | - Orhan Kocaman
- TR Ministry of Health, DPU Kütahya Evliya Çelebi Research and Training Hospital, Kütahya, Turkey
| | - Nihal Yurteri Çetin
- Düzce University School of Medicine, Child and Adolescent Psychiatry, Düzce, Turkey
| | - Aynur Akay
- Dokuz Eylül University School of Medicine, Child and Adolescent Psychiatry, İzmir, Turkey
| | - Yüksel Sümeyra Karagöz
- Child and Adolescent Psychiatry Department, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Özlem Doğan
- Department of Biochemistry, Ankara University School of Medicine, Ankara, Turkey
| | - Serenay Ülkar
- Department of Biochemistry, Ankara University School of Medicine, Ankara, Turkey
| | - Birim Günay Kılıç
- Child and Adolescent Psychiatry Department, Ankara University School of Medicine, Ankara, Turkey
| | - Hacer Akgül Ceyhun
- Department of Psychiatry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Esat Fahri Aydın
- Department of Psychiatry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Tuba Ülkevan
- Department of Psychiatry, Health Scıence Unıversity Van Training and Research Hospital, Van, Turkey
| | - Nilifer Gürbüzer
- Department of Psychiatry, Ataturk University School of Medicine, Erzurum, Turkey
| | - Hasan Cem Aykutlu
- Trakya University School of Medicine, Child and Adolescent Psychiatry Department, Edirne, Turkey
| | - Işık Görker
- Trakya University School of Medicine, Child and Adolescent Psychiatry Department, Edirne, Turkey
| | - Emel Özen
- Department of Child and Adolescent Psychiatry, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Evrim Aktepe
- Department of Child and Adolescent Psychiatry, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Mustafa Asım Aydın
- Department of Plastic and Reconstructive Surgery, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Dudu Dilek Yavuz
- Department of Plastic and Reconstructive Surgery, Suleyman Demirel University School of Medicine, Isparta, Turkey
| | - Umut Karaaslan
- Department of Child and Adolescent Psychiatry, Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Hatice Altun
- Department of Child and Adolescent Psychiatry, Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Abdullah Karataş
- Department of Child and Adolescent Psychiatry, Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Zehra Sancak
- İstanbul Gelişim University, Clinical Psychology, Istanbul, Turkey
| | - Nihal Yurteri Çetin
- Düzce University School of Medicine, Child and Adolescent Psychiatry, Düzce, Turkey
| | | | | | - Erhan Eser
- Department of Public Health, Manisa Celal Bayar University School of Medicine, Manisa, Turkey
| | - Mehmet Murat Demet
- Department of Psychiatry, Manisa Celal Bayar University School of Medicine, Manisa, Turkey
| | | | - Ece Yazla Asafov
- Hitit University, School of Medicine Department of Psychiatry, Çorum, Turkey
| | | | - Ayhan Algül
- Sultan Abdulhamid Han Research and Training Hospital, Department of Psychiatry, Istanbul
| | - İbrahim Gündoğmuş
- Sultan Abdulhamid Han Research and Training Hospital, Department of Psychiatry, Istanbul
| | - Fatih Hilmi Cetin
- Department of Child and Adolescent Psychiatry, Selçuk University School of Medicine, Konya, Turkey
| | - Hasan Ali Guler
- Department of Child and Adolescent Psychiatry, Selçuk University School of Medicine, Konya, Turkey
| | - Serhat Turkoglu
- Department of Child and Adolescent Psychiatry, Selçuk University School of Medicine, Konya, Turkey
| | - Bahar Keleş Çolpan
- Department of Otolaryngology, Selçuk University School of Medicine, Konya, Turkey
| | - Yaşar Tanır
- Department of Child and Adolescent Psychiatry, Kutahya Dumlupınar University Evliya Celebi Training and Research Hospital, Kütahya, Turkey
| | - Elif Bayram
- Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara Turkey
| | | | - Serap Tıraş Teber
- Department of Pediatric Neurology, Ankara University School of Medicine, Ankara, Turkey
| | - Birim Günay Kılıç
- Department of Child and Adolescent Psychiatry, Ankara University School of Medicine, Ankara Turkey
| | - Nagihan Saday Duman
- Department of Child and Adolescent Psychiatry, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - Emel Sarı Gökten
- Department of Child and Adolescent Psychiatry, NPIstanbul Brain Hospital of Uskudar University, İstanbul, Turkey
| | | | | | - Ayşen Çetin Kardeşler
- Department of Biochemistry, Pamukkale University School of Medicine, Denizli, Turkey
| | - Yaşar Enli
- Department of Biochemistry, Pamukkale University School of Medicine, Denizli, Turkey
| | - Neslihan Kurtul
- Department of Radiation Oncology, Kahramanmaras Sutcu Imam University School of Medicine, Kahramanmaras, Turkey
| | - Hatice Altun
- Department of Child and Adolescent Psychiatry, Kahramanmaras Sutcu Imam University School of Medicine, Kahramanmaras, Turkey
| | - Cihan Aslan
- Kırıkkale Yüksek İhtisas State Hospital, Department of Child and Adolescent Psychiatry, Kırıkkale, Turkey
| | - Bahadır Konuşkan
- Hacettepe University School of Medicine, Department of Pediatric Neurology, Ankara, Turkey
| | - Burçin Şener
- Hacettepe University School of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Banu Anlar
- Hacettepe University School of Medicine, Department of Pediatric Neurology, Ankara, Turkey
| | - Fatih Ünal
- Hacettepe University School of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey
| | - Bülent Devrim Akçay
- Gülhane Research and Training Hospital, Psychiatry Clinic, Sleep Research Center, Ankara, Turkey
| | - Güray Koç
- Gülhane Research and Training Hospital, Psychiatry Clinic, Sleep Research Center, Ankara, Turkey
| | - Sinan Yetkin
- Gülhane Research and Training Hospital, Psychiatry Clinic, Sleep Research Center, Ankara, Turkey
| | - Serkan Bayad
- Department of Psychiatry, Manisa Celal Bayar University School of Medicine, Manisa, Turkey
| | - Müge Elbir
- Department of Psychiatry, Manisa Celal Bayar University School of Medicine, Manisa, Turkey
| | - Özge Alp Topbaş
- Department of Psychiatry, Manisa Celal Bayar University School of Medicine, Manisa, Turkey
| | - Tuğba Kocabaş
- Department of Psychiatry, Manisa Celal Bayar University School of Medicine, Manisa, Turkey
| | - Ömer Aydemir
- Department of Psychiatry, Manisa Celal Bayar University School of Medicine, Manisa, Turkey
| | | | - Adem Aydın
- Department of Psychiatry, Necmettin Erbakan University School of Medicine, Konya, Turkey
| | - Abdullah Atli
- Department of Psychiatry, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Abdullah Atli
- Department of Psychiatry, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Pelin Avcu Çelik
- Department of Psychiatry, İskenderun State Hospital, Hatay, Turkey
| | | | - Deniz Argüz Çıldır
- Department of Child And Adolescent Psychiatry, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Aylin Özbek
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Aybuke Tuğçe Mustan
- Department of Child And Adolescent Psychiatry, Dr. Ersin Arslan Training and Research Hospital, Gaziantep, Turkey
| | - Ayşe Sevgi Karadağ
- Department of Ophthalmology, Adiyaman University School of Medicine, Adiyaman, Turkey
| | - Aysun Kalenderoğlu
- Department of Psychiatry, Adiyaman University School of Medicine, Adiyaman, Turkey
| | - Mehmet Hamdi Örüm
- Department of Psychiatry, Adiyaman University School of Medicine, Adiyaman, Turkey
| | | | | | - Aysun Kalenderoğlu
- Department of Psychiatry, School of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Ayşe Sevgi Karadağ
- Department of Ophthalmology, Adiyaman University School of Medicine, Adiyaman, Turkey
| | - Mehmet Hamdi Örüm
- Department of Psychiatry, School of Medicine, Adiyaman University, Adiyaman, Turkey
| | | | - Dilek Bingöl Aydın
- Department of Pediatrics, Sakarya University School of Medicine, Sakarya, Turkey
| | - Bahri Elmas
- Department of Pediatrics, Sakarya University School of Medicine, Sakarya, Turkey
| | - Serhat Nasıroğlu
- Department of Child and Adolescent Psychiatry, Sakarya University School of Medicine, Sakarya, Turkey
| | - Engin Aydın
- Department of Pediatrics, Sakarya University School of Medicine, Sakarya, Turkey
| | - Öner Özdemir
- Department of Pediatric Allergy and Immunology, Sakarya University School of Medicine, Sakarya, Turkey
| | - Özcan Erel
- Department of Biochemistry, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Hatice Altun
- Department of Child and Adolescent Psychiatry, Kahramanmaras Sutcu Imam University School of Medicine, Kahramanmaras, Turkey
| | - Ülker Fedai
- Department of Psychiatry, Balikligol State Hospital, Sanliurfa, Turkey
| | - Mehmet Asoğlu
- Department of Psychiatry, Harran University School of Medicine, Sanliurfa, Turkey
| | - Rümeysa Yeni Elbay
- Department of Psychiatry, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Hasan Turan Karatepe
- Department of Psychiatry, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Celal Ulaşoğlu
- Department of Gastroenterology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Hamza Ayaydın
- Department of Child and Adolescent Psychiatry, Harran University School of Medicine, Sanliurfa, Turkey
| | - Fethiye Kılıçaslan
- Department of Child and Adolescent Psychiatry, Harran University School of Medicine, Sanliurfa, Turkey
| | - Mehmet Asoğlu
- Department of Psychiatry, Harran University School of Medicine, Sanliurfa, Turkey
| | - Berkan Şahin
- Iğdır State Hospital, Child and Adolescent Psychiatry, Iğdır, Turkey
| | - Koray Karabekiroğlu
- Ondokuz Mayıs University School of Medicine, Child and Adolescent Psychiatry, Samsun, Turkey
| | - Abdullah Bozkurt
- Konya Training And Research Hospital, Child and Adolescent Psychiatry, Konya, Turkey
| | - Miraç Barış Usta
- Samsun Training And Research Hospital, Child and Adolescent Psychiatry, Samsun, Turkey
| | - Muazzez Aydın
- Ondokuz Mayıs University School of Medicine, Child and Adolescent Psychiatry, Samsun, Turkey
| | - Cansu Çobanoğlu
- Ondokuz Mayıs University School of Medicine, Child and Adolescent Psychiatry, Samsun, Turkey
| | - Hüseyin Kara
- Akdeniz University School of Medicine, Department of Psychiatry, Antalya, Turkey
| | - Yalçın Kahya
- Akdeniz University School of Medicine, Department of Psychiatry, Antalya, Turkey
| | - Özgen Özçelik
- Akdeniz University School of Medicine, Department of Psychiatry, Antalya, Turkey
| | - Dilara İnan
- Akdeniz University School of Medicine, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey
| | - Mehmet Murat Kuloğlu
- Akdeniz University School of Medicine, Department of Psychiatry, Antalya, Turkey
| | - Ali Ercan Altınöz
- Department of Psychiatry, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Ferdi Köşger
- Department of Psychiatry, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Altan Eşsizoğlu
- Department of Psychiatry, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Mehmet Arslan
- Department of Psychiatry, Babaeski State Hospital, Kırklareli, Turkey
| | | | - Duygu Göktaş
- Department of Psychiatry, Yozgat City Hospital, Yozgat, Turkey
| | - İkbal İnanlı
- Department of Psychiatry, Konya Training and Research Hospital, Konya, Turkey
| | - Saliha Çalışır
- Department of Psychiatry, Konya Training and Research Hospital, Konya, Turkey
| | - İbrahim Eren
- Department of Psychiatry, Konya Training and Research Hospital, Konya, Turkey
| | - Zeynep Baran Tatar
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Erhan Kurt
- Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
| | - Gokhan Unal
- Erciyes University School of Pharmacy, Department pf Pharmacology, Kayseri, Turkey
| | - Feyza Aricioglu
- Marmara University School of Pharmacy, Department of Pharmacology and Psychopharmacology Research Unit, Istanbul, Turkey
| | - Fatih Hilmi Cetin
- Department of Child and Adolescent Psychiatry, Selçuk University School of Medicine, Konya, Turkey
| | - Hasan Ali Guler
- Department of Child and Adolescent Psychiatry, Selçuk University School of Medicine, Konya, Turkey
| | - Mustafa Esad Tezcan
- Department of Child and Adolescent Psychiatry, Selçuk University School of Medicine, Konya, Turkey
| | - Serhat Turkoglu
- Department of Child and Adolescent Psychiatry, Selçuk University School of Medicine, Konya, Turkey
| | | | | | | | - Çigdem Yektaş
- Duzce University School of Medicine, Department of Child and Adolescent Psychiatry, Duzce, Turkey
| | - Recep Eroz
- Duzce University School of Medicine, Department of Child and Adolescent Psychiatry, Duzce, Turkey
| | - Gokhan Yurdakul
- Ondokuz Mayıs University Health Sciences Institute, Samsun, Turkey
| | - Mahmut Cakır
- Child Psychiatry Clinic, SS Amasya Education and Research Hospital, Amasya, Turkey
| | | | - Saliha Baykal
- Namık Kemal University School of Medicine, Child and Adolescent Psychiatry Department, Tekirdag, Turkey
| | - Mirac Barıs Usta
- Child Psychiatry Clinic, Samsun Education and Research Hospital, Samsun, Turkey
| | | | - Koray Karabekiroglu
- Ondokuz Mayıs University School of Medicine, Department of Child Psychiatry, Samsun, Turkey
| | - Yasemin Yulaf
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Funda Gümştaş
- Child and Adolescent Psychiatry Clinic, Marmara University Education Research Hospital, Istanbul, Turkey
| | - Sebla Gökçe
- Child and Adolescent Psychiatry Clinic, Maltepe University School of Medicine, Istanbul, Turkey
| | - Yankı Yazgan
- Child and Adolescent Psychiatry Clinic, Marmara University School of Medicine, Istanbul, Turkey
| | - Çağdaş Öykü Memiş
- Departent of Psychiatry, School of Medicine, Adnan Menderes, Aydın, Turkey
| | - Doğa Sevincok
- Departmet of Child and Adolescent Psychiatry, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Bilge Doğan
- Departent of Psychiatry, School of Medicine, Adnan Menderes, Aydın, Turkey
| | - Ayşe Kutlu
- Departmet of Child and Adolescent Psychiatry, Behcet Uz Child Diseases and Neurosurgery Research and Training Hospital, İzmir, Turkey
| | - Burcu Çakaloz
- Departmet of Child and Adolescent Psychiatry, Pamukkale University School of Medicine, Denizli, Turkey
| | - Levent Sevinçok
- Departent of Psychiatry, School of Medicine, Adnan Menderes, Aydın, Turkey
| | - Deniz Argüz Çıldır
- Department of Child and Adolescent Psychiatry, Tepecik Research and Training Hospital, Izmir, Turkey
| | - Tugba Kalyoncu
- Department of Child and Adolescent Psychiatry, Tepecik Research and Training Hospital, Izmir, Turkey
| | - Fazilet Arkat Ergüvendi
- Department of Child and Adolescent Psychiatry, Tepecik Research and Training Hospital, Izmir, Turkey
| | - Çağatay Uğur
- Health Sciences University, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Child and Adolescent Psychiatry Department
| | - İbrahim Yağcı
- Kars Harakani State Hospital, Department of Psychiatry, Kars, Turkey
| | - Sema Avcı
- Kars Harakani State Hospital, Department of Emergency, Kars, Turkey
| | - Yüksel Kıvrak
- Kafkas University School of Medicine, Department of Psychiatry, Kars, Turkey
| | - Alişan Burak Yaşar
- Department of Psychiatry, Health Sciences University Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Ceyhun Sayman
- Department of Neurology, Health Sciences University Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Serap Erdoğan Taycan
- Department of Psychiatry, Health Sciences University Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Yılmaz Çetinkaya
- Department of Neurology, Health Sciences University Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Anıl Gündüz
- Department of Psychiatry, Health Sciences University Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Hülya Tireli
- Department of Neurology, Health Sciences University Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey
| | - Kemal Utku Yazici
- Firat University School of Medicine, Department of Child and Adolescent Psychiatry, Elazig, Turkey
| | - Ipek Percinel Yazici
- Firat University School of Medicine, Department of Child and Adolescent Psychiatry, Elazig, Turkey
| | - Yüksel Kıvrak
- Kafkas University School of Medicine, Department Psychiatry, Kars, Turkey
| | | | - Süleyman Gül
- Kafkas University School of Science, Department of Molecular Biology, Kars, Turkey
| | - İbrahim Yağcı
- Kars Harakani State Hospital, Department of Psychiatry, Kars, Turkey
| | - Ipek Percınel Yazici
- Firat University School of Medicine, Department of Child and Adolescent Psychiatry, Elazig, Turkey
| | - Kemal Utku Yazici
- Firat University School of Medicine, Department of Child and Adolescent Psychiatry, Elazig, Turkey
| | - Deniz Argüz Çıldır
- Department of Child And Adolescent Psychiatry, Tepecik Research and Training Hospital, Izmir, Turkey
| | - Aylin Özbek
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, Izmir, Turkey
| | - Ayçin Darıcı Sümer
- Department of Child and Adolescent Psychiatry, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Esra Çöp
- Department of Child and Adolescent Psychiatry, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Duygu Bilgili
- Department of Child and Adolescent Psychiatry, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Müge Şahin
- Department of Child and Adolescent Psychiatry, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Gülser Şenses Dinç
- Department of Child and Adolescent Psychiatry, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Özlem Hekim
- Department of Child and Adolescent Psychiatry, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Emine Dibek Mısırlıoğlu
- Department of Pediatrics, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Funda Kurt
- Department of Pediatrics, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Zeynep Göker
- Department of Child and Adolescent Psychiatry, Ankara Pediatric Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Özden Üneri
- Department of Child and Adolescent Psychiatry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Yüksel Kıvrak
- Kafkas University School of Medicine, Department Psychiatry, Kars, Turkey
| | - Yüksel Kıvrak
- Kafkas University School of Medicine, Department Psychiatry, Kars, Turkey
| | - İbrahim Yağcı
- Kars Harakani State Hospital, Department of Psychiatry, Kars, Turkey
| | - Yüksel Kıvrak
- Kafkas University School of Medicine, Department Psychiatry, Kars, Turkey
| | - Eray Atalay
- Kafkas University School of Medicine, Department Internal Medicine, Kars, Turkey
| | - İrem Yıldırım
- Kafkas University School of Medicine, Department of Neurology, Kars, Turkey
| | - İbrahim Yağcı
- Kars Harakani State Hospital, Department of Psychiatry, Kars, Turkey
| | - Ali İnaltekin
- Kafkas University School of Medicine, Department Psychiatry, Kars, Turkey
| | - Bengü Yücens
- Afyon Kocatepe University Medical Faculty, Department of Psychiatry, Afyonkarahisar, Turkey
| | - Vahap Ozan Kotan
- Başkent University School of Medicine, Department of Psychiatry, Ankara, Turkey
| | - Nihal Özkayar
- Hitit University School of Medicine, Department of Nephrology, Çorum, Turkey
| | - Fatih Dede
- Ankara Numune Research and Training Hospital, Department of Nephrology, Ankara, Turkey
| | - Rabia Nazik Yüksel
- Ankara Numune Research and Training Hospital, Department of Psychiatry, Ankara, Turkey
| | - Şenol Bayram
- Ankara Numune Research and Training Hospital, Department of Psychiatry, Ankara, Turkey
| | - Zeynep Kotan
- Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Department of Psychiatry, Ankara, Turkey
| | - Erol Göka
- Ankara Numune Research and Training Hospital, Department of Psychiatry, Ankara, Turkey
| | | | - Gökçe Nur Say
- Ondokuz Mayis University School of Medicine, Department Psychiatry, Samsun, Turkey
| | | | | | - Merve Kalyoncu
- Ondokuz Mayis University School of Medicine, Department Psychiatry, Samsun, Turkey
| | - Muazzez Aydın
- Ondokuz Mayis University School of Medicine, Department Psychiatry, Samsun, Turkey
| | - Cansu Çobanoğlu
- Ondokuz Mayis University School of Medicine, Department Psychiatry, Samsun, Turkey
| | - Özlem Beğinoğlu
- Harran University School of Medicine, Department of Psychiatry
| | - Mehmet Asoğlu
- Harran University School of Medicine, Department of Psychiatry
| | - Bahadir Bilgin Basgoz
- Health Sciences University Gulhane School of Medicine, Department of Internal Medicine, Ankara, Turkey
| | - Semra Ince
- Health Sciences University Gulhane School of Medicine, Department of Nuclear Medicine, Ankara, Turkey
| | - Umut Safer
- Health Sciences University Gulhane School of Medicine, Department of Internal Medicine, Ankara, Turkey
| | - İlker Tasci
- Health Sciences University Gulhane School of Medicine, Department of Internal Medicine, Ankara, Turkey
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Büyüktuna SA, Saba R, Gözel MG, Turhan Ö, İnan D, Aşık Z, Köse A. Secondary infections after cytotoxic chemotherapy in patient with hematological malignancies. J Infect Dev Ctries 2017; 11:521-526. [DOI: 10.3855/jidc.8530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 12/22/2016] [Indexed: 10/31/2022] Open
Abstract
Introduction: This study was initiated to investigate the risk factors of secondary infections in febrile neutropenic patients following chemotherapy, and to evaluate the clinical, microbiological, and mortality outcomes of these infections.
Methodology: An evaluation was done on all patients with hematological malignancy who developed a febrile neutropenic episode (FNE) after cytotoxic chemotherapy in the Department of Hematology, Akdeniz University Faculty of Medicine, between January 2007 and December 2008.
Results: A total of 294 primary FNEs that responded to the initial empirical or targeted treatment were included in the study, and secondary infections developed after 72 (24.5%) of 294 primary FNEs. Risk factors for secondary infections were determined as acute leukemia as the underlying disease, salvage chemotherapy for refractory/relapse diseases, prolonged neutropenia (10 days and over), Multinational Association of Supportive Care in Cancer (MASSC) score < 21, and fungal infection during the primary episode. The mortality rate of patients who developed secondary infections was significantly higher compared to patients without secondary infections (27.8% and 5.4%, respectively; p = 0.001).
Conclusions: The development of secondary infections in patients with hematological malignancy was not very rare. Greater concern should be shown for these infections to increase patient survival rates.
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Sayan M, Gündüz A, Ersöz G, İnan A, Deveci A, Özgür G, Sargın F, Karagöz G, İnci A, İnan D, Ülçay A, Karaoğlan I, Kaya S, Kutlu SS, Süer K, Çağatay A, Akalın H. Integrase Strand Transfer Inhibitors (INSTIs) Resistance Mutations in HIV-1 Infected Turkish Patients. HIV Clin Trials 2016; 17:109-13. [PMID: 27125365 DOI: 10.1080/15284336.2016.1153303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Integrase strand transfer inhibitor (INSTI) is a new class of antiretroviral (ARV) drugs designed to block the action of the integrase viral enzyme, which is responsible for insertation of the HIV-1 genome into the host DNA. The aim of this study was to evaluate for the first time INSTI resistance mutations in Turkish patients. METHODS This study was conducted in Turkey, between April 2013 and April 2015 using 169 HIV-1-infected patients (78 ARV naive patients and 91 ARV-experienced patients). Laboratory and clinical characteristics of ARV naive and ARV-experienced patients were as follows: gender (M/F): 71/7 and 80/11, median age: 38 and 38.4; median CD4(+) T-cell: 236 and 216 cells/mm(3), median HIV-1 RNA: 4.95+E5 and 1.08E+6 copies/ml. Population-based seqeunces of the reverse transcriptase, protease, and integrase domains of the HIV-1 pol gene were used to detect HIV-1 drug resistance mutations. RESULT INSTI resistance mutations were not found in recently diagnosed HIV-1-infected patients. However, ARV-experienced patients had major resistance mutations associated with raltegravir and elvitegravir; the following results were generated:F121Y, Y143R, Q148R and E157Q (6/91 - 6.6%). CONCLUSIONS The prevalence of INSTI resistant mutations in ART-experienced patients suggested that resistance testing must be incorporated as an integral part of HIV management with INSTI therapies.
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Affiliation(s)
- M Sayan
- a Faculty of Medicine, Clinical Laboratory, PCR Unit , University of Kocaeli , Kocaeli , Turkey.,b Research Center of Experimental Health Sciences, University of Near East , Nicosia , Northern Cyprus
| | - A Gündüz
- c Clinic of Infectious Diseases , Sisli Etfal, Educational and Research Hospital , Istanbul , Turkey
| | - G Ersöz
- d Faculty of Medicine, Department of Infectious Diseases , University of Mersin , Mersin , Turkey
| | - A İnan
- e Clinic of Infectious Diseases , Haydarpasa Numune, Educational and Research Hospital , Istanbul , Turkey
| | - A Deveci
- f Faculty of Medicine, Department of Infectious Diseases , University of 19 Mayis , Samsun , Turkey
| | - G Özgür
- g Clinic of Infectious Diseases , Samsun Educational and Research Hospital , Samsun , Turkey
| | - F Sargın
- h Clinic of Infectious Diseases , Medeniyet University, Goztepe Educational and Research Hospital , Istanbul , Turkey
| | - G Karagöz
- i Clinic of Infectious Diseases , Umraniye Educational and Research Hospital , İstanbul , Turkey
| | - A İnci
- j Clinic of Infectious Diseases , Istanbul Kanuni Sultan Süleyman, Educational and Research Hospital , Istanbul , Turkey
| | - D İnan
- k Faculty of Medicine, Department of Infectious Diseases , University of Akdeniz , Antalya , Turkey
| | - A Ülçay
- l Clinic of Infectious Diseases , Gulhane Military Medical Academy , Istanbul , Turkey
| | - I Karaoğlan
- m Faculty of Medicine, Department of Infectious Diseases , University of Gaziantep , Gaziantep , Turkey
| | - S Kaya
- n Faculty of Medicine, Department of Infectious Disease , University of Karadeniz Technical , Trabzon , Turkey
| | - S S Kutlu
- o Faculty of Medicine, Department of Infectious Diseases , University of Pamukkale , Denizli , Turkey
| | - K Süer
- p Faculty of Medicine, Department of Infectious Diseases , University of Near East , Nicosia , Northern Cyprus
| | - A Çağatay
- q Faculty of Medicine, Department of Infectious Diseases , University of Istanbul , İstanbul , Turkey
| | - H Akalın
- r Faculty of Medicine, Department of Infectious Diseases , University of Uludag , Bursa , Turkey
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Süer KH, İnan D. Chronic Hepatitis C Treatment in a Thalassemia Major Patient: A Case Report. Egypt J Immunol 2014. [DOI: 10.4274/vhd.83803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sağlik İ, Mutlu D, Öngut G, İnan D, Öğünç D, Can Sarinoğlu R, Özhak Baysan B, Gültekin M, Çolak D. [Distribution of hepatitis C virus genotypes among patients with chronic hepatitis C infection in Akdeniz University Hospital, Antalya, Turkey: a five-year evaluation]. MIKROBIYOL BUL 2014; 48:429-37. [PMID: 25052109 DOI: 10.5578/mb.7685] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hepatitis C virus (HCV) is one of the major causes of chronic hepatitis. It is important to know the genotypes of HCV in the decision of the HCV related chronic hepatitis therapy. The aim of this study was to evaluate the HCV genotypes determined at the Microbiology Laboratory of Akdeniz University Hospital, and to evaluate the changes in the distribution of the genotypes within the last five years. A total of 422 blood samples from HCV-RNA positive chronic hepatitis C patients (219 male, 203 female; age range: 8-79 yrs, mean age 46.3 ± 15.5 yrs) which were sent to our laboratory for genotyping between 2009-2013 period, were analyzed retrospectively. HCV-RNA extractions were performed in an automated system (EZ1 Virus Mini Kit v2.0, Qiagen, Germany), and a commercial reverse hybridization line probe-based assay (LIPA; GEN-C RT-PCR, Italy) was carried out for genotyping, For viral load determinations, a real-time PCR method (Cobas TaqMan HCV, Roche Diagnostics, Germany) was used. Demographic data of the patients were obtained from the hospital information systems and electronic patients' files. Out of the 422 patients, genotype 1b was detected in 63.3% (n= 267), genotype 1a in 14.7% (n= 62), genotype 3a in 11.1% (n= 47), genotype 2b in 0.9% (n= 4), genotype 4e in 0.2% (n= 1). The subtypes couldn't be determined for 5.4% (n= 23), 2.6% (n= 11) and 1.4% (n= 6) of the patients infected with genotype 1, 2 and 4, respectively. One (0.2%) patient, was coinfected with genotype 1 and 4. Of the patients, 40 were foreign-born (16 cases from Russia; 4 of each from Ukraine and Georgia; 3 of each from Turkmenistan, Kyrgyzstan, and Germany; one of each from Tajikistan, Azerbaijan, Uzbekistan, Chechnya, Moldova, Switzerland and Romania) and among these patients genotype 3a (19/40; 47.5%) was the most common genotype followed by genotype 1b (17/40; 42.5%). Median values of HCV viral load were 668.500 IU/ml (range: 2.000-9.630.000) in the whole group; while it was 732.000 IU/ml (range: 2.000-9.630.000) in patients infected with genotype 1 and 444.000 IU/ml (range: 2.650- 8.330.000) in patients infected with the other genotypes (p> 0.05). Patients infected with genotype 1 were found to be older than those infected with other genotypes (47 ± 15.7 and 39.5 ± 12.2, respectively; p< 0.001). Among patients infected with different genotypes, there was no statistically significant difference in terms of genders (p> 0.05). In conclusion, the determination of HCV genotypes is of crucial importance for treatment decision-making of chronic HCV infection. Besides, it also allows monitoring the changes in the epidemiology of HCV. In this study, although genotype 1b was determined as the most common HCV genotype, the detection of other genotypes was remarkable. This finding was attributed to the presence of many foreign national people in Antalya region which was a high capacity tourism area in Turkey.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Dilek Çolak
- Akdeniz University Faculty of Medicine, Department of Medical Microbiology, Antalya, Turkey.
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