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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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Erdem H, Baymakova M, Alkan S, Letaief A, Yahia WB, Dayyab F, Kolovani E, Grgic S, Cosentino F, Hasanoglu I, Khedr R, Marino A, Pekok AU, Eser F, Arapovic J, Guner HR, Miftode IL, Poposki K, Sanlidag G, Tahmaz A, Sipahi OR, Miftode EG, Oncu S, Cagla-Sonmezer M, Addepalli SK, Darazam IA, Kumari HP, Koc MM, Kumar MR, Sayana SB, Wegdan AA, Amer F, Ceylan MR, El-Kholy A, Onder T, Tehrani HA, Hakamifard A, Kayaaslan B, Shehata G, Caskurlu H, El-Sayed NM, Mortazavi SE, Pourali M, Elbahr U, Kulzhanova S, Yetisyigit T, Saad SA, Cag Y, Eser-Karlidag G, Pshenichnaya N, Belitova M, Akhtar N, Al-Majid F, Ayhan M, Khan MA, Lanzafame M, Makek MJ, Nsutebu E, Cascio A, Dindar-Demiray EK, Evren EU, Kalas R, Kalem AK, Baljić R, Ikram A, Kaya S, Liskova A, Szabo BG, Rahimi BA, Mutlu-Yilmaz E, Sener A, Rello J. Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study. Eur J Clin Microbiol Infect Dis 2023; 42:387-398. [PMID: 36790531 PMCID: PMC9930069 DOI: 10.1007/s10096-023-04561-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023]
Abstract
Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies). This research included 788 patients. FUO diagnoses were as follows: infections (51.6%; n = 407), neoplasms (11.4%, n = 90), collagen vascular disorders (9.3%, n = 73), undiagnosed (20.1%, n = 158), miscellaneous diseases (7.7%, n = 60). The most common infections were tuberculosis (n = 45, 5.7%), brucellosis (n = 39, 4.9%), rickettsiosis (n = 23, 2.9%), HIV infection (n = 20, 2.5%), and typhoid fever (n = 13, 1.6%). Cardiovascular infections (n = 56, 7.1%) were the most common infectious syndromes. Only collagen vascular disorders were reported significantly more from developed countries (RR = 2.00, 95% CI: 1.19-3.38). FUO had similar characteristics in LI/LMI and UMI/HI countries including the portion of undiagnosed cases (OR, 95% CI; 0.87 (0.65-1.15)), death attributed to FUO (RR = 0.87, 95% CI: 0.65-1.15, p-value = 0.3355), and the mean duration until diagnosis (p = 0.9663). Various aspects of FUO cannot be determined by the economic development solely. Other development indices can be considered in future analyses. Physicians in different countries should be equally prepared for FUO patients.
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Affiliation(s)
- Hakan Erdem
- Department of Infectious Diseases & Clinical Microbiology, Gulhane School of Medicine, Turkish Health Sciences University, Ankara, Turkey
| | - Magdalena Baymakova
- Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria
| | - Sevil Alkan
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Amel Letaief
- Department of Infectious Diseases, Farhat Hached University Hospital, Ibn El Jazzar Medical School, University of Sousse, Sousse, Tunisia
| | - Wissal Ben Yahia
- Department of Infectious Diseases, Farhat Hached University Hospital, Ibn El Jazzar Medical School, University of Sousse, Sousse, Tunisia
| | - Farouq Dayyab
- Department of Internal Medicine, King Hamad University Hospital, Al Sayh, Manama, Bahrain
| | - Entela Kolovani
- Infectious Disease Clinic, University Hospital Center 'Mother Theresa', Tirana, Albania
| | - Svjetlana Grgic
- Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Federica Cosentino
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | - Imran Hasanoglu
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Reham Khedr
- Department of Pediatric Oncology, National Cancer Institute - Cairo University, Children Cancer Hospital Egypt, Cairo, Egypt
| | - Andrea Marino
- Department of Clinical and Experimental Medicine, Unit of Infectious Diseases, ARNAS Garibaldi Hospital, University of Catania, Catania, Italy
| | | | - Fatma Eser
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Jurica Arapovic
- Department of Infectious Diseases, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Hatice Rahmet Guner
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | - Kostadin Poposki
- Faculty of Medicine, University Clinic for Infectious Diseases and Febrile Conditions, Skopje, Republic of North Macedonia
| | - Gamze Sanlidag
- Department of Infectious Diseases & Clinical Microbiology, Ege School of Medicine, Izmir, Turkey
| | - Alper Tahmaz
- Department of Infectious Diseases & Clinical Microbiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Oguz Resat Sipahi
- Department of Infectious Diseases & Clinical Microbiology, Ege School of Medicine, Izmir, Turkey
| | | | - Serkan Oncu
- Department of Infectious Diseases & Clinical Microbiology, School of Medicine, Adnan Menderes University, Aydin, Turkey
| | - Meliha Cagla-Sonmezer
- Department of Infectious Diseases & Clinical Microbiology, Hacettepe School of Medicine, Hacettepe University, Ankara, Turkey
| | - Syam Kumar Addepalli
- Department of Pharmacology, GITAM Institute of Medical Sciences and Research, Visakhapatnam, Andhra Pradesh, India
| | - Ilad Alavi Darazam
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hema Prakash Kumari
- Department of Microbiology, GITAM Institute of Medical Sciences and Research, Visakhapatnam, Andhra Pradesh, India
| | - Meliha Meriç Koc
- Department of Infectious Diseases & Clinical Microbiology, School of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Meela Ranjith Kumar
- Department of Pharmacology, Government Medical College &, Government General Hospital, Suryapet, Telangana, India
| | - Suresh Babu Sayana
- Department of Pharmacology, Government Medical College, Suryapet, Telangana, India
| | - Ahmed Ashraf Wegdan
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Fatma Amer
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mehmet Resat Ceylan
- Department of Infectious Diseases & Clinical Microbiology, School of Medicine, Harran University, Sanliurfa, Turkey
| | - Amani El-Kholy
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Taylan Onder
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Hamed Azhdari Tehrani
- Department of Hematology and Medical Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atousa Hakamifard
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bircan Kayaaslan
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | - Hulya Caskurlu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | | | - Seyed Erfan Mortazavi
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Pourali
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Umran Elbahr
- Department of Infectious Diseases, Bahrain Oncology Center, King Hamad University Hospital, Busaiteen, Bahrain
| | - Sholpan Kulzhanova
- Department of Infectious Diseases, Astana Medical University, Nur-Sultan, Kazakhstan
| | - Tarkan Yetisyigit
- Department of Oncology, Bahrain Oncology Center, King Hamad University Hospital, Busaiteen, Bahrain
| | - Sahar Ahmed Saad
- Department of Rheumatology, King Hamad Univesity Hospital, Al Sayh, Bahrain
| | - Yasemin Cag
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
| | - Gulden Eser-Karlidag
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Elazig Fethi Sekin City Hospital, Elazig, Turkey
| | | | | | - Nasim Akhtar
- Pakistan Institute of Medical Sciences, Islamabad, G-8/3, Pakistan
| | - Fahad Al-Majid
- Department of Medicine, Infectious Diseases Division, King Saud University, Riyadh, Saudi Arabia
| | - Muge Ayhan
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | | | | | - Emmanuel Nsutebu
- Tropical and Infectious Diseases Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Antonio Cascio
- Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE) - Infectious Disease Unit, Policlinico 'P. Giaccone', University of Palermo, Palermo, Italy
| | | | - Emine Unal Evren
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, University of Kyrenia, Kyrenia, Cyprus
| | - Rama Kalas
- Internal Medicine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Ayşe Kaya Kalem
- Department of Infectious Diseases & Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | | | - Aamer Ikram
- National Institutes of Health, Islamabad, Pakistan
| | - Selcuk Kaya
- Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Anna Liskova
- Hospital Nitra, St. Elisabeth University of Health Care and Social Work, Bratislava, Slovak Republic
| | - Balint Gergely Szabo
- South Pest Central Hospital, National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Bilal Ahmad Rahimi
- Department of Infectious Diseases, Kandahar University Medical Faculty, Teaching Hospital, Kandahar, Afghanistan
| | - Esmeray Mutlu-Yilmaz
- Department of Infectious Diseases & Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Alper Sener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Jordi Rello
- Clinical Research and Epidemiology in Pneumonia and Sepsis, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain
- Clinical Research, CHRU Nîmes, Nîmes, France
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Tahmaz A, Çetin E, Balcı U, Sarıgül Yıldırım F, Seyman D, Gürgen A. [The Evaluation of Long Coronavirus Disease Symptoms at Ninth Month from a Hospital in Türkiye]. MIKROBIYOL BUL 2022; 56:657-666. [PMID: 36458712 DOI: 10.5578/mb.20229604] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Long COVID is defined as symptoms related to various organs following COVID-19. There is currently very little information available about the prevalence of these symptoms and their long-term recovery time. The aim of this study was to describe the symptoms that persisted nine months after COVID-19. This cross-sectional study was conducted in Antalya, Türkiye, between November 1 and 30, 2020 on COVID-19 patients. Patients were contacted approximately nine months later by two infectious diseases physicians, and the questionnaire which included 27 symptoms was completed. Of the 390 patients who met the criteria, 329 agreed to participate in the study. Patients' average age was 48.9 ± 14.4 years, and 51.7% were male. 79.3% of the people still had at least one symptom at the end of the ninth month. The most common symptoms were weakness-fatigue (54.7%), forgetfulness (45.3%), effort loss (35.0%), sleep disturbance (34.3%), joint pain (27.4%), and hair loss (23.4%). According to analysis performed in terms of sex; hair loss, diarrhea, nausea, dizziness, sore throat, loss of taste and smell were more common in women than in men (p= 0.042, p= 0.047, p= 0.050, p= 0.026, p= 0.016, p= 0.036, p= 0.027, respectively). Individuals aged 65 years and over had a significantly lower number of symptoms (p= 0.029) than all other age groups. Furthermore, the number of symptoms was higher in patients who used steroids (p= 0.049). This study is an important source of information on the long-term symptoms of COVID-19. Our results have shown that the symptoms associated with COVID-19 do not completely resolve even after nine months, which explains why long COVID requires continuous monitoring.
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Affiliation(s)
- Alper Tahmaz
- Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Eda Çetin
- Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Umay Balcı
- Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Figen Sarıgül Yıldırım
- Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Derya Seyman
- Antalya Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, Antalya, Türkiye
| | - Atila Gürgen
- Ordu State Hospital, Clinic of Mental Health and Diseases, Ordu, Türkiye
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