Hepatitis C virus (HCV) and hepatitis E virus (HEV) are the principal causes of non-A, non-B hepatitis worldwide, and in Turkey one-third of the cases of acute hepatitis are non-A, non-B. To explore the epidemiology of HCV in Turkey... more
Hepatitis C virus (HCV) and hepatitis E virus (HEV) are the principal causes of non-A, non-B hepatitis worldwide, and in Turkey one-third of the cases of acute hepatitis are non-A, non-B. To explore the epidemiology of HCV in Turkey (including the association of HCV with HEV), a seroprevalence study of HCV was conducted. Sera from residents from five distinct regions of the country were tested for antibodies to HCV (anti-HCV) and HEV (anti-HEV). Anti-HCV was detected in 21 (1.5%) of 1,374 persons and was more common in residents over 54 years of age (p = 0.02), with less than primary education (p = 0.013), more than two children (p = 0.003), and who lived in the regions of Ayvalik (p = 0.046) or Trabzon (p = 0.038) compared to Istanbul. Anti-HCV was marginally associated with anti-HEV, which was found in 5.9% of residents. However, this association was lost after controlling for age and education (p = 0.225). HCV infection occurs in all regions of Turkey and is more common in persons who are older and of low socioeconomic status. As resources permit, efforts to reduce the transmission of HCV in Turkey (such as screening blood donations for anti-HCV) are indicated.
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SEN viruses are transmitted parenterally and can cause post-transfusion hepatitis. The prevalence and clinical significance of SEN viruses have been investigated in patients with chronic hepatitis C and B but not in D. We aimed to... more
SEN viruses are transmitted parenterally and can cause post-transfusion hepatitis. The prevalence and clinical significance of SEN viruses have been investigated in patients with chronic hepatitis C and B but not in D. We aimed to determine the prevalence and clinical significance of SEN viruses- H in patients with chronic hepatitis C, B and delta in Turkey. SEN viruses-H was analyzed in 85 patients with chronic viral hepatitis (30 HCV, 30 HBV and 25 HDV) and 43 non-professional blood donors. HBV DNA, HCV RNA and HDV RNA were positive in patients with hepatitis B, C and D, respectively. SEN viruses-H DNA was detected by semi-nested polymerase chain reaction method (L2AS, C5S primer in first step, L2AS, D11 in second step) after extraction of DNA from sera (NucleoSpin blood; Macherey-Nagel GmbH & Co KG, Germany). SEN viruses-H DNA was found to be positive in 7/30 (23.3%), 10/30 (33.3%), 6/25 (24%), and 7/43 (16.2%) of patients with chronic C, B, and D hepatitis and healthy blood donors, respectively. There was no significant difference in clinical features and treatment response between SEN viruses- H-positive and -negative patients with chronic viral hepatitis. SEN viruses is more frequent in chronic hepatitis patients than in healthy blood donors. These results indicate that SEN viruses has no effect on the clinical course and treatment response of chronic viral hepatitis.
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To investigate the clinical features and treatment response in patients with hepatitis B (HBV) and hepatitis C virus (HCV) co-infection receiving anti-HCV therapy. Patients with HBV/HCV co-infection, who were eligible for anti-HCV... more
To investigate the clinical features and treatment response in patients with hepatitis B (HBV) and hepatitis C virus (HCV) co-infection receiving anti-HCV therapy. Patients with HBV/HCV co-infection, who were eligible for anti-HCV therapy, were included in the study. Patients had detectable HBsAg for at least 6 months and detectable HCV-RNA before the initiation of therapy. Primary end-point was the proportion of patients achieving sustained virological response (SVR). HBV serology and HBV-DNA results obtained during the follow-up were assessed to determine HBV clearance or reactivation after anti-HCV therapy. There were 612 patients in the HCV cohort and 52 (8.5%) of them were HBV/HCV co-infected. Twenty-eight patients (20 male, mean age: 47 ± 12) received anti-HCV treatment and followed-up for a mean duration of 53 months (12-156). Fifteen patients received peginterferon/ribavirin combination while the remaining patients received standard interferon/ribavirin combination (n=6) or standard interferon monotherapy (n=7). Patients receiving interferon monotherapy were under chronic hemodialysis therapy. SVR was achieved in 14 (50%) patients at the end of follow-up. The proportion of patients with SVR in three treatment arms were not significantly different (P=0.78). Eight of 11 patients with detectable HBV-DNA cleared HBV-DNA during treatment. Seven (25%) patients experienced a rebound in HBV-DNA, and one patient experienced an acute hepatitis flare which was controlled by tenofovir therapy. Two (7%) patients cleared HBsAg and one of them was seroconverted to anti-HBs. Co-infection with HBV does not have a negative impact on the efficacy of anti-HCV treatment, but HBV-DNA should be monitored to overcome the risk of HBV exacerbation.
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Incidence of hepatitis B virus infection (HBV) has been greatly reduced globally after the introduction of universal vaccination programs. However, another potential threat was noticed almost 2 decades ago, which is the selection of... more
Incidence of hepatitis B virus infection (HBV) has been greatly reduced globally after the introduction of universal vaccination programs. However, another potential threat was noticed almost 2 decades ago, which is the selection of antibody escape HBV strains. Antibody or immune escape strains of HBV carry mutations in the S gene which encodes "a" determinant region located at amino acid positions 124 to 149. Certain mutations in this region, which promotes antibody response, might lead to an alteration in the antigenicity of hepatitis B surface antigen (HBsAg). Anti-HBs might fail to neutralize the mutant virus and transmission or reappearance of infection in previously immunized individuals can be possible. Herein, we report a patient with known HBV seropositivity (HBsAg negative, anti-HBs positive, anti-HBc IgG positive) for more than 10 years who developed a symptomatic acute hepatitis due to occurrence of immune escape mutants in the absence of any immunosuppression or cytotoxic chemotherapy. To the best of our knowledge, this is the first reported case of acute hepatitis B due to escape mutations in a naturally immune patient.
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This study was undertaken to investigate the prevalence of HBsAg, anti-HBs and anti-HCV positivity in Istanbul, Turkey. The frequencies of HBsAg, anti-HBs and anti-HCV positivity were determined in 1,157 randomly selected patients... more
This study was undertaken to investigate the prevalence of HBsAg, anti-HBs and anti-HCV positivity in Istanbul, Turkey. The frequencies of HBsAg, anti-HBs and anti-HCV positivity were determined in 1,157 randomly selected patients attending the outpatient clinic of Istanbul University Hospital, Istanbul, Turkey, during the years 1998 and 2001. All patients underwent complete physical and various routine laboratory examinations. Of the 1,157 patients, the prevalence of HBsAg, anti-HBs and anti-HCV was 6.6, 28.1 and 2.4%, respectively. It appeared that having dental and surgical procedures formed the risk factors for HBV infection. HBsAg positivity in the health care workers was not different from that of the other professions, but anti-HBs was significantly higher in this group. Our findings indicate that HBV infection occurs more frequently than HCV in Istanbul, and this poses an important health problem in the community.
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This study was performed for evaluation of seroprevalence of hepatitis A, B, and E among children in Istanbul, Turkey. The study group included 909 children who were 6 months-15 years of age. The children were separated to three age... more
This study was performed for evaluation of seroprevalence of hepatitis A, B, and E among children in Istanbul, Turkey. The study group included 909 children who were 6 months-15 years of age. The children were separated to three age groups: Group 1 (6 months-4.9 years; n = 321), Group 2 (5.0-9.9 years; n = 318), and Group 3 (10.0-15.0 years; n = 270). Group I was divided to two subgroups for evaluation of the maternal antibody sera (6 months-2 years and over 2 years). Serum IgG anti-HAV, anti-HBc, and anti-HEV were tested by commercial ELISA kits. The data were studied by multivariant analysis. In all subjects, seroprevalence of hepatitis A, B, and E were determined as 29, 15.9, and 2.1% respectively. The prevalence of hepatitis A increased with age (p < 0.05; Group 1 15.1% and Group 3 49.6%). Anti-HBc IgG level did not significantly change with age (Group 1 18.6% and Group 3 15.4%; p > 0.05). The seroprevalence of hepatitis E virus infection was higher in Group 1 (3.7%) than Group 3 (0.3%; p < 0.05). In Group 1 first subgroup, between 6 month and 2 year, antibody levels were 12.2, 17.3, and 4.8% respectively, for anti-HAV IgG, anti-HBc IgG and anti-HEV IgG. Hepatitis A and B infection is a community health problem, but hepatitis E infection is low in children in Istanbul, Turkey. The high positive rate in Group I for IgG anti-HEV may be due to maternal antibodies.
Research Interests: Epidemiology, Child Welfare, Turkey, Community Health, Adolescent, and 22 moreMultivariate Analysis, Hepatitis B, Humans, Child, Age, Liver, Virus, Female, Male, Infant, European, Prevalence, Public health systems and services research, Group, Age Factors, hepatitis E, Hepatitis E Virus, hepatitis A, Sensitivity and Specificity, Age Groups, immunoglobulin G, and Nino
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Research Interests: Rheumatoid Arthritis, High Frequency, Humans, Female, Clinical, and 14 moreMale, Cyclic peptides, Differential Diagnosis, Clinical Sciences, Aged, Middle Aged, Adult, Sjogren´s Syndrome, Reproducibility of Results, Biological markers, Sensitivity and Specificity, Enzyme Linked Immunosorbent Assay, Autoantibodies, and Keratins
Yasal uyarı: Bu sitede yayınlanan resim, yazı ve diğer uygulamaların her hakkı Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş. 'ye aittir. Kaynak gösterilmeden kullanılamaz. Bu site hekimleri... more
Yasal uyarı: Bu sitede yayınlanan resim, yazı ve diğer uygulamaların her hakkı Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş. 'ye aittir. Kaynak gösterilmeden kullanılamaz. Bu site hekimleri sağlık alanında bilgilendirmeye yönelik hazırlanmıştır. ...
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MICs determined in the agar dilution assay at neutral pH probably reflect the amount of the compounds activated during the long incubation period, but cannot be used for comparison of their antibacterial potential with that of antibiotics... more
MICs determined in the agar dilution assay at neutral pH probably reflect the amount of the compounds activated during the long incubation period, but cannot be used for comparison of their antibacterial potential with that of antibiotics since the compounds require acidic conditions for complete activation. To estimate the concentrations necessary for antibacterial activity at pH 4, dose-response studies were performed for two strains using different concentrations of pantoprazole in a short-term incubation assay as described above: Depending on the strain used, 0.064--0.25 mg/ml was the lowest concentration still resulting in a decrease of viable counts by more than four times. Significant decreases of viable counts were seen at concentrations as low as 0.016--0.064 mg/ml. We conclude from these studies that substituted benzimidazoles developed as inhibitors of gastric acid secretion have bactericidal activity against Helicobacter pylori in vitro. This action requires the same pro...
Influenza is a public health problem that affects 5-20% of the world population annually causing high morbidity and mortality especially in risk groups. In addition to determining prevention and treatment strategies with vaccines and... more
Influenza is a public health problem that affects 5-20% of the world population annually causing high morbidity and mortality especially in risk groups. In addition to determining prevention and treatment strategies with vaccines and antivirals, surveillance data plays an important role in combat against influenza. Surveillance provides valuable data on characteristics of influenza activity, on types, sub-types, antigenic properties and antiviral resistance profile of circulating viruses in a given region. The first influenza surveillance was initiated as a pilot study in 2003 by now named National Influenza Reference Laboratory, Istanbul Faculty of Medicine. Surveillance was launced at national level by Ministry of Health in 2004 and two National Influenza Laboratories, one in Istanbul and the other in Ankara, have been conducting surveillance in Turkey. Surveillance data obtained for nine consequtive years, 2003-2012, by National Influenza Reference Laboratory in Istanbul Faculty ...
Research Interests: Turkey, Adolescent, Humans, Child, Young Adult, and 4 moreInfant, Middle Aged, Adult, and Nasal cavity
The objective of this study was to determine the phenotypic profile of blood mononuclear cells, specifically CD8(+)/CD28(+) cells, in patients with generalized aggressive periodontitis (GAgP) and chronic periodontitis (CP) in peripheral... more
The objective of this study was to determine the phenotypic profile of blood mononuclear cells, specifically CD8(+)/CD28(+) cells, in patients with generalized aggressive periodontitis (GAgP) and chronic periodontitis (CP) in peripheral blood and in blood obtained from periodontal defect site which might contribute to tissue damage. 13 GAgP, 11 chronic periodontitis (CP) and 5 healthy controls (H) were included in the study. Plaque index (PI), bleeding on probing (BoP), periodontal probing depth (PPD) and clinical attachment level (CAL) were recorded. Blood from the base of periodontal defect site and peripheral blood from the antecubital vein were obtained. Relative counts of CD45(+), CD3(+), CD4(+), CD8(+)/CD28(+), CD8(+)/CD28(-), CD19(+), CD16(+)/CD56(+)/CD3, CD3(+)/CD16(+)/CD56(+) receptors were determined with two color flow cytometry using monoclonal antibodies. BoP, PPD and CAL were significantly higher in both periodontitis groups than healthy controls (p <0.05). Activate...
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Hepatitis delta virus (HDV) is a subviral pathogen of humans, a satellite of hepatitis B virus (HBV) that induces severe acute and chronic liver diseases. The genus Deltavirus consists of eight clades or genotypes, with HDV1 being... more
Hepatitis delta virus (HDV) is a subviral pathogen of humans, a satellite of hepatitis B virus (HBV) that induces severe acute and chronic liver diseases. The genus Deltavirus consists of eight clades or genotypes, with HDV1 being ubiquitous and frequently characterized. In Turkey, HDV1 infection is highly endemic among HBsAg carriers, especially in the southeastern region. In this study, we analyzed 34 samples from patients who were chronically infected with HBV/HDV, originating from 22 cities of rural regions in the central and eastern parts of Turkey, in order to determine the levels of viral replication and genetic diversity. HDV RNA levels ranged between 3.02 and 8.75 Log copies/mL, and HBV DNA was detected in 25 samples (73.5%), with values ranging from 2.53 to 5.30 Log copies/mL. Analysis of nucleotides 900-1280 of HDV genomes (n = 34) and full-length (n = 17) sequences indicated that all of the strains belonged to genotype HDV1. However, a high genetic diversity was observed among the isolates, with a mean full-length dissimilarity score of 13.05%. HDV sequences clustered with sequences from Western Europe (n = 11), Eastern Europe and Asia (n = 19) or Africa (n = 4). HDV1 isolates related to strains of African origin had a serine residue instead of an alanine at position 202 of the large delta protein. HBV preS1 sequences obtained for 34 isolates indicated an HBV/D genotype in all cases. Taken together, our results indicate that in Turkey, where HBV-HDV dual infection is highly endemic, both viruses have high levels of replication, and HDV strains exhibit wide genetic diversity, which might reflect ancient evolution and/or successive outbreaks.
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Generalized aggressive periodontitis (GAgP) is a complex periodontal disease affecting the entire dentition with a rapid destruction of the periodontium and resulting in loss of teeth. We hypothesized that better clinical healing of... more
Generalized aggressive periodontitis (GAgP) is a complex periodontal disease affecting the entire dentition with a rapid destruction of the periodontium and resulting in loss of teeth. We hypothesized that better clinical healing of adjunctive use of amoxicillin plus metronidazole combination may be related to the effect of this combination therapy to restore imbalance between matrix metalloproteinases (MMP) and their tissue inhibitors (TIMP) which is associated with connective tissue and alveolar bone destruction in patients with GAgP. Twenty-eight subjects diagnosed with GAgP were recruited. Patients were randomly assigned to test or control groups. MMP-1/TIMP-1 ratio was compared between groups receiving scaling and root planning (SRP) alone (control) or in combination with amoxicillin plus metronidazole (test). Clinical periodontal variables were measured. Gingival crevicular fluid samples were obtained and analyzed for MMP-1 and TIMP-1. Measurements were taken at baseline and r...
Hepatitis C virus transmission routes in chronic hepatitis C patients, the relationship between the viral genotype and the transmission routes were studied. Genotyping was performed by using a commercial reverse hybridization method, Line... more
Hepatitis C virus transmission routes in chronic hepatitis C patients, the relationship between the viral genotype and the transmission routes were studied. Genotyping was performed by using a commercial reverse hybridization method, Line Probe Assay. Genotyping of 108 HCV RNA positive patients revealed four different types (1, 2, 3, and 4) and some mixed types. Subtype 1b was the most common (n=82). Subtype 1a and 3a were detected in six patients, 2a/2c was detected in seven patients, and 4c/4d was detected in one patient respectively. Six subjects revealed mixed infections. Three of them were 1a+1b, two of them were 1b+4a, and one of them was 1b+2a/2c. Genotype 1b was most common in all groups. In 38.8% of the 108 patients with a history of blood or blood product transfusions, 16.6% of patients with a history of surgery, 15.7% of patients had an anamnesis of dental treatment and, 12.9% of patients receiving dialysis. Before the routine screening of blood donor practices became man...
Research Interests: Turkey, Adolescent, Humans, Child, Female, and 10 moreTURKISH, Male, Young Adult, Aged, Middle Aged, Genotype, Adult, Dental Care, Blood Transfusion, and Renal Dialysis
The aim of this study was to describe the clinical and epidemiological characteristics of pandemic influenza in hospitalized children. A total of 114 patients with suspected H1N1 virus infection were hospitalized, and nasal swabs were... more
The aim of this study was to describe the clinical and epidemiological characteristics of pandemic influenza in hospitalized children. A total of 114 patients with suspected H1N1 virus infection were hospitalized, and nasal swabs were sent to National Influenza Reference Laboratory for confirmation of pandemic influenza A (H1N1) virus infection by rRT-PCR assay. Forty-six female and 68 male patients were included in the study. Age of the patients ranged from 40 days to 16 years. Clinical and/or radiological pneumonia were detected in 96% of all. Sixteen patients required mechanical ventilation due to hypoxemia. Previously healthy children required mechanical ventilation and oxygen therapy more than patients with chronic diseases. Elevated levels of CRP and LDH in patients with respiratory distress and patients who required mechanical ventilation were statistically significant. Our study showed that progress of pandemic influenza infection in previously healthy children is as severe ...
This study was performed to determine hepatitis B and measles seroprevalence among the population under 30 years of age in Turkey. Blood samples of 2,683 subjects from eight provinces of Turkey were studied. Measles IgG was determined by... more
This study was performed to determine hepatitis B and measles seroprevalence among the population under 30 years of age in Turkey. Blood samples of 2,683 subjects from eight provinces of Turkey were studied. Measles IgG was determined by hemagglutinin inhibition method, and hepatitits B surface antigen (HBsAg), anti-hepatitis B surface antibody (anti-HBs) and anti-hepatitis B core antibodies (anti-HBc) were determined by ELISA method. Overall seropositivity for measles was found to be 59.6%. There was a significant difference in seropositivity among provinces. The seropositivity was found to increase with age. The overall seropositivities for HBsAg, anti-HBs and anti-HBc were found to be 5.4%, 17% and 15.1%, respectively. The seroprevalences differed significantly among provinces. Although seroprevalence for anti-HBs and anti-HBc increased with age, HBsAg seropositivity did not change significantly after one year of age. Seroprevalence was not affected by sex. It was concluded that ...
Research Interests: Turkey, Adolescent, Hepatitis B, Humans, Child, and 7 moreFemale, Male, Cluster Analysis, Infant, Adult, Age Factors, and Measles
This study was conducted to determine the hepatitis A virus (HAV) seroprevalence in nine provinces representative of Turkey as a whole. These provinces are representative of the country's geographical location, and demographic,... more
This study was conducted to determine the hepatitis A virus (HAV) seroprevalence in nine provinces representative of Turkey as a whole. These provinces are representative of the country's geographical location, and demographic, economic and social characteristics. In each province, sample sizes were determined using published data on HAV seroprevalence, and sample sizes for each province and for the cluster were calculated for each group of subjects under the age of 30 for seroprevalence estimates within a 95% confidence interval. The samples were selected by a cluster method, and the planned recruitment was a total of 4,800 subjects, including 600 subjects each from five large provinces (Istanbul, Ankara, Izmir, Adana, Diyarbakir) and 450 subjects from each of the remaining four provinces (Samsun, Erzurum, Trabzon, Edirne). These numbers were distributed in accordance with the percentages for age groups in five-year increments starting from age five for the population under the...
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This study was performed for evaluation of seroprevalence of hepatitis A, B, and E among children in Istanbul, Turkey. The study group included 909 children who were 6 months-15 years of age. The children were separated to three age... more
This study was performed for evaluation of seroprevalence of hepatitis A, B, and E among children in Istanbul, Turkey. The study group included 909 children who were 6 months-15 years of age. The children were separated to three age groups: Group 1 (6 months-4.9 years; n = 321), Group 2 (5.0-9.9 years; n = 318), and Group 3 (10.0-15.0 years; n = 270). Group I was divided to two subgroups for evaluation of the maternal antibody sera (6 months-2 years and over 2 years). Serum IgG anti-HAV, anti-HBc, and anti-HEV were tested by commercial ELISA kits. The data were studied by multivariant analysis. In all subjects, seroprevalence of hepatitis A, B, and E were determined as 29, 15.9, and 2.1% respectively. The prevalence of hepatitis A increased with age (p < 0.05; Group 1 15.1% and Group 3 49.6%). Anti-HBc IgG level did not significantly change with age (Group 1 18.6% and Group 3 15.4%; p > 0.05). The seroprevalence of hepatitis E virus infection was higher in Group 1 (3.7%) than ...
Research Interests: Epidemiology, Child Welfare, Turkey, Community Health, Adolescent, and 22 moreMultivariate Analysis, Hepatitis B, Humans, Child, Age, Liver, Virus, Female, Male, Infant, European, Prevalence, Public health systems and services research, Group, Age Factors, hepatitis E, Hepatitis E Virus, hepatitis A, Sensitivity and Specificity, Age Groups, immunoglobulin G, and Nino
To evaluate the efficacy of tenofovir in chronic hepatitis B (CHB) patients with adefovir resistance (ADF-R) and suboptimal response to adefovir (ADF-S). Nucleos(t)ide analogue (NA)-naïve patients and patients with previous... more
To evaluate the efficacy of tenofovir in chronic hepatitis B (CHB) patients with adefovir resistance (ADF-R) and suboptimal response to adefovir (ADF-S). Nucleos(t)ide analogue (NA)-naïve patients and patients with previous adefovir-failure receiving tenofovir therapy for at least 6 months were included in the study. Biochemical and virological tests were obtained at baseline and 3-month intervals in the first year and every 6 months thereafter. The primary outcome measure was complete virological response (CVR) (HBVDNA&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;20 IU/ml). CVR rates were calculated by Kaplan-Meier analysis and a multivariate Cox proportional hazard model was generated to find out factors independently associated with CVR. 165 patients (118 male, mean age 42±12, 64 HBeAg(+) ) were included in the study. There were 105 patients in NA-naïve, 32 patients in ADF-S, and 28 patients in ADF-R groups. All patients in the ADF-R group had multidrug resistance patterns. Mean duration of tenofovir treatment was 29±14 months. CVR rates in NA-naïve, ADV-S and ADV-R groups were 65% vs 75% vs 58% at 12(th) month, 77% vs 87% vs 79% at 24(th) month and 83% vs 94% vs 79% at 36(th) month, respectively. According to multivariate Cox regression model HBeAg-positivity (HR=0.56, 95%CI 0.36-0.86, p=0.008), high baseline HBVDNA level (HR=0.64, 95%CI 0.55-0.74, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) and ADF-R (HR=0.47, 95%CI 0.28-0.81, p=0.006) were independent predictors for CVR. Seven patients encountered mild renal dysfunction and managed by dose adjustments. CVR rates during the follow-up shows that tenofovir has a decreased, yet still potent in vivo efficacy against multidrug resistant strains of HBV. This article is protected by copyright. All rights reserved.
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Research Interests: Health Care, Turkey, Adolescent, Biological Sciences, Humans, and 18 moreChild, Sampling methods, Infectious Disease, Female, Blood sampling, Male, Infant, Vaccine, Field Study, Newborn Infant, Adult, Random sampling, Sex Factors, Age Factors, Rural Area, Chickenpox, Urban Area, and Varicella Zoster Virus
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To evaluate whether the cytokine responses in liver and serum differ in chronic hepatitis C patients with normal and high alanine aminotransferase (ALT) levels. Thirty-three (16 with normal ALT level as group 1 and 17 with elevated ALT... more
To evaluate whether the cytokine responses in liver and serum differ in chronic hepatitis C patients with normal and high alanine aminotransferase (ALT) levels. Thirty-three (16 with normal ALT level as group 1 and 17 with elevated ALT level as group 2) patients infected with genotype 1b hepatitis C virus (HCV) were examined. Liver infiltrating lymphomononuclear cells (LILMCs) were isolated from liver biopsy by collagenase type 1 and stimulated with phytohemagglutinin and interleukin 2 (IL-2). IL-10, IL-12, interferon gamma (IFN-gamma) and tumor necrosis factor alpha (TNF-alpha) were determined in serum and LILMCs by ELISA. Serum cytokine levels were similar in both groups (P>0.05). Stimulated IFN-gamma and TNF-alpha levels in LILMCs were increased in both groups. IL-12 and IL-10 levels stimulated with IL-2 were higher in group 1 than in group 2 (P = 0.023). Histological activity index (HAI) and stage had a negative correlation with TNF-alpha and IFN-gamma levels in group 2. Incr...
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To investigate the efficacy of the combined therapy of lamivudine (LAM) plus alpha interferon (IFN) and LAM monotherapy in HBeAg negative chronic hepatitis B (CHB) patients who were unresponsive to previous IFN monotherapy, and the... more
To investigate the efficacy of the combined therapy of lamivudine (LAM) plus alpha interferon (IFN) and LAM monotherapy in HBeAg negative chronic hepatitis B (CHB) patients who were unresponsive to previous IFN monotherapy, and the incidence of YMDD mutations. Forty-five HBeAg negative patients were enrolled in this study. 24 of these were treated with LAM (100 mg/day, PO, for 24 months) alone (group 1) and 21 with combined therapy (IFN-alpha-2b, 10 MU, tiw, SC, for 6 months plus LAM 100 mg/day, PO, for 24 months) (group 2). Normal alanine aminotransferase values and negativity of HBV DNA (molecular hybridization; Digene, USA) were accepted as treatment response. YMDD variants were analyzed at the end of treatment or when clinical breakthrough was observed (Inno-Lipa Innogenetic kit, Belgium). End of follow-up response rate was 29.2%, by ITT in group 1, 19% in group 2 (p > 0.05). Histological activity index was statistically decreased by LAM monotherapy as compared to combination...
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The alpha interferon treatment criteria have not been established in children with chronic hepatitis B. We report the results of a prospective study. Between 1988-1992 14 children (2 girls and 12 boys) with chronic hepatitis B received 3... more
The alpha interferon treatment criteria have not been established in children with chronic hepatitis B. We report the results of a prospective study. Between 1988-1992 14 children (2 girls and 12 boys) with chronic hepatitis B received 3 million U/m2 of interferon alpha three times a week for 6 months. All patients underwent a liver biopsy that showed a pattern of chronic active hepatitis. One patient had cirrhosis. Hepatitis B surface antigen, hepatitis Be antigen and hepatitis B virus DNA had been positive in the serum in all for at least 6 months and anti-delta antibodies were negative in all. Pretreatment aminotransferase levels were at least 1.5 times the upper limit of normal. After treatment patients were followed up for at least one year (mean: 21.5 +/- 8.3 months). At the end of treatment HBV DNA was negative in 13 out of 14 patients and reappeared in one; HBeAg seroconversion was observed in 11 patients with the appearance of anti-HBe antibodies. Six patients lost the HBs antigen within 1 to 14 months after treatment. Anti-HBs antibodies did not appear in any patients and aminotransferase level normalized in 13 patients. Thirteen patients underwent liver biopsy after treatment which showed improvement in 12. Treatment with alpha interferon at doses of 3 MU/m2 is effective in children with active hepatitis B. Long-term follow up is needed to evaluate the effectiveness of this therapy.
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Girifl ‹nfluenza viruslar›n›n neden olduu infeksiyonlar›n tüm dünyada önemli bir halk sal›¤› sorunu olduu; yüksek morbi- dite ve mortalite oranlar› ile karakterize olan bu önemli hasta- l›¤›n, salg›nlar s›ras›nda hastanelere baflvurularda... more
Girifl ‹nfluenza viruslar›n›n neden olduu infeksiyonlar›n tüm dünyada önemli bir halk sal›¤› sorunu olduu; yüksek morbi- dite ve mortalite oranlar› ile karakterize olan bu önemli hasta- l›¤›n, salg›nlar s›ras›nda hastanelere baflvurularda ve yat›fllar- da art›fla, özellikle risk grubundan bireyler aras›nda ölümlere, ülke genelinde ise ekonomik kay›plara neden olduu bilin- mektedir (1). Mevsimsel gribin bu tip olumsuzluklar›n›n yan› s›ra, belirli aral›klarla
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To determine the frequency rate of C. pneumoniae, rhinovirus, respiratory syncytial virus (RSV), influenza virus, metapneumovirus,... more
To determine the frequency rate of C. pneumoniae, rhinovirus, respiratory syncytial virus (RSV), influenza virus, metapneumovirus, adenovirus&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, parainfluenza virus and coronavirus in acute respiratory tract infections in children. One hundred nine pediatric patients having respiratory tract infections were included in this study. Real time PCR, DFA and cell culture method were used for detection of C. pneumoniae, RSV antigen and influenza virus respectively. Multiplex PCR was used for detection of other viruses. No C. pneumoniae DNA was detected in the samples. Virus was detected in 43 cases from larynx swabs (43/109, 39.4 %). The frequency order of the viral agents detected were as follows; rhinoviruses 14.7 %, RSV B 7.3 %, influenza A 6.4 %, metapneumovirus 3.6 %, adenovirus 3.6 %, coronavirus 0.9 %, parainfluenzavirus type 3, 0.9 %, parainfluenzavirus type 4, 0.9 % and RSV A 0.9 %. Sensitivity of the PCR and DFA methods for the diagnosis of RSV infections were detected as 100 % and 100 %, respectively. Specificity of the PCR and DFA methods for RSV infections were detected as 97 % and 100 % respectively. Sensitivity of the PCR and cell culture methods for influenzavirus infections were detected as 100 % and 100 %, respectively. Specificity of the PCR and DFA methods for RSV infections were detected as 96 % and 100 % respectively. Prevalence of viral agents was detected as 39.4 %. Influenza viruses and RSV were common. Metapneumovirus was also frequent (3.6 %). C. pneumoniae was not found to be a common agent for acute respiratory disease in children.