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Yaylali E, Erdogan ZM, Calisir F, Pullukcu H, Yildirim F, Inan A, Aydin OA, Tekin S, Sonmezer MC, Sahin T, Ozcagli TG, Ozelgun B. Rapid initiation of antiretroviral therapy in Turkey: a modeling study. Front Public Health 2024; 12:1224449. [PMID: 38344235 PMCID: PMC10853345 DOI: 10.3389/fpubh.2024.1224449] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/02/2024] [Indexed: 02/15/2024] Open
Abstract
Background To effectively control the HIV epidemic and meet global targets, policymakers recommend the rapid initiation of antiretroviral therapy (ART). Our study aims to investigate the effect of rapid ART programs on individuals diagnosed with HIV, considering varying coverage and initiation days after diagnosis, and compare it to standard-of-care ART treatment in Turkey. Methods We used a dynamic compartmental model to simulate the dynamics of HIV infection in Turkey. Rapid treatment, defined as initiation of ART within 7 days of diagnosis, was contrasted with standard-of-care treatment, which starts within 30 days of diagnosis. This study considered three coverage levels (10%, 50%, and 90%) and two rapid periods (7 and 14 days after diagnosis), comparing them to standard-of-care treatment in evaluating the number of HIV infections between 2020 and 2030. Results Annual HIV incidence and prevalence for a 10-year period were obtained from model projections. In the absence of a rapid ART program, the model projected approximately 444,000 new HIV cases while the number of cases were reduced to 345,000 (22% reduction) with 90% of diagnosed cases included in the rapid ART program. Similarly, 10% and 50% rapid ART coverage has resulted in 3% and 13% reduction in HIV prevalence over a 10-year period. Conclusion Rapid ART demonstrates the potential to mitigate the increasing HIV incidence in Turkey by reducing the number of infections. The benefit of the rapid ART program could be substantial when the coverage of the program reaches above a certain percentage of diagnosed population.
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Affiliation(s)
- Emine Yaylali
- Department of Industrial Engineering, Istanbul Technical University, Istanbul, Türkiye
| | | | - Fethi Calisir
- Department of Industrial Engineering, Istanbul Technical University, Istanbul, Türkiye
| | | | - Figen Yildirim
- Infectious Diseases and Clinical Microbiology, Akdeniz Yasam Hospital, Antalya, Türkiye
| | - Asuman Inan
- Infectious Diseases and Clinical Microbiology, Haydarpasa-Numune Training and Research Hospital, Istanbul, Türkiye
| | - Ozlem Altuntas Aydin
- Infectious Diseases and Clinical Microbiology, University of Health Sciences, Istanbul, Türkiye
| | - Suda Tekin
- Infectious Diseases and Clinical Microbiology, Koc University, Istanbul, Türkiye
| | - Meliha Cagla Sonmezer
- Infectious Diseases and Clinical Microbiology, Hacettepe University, Ankara, Türkiye
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Tanriover MD, Aydin OA, Guner R, Yildiz O, Celik I, Doganay HL, Kose S, Akhan S, Akalin EH, Sezer Z, Ozdarendeli A, Unal S. Efficacy, Immunogenicity, and Safety of the Two-Dose Schedules of TURKOVAC versus CoronaVac in Healthy Subjects: A Randomized, Observer-Blinded, Non-Inferiority Phase III Trial. Vaccines (Basel) 2022; 10:1865. [PMID: 36366373 PMCID: PMC9698857 DOI: 10.3390/vaccines10111865] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 09/29/2023] Open
Abstract
We present the interim results of the efficacy, immunogenicity, and safety of the two-dose schedules of TURKOVAC versus CoronaVac. This was a randomized, observer-blinded, non-inferiority trial (NCT04942405). Volunteers were 18-55 years old and randomized at a 1:1 ratio to receive either TURKOVAC or CoronaVac at Day 0 and Day 28, both of which are 3 μg/0.5 mL of inactivated severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) adsorbed to aluminum hydroxide. The primary efficacy outcome was the prevention of polymerase chain reaction (PCR)-confirmed symptomatic coronavirus disease 2019 (COVID-19) at least 14 days after the second dose in the modified per-protocol (mPP) group. Safety analyses were performed in the modified intention-to-treat (mITT) group. Between 22 June 2021 and 7 January 2022, 1290 participants were randomized. The mITT group consisted of 915 participants, and the mPP group consisted of 732 participants. During a median follow-up of 90 (IQR 86-90) days, the relative risk reduction with TURKOVAC compared to CoronaVac was 41.03% (95% CI 12.95-60.06) for preventing PCR-confirmed symptomatic COVID-19. The incidences of adverse events (AEs) overall were 58.8% in TURKOVAC and 49.7% in CoronaVac arms (p = 0.006), with no fatalities or grade four AEs. TURKOVAC was non-inferior to CoronaVac in terms of efficacy and demonstrated a good safety and tolerability profile.
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Affiliation(s)
- Mine Durusu Tanriover
- Department of Internal Medicine, Hacettepe University Faculty of Medicine, 06230 Ankara, Türkiye
- Vaccine Institute, Hacettepe University, 06230 Ankara, Türkiye
| | - Ozlem Altuntas Aydin
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Başaksehir Cam and Sakura City Hospital, 34480 Istanbul, Türkiye
| | - Rahmet Guner
- Infectious Diseases and Clinical Microbiology Clinic, Ankara Yildirim Beyazit University, Ankara City Hospital, 06800 Ankara, Türkiye
| | - Orhan Yildiz
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University Faculty of Medicine, 38030 Kayseri, Türkiye
| | - Ilhami Celik
- Department of Infectious Diseases and Clinical Microbiology, Kayseri City Training and Research Hospital, 38080 Kayseri, Türkiye
| | - Hamdi Levent Doganay
- Department of Gastroenterology, Medical Park Pendik Hospital, 34899 Istanbul, Türkiye
- Department of Internal Medicine, Bahcesehir University School of Medicine, 34734 Istanbul, Türkiye
| | - Sukran Kose
- Infectious Diseases Clinic, University of Health Sciences, Izmir Tepecik Training and Research Hospital, 35020 Izmir, Türkiye
| | - Sila Akhan
- Department of Infectious Diseases and Clinical Microbiology, Kocaeli University Faculty of Medicine, 41001 Kocaeli, Türkiye
| | - Emin Halis Akalin
- Department of Infectious Diseases and Clinical Microbiology, Bursa Uludag University Faculty of Medicine, 16059 Bursa, Türkiye
| | - Zafer Sezer
- Department of Medical Pharmacology, Erciyes University Faculty of Medicine, 38030 Kayseri, Türkiye
| | - Aykut Ozdarendeli
- Department of Microbiology, Erciyes University Faculty of Medicine, 38030 Kayseri, Türkiye
- Vaccine Research, Development and Application Centre (ERAGEM), Erciyes University, 38280 Kayseri, Türkiye
| | - Serhat Unal
- Vaccine Institute, Hacettepe University, 06230 Ankara, Türkiye
- Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, 06230 Ankara, Türkiye
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Sonsoz MR, Guven G, Yildiz U, Koyuncu A, Altuntas Aydin O, Kahveci G. Right atrial reservoir strain and right ventricular strain improves in patients recovered from hospitalisation for non-severe COVID-19. Acta Cardiol 2022; 78:400-408. [PMID: 35670268 DOI: 10.1080/00015385.2022.2082734] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE Those hospitalised with coronavirus disease 2019 (COVID-19) have recently been shown to have impaired right ventricular (RV) strain, but data about the course of heart function after discharge are limited. Our aim was to compare right ventricular strain and right atrial reservoir strain (RASr) associated with COVID-19 between acute disease (during hospitalisation) and follow-up (after discharge). METHODS In this retrospective single-center study, we analysed the echocardiograms of 43 patients hospitalised for non-severe COVID-19 between December 2020 and March 2021, undergoing echocardiography both during and after hospitalisation. In addition to conventional echocardiographic parameters, we applied 2-dimensional speckle tracking to obtain RV global longitudinal strain (RV-GLS), RV free wall strain (RV-FWS), and RASr. RESULTS Mean (standard deviation) age of the study population was 50 (9) years, and 18 (42%) of the participants were women. Median duration between exams was 6 months (range, 5-7 months). Both mean RV-GLS and mean RV-FWS significantly increased at follow-up (-20.8 [3.8] vs. -23.5 [2.8], p < 0.001 and -23.3 [4.2] vs. -28.2 [2.8], p < 0.001; respectively), and RASr significantly improved as well (-32.3 [6.6] vs. -41.9 [9.8], p < 0.001). CONCLUSION In patients hospitalised for non-severe COVID-19 pneumonia, RV-GLS, RV-FWS, and RASr improved significantly between acute disease and 6 months after discharge.
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Affiliation(s)
- Mehmet Rasih Sonsoz
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Gulden Guven
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Ufuk Yildiz
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Atilla Koyuncu
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Ozlem Altuntas Aydin
- Department of Infectious Diseases, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Gokhan Kahveci
- Department of Cardiology, Liv Hospital Vadistanbul, Istinye University, Istanbul, Turkey
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Karaosmanoglu HK, Mete B, Gunduz A, Sevgi DY, Aydin OA, Dokmetas I, Tabak F. Changing Characteristics of Patients Living with HIV/AIDS after COVID-19 Pandemics in Turkey. Curr HIV Res 2022; 20:236-241. [PMID: 35240974 DOI: 10.2174/1570162x20666220303103805] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 01/04/2022] [Accepted: 01/27/2022] [Indexed: 11/22/2022]
Abstract
AIMS COVID-19 pandemic has substantially changed the life and presented several barriers to health services. HIV care continuum needs a high rate of diagnosis, an effective treatment and a sustained suppression of viral replication. COVID-19 pandemic has affected these three steps of HIV care. In this study, we investigated the characteristics of newly diagnosed patients living with HIV/AIDS (PLWH) during the COVID pandemic and compared them with those before the pandemic. METHODS All newly diagnosed patients in three HIV healthcare center, in Istanbul, Turkey were included into the study. Pandemic period included April 1, 2020 to April 1, 2021 and pre-pandemic period included March 1, 2019 to March 1, 2020. RESULTS During pre-pandemic period, 756 patients were diagnosed HIV/AIDS. In pandemic period, this figure was 58% less: 315. Patients in pre-pandemic and pandemic period had comparable age and gender distributions. PLWH diagnosed in pandemic period had higher rates of low CD4 cells: low CD4 (<350 cells /mm3) was measured in 243 (36.4%) patients in pre-pandemic, while it was done in 126 (47.9%) in pandemic period (p<0.01). Also the distribution of CD4 cells was significantly different between periods: In pandemic period, CD4 cell distribution skewed to lower CD4 categories significantly. Symptomatic patient rate and AIDS-defining disorder rate among symptomatic patients were comparable. Viral loads were not significantly different in two periods. CONCLUSION Less number of newly diagnosed PLWH can be explained by less HIV testing, less admission to the health care or actual decrease of HIV prevalence during pandemic. Sexual behaviors may have changed during COVID-19 pandemic which could lead to HIV transmission restriction. Lower CD4 counts among the newly diagnosed PLWH suggest that admittance to health care is late and a significant portion of PLWH remain undiagnosed.
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Affiliation(s)
- Hayat Kumbasar Karaosmanoglu
- Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Birgul Mete
- Cerrahpasa University Medical Faculty, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Alper Gunduz
- Sisli Hamidiye Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Dilek Yildiz Sevgi
- Sisli Hamidiye Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Ozlem Altuntas Aydin
- Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Ilyas Dokmetas
- Sisli Hamidiye Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Fehmi Tabak
- Cerrahpasa University Medical Faculty, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Mete B, Gunduz A, Karaosmanoglu HK, Gumuser F, Bolukcu S, Yildiz DS, Aydin OA, Bilge B, Dokmetas I, Tabak F. Effectiveness and safety of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate single-tablet combination among HIV-infected patients in Turkey: results from a real world setting. Afr Health Sci 2021; 21:1593-1602. [PMID: 35283956 PMCID: PMC8889812 DOI: 10.4314/ahs.v21i4.13] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Efficacy of elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil (E/C/F/TDF) in treatment-naïve and experienced patients with HIV infection was demonstrated in phase 3 trials. The primary objective of this study was to evaluate effectiveness and safety of E/C/F/TDF in real world settings. Methods Retrospective, observational data collected by the Turkish ACTHIV-IST study group between May 2015 and December 2016 were analysed. Results A total of 387 patients were prescribed E/C/F/TDF; 210 patients with available data at 6th month were eligible; 91.5% were male, and mean age was 35.2 (SD: 10.8) years; 54.0% of males identified themselves as MSM. Sixty-three percent (133) of the study population were treatment-naïve patients, and 37% (77) were treatment experienced. HIV RNA level was below 100 copies/mL in 78.9% of treatment-naïve patients and 89.9% of treatment experienced patients at month 6. Median increase in CD4 T lymphocyte count was 218 copies/mL in treatment-naïve patients and remained stable or increased in treatment experienced patients. Adverse events were observed in 15% of the patients, and the regimen was discontinued in only six patients. Conclusion Real world data on the effectiveness and safety of E/C/F/TDF is comparable with the phase 3 trial results Adverse events are uncommon and manageable.
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Affiliation(s)
- Bilgul Mete
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine Department of Infectious Diseases and Clinical Microbiology
| | - Alper Gunduz
- Sisli Hamidiye Etfal Research and Training Hospital Department of Infectious Diseases and Clinical Microbiology
| | - Hayat Kumbasar Karaosmanoglu
- Bakirkoy Dr Sadi Konuk Research and Training Hospital, Department of Infectious Diseases and Clinical Microbiology
| | - Fatma Gumuser
- Goztepe Medeniyet University, Medical School Department of Infectious Diseases and Clinical Microbiology
| | - Sibel Bolukcu
- Bezm-i Alem University, Vakif Gureba Hospital, Department of Infectious Diseases and Clinical Microbiology
| | - Dilek Sevgi Yildiz
- Sisli Hamidiye Etfal Research and Training Hospital Department of Infectious Diseases and Clinical Microbiology
| | - Ozlem Altuntas Aydin
- Bakirkoy Dr Sadi Konuk Research and Training Hospital, Department of Infectious Diseases and Clinical Microbiology
| | - Bilgenur Bilge
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine Department of Medical Genetics All authors meet the ICMJE authorship criteria
| | - Ilyas Dokmetas
- Sisli Hamidiye Etfal Research and Training Hospital Department of Infectious Diseases and Clinical Microbiology
| | - Fehmi Tabak
- Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine Department of Infectious Diseases and Clinical Microbiology
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Sonsoz MR, Alp ME, Guven G, Guler A, Unsel M, Altuntas Aydin O. Increasing modified CHA2DS2-VASc risk score is associated with acute cardiac injury in hospitalised COVID-19 patients. Acta Cardiol 2021; 77:435-441. [PMID: 34275416 DOI: 10.1080/00015385.2021.1952000] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Prediction of hospital mortality in patients with COVID-19 by the CHA2DS2VASc (M-CHA2DS2VASc) has been recently shown. Because COVID-19 patients with acute cardiac injury have higher mortality compared to those without, we assumed that this risk score may also predict acute cardiac injury in these patients. METHODS In this retrospective, single centre cohort study, we included 352 hospitalised patients with laboratory-confirmed COVID-19 and divided into three groups according to M-CHA2DS2VASc risk score which was created by changing gender criteria of the CHA2DS2VASc from female to male (Group 1, score 0-1 (n = 142); group 2, score 2-3 (n = 138) and group 3, score ≥4 (n = 72)). RESULTS As the M-CHA2DS2VASc risk score increased, acute cardiac injury was also significantly increased (Group 1, 11.3%; group 2, 48.6%; group 3, 76%; p < 0.001). The higher M-CHA2DS2VASc tertile had higher prevalence of arrhythmias compared to lower tertile. The multivariate logistic regression analysis showed that M-CHA2DS2VASc risk score, admission to intensive care unit and invasive mechanical ventilation were independent predictors of acute cardiac injury (p = 0.001, odds ratio 1.675 per scale for M-CHA2DS2VASc). In receiver operating characteristic analysis, M-CHA2DS2VASc risk score was able to predict acute cardiac injury (Area under the curve value for acute cardiac injury was 0.80; p < 0.001). CONCLUSION Admission M-CHA2DS2VASc risk score was associated with acute cardiac injury in hospitalised patients with COVID-19.
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Affiliation(s)
- Mehmet Rasih Sonsoz
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Murat Erdem Alp
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Gulden Guven
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Ahmet Guler
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Murat Unsel
- Department of Intensive Care Medicine, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Ozlem Altuntas Aydin
- Department of Infectious Diseases, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
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Alay I, Yildiz S, Kaya C, Yasar KK, Aydin OA, Karaosmanoglu HK, Aydeniz B, Salihoglu O, Yaşar L, Ekin M. The clinical findings and outcomes of symptomatic pregnant women diagnosed with or suspected of having coronavirus disease 2019 in a tertiary pandemic hospital in Istanbul, Turkey. J Obstet Gynaecol Res 2020; 46:2552-2560. [PMID: 32954601 PMCID: PMC7537119 DOI: 10.1111/jog.14493] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/08/2020] [Revised: 08/31/2020] [Accepted: 09/05/2020] [Indexed: 01/08/2023]
Abstract
AIM To observe the clinical course of symptomatic pregnant women diagnosed with or suspected of having COVID-19. METHODS This study analyzed the clinical and laboratory results of 27 patients with real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 and 25 patients with a suspected COVID-19 diagnosis based on their symptoms and chest computed tomography (CT) findings. The patients' coagulation parameters and acute-phase reactants were evaluated both before and after treatment. The maternal and neonatal outcomes were also reviewed. RESULTS The mean duration of hospitalization was 6.1 ± 3 days. The gestational age of the patients ranged from 6w2d to 40w2d. Thirty-five patients' CT scan findings suggested viral pneumonia. Four patients delivered vaginally, and 10 patients underwent a cesarean section during the study period. Four of the cesarean deliveries were indicated due to COVID-19 hypoxemia-related fetal distress. Four patients were admitted to the intensive care unit (ICU) after the cesarean section. CONCLUSION Early hospitalization and medical treatment can alleviate symptoms, improve the clinical course and reduce the need for ICU in symptomatic pregnant patients with suspected or confirmed COVID-19. Chest CT scans are a suitable option for suspected but unconfirmed COVID-19 infection.
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Affiliation(s)
- Ismail Alay
- Department of Obstetrics and GynecologyUniversity of Health Sciences Turkey, Bakirkoy Dr. Sadi Konuk Education and Training HospitalIstanbulTurkey
| | - Sukru Yildiz
- Department of Obstetrics and GynecologyUniversity of Health Sciences Turkey, Bakirkoy Dr. Sadi Konuk Education and Training HospitalIstanbulTurkey
| | - Cihan Kaya
- Department of Obstetrics and GynecologyUniversity of Health Sciences Turkey, Bakirkoy Dr. Sadi Konuk Education and Training HospitalIstanbulTurkey
| | - Kadriye Kart Yasar
- Department of Infectious Diseases and Clinical MicrobiologyUniversity of Health Sciences Turkey, Bakirkoy Dr.Sadi Konuk Education and Training HospitalIstanbulTurkey
| | - Ozlem Altuntas Aydin
- Department of Infectious Diseases and Clinical MicrobiologyUniversity of Health Sciences Turkey, Bakirkoy Dr.Sadi Konuk Education and Training HospitalIstanbulTurkey
| | - Hayat Kumbasar Karaosmanoglu
- Department of Infectious Diseases and Clinical MicrobiologyUniversity of Health Sciences Turkey, Bakirkoy Dr.Sadi Konuk Education and Training HospitalIstanbulTurkey
| | - Banu Aydeniz
- Departent of Physical Medicine and RehabilitationUniversity of Health Sciences Turkey, Bakirkoy Dr. Sadi Konuk Education and Training HospitalIstanbulTurkey
| | - Ozgul Salihoglu
- Department of Pediatrics, Division of NeonatologyUniversity of Health Sciences Turkey, Bakirkoy Dr. Sadi Konuk Education and Training HospitalIstanbulTurkey
| | - Levent Yaşar
- Department of Obstetrics and GynecologyUniversity of Health Sciences Turkey, Bakirkoy Dr. Sadi Konuk Education and Training HospitalIstanbulTurkey
| | - Murat Ekin
- Department of Obstetrics and GynecologyUniversity of Health Sciences Turkey, Bakirkoy Dr. Sadi Konuk Education and Training HospitalIstanbulTurkey
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Altuntas Aydin O, Kumbasar Karaosmanoglu H, Kart Yasar K. HIV/SARS-CoV-2 coinfected patients in Istanbul, Turkey. J Med Virol 2020; 92:2288-2290. [PMID: 32347975 DOI: 10.1002/jmv.25955] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 04/27/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Ozlem Altuntas Aydin
- Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Hayat Kumbasar Karaosmanoglu
- Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Kadriye Kart Yasar
- Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Aydin OA, Gunduz A, Sargin F, Mete B, Karaosmanoglu HK, Sevgi DY, Yemisen M, Durdu B, Dokmetas I, Tabak F. Prevalence and mortality of cancer among people living with HIV and AIDS patients: a large cohort study in Turkey. East Mediterr Health J 2020; 26:276-282. [PMID: 32281636 DOI: 10.26719/emhj.19.030] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 06/14/2018] [Indexed: 11/09/2022]
Abstract
Background Cancer is responsible for elevated human immunodeficiency virus (HIV)-related mortality but there are insufficient data about cancer in HIV-positive patients in Turkey. Aims We aimed to investigate the prevalence and mortality of cancer among people living with HIVand AIDS patients in Istanbul, Turkey. Methods Between January 1998 and December 2016, people living with HIVand AIDS patients were enrolled in this study by the ACTHIV-IST Study Group, which consists of 5 centres to follow-up HIV-positive patients in Istanbul. The cancer diagnoses included AIDS-defining cancers (ADCs) and non AIDS-defining cancers (NADCs). Results Among 1872 patients, 37 (1.9%) were diagnosed with concurrent cancer. Eleven patients were diagnosed during follow-up; the prevalence of cancer among people living with HIVand AIDS patients was 2.6%. Among 48 cancer patients, 35 patients had ADCs, and 32 of them were diagnosed at their first hospital admission. There were 1007 late presenters and 39 of them had cancer (29 were ADCs). The most prevalent NADCs were gastrointestinal, genitourinary, and pulmonary cancers. NADCs were mostly diagnosed during follow-up of patients. The mortality of this group was significantly higher than that of patients with ADCs (53.9% vs 22.9%). Conclusions These results indicate the importance of cancer screening at diagnosis and during follow-up of HIV infection. A detailed physical examination contributes to diagnosis of the most prevalent ADCs (Kaposi's sarcoma and non-Hodgkin's lymphoma), especially in late presenters. For NADCs, individual risk factors should be considered.
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Affiliation(s)
- Ozlem Altuntas Aydin
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Alper Gunduz
- University of Health Sciences, Sisli Etfal Hamidiye Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Fatma Sargin
- Istanbul Medeniyet University, Goztepe Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Bilgül Mete
- Istanbul University, Cerrahpasa Medical School, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Hayat Kumbasar Karaosmanoglu
- University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Dilek Yildiz Sevgi
- University of Health Sciences, Sisli Etfal Hamidiye Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Mucahit Yemisen
- Medistate Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Bulent Durdu
- Bezmialem Vakif University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Ilyas Dokmetas
- University of Health Sciences, Sisli Etfal Hamidiye Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Fehmi Tabak
- Istanbul University, Cerrahpasa Medical School, Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Bolukcu S, Mete B, Gunduz A, Karaosmanoglu HK, Sargin F, Durdu B, Aydin OA, Yildiz D, Dokmetas I, Aslan T, Tabak F. Assessment of the 24th Week Success of Anti-Retroviral Therapy in the Action against HIV in Istanbul Database: Results from a Region with Increasing Incidence. Jpn J Infect Dis 2019; 72:173-178. [PMID: 30700656 DOI: 10.7883/yoken.jjid.2018.105] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aimed to assess the 24-week virological and immunological success of the treatment of treatment-naive and treatment-experienced patients included in the Action against HIV in Istanbul (ACTHIV-IST) database. The ACTHIV-IST database was screened retrospectively from January 2012 to January 2014. The data for these patients such as age, sex, treatment-naive or treatment-experienced status, date of diagnosis, date of commencing antiretroviral therapy, antiretroviral therapy regimen, CD4+ cell count, and viral load before and after therapy were analyzed. In the 24th week of antiretroviral therapy, there were 40 (17.9%) and 29 (14.1%) virological and immunological failures, respectively. Virological failure (VF) was associated with a baseline viral load > 100,000 copies (p = 0.004). A CD4+ cell count lower than 200 cells/μl was not found to be associated with VF (p = 0.843). Immunological failure was substantially rare in patients with a baseline CD4+ cell count > 200 cells/μl (p = 0.005). Although an HIV-RNA ≤ 100,000 copies/ml was protective against VF in the 24th week, in individuals with an HIV-RNA > 100,000 copies/ml, VF was 3.2 times more likely to occur. Baseline VF was the most predictive parameter to estimate 24th week virological success and VF. VF is an important prognostic parameter resulting in CD4+ cell depletion, AIDS-related events, and increased mortality.
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Affiliation(s)
- Sibel Bolukcu
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Faculty of Medicine
| | - Bilgul Mete
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical School
| | - Alper Gunduz
- Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Education and Research Hospital
| | - Hayat Kumbasar Karaosmanoglu
- Department of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital
| | - Fatma Sargin
- Department of Infectious Diseases and Clinical Microbiology, Medeniyet University, Goztepe Education and Research Hospital
| | - Bulent Durdu
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Faculty of Medicine
| | - Ozlem Altuntas Aydin
- Department of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital
| | - Dilek Yildiz
- Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Education and Research Hospital
| | - Ilyas Dokmetas
- Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Education and Research Hospital
| | - Turan Aslan
- Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Faculty of Medicine
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University, Cerrahpasa Medical School
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Yildiz Sevgi D, Gunduz A, Altuntas Aydin O, Mete B, Sargin F, Kumbasar Karaosmanoglu H, Uzun N, Yemisen M, Dokmetas I, Tabak F. Adherence to Antiretroviral Therapy in Turkey: Results from the ACTHIV-IST Study Group. AIDS Res Hum Retroviruses 2017; 33:1192-1198. [PMID: 28854809 DOI: 10.1089/aid.2016.0266] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Maintaining optimal adherence to antiretroviral therapy (ART) is essential for optimizing the management of HIV infection. The aim of this study is to explore ART adherence rates in Turkey. Included in this study were a total of 263 HIV-infected patients followed up by the ACTHIV-IST (ACTion against HIV in Istanbul) Study Group affiliated with four tertiary hospitals. The study population included patients 18 years of age or older who were on ART for over 12 months. Adherence was assessed by the medication possession ratio (MPR) calculated for each patient using data (a list of all drugs dispensed within the previous year for that patient) obtained from pharmacy medication records. In addition, patients completed a self-report questionnaire addressing missed doses and the AIDS Clinical Trials Group (ACTG) adherence questionnaire. The study was reviewed and approved by the Ethics Committee of Cerrahpasa Medical Faculty. Patient ages ranged from 19 to 71 years. Two hundred and thirty-one patients were male (88%). Two hundred and twenty-four patients (85%) had optimal adherence (MPR ≥95%). During the course of ART, 236 patients (90%) reported no missed doses in the past 4 days of their treatment, whereas 206 patients (78%) reported no missed doses in the past month. Simply forgetting was the most common reason for nonadherence. MPR was associated with virologic rebound. Major factors affecting adherence were being female, taking antituberculosis drugs, having an opportunistic infection, being able to take all or most of the medication as directed, and being aware of the need to take medication exactly as instructed to prevent the development of drug resistance. Adherence to ART measured by MPR and self-report surveys is relatively high in Turkey when compared with other countries, which probably led to high ART success rates.
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Affiliation(s)
- Dilek Yildiz Sevgi
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Alper Gunduz
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Altuntas Aydin
- Department of Infectious Diseases and Clinical Microbiology, Bakirkoy Doktor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Bilgul Mete
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Fatma Sargin
- Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, Turkey
| | - Hayat Kumbasar Karaosmanoglu
- Department of Infectious Diseases and Clinical Microbiology, Bakirkoy Doktor Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Nuray Uzun
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mucahit Yemisen
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ilyas Dokmetas
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Sargin F, Yildiz D, Aydin OA, Mete B, Gunduz A, Karaosmanoglu HK, Yemisen M, Yazici S, Bolukcu S, Durdu B, Senates E, Ozaras R, Dokmetas I, Tabak F. Changes in HIV demographic patterns in a low prevalence population: no evidence of a shift towards men who have sex with men. Int J Infect Dis 2016; 48:52-6. [PMID: 27173075 DOI: 10.1016/j.ijid.2016.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 01/07/2016] [Revised: 05/02/2016] [Accepted: 05/04/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study aimed to examine the changes in HIV demographics over time in an exceptionally low prevalence population, with particular emphasis on men who have sex with men (MSM). METHODS A total of 1292 newly diagnosed HIV-positive patients registered in the ACTHIV-IST Study Group database between 2000 and 2014 were included. The changes occurring over time in the characteristics of patients at the time of initial admission were examined retrospectively. RESULTS A gradual increase in the total number of newly diagnosed patients was evident during the study period; however, it was not possible to show an increase in the proportion of MSM within the study population (p=0.63). There was a male predominance throughout the study (85% vs. 15%), with further increases in the proportion of males in recent years. The mean age was lower at the end of the study (p<0.05) and there was an increase in the number of unmarried patients (p<0.05). CONCLUSIONS Sexual preference patterns of HIV patients in extremely low prevalence populations may be different, possibly due to an early phase of the epidemic. Nevertheless, MSM still represent a target subgroup for interventions, since they account for a substantial proportion of cases and a resurgent epidemic may be expected among this group in later phases of the epidemic.
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Affiliation(s)
- Fatma Sargin
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
| | - Dilek Yildiz
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Altuntas Aydin
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Bilgul Mete
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - Alper Gunduz
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Hayat Kumbasar Karaosmanoglu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Mucahit Yemisen
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - Saadet Yazici
- Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Sibel Bolukcu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Bulent Durdu
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Ebubekir Senates
- Department of Gastroenterology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Resat Ozaras
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
| | - Ilyas Dokmetas
- Department of Infectious Diseases and Clinical Microbiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey
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Midilli K, Kuskucu MA, Mete B, Aydin OA, Ýmamova N, Tabak F. Emergence of E138 mutations among treatment naïve HIV-infected patients in Istanbul. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.265] [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: 11/24/2022]
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Ozgumus S, Altuntas Aydin O, Kuvat N, Isik ME, Sengoz G. Phenotypic Determination of Metallo-β-Lactamase Production in Nosocomial Pseudomonas Strains. Klimik Dergisi 2015. [DOI: 10.5152/kd.2014.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Aydin OA, Yemisen M, Karaosmanoglu HK, Sargin F, Gunduz A, Ceylan B, Mete B, Ozgunes N, Sevgi DY, Ozaras R, Tabak F. Low Prevalence of Hepatitis C Virus Infection Among HIV-Positive Patients: Data From a Large-Scale Cohort Study in Istanbul, Turkey. Hepat Mon 2014; 14:e18128. [PMID: 25337142 PMCID: PMC4199144 DOI: 10.5812/hepatmon.18128] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 04/29/2014] [Accepted: 08/07/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Rate of coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) varies in different countries. This may be attributable to common transmission routes as well as social, economic, and cultural factors. OBJECTIVES The purpose of this study was to investigate the prevalence and risk factors of HCV infection among HIV-positive patients in Istanbul, Turkey. PATIENTS AND METHODS Since January 2006 to November 2013, 949 HIV-positive patients that were enrolled in this study by ACTHIV-IST (Action Against HIV in Istanbul) Study Group, which consists of five centers to follow up HIV-positive patients in Istanbul. Epidemiologic and clinical data were collected retrospectively from medical records and were transferred to an HIV database system. RESULTS Among 949 patients, 84% were men and the mean age was 37.92 ± 11.54 years (range, 17-79). The most frequent route of transmission was heterosexual intercourse (48.8%), followed by men having sex with men (30.5%). Only nine patients (0.9%) had history of injection drug use (IDU). The prevalence of HIV/HCV coinfection was 0.9% (9:949). The IDU rate was 44.4% (4:9) in patients with HIV/HCV coinfection (three of them were not Turkish citizens), whereas this rate was only 0.6% (5:881) in patients with only HIV infection (P < 0.01). Genotypes 1b, 2a/2c, and 3 were determined in five, one, and two patients, respectively. Genotype could not be determined in one patient. History of residence in a foreign country (P < 0.01) and imprisonment (P < 0.01) were also considered as risk factors in terms of HIV/HCV coinfection. CONCLUSIONS Prevalence of HIV/HCV coinfection is considerably low in Turkey. The extremely rare prevalence of IDU might have a role in this low prevalence.
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Affiliation(s)
- Ozlem Altuntas Aydin
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
- Corresponding Author: Ozlem Altuntas Aydin, Department of Infectious Diseasaes and Clinical Microbiology, Haseki Training and Research Hospital, Aksaray-Fatih, Istanbul, Turkey. Tel: +90-2125294400, Fax: +90-5057962570, E-mail:
| | - Mucahit Yemisen
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Hayat Kumbasar Karaosmanoglu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Fatma Sargin
- Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Alper Gunduz
- Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Bahadir Ceylan
- Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Bezmialem Vakif University, Istanbul, Turkey
| | - Bilgul Mete
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Nail Ozgunes
- Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Dilek Yildiz Sevgi
- Department of Infectious Diseases and Clinical Microbiology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Resat Ozaras
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Karaosmanoglu HK, Aydin OA, Nazlican O. Isolated anti-HBc among HIV-infected patients in Istanbul, Turkey. HIV Clin Trials 2014; 14:17-20. [PMID: 23372111 DOI: 10.1310/hct1401-17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Isolated antibody to hepatitis B core antigen (anti-HBc) is frequent in HIV-infected patients, and it may be a marker of occult hepatitis B. We aimed to determine the prevalence and associated risk factors of isolated anti-HBc among HIV-infected patients in Turkey, which is classified as an intermediate HBV, low HIV endemic region. METHOD HIV/AIDS patients followed by the Infectious Diseases and Clinical Microbiology Outpatient Clinic of Haseki Training and Research Hospital between January 2006 and March 2011 were included in this study. Medical records were reviewed to determine the prevalence of isolated anti-HBc and to identify the risk factors associated with isolated anti-HBc. The frequency of isolated anti-HBc in 209 HIV-infected patients was compared with 83 volunteer blood donors. RESULTS Of 209 HIV-infected patients, 40 subjects (19.1%) had isolated anti-HBc compared with control group, which consisted of 83 volunteer blood donors who had similar age (P = .13) and sex (P = .29). In the control group, only 2 (2.4%) had isolated anti-HBc. Isolated anti-HBc was significantly more frequent in HIV-infected patients (P < .001). The characteristics such as age, gender, injecting drug use, anti-HCV seropositivity, and CD4 cell counts were not significantly different between HIV-infected patients with or without isolated anti-HBc. Only 3 (7.5%) of HIV-infected patients had occult infection. CONCLUSION Prevalence of isolated anti-HBc in Turkish HIV-infected patients was 19.1%, which was significantly more frequent than in blood donors. Isolated anti-HBc could be associated with occult infection. Thus, all HIV-infected patients should be screened for anti-HBc before starting antiretroviral therapy.
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Abstract
BACKGROUND Isolated antibody to hepatitis B core antigen (anti-HBc) is frequent in HIV-infected patients, and it may be a marker of occult hepatitis B. We aimed to determine the prevalence and associated risk factors of isolated anti-HBc among HIV-infected patients in Turkey, which is classified as an intermediate HBV, low HIV endemic region. METHOD HIV/AIDS patients followed by the Infectious Diseases and Clinical Microbiology Outpatient Clinic of Haseki Training and Research Hospital between January 2006 and March 2011 were included in this study. Medical records were reviewed to determine the prevalence of isolated anti-HBc and to identify the risk factors associated with isolated anti-HBc. The frequency of isolated anti-HBc in 209 HIV-infected patients was compared with 83 volunteer blood donors. RESULTS Of 209 HIV-infected patients, 40 subjects (19.1%) had isolated anti-HBc compared with control group, which consisted of 83 volunteer blood donors who had similar age (P = .13) and sex (P = .29). In the control group, only 2 (2.4%) had isolated anti-HBc. Isolated anti-HBc was significantly more frequent in HIV-infected patients (P < .001). The characteristics such as age, gender, injecting drug use, anti-HCV seropositivity, and CD4 cell counts were not significantly different between HIV-infected patients with or without isolated anti-HBc. Only 3 (7.5%) of HIV-infected patients had occult infection. CONCLUSION Prevalence of isolated anti-HBc in Turkish HIV-infected patients was 19.1%, which was significantly more frequent than in blood donors. Isolated anti-HBc could be associated with occult infection. Thus, all HIV-infected patients should be screened for anti-HBc before starting antiretroviral therapy.
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Kumbasar Karaosmanoglu H, Altuntas Aydin O, Sandikci S, Yamanlar ER, Nazlican O. Seroprevalence of hepatitis B: Do blood donors represent the general population? J Infect Dev Ctries 2011; 6:181-3. [DOI: 10.3855/jidc.2084] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 06/28/2011] [Accepted: 09/06/2011] [Indexed: 10/31/2022] Open
Abstract
Introduction: In this study, we aimed to compare the HBV seroprevalances of voluntary blood donors and the healthy persons who required premarital screening. Methodology: HBsAg ELISA results were collected retrospectively from the records of 9,949 blood donors and 954 healthy persons who required premarital screening. Results: HBsAg was detected in 182 of 9,949 (%1.8) voluntary blood donors and 32 of 954 (%3.4) healthy persons who required premarital screening. HBsAg seropositivity was significiantly higher in the healthy persons who required premarital screening than in blood donors (p = 0.0016). Conclusion: Premarital screening is mandatory in our country, and it may provide more accurate epidemiological data to determine HBV seroprevalence than in other selected groups such as blood donors.
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Abstract
BACKGROUND In Turkey, the first HIV/AIDS case was reported in 1985. Although HIV/AIDS incidence has been increasing, only 3,671 cases have been documented to date in this country, with a population of 71,517,100. The aim of this study was to determine the epidemiologic and clinical features of patients with HIV infection and AIDS followed during a 3.5-year period. METHODS A total of 136 HIV-infected patients attending Infectious Diseases and Clinical Microbiology Outpatient Clinic of Haseki Training and Research Hospital between January 2006 and June 2009 were included in the study. Epidemiologic and clinical data, such as age, gender, marital status, occupation, level of education, transmission routes, condom usage, type of screening tests, clinical findings, and CD4 T-cell counts and viral loads at diagnosis, were collected retrospectively from case records completed on admission. RESULTS Patients with a diagnosis of HIV infection comprised a group of 136 persons (80% men, mean age 36 years [range, 20-72 years]). Six patients (8%) were university graduates. Heterosexual intercourse was the most common route of transmission (60%), followed by homosexual intercourse and intravenous drug use. Almost all women (24 out of 25; 96%) acquired the infection from their husbands. Median CD4 T-cell count at diagnosis was 302/mm3 (range, 9-1,270). On admission, CD4 T-cell count was < 200/mm3 in 39%, 200-350/mm3 in 30%, and ≯350/mL in 31%. Mean viral load at diagnosis was 1,033,871 copies/mL. Forty-four percent of the patients were admitted with obvious clinical signs and symptoms, whereas 56% were diagnosed through screening tests. CONCLUSIONS Poorly educated individuals and men constituted the majority of the cases. Most women acquired the disease from their husbands. Considering the poor level of education among the patients we studied, effective educational programs should be developed to reduce the transmission of HIV. Although heterosexual intercourse was the most common route of transmission, 38% of the patients we studied reported male-to-male intercourse. This is markedly higher than the 9% rate of transmission by this route in Turkey.
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Altuntas Aydin O, Kumbasar Karaosmanoglu H, Korkusuz R, Nazlican O. Toxoplasma gondii IgG Seroprevalence in HIV/AIDS Patients. TurkiyeParazitolDerg 2011; 35:65-7. [DOI: 10.5152/tpd.2011.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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