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    A national multicenter study on initial antiviral treatment preferences on chronic hepatitis B: Entecavir versus Tenofovir disoproxil fumarate
    (Elsevier, 2024) Yamazhan, Tansu; Zerdali, Esra; Onlen, Yusuf; Tosun, Selma; Gunal, Ozgur; Batirel, Ayse; Hasanoglu, Imran
    [Anstract Not Available]
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    Noninvasive Models to Predict Liver Fibrosis in Patients with Chronic Hepatitis B: A Study from Turkey
    (Kowsar Publ, 2017) Korkmaz, Pinar; Demirturk, Nese; Batirel, Ayse; Yardimci, Ahmet Cem; Cagir, Unal; Nemli, Salih Atakan; Korkmaz, Fatime
    Background: Manynoninvasive methods, including aspartateaminotransaminase (AST)/alanineaminotransaminase (ALT) ratio (AAR), AST-to-platelet ratio index (APRI), Bonacini cirrhosis discriminant score (CDS), fibrosis-4 (FIB4) index, and age-platelet index (API), have been described to determine the stage of hepatic fibrosis. However, thesemethodsare developed for patients with chronic hepatitisC(CHC) andproduce conflicting results in the prediction of liver fibrosis in patients with chronic hepatitis B (CHB). Objectives: The aim of this study was to evaluate the relationship between 7 noninvasive models, including AAR, APRI, CDS, API, FIB-4, neutrophil-to-lymphocyte ratio (NLR), and red cell distribution width (RDW)-to-platelet ratio (RPR) in patients with CHB. Methods: The study population included all patients with CHB, undergoing liver biopsy to determine HBsAg and HBV DNA positivity in more than 6 months. Results: A total of 2520 treatment-naive CHB patients from 40 different centers were included in the study. In total, 62.6% of the patients were male, and the mean age was 40.60 +/- 12.34 years (minimum, 18 years; maximum, 77 years). The Ishak fibrosis score was >= 3 in 29.8% of the patients, indicating significant fibrosis. The mean API, APRI, CDS, NLR, FIB4, and RPR scores in the noninvasive models were significantly different between the groups with significant and low fibrosis (P < 0.05). All the noninvave models (API, APRI, AAR, CDS, NLR, RPR, and FIB4) were found to be significant in the discrimination of cirrhosis (P < 0.05). In the multiple logistic regression analysis, CDS, albumin, alkaline phosphatase (ALP), total bilirubin, neutrophil count, NLR, mean platelet volume (MPV), and FIB4 were independent indices for cirrhosis. Conclusions: In the present study, the role of noninvasive tests in the prediction of liver fibrosis stage and cirrhosis was evaluated in a large cohort of CHB patients. Overall, noninvasive models are gradually becoming more promising. Accordingly, the need for liver biopsy can be reduced with a combination of noninvasive methods in the future.
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    Ombitasvir/ Paritaprevir/ Ritonavir
    (Doc Design Informatics Co Ltd, 2019) Aygen, Bilgehan; Demirturk, Nese; Yildiz, Orhan; Celik, Ilhami; Guzel, Deniz Kamalak; Ersoz, Guelden; Batirel, Ayse
    Objective: Objective: Ombitasvir/paritaprevir/ritonavir (OMV/PTV/r) + ribavirin (RBV) combination improved the efficacy, safety, and tolerability of the treatment of chronic hepatitis C virus (HCV) genotype 4 infection. We described the effectiveness and safety of OMV/PTV/r + RBV therapy in patients with genotype 4 infection. Materials and Methods: In this prospective cohort study, HCV genotype 4-infected patients treated with OMV/PTV/r + RBV (n=55) who were registered in a national database were included. Study patients were treatment-naive or interferon plus RBV-experienced with or without compensated cirrhosis. Demographic, clinical and virological data were analyzed. Details of clinical and laboratory adverse events (AEs) were recorded.Results: The mean age of the patients was 55.2, and 52.7% were male. The majority of patients were non-cirrhotic (81.8%), and 69.1% were treatment-naive. The HCV RNA level was below 800.000 IU/mL in 16 of the cases. Seventy-eight percent of the patients had an underlying disease. SVR12 rate was 98% in all patients. One patient had virological failure. HCV RNA was undetectable at treatment week 4 in 77.6%, at treatment week 8 in 100%, and at end of treatment in 98%. The SVR12 rates were 100% and 88.9% for those without or with compensated cirrhosis (p= 0.176). Rates of AEs and AEsassociated treatment discontinuation were 69.1% and 3.6% in the patients, respectively.Conclusion: The OBV/PTV/r + RBV combination was found to have high efficacy and safety profile in the patients with chronic HCV genotype 4 infection.
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    Profiles of primary brain abscesses and their impact on survival: An international ID-IRI study
    (Elsevier Sci Ltd, 2024) Sahin, Meyha; Mert, Ali; Emecen, Ahmet Naci; Strunjas, Natalija Planinc; Fasanekova, Lenka; Batirel, Ayse; Darazam, Ilad Alavi
    Objectives: This study of 331 primary brain abscess (PBA) patients aimed to understand infecting agents, predisposing factors, and outcomes, with a focus on factors affecting mortality. Methods: Data were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed. Results: The patients had a mean +/- SD age of 46.8 +/- 16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with Viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI: 1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15). Conclusion: The risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )
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    The Efficacy of Glecaprevir/Pibrentasvir in Chronic Hepatitis C Patients and the Impact of the COVID-19 Pandemic: Multicenter Real-Life Data
    (Doc Design Informatics Co Ltd, 2024) Gurbuz, Yunus; Kocagul-Celikbas, Aysel; Oztoprak, Nefise; Aygen, Bilgehan; Batirel, Ayse; Habiloglu, Arif Dogan; Aktug-Demir, Nazlim
    Objective: This study aimed to demonstrate the real-life efficacy and safety of glecaprevir / pibrentasvir in the treatment of chronic hepatitis C, as well as to identify the problems caused by the COVID-19 pandemic in the follow-up and treatment of patients. Materials and Methods: The study was conducted retrospectively with the participation of researchers from universities or training and research hospitals. It included patients with chronic hepatitis C who were over 18 years of age, treatment-na & iuml;ve or treatment-experienced, had detectable HCV RNA and were receiving glecaprevir/pibrentasvir treatment Results: Only 188 of the 385 patients who participated in the study came to the follow-up visit 12 weeks after treatment, and all of them had a sustained virological response. It was thought that a significant portion of the 177 patients who did not come to the follow-up visit at 12 weeks after treatment refrained from coming to the hospital due to the COVID-19 pandemic. None of the patients who attended the follow-up visits required treatment discontinuation due to adverse events. Conclusion: Glecaprevir/pibrentasvir is a highly effective and relatively safe drug in the treatment of chronic hepatitis C. The COVID-19 pandemic has negatively affected the follow-up and treatment processes of patients. New measures are needed for the follow-up and treatment of patients with chronic hepatitis C during pandemics.