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    Evaluation of Dual Therapy in Real Life Setting in Treatment-Naïve Turkish Patients with HCV Infection: A Multicenter, Retrospective Study
    (2016) Gürbüz, Yunus; Tülek, Necla Eren; Tütüncü, Emin Ediz; Koruk, Süda Tekin; Aygen, Bilgehan; Demirtürk, Neşe; Kınıklı, Sami
    Background: Before the introduction of direct-acting antivirals in the treatment of chronic hepatitis C patients, the combination of peginterferon alpha and ribavirin was the standard therapy. Observational studies that in-vestigated sustained virological response (SVR) rates by these drugs yielded different outcomes. Aims: The goal of the study was to demonstrate real life data concerning SVR rate achieved by peginterferon al-pha plus ribavirin in patients who were treatment-naïve. Study Design: A multicenter, retrospective observa-tional study.Methods: The study was conducted retrospectively on 1214 treatment naïve-patients, being treated with pegin-terferon alpha-2a or 2b plus ribavirin in respect of the current guidelines between 2005 and 2013. The patients' data were collected from 22 centers via a standard form, which has been prepared for this study. The data includ-ed demographic and clinical characteristics (gender, age, body weight, initial Hepatitis C virus RNA (HCV RNA) level, disease staging) as well as course of treatment (du-ration of treatment, outcomes, discontinuations and ad-verse events). Renal insufficiency, decompensated liver disease, history of transplantation, immunosuppressive therapy or autoimmune liver disease were exclusion criteria for the study. Treatment efficacy was assessed according to the patient's demographic characteristics, baseline viral load, genotype, and fibrosis scores. Results: The mean age of the patients was 50.74 (±0.64) years. Most of them were infected with genotype 1 (91.8%). SVR was achieved in 761 (62.7%) patients. SVR rate was 59.1% in genotype 1, 89.4% in genotype 2, 93.8% in genotype 3, and 33.3% in genotype 4 pa-tients. Patients with lower viral load yielded higher SVR (65.8% vs. 58.4%, p=0.09). SVR rates according to his-tologic severity were found to be 69.3%, 66.3%, 59.9%, 47.3%, and 45.5% in patients with fibrosis stage 0, 1, 2, 3 and 4, respectively. The predictors of SVR were male gender, genotype 2/3, age less than 45 years, low fibrosis stage, low baseline viral load and presence of early viro-logical response. SVR rates to each peginterferon were found to be similar in genotype 1/4 although SVR rates were found to be higher for peginterferon alpha-2b in patients with genotype 2/3. The number of patients who failed to complete treatment due to adverse effects was 33 (2.7%). The number of patients failed to complete treatment due to adverse effects was 33 (2.7%).Conclusion: Our findings showed that the rate of SVR to dual therapy was higher in treatment-naïve Turkish pa-tients than that reported in randomized controlled trials. Also peginterferon alpha-2a and alpha-2b were found to be similar in terms of SVR in genotype 1 patients.
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    Management of Chronic Hepatitis C Virus Infection: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases-2017 Update
    (2017) Aygen, Bilgehan; Demirtürk, Neşe; Türker, Nesrin; Asan, Ali; Eraksoy, Haluk; Gürbüz, Yunus; İnan, Dilara
    Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Viral Hepatit Çalışma Grubu tarafından, ilk olarak 2014 yılında tüm dünyada önemli bir sağlık sorunu olan hepatit C virusu (HCV) infeksiyonunun yönetimine ilişkin bir uzlaşı raporu hazırlanmış ve Klimik Dergisi'nde yayımlanmıştır. Kronik hepatit Recently, we needed to update this report considering the new developments in treatment of chronic hepatitis C (CHC). This new consensus report is based on review of current literature and international guidelines. Agreed recommendations are presented at the end of each section such as epidemiology and natural history of HCV infection, diagnosis of acute hepatitis C (AHC) and CHC, treatment of AHC, goals of CHC therapy and pre-therapeutic assessment of CHC therapy, indications for treatment, contraindications to therapy, direct-acting antivirals (DAA) in the treatment of CHC and drug-drug interactions in the treatment of DAA, resistance problem in DAA treatment and clinical assesment of resistance, monitoring and managing treatment safety and side effects, post-treatment follow-up of patients who achieve a sustained virological response (SVR), follow-up of patients who didn't achieve an SVR and prevention of HCV infection. Klimik Dergisi 2017; 30(Suppl. 1): 2-36
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    Management of chronic hepatitis C virus infection: A consensus report of the study group for viral hepatitis of the Turkish society of clinical microbiology and infectious diseases-2017 update
    (AVES Ibrahim Kara, 2017) Aygen, Bilgehan; Demirtürk, Neşe; Türker, Nesrin; Asan, Ali; Eraksoy, Haluk; Gürbüz, Yunus; İnan, Dilara
    Previously a consensus report about management of hepatitis C virus (HCV) infection, a major health problem all over the world had been prepared by Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases. It was first published in the Klimik Journal in 2014. Recently, we needed to update this report considering the new developments in treatment of chronic hepatitis C (CHC). This new consensus report is based on review of current literature and international guidelines. Agreed recommendations are presented at the end of each section such as epidemiology and natural history of HCV infection, diagnosis of acute hepatitis C (AHC) and CHC, treatment of AHC, goals of CHC therapy and pre-therapeutic assessment of CHC therapy, indications for treatment, contraindications to therapy, direct-acting antivirals (DAA) in the treatment of CHC and drug-drug interactions in the treatment of DAA, resistance problem in DAA treatment and clinical assesment of resistance, monitoring and managing treatment safety and side effects, post-treatment follow-up of patients who achieve a sustained virological response (SVR), follow-up of patients who didn’t achieve an SVR and prevention of HCV infection. © 2017, AVES Ibrahim Kara. All rights reserved.
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    Öğe
    Real-world data from Turkey: Is sofosbuvir/ledipasvir with or without ribavirin treatment for chronic hepatitis C really effective?
    (Turkish Society of Gastroenterology, 2021) Demirtürk, Neşe; Aygen, Bilgehan; Çelik, İlhami; Mıstık, Reşit; Akhan, Sıla; Barut, Şener; Şener, Alper
    Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice. Methods: Data from patients with chronic hepatitis C treated with SOF/LDV ± RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed. Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 ± 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV ± RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect. Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV ± RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.