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Introduction: Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) continues to be a serious worldwide public health problem despite widespread efforts to control the disease. Today, with the introduction of high-active antiretroviral therapy, AIDS-related mortality rates are significantly reduced and life expectancy for HIV-infected patients has increased. In this study, it was aimed to evaluate AIDS-defining illnesses during the clinical course of HIV infection and the effects of immune status on clinical outcomes. Methods: The medical records of HIV infected patients who were followed up between January 2005 and November 2018 were retrospectively investigated. Results: During the study period, 336 HIV-infected patients were followed up. Among 336 patients, 45 (13.3%) had experienced one or more, a total of 59 episodes of AIDS-defining illnesses during follow-ups. Of 45 patients who had experienced AIDS-defining illnesses, 42 (93,3%) were male, the mean age was 41.1±9.7 years and 12 of them were found to have died when this study conducted. The median count of CD4 T lymphocytes and the mean age at the time of diagnosis of 33 alive and 12 died patients were 106 cells/mm3, 40.1±9.9 years, and 94 cells/mm3, 43.9±8.5 years, respectively. There was no statistically significant difference between the median count of CD4 T lymphocytes and the mean age of alive and died patients. The most common AIDS-defining illness was Pneumocystis jirovecii pneumonia with 28.8%. The most common diagnosed cause of mortality was AIDS-related carcinomas with 33%. Discussion and Conclusion: These findings reveal that the most important preventive measure for survival in HIV-infected patients is the early diagnosis of the disease and the initiation of antiretroviral therapy before the emergence of AIDS-defining illnesses due to severe immune deficiency. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of olfactory dysfunction on the course and severity of COVID-19 and its prognostic and predictive significance for COVID-19. Study Design: Prospective case-control study. Setting: Ondokuz Mayıs University School of Medicine. Methods: Reverse transcription polymerase chain reaction (PCR)–positive patients, patients with COVID-19–related symptoms who had a negative PCR result, and healthy controls were included in the study. Clinicodemographic characteristics, inflammatory markers, and computed tomography stages were recorded. Disease progression and intensive care unit admission were registered. The visual analog scale (0, worst; 10, best) was used to evaluate subjective olfactory, taste, and nasal breathing ability, and the Sniffin' Sticks identification (SS-ID) test was used for psychophysical olfactory assessment. Results: Mean SS-ID scores were significantly lower in the positive group (8.77) than in the negative (10.43) and healthy control (12.17) groups. VAS-smell scores were significantly lower and anosmia was more prevalent in PCR-positive patients (P <.01). SS-ID and VAS-smell scores were significantly correlated (r = 0.681, P <.001). The inflammatory parameters, pulmonary infiltration stage, disease progression, and ICU admission were not associated with SS-ID scores. A cutoff SS-ID score <9 resulted in 55.56% sensitivity in predicting COVID-19 positivity, and a cutoff VAS-smell score <8 yielded 72.22% sensitivity. Conclusion: Olfactory dysfunction was detected objectively and subjectively in the PCR-positive group, and no difference was found in terms of taste function and nasal breathing. The severity and prognosis of COVID-19 are not exclusively dependent on olfactory dysfunction. The degree of olfactory dysfunction can be useful in predicting PCR positivity. [ABSTRACT FROM AUTHOR]

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Purpose: To investigate the frequency of concurrent drug use and drug interactions in patients with human immunodeficiency virus (HIV) infection. Methods: The medical records of HIV-infected patients followed up at Ondokuz Mayis University Hospital in the last six months were retrospectively reviewed to assess the antiretroviral therapy (ART) regimens used, the prescribed concurrent drugs, and their interactions Results: The records of 268 patients were evaluated; of these, 43 (16 %) were women, and 225 (84 %) were men. The mean age of the patients was 43.8 ± 12.1 years. Concurrent drugs were prescribed to 210 (78.3 %) patients. Drug interactions were detected in 115 (42.9 %) patients. Of the 210 drug interactions detected, 168 (80 %) were potential interactions, 39 (18.6 %) were weak interactions, and 3 (1.4 %) were contraindicated. A statistically significant relationship was not observed in gender, age, and rate of concurrent drug prescription. Increased nephrotoxicity was the most common potential drug interaction. Non-steroidal anti-inflammatory drugs were the most commonly prescribed class of drugs along with ART. Conclusion: Physicians treating HIV-infected patients should be conscious of, and careful about the concurrent use of drugs and their potential drug interactions. [ABSTRACT FROM AUTHOR]

In December 2019, several cases of pneumonia of unknown origin were reported in the city of Wuhan, province of Hubei, China. The pathogen was named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease was named coronavirus disease 2019 (COVID-19). Acute phase reactans (APRs) are critical in the early diagnosis, treatment, and for monitoring the progression of COVID-19. Seventy two patients were included in the study and infections confirmed by real-time reverse transcription polymerase chain reaction. Clinical parameters, the level of APFs and D-dimer were assessed and results were retrived from the patients' medical records. Chest computed tomography (CT) findings were described for each patient and they were divided into two groups, with or without COVID-19 pneumonia. The correlation between APRs and CT findings and the patients' prognosis were evaluated. Twenty eight (38.8%) of the 72 patients were female and 44 (61.2%) were male. The most common symptom was cough (43%) and the most common associated chronic disease was hypertension (12.5%). Thirty (41.6%) patients had completely normal chest CT, while 42 (58.4%) patients had typical findings in terms of COVID-19 pneumonia. C reactive protein (CRP), lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), ferritin, procalcitonin and D-Dimer levels were statistically significantly higher in patients with pneumonia than in those without pneumonia and these parameters were also statistically significantly higher in patients with severe illness. In conclusion, CRP, LDH, ESR, ferritin, and D-Dimer were associated with severe COVID-19 pneumonia. These biomarkers can be used to evaluate the prognosis to predict the clinical course of disease, allowing a proper management and treatment of the patients. [ABSTRACT FROM AUTHOR]

Background: Because of their similar modes of transmission, the simultaneous infection of viral hepatitis and human immunodeficiency virus are increasingly seen as a big problem related to human health. Aims: To determine the drug mutations in hepatitis B virus and/ or hepatitis C virus co-infected human immunodeficiency virus-1 patients in Turkey. Study Design: Retrospective cross-sectional study. Methods: The present study was conducted between 2010 and 2017. HBsAg, anti-hepatitis C virus, and anti-human immunodeficiency virus were tested with ELISA. All anti-human immunodeficiency virus positive results by ELISA were verified for anti-human immunodeficiency virus positivity by a Western blot test, and Antihuman immunodeficiency virus positive patients with HBsAg and/or anti-hepatitis C virus positivity were included in the study. Subtyping and genotypic resistance analyses were performed by population sequencing of the viral protease and reverse transcriptase regions of the human immunodeficiency virus-1 pol gene. Results: We detected 3896 human immunodeficiency virus-1 positive patients whose sera were sent from numerous hospitals across the country to our polymerase chain reaction unit for detection of drug resistance mutations and whose molecular laboratory tests were completed. Viral hepatitis co-infections were detected in 4.3% (n=170) of patients. Hepatitis B virus and hepatitis C virus co-infection were observed in 3.2% and 0.5% of all human immunodeficiency virus-1 infected patients, respectively. The major human immunodeficiency virus-1 subtype detected was group M, subtype B (62.9%). However, 13.5% of drug resistance mutation motifs were found in human immunodeficiency virus-1 genomes of patients included in the study. Conclusion: Due to similar transmission routes, HIV1 patients are at risk of hepatitis B and C virus co-infection. However, antiretroviral drug resistance mutation model is similar to patients with hepatitis negative. [ABSTRACT FROM AUTHOR]

Crimean-Congo haemorrhagic fever (CCHF) is a severe form of haemorrhagic fever identified in parts of Africa, Asia, Eastern Europe and the Middle East. CCHF continues to be a justifiable cause of concern for people in rural areas where the disease is endemic. A total of 151 patients, diagnosed with CCHF, were evaluated retrospectively. The demographic characteristics of these patients and the relationship between the neutrophil-lymphocyte ratio (NLR) at admission and survival were examined. There were 21 (13.9%) deaths. There was no relationship between age, gender and mortality, but elevated neutrophil-lymphocyte ratio (NLR) on admission was statistically associated with mortality. NLR is a laboratory marker that can be studied even in medical centres with limited facilities and may be helpful in predicting the clinical course of the disease. [ABSTRACT FROM AUTHOR]

Introduction: Enterococcus hirae (E. hirae) constitutes less than 1% of the enterococci strains in human clinical specimens. In this article, we report the first case of urinary tract infection-related bacteremia due to E. hirae from Turkey. Case Presentation: A 74-year-old male patient with a history of coronary artery disease, hypertension, and chronic renal failure was admitted to the emergency department with abdominal pain, dysuria, and fever. The urine sample collected from the urinary catheter resulted as ampicillin-sensitive E. hirae. On the 4th day of hospitalization, E. hirae growth with the same sensitivity pattern was also reported in blood culture. Intravenous ampicillin 4x2 g/day treatment was initiated. There was no growth in subsequent blood and urine cultures. Fever resolved and general condition improved. The patient was discharged on the thirteenth day with clinical improvement after moxifloxacin treatment for four days and ampicillin treatment for nine days. Discussion: The patient's medical history included risk factors for enterococcal bacteremia. There are a limited number of reports in the literature describing human infections caused by E. hirae. The reason for the rare isolation of E. hirae from clinical specimens may be the difficulty of identifying with standard diagnostic approaches. Conclusions: For diagnostic purposes, as in our case, rapid and high sensitive diagnostic methods such as Matrix-assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) and molecular techniques may be useful to guide the selection of the least toxic and optimal duration of antibiotic treatment. [ABSTRACT FROM AUTHOR]

Objective: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities co-infect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases.Methods: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases.Results: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm3 reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%.Conclusion: Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is a major cause of mortality among people living with HIV (PLWH). We aimed to assess the prevalence of diagnosed CVD and the risk of CVD among PLWH using 5 different tools., Methods: This retrospective, cross-sectional study was conducted in 20 tertiary centers in Türkiye between October 2021 and March 2022, among 1425 PLWH aged 40-75 years. About 82.7% were male, with a median age of 51. Web-based tools for each score were used for CVD risk calculations., Results: Of 1425 PLWH enrolled, 10.8% had confirmed CVD, and 1132 had their risk scores evaluated. Of those participants, 42.8% had a higher risk of CVD (10-year risk of atherosclerotic CVD risk score (ASCVD) above 7.5%), and according to the European Society of Cardiology systemic coronary risk evaluation 2 (SCORE2), 71.7% had a high- to very high-risk rate. The agreement between various CVD risk tools varied, with Framingham heart study risk score (FRS), modified FRS, data collection on adverse effects of anti-HIV drugs (DAD), and SCORE2 for high-risk countries showing overall agreement rates of 82%, 94%, 91%, and 36%, respectively, compared to ASCVD. According to the 2021 European and 2019 American Cardiology guidelines, 75.3% and 47.1% of PLWH would be eligible for lipid-lowering agents, respectively., Conclusion: The diagnosed CVD prevalence highlighted the importance of monitoring cardiovascular health and comorbidities in this population. SCORE2 identified a greater number of individuals at high/very high risk compared to other prediction tools. The implementation of CVD prevention through lipid-lowering therapy was far from desired levels in our cohort.

Objective: As the Coronavirus disease 2019 (COVID-19) pandemic spread globally, more human immunodeficiency virus (HIV) positive patients began to appear infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to evaluate the clinical course of HIV and SARS-CoV-2 co-infected patients from a local perspective., Methods: HIV and SARS-CoV-2 co-infected patients diagnosed between March 2020 to June 2021 at a tertiary hospital in Turkey were analyzed retrospectively., Results: Thirty HIV and SARS-CoV-2 co-infected patients were included. Five patients were female, 25 were male, and the mean age was 44.5 ±10.2 years. Twenty-three (76.7%) patients were known to be HIV-positive before their admission to the hospital, and seven (23.7%) patients, were detected by screening after the diagnosis of COVID-19. All patients were known to be HIV-positive; they were on antiretroviral therapy (ART) and virologically suppressed. Twenty-seven patients had a mild course. Three patients were hospitalized, and of them, two patients had died. All hospitalized patients were male and were ART-naïve., Conclusion: HIV infection alone did not increase the severity of the course of COVID-19 and did not increase the mortality in COVID-19., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 Infectious Diseases and Clinical Microbiology.)

Objectives: A new type of coronavirus outbreak has emerged in China and caused a pandemic. World Health Organization (WHO) announced the official name of this disease 'COVID-19'. The main purpose of this study is to evaluate pain in COVID-19 patients., Methods: Patients who were followed in the ward of an infectious diseases department because of possible or confirmed COVID-19 between May and September of 2020 were included in the study. The Turkish version of the Brief Pain Inventory (BPI) was applied. Demographic features, frequency, location, the intensity of pain, and response to analgesics were analyzed., Results: A total of 178 participants were included in the study. Ninety-one (51.1%) of patients had pain complaints and the mean pain score (MPS) was 2.28±2.81 over 10. Fifty-nine (56.0%) of participants with pain required analgesic therapy and 41 (80.3%) of them showed ≥50% pain relief with simple analgesics. Twelve of the remaining 18 who did not get enough pain relief with simple analgesic were taking their analgesics pro re nata (PRN) rather than around the clock (ATC). Pain frequency and intensity and mean hospitalization duration (MHD) were similar between confirmed and possible cases., Conclusion: Regarding the results, we conclude that pain is not one of the challenging symptoms and easily manageable in patients with a mild-moderate intensity of COVID-19. Our results were not enough to make a correlation between pain and the clinical course of the disease. Further studies are required for the evaluation of pain including patients in intensive care units.

In December 2019, several cases of pneumonia of unknown origin were reported in the city of Wuhan, province of Hubei, China. The pathogen was named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease was named coronavirus disease 2019 (COVID-19). Acute phase reactans (APRs) are critical in the early diagnosis, treatment, and for monitoring the progression of COVID-19. Seventy two patients were included in the study and infections confirmed by real-time reverse transcription polymerase chain reaction. Clinical parameters, the level of APFs and D-dimer were assessed and results were retrived from the patients' medical records. Chest computed tomography (CT) findings were described for each patient and they were divided into two groups, with or without COVID-19 pneumonia. The correlation between APRs and CT findings and the patients' prognosis were evaluated. Twenty eight (38.8%) of the 72 patients were female and 44 (61.2%) were male. The most common symptom was cough (43%) and the most common associated chronic disease was hypertension (12.5%). Thirty (41.6%) patients had completely normal chest CT, while 42 (58.4%) patients had typical findings in terms of COVID-19 pneumonia. C reactive protein (CRP), lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), ferritin, procalcitonin and D-Dimer levels were statistically significantly higher in patients with pneumonia than in those without pneumonia and these parameters were also statistically significantly higher in patients with severe illness. In conclusion, CRP, LDH, ESR, ferritin, and D-Dimer were associated with severe COVID-19 pneumonia. These biomarkers can be used to evaluate the prognosis to predict the clinical course of disease, allowing a proper management and treatment of the patients.

Human toxocariasis is a parasitic disease transmitted to humans by ingestion of Toxocara spp. larvae. Rural area residents and children have higher risk for this parasitic infection. The disease is frequently asymptomatic; however, it may cause symptoms such as cough, fever, headache, myalgia or other conditions such as lymphadenopathy and granulomatous hepatitis. Albendazole is used for the treatment of toxocariasis diagnosed by serologic and immunological methods. Herein, we report two cases of toxocariasis that were investigated due to hypereosinophilia and lymphadenopathy for a long time.