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Aim: In this study, the aim is to detect polymorphisms in the gene encoding the sodium taurocholate cotransporting polypeptide (NTCP), the functional receptor for hepatitis B virus (HBV) and hepatitis D virus. Materials and Methods: The study included a total of 293 patients, with 150 diagnosed with chronic hepatitis B (CHB) and 143 undergoing liver parenchyma biopsy procedures due to different clinical indications. Total DNA was isolated from liver biopsy samples. The TaqMan SNP genotyping method was used to determine the rs2296651 polymorphism in the SLC10A1 gene, which leads to the NTCP S267F variation. Results: In patients with CHB and the control group, the NTCP-interacting domain was highly conserved, and no variation of the SNP rs2296651 in the SLC10A1 gene leading to the NTCP S267F variation was detected in any of the patients. Conclusion: It was thought that in patients with CHB, the impact of the NTCP S267F variation on the progression of HBV-associated diseases and its influence on the therapeutic efficacy of anti-viral agents targeting NTCP blockade may be limited.

Copyright of ANKEM Antibiyotik & Kemoterapi Dergisi is the property of ANKEM Antibiyotik & Kemoterapi Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: There is not a definitive virological treatment for chronic hepatitis B . Withdrawal of nucleos(t)ide analogue (NA) therapy frequently results in viral recurrence, necessitating lifetime treatment. We aimed to look into the results of discontinuation of nucleos(t)ide analogue therapy in HBeAg negative patients. Methods: Treatment of HBeAg-negative patients without cirrhosis who had suppressed HBV DNA for a mean of ≥7 years and underwent nucleos(t)ide analogue therapy for a mean of ≥7 years were stopped according to the EASL guideline stopping rule. Standard laboratory tests, such as HBV DNA viral load, HBsAg, alanine aminotransferase, and adverse events, were monitored for more than four years during therapy and afterwards. Results: HBsAg loss was not observed in any of the patients during the four-year follow-up period. After the first 12 weeks, HBV-DNA was detected in all patients whose nucleos(t)ide analogue treatment was discontinued. The percentage of patients with HBV DNA >2000 IU/mL was 70% at 6 months, 74% at 12 months, 78% at 24 months, and 79.7% at 36 months, HBV DNA >2000 IU/mL was not detected in remaining patients over a four-year period. In the first year, 26% (n=18) of patients were started treatment for relapse, 46% (n=32) in the second year, 49% (n=34) in the third year, and 55% (n=38) in the fourth year. 45% (n=31) of the patients were still being followed without treatment at the end of the fourth year. Conclusion: Although the follow-up of hepatitis B e antigen-negative CHB patients on NA therapy was longer than in the literature, our recurrence rates were similar to other studies, and no patient lost HBsAg. The most significant benefit was that we were able to follow half of the patients without therapy for more than four years, eliminating the need for the patients to use drugs. [ABSTRACT FROM AUTHOR]

Turkish Society of Clinical Microbiology and Infectious Diseases Viral Hepatitis Working Group updated the consensus report on the management of chronic hepatitis B (CHB) in private hosts and special situations. Relevant literature and international guidelines are reviewed, and agreed recommendations are presented at the end of each chapter. In the report, treatment of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection, management of HBV and hepatitis C virus (HCV) coinfection, management of CHB in severe COVID-19 patients, non-transplant immunocompromised patients. [ABSTRACT FROM AUTHOR]

The consensus report on the management of chronic hepatitis B (CHB) was first published in 2014 by the Viral Hepatitis Study Group of the Turkish Society of Clinical Microbiology and Infectious Diseases. The need for updating has arisen due to reestablished stages of the infection course, changes in treatment indications, new biomarkers used in diagnosis and follow-up, and new biomarkers that are not yet in daily use. Therefore, we prepared a new consensus report by reviewing the current literature and international evidence-based guidelines. We hope the updated consensus report will be a valuable resource for CHB, which is still an essential problem in our country. [ABSTRACT FROM AUTHOR]

Background: It was aimed to present the knowledge, awareness levels and clinical follow-up data of the hepatitis B infected healthcare workers about hepatitis B virus in our hospital. Materials and Methods: In this study, HBsAg positivity among healthcare workers who were screened by Occupational Health and Safety Unit at Batman Training and Research Hospital between 01.01.2022 and 31.12.2022 were referred to the Infectious Diseases and Clinical Microbiology outpatient clinic. The demographic characteristics of the workers, the current status of hepatitis B, the vaccination status of family members, the history of sharp injuries, and the answers to the questions about the stigma exposure due to hepatitis B were evaluated. The results of advanced laboratory tests related to hepatitis B of the patients were analyzed. Results: HBsAg positivity was detected in 69 (3.2%) of the 2148 workers who were screened. The mean age of workers was 38.55±9.21 years (min-max: 20-60), 52 (75.4%) were male. The majority of those with HBsAg positivity (n=25, 36.2%) were nurses/midwives/health officials, followed by cleaning staff (n=16, 23.2%). The diagnosis of hepatitis B virus infection was first determined during occupational screening (55.2%) and secondly during family screening. It was determined that 44.8% of the workers had a history of sharp injuries, 23.3% had viral serological examinations after injury, and only 13.3% had the serology of the source checked. It was observed that 14 (20.9%) workers diagnosed of hepatitis B did not tell other healthcare workers about their diagnosis. It was found that of those with HBsAg positivity 28 (41.8%) never came to the Infectious Diseases and Clinical Microbiology or Gastroenterology outpatient controls, 10 (14.9%) rarely came, and 8 (11.6%) received treatment for chronic hepatitis B. Conclusions: In this study, the fact that healthcare workers did not go to outpatient follow-ups at regular intervals for further examination and treatment despite the suspicion of hepatitis B infection with life-threatening chronic complications or the known disease suggests that they do not have sufficient awareness of the disease. In addition, the lack of serological control of the source when exposed to sharps injuries is an important problem of preventing infectious diseases. The data of the study reveal that training for workers should be given more importance. [ABSTRACT FROM AUTHOR]

Objectives: Chronic hepatitis is a clinical and pathological condition defined by etiological, clinical, and pathological aspects, in which inflammation in the liver continues for more than six months. Hepatitis B virus is one of the most important causes of etiology. Although liver biopsy is accepted as the gold standard test, there is a need to search for an alternative method due to the risk of complications, invasiveness, and cost. Our aim in this study was; to evaluate the predictive value of calculating fibrosis four scores (FIB -4), age platelet index (API), AST ALT ratio (AAR), AST platelet ratio index (APRI), Hui score, Goteburg University cirrhosis index (GUCI) indices in relation to liver biopsy in patients with chronic hepatitis B diagnosis who have not received any treatment before. Methods: The study included treatment-naive cases who underwent liver biopsy at Ankara University School of Medicine Hospitals Gastroenterology Clinics between March 2013 and November 2017 and at Ankara City Hospital Gastroenterology Clinic between 2019-2021. Non-invasive scores of the cases were evaluated simultaneously with liver biopsy. Results: A total of 159 patients, 45 (28.3%) female and 114 (71.7%) male, were included in our study. Eight non-invasive fibrosis markers were used, including APRI, FIB-4, AAR, API, CDS, Lok, GUCI, and Hui. GUCI and Hui non-invasive fibrosis markers were numerically superior to all other parameters in differentiating mild hepatitis from severe hepatitis and patients with cirrhosis, without cirrhosis. In the comparison of area under -- receiver operating characteristic (AUROC) values using the Hanley-McNeal test to differentiate the cirrhosis patient from the non-cirrhosis patient, statistical superiority was found only against AAR and API (p<0.001, p<0.001). Conclusion: Although many markers were found successful in our study, AUC values were not significantly superior to each other, and we determined that they could not be an alternative to liver biopsy on their own. [ABSTRACT FROM AUTHOR]

Purpose: Chronic hepatitis B is still one of the leading causes of cirrhosis and hepatocellular carcinoma worldwide, and the liver biopsy the gold standard method to assess the severity of liver fibrosis. Noninvasive predictive factors are needed for histological evaluation of liver biopsies. In this study, it was aimed to investigate the diagnostic value of hemogram and biochemical parameters for modified histological activity index and fibrosis in patients with chronic hepatitis B. Materials and Methods: In this study, liver tru-cut biopsies of 248 patients diagnosed with chronic hepatitis B, were evaluated retrospectively. Modified histological activity index and fibrosis were scored in accordance with the Ishak staging system and compared with hemogram and biochemical parameters. Results: In the fibrosis groups, the aspartate aminotransferase (AST) value was the best marker to discriminate < 3 ve ≥3 groups, with 70,3% discrimination performance. In the histological activity index groups, AST, alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT) was the best parameters to discriminate

Potent antivirals are used for the treatment of hepatitis B infection. A 38-year-old female patient whose hepatit B virus (HBV) viral load was suppressed under tenofovir disoproxil fumarate treatment but had a viral flare during in vitro fertilization (IVF) treatment is presented. Although HBV DNA was negative continuously in the controls, an increase in HBV DNA was observed during IVF treatment. Hepatitis B has been isolated from many extrahepatic tissues. Ovarian stimulation is likely to increase viral replication. Therefore, it is essential to check HBV DNA periodically to prevent vertical transmission. [ABSTRACT FROM AUTHOR]

Objective: Hepatitis B virus is an important health problem leading to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. This study aimed to compare the efficacy and side effects of antiviral drugs used in chronic hepatitis B (CHB). Methods: Five hundred seventy-two patients who were followed and treated with CHB in our clinic were evaluated retrospectively. Results: Fifty-six point five of 572 patients were male, 43.5% were female, and the mean age of the patients was 43.4 ± 12.4. Of the patients, 153 (26.8%) used tenofovir disoproxil fumarate (TDF), 134 (23.4%) telbivudine (LdT), 114 (20%) entecavir (ETC), 92 (16%) lamivudine (LAM), 26 (4.5%) adefovir (ADV), 27 (4.7%) pegylated interpheron alpha (PEG-IFN-α), and 26 (4.6%) used PEG-IFN-α + nucleoside analogue (NA). No significant difference was detected between the treatment groups in terms of age, sex ratio, fibrosis, histological activity index (HAI) score, baseline platelet, international normalized ratio (INR), alpha-fetoprotein (AFP) values (p> 0.05). Seventy (12.3%) of 568 patients were HBeAg (+), 498 (87.7%) were HBeAg (-). At the end of the first year, the virological response rates were 92.5% in LdT, 82.6% in LAM, 72.8% in ETV, 60.7% in TDF, 26.9% in ADV, 22.2% in PEG-IFN-α, 65.3% in PEG-IFN- α+NA groups. Twenty-three point eight of the patients had treatment changes, and 76.3% of these patients preferred TDF as a new treatment. Virological breakthrough was observed at 43.5% in LAM, 13.4% in LdT, 7% in ETV and 0.6% in TDF groups. At the end of 3, 4, and 5 years without treatment change, all patients who continued TDF, ETV, LdT, ADV, and LAM treatment were HBV DNA negative. HBsAg clearance developed in 13 (2.3%) patients. At least one side effect was observed in 169 (29.5%) of all patients, and the group with the most frequent side effects was PEGIFN- α+NA (92.3%) and PEG-IFN-α (77.8%). Amylase increase in LAM (%3.2), CPK increase in LdT (%27.6), CPK increase in TDF (%3.2) groups were the most common side effects. Conclusions: The drug with the lowest virological response rate and the most common side effect is PEG-IFN-α, so its use should be limited to selected patient groups. Treatments with the lowest incidence of side effects and development of resistance were found to be with TDF and ETV. Considering the high virological response rates, TDF and ETV should be preferred in the treatment of CHB. When all treatments are evaluated, HBsAg loss and cure rates are inadequate. [ABSTRACT FROM AUTHOR]

INTRODUCTION[|]Hepatitis B and hepatitis C infections are the major causes of death due to chronic liver disease. Treatment is very important in reducing long-term cirrhosis and hepatocellular carcinoma. In this study, we aimed to determine the real-life data of patients treated with hepatitis B and C.[¤]METHODS[|]Thirty patients with chronic hepatitis B and 21 patients with chronic hepatitis C who were treated in an Infectious Diseases and Clinical Microbiology outpatient clinic in a training and research hospital in Izmir between May 2007 and December 2008 were retrospectively evaluated in this study.[¤]RESULTS[|]In chronic hepatitis B patients, the virological response rate to 48 weeks of pegylated interferon treatment was 57%. However, in 85% of the patients who developed virological response at the end of the treatment, we started oral antiviral treatments within a year due to biochemical and virological exacerbations. HBeAg seroconversion developed in two of the 14 patients receiving pegylated interferon treatment, while 11 of 14 patients were switched to oral antivirals. Virological and biochemical suppression was achieved in one patient. In patients who received entecavir and tenofovir treatment, virological response rates were 91% and 100% at 48 weeks of treatment, respectively. The rate of sustained virologic response was 100% in patients treated with ribavirin plus pegylated interferon treatments in 21 hepatitis C patients.[¤]DISCUSSION AND CONCLUSION[|]We think pegylated interferon treatment should be given only to selected chronic hepatitis B patient groups with HBeAg (+), low viral load and high ALT levels because of the low treatment response to a high potential for side effects. Although direct-acting antivirals (DAA) are recommended treatments for patients with Chronic hepatitis C due to their high persistent virological responses and much fewer side effects, especially in developing and undeveloped countries, because of the high cost of DAA drugs, pegylated interferon alfa 2a or 2b treatment combined with ribavirin should be considered as an alternative.[¤]

Purpose: Many noninvasive tests have been studied for the diagnosis and determining the liver fibrosis score. In this study, we aimed to research the correlation of platelet parameters and stage of liver fibrosis in patients with chronic hepatitis B (CHB).Materials and Methods: A total of 140 biopsy-proven naive CHB cases were included in the study. HBV-DNA level, liver enzymes and function tests, white blood cell count, platelet parametres, hemoglobin, histological activity index (HAI) and other routine biochemical parameters were tested. Patients were divided into two groups as F0-2 and F3-6 with Ishak scoring system according to the severity of liver fibrosis.Results: There was no significant difference between the groups F0-2 and F3-6 in terms of, platelet (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT). There was a significant difference between these two groups for HAI, aspartate aminotransferase (AST), gamma glutamyl transpeptidase (GGT), age and lymphocyte (LYM) parameters. The formulation of (AST x Age x LYM) / √PLT)which was formed from many different combinations, was investigated in order to be used in predicting the liver fibrosis stage. Conclusion: Although our new index is more sensitivitythan other noninvasive scoring systems, it is needed to have a larger sample size in patients with severe stage liver fibrosis in order to be used safely as a noninvasive marker.

Objective: Occult hepatitis B infection (OBI) can be characterized by the long-term persistence of HBV DNA in the liver of individuals who test negative for the hepatitis B surface antigen (HBsAg) using the currently available assays. This study aimed to evaluate genotype, subgenotype and subtype profiles of HBVs obtained from patients with OBI. Material and Method: The study included 32 patients with OBI who were diagnosed with HBV DNA by Nested PCR method in liver biopsy samples of patients who underwent liver parenchymal biopsy due to HBsAg negative different clinic indications and 17 chronic hepatitis B patients. The MHR region of the HBV S gene was amplified using nested PCR. Sanger sequencing method was used to determine the genotype, subgenotypes and subtype/serotype of HBV. Results: In this study it was determined that the genotypes of all HBVs isolated from OBI and chronic hepatitis B patients were HBV/D, subgenotypes were respectively HBV/ D1 (75.5%), HBV/ D2 (6.1%) and HBV/D3 (18.4%), serotypes were respectively ayw2 (73.5%) and ayw3 (26.5%). Although the subgenotype of 28.1% of patients with OBI was determined as HBV/D3, none of the chronic hepatitis B patients had the HBV/D3 subgenotype. Conclusion: The potential effects of subgenotype HBV/D3 on the dynamics of viral biogenesis may be associated with OBI, characterized by low replication competence and HBsAg negativity. [ABSTRACT FROM AUTHOR]

Objective: Mean platelet volume (MPV) is one of the most important parameters of platelet size and is a potential marker of platelet reactivity. Clinical and histopathological correlations with MPV have been demonstrated in most diseases. In this study, we aimed to investigate the relationship between hepatic histopathology and platelet count and MPV levels associated with viral hepatitis. Material and Method: In our clinic, we conducted a retrospective case control study based on some histological and clinical parameters of patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). The patients were divided into two groups, CHB and CHC. These groups were then divided into groups consisting of histological activity index (HAI) and fibrosis scores according to liver biopsy results. Clinical features of chronic viral hepatitis patients including demographic, laboratory and liver biopsy findings were evaluated. Results: In the study, a statistically significant difference was found between the HAI classes in patients with CHB and CHC in terms of MPV and platelet distribution width (PDW)/MPV levels (p <0.001). A statistically significant difference was found between the fibrosis classes in patients with CHB in terms of MPV and PDW/MPV levels (p <0.001). A statistically significant difference was found between the fibrosis classes in patients with CHC in terms of MPV and creatine levels (respectively p =0,032, p =0,042). Conclusion: It can be used as a predictive parameter in patients with MPV, CHB and CHC, which are viewed by a simple method such as complete blood count. Therefore, the examination of the correlation between MPV levels and CHB and CHC with larger prospective studies is necessary to confirm these findings. [ABSTRACT FROM AUTHOR]

Copyright of Van Tip Dergisi is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Natural course and clinical outcomes of chronic hepatitis B virus (HBV) infection is closely releated to immun responses of host and viral factors. Studies have suggested that there is strongly correlation between the level of IL-17 and especially of advanced liver damages associated with HBV. Role of IL-17 on natural course of chronic hepatitis B disease is yet to be fully clarified. This study aimed to evaluate the correlation between serum IL-17 levels with histological, virological, serological and biochemical data of chronic hepatitis B patients. Material and Method: Simultaneous liver biopsy and blood samples were obtained from 88 with chronic HBV enfection. Ishak modified histological activity index system was used for histological evaluation.The patients were divided into three groups taking into account by scoring as none/mild (F0-1), moderate / severe (F2-4) and cirrhosis (F5-6) according to the stages of fibrosis (F). It was analyzed using enzyme-linked immunosorbent assay (ELISA) to IL-17 levels in serum samples. Results: A total of 88 CHB patients were evaluated, with an average age of 41.77±13.39, 43 male and 45 female. Fibrosis stage of 64 (72.7%) of the patients included in the study was determined as F2-4. There were no statistically significant correlation between serum IL-17 levels with histological, virological, serological and biochemical data of patients. Conclusion: These data indicate that the immunopathological role of IL-17 on HBV-related especially low and moderate liver injuries are limited. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Internal Medicine / Türkiye Klinikleri İç Hastalıkları Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The optimal duration of nucleos(t)ide analogues (NAs) therapy is unknown for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients. The European Association for the Study of the Liver (EASL) recommends the cessation of NAs in selected non-cirrhotic HBeAg-negative patients achieving long-term (at least three years) virological suppression under treatment if close monitoring can be guaranteed after the cessation of NAs. This study aimed to test this “cut-off rule” in HBeAg-negative CHB patients treated with NAs. Materials and Methods: Seventy-one non-cirrhotic patients were treated with NAs for an average of nine (3-14) years before treatment was discontinued, and patients’ hepatitis B virus (HBV) DNAs were negative for an average of seven (3-13) years. After treatment cessation, serum HBV-DNA and alanine aminotransferase levels were monitored every four weeks for the first six months and every three months from six months to 12 months. The patients were followed-up for 48 weeks after treatment cessation. Results: In 48 weeks after NA treatment cessation, 30 of 71 patients (42.3%) experienced relaps. Hepatitis B e antigen seroreversion in two consecutive visits was observed in one patient (3.4%), HBV-DNA >20,000 IU/ml twice was observed in 23 patients (76.6%), and both virological and biochemical relapses were observed in six patients (20%). Median retreatment time was 21.6 (4-48) weeks. There were no significant differences between relapsers and non-relapsers in terms of baseline features. Conclusion: Although the viral suppression time in NA treatment of HBeAg-negative CHB patients was longer than the EASL recommendation, the relapse rate was found to be similar to that in other studies. Our study has shown that applying EASL recommendations in patients meeting the suitable criteria who can be closely followed up is appropriate.

Objective: Hepatitis B virus (HBV) infection is a common cause of cirrhosis and hepatocellular carcinoma. Interferons and nucleos(t)ide analogs are being used for the treatment of chronic HBV infection. Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) are the strongest oral antiviral agents. In this study, we aimed to investigate efficacy and safety of ETV and TDF in treatment of naive cirrhotic patients infected with HBV. Methods: A total of 58 cirrhotic patients infected with HBV who were treatment-naïve and initiated ETV or TDF as first therapy regimen were included in the study. Their demographic features such as sex, age, Child-Pugh and model for end-stage liver disease (MELD) scores and HBV DNA, HBsAg, HBeAg, serum alanine aminotransferase, creatinine, phosphorus and total creatine kinase levels were recorded at baseline and at 3rd, 6th, 12th, 18th, and 24th months of therapy. Drug side effects and complications of cirrhosis were also determined in the follow-up period. ETV and TDF groups were compared in terms of response to treatment. Results: There were 32 and 26 patients in TDF and ETV groups, respectively. Majority of patients in both groups were Child-Pugh class A. Sex and age distribution and baseline laboratory parameters were similar in both groups (p>0.05). Percentage of patients who were their HBV DNA becoming negative were higher significantly in ETV group only at the 6th month of therapy (p=0.04), however there were no statistically significant differences at 12th, 18th and 24th months between groups. HBV DNA was negative in 100% of patients in TDF group and 89% of patients in ETV group at the end of follow-up period (24th month) (p=0.31). In the followup period, there were significant increases in creatinine levels in both groups (p=0.04), however, this was within normal ranges and there was no statistically significant difference between the groups (p=0.71). There were significant declines in both mean MELD and Child-Pugh scores in TDF group (p=0.02 and p=0.001, respectively), and there was a significant decrease at mean Child- Pugh score and no significant difference at MELD score in ETV group (p=0.003 and p=0.14 respectively) at the end of the follow-up period. Conclusions: Both ETV and TDF are considerably safe and effective in treatment-naïve patients with HBV-positive cirrhosis. The efficacy of these two drugs is similar. [ABSTRACT FROM AUTHOR]

Objective: Chemotherapy can lead to hepatitis B virus reactivation (HBVr) in oncological patients. Most of clinical guidelines recommend screening tests for hepatitis B infection before chemotherapy. The aim of this study was to determine the seroprevalence of .Hepatitis B before chemotherapy retrospectively by using the hospital computer database in patients who were followed up in our hospital and received chemotherapy, and asses whether or not vaccination is performed in patients who are anti-HBs negative. Material and Method: A total of 615 patients who underwent chemotherapy for solid organ malignancy from 1310 patients who were diagnosed and treated in the medical oncology outpatient clinic of our hospital between September 2013 and September 2011 were included in this study. The demographic characteristics and laboratory results of the patients were retrospectively reviewed in the hospital computer database HRçAg, anti-HBs, anl.i- HBc total ELISA, IIBV DNA levels of the patients were evaluated. Results: Of the 615 patients receiving chemotherapy, 353 (57.4%) were females and 262 (42.6%) were males. The mean age of the patients who had chemotherapy for solid organ malignancy was 58.50 (19-95 years). In these patients, HBsAg positivity was found in 28 patients (5%), anti-HBs positivity was found in 409 patients (66.5%), anti-HBs negative was found in 206 patients (33.5%), anti-HBc total positivity was found in 195 patients (31.7%). HBV DNA positivity was detected in 16 patients. Conclusion: Risk factors such as HBVr, hepatic failure and chemotherapy interruption should be taken into consideration in patients receiving chemotherapy for solid organ malignancy and these patients should be screened for HBV infection and vaccination should be performed in anti-HBs negative cases. [ABSTRACT FROM AUTHOR]

Copyright of Firat Universitesi Sağlik Bilimleri Tip Dergisi is the property of Firat Universitesiu, Saglik Bilimleri Enstitusu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The aim of this study is to explore the prevalence of hepatitis delta among individuals with chronic hepatitis B virus (HBV) infection in our province,and thereby contribute to the national epidemiological data. Methods: Anti-hepatitis delta virus (anti-HDV) results of patients aged 18 and over who were followed with chronic hepatitis B diagnosis in the period from January 1, 2017 to March 1, 2019 were evaluated retrospectively. Patients were separated into two groups, according to 2017 Clinical Practice Guidelines of the European Association for the Study of the Liver, namely, those with chronic infection and those with chronic hepatitis. Demographic data of patients were recorded. Results: The age range of the 455 patients diagnosed with chronic HBV infection (205 with chronic infection and 250 with chronic hepatitis) was 20 to 78 years (mean 43.20±13.25) and 259 were (56.9%) male, and 196 (43.1%) were female. 40 (8.8%) of the 455 chronic HBV infection patients were anti-HDV-seropositive. Anti-HDV seropositivity was identified in 16 (7.8%) of the patients followed-up for chronic infection, and in 24 (9.6%) of those followed-up for chronic hepatitis. Of the anti-HDV-seropositive patients, 24 (60%) had a familial history of chronic HBV infection and 13 (32.5%) had a familial history of cirrhosis associated with chronic HBV infection. Familial history of cirrhosis associated with chronic HBV infection was found statistically significantly higher in anti-HDV-seropositive patients versus anti-HDV-seronegative patients (p<0.001). Conclusions: Anti-HDV seropositivity rates found in our study are lower than those previously reported for our region but higher than those reported for the country and for the western regions of the country. The high rate of familial history for chronic HBV infection among our patients reveals the importance of intrafamilial transmission. Beside HBV prevention programmes, the creation of the HDV infection awareness in the areas where hepatitis delta frequency is high is of crucial importance in terms of avoiding the HDV infection. [ABSTRACT FROM AUTHOR]

Objective: Both chronic hepatitis B (CHB) and hepatosteatosis may lead to necroinflammation in liver. Therefore, the presence of hepatosteatosis might negatively affect the efficacy of antiviral therapy. We aimed to determine the effect of hepatosteatosis on virological response in patients with CHB receiving entecavir (ETV) and tenofovir (TDF) treatment. Methods: The study was designed retrospectively. All patients receiving antiviral therapy due to CHB in the departments of Infectious Diseases and Clinical Microbiology of 29 different hospitals between January 2012 and June 2017 were searched by examining medical records. Results: A total of 1069 patients were included. Six hundred and fifty of the patients had been receiving TDF and 419 of them had been receiving ETV. The rate of virological response obtained at the 48th week of TDF was higher in patients with steatosis (p=0.029). Virological response at the 24th week and 48th week of ETV were higher in the patients without steatosis (p=0.001). TDF and ETV therapies were compared in the patients with hepatosteatosis and it was found that the virological response at 48th week was higher in the TDF group. Conclusion: Although steatosis has an effect on virological response in the short-term results of nucleos(t)ide therapy, it does not have any effect on virological response in the long-term results. [ABSTRACT FROM AUTHOR]

Objective: Occult hepatitis B (OHB) is defined as identification of hepatitis B virus (HBV) genome in the liver and/or in the serum of HBsAg-negative individuals. We aimed to identify the situation of OHB in persons with chronic HBV infection among family members. Methods: 327 individuals (ages18 and above) who were referred to Infectious Diseases and Clinical Microbiology Outpatient Clinic between 2015 and 2016, and found as HBsAg-negative but learned the presence of chronic HBV infection among their family members (mother, father, spouse, sibling and offspring) were included in the study. HBsAg, anti-HBs and anti-HBc IgG tests were performed by ELISA, and HBV DNA levels were studied by real time polymerase chain reaction (PCR) in the sera. Results: Of the 327 persons included in the study, 168 (51.4%) were female and 159 (48.6%) were male. Only 6 (%1.8) had HBV DNA positivity. Anti-HBc IgG was positive in 110 (33.6%) and anti-HBs in 193 (59%) persons. Of the individuals whose relatives were evaluated; chronic HBV infection was found in 53 (16.2%) mothers, 60 (18.3%) fathers, 84 (25.7%) siblings, 103 (31.5%) spouses, 14 (4.3%) offsprings and in 13 (4.0%) individuals whose combinations consisted of more than one family member. Of the six cases with positive HBV DNA, 3 had spouses with a history of hepatitis B and in 3 cases, a father, brother and offspring had a history of hepatitis B. Conclusions: It is concluded that intrafamilial OHB screening is not required in family members due to the low incidence of OHB and high cost of HBV DNA testing. Considering both community health and cost, it is more appropriate to give family members the necessary education about HBV transmission paths, clinical importance and how to take measures instead of screening to prevent the emergence of new cases. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) infection results in various consequences ranging from asymptomatic state to progressive liver disease, chronic hepatitis, hepatic failure, liver cirrhosis and hepatocellular carcinoma (HCC). Currently available nucleo(s)tide analogue (NA) drugs approved in the treatment, suppress viral replication. Since NAs have little effect on HBV cccDNA synthesis in infected hepatocytes, they do not provide complete cure of HBV infection, and the optimal endpoint of NA therapy, i.e. HBV surface antigen (HBsAg) loss, is rarely achieved. Some of the current HBV management guidelines have begun to consider treatment cessation in selected populations of patients. Concerns regarding treatment cessation include virological and clinical relapse and also the possibility of fibrosis or cirrhosis, hepatic decompensation, liver failure and death. On the other hand, there are some potential concerns about lifelong NA treatment, like side effects on kidneys and bone, increase in the incidence of some chronic conditions such as metabolic syndrome and diabetes mellitus, economic burden to the countries, and possible effects on newborn infants of pregnant women treated with the NAs. So, some unanswered questions remain, namely "in which patients could treatment cessation strategy be effective?" and "what is the optimal time point to perform it?". The outcome of chronic hepatitis B depends on the equilibrium between HBV and the host's immune system. In this review, potential immunological and several viral biomarkers for safe NA discontinuation and areas of uncertainty in deciding the best timing to stop NA treatment in chronic hepatitis B is discussed by summarizing the recommendations on actual guidelines. [ABSTRACT FROM AUTHOR]

Background: Liver biopsy is recommended before antiviral treatment for patients with chronic hepatitis B. Although liver biopsy is the gold standard procedure, many noninvasive tests have been established for the determining of liver damage. The objective of this study was to compare the performances of several noninvasive indirect biochemical markers used to detect advanced fibrosis in patients with chronic hepatitis B. Methods: In total, 91 patients with chronic hepatitis B were included. Then patient with chronic hepatitis B infection were divided as a mild and advanced fibrosis and this two groups were compared Results: The mean age was 39.5 ± 14.9. The areas under receiver operating characteristic curve in the prediction of significant fibrosis were 0.756, 0.849, 0.742 and 0.825 for King score, Bonacini (CDS index), FibroQ score. FibroQ and King score were the best indicators for the detection of advanced fibrosis. For FIB 4 and AP index, the cut-off value for the prediction of advanced fibrosis were > 1,55 and >9,7 with a sensitivity and specificity of 82%,91% and 70%,67% respectively. (p<0.0001) Conclusions: According to the results of our study, FibroQ score and King score may be considered as a good indicator for predicting advanced fibrosis in chronic hepatitis B subjects. [ABSTRACT FROM AUTHOR]

Objective: Hepatitis B virus (HBV) infection is a widespread health problem all over the world and has high morbidity and mortality. Erectile dysfunction (ED) is defined as the inability to obtain or maintain a penile erection sufficient for achieving satisfactory sexual activity. We evaluated the prevalence of ED and lower urinary tract symptoms in patients with hepatitis B. Methods: Our cross-sectional study was carried out in infectious diseases and clinical microbiology and urology outpatient clinics. The study included 58 hepatitis B patients who did not receive antiviral therapy and 93 patients as a control group. The International Prostate Symptom Score (IPSS) form was used to identify lower urinary tract symptoms, and the International Index of Erectile Function (IIEF) form was used to assess sexual functions. Results: The mean ages of patients with hepatitis B and control group were 46.55±9.18 and 43.45±12.70 years, respectively (p=0.11). When we analyzed 58 patients; 27 (46.6%) of them were chronic hrepatitis B (CHB) and 31 (53.4%) of them were of inactive hepatitis B carriers. The prevalence of ED was 67.2% and 46.2% for those with hepatitis B and control group, respectively (p=0.01). When subgroup analysis was performed, ED was 81.5% and 54.8% in CHB patients and inactive carriers, respectively, and the difference between the groups was statistically significant (p=0.03). The mean IIEF was 18.33±5.45 and 20.49±4.97 (p=0.01) and the mean IPSS was 8.05± 6.99 and 5.39±6.00 in the hepatitis B patients and the control group, respectively (p=0.02). Conclusions: In our study, it was determined that the prevalence of ED and lower urinary tract symptoms were increased in hepatitis B patients. Patients with hepatitis B should be monitored for ED and evaluated for treatment. There is a need of prospective randomized and controlled studies in this area. [ABSTRACT FROM AUTHOR]

Objective: In HBeAg-negative patients who constitute most of the hepatitis B patients in our country, treatment decision is made according to biopsy result. Guidelines do not require biopsy in some patient groups and suggest the treatment decision with HBV DNA and alanine aminotransferase (ALT) level. Non-invasive fibrosis measurement tests can also be used to assess liver fibrosis status. In our study, we aimed to investigate fibrosis measurement tests' predictability of liver biopsy result which is an invasive procedure and to evaluate our patients in terms of guidelines and national treatment justification criteria. Methods: HBeAg-negative 25 patients who had undergone liver biopsy in our clinic were investigated retrospectively. Patients' demographic features, liver biopsy results, HBV DNA levels and treatment decisions were recorded. AST to Platelet Ratio Index (APRI) and Fibrosis-4 (FIB4) scores were calculated. The correlation between APRI and FIB4 scores and biopsy results was investigated. Patients whom treatment could not be started were evaluated for eligibility according to guidelines. Results: With the biopsy results, the treatment was started in 15 patients while 10 (40%) of the patients could not be treated according to the valid national reimbursement regulations. Six of these 10 patients were the patients with high HBV DNA and ALT levels. APRI scores did not correlate with biopsy Ishak histologic activity index and fibrosis scores (p=0.4, p=0.3). FIB4 scores were in correlation with biopsy Ishak HAI scores (p=0.03) but did not correlate with fibrosis scores (p=0.5). Conclusions: In our study, it was understood that 40% of the patients who had undergone biopsy were not able to start treatment, and some of these patients were recommended to be treated without the necessity of liver biopsy according to the guidelines. Fibrosis tests are insufficient to predict liver biopsy results. It is thought that they cannot help to reduce the need for liver biopsy. [ABSTRACT FROM AUTHOR]

Objective: Chronic hepatitis is a common cause of liver-related morbidity due to hepatotropic viruses, such as hepatitis B virus (HBV) and hepatitis C virus (HCV). HBV/HCV coinfection leads to more severe liver diseases and increased risk of hepatocellular carcinoma. In addition, hepatitis B virus reactivation has been reported after treatment for chronic hepatitis C in patients with HBV/HCV coinfection. In our study, we aimed to detect the prevalence of HBV/HCV coinfection in anti-HCV-positive samples, retrospectively. Methods: A total of 800 anti-HCV-positive samples were included in the study. Electrochemiluminescence immunoassay for anti-HCV and HBsAg, and quantitative real-time polymerase chain reaction for HBV DNA and HCV RNA were used. Results: HBsAg, which indicates HBV infection, was found to be positive in 19 (2.4%) of 800 anti-HCV-positive samples. Out of 19 HBsAg-positive samples, 9 (47%) were simultaneously positive for both HBV DNA and HCV RNA. Conclusions: As HBV and HCV share common routes of transmission, coinfections can be encountered. Our results suggest that the prevalence of HBV/HCV coinfection was not uncommon in anti-HCV-positive samples. Thus, we suggest that patients with chronic HCV infection should also be screened for HBV infection to determine the prognosis and prevent HBV reactivation during antiviral therapy. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to compare the anxiety, depression and quality of life scores of chronic hepatitis B (CHB) patients and inactive hepatitis B virus (HBV) carriers with healthy control subjects and to demonstrate the need for a multidisciplinary approach in the follow-up and treatment of patients with HBV infection. Methods: The study was carried out by comparing 200 subjects including 100 CHB patients and 100 inactive HBV carriers, who were admitted to the Outpatient Clinic of Infectious Diseases and Clinical Microbiology Department, Faculty of Medicine, Selcuk University between August 2013 and August 2014 with 100 healthy control subjects. All subjects were given Hospital Anxiety and Depression (HAD) Scale and Short Form-36 (SF-36) to assess their quality of life. Results: Based on the HAD Scale, anxiety risk among the carriers was higher than the control group (p=0.031). Depression risk in the patient (p=0.031) and carrier groups (p=0.046) were higher than the control group. There was no significant difference between the patient and carrier groups with regard to anxiety risk or depression risk (p>0.05). Females had higher anxiety risk in the patient (p=0.015), carrier (p=0.035) and control (p=0.001) groups. Depression risk was also higher in females in the patient (p=0.037) and carrier (p=0.038) groups. There were no significant relations between marital status, family type, place of living and anxiety and depression risks (p>0.05). Three quality of life parameters including general health, role limitations due to physical health and vitality scores in the inactive HBV carriers and CHB patients were lower than those of the control group (p<0.05). Conclusions: Psychological state of the patients who are chronically infected with HBV should not be neglected during treatment and follow-up. If a psychiatric disturbance is identified, effective treatment will increase quality of life and improve compliance to treatment. [ABSTRACT FROM AUTHOR]

Objective: Patients with chronic hepatitis B virus (HBV) infection that develop a superinfection due to hepatitis A virus (HAV), experience a more severe clinical picture compared to healthy individuals, and their underlying liver disease may exacerbate. Therefore, immunity to HAV should be investigated in patients with chronic HBV infection. In this study, it was aimed to investigate HAV serology among patients with chronic HBV infection, and to evaluate for immunization of seronegative cases. Methods: One hundred HBsAg-positive patients were included in the study. HAV serologies of patients with chronic HBV infection were evaluated for susceptibility to HAV infection. Sera were examined with chemiluminescence immunoassay using Architect i1000SR (Abbott Diagnostics, Singapore) analyzer. Statistical analyses were done with IBM SPSS Statistics for Windows. Version 20.0 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA). Results: Of patients whose mean age was 44 (range, 20-82) years, 46 (46%) were female and 54 (54%) were male. Anti-HAV IgG was positive in 77 (77%) patients, and negative in 23 (23%) patients. When patients were grouped as under 40 and over 40 years, anti- HAV IgG negativity were 51% and 5%, respectively. Conclusions: Percentage of higher than 50% susceptibility to HAV infection was noteworthy among patients with chronic hepatitis B. Vaccination against hepatitis A should not be neglected for susceptible ones during the follow up of these patients. [ABSTRACT FROM AUTHOR]

Tenofovir disoproxil fumarate (TDF) is widely used for chronic hepatitis B treatment and is a safe and potent antiviral drug that has high genetic barrier. The TDF therapy is rarely changed due to side effects. The side effects of TDF include nausea, vomiting, hypophosphatemia, elevated creatinine, lactic acidosis, and dermatitis. Nail pitting as a side effect due to the use of TDF has not been found in the literature which we could reach. A case of chronic hepatitis B is presented in this report in which treatment was changed due to nail pitting and nausea in the sixth month of TDF treatment. [ABSTRACT FROM AUTHOR]

Objectives: In this study, we aimed at investigating the accuracy of fibrotest (FT) in measuring fibrosis and actitest (AT) in measuring necroinflammatory activity by taking the fibrosis and inflammation level found in liver biopsy as reference in chronic hepatitis B (CHB). Material and Methods: This prospective study included 53 CHB patients who were being monitored in 2013. The biopsies were assessed in line with the modified Knodell scoring system Blood samples were drawn from the patients for FT and AT on the day when their liver biopsies were performed. Results: Twenty two of the patients included in the study were female and 31 male. FT sensitivity of 93.5% and selectivity of 54.5% was detected to identify severe fibrosis in CHB patients as a result of comparison of liver biopsy with FT. Positive predictive value (PPV) of FT was calculated as 74.3% and negative predictive value (NPV) as 85.7%. ROC curves analysis showed an AUC value of 75.1% for FT (p=0.003). In comparison of the liver biopsy with AT, on the other hand, an AT sensitivity of 89.2% and selectivity of 64% was detected to identify severe necroinflammation in CHB patients. PPV was calculated as 73.5% and NPV as 84.2%. ROC curves analysis showed an AUC value of 65% for AT (p=0.001). Conclusion: The accuracy of FT and AT in showing fibrosis and necroinflammation in CHB was quite high. However FT and AT does not seem to be a marker to be used alone without performing a liver biopsy. [ABSTRACT FROM AUTHOR]

Objective: Psychiatric disorders like depression and anxiety are known to be more prevalent in patients with chronic hepatitis B than healthy individuals. This increased prevalence may be due to multiple factors such as psychological distress associated with having a chronic disease, necroinflammatory activity in liver, side effects of treatment with antiviral agents or interferons, and/or direct effect of hepatitis viruses on central nervous system. Purpose of this study was to evaluate several risk factors that may be associated with anxiety and depression in patients with chronic hepatitis B. Methods: This study included 195 chronic hepatitis B patients. A psychiatrist made clinical interviews with the patients and filled Sociodemographic Data Form, Hamilton Anxiety Rating Scale (HARS), and Hamilton Depression Rating Scale (HDRS). Needle biopsies were performed to 175 patients who met biopsy criteria of American Association for the Study of Liver Diseases. Knodell Histological Activity Index was used to evaluate biopsy materials. HBV DNA and ALT levels were measured from patients' sera. Findings: In the study sample, 119 patients were males and 76 were females. Mean HARS score was 7.3±6.2 and mean HDRS score was 8.8±6.6. Both HARS and HDRS scores were higher in females than males. HARS score was higher in patients with a family history of chronic hepatitis and both HARS and HDRS scores were higher in patients with comorbid medical illness. Alanine aminotransferase, HBV DNA levels, and level of fibrosis in liver biopsy didn't affect HARS or HDRS scores. Also, there wasn't a difference in HARS or HDRS scores according to patients' usage of pegylated interferon, or oral antiviral therapy. Conclusion: Multiple factors affect the relation between chronic hepatitis and psychiatric disorders like anxiety and depression. Results of our study suggest that female sex, presence of a family history for chronic hepatitis B, comorbidity of other medical diseases, and ethnic origin affect more than the level of necroinflammatory activity and cellular damage in the liver or antiviral treatments. [ABSTRACT FROM AUTHOR]

Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases convened a meeting to develop a consensus report on management of chronic hepatitis in special hosts and special situations. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented at the end of each section such as therapy of chronic hepatitis B (CHB) in patients with compensated and decompensated cirrhosis, prevention and therapy of recurrent hepatitis B after liver transplantation, management of fulminant hepatitis B, therapy of CHB in hemodialysis patients, management of CHB in nonliver solid organ transplant recipients, management of CHB in immunosuppressed nontransplant patients, therapy of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection, management of HBV and hepatitis C virus (HCV) coinfection, management of CHB in alcoholic patients and injecting drug users, therapy of CHB in pregnancy and lactation period, extrahepatic manifestations in HBV infection, HBV, HCV and hepatitis D virus coinfection, therapy of chronic hepatitis C (CHC) in patients with compensated and decompensated cirrhosis, treatment of patients with recurrent HCV infection following liver transplantation, therapy of CHC in hemodialysis patients, management of CHC in nonliver solid organ transplant recipients, therapy of HCV, HBV and HIV coinfection, management of CHC in immunosuppressed nontransplant patients, HCV infection and biological agents, HCV infection and chemotherapy, management of CHC in alcoholic patients and injecting drug users, fatty liver and CHC, hemoglobinopathy and CHC, CHC in pregnancy and lactation period, extrahepatic manifestations in HCV infection. [ABSTRACT FROM AUTHOR]

Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases convened a meeting to develop a consensus report on management of chronic hepatitis B virus (HBV) infection, a global public health problem, affecting more than 400 million people worldwide. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented at the end of each section such as epidemiology and natural history of HBV infection, economic burden of chronic hepatitis B (CHB), diagnosis of acute hepatitis B (AHB) and CHB, differentiation of AHB from acute exacerbation of CHB, treatment of CHB, evaluation of response to treatment and longterm outcomes in HBeAg-positive and negative patients, antiviral resistance and its follow-up, and prevention of HBV infection. Examples of some selected recommendations are as follows: [1] The selection of a highly potent drug such as entecavir or tenofovir with a high genetic barrier to resistance as a first line therapy provides the best approach of achieving the goals of long-term treatment. [2] Antiviral drugs with a low genetic barrier to resistance such as lamivudine or telbivudine should not be among the first choices. [3] Pegylated interferon a should be used in selected patient groups. [4] Analysis of HBV drug resistance gene mutation should be a part of managing clinical treatment. [ABSTRACT FROM AUTHOR]

Objective: Hepatitis B virüs infection is a very important health problem for our country. Our country is in a mid-endemic area for hepatitis B infection. The aim of our study is to determine the prevalence of depression among patients with chronic hepatitis B. Methods: In this study, 170 cases with chronic hepatitis B who were followed in the Infectious Diseases polyclinic were included. Beck Depression Inventory was administered to cases. Results: This study has shown that depression scores of female cases are higher than males and smokers cases are higher than nonsmokers. Conclusion: The presence of depression might be related to poor treatment outcome. Psychiatric assessment and early intervention is very important in this case. [ABSTRACT FROM AUTHOR]

Copyright of Turk Psikiyatri Dergisi is the property of Turk Psikiyatri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Viral Hepatitis Journal / Viral Hepatit Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Papulosquamous drug eruptions are a group of skin lesions triggered by various drugs. Hepatitis B is an important health problem all over the world as well as in our country. Entekavir is a nucleoside analogue used in the treatment of chronic hepatitis B. A 56-year-old female patient using Entekavir for chronic hepatitis B for four years was admitted to our outpatient clinics with the complaints of dystrophic changes of the fingernails and toenails, and erythematous scaling lesions of the fingers and toes for one year. She had no history of drug use other than Entekavir. Laboratory examination revealed: HbsAg: positive, HBeAg: negative, anti-HBe: positive, HBV DNA: negative, total anti-HDV: negative, and alanine aminotransferase: 32 U/L. Biopsies were taken from the patient's finger and toe nails after three negative fungal examination of native smears. Biopsy results were consistent with drug eruptions and according to these results, the lesions were thought to be a side effect of Entekavir. Entekavir treatment was terminated and transaminase levels were followed at regular intervals. Mometasone furoate ointment and urea-containing moisturizers (2 times a day/seven days) were started for the treatment of skin lesions. Two weeks later, the lesions improved and the patient was called for follow-up at regular intervals. To the best of our knowledge, at present, there is only one case report in the literature about drug eruptions caused by Entekavir. Here, we describe the first patient who developed papulosquamous skin eruptions and nail disorders caused by Entekavir. [ABSTRACT FROM AUTHOR]

Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases set up a task force to develop a consensus report focused on chronic hepatitis B in pregnancy, a complex issue for both the mother with an advanced liver disease and the unborn child who is under the risk of hepatitis B virus (HBV) transmission. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented in the report. An algorithm adapted from actual publications is also proposed for management of chronic hepatitis B in the pregnant patient. Since many women of childbearing age are in the immune tolerant phase of infection, there is generally no need for therapy and no indication to start therapy during the early stages of pregnancy. Initiation of antiviral therapy in the beginning of the third trimester in highly viremic (HBV DNA >200 000 IU/mL) pregnant women can prevent mother-to-child-transmission of HBV despite postnatal passive and active immunoprophylaxis provided. Given its potency and its high genetic barrier to resistance, tenofovir might be an appropriate option for mothers who might need to continue their treatment for active hepatitis B after delivery. [ABSTRACT FROM AUTHOR]

Objective: in this study treatment response of 201 chronic hepatitis B (CHB) patients to 245 mg/day tenofovir disoproxil furnarate (TDF) was evaluated upon 48th week of treatment. Material and Method: This retrospective study included 201 treatment naive chronic hepatitis B patients who admitted to infectious diseases chnics of Athyaman State Hospital, Adiyaman 82nd Year State Hospital and Selcuk University Selcuklu Medical Faculty between 01-Jan-2010 and 31-Dec-2011. Indication for biopsy was defined using American Association for the Study of Liver Disease (AASLD) criteria. Patient charts were retrospectively reviewed. Data were entered to SPSS 16.0 package program. Regarding statistical evaluation chi square test was used for cathegorical variables, and T test, Mann Whitney U test was used for continous variables. For analysis of repeated measurements variance analysis for repeated measures was used and significant groups were tested by signed rank test. p<0.05 was considered statistically significant. Results: One hundred thirty eight (68.7%) patients were males, 63 (31.3%) were females, and mean age was 39.9±12.5. HBeAg was positive in 88 (43.8%) and anti-HBe was positive in 113 (56.2%) patients. Median value for HBV DNA was 52920000 (6032800-34x1 09) IU/mL, ALT was 98.0 (14.0-665.0) u/L. At 24th week HBV DNA level was below 400 copy/ml in 57% of HBeAg positive and 69.5% of HBeAg negative patients and at 48th week in 81.3% of HBeAg positive and 89% of HBeAg negative patients. At 24th week of treatment ALT level normalized in 64.4% of HBeAg positive and 6 7.3% of HBeAg negative patients and at 48th week in 83% of HBeAg positive and 79% of HBeAg negative patients. ALT, and HBV DNA values significantly decreased relative to controls. Follow up did not reveal any significant change in creatinine, phosphor calcium and ALP values. Conclusion: We conclude that TDF treatment was effective and safe during follow up. Because long term treatment is needed for CHB, more long term studies with big sample sizes are needed to determine effectiveness and side effects of tenofovir treatment. [ABSTRACT FROM AUTHOR]

Copyright of Viral Hepatitis Journal / Viral Hepatit Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: In this study, it is aimed to evaluate the correlation of the test results of anti-HDV and HDAg in patients with chronic HBV infection and to collect data concerning HDV epidemiology. Materials and methods: Anti-HDV and HDAg test results and demographic data of the patients with chronic HBV infection by gastroenterology and infectious diseases in Agri State Hospital between January 2009-May 2012 were analyzed retrospectively. HBsAg and Anti-HBc IgM tests were performed with macroelisa, anti-HDV and HDAg were tested with microelisa. Results: A total of 787 patients constituting 315(40.0%) females and 472(60.0%) males were included in the study. All the patients were HBsAg positive and Anti-HBc IgM negative. Of these patients, 55(7.0%) cases were only anti-HDV positive; 19(2.4%) were only HDAg positive and two cases were both anti-HDV and HDAg positive. A total of 76(9.7%) patients had positive findings of HDV infection. The mean age of HDV-positive patients was 42.1±15.2 (11-77 years); of these 36(47.4) were female and 40(52.6) were male. Conclusion: In patients with chronic viral hepatitis, HDV infection still remains significant. In our study HDV infection rate was detected as 9.7%. Although this rate is lower than the earlier reports of the same region, it is above the national average. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to retrospectively evaluate patients in terms of the treatment applied to them, their responses to treatment, factors affecting the response to treatment and complications of the disease. Materials and Methods: A total of 89 patients included in the study were divided into five groups: those carrying hepatitis B virus, those receiving interferon treatment (IFN), those receiving lavumidin treatment (LAM), those receiving lavumidin and interferon treatment (IFN+LAM), and those with chronic hepatitis B but not receiving any medical treatment for this disease. Results: The rate of full viral clearance was 6.7%. The full response rate was 53.8% in the IFN group, 39.3% in the LAM group, and 29.4% in the IFN+LAM group. There was a statistically significant relationship between the HBV DNA level at the time of treatment initiation and the response to treatment (p<0.05). After five years of follow- up, it was found that one patient experienced hepatic failure and one patient experienced esophageal varices. Conclusion: Complications associated with chronic HBV infection are rarely seen in the juvenile age group. Despite many treatment choices, only approximately one half of the patients show a full response to treatment. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of Helicobacter pylori infection and the extent of gastric inflammation on histologic activity index and fibrosis score in liver biopsy in patients with chronic hepatitis B infection. Material and Method: Patients with chronic HBVinfection previously who have had liver biopsy, upper gastrointestinal endoscopy and gastric mucosal biopsy were included in this retrospective study. Liver histopathology was assessed according to Knodell scale and gastric histopathology according to Sydney Classification. The patients grouped according to Knodell score and fibrosis score were compared in terms of baseline parameters and gastric mucosal histopathology and Helicobacter pylori infection. Results: Ninety three patients (63 males and 30 females, median age 44 years) were included in this study. The serum alanin aminotransferase levels were higher in patients who had Knodell score between 13-18 than patients whose score between 0-8 (103 and 63.5 IU/L, respectively, p=0.014). Age and the ratio of male gender were higher in the group with fibrosis score between 3-4 compared to the group with fibrosis score between 0-2 [male gender 55 (72.4%) and 8 (47.1%) respectively, p=0.044; age 45.5 and 38 years respectively, p-0.009]. The independent predictor of fibrosis score was age (odds ratio 1.07, p=0.014). Helicobacter pylori infection and the extent of gastric inflammation did not influence the severity of histologic activity index and fibrosis in liver biopsy (p>0.05). Conclusion: Helicobacter pylori infection and gastric mucosal inflammation does not effect liver damage in liver biopsy. [ABSTRACT FROM AUTHOR]

Chronic hepatitis B (CHB) is a serious infectious diseases, leading to life threatening complications such as liver cirrhosis, hepatic decompensation and hepatocelluler carcinoma. The main goal for treatment of CHB is to prevent these complications, and to reduce the viral load, because current antiviral therapies are inadequate to eradicate Hepatitis B virus infection. In this article, current state of antiviral therapy of CHB and antiviral drugs were summarized. [ABSTRACT FROM AUTHOR]

Objective: The proportion of infection in babies born from hepatitis B early antigen positive mothers is 60-90% and if they are not treated more than 90% of them will be chronic hepatitis B carriers and this brings the risk for chronic hepatitis and hepatocellular cancer. We tried to find out the proportion of the pregnant women with HbsAg (surface antigen of hepatitis B), anti-HBs (antibody against hepatitis B surface antigen) and anti-HCV (antibody of hepatitis C). Methods: In this study, 795 pregnant women are evaluated retrospectively for HbsAg, anti-HBs and anti-HCV in Taksim Training and Research Hospital, Clinics of Obstetrics and Gynecology between October and December 2010. The percentages are determined. Results: None of the parameters like age, week of gestation and social or economical status were criteria for the pregnants taken into the study. 29 of the 795 pregnants (3.65%) were HbsAg positive, 69 of them (8.68%) were anti-HBs positive and 6 of them (0.75%) were anti-HCV positive. These findings of our study is correlated the results of other studies in our country. Conclusion: It has been necessary to make serological tests for hepatitis B routinely for the protection and treatment of the newborn. All of the pregnant women should be informed. Also after the screening tests for hepatitis B, vaccination before the conception should be done. Our country is involved by the vaccination program in 1998. Although low percentage of spread, the screening of hepatitis C infection in risk groups is important for community and newborn health. The results of our study is correlated with the statistics of these study of our country. [ABSTRACT FROM AUTHOR]