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2. The case for simplifying and using absolute targets for viral hepatitis elimination goals

Author

Razavi, H. Blach, S. Razavi-Shearer, D. Abaalkhail, F. Abbas, Z. Abdallah, A. Abrao Ferreira, P. Abu Raddad, L.J. Adda, D. Agarwal, K. Aghemo, A. Ahmed, A. Al-Busafi, S.A. Al-hamoudi, W. Al-Kaabi, S. Al-Romaihi, H. Aljarallah, B. AlNaamani, K. Alqahtani, S. Alswat, K. Altraif, I. Asselah, T. Bacon, B. Bessone, F. Bizri, A.R. Block, T. Bonino, F. Brandão-Mello, C.E. Brown, K. Bruggmann, P. Brunetto, M.R. Buti, M. Cabezas, J. Calleja, J.L. Castro Batänjer, E. Chan, H.L.-Y. Chang, H. Chen, C.-J. Christensen, P.B. Chuang, W.-L. Cisneros, L. Cohen, C. Colombo, M. Conway, B. Cooper, C. Craxi, A. Crespo, J. Croes, E. Cryer, D. Cupertino de Barros, F.P. Derbala, M. Dillon, J. Doss, W. Dou, X. Doyle, J. Duberg, A.-S. Dugan, E. Dunn, R. Dusheiko, G. El Khayat, H. El-Sayed, M.H. Eshraghian, A. Esmat, G. Esteban Mur, R. Ezzat, S. Falconer, K. Fassio, E. Ferrinho, P. Flamm, S. Flisiak, R. Foster, G. Fung, J. García-Samaniego, J. Gish, R.G. Gonçales, F. Halota, W. Hamoudi, W. Hassany, M. Hatzakis, A. Hay, S. Himatt, S. Hoepelman, I.M. Hsu, Y.-C. Hui, Y.T. Hunyady, B. Jacobson, I. Janjua, N. Janssen, H. Jarcuska, P. Kabagambe, K. Kanto, T. Kao, J.-H. Kaymakoglu, S. Kershenobich, D. Khamis, F. Kim, D.J. Kim, D.Y. Kondili, L.A. Kottilil, S. Kramvis, A. Kugelmas, M. Kurosaki, M. Lacombe, K. Lagging, M. Lao, W.-C. Lavanchy, D. Lazarus, J.V. Lee, A. Lee, S.S. Levy, M. Liakina, V. Lim, Y.-S. Liu, S. Maddrey, W. Malekzadeh, R. Marinho, R.T. Mathur, P. Maticic, M. Mendes Correa, M.C. Mera, J. Merat, S. Mogawer, S. Mohamed, R. Muellhaupt, B. Muljono, D. Mostafa, I. Nahum, M.S. Nawaz, A. Negro, F. Ninburg, M. Ning, Q. Ntiri- Reid, B. Nymadawa, P. Oevrehus, A. Ormeci, N. Orrego, M. Osman, A. Oyunsuren, T. Pan, C. Papaevangelou, V. Papatheodoridis, G. Popping, S. Prasad, P. Prithiviputh, R. Qureshi, H. Ramji, A. Razavi-Shearer, K. Reddy, R. Remak, W. Richter, C. Ridruejo, E. Robaeys, G. Roberts, S. Roberts, L. Roudot-Thoraval, F. Saab, S. Said, S. Salamat, A. Sanai, F. Sanchez-Avila, J.F. Schiff, E. Schinazi, R. Sebastiani, G. Seguin-Devaux, C. Shanmugam, R.P. Sharara, A. Shilton, S. Shouval, D. Sievert, W. Simonova, M. Sohrabpour, A.A. Sonderup, M. Soza, A. Wendy Spearman, C. Steinfurth, N. Sulkowski, M. Tan, S.-S. Tanaka, J. Tashi, D. Thein, H.-H. Thompson, P. Tolmane, I. Toy, M. Valantinas, J. Van de Vijver, D. Vélez-Möller, P. Vince, A. Waked, I. Wang, S. Wedemeyer, H. Wong, V. Xie, Q. Yamada, S. Yang, H.-I. Yesmembetov, K. Yilmaz, Y. Younossi, Z. Yu, M.-L. Yuen, M.-F. Yurdaydin, C. Yusuf, A. Zekry, A. Zeuzem, S. Polaris Observatory Collaborators

Subjects
digestive system diseases
Abstract

The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries’ progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to ≤5 per 100 000, reduce HBV prevalence among 1-year-olds to ≤0.1%, reduce HBV and HCV mortality to ≤5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit. © 2020 John Wiley & Sons Ltd

Published
2021

3. The case for simplifying and using absolute targets for viral hepatitis elimination goals.

Author

Razavi H., Blach S., Razavi-Shearer D., Abaalkhail F., Abbas Z., Abdallah A., Abrao Ferreira P., Abu Raddad L.J., Adda D., Agarwal K., Aghemo A., Ahmed A., Al-Busafi S.A., Al-hamoudi W., Al-Kaabi S., Al-Romaihi H., Aljarallah B., AlNaamani K., Alqahtani S., Alswat K., Altraif I., Asselah T., Bacon B., Bessone F., Bizri A.R., Block T., Bonino F., Brandao-Mello C.E., Brown K., Bruggmann P., Brunetto M.R., Buti M., Cabezas J., Calleja J.L., Castro Batanjer E., Chan H.L.-Y., Chang H., Chen C.-J., Christensen P.B., Chuang W.-L., Cisneros L., Cohen C., Colombo M., Conway B., Cooper C., Craxi A., Crespo J., Croes E., Cryer D., Cupertino de Barros F.P., Derbala M., Dillon J., Doss W., Dou X., Doyle J., Duberg A.-S., Dugan E., Dunn R., Dusheiko G., El Khayat H., El-Sayed M.H., Eshraghian A., Esmat G., Esteban Mur R., Ezzat S., Falconer K., Fassio E., Ferrinho P., Flamm S., Flisiak R., Foster G., Fung J., Garcia-Samaniego J., Gish R.G., Goncales F., Halota W., Hamoudi W., Hassany M., Hatzakis A., Hay S., Himatt S., Hoepelman I.M., Hsu Y.-C., Hui Y.T., Hunyady B., Jacobson I., Janjua N., Janssen H., Jarcuska P., Kabagambe K., Kanto T., Kao J.-H., Kaymakoglu S., Kershenobich D., Khamis F., Kim D.J., Kim D.Y., Kondili L.A., Kottilil S., Kramvis A., Kugelmas M., Kurosaki M., Lacombe K., Lagging M., Lao W.-C., Lavanchy D., Lazarus J.V., Lee A., Lee S.S., Levy M., Liakina V., Lim Y.-S., Liu S., Maddrey W., Malekzadeh R., Marinho R.T., Mathur P., Maticic M., Mendes Correa M.C., Mera J., Merat S., Mogawer S., Mohamed R., Muellhaupt B., Muljono D., Mostafa I., Nahum M.S., Nawaz A., Negro F., Ninburg M., Ning Q., Ntiri- Reid B., Nymadawa P., Oevrehus A., Ormeci N., Orrego M., Osman A., Oyunsuren T., Pan C., Papaevangelou V., Papatheodoridis G., Popping S., Prasad P., Prithiviputh R., Qureshi H., Ramji A., Razavi-Shearer K., Reddy R., Remak W., Richter C., Ridruejo E., Robaeys G., Roberts S., Roberts L., Roudot-Thoraval F., Saab S., Said S., Salamat A., Sanai F., Sanchez-Avila J.F., Schiff E., Schinazi R., Sebastiani G., Seguin-Devaux C., Shanmugam R.P., Sharara A., Shilton S., Shouval D., Sievert W., Simonova M., Sohrabpour A.A., Sonderup M., Soza A., Wendy Spearman C., Steinfurth N., Sulkowski M., Tan S.-S., Tanaka J., Tashi D., Thein H.-H., Thompson P., Tolmane I., Toy M., Valantinas J., Van de Vijver D., Velez-Moller P., Vince A., Waked I., Wang S., Wedemeyer H., Wong V., Xie Q., Yamada S., Yang H.-I., Yesmembetov K., Yilmaz Y., Younossi Z., Yu M.-L., Yuen M.-F., Yurdaydin C., Yusuf A., Zekry A., Zeuzem S., Razavi H., Blach S., Razavi-Shearer D., Abaalkhail F., Abbas Z., Abdallah A., Abrao Ferreira P., Abu Raddad L.J., Adda D., Agarwal K., Aghemo A., Ahmed A., Al-Busafi S.A., Al-hamoudi W., Al-Kaabi S., Al-Romaihi H., Aljarallah B., AlNaamani K., Alqahtani S., Alswat K., Altraif I., Asselah T., Bacon B., Bessone F., Bizri A.R., Block T., Bonino F., Brandao-Mello C.E., Brown K., Bruggmann P., Brunetto M.R., Buti M., Cabezas J., Calleja J.L., Castro Batanjer E., Chan H.L.-Y., Chang H., Chen C.-J., Christensen P.B., Chuang W.-L., Cisneros L., Cohen C., Colombo M., Conway B., Cooper C., Craxi A., Crespo J., Croes E., Cryer D., Cupertino de Barros F.P., Derbala M., Dillon J., Doss W., Dou X., Doyle J., Duberg A.-S., Dugan E., Dunn R., Dusheiko G., El Khayat H., El-Sayed M.H., Eshraghian A., Esmat G., Esteban Mur R., Ezzat S., Falconer K., Fassio E., Ferrinho P., Flamm S., Flisiak R., Foster G., Fung J., Garcia-Samaniego J., Gish R.G., Goncales F., Halota W., Hamoudi W., Hassany M., Hatzakis A., Hay S., Himatt S., Hoepelman I.M., Hsu Y.-C., Hui Y.T., Hunyady B., Jacobson I., Janjua N., Janssen H., Jarcuska P., Kabagambe K., Kanto T., Kao J.-H., Kaymakoglu S., Kershenobich D., Khamis F., Kim D.J., Kim D.Y., Kondili L.A., Kottilil S., Kramvis A., Kugelmas M., Kurosaki M., Lacombe K., Lagging M., Lao W.-C., Lavanchy D., Lazarus J.V., Lee A., Lee S.S., Levy M., Liakina V., Lim Y.-S., Liu S., Maddrey W., Malekzadeh R., Marinho R.T., Mathur P., Maticic M., Mendes Correa M.C., Mera J., Merat S., Mogawer S., Mohamed R., Muellhaupt B., Muljono D., Mostafa I., Nahum M.S., Nawaz A., Negro F., Ninburg M., Ning Q., Ntiri- Reid B., Nymadawa P., Oevrehus A., Ormeci N., Orrego M., Osman A., Oyunsuren T., Pan C., Papaevangelou V., Papatheodoridis G., Popping S., Prasad P., Prithiviputh R., Qureshi H., Ramji A., Razavi-Shearer K., Reddy R., Remak W., Richter C., Ridruejo E., Robaeys G., Roberts S., Roberts L., Roudot-Thoraval F., Saab S., Said S., Salamat A., Sanai F., Sanchez-Avila J.F., Schiff E., Schinazi R., Sebastiani G., Seguin-Devaux C., Shanmugam R.P., Sharara A., Shilton S., Shouval D., Sievert W., Simonova M., Sohrabpour A.A., Sonderup M., Soza A., Wendy Spearman C., Steinfurth N., Sulkowski M., Tan S.-S., Tanaka J., Tashi D., Thein H.-H., Thompson P., Tolmane I., Toy M., Valantinas J., Van de Vijver D., Velez-Moller P., Vince A., Waked I., Wang S., Wedemeyer H., Wong V., Xie Q., Yamada S., Yang H.-I., Yesmembetov K., Yilmaz Y., Younossi Z., Yu M.-L., Yuen M.-F., Yurdaydin C., Yusuf A., Zekry A., and Zeuzem S.

Abstract

The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries' progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to <=5 per 100 000, reduce HBV prevalence among 1-year-olds to <=0.1%, reduce HBV and HCV mortality to <=5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit.Copyright © 2020 John Wiley & Sons Ltd

Published
2021

6. Strategies to manage hepatitis C virus (HCV) disease burden

Author

Wedemeyer, H., Duberg, A. S., Buti, M., Rosenberg, W. M., Frankova, S., Esmat, G., Örmeci, N., Van Vlierberghe, H., Gschwantler, M., Akarca, U., Aleman, S., Balk, İ., Berg, T., Bihl, F., Bilodeau, M., Blasco, A. J., Brandão Mello, C. E., Bruggmann, P., Calinas, F., Calleja, J. L., Cheinquer, H., Christensen, P. B., Clausen, M., Coelho, H. S. M., Cornberg, M., Cramp, M. E., Dore, G. J., Doss, W., El-Sayed, M. H., Ergör, G., Estes, C., Falconer, K., Félix, J., Ferraz, M. L. G., Ferreira, P. R., García-Samaniego, J., Gerstoft, J., Giria, J. A., Gonçales, F. L., Jr, Guimarães Pessôa, M., Hézode, C., Hindman, S. J., Hofer, H., Husa, P., Idilman, R., Kåberg, M., Kaita, K. D. E., Kautz, A., Kaymakoglu, S., Krajden, M., Krarup, H., Laleman, W., Lavanchy, D., Lázaro, P., Marinho, R. T., Marotta, P., Mauss, S., Mendes Correa, M. C., Moreno, C., Müllhaupt, B., Myers, R. P., Nemecek, V., vrehus, A. L. H., Parkes, J., Peltekian, K. M., Ramji, A., Razavi, H., Reis, N., Roberts, S. K., Roudot-Thoraval, F., Ryder, S. D., Sarmento-Castro, R., Sarrazin, C., Semela, D., Sherman, M., Shiha, G. E., Sperl, J., Stärkel, P., Stauber, R. E., Thompson, A. J., Urbanek, P., Van Damme, P., van Thiel, I., Vandijck, D., Vogel, W., Waked, I., Weis, N., Wiegand, J., Yosry, A., Zekry, A., Negro, F., Sievert, W., and Gower, E.

Published
2014
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7. The present and future disease burden of hepatitis C virus (HCV) infection with todayʼs treatment paradigm

Author

Razavi, H., Waked, I., Sarrazin, C., Myers, R. P., Idilman, R., Calinas, F., Vogel, W., Mendes Correa, M. C., Hézode, C., Lázaro, P., Akarca, U., Aleman, S., Balk, İ., Berg, T., Bihl, F., Bilodeau, M., Blasco, A. J., Brandão Mello, C. E., Bruggmann, P., Buti, M., Calleja, J. L., Cheinquer, H., Christensen, P. B., Clausen, M., Coelho, H. S. M., Cramp, M. E., Dore, G. J., Doss, W., Duberg, A. S., El-Sayed, M. H., Ergör, G., Esmat, G., Falconer, K., Félix, J., Ferraz, M. L. G., Ferreira, P. R., Frankova, S., García-Samaniego, J., Gerstoft, J., Giria, J. A., Gonçales, F. L., Jr, Gower, E., Gschwantler, M., Guimarães Pessôa, M., Hindman, S. J., Hofer, H., Husa, P., Kåberg, M., Kaita, K. D. E., Kautz, A., Kaymakoglu, S., Krajden, M., Krarup, H., Laleman, W., Lavanchy, D., Marinho, R. T., Marotta, P., Mauss, S., Moreno, C., Murphy, K., Negro, F., Nemecek, V., Örmeci, N., vrehus, A. L. H., Parkes, J., Pasini, K., Peltekian, K. M., Ramji, A., Reis, N., Roberts, S. K., Rosenberg, W. M., Roudot-Thoraval, F., Ryder, S. D., Sarmento-Castro, R., Semela, D., Sherman, M., Shiha, G. E., Sievert, W., Sperl, J., Stärkel, P., Stauber, R. E., Thompson, A. J., Urbanek, P., Van Damme, P., van Thiel, I., Van Vlierberghe, H., Vandijck, D., Wedemeyer, H., Weis, N., Wiegand, J., Yosry, A., Zekry, A., Cornberg, M., Müllhaupt, B., and Estes, C.

Published
2014
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8. Historical epidemiology of hepatitis C virus (HCV) in selected countries

Author

Bruggmann, P., Berg, T., vrehus, A. L. H., Moreno, C., Brandão Mello, C. E., Roudot-Thoraval, F., Marinho, R. T., Sherman, M., Ryder, S. D., Sperl, J., Akarca, U., Balk, İ., Bihl, F., Bilodeau, M., Blasco, A. J., Buti, M., Calinas, F., Calleja, J. L., Cheinquer, H., Christensen, P. B., Clausen, M., Coelho, H. S. M., Cornberg, M., Cramp, M. E., Dore, G. J., Doss, W., Duberg, A. S., El-Sayed, M. H., Ergör, G., Esmat, G., Estes, C., Falconer, K., Félix, J., Ferraz, M. L. G., Ferreira, P. R., Frankova, S., García-Samaniego, J., Gerstoft, J., Giria, J. A., Gonçales, F. L., Jr, Gower, E., Gschwantler, M., Guimarães Pessôa, M., Hézode, C., Hofer, H., Husa, P., Idilman, R., Kåberg, M., Kaita, K. D. E., Kautz, A., Kaymakoglu, S., Krajden, M., Krarup, H., Laleman, W., Lavanchy, D., Lázaro, P., Marotta, P., Mauss, S., Mendes Correa, M. C., Müllhaupt, B., Myers, R. P., Negro, F., Nemecek, V., Örmeci, N., Parkes, J., Peltekian, K. M., Ramji, A., Razavi, H., Reis, N., Roberts, S. K., Rosenberg, W. M., Sarmento-Castro, R., Sarrazin, C., Semela, D., Shiha, G. E., Sievert, W., Stärkel, P., Stauber, R. E., Thompson, A. J., Urbanek, P., van Thiel, I., Van Vlierberghe, H., Vandijck, D., Vogel, W., Waked, I., Wedemeyer, H., Weis, N., Wiegand, J., Yosry, A., Zekry, A., Van Damme, P., Aleman, S., and Hindman, S. J.

Published
2014
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14. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study

Author

Razavi-Shearer, D. Gamkrelidze, I. Nguyen, M.H. Chen, D.-S. Van Damme, P. Abbas, Z. Abdulla, M. Abou Rached, A. Adda, D. Aho, I. Akarca, U. Al Ali, F.H. Lawati, F.A.L. Naamani, K.A.L. Alashgar, H.I. Alavian, S.M. Alawadhi, S. Albillos, A. Al-Busafi, S.A. Aleman, S. Alfaleh, F.Z. Aljumah, A.A. Anand, A.C. Anh, N.T. Arends, J.E. Arkkila, P. Athanasakis, K. Bane, A. Ben-Ari, Z. Berg, T. Bizri, A.R. Blach, S. Brandão Mello, C.E. Brandon, S.M. Bright, B. Bruggmann, P. Brunetto, M. Buti, M. Chan, H.L.Y. Chaudhry, A. Chien, R.-N. Choi, M.S. Christensen, P.B. Chuang, W.-L. Chulanov, V. Clausen, M.R. Colombo, M. Cornberg, M. Cowie, B. Craxi, A. Croes, E.A. Cuellar, D.A. Cunningham, C. Desalegn, H. Drazilova, S. Duberg, A.-S. Egeonu, S.S. El-Sayed, M.H. Estes, C. Falconer, K. Ferraz, M.L.G. Ferreira, P.R. Flisiak, R. Frankova, S. Gaeta, G.B. García-Samaniego, J. Genov, J. Gerstoft, J. Goldis, A. Gountas, I. Gray, R. Guimarães Pessôa, M. Hajarizadeh, B. Hatzakis, A. Hézode, C. Himatt, S.M. Hoepelman, A. Hrstic, I. Hui, Y.-T.T. Husa, P. Jahis, R. Janjua, N.Z. Jarcuška, P. Jaroszewicz, J. Kaymakoglu, S. Kershenobich, D. Kondili, L.A. Konysbekova, A. Krajden, M. Kristian, P. Laleman, W. Lao, W.-C.C. Layden, J. Lazarus, J.V. Lee, M.-H. Liakina, V. Lim, Y.-S.S. Loo, C.-K.K. Lukšic, B. Malekzadeh, R. Malu, A.O. Mamatkulov, A. Manns, M. Marinho, R.T. Maticic, M. Mauss, S. Memon, M.S. Mendes Correa, M.C. Mendez-Sanchez, N. Merat, S. Metwally, A.M. Mohamed, R. Mokhbat, J.E. Moreno, C. Mossong, J. Mourad, F.H. Müllhaupt, B. Murphy, K. Musabaev, E. Nawaz, A. Nde, H.M. Negro, F. Nersesov, A. Nguyen, V.T.T. Njouom, R. Ntagirabiri, R. Nurmatov, Z. Obekpa, S. Ocama, P. Oguche, S. Omede, O. Omuemu, C. Opare-Sem, O. Opio, C.K. Örmeci, N. Papatheodoridis, G. Pasini, K. Pimenov, N. Poustchi, H. Quang, T.D. Qureshi, H. Ramji, A. Razavi-Shearer, K. Redae, B. Reesink, H.W. Rios, C.Y. Rjaskova, G. Robbins, S. Roberts, L.R. Roberts, S.K. Ryder, S.D. Safadi, R. Sagalova, O. Salupere, R. Sanai, F.M. Sanchez-Avila, J.F. Saraswat, V. Sarrazin, C. Schmelzer, J.D. Schréter, I. Scott, J. Seguin-Devaux, C. Shah, S.R. Sharara, A.I. Sharma, M. Shiha, G.E. Shin, T. Sievert, W. Sperl, J. Stärkel, P. Stedman, C. Sypsa, V. Tacke, F. Tan, S.S. Tanaka, J. Tomasiewicz, K. Urbanek, P. van der Meer, A.J. Van Vlierberghe, H. Vella, S. Vince, A. Waheed, Y. Waked, I. Walsh, N. Weis, N. Wong, V.W. Woodring, J. Yaghi, C. Yang, H.-I. Yang, C.-L. Yesmembetov, K. Yosry, A. Yuen, M.-F. Yusuf, M.A.M. Zeuzem, S. Razavi, H. The Polaris Observatory Collaborators

Abstract

Background: The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030. Although no virological cure exists for hepatitis B virus (HBV) infection, existing therapies to control viral replication and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. We aimed to estimate the national, regional, and global prevalence of HBsAg in the general population and in the population aged 5 years in 2016, as well as coverage of prophylaxis, diagnosis, and treatment. Methods: In this modelling study, we used a Delphi process that included a literature review in PubMed and Embase, followed by interviews with experts, to quantify the historical epidemiology of HBV infection. We then used a dynamic HBV transmission and progression model to estimate the country-level and regional-level prevalence of HBsAg in 2016 and the effect of prophylaxis and treatment on disease burden. Findings: We developed models for 120 countries, 78 of which were populated with data approved by experts. Using these models, we estimated that the global prevalence of HBsAg in 2016 was 3·9% (95% uncertainty interval [UI] 3·4–4·6), corresponding to 291 992 000 (251 513 000–341 114 000) infections. Of these infections, around 29 million (10%) were diagnosed, and only 4·8 million (5%) of 94 million individuals eligible for treatment actually received antiviral therapy. Around 1·8 (1·6–2·2) million infections were in children aged 5 years, with a prevalence of 1·4% (1·2–1·6). We estimated that 87% of infants had received the three-dose HBV vaccination in the first year of life, 46% had received timely birth-dose vaccination, and 13% had received hepatitis B immunoglobulin along with the full vaccination regimen. Less than 1% of mothers with a high viral load had received antiviral therapy to reduce mother-to-child transmission. Interpretation: Our estimate of HBV prevalence in 2016 differs from previous studies, potentially because we took into account the effect of infant prophylaxis and early childhood vaccination, as well as changing prevalence over time. Although some regions are well on their way to meeting prophylaxis and prevalence targets, all regions must substantially scale-up access to diagnosis and treatment to meet the global targets. Funding: John C Martin Foundation. © 2018 Elsevier Ltd

Published
2018

15. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study.

Author

Falconer K., Ormeci N., Papatheodoridis G., Pasini K., Pimenov N., Poustchi H., Quang T.D., Qureshi H., Ramji A., Razavi-Shearer K., Redae B., Reesink H.W., Rios C.Y., Rjaskova G., Robbins S., Roberts L.R., Roberts S.K., Ryder S.D., Safadi R., Sagalova O., Salupere R., Sanai F.M., Sanchez-Avila J.F., Saraswat V., Sarrazin C., Schmelzer J.D., Schreter I., Scott J., Seguin-Devaux C., Shah S.R., Sharara A.I., Sharma M., Shiha G.E., Shin T., Sperl J., Starkel P., Stedman C., Sypsa V., Tacke F., Tan S.S., Tanaka J., Tomasiewicz K., Urbanek P., van der Meer A.J., Van Vlierberghe H., Vella S., Vince A., Waheed Y., Waked I., Walsh N., Weis N., Wong V.W., Woodring J., Yaghi C., Yang H.-I., Yang C.-L., Yesmembetov K., Yosry A., Yuen M.-F., Yusuf M.A.M., Zeuzem S., Razavi H., Sievert W., Razavi-Shearer D., Gamkrelidze I., Nguyen M.H., Chen D.-S., Van Damme P., Abbas Z., Abdulla M., Abou Rached A., Adda D., Aho I., Akarca U., Al Ali F.H., Lawati F.A.L., Naamani K.A.L., Alashgar H.I., Alavian S.M., Alawadhi S., Albillos A., Al-Busafi S.A., Aleman S., Alfaleh F.Z., Aljumah A.A., Anand A.C., Anh N.T., Arends J.E., Arkkila P., Athanasakis K., Bane A., Ben-Ari Z., Berg T., Bizri A.R., Blach S., Brandao Mello C.E., Brandon S.M., Bright B., Bruggmann P., Brunetto M., Buti M., Chan H.L.Y., Chaudhry A., Chien R.-N., Choi M.S., Christensen P.B., Chuang W.-L., Chulanov V., Clausen M.R., Colombo M., Cornberg M., Cowie B., Craxi A., Croes E.A., Cuellar D.A., Cunningham C., Desalegn H., Drazilova S., Duberg A.-S., Egeonu S.S., El-Sayed M.H., Estes C., Ferraz M.L.G., Ferreira P.R., Flisiak R., Frankova S., Gaeta G.B., Garcia-Samaniego J., Genov J., Gerstoft J., Goldis A., Gountas I., Gray R., Guimaraes Pessoa M., Hajarizadeh B., Hatzakis A., Hezode C., Himatt S.M., Hoepelman A., Hrstic I., Hui Y.-T.T., Husa P., Jahis R., Janjua N.Z., Jarcuka P., Jaroszewicz J., Kaymakoglu S., Kershenobich D., Kondili L.A., Konysbekova A., Krajden M., Kristian P., Laleman W., Lao W.-C.C., Layden J., Lazarus J.V., Lee M.-H., Liakina V., Lim Y.-S.S., Loo C.-K.K., Lukic B., Malekzadeh R., Malu A.O., Mamatkulov A., Manns M., Marinho R.T., Maticic M., Mauss S., Memon M.S., Mendes Correa M.C., Mendez-Sanchez N., Merat S., Metwally A.M., Mohamed R., Mokhbat J.E., Moreno C., Mossong J., Mourad F.H., Mullhaupt B., Murphy K., Musabaev E., Nawaz A., Nde H.M., Negro F., Nersesov A., Nguyen V.T.T., Njouom R., Ntagirabiri R., Nurmatov Z., Obekpa S., Ocama P., Oguche S., Omede O., Omuemu C., Opare-Sem O., Opio C.K., Falconer K., Ormeci N., Papatheodoridis G., Pasini K., Pimenov N., Poustchi H., Quang T.D., Qureshi H., Ramji A., Razavi-Shearer K., Redae B., Reesink H.W., Rios C.Y., Rjaskova G., Robbins S., Roberts L.R., Roberts S.K., Ryder S.D., Safadi R., Sagalova O., Salupere R., Sanai F.M., Sanchez-Avila J.F., Saraswat V., Sarrazin C., Schmelzer J.D., Schreter I., Scott J., Seguin-Devaux C., Shah S.R., Sharara A.I., Sharma M., Shiha G.E., Shin T., Sperl J., Starkel P., Stedman C., Sypsa V., Tacke F., Tan S.S., Tanaka J., Tomasiewicz K., Urbanek P., van der Meer A.J., Van Vlierberghe H., Vella S., Vince A., Waheed Y., Waked I., Walsh N., Weis N., Wong V.W., Woodring J., Yaghi C., Yang H.-I., Yang C.-L., Yesmembetov K., Yosry A., Yuen M.-F., Yusuf M.A.M., Zeuzem S., Razavi H., Sievert W., Razavi-Shearer D., Gamkrelidze I., Nguyen M.H., Chen D.-S., Van Damme P., Abbas Z., Abdulla M., Abou Rached A., Adda D., Aho I., Akarca U., Al Ali F.H., Lawati F.A.L., Naamani K.A.L., Alashgar H.I., Alavian S.M., Alawadhi S., Albillos A., Al-Busafi S.A., Aleman S., Alfaleh F.Z., Aljumah A.A., Anand A.C., Anh N.T., Arends J.E., Arkkila P., Athanasakis K., Bane A., Ben-Ari Z., Berg T., Bizri A.R., Blach S., Brandao Mello C.E., Brandon S.M., Bright B., Bruggmann P., Brunetto M., Buti M., Chan H.L.Y., Chaudhry A., Chien R.-N., Choi M.S., Christensen P.B., Chuang W.-L., Chulanov V., Clausen M.R., Colombo M., Cornberg M., Cowie B., Craxi A., Croes E.A., Cuellar D.A., Cunningham C., Desalegn H., Drazilova S., Duberg A.-S., Egeonu S.S., El-Sayed M.H., Estes C., Ferraz M.L.G., Ferreira P.R., Flisiak R., Frankova S., Gaeta G.B., Garcia-Samaniego J., Genov J., Gerstoft J., Goldis A., Gountas I., Gray R., Guimaraes Pessoa M., Hajarizadeh B., Hatzakis A., Hezode C., Himatt S.M., Hoepelman A., Hrstic I., Hui Y.-T.T., Husa P., Jahis R., Janjua N.Z., Jarcuka P., Jaroszewicz J., Kaymakoglu S., Kershenobich D., Kondili L.A., Konysbekova A., Krajden M., Kristian P., Laleman W., Lao W.-C.C., Layden J., Lazarus J.V., Lee M.-H., Liakina V., Lim Y.-S.S., Loo C.-K.K., Lukic B., Malekzadeh R., Malu A.O., Mamatkulov A., Manns M., Marinho R.T., Maticic M., Mauss S., Memon M.S., Mendes Correa M.C., Mendez-Sanchez N., Merat S., Metwally A.M., Mohamed R., Mokhbat J.E., Moreno C., Mossong J., Mourad F.H., Mullhaupt B., Murphy K., Musabaev E., Nawaz A., Nde H.M., Negro F., Nersesov A., Nguyen V.T.T., Njouom R., Ntagirabiri R., Nurmatov Z., Obekpa S., Ocama P., Oguche S., Omede O., Omuemu C., Opare-Sem O., and Opio C.K.

Abstract

Background: The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030. Although no virological cure exists for hepatitis B virus (HBV) infection, existing therapies to control viral replication and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. We aimed to estimate the national, regional, and global prevalence of HBsAg in the general population and in the population aged 5 years in 2016, as well as coverage of prophylaxis, diagnosis, and treatment. Method(s): In this modelling study, we used a Delphi process that included a literature review in PubMed and Embase, followed by interviews with experts, to quantify the historical epidemiology of HBV infection. We then used a dynamic HBV transmission and progression model to estimate the country-level and regional-level prevalence of HBsAg in 2016 and the effect of prophylaxis and treatment on disease burden. Finding(s): We developed models for 120 countries, 78 of which were populated with data approved by experts. Using these models, we estimated that the global prevalence of HBsAg in 2016 was 3.9% (95% uncertainty interval [UI] 3.4-4.6), corresponding to 291 992 000 (251 513 000-341 114 000) infections. Of these infections, around 29 million (10%) were diagnosed, and only 4.8 million (5%) of 94 million individuals eligible for treatment actually received antiviral therapy. Around 1.8 (1.6-2.2) million infections were in children aged 5 years, with a prevalence of 1.4% (1.2-1.6). We estimated that 87% of infants had received the three-dose HBV vaccination in the first year of life, 46% had received timely birth-dose vaccination, and 13% had received hepatitis B immunoglobulin along with the full vaccination regimen. Less than 1% of mothers with a high viral load had received antiviral therapy to reduce mother-to-child transmission. Interpretation(s): Our estimate of HBV prevalence in 2016 differs from previous studies, potentia

Published
2018

16. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: A modelling study

Author

Blach, S. Zeuzem, S. Manns, M. Altraif, I. Duberg, A.-S. Muljono, D.H. Waked, I. Alavian, S.M. Lee, M.-H. Negro, F. Abaalkhail, F. Abdou, A. Abdulla, M. Abou Rached, A. Aho, I. Akarca, U. Al Ghazzawi, I. Al Kaabi, S. Al Lawati, F. Al Namaani, K. Al Serkal, Y. Al-Busafi, S.A. Al-Dabal, L. Aleman, S. Alghamdi, A.S. Aljumah, A.A. Al-Romaihi, H.E. Andersson, M.I. Arendt, V. Arkkila, P. Assiri, A.M. Baatarkhuu, O. Bane, A. Ben-Ari, Z. Bergin, C. Bessone, F. Bihl, F. Bizri, A.R. Blachier, M. Blasco, A.J. Brandao Mello, C.E. Bruggmann, P. Brunton, C.R. Calinas, F. Chan, H.L.Y. Chaudhry, A. Cheinquer, H. Chen, C.-J. Chien, R.-N. Choi, M.S. Christensen, P.B. Chuang, W.-L. Chulanov, V. Cisneros, L. Clausen, M.R. Cramp, M.E. Craxi, A. Croes, E.A. Dalgard, O. Daruich, J.R. De Ledinghen, V. Dore, G.J. El-Sayed, M.H. Ergor, G. Esmat, G. Estes, C. Falconer, K. Farag, E. Ferraz, M.L.G. Ferreira, P.R. Flisiak, R. Frankova, S. Gamkrelidze, I. Gane, E. Garcia-Samaniego, J. Khan, A.G. Gountas, I. Goldis, A. Gottfredsson, M. Grebely, J. Gschwantler, M. Guimaraes Pessoa, M. Gunter, J. Hajarizadeh, B. Hajelssedig, O. Hamid, S. Hamoudi, W. Hatzakis, A. Himatt, S.M. Hofer, H. Hrstic, I. Hui, Y.-T. Hunyady, B. Idilman, R. Jafri, W. Jahis, R. Janjua, N.Z. Jarčuška, P. Jeruma, A. Jonasson, J.G. Kamel, Y. Kao, J.-H. Kaymakoglu, S. Kershenobich, D. Khamis, J. Kim, Y.S. Kondili, L. Koutoubi, Z. Krajden, M. Krarup, H. Lai, M.-S. Laleman, W. Lao, W.-C. Lavanchy, D. Lazaro, P. Leleu, H. Lesi, O. Lesmana, L.A. Li, M. Liakina, V. Lim, Y.-S. Luksic, B. Mahomed, A. Maimets, M. Makara, M. Malu, A.O. Marinho, R.T. Marotta, P. Mauss, S. Memon, M.S. Mendes Correa, M.C. Mendez-Sanchez, N. Merat, S. Metwally, A.M. Mohamed, R. Moreno, C. Mourad, F.H. Mullhaupt, B. Murphy, K. Nde, H. Njouom, R. Nonkovic, D. Norris, S. Obekpa, S. Oguche, S. Olafsson, S. Oltman, M. Omede, O. Omuemu, C. Opare-Sem, O. Ovrehus, A.L.H. Owusu-Ofori, S. Oyunsuren, T.S. Papatheodoridis, G. Pasini, K. Peltekian, K.M. Phillips, R.O. Pimenov, N. Poustchi, H. Prabdial-Sing, N. Qureshi, H. Ramji, A. Razavi-Shearer, D. Razavi-Shearer, K. Redae, B. Reesink, H.W. Ridruejo, E. Robbins, S. Roberts, L.R. Roberts, S.K. Rosenberg, W.M. Roudot-Thoraval, F. Ryder, S.D. Safadi, R. Sagalova, O. Salupere, R. Sanai, F.M. Sanchez Avila, J.F. Saraswat, V. Sarmento-Castro, R. Sarrazin, C. Schmelzer, J.D. Schreter, I. Seguin-Devaux, C. Shah, S.R. Sharara, A.I. Sharma, M. Shevaldin, A. Shiha, G.E. Sievert, W. Sonderup, M. Souliotis, K. Speiciene, D. Sperl, J. Starkel, P. Stauber, R.E. Stedman, C. Struck, D. Su, T.-H. Sypsa, V. Tan, S.-S. Tanaka, J. Thompson, A.J. Tolmane, I. Tomasiewicz, K. Valantinas, J. Van Damme, P. Van Der Meer, A.J. Van Thiel, I. Van Vlierberghe, H. Vince, A. Vogel, W. Wedemeyer, H. Weis, N. Wong, V.W.S. Yaghi, C. Yosry, A. Yuen, M.-F. Yunihastuti, E. Yusuf, A. Zuckerman, E. Razavi, H. The Polaris Observatory HCV Collaborators

Abstract

Background The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of—and expansion on—the 2014 analysis, which reported 80 million (95% CI 64–103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8–1·1) in 2015, corresponding to 71·1 million (62·5–79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation. © 2017 Elsevier Ltd

Published
2017

17. Recurrence and occurrence of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment for chronic hepatitis C in patients with advanced liver disease: Turkish multicenter early access program

Author

Jdilman, R., primary, Demir, M., additional, Aladag, M., additional, Kaymakoglu, S., additional, Erol, C., additional, Cavus, B., additional, Iliaz, R., additional, Akarca, U.S., additional, Koklu, S., additional, Cakaloglu, Y., additional, Sahin, M., additional, Koksal, I., additional, Ozgenel, M., additional, Toka, B., additional, Karasu, Z., additional, Ersoz, G., additional, Kiyici, M., additional, Akdogan, M., additional, and Turkey, E.A.P., additional

Published
2018
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18. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: A modelling study.

Author

Farag E., De Ledinghen V., Dore G.J., Papatheodoridis G., Pasini K., Peltekian K.M., Phillips R.O., Pimenov N., Poustchi H., Prabdial-Sing N., Qureshi H., Ramji A., Razavi-Shearer D., Razavi-Shearer K., Redae B., Reesink H.W., Ridruejo E., Robbins S., Roberts L.R., Roberts S.K., Rosenberg W.M., Roudot-Thoraval F., Ryder S.D., Safadi R., Sagalova O., Salupere R., Sanai F.M., Sanchez Avila J.F., Saraswat V., Sarmento-Castro R., Sarrazin C., Schmelzer J.D., Schreter I., Seguin-Devaux C., Shah S.R., Sharara A.I., Sharma M., Shevaldin A., Shiha G.E., Sonderup M., Souliotis K., Speiciene D., Sperl J., Starkel P., Stauber R.E., Stedman C., Struck D., Su T.-H., Sypsa V., Tan S.-S., Tanaka J., Thompson A.J., Tolmane I., Tomasiewicz K., Valantinas J., Van Damme P., Van Der Meer A.J., Van Thiel I., Van Vlierberghe H., Vince A., Vogel W., Wedemeyer H., Weis N., Wong V.W.S., Yaghi C., Yosry A., Yuen M.-F., Yunihastuti E., Yusuf A., Zuckerman E., Razavi H., Sievert W., Blach S., Zeuzem S., Manns M., Altraif I., Duberg A.-S., Muljono D.H., Waked I., Alavian S.M., Lee M.-H., Negro F., Abaalkhail F., Abdou A., Abdulla M., Abou Rached A., Aho I., Akarca U., Al Ghazzawi I., Al Kaabi S., Al Lawati F., Al Namaani K., Al Serkal Y., Al-Busafi S.A., Al-Dabal L., Aleman S., Alghamdi A.S., Aljumah A.A., Al-Romaihi H.E., Andersson M.I., Arendt V., Arkkila P., Assiri A.M., Baatarkhuu O., Bane A., Ben-Ari Z., Bergin C., Bessone F., Bihl F., Bizri A.R., Blachier M., Blasco A.J., Brandao Mello C.E., Bruggmann P., Brunton C.R., Calinas F., Chan H.L.Y., Chaudhry A., Cheinquer H., Chen C.-J., Chien R.-N., Choi M.S., Christensen P.B., Chuang W.-L., Chulanov V., Cisneros L., Clausen M.R., Cramp M.E., Craxi A., Croes E.A., Dalgard O., Daruich J.R., El-Sayed M.H., Ergor G., Esmat G., Estes C., Falconer K., Ferraz M.L.G., Ferreira P.R., Flisiak R., Frankova S., Gamkrelidze I., Gane E., Garcia-Samaniego J., Khan A.G., Gountas I., Goldis A., Gottfredsson M., Grebely J., Gschwantler M., Guimaraes Pessoa M., Gunter J., Hajarizadeh B., Hajelssedig O., Hamid S., Hamoudi W., Hatzakis A., Himatt S.M., Hofer H., Hrstic I., Hui Y.-T., Hunyady B., Idilman R., Jafri W., Jahis R., Janjua N.Z., Jarcuska P., Jeruma A., Jonasson J.G., Kamel Y., Kao J.-H., Kaymakoglu S., Kershenobich D., Khamis J., Kim Y.S., Kondili L., Koutoubi Z., Krajden M., Krarup H., Lai M.-S., Laleman W., Lao W.-C., Lavanchy D., Lazaro P., Leleu H., Lesi O., Lesmana L.A., Li M., Liakina V., Lim Y.-S., Luksic B., Mahomed A., Maimets M., Makara M., Malu A.O., Marinho R.T., Marotta P., Mauss S., Memon M.S., Mendes Correa M.C., Mendez-Sanchez N., Merat S., Metwally A.M., Mohamed R., Moreno C., Mourad F.H., Mullhaupt B., Murphy K., Nde H., Njouom R., Nonkovic D., Norris S., Obekpa S., Oguche S., Olafsson S., Oltman M., Omede O., Omuemu C., Opare-Sem O., Ovrehus A.L.H., Owusu-Ofori S., Oyunsuren T.S., Farag E., De Ledinghen V., Dore G.J., Papatheodoridis G., Pasini K., Peltekian K.M., Phillips R.O., Pimenov N., Poustchi H., Prabdial-Sing N., Qureshi H., Ramji A., Razavi-Shearer D., Razavi-Shearer K., Redae B., Reesink H.W., Ridruejo E., Robbins S., Roberts L.R., Roberts S.K., Rosenberg W.M., Roudot-Thoraval F., Ryder S.D., Safadi R., Sagalova O., Salupere R., Sanai F.M., Sanchez Avila J.F., Saraswat V., Sarmento-Castro R., Sarrazin C., Schmelzer J.D., Schreter I., Seguin-Devaux C., Shah S.R., Sharara A.I., Sharma M., Shevaldin A., Shiha G.E., Sonderup M., Souliotis K., Speiciene D., Sperl J., Starkel P., Stauber R.E., Stedman C., Struck D., Su T.-H., Sypsa V., Tan S.-S., Tanaka J., Thompson A.J., Tolmane I., Tomasiewicz K., Valantinas J., Van Damme P., Van Der Meer A.J., Van Thiel I., Van Vlierberghe H., Vince A., Vogel W., Wedemeyer H., Weis N., Wong V.W.S., Yaghi C., Yosry A., Yuen M.-F., Yunihastuti E., Yusuf A., Zuckerman E., Razavi H., Sievert W., Blach S., Zeuzem S., Manns M., Altraif I., Duberg A.-S., Muljono D.H., Waked I., Alavian S.M., Lee M.-H., Negro F., Abaalkhail F., Abdou A., Abdulla M., Abou Rached A., Aho I., Akarca U., Al Ghazzawi I., Al Kaabi S., Al Lawati F., Al Namaani K., Al Serkal Y., Al-Busafi S.A., Al-Dabal L., Aleman S., Alghamdi A.S., Aljumah A.A., Al-Romaihi H.E., Andersson M.I., Arendt V., Arkkila P., Assiri A.M., Baatarkhuu O., Bane A., Ben-Ari Z., Bergin C., Bessone F., Bihl F., Bizri A.R., Blachier M., Blasco A.J., Brandao Mello C.E., Bruggmann P., Brunton C.R., Calinas F., Chan H.L.Y., Chaudhry A., Cheinquer H., Chen C.-J., Chien R.-N., Choi M.S., Christensen P.B., Chuang W.-L., Chulanov V., Cisneros L., Clausen M.R., Cramp M.E., Craxi A., Croes E.A., Dalgard O., Daruich J.R., El-Sayed M.H., Ergor G., Esmat G., Estes C., Falconer K., Ferraz M.L.G., Ferreira P.R., Flisiak R., Frankova S., Gamkrelidze I., Gane E., Garcia-Samaniego J., Khan A.G., Gountas I., Goldis A., Gottfredsson M., Grebely J., Gschwantler M., Guimaraes Pessoa M., Gunter J., Hajarizadeh B., Hajelssedig O., Hamid S., Hamoudi W., Hatzakis A., Himatt S.M., Hofer H., Hrstic I., Hui Y.-T., Hunyady B., Idilman R., Jafri W., Jahis R., Janjua N.Z., Jarcuska P., Jeruma A., Jonasson J.G., Kamel Y., Kao J.-H., Kaymakoglu S., Kershenobich D., Khamis J., Kim Y.S., Kondili L., Koutoubi Z., Krajden M., Krarup H., Lai M.-S., Laleman W., Lao W.-C., Lavanchy D., Lazaro P., Leleu H., Lesi O., Lesmana L.A., Li M., Liakina V., Lim Y.-S., Luksic B., Mahomed A., Maimets M., Makara M., Malu A.O., Marinho R.T., Marotta P., Mauss S., Memon M.S., Mendes Correa M.C., Mendez-Sanchez N., Merat S., Metwally A.M., Mohamed R., Moreno C., Mourad F.H., Mullhaupt B., Murphy K., Nde H., Njouom R., Nonkovic D., Norris S., Obekpa S., Oguche S., Olafsson S., Oltman M., Omede O., Omuemu C., Opare-Sem O., Ovrehus A.L.H., Owusu-Ofori S., and Oyunsuren T.S.

Abstract

Background The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of-and expansion on-the 2014 analysis, which reported 80 million (95% CI 64-103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1.0% (95% uncertainty interval 0.8-1.1) in 2015, corresponding to 71.1 million (62.5-79.4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation.Copyright © 2017 Elsevier Ltd

Published
2017

19. Can Helicobacter pylori be eradicated with high-dose proton pump inhibitor in extensive metabolizers with the CYP2C19 genotypic polymorphism?

Author

Ormeci A, Emrence Z, Baran B, Om, Soyer, Gokturk S, Evirgen S, Akyuz F, Karaca C, Besisik F, Kaymakoglu S, Duran Ustek, and Demir K

Subjects
Cytochrome P-450 CYP2C19, Genotype, Helicobacter pylori, Humans, Proton Pump Inhibitors, Helicobacter Infections
Abstract

Proton pump inhibitors (PPI) metabolism and pharmacokinetics are regulated by cytochrome P450 enzymes in the liver. Cytochrome P450 2C19 (CYP2C19) polymorphism plays an import role in the metabolism of PPIs. The three possible genotypes for CYP2C19 each has a distinct effect on the pharmacodynamics of PPIs. Homozygote extensive metabolizers (HomEM) are the most frequent genotype and have two wild-types (non-mutant) (*1/*1) alleles. HomEM is associated with increased enzyme activity, which increases the rate of PPI metabolism. Intragastric pH, which is required for eradication, is lowest in HomEM. In HomEMs, an insufficient increase in intragastric pH results in decreased anti-Helicobacter pylori (HP) efficacy of the antibiotics and, therefore, lower eradication rates. We determined whether the HP eradication rate would increase after high-dose PPI treatment of extensive PPI metabolizers who had been treated unsuccessfully with a standard PPI dose. In our report, increasing the PPI dosage in patients with genotype polymorphisms may be effective on eradication rates. Eradication rates are directly affected by CYP2C19 polymorphisms, and eradication treatments should be planned considering such genotypic polymorphisms. Hence, CYP2C19 genotyping prior to treatment may facilitate determination of the optimum PPI dose to improve the therapeutic outcome. However, further researches are required to confirm this hypothesis.

Published
2016

20. Anticoagulant therapy and Budd-Chiari syndrome: Is it successful?

Author

Akyüz, F., Çakaloglu, Y., Pinarbaşi, B., Demir, K., Akyüz, Ü., Özdil, S., Kaymakoglu, S., Akyüz, F., Çakaloglu, Y., Pinarbaşi, B., Demir, K., Akyüz, Ü., Özdil, S., Kaymakoglu, S., and Yeditepe Üniversitesi

Subjects
Budd-Chiari syndrome, Anticoagulant therapy
Abstract

Background/Aims: Anticoagulant therapy is an accepted treatment for Budd-Chiari syndrome (BCS). However, the natural course of untreated patients is unclear. We aimed to evaluate the efficacy of anticoagulant therapy on survival in BCS. Methodology: Between 1995 and 2007, 45 patients diagnosed with BCS based on the clinical, biochemical, radiological and histological findings were retrospectively evaluated with respect to underlying disease, therapeutic interventions, complications and overall outcome. Complications and survival during the follow-up period were compared in between anticoagulant treated and untreated cases. Results: Mean patient age was 34.4±11.8 years and 46.7% (21) of them were male. Median follow-up time was 24 months (6-132); 8.9% of patients were diagnosed as acute, 31.1% as subacute and 60% as chronic BCS according to disease duration. Centrilobular necrosis was found in 16 of 36 biopsy performed patients. Etiological factors were detected in 60% of patients and 40% of them were cryptogenic. Twenty four of them received anticoagulant therapy, the remaining 21 were followed-up with supportive medical therapy. Five patients who had shunt operation were excluded for survival analyses. Complications were similar between treated and untreated cases (p>0.05). There was a positive correlation between survival and centrilobular necrosis (r=0.376, p=0.037). The mean survival periods were 95.5 months (%95 CI 73-117 months) and 72.5 months (%95 CI 42-103 months) in anticoagulant treated and untreated patients, respectively (p>0.246). Conclusion: Most patients with BCS are admitted to hospital at the chronic stage and more than half of them have underlying thrombotic risk factor. In our study, no beneficial effects of anticoagulant therapy were observed on the survival and complications of liver disease. © H.G.E. Update Medical Publishing S.A.

Published
2011

22. THU-381 - Recurrence and occurrence of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment for chronic hepatitis C in patients with advanced liver disease: Turkish multicenter early access program

Author

Jdilman, R., Demir, M., Aladag, M., Kaymakoglu, S., Erol, C., Cavus, B., Iliaz, R., Akarca, U.S., Koklu, S., Cakaloglu, Y., Sahin, M., Koksal, I., Ozgenel, M., Toka, B., Karasu, Z., Ersoz, G., Kiyici, M., Akdogan, M., and Turkey, E.A.P.

Published
2018
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24. Historical epidemiology of hepatitis C virus (HCV) in selected countries

Author

Bruggmann, P, Berg, T, Øvrehus, ALH, Moreno, C, Brandão Mello, CE, Roudot-Thoraval, F, Marinho, RT, Sherman, M, Ryder, SD, Sperl, J, Akarca, U, Balık, I, Bihl, F, Bilodeau, M, Blasco, AJ, Buti, M, Calinas, F, Calleja, JL, Cheinquer, H, Christensen, PB, Clausen, M, Coelho, HSM, Cornberg, M, Cramp, ME, Dore, GJ, Doss, W, Duberg, AS, El-Sayed, MH, Ergör, G, Esmat, G, Estes, C, Falconer, K, Félix, J, Ferraz, MLG, Ferreira, PR, Frankova, S, García-Samaniego, J, Gerstoft, J, Giria, JA, Gonçales, FL, Gower, E, Gschwantler, M, Guimarães Pessôa, M, Hézode, C, Hofer, H, Husa, P, Idilman, R, Kåberg, M, Kaita, KDE, Kautz, A, Kaymakoglu, S, Krajden, M, Krarup, H, Laleman, W, Lavanchy, D, Lázaro, P, Marotta, P, Mauss, S, Mendes Correa, MC, Müllhaupt, B, Myers, RP, Negro, F, Nemecek, V, Örmeci, N, Parkes, J, Peltekian, KM, Ramji, A, Razavi, H, Reis, N, Roberts, SK, Rosenberg, WM, Sarmento-Castro, R, Sarrazin, C, Semela, D, Shiha, GE, Sievert, W, Stärkel, P, Stauber, RE, Thompson, AJ, Urbanek, P, van Thiel, I, Van Vlierberghe, H, Vandijck, D, Vogel, W, Waked, I, Wedemeyer, H, Weis, N, Wiegand, J, Yosry, A, Zekry, A, Van Damme, P, Aleman, S, Hindman, SJ, Bruggmann, P, Berg, T, Øvrehus, ALH, Moreno, C, Brandão Mello, CE, Roudot-Thoraval, F, Marinho, RT, Sherman, M, Ryder, SD, Sperl, J, Akarca, U, Balık, I, Bihl, F, Bilodeau, M, Blasco, AJ, Buti, M, Calinas, F, Calleja, JL, Cheinquer, H, Christensen, PB, Clausen, M, Coelho, HSM, Cornberg, M, Cramp, ME, Dore, GJ, Doss, W, Duberg, AS, El-Sayed, MH, Ergör, G, Esmat, G, Estes, C, Falconer, K, Félix, J, Ferraz, MLG, Ferreira, PR, Frankova, S, García-Samaniego, J, Gerstoft, J, Giria, JA, Gonçales, FL, Gower, E, Gschwantler, M, Guimarães Pessôa, M, Hézode, C, Hofer, H, Husa, P, Idilman, R, Kåberg, M, Kaita, KDE, Kautz, A, Kaymakoglu, S, Krajden, M, Krarup, H, Laleman, W, Lavanchy, D, Lázaro, P, Marotta, P, Mauss, S, Mendes Correa, MC, Müllhaupt, B, Myers, RP, Negro, F, Nemecek, V, Örmeci, N, Parkes, J, Peltekian, KM, Ramji, A, Razavi, H, Reis, N, Roberts, SK, Rosenberg, WM, Sarmento-Castro, R, Sarrazin, C, Semela, D, Shiha, GE, Sievert, W, Stärkel, P, Stauber, RE, Thompson, AJ, Urbanek, P, van Thiel, I, Van Vlierberghe, H, Vandijck, D, Vogel, W, Waked, I, Wedemeyer, H, Weis, N, Wiegand, J, Yosry, A, Zekry, A, Van Damme, P, Aleman, S, and Hindman, SJ

Abstract

Chronic infection with hepatitis C virus (HCV) is a leading indicator for liver disease. New treatment options are becoming available, and there is a need to characterize the epidemiology and disease burden of HCV. Data for prevalence, viremia, genotype, diagnosis and treatment were obtained through literature searches and expert consensus for 16 countries. For some countries, data from centralized registries were used to estimate diagnosis and treatment rates. Data for the number of liver transplants and the proportion attributable to HCV were obtained from centralized databases. Viremic prevalence estimates varied widely between countries, ranging from 0.3% in Austria, England and Germany to 8.5% in Egypt. The largest viremic populations were in Egypt, with 6,358,000 cases in 2008 and Brazil with 2,106,000 cases in 2007. The age distribution of cases differed between countries. In most countries, prevalence rates were higher among males, reflecting higher rates of injection drug use. Diagnosis, treatment and transplant levels also differed considerably between countries. Reliable estimates characterizing HCV-infected populations are critical for addressing HCV-related morbidity and mortality. There is a need to quantify the burden of chronic HCV infection at the national level.

Published
2014

25. Strategies to manage hepatitis C virus (HCV) disease burden

Author

Wedemeyer, H, Duberg, AS, Buti, M, Rosenberg, WM, Frankova, S, Esmat, G, Örmeci, N, Van Vlierberghe, H, Gschwantler, M, Akarca, U, Aleman, S, Balık, I, Berg, T, Bihl, F, Bilodeau, M, Blasco, AJ, Brandão Mello, CE, Bruggmann, P, Calinas, F, Calleja, JL, Cheinquer, H, Christensen, PB, Clausen, M, Coelho, HSM, Cornberg, M, Cramp, ME, Dore, GJ, Doss, W, El-Sayed, MH, Ergör, G, Estes, C, Falconer, K, Félix, J, Ferraz, MLG, Ferreira, PR, García-Samaniego, J, Gerstoft, J, Giria, JA, Gonçales, FL, Guimarães Pessôa, M, Hézode, C, Hindman, SJ, Hofer, H, Husa, P, Idilman, R, Kåberg, M, Kaita, KDE, Kautz, A, Kaymakoglu, S, Krajden, M, Krarup, H, Laleman, W, Lavanchy, D, Lázaro, P, Marinho, RT, Marotta, P, Mauss, S, Mendes Correa, MC, Moreno, C, Müllhaupt, B, Myers, RP, Nemecek, V, Øvrehus, ALH, Parkes, J, Peltekian, KM, Ramji, A, Razavi, H, Reis, N, Roberts, SK, Roudot-Thoraval, F, Ryder, SD, Sarmento-Castro, R, Sarrazin, C, Semela, D, Sherman, M, Shiha, GE, Sperl, J, Stärkel, P, Stauber, RE, Thompson, AJ, Urbanek, P, Van Damme, P, van Thiel, I, Vandijck, D, Vogel, W, Waked, I, Weis, N, Wiegand, J, Yosry, A, Zekry, A, Negro, F, Sievert, W, Gower, E, Wedemeyer, H, Duberg, AS, Buti, M, Rosenberg, WM, Frankova, S, Esmat, G, Örmeci, N, Van Vlierberghe, H, Gschwantler, M, Akarca, U, Aleman, S, Balık, I, Berg, T, Bihl, F, Bilodeau, M, Blasco, AJ, Brandão Mello, CE, Bruggmann, P, Calinas, F, Calleja, JL, Cheinquer, H, Christensen, PB, Clausen, M, Coelho, HSM, Cornberg, M, Cramp, ME, Dore, GJ, Doss, W, El-Sayed, MH, Ergör, G, Estes, C, Falconer, K, Félix, J, Ferraz, MLG, Ferreira, PR, García-Samaniego, J, Gerstoft, J, Giria, JA, Gonçales, FL, Guimarães Pessôa, M, Hézode, C, Hindman, SJ, Hofer, H, Husa, P, Idilman, R, Kåberg, M, Kaita, KDE, Kautz, A, Kaymakoglu, S, Krajden, M, Krarup, H, Laleman, W, Lavanchy, D, Lázaro, P, Marinho, RT, Marotta, P, Mauss, S, Mendes Correa, MC, Moreno, C, Müllhaupt, B, Myers, RP, Nemecek, V, Øvrehus, ALH, Parkes, J, Peltekian, KM, Ramji, A, Razavi, H, Reis, N, Roberts, SK, Roudot-Thoraval, F, Ryder, SD, Sarmento-Castro, R, Sarrazin, C, Semela, D, Sherman, M, Shiha, GE, Sperl, J, Stärkel, P, Stauber, RE, Thompson, AJ, Urbanek, P, Van Damme, P, van Thiel, I, Vandijck, D, Vogel, W, Waked, I, Weis, N, Wiegand, J, Yosry, A, Zekry, A, Negro, F, Sievert, W, and Gower, E

Abstract

The number of hepatitis C virus (HCV) infections is projected to decline while those with advanced liver disease will increase. A modeling approach was used to forecast two treatment scenarios: (i) the impact of increased treatment efficacy while keeping the number of treated patients constant and (ii) increasing efficacy and treatment rate. This analysis suggests that successful diagnosis and treatment of a small proportion of patients can contribute significantly to the reduction of disease burden in the countries studied. The largest reduction in HCV-related morbidity and mortality occurs when increased treatment is combined with higher efficacy therapies, generally in combination with increased diagnosis. With a treatment rate of approximately 10%, this analysis suggests it is possible to achieve elimination of HCV (defined as a >90% decline in total infections by 2030). However, for most countries presented, this will require a 3-5 fold increase in diagnosis and/or treatment. Thus, building the public health and clinical provider capacity for improved diagnosis and treatment will be critical.

Published
2014

26. The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm

Author

Razavi, H, Waked, I, Sarrazin, C, Myers, RP, Idilman, R, Calinas, F, Vogel, W, Mendes Correa, MC, Hézode, C, Lázaro, P, Akarca, U, Aleman, S, Balık, I, Berg, T, Bihl, F, Bilodeau, M, Blasco, AJ, Brandão Mello, CE, Bruggmann, P, Buti, M, Calleja, JL, Cheinquer, H, Christensen, PB, Clausen, M, Coelho, HSM, Cramp, ME, Dore, GJ, Doss, W, Duberg, AS, El-Sayed, MH, Ergör, G, Esmat, G, Falconer, K, Félix, J, Ferraz, MLG, Ferreira, PR, Frankova, S, García-Samaniego, J, Gerstoft, J, Giria, JA, Gonçales, FL, Gower, E, Gschwantler, M, Guimarães Pessôa, M, Hindman, SJ, Hofer, H, Husa, P, Kåberg, M, Kaita, KDE, Kautz, A, Kaymakoglu, S, Krajden, M, Krarup, H, Laleman, W, Lavanchy, D, Marinho, RT, Marotta, P, Mauss, S, Moreno, C, Murphy, K, Negro, F, Nemecek, V, Örmeci, N, Øvrehus, ALH, Parkes, J, Pasini, K, Peltekian, KM, Ramji, A, Reis, N, Roberts, SK, Rosenberg, WM, Roudot-Thoraval, F, Ryder, SD, Sarmento-Castro, R, Semela, D, Sherman, M, Shiha, GE, Sievert, W, Sperl, J, Stärkel, P, Stauber, RE, Thompson, AJ, Urbanek, P, Van Damme, P, van Thiel, I, Van Vlierberghe, H, Vandijck, D, Wedemeyer, H, Weis, N, Wiegand, J, Yosry, A, Zekry, A, Cornberg, M, Müllhaupt, B, Estes, C, Razavi, H, Waked, I, Sarrazin, C, Myers, RP, Idilman, R, Calinas, F, Vogel, W, Mendes Correa, MC, Hézode, C, Lázaro, P, Akarca, U, Aleman, S, Balık, I, Berg, T, Bihl, F, Bilodeau, M, Blasco, AJ, Brandão Mello, CE, Bruggmann, P, Buti, M, Calleja, JL, Cheinquer, H, Christensen, PB, Clausen, M, Coelho, HSM, Cramp, ME, Dore, GJ, Doss, W, Duberg, AS, El-Sayed, MH, Ergör, G, Esmat, G, Falconer, K, Félix, J, Ferraz, MLG, Ferreira, PR, Frankova, S, García-Samaniego, J, Gerstoft, J, Giria, JA, Gonçales, FL, Gower, E, Gschwantler, M, Guimarães Pessôa, M, Hindman, SJ, Hofer, H, Husa, P, Kåberg, M, Kaita, KDE, Kautz, A, Kaymakoglu, S, Krajden, M, Krarup, H, Laleman, W, Lavanchy, D, Marinho, RT, Marotta, P, Mauss, S, Moreno, C, Murphy, K, Negro, F, Nemecek, V, Örmeci, N, Øvrehus, ALH, Parkes, J, Pasini, K, Peltekian, KM, Ramji, A, Reis, N, Roberts, SK, Rosenberg, WM, Roudot-Thoraval, F, Ryder, SD, Sarmento-Castro, R, Semela, D, Sherman, M, Shiha, GE, Sievert, W, Sperl, J, Stärkel, P, Stauber, RE, Thompson, AJ, Urbanek, P, Van Damme, P, van Thiel, I, Van Vlierberghe, H, Vandijck, D, Wedemeyer, H, Weis, N, Wiegand, J, Yosry, A, Zekry, A, Cornberg, M, Müllhaupt, B, and Estes, C

Abstract

The disease burden of hepatitis C virus (HCV) is expected to increase as the infected population ages. A modelling approach was used to estimate the total number of viremic infections, diagnosed, treated and new infections in 2013. In addition, the model was used to estimate the change in the total number of HCV infections, the disease progression and mortality in 2013-2030. Finally, expert panel consensus was used to capture current treatment practices in each country. Using today's treatment paradigm, the total number of HCV infections is projected to decline or remain flat in all countries studied. However, in the same time period, the number of individuals with late-stage liver disease is projected to increase. This study concluded that the current treatment rate and efficacy are not sufficient to manage the disease burden of HCV. Thus, alternative strategies are required to keep the number of HCV individuals with advanced liver disease and liver-related deaths from increasing.

Published
2014

28. P1046 ENTECAVIR AND TENOFOVIR HAVE A COMPARABLE EFFICACY IN TREATMENT OF NUCLEOS(T)IDE ANALOGUE NAIVE PATIENTS WITH CHRONIC HEPATITIS B: A REAL LIFE EXPERIENCE

Author

Baran, B., primary, Soyer, O.M., additional, Ormeci, A.C., additional, Gokturk, S., additional, Evirgen, S., additional, Akyuz, F., additional, Karaca, C., additional, Demir, K., additional, Gulluoglu, M., additional, Onel, D., additional, Badur, S., additional, Besisik, F., additional, and Kaymakoglu, S., additional

Published
2014
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29. Genes of major histocompatibility complex class II influence chronic C hepatitis treatment with interferon in hemodialysis patients

Author

Dinçer D., Besisik F., Oguz F., Sükrü Sever M., Kaymakoglu S., Çakaloglu Y., and Demir K.

Subjects
HLA, Hemodialysis, Interferon
Abstract

The prevalence of anti-HCV among patients on hemodialysis is consistently higher than in the general population, indicating that patients on hemodialysis programs are at risk of acquiring HCV infection. The response to interferon alpha 2b (IFN-? 2b) therapy in chronic C hepatitis depends on viral and host factors. We treated 22 chronic C hepatitis uremic patients with IFN -? 2b (3 MU three times a week) and compared interferon responsive and unresponsive patients with regard to HLA II genes. HLA II genes were investigated by PCR-SSP low resolution, anti-HCV with ELISA II and HCV-RNA with reverse transcriptase "nested" PCR. Findings: HLA DRB1*13 is 50% positive in the non-responder group (four women, four men, mean age; 28.8 ± 11.9 years) and 7% in the responder group (five women, nine men, mean age; 32.2 ± 7.8 years) (p

Published
2001

36. Effect of cytochrome P450 2C19 polymorphisms on the Helicobacter pylori eradication rate following two-week triple therapy with pantoprazole or rabeprazole.

Author

ORMECI, A., EMRENCE, Z., BARAN, B., GOKTURK, S., SOYER, O. M., EVIRGEN, S., AKYUZ, F., KARACA, C., BESISIK, F., KAYMAKOGLU, S., USTEK, D., and DEMIR, K.

Abstract

OBJECTIVE: Cytochrome P450 2C19 (CYP2C19) polymorphisms play an important role in the metabolism of proton pump inhibitors. Rabeprazole is primarily metabolized via non-enzymatic pathways. In this study, we determined whether rabeprazole- and pantoprazole- based eradication treatments were influenced by CYP2C19 polymorphisms. PATIENTS AND METHODS: A total of 200 patients infected with Helicobacter pylori were treated with either 40 mg of pantoprazole or 20 mg of rabeprazole plus 500 mg of clarithromycin, 1000 mg of amoxicillin twice daily for 2 weeks. CYP2C19 genotype status was determined by Polymerase Chain Reaction (PCR)- restriction-fragment-length polymorphism. The genotypes of cytochrome P450 2C19 were classified as homozigote extensive metabolizer (HomEM), heterozigote metabolizer (HetEM) and poor metabolizer (PM). The CYP2C19 genotype of all patients, the effectiveness of the treatment, the effect of the genotypic polymorphism on the treatment were assessed. RESULTS: The frequencies of HotEM, HetEM, PM were 78%, 19.5% and 2.5%, respectively. 48% (n = 96) of the patients received treatment with rabeprazole and 52% (n = 104) with pantoprazole. The eradication rate was 64.7% for HomEM, 79.4% for HetEM, 100% for PM (p = 0.06). In HetEM, PM, are considered as a single group, the eradication rates were higher in patients with the HetEM and PM (HetEM+PM) genotypes than in those with the wild-type genotype (81.8 vs. 64.7% p = 0.031). Among the patients treated with rabeprazole, the eradication rates were significantly lower in those with the HomEM genotype than in those with the Het- EM+PM genotypes (60% vs. 85.7% p = 0.023). CONCLUSIONS: The genotypic polymorphism is effective on the rate of eradication. Eradication treatment rate with rabeprazole is influenced by CYP2C19 genotype. [ABSTRACT FROM AUTHOR]

Published
2016

37. Steroid-refractory inflammatory bowel disease is a risk factor for CMV infection.

Author

ORMECI, A. C., AKYUZ, F., BARAN, B., SOYER, O. M., GOKTURK, S., ONEL, M., ONEL, D., AGACFIDAN, A., DEMIRCI, M., YEGEN, G., GULLUOGLU, M., KARACA, C., DEMIR, K., BESISIK, F., and KAYMAKOGLU, S.

Abstract

OBJECTIVE: Patients with inflammatory bowel disease (IBD) show increased the prevalence of cytomegalovirus (CMV) infection due to the severity of the disease and the immunosuppressive treatments they receive. The aim of this study was to determine the prevalence of CMV infection in IBD patients and identify the risk factors for CMV infection with different demographic characteristics in IBD patients. PATIENTS AND METHODS: We enrolled 85 patients diagnosed with IBD (43 with ulcerative colitis (UC) and 42 with Crohn's disease (CD)) in this prospective study. The clinical disease activities of UC and CD were assessed using Truelove- Witts and Crohn's disease activity index (CDAI). CMV infection was assessed by detection of DNA using real-time polymerase chain reaction (PCR) in blood samples and quantitative PCR in colonic biopsy specimens and by detection of inclusion bodies using hematoxylineosin staining. RESULTS: Thirteen patients with IBD exhibited concomitant CMV infection. CMV infection was not detected in any of the patients in remission. Viral loads measured in the colonic mucosa of infected patients ranged from 800-7000 genome copies/mL total extracted DNA. The mean serum CMV DNA level was 1694 ± 910 copies/mL (range: 800-3800). The rate of steroid resistance in CMV-positive cases was significantly higher than that in CMV-negative cases (p = 0.001). CD with acute exacerbation was a risk factor for CMV disease (p = 0.04). All of the CMV-positive patients received immunosuppressive treatments. CONCLUSIONS: CMV infection should be suspected in steroid-resistant UC and CD. Antiviral treatment improved the clinical outcome in steroid-resistant IBD cases with serum CMV DNA levels above 1000 copies/mL. [ABSTRACT FROM AUTHOR]

Published
2016

41. 914 HBsAg CLEARENCE AFTER LONG-TERM FOLLOW-UP IN CHRONIC HEPATITIS B PATIENTS TREATED WITH INTERFERON ALPHA AND NUCLEOS(T)IDE ANALOGUES

Author

Pinarbasi, B., primary, Kaymakoglu, S., additional, Akyuz, F., additional, Issever, H., additional, Ermis, F., additional, Uyanikoglu, A., additional, Baran, B., additional, Hindilerden, F., additional, Sumnu, A., additional, Demir, K., additional, Besisik, F., additional, Cakaloglu, Y., additional, Mungan, Z., additional, and Okten, A., additional

Published
2009
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42. 910 ELECTRON MICROSCOPIC FINDINGS IN NON-ALCOHOLIC FATTY LIVER DISEASE; IS THERE ANY DIFFERENCE BETWEEN HEPATOSTEATOSIS AND STEATOHEPATITIS?

Author

Ahishali, E., primary, Demir, K., additional, Ahishali, B., additional, Akyuz, F., additional, Pinarbasi, B., additional, Poturoglu, S., additional, Ibrisim, D., additional, Gulluoglu, M., additional, Ozdil, S., additional, Besisik, F., additional, Kaymakoglu, S., additional, Boztas, G., additional, Cakaloglu, Y., additional, Mungan, Z., additional, Canberk, Y., additional, and Okten, A., additional

Published
2008
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