Evaluation of Dual Therapy in Real Life Setting in Treatment-Naïve Turkish Patients with HCV Infection: A Multicenter, Retrospective Study.

BACKGROUND: Before the introduction of direct-acting antivirals in the treatment of chronic hepatitis C patients, the combination of peginterferon alpha and ribavirin was the standard therapy. Observational studies that investigated sustained virological response (SVR) rates by these drugs yielded different outcomes. AIMS: The goal of the study was to demonstrate real life data concerning SVR rate achieved by peginterferon alpha plus ribavirin in patients who were treatment-naïve. STUDY DESIGN: A multicenter, retrospective observational study. METHODS: The study was conducted retrospectively on 1214 treatment naïve-patients, being treated with peginterferon alpha-2a or 2b plus ribavirin in respect of the current guidelines between 2005 and 2013. The patients' data were collected from 22 centers via a standard form, which has been prepared for this study. The data included demographic and clinical characteristics (gender, age, body weight, initial Hepatitis C virus RNA (HCV RNA) level, disease staging) as well as course of treatment (duration of treatment, outcomes, discontinuations and adverse events). Renal insufficiency, decompensated liver disease, history of transplantation, immunosuppressive therapy or autoimmune liver disease were exclusion criteria for the study. Treatment efficacy was assessed according to the patient's demographic characteristics, baseline viral load, genotype, and fibrosis scores. RESULTS: The mean age of the patients was 50.74 (±0.64) years. Most of them were infected with genotype 1 (91.8%). SVR was achieved in 761 (62.7%) patients. SVR rate was 59.1% in genotype 1, 89.4% in genotype 2, 93.8% in genotype 3, and 33.3% in genotype 4 patients. Patients with lower viral load yielded higher SVR (65.8% vs. 58.4%, p=0.09). SVR rates according to histologic severity were found to be 69.3%, 66.3%, 59.9%, 47.3%, and 45.5% in patients with fibrosis stage 0, 1, 2, 3 and 4, respectively. The predictors of SVR were male gender, genotype 2/3, age less than 45 years, low fibrosis stage, low baseline viral load and presence of early virological response. SVR rates to each peginterferon were found to be similar in genotype 1/4 although SVR rates were found to be higher for peginterferon alpha-2b in patients with genotype 2/3. The number of patients who failed to complete treatment due to adverse effects was 33 (2.7%). The number of patients failed to complete treatment due to adverse effects was 33 (2.7%). CONCLUSION: Our findings showed that the rate of SVR to dual therapy was higher in treatment-naïve Turkish patients than that reported in randomized controlled trials. Also peginterferon alpha-2a and alpha-2b were found to be similar in terms of SVR in genotype 1 patients.

Neuraminidase produces dose-dependent decrease of slime production and adherence of slime-forming, coagulase-negative staphylococci.

BACKGROUND: Slime is one of the important structures of certain bacterial strains involved in nonspecific adherence. This study was conducted to determine the role of neuraminidase on slime formation and adherence of slime-forming coagulase-negative staphylococci to inert surface. METHODS: Quantitative biofilm and qualitative bacterial adherence assays were performed with increasing concentrations of neuraminidase extracted from Clostridium perfringens-treated bacteria in polystyrene plates and polypropylene tubes. RESULTS: Slime production of slime-forming, coagulase-negative staphylococci was significantly decreased dose dependently at > or =100 mU/mL (p <0.001). Bacterial adherence to smooth surface was impeded at > or =100 mU/mL of neuraminidase treatment and adherence results were comparable with slime production assay results. CONCLUSIONS: Sialic acid may be a constituent molecule of slime and involved in bacterial adherence to inert surface. These results represent new insight into the mechanism of slime production and adherence of slime-forming, coagulase-negative staphylococci to inert surface.

Morphological characteristics of chronic hepatitis: a comparative study on Turkish patients.

BACKGROUND: Chronic hepatitis caused by hepatitis B and hepatitis C virus have characteristic histological features. We aimed to compare these histological features between two groups. METHODS: We worked on two groups each contains 50 patients, that are serologically proven, have hepatitis B and hepatitis C. These patients were analysed according to the histological features which are more often seen in chronic hepatitis C. RESULTS: We found higher percentage of lymphoid follicles and aggregates in portal tracts, bile duct damage or loss and lymphoreticular reaction in patients with chronic hepatitis C than chronic hepatitis B (44%-12%, 96%-14%, 84%-40%, respectively). We recorded most patients with severe portal tract inflammation were in group of chronic hepatitis C (86%). Bile duct loss wasn't observed in any patients with chronic hepatitis B, while it was present in 44% of chronic hepatitis C group. There was no significant difference between two hepatitis groups with regard to fatty change. 13 out of 14 patients, having all those above mentioned histological findings, diagnosed with chronic hepatitis C whereas only one patient had chronic hepatitis B. CONCLUSIONS: Aggregates and follicles forming portal inflammation, lymphoreticular reaction together with bile duct damage, especially with bile duct loss strongly indicates presence of chronic hepatitis C.

Brucellar orchitis in Innerwest Anatolia Region of Turkey. A report of 12 cases.

Brucellosis, which affects the genitourinary system in rate of 2-20%, is a multiorgan infectious disease. Twelve patients were diagnosed as having brucellar orchitis serologically, clinically and ultrasonographically. In 2 patients, Brucella melitensis was isolated in blood cultures. All the patients were working in cattle dealing. They were treated with 600 mg/day rifampicin plus 200 mg/day doxycycline for 6 weeks and followed up during 1 year. They recovered clinically within 3 weeks. Although they did not have any symptoms or findings, in 4 patients, serological titers did not return to normal after 6 weeks. In 2 of these patients, relapse was seen in the 6th and 8th months, respectively. These 2 patients recovered with 1 g/day ciprofloxacin plus 2 g/day tetracycline for 6 weeks. Relapse did not occur again. Conclusively, brucellosis must be considered as a cause of orchitis in especially endemic regions where cattle dealing is widespread. The patients must be followed for relapse during at least 1 year.