Eda Karadogan, H. Uzar, A. Sertçelik, Mithat Temizer, S. A. Kara, Damla Ozyurek, Fahriye Has-Akdag, Mustafa Enes Ozden, A. Alp, A. Pınar, Bahar Guciz-Dogan, B. Şener, Ceyda Şahan, D. Yuce, Duygu Ayhan-Baser, Hilal Aksoy, I. Fidancı, Lütfiye Hilal Ozcebe, M. Akova, O. Portakal, Sehnaz Ozyavuz-Alp, V. Arslan, Z. Dikmen, B. Çakır
Objective: This study included participants from Hacettepe University 4th, 5th, and 6th-grade students of Medical School and 4th and 5th-grade students of Dental School; and aimed to evaluate the general health status, COVID-19 history, vaccination status, and SARS-CoV-2 antibody levels of the participants to support their physical and social health, during the pandemic period. Methods: A prospective cohort study was conducted with an integrated, matched, nested case-control study. Sociodemographic characteristics, life habits, COVID-19 history, vaccination status, compliance with mask-distance-hygiene rules, and risks (if any) for COVID-19 were inquired via online questionnaires. Physical examinations, complete blood count, biochemistry tests, and anti-SARS-CoV-2 anti-spike antibody tests were conducted for all consenting participants. All analyses were established using depersonalized data. Results: Of the 778 participants completing the baseline visit in June-July 2021, the percentages of those vaccinated with at least one, two, and three/more doses of COVID-19 vaccine were 99.1%, 98.0%, and 11.7%, respectively; one had four doses. The median (minimum-maximum) time since the last vaccination was 134 (34-166) days for those vaccinated with two doses [CoronaVac (Sinovac Life Sciences, Beijing, China)] and 25 (14-56) days for those vaccinated with three doses [two doses of CoronaVac and a last dose of Pfizer-BioNTech mRNA vaccine (Comirnaty®). The third dose was applied at a median of 164 (151-202) days after the second dose, and all were heterologous in type. The median (minimum-maximum) antibody level for the overall group was 53.55(0-5680) BAU/mL: 47.19 BAU/mL in those who received two doses, with a more than 100 times increase after a third dose (4943.64 BAU/mL). Of the 522 participants followed up to October 1, 2021, 6 PCR-positive symptomatic participants were diagnosed with COVID-19: the incidence rate was 4/1000 person-months. Conclusion: A 100-fold neutralizing antibody level following the third dose demonstrated the importance of a booster dose. Given the time lag between doses, antibody measurements of BioNTech recipients should be repeated in the upcoming months. Booster selection should involve antibody level, variant sensitivity of the vaccine, and individual characteristics of the recipient.
{"title":"Hacettepe Health Cohort (HU-CoVaCS): Study Design, Baseline Characteristics and the First 3-Month-Follow Up of COVID-19 Vaccinated Students","authors":"Eda Karadogan, H. Uzar, A. Sertçelik, Mithat Temizer, S. A. Kara, Damla Ozyurek, Fahriye Has-Akdag, Mustafa Enes Ozden, A. Alp, A. Pınar, Bahar Guciz-Dogan, B. Şener, Ceyda Şahan, D. Yuce, Duygu Ayhan-Baser, Hilal Aksoy, I. Fidancı, Lütfiye Hilal Ozcebe, M. Akova, O. Portakal, Sehnaz Ozyavuz-Alp, V. Arslan, Z. Dikmen, B. Çakır","doi":"10.36519/kd.2023.4423","DOIUrl":"https://doi.org/10.36519/kd.2023.4423","url":null,"abstract":"Objective: This study included participants from Hacettepe University 4th, 5th, and 6th-grade students of Medical School and 4th and 5th-grade students of Dental School; and aimed to evaluate the general health status, COVID-19 history, vaccination status, and SARS-CoV-2 antibody levels of the participants to support their physical and social health, during the pandemic period.\u0000\u0000Methods: A prospective cohort study was conducted with an integrated, matched, nested case-control study. Sociodemographic characteristics, life habits, COVID-19 history, vaccination status, compliance with mask-distance-hygiene rules, and risks (if any) for COVID-19 were inquired via online questionnaires. Physical examinations, complete blood count, biochemistry tests, and anti-SARS-CoV-2 anti-spike antibody tests were conducted for all consenting participants. All analyses were established using depersonalized data.\u0000\u0000Results: Of the 778 participants completing the baseline visit in June-July 2021, the percentages of those vaccinated with at least one, two, and three/more doses of COVID-19 vaccine were 99.1%, 98.0%, and 11.7%, respectively; one had four doses. The median (minimum-maximum) time since the last vaccination was 134 (34-166) days for those vaccinated with two doses [CoronaVac (Sinovac Life Sciences, Beijing, China)] and 25 (14-56) days for those vaccinated with three doses [two doses of CoronaVac and a last dose of Pfizer-BioNTech mRNA vaccine (Comirnaty®). The third dose was applied at a median of 164 (151-202) days after the second dose, and all were heterologous in type. The median (minimum-maximum) antibody level for the overall group was 53.55(0-5680) BAU/mL: 47.19 BAU/mL in those who received two doses, with a more than 100 times increase after a third dose (4943.64 BAU/mL). Of the 522 participants followed up to October 1, 2021, 6 PCR-positive symptomatic participants were diagnosed with COVID-19: the incidence rate was 4/1000 person-months. \u0000\u0000Conclusion: A 100-fold neutralizing antibody level following the third dose demonstrated the importance of a booster dose. Given the time lag between doses, antibody measurements of BioNTech recipients should be repeated in the upcoming months. Booster selection should involve antibody level, variant sensitivity of the vaccine, and individual characteristics of the recipient.","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42754807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed to determine the birth control methods preferred by women living with human immunodeficiency virus (HIV) followed by our clinic and to review their pregnancy management strategies. Methods: The medical records of HIV-infected women followed by our clinic between 1999 and 2021 were analyzed retrospectively. The following parameters were recorded from medical files: Demographic characteristics, birth control methods used and the duration of usage, conception methods in those who became pregnant after being infected with HIV, whether the pregnancy was planned or not, the antiretroviral treatments used before pregnancy and whether treatment was modified during pregnancy, HIV-1 RNA and CD4+ T lymphocyte counts before delivery, type of delivery, prophylaxis given to the baby and the mother and its duration, and HIV serological status of the babies. Results: Out of 80 women actively followed by our clinic, 75 (93.7%) with available data were included in the study. The mean age of the cases was 43.5 +/- 11.4 (min=18-max=68). The number of cases using any birth control method was 51 (68%). The most common contraceptive method was a condom used by their partners (n=31, 60.7%). Thirty-six pregnancies developed in 25/60 (41.6%) sexually active cases not in the menopausal period and 33 babies were born. One baby was infected with HIV. Conclusion: Contraception methods in sexually active HIV-infected women should be chosen upon discussion between the healthcare provider and the patient. Close monitoring and standard care during pregnancy are critical for the long-term prognosis of both the mother and the baby.
{"title":"Birth Control and Pregnancy Management Among Women Living with HIV","authors":"Deniz Akyol, D. Gokengin","doi":"10.36519/kd.2023.4252","DOIUrl":"https://doi.org/10.36519/kd.2023.4252","url":null,"abstract":"Objective: This study aimed to determine the birth control methods preferred by women living with human immunodeficiency virus (HIV) followed by our clinic and to review their pregnancy management strategies. Methods: The medical records of HIV-infected women followed by our clinic between 1999 and 2021 were analyzed retrospectively. The following parameters were recorded from medical files: Demographic characteristics, birth control methods used and the duration of usage, conception methods in those who became pregnant after being infected with HIV, whether the pregnancy was planned or not, the antiretroviral treatments used before pregnancy and whether treatment was modified during pregnancy, HIV-1 RNA and CD4+ T lymphocyte counts before delivery, type of delivery, prophylaxis given to the baby and the mother and its duration, and HIV serological status of the babies. Results: Out of 80 women actively followed by our clinic, 75 (93.7%) with available data were included in the study. The mean age of the cases was 43.5 +/- 11.4 (min=18-max=68). The number of cases using any birth control method was 51 (68%). The most common contraceptive method was a condom used by their partners (n=31, 60.7%). Thirty-six pregnancies developed in 25/60 (41.6%) sexually active cases not in the menopausal period and 33 babies were born. One baby was infected with HIV. Conclusion: Contraception methods in sexually active HIV-infected women should be chosen upon discussion between the healthcare provider and the patient. Close monitoring and standard care during pregnancy are critical for the long-term prognosis of both the mother and the baby.","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47713437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Our study aimed to reveal the syphilis coinfection data in patients living with HIV. In this context, data on coinfection rates, the period in which syphilis was diagnosed, reinfection rates, and the determination of the population at risk for syphilis in patients living with HIV/AIDS were presented. Methods: Patients with HIV/AIDS confirmed between January 2016 and December 2020 at a training and research hospital were retrospectively screened for syphilis serological examinations (RPR, TPHA). The conventional diagnostic algorithm was used in all patients. Results: The rate of syphilis co-infection was 23.38% (47/201) in 201 individuals living with HIV in our patient population. Of 47 HIV/syphilis co-infected patients included in the study, 4.2% were female, and 95.8% were male. The mean age of our patients was 41.11±12.42 years. Primary syphilis was diagnosed in 6 (14.2%) patients; secondary syphilis was diagnosed in 3 (7.1%) patients, and 38 (80.8%) patients were diagnosed in the latent syphilis period. We did not have a patient diagnosed with tertiary syphilis, neurosyphilis, or congenital syphilis. Twenty-six patients (55.3%) were heterosexual, 17 patients (36.2%) were men who had sex with men (MSM), and four patients (8.5%) were bisexual. While syphilis co-infection rates were 17.9% (26/145) in heterosexual individuals, it was 37.5% (21/56) in MSM and bisexual individuals. While 32 patients (68%) were in the HIV infection stage, 15 (32%) were diagnosed with AIDS. Reinfection was detected in 8.51% (4/47) of the patients. Conclusion: Most HIV/syphilis co-infected patients are male individuals who have sex with men diagnosed with latent syphilis. HIV/AIDS and syphilis infections are increasing every year in our country. Undetectable= Untransmissible approach causes prevention methods to be thrown into the background. Sexual protection with barrier methods in patients living with HIV continues to maintain its importance today due to co-infections.
{"title":"Syphilis Co-Infection in Individuals Living with HIV: Data from Tertiary Hospitals","authors":"Servet Ozturk","doi":"10.36519/kd.2023.4263","DOIUrl":"https://doi.org/10.36519/kd.2023.4263","url":null,"abstract":"Objective: Our study aimed to reveal the syphilis coinfection data in patients living with HIV. In this context, data on coinfection rates, the period in which syphilis was diagnosed, reinfection rates, and the determination of the population at risk for syphilis in patients living with HIV/AIDS were presented.\u0000\u0000Methods: Patients with HIV/AIDS confirmed between January 2016 and December 2020 at a training and research hospital were retrospectively screened for syphilis serological examinations (RPR, TPHA). The conventional diagnostic algorithm was used in all patients.\u0000\u0000Results: The rate of syphilis co-infection was 23.38% (47/201) in 201 individuals living with HIV in our patient population. Of 47 HIV/syphilis co-infected patients included in the study, 4.2% were female, and 95.8% were male. The mean age of our patients was 41.11±12.42 years. Primary syphilis was diagnosed in 6 (14.2%) patients; secondary syphilis was diagnosed in 3 (7.1%) patients, and 38 (80.8%) patients were diagnosed in the latent syphilis period. We did not have a patient diagnosed with tertiary syphilis, neurosyphilis, or congenital syphilis. Twenty-six patients (55.3%) were heterosexual, 17 patients (36.2%) were men who had sex with men (MSM), and four patients (8.5%) were bisexual. While syphilis co-infection rates were 17.9% (26/145) in heterosexual individuals, it was 37.5% (21/56) in MSM and bisexual individuals. While 32 patients (68%) were in the HIV infection stage, 15 (32%) were diagnosed with AIDS. Reinfection was detected in 8.51% (4/47) of the patients.\u0000\u0000Conclusion: Most HIV/syphilis co-infected patients are male individuals who have sex with men diagnosed with latent syphilis. HIV/AIDS and syphilis infections are increasing every year in our country. Undetectable= Untransmissible approach causes prevention methods to be thrown into the background. Sexual protection with barrier methods in patients living with HIV continues to maintain its importance today due to co-infections.","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48592714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Tanyel, A. Deveci, L. Sensoy, Fatih Temoçin, Derya Oztomurcuk
Objective: Extrapulmonary tuberculosis (EPTB) can be easily missed due to challenges in diagnosis or overlooked in the differential diagnosis. Therefore, EPTB should be considered in endemic regions, especially in the differential diagnosis of fever of unknown origin. Methods: Adult patients diagnosed and treated for EPTB at Ondokuz Mayıs University School of Medicine Hospital between 2005 and 2018 were analyzed retrospectively. Results: One hundred and nineteen patients with a mean age of 48.4±17.8 years, including 75 (63%) females and 44 (37%) males, were included in the study. The mean age of female patients was 51.8±16.7, and the mean age of male patients was 42.6±18.4. Female patients were significantly older than male patients (p<0.05). Urban and rural residency rates were 45.4 and 40%, respectively. EPTB involved lymph nodes in 60 (50.4%), the central nervous system in 15 (12.6%), the vertebral column in 14 (11.8%), bone in 7 (5.9%), the urogenital system in 7 (5.9%), peritoneum in 6 (5%), the gastrointestinal system in 6 (5%), pleura in 3 (2.5%) and eye in 1 (0.8%) patient. Acid-fast bacilli were seen in 4 (8.1%) of 49 samples; Mycobacterium tuberculosis grew in cultures of 29 (48.3%) of 60 samples; and the polymerase chain reaction was positive for tuberculosis in 24 (52%) of 46 samples. In the histopathologic examination, caseous granulomatous inflammation was the most reported finding (41.2%). The most common adverse event related to antituberculosis drugs was hepatotoxicity. Conclusion: EPTB can involve various organ systems and should be included in the differential diagnosis.
{"title":"Evaluation Of Adult Extrapulmonary Tuberculosis Patients","authors":"E. Tanyel, A. Deveci, L. Sensoy, Fatih Temoçin, Derya Oztomurcuk","doi":"10.36519/kd.2023.4206","DOIUrl":"https://doi.org/10.36519/kd.2023.4206","url":null,"abstract":"Objective: Extrapulmonary tuberculosis (EPTB) can be easily missed due to challenges in diagnosis or overlooked in the differential diagnosis. Therefore, EPTB should be considered in endemic regions, especially in the differential diagnosis of fever of unknown origin.\u0000\u0000Methods: Adult patients diagnosed and treated for EPTB at Ondokuz Mayıs University School of Medicine Hospital between 2005 and 2018 were analyzed retrospectively.\u0000\u0000Results: One hundred and nineteen patients with a mean age of 48.4±17.8 years, including 75 (63%) females and 44 (37%) males, were included in the study. The mean age of female patients was 51.8±16.7, and the mean age of male patients was 42.6±18.4. Female patients were significantly older than male patients (p<0.05). Urban and rural residency rates were 45.4 and 40%, respectively. EPTB involved lymph nodes in 60 (50.4%), the central nervous system in 15 (12.6%), the vertebral column in 14 (11.8%), bone in 7 (5.9%), the urogenital system in 7 (5.9%), peritoneum in 6 (5%), the gastrointestinal system in 6 (5%), pleura in 3 (2.5%) and eye in 1 (0.8%) patient. Acid-fast bacilli were seen in 4 (8.1%) of 49 samples; Mycobacterium tuberculosis grew in cultures of 29 (48.3%) of 60 samples; and the polymerase chain reaction was positive for tuberculosis in 24 (52%) of 46 samples. In the histopathologic examination, caseous granulomatous inflammation was the most reported finding (41.2%). The most common adverse event related to antituberculosis drugs was hepatotoxicity.\u0000\u0000Conclusion: EPTB can involve various organ systems and should be included in the differential diagnosis.","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46012413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gunel Guliyeva, Deniz Akyol, H. Pullukçu, D. Gokengin
Objective: The primary aim of the study was to analyze the changes in time in HIV care and management and virologic success rates. The secondary aims were to analyze the epidemiological features, clinical and laboratory findings, and factors affecting survival. Methods: HIV-infected individuals aged ≥ 18 years presenting to our clinic between January 1996 and December 2015 were included. Data were collected retrospectively from medical records, and two decades (1996-2005 and 2006-2015) were analyzed. Results: Overall, 80% were male; the median age (min; max) was 36.43 (17; 77) years. Patients with stage 3 disease were significantly higher in the first decade compared to the second decade (p=0.00). The median (min; max) CD4+ T lymphocyte count at baseline was 160 (3; 650) and 355 (0; 1800) cells/mm3 in the first and second decades, respectively (p=0.00). The treatment initiation rate was 94.2%; virologic suppression rates at six months of treatment and throughout the total follow-up time were 70.1% and 78.1%, respectively. The difference between the two decades in virologic suppression was significant (p=0.004). AIDS-defining disease developed in 12.9% (52.6% in the first and 11% in the second decade) (p=0.01). The adverse event rate was 60.8%; hyperlipidemia was the most common (60.2%). The death rate was 6.5% and lymphoma (14.3%) and tuberculosis (10.9%) were the most common causes of death. The estimated survival time was 272 months (95% confidence interval 225-320). The inability to achieve virologic suppression, an AIDS-defining disease, and a baseline CD4+ T lymphocyte count <200 cells/mm3 was inversely correlated with survival time. Conclusion: Significant improvements in HIV care and management were recorded in time in our cohort in line with the improvements in global HIV care. Treatment and viral suppression rates were above the Joint United Nations Programme on HIV/AIDS – UNAIDS 90-90-90 target in the second decade. This may be attributed to the recent developments in antiretroviral treatment and the competence of the HIV team in the Aegean University Medical Faculty Infectious Diseases and Clinical Microbiology Department.
{"title":"Care and Management of Aegean University HIV Cohort: Change Over Time","authors":"Gunel Guliyeva, Deniz Akyol, H. Pullukçu, D. Gokengin","doi":"10.36519/kd.2023.4248","DOIUrl":"https://doi.org/10.36519/kd.2023.4248","url":null,"abstract":"Objective: The primary aim of the study was to analyze the changes in time in HIV care and management and virologic success rates. The secondary aims were to analyze the epidemiological features, clinical and laboratory findings, and factors affecting survival. \u0000\u0000Methods: HIV-infected individuals aged ≥ 18 years presenting to our clinic between January 1996 and December 2015 were included. Data were collected retrospectively from medical records, and two decades (1996-2005 and 2006-2015) were analyzed.\u0000\u0000Results: Overall, 80% were male; the median age (min; max) was 36.43 (17; 77) years. Patients with stage 3 disease were significantly higher in the first decade compared to the second decade (p=0.00). The median (min; max) CD4+ T lymphocyte count at baseline was 160 (3; 650) and 355 (0; 1800) cells/mm3 in the first and second decades, respectively (p=0.00). The treatment initiation rate was 94.2%; virologic suppression rates at six months of treatment and throughout the total follow-up time were 70.1% and 78.1%, respectively. The difference between the two decades in virologic suppression was significant (p=0.004). AIDS-defining disease developed in 12.9% (52.6% in the first and 11% in the second decade) (p=0.01). The adverse event rate was 60.8%; hyperlipidemia was the most common (60.2%). The death rate was 6.5% and lymphoma (14.3%) and tuberculosis (10.9%) were the most common causes of death. The estimated survival time was 272 months (95% confidence interval 225-320). The inability to achieve virologic suppression, an AIDS-defining disease, and a baseline CD4+ T lymphocyte count <200 cells/mm3 was inversely correlated with survival time.\u0000\u0000Conclusion: Significant improvements in HIV care and management were recorded in time in our cohort in line with the improvements in global HIV care. Treatment and viral suppression rates were above the Joint United Nations Programme on HIV/AIDS – UNAIDS 90-90-90 target in the second decade. This may be attributed to the recent developments in antiretroviral treatment and the competence of the HIV team in the Aegean University Medical Faculty Infectious Diseases and Clinical Microbiology Department.","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44931197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Hepatit B Virus DNA Flare During In Vitro Fertilization","authors":"Muge Toygar-Deniz, S. Akhan","doi":"10.36519/kd.2022.4211","DOIUrl":"https://doi.org/10.36519/kd.2022.4211","url":null,"abstract":"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.","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43461526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gokhan Aygun, Pakize Aygun, A. Azap, N. Benzonana, F. Can, O. Ergonul, Aysen Gargili-Keles, O. Kurt-Azap, M. Kuşkucu, S. Şimşek-Yavuz, Ayfer Turhan, Z. Vatansever
{"title":"In Memoriam: Prof. Dr. Kenan Midilli (1963-2022)","authors":"Gokhan Aygun, Pakize Aygun, A. Azap, N. Benzonana, F. Can, O. Ergonul, Aysen Gargili-Keles, O. Kurt-Azap, M. Kuşkucu, S. Şimşek-Yavuz, Ayfer Turhan, Z. Vatansever","doi":"10.36519/kd.2022.4536","DOIUrl":"https://doi.org/10.36519/kd.2022.4536","url":null,"abstract":"","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44655190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sevgi Ozan-Kose, Firuze Soyak, Akide Cakmak-Sen, M. Kutlu, S. Sayın-Kutlu
Objective: Acute HIV infection (AHI) is a stage with a rapid decrease in CD4+ T lymphocyte count, high viremia, and high transmissibility. Early diagnosis of AHI represents an opportunity for treatment and prevention of transmission. Therefore, we aimed to determine the clinical and laboratory findings in patients with acute HIV infection. Methods: Patients diagnosed with AHI among newly diagnosed HIV-infected patients were evaluated in the study. AHI diagnosis was defined as an HIV RNA result of at least 10,000 copies/ml with one of the following criteria: a negative or indeterminate HIV antibody test result in a person with a reactive Ag/Ab test result or a patient with a negative Ag/Ab test result has HIV RNA detected in serum or plasma or HIV serology positivity in a patient with signs and symptoms of AHI starting 2-6 weeks after high-risk HIV exposure. In addition, the history, clinical, and laboratory findings of patients with AHI were analyzed retrospectively. Results: One hundred six patients had a new HIV diagnosis during the study period. Of those, 12 (11.3%) were AHI. 10 (83.3%) of the patients with AHI were male, and seven were men who had sex with men. The mean age of the patients was 30 (21-50) years. Fourth-generation ELISA was negative in one patient initially; the repeated test was positive ten days later. While the 4th generation ELISA test of two patients was positive at the time of diagnosis, the confirmation test result was indeterminate. The 4th generation ELISA test was positive in nine patients with AHI symptoms starting 10-30 days after unprotected sexual intercourse. The duration of the patient’s complaints until the admission was found to be 13 (7-30) days. The most common findings were fever, diarrhea, fatigue, sore throat, lymphadenopathy, rash, nausea, and vomiting. Conclusion: The AHI rate was 11.3% in newly diagnosed cases of HIV infection. Awareness of AHI’s signs and symptoms to initiate early diagnosis and treatment. Thus, a better HIV infection course and reduced HIV transmission can be achieved.
{"title":"Evaluation of Acute Human Immunodeficiency Virus Infection Cases","authors":"Sevgi Ozan-Kose, Firuze Soyak, Akide Cakmak-Sen, M. Kutlu, S. Sayın-Kutlu","doi":"10.36519/kd.2022.3681","DOIUrl":"https://doi.org/10.36519/kd.2022.3681","url":null,"abstract":"Objective: Acute HIV infection (AHI) is a stage with a rapid decrease in CD4+ T lymphocyte count, high viremia, and high transmissibility. Early diagnosis of AHI represents an opportunity for treatment and prevention of transmission. Therefore, we aimed to determine the clinical and laboratory findings in patients with acute HIV infection.\u0000\u0000Methods: Patients diagnosed with AHI among newly diagnosed HIV-infected patients were evaluated in the study. AHI diagnosis was defined as an HIV RNA result of at least 10,000 copies/ml with one of the following criteria: a negative or indeterminate HIV antibody test result in a person with a reactive Ag/Ab test result or a patient with a negative Ag/Ab test result has HIV RNA detected in serum or plasma or HIV serology positivity in a patient with signs and symptoms of AHI starting 2-6 weeks after high-risk HIV exposure. In addition, the history, clinical, and laboratory findings of patients with AHI were analyzed retrospectively.\u0000\u0000Results: One hundred six patients had a new HIV diagnosis during the study period. Of those, 12 (11.3%) were AHI. 10 (83.3%) of the patients with AHI were male, and seven were men who had sex with men. The mean age of the patients was 30 (21-50) years. Fourth-generation ELISA was negative in one patient initially; the repeated test was positive ten days later. While the 4th generation ELISA test of two patients was positive at the time of diagnosis, the confirmation test result was indeterminate. The 4th generation ELISA test was positive in nine patients with AHI symptoms starting 10-30 days after unprotected sexual intercourse. The duration of the patient’s complaints until the admission was found to be 13 (7-30) days. The most common findings were fever, diarrhea, fatigue, sore throat, lymphadenopathy, rash, nausea, and vomiting.\u0000\u0000Conclusion: The AHI rate was 11.3% in newly diagnosed cases of HIV infection. Awareness of AHI’s signs and symptoms to initiate early diagnosis and treatment. Thus, a better HIV infection course and reduced HIV transmission can be achieved.","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49253317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yusuf Ozkaraman, D. Seyman, Aysegul Seremet-Keskin, Mustafa Deniz, Z. Adıguzel
Objective: Sandfly fever (SF) is a self-limited vector-related viral infection caused by the SF virus and is spread by phlebotomine sandflies (PSF). Fever, headache, myalgia, arthralgia, loss of appetite, weakness, nausea, and vomiting are the most common symptoms. Laboratory findings include leukopenia, thrombocytopenia, and elevated liver transaminase enzymes. We aimed to examine the demographic, clinical, and laboratory data of patients who were followed with SF diagnosis. Methods: Patients who were followed with SF diagnosis in our hospital between January 2011 and December 2018 were included. The data were obtained retrospectively. Results: A total of 64 patients were included in the study. The mean age was 33.1 ± 9.7(min:19-max:58) years and 35(54.7%) of them were male. Although 53.1% had a history of contact with PSF, 92.2% had a bite mark. 91.6% of the patients were living on the ground and first floor. Fever was the most common symptom in 95.3% of the patients; 89% had myalgia-weakness, 79.6% had a headache, and 50% had a conjunctival rash. Increased transaminase enzyme levels were observed in approximately 93% of the patients. The average of ALT and AST were 284.7 U/L and 243.5 U/L, respectively. Leukopenia was observed in 79.6% (51/64) of them, and thrombocytopenia in 78% (50/64). CK elevation was 54% ratio (35/64). Samples were tested from 19 patients for the serological diagnosis of SF. IgM was positive in 15 (78.9%) of 19 patients and negative in 4(21%) patients. IgG was positive in 10 (52.6%) of 19 patients. Both IgG and IgM were positive in 9 patients. Only IgG positivity was detected in one patient. Conclusion: SF should be considered in patients presenting with complaints such as fever, headache, muscle joint pain, nausea-vomiting, redness in the eyes, leukopenia, thrombocytopenia, elevated transaminase enzyme, CK level, and living in or having a history of travel to subtropical regions, especially during the summer season and a history of PSF contact.
{"title":"Vector-borne Endemic Viral Infection in Antalya Region: Sandfly Fever","authors":"Yusuf Ozkaraman, D. Seyman, Aysegul Seremet-Keskin, Mustafa Deniz, Z. Adıguzel","doi":"10.36519/kd.2022.3789","DOIUrl":"https://doi.org/10.36519/kd.2022.3789","url":null,"abstract":"Objective: Sandfly fever (SF) is a self-limited vector-related viral infection caused by the SF virus and is spread by phlebotomine sandflies (PSF). Fever, headache, myalgia, arthralgia, loss of appetite, weakness, nausea, and vomiting are the most common symptoms. Laboratory findings include leukopenia, thrombocytopenia, and elevated liver transaminase enzymes. We aimed to examine the demographic, clinical, and laboratory data of patients who were followed with SF diagnosis.\u0000\u0000Methods: Patients who were followed with SF diagnosis in our hospital between January 2011 and December 2018 were included. The data were obtained retrospectively.\u0000\u0000Results: A total of 64 patients were included in the study. The mean age was 33.1 ± 9.7(min:19-max:58) years and 35(54.7%) of them were male. Although 53.1% had a history of contact with PSF, 92.2% had a bite mark. 91.6% of the patients were living on the ground and first floor. Fever was the most common symptom in 95.3% of the patients; 89% had myalgia-weakness, 79.6% had a headache, and 50% had a conjunctival rash. Increased transaminase enzyme levels were observed in approximately 93% of the patients. The average of ALT and AST were 284.7 U/L and 243.5 U/L, respectively. Leukopenia was observed in 79.6% (51/64) of them, and thrombocytopenia in 78% (50/64). CK elevation was 54% ratio (35/64). Samples were tested from 19 patients for the serological diagnosis of SF. IgM was positive in 15 (78.9%) of 19 patients and negative in 4(21%) patients. IgG was positive in 10 (52.6%) of 19 patients. Both IgG and IgM were positive in 9 patients. Only IgG positivity was detected in one patient.\u0000\u0000Conclusion: SF should be considered in patients presenting with complaints such as fever, headache, muscle joint pain, nausea-vomiting, redness in the eyes, leukopenia, thrombocytopenia, elevated transaminase enzyme, CK level, and living in or having a history of travel to subtropical regions, especially during the summer season and a history of PSF contact.","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46288337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gunay Tuncer-Ertem, Ayse Buyukdemirci, Filiz Demirel, M. Ozsoy, Fatma Sebnem Erdinc, C. Ataman-Hatipoglu, Ulku Oztoprak-Siyah, S. Cesur, S. Kınıklı, Pinar Gurkaynak, Erkan Buyukdemirci
Objective: We evaluated PCR negativity in oropharyngeal and nasopharyngeal secretions of COVID-19 patients at the end of hydroxychloroquine and/or favipiravir treatments. Methods: Study inclusion criteria were being hospitalized, being older than 18 years, PCR positivity in oropharyngeal and nasopharyngeal secretions and being tested for SARS CoV-2-RNA PCR after treatment. Initially hydroxychloroquine treatment (group 1) was administered to the patients according to COVID-19 guide of Health Ministry. Favipiravir (group 2) alone or in combination with hydroxychloroquine (group 3) was administered to patients who were unresponsive to hydroxychloroquine or had severe pneumonia or were admitted to intensive care unit. Control respiratory specimens were taken no earlier than 24 hours, after the end of therapy. Repeated tests with 24–48-hour intervals were performed in patients with still positive PCR test results. The detection of SARS CoV-2-RNA was made by real-time PCR. Results: The study group included 492 patients who received treatment. Mean duration of symptoms was similar among three groups. PCR negativity rate was 52.8% in the specimens taken 24 hours after the end of treatment. PCR negativity rates was 27.9% (200/492) in 48 hours after the end of treatment, %13.8 (123/492) in 72nd hour and %3.8 (80/492) in 96th hour. The ratios of PCR negativity for all specimen days were similar in three groups. There was no statistically significant difference between the groups for time to PCR negativity from the date of positivity and after the end of treatment. We determined that early or late treatment did not make a difference in terms PCR negativity time. Conclusion: No difference was found in terms of the ratios of PCR negativity or time for negativity in oropharyngeal and/or nasopharyngeal specimens taken after the end of treatment in COVID-19 patients receiving hydroxychloroquine and/or favipiravir treatment.
{"title":"Evaluation of PCR Negativity in Respiratory Specimens of COVID-19 Patients After Hydroxychloroquine and/or Favipiravir Treatment","authors":"Gunay Tuncer-Ertem, Ayse Buyukdemirci, Filiz Demirel, M. Ozsoy, Fatma Sebnem Erdinc, C. Ataman-Hatipoglu, Ulku Oztoprak-Siyah, S. Cesur, S. Kınıklı, Pinar Gurkaynak, Erkan Buyukdemirci","doi":"10.36519/kd.2022.4268","DOIUrl":"https://doi.org/10.36519/kd.2022.4268","url":null,"abstract":"Objective: We evaluated PCR negativity in oropharyngeal and nasopharyngeal secretions of COVID-19 patients at the end of hydroxychloroquine and/or favipiravir treatments. \u0000\u0000Methods: Study inclusion criteria were being hospitalized, being older than 18 years, PCR positivity in oropharyngeal and nasopharyngeal secretions and being tested for SARS CoV-2-RNA PCR after treatment. Initially hydroxychloroquine treatment (group 1) was administered to the patients according to COVID-19 guide of Health Ministry. Favipiravir (group 2) alone or in combination with hydroxychloroquine (group 3) was administered to patients who were unresponsive to hydroxychloroquine or had severe pneumonia or were admitted to intensive care unit. Control respiratory specimens were taken no earlier than 24 hours, after the end of therapy. Repeated tests with 24–48-hour intervals were performed in patients with still positive PCR test results. The detection of SARS CoV-2-RNA was made by real-time PCR.\u0000Results: The study group included 492 patients who received treatment. Mean duration of symptoms was similar among three groups. PCR negativity rate was 52.8% in the specimens taken 24 hours after the end of treatment. PCR negativity rates was 27.9% (200/492) in 48 hours after the end of treatment, %13.8 (123/492) in 72nd hour and %3.8 (80/492) in 96th hour. The ratios of PCR negativity for all specimen days were similar in three groups. There was no statistically significant difference between the groups for time to PCR negativity from the date of positivity and after the end of treatment. We determined that early or late treatment did not make a difference in terms PCR negativity time.\u0000Conclusion: No difference was found in terms of the ratios of PCR negativity or time for negativity in oropharyngeal and/or nasopharyngeal specimens taken after the end of treatment in COVID-19 patients receiving hydroxychloroquine and/or favipiravir treatment.","PeriodicalId":44309,"journal":{"name":"Klimik Journal","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44040286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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