Oxidative stress could play a role in pathogenesis of hepatitis C virus (HCV) infection. The aim of our study is to determine oxidant/antioxidant status of patients with chronic hepatitis C (CHC), and the effect of pegylated interferon alfa-2b plus ribavirin combination therapy on oxidative stress. Nineteen patients with chronic HCV infection and 28 healthy controls were included in the study. In control and patient groups, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, erythrocyte malondialdehyde (MDA) levels, erythrocyte CuZn-superoxide dismutase (SOD), erythrocyte glutathione peroxidase (GSH-Px) activities were measured. After pegylated interferon alfa-2b and ribavirin combination therapy for 48 weeks, these parameters were measured again in the patient group. Serum MDA levels increased significantly in CHC patients (n:19), before the treatment when compared with healthy subjects (n:28) 9.28 ± 1.61, 4.20 ± 1.47 nmol/ml, p < 0.001 respectively. MDA concentration decreased significantly (p < 0.001) after the treatment as well as ALT, AST activity, in erythrocytes of these patients. Average antioxidant enzymes (superoxide dismutase and glutathione peroxidase) were significantly lower in erythrocytes of patients with CHC before treatment compared with the control group (both, p < 0.001). Chronic Hepatitis C patients after pegylated interferon alfa-2b and ribavirin therapy showed values of SOD, GSH-Px were significantly higher than pretreatment levels (both, p < 0.001). Our results show that patients with chronic HCV infection are under the influence of oxidative stress associated with lower levels of antioxidant enzymes. These impairments return to level of healthy controls after pegylated interferon alfa-2b plus ribavirin combination therapy of CHC patients. Although interferon and ribavirin are not antioxidants, their antiviral capacity might reduce viral load, and inflammation, and perhaps through this mechanism might reduce virus-induced oxidative stress.

Since symptomatic toxoplasmosis in in human immunodeficiency virus (HIV)/Acquired immunodeficiency syndrome (AIDS) almost always occurs as a result of reactivation of chronic infection, screening Toxoplasma serology has an important role in the follow up of the main disease in these populations. In this meta-analysis, we aimed to reveal the difference in the seroprevalence rates of Toxoplasma gondii infection between groups in relation to CD4 counts (CD4-counts ≥200 and <200 cells/mm3) HIV-infected population. The meta-analysis was performed by searching for the studies in English that were published in the last 20-year period in databases including PubMed, Google Scholar, Embase, Science Direct and Web of Science. The process of searching was carried out using the keywords: “Acquired immunodeficiency syndrome”, “AIDS”, “Human immunodeficiency virus”, “HIV”, “Toxoplasma”, “Toxoplasmosis”, “Toxoplasma gondii”, “seroprevalence”, “prevalence” and “immunoglobulin G”. A total of 16 studies including 3982 seropositive samples of T. gondii, 2792 of which were in first group (HIV positive patients with CD4-counts ≥200 cells/mm3) and 1190 were in second group (HIV positive patients with CD4-counts <200 cells/mm3), were included in the meta-analysis. The seroprevalence of T. gondii was 40.03% in HIV-positive patients with CD4 counts ≥200 cells/mm3, and 43.5% in the group with CD4 counts <200 cells/mm3. Seroprevalence rates in the studies included in the meta-analysis showed variability (heterogeneity) in both groups and heterogeneity between studies was higher in group 1 [Group 1; Cochran Q=994.16, DF=15, I²=98.49%, p<0.0001 and group 2; Cochran Q=368.50, DF=15, I²=95.93%, p<0.0001]. We concluded that HIV/AIDS patients with low CD4 counts have higher epidemiological risk as well as immunological risk of toxoplasmosis. To the best of our knowledge, this is the first meta-analysis evaluating the seroprevalence of T. gondii in AIDS/HIV population by comparing the seroprevalance of T. gondii in subgroups formed according to CD4 counts.

To determine the clinical characteristics of patients with cystic echinococcosis and the diagnostic and therapeutic approaches used. This is a multicentre, retrospective study. Patients from six centres who were diagnosed with hydatid cysts in the last five years were evaluated. The mean age was 45.4±17.4 years, and 54.7% were female. The most common complaints were abdominal pain, nausea and vomiting, and the most common physical examination finding was abdominal tenderness. Most patients were diagnosed within 2-6 months. Anaemia and eosinophilia were the most common laboratory findings. The liver was the most commonly involved organ (n=153, 90%). One hundred twenty-five (73.5%) patients underwent ultrasonography. The largest cyst was present in the liver at stage four, and its diameter was 160x170 mm. The rates of the negative, grey zone and positive results were 9.4%, 8.8% and 81.8%. Surgery was more common (n=72, 42.4%) than puncture, aspiration, injection, and re-aspiration treatments (n=14, 8.2%). Of the 47 patients who had a recurrence, 22 (46.8%) had a history of hydatid cyst treatment. Hydatid disease, which is endemic in our country, is diagnosed at a late stage. In terms of disease diagnosis, serological tests may be misleading. It was not possible to compare the success rates according to the treatment choices because of the lack of randomisation of stages and sizes of the lesions.

Rubella infection prevalence in pregnant women can vary from country to country, or even across regions in the same country. In this metaanalysis, the seroprevalence Rubella among pregnant women in Turkey in the last decade was evaluated. Studies conducted in Turkey between 2007 and 2017 were analyzed, and differences in seroprevalence between provinces were compared by evaluating Rubella immunoglobulin (Ig)-G, IgM, and IgG avidity results in pregnancy in this period. A data search was performed using the search terms Rubella, kızamıkçık, gebe, hamile, pregnancy, Türkiye, Turkey in Google Scholar, PubMed, Web of Science, Türk Medline, and the YÖK thesis database center. A total of 26 articles associated with the seroprevalence of Rubella among pregnant women in Turkey were enrolled in the meta-analysis. As a result of an analysis of 84398 Rubella IgG, and 90988 Rubella IgM serology tests among pregnant women in 26 studies; Rubella IgG and IgM seroprevalence rates in pregnant woman in Turkey were found as 93.47% (95% CI: 91.72 to 95.03) and 0.783% (95% CI: 0.505 to 1.120), respectively. Rubella IgG low, intermediate, and high avidity rates were 4.66% (95% CI: 0.969 to 10.906), 7.51% (95% CI: 5.101 to 10.345), and 93.55% (95% CI: 82.584 to 99.311), respectively. The Rubella IgG seropositivity rate in Turkey among pregnant woman is high, whereas it is low for IgM. These rates may be considered as the result of successful immunization policies and practices. In a few provinces, it is necessary to revise the Rubella immunization procedures and adult vaccination strategies should be developed in order to control Rubella infections in adults, including pregnant women.

Background/Aims: The present study aimed to determine the changes in the epidemiology of hepatitis in recent years in an adult Turkish population. Materials and Methods: Overall, 852 patients with acute viral hepatitis from 17 centers were included in this study. Their sociodemographic characteristics, clinical courses, treatments, and laboratory findings were retrospectively analyzed. Results: The most commonly found microorganisms were the hepatitis B virus (55.2%) and hepatitis A virus (37.6%), and the types of acute viral hepatitis differed significantly according to the age group (p≤0.001). The most frequently reported symptom was fatigue (73.7%), and the most common complications were cholecystitis (0.4%) and fulminant hepatitis (0.4%). The median hospital stay was 9 days (range 1-373). In total, 40.8% patients with acute hepatitis B virus developed immunity. Conclusion: In Turkey, there are significantly large adolescent and adult populations susceptible to acute viral hepatitis. Therefore, larger vaccination programs covering these age groups should be implemented. Cite this article as: Karacaer Z, Tosun S, Batırel A, et al. Changes in acute viral hepatitis epidemiology in the Turkish adult population: A multicenter study. Turk J Gastroenterol 2018; 29: 177-82.

Background: In this study, we aimed to investigate the efficacy and safety of sofosbuvir-based therapies in the treatment of chronic hepatitis C in real-world clinical practice. Methods: Data from patients with chronic hepatitis C treated with SOF/LDV ± RBV or SOF/RBV in 31 centers across Turkey between April 1, 2017, and August 31, 2018, were recorded in a nationwide database among infectious disease specialists. Demographics, clinical, and virological outcomes were analyzed. Results: A total of 552 patients were included in the study. The mean age of the patients was 51.28 ± 14.2, and 293 (55.8%) were female. The majority had HCV genotype 1b infection (65%), 75.04% of the patients underwent treatment, and non-cirrhosis was present at baseline in 381 patients (72.6%). SOF/LDV ± RBV treatment was given to 477 patients and 48 patients received SOF/RBV according to HCV genotype. The total SVR12 rate was 99% in all patients. Five patients experienced disease relapse during the study and all of them were genotype 2. In patients infected with HCV GT2, SVR12 was 77.3%. SVR was 100% in all patients infected with other HCV genotypes. All treatments were well tolerated by patients without causing severe adverse events. Side effects and side effects-associated treatment discontinuation rates were 28.2% and 0.4%, respectively. Weakness (13.7%) was the common side effect. Conclusion: The present real-world data of 525 patients with HCV genotypes 1, 1a, 1b, 3, 4, and 5 who underwent SOF/LDV ± RBV treatment in Turkey demonstrated a high efficacy and safety profile. HCV GT2 patients should be treated with more efficacious treatment.