In this study, it was aimed to determine the antibody responses after the two doses of inactivated severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccinations in people who were above 65 years old and to evaluate the factors affecting this response. A total of 235 participants aged 65 years and older were included. Blood samples were taken and data about age, gender, comorbid diseases, and presence of side effects after vaccination were noted. Anti‐SARS‐CoV‐2 QuantiVac ELISA (IgG) test kit (catalogue number: EI‐2606‐9601‐10‐G, Euroimmun) was used. The mean age was 70.38 ± 4.76. Approximately 120 of 235 participants had at least one comorbid disease. The mean levels of anti‐SARS‐CoV‐2 IgG antibody after 4 weeks from the first and second doses of vaccine were 37.70 ± 57.08 IU/ml, and 194.61 ± 174.88 IU/ml, respectively. Additionally, 134 of 235 participants (57.02%) had under 25.6 IU/ml antibody level (negative) after 4 weeks from the first vaccine dose while this rate was 11.48% (n = 27) after 4 weeks from the second vaccine dose. The 19 (70.4%) participants who had under had 25.6 IU/ml antibody level after 4 weeks from the first dose of vaccine had at least one comorbid disease including diabetes mellitus, and 8 (29.6%) participants had no comorbid disease (F = 2.352, p = 0.006). Lower rates of antibody response were detected in participants aged 65 years and older and those with comorbidities both in our study and similar studies in the current literature. Further studies should evaluate whether the low antibody titers are really associated with age and comorbidities or not. Finally, prospective studies are needed to determine how long the immunity provided by SARS‐CoV‐2 vaccines will continue.

Background: The ongoing coronavirus disease 2019 (Covid‐19) pandemic has been rapidly spreading throughout the world with confirmed case numbers already exceeding 75 million. Although nasopharyngeal swabs are the most commonly utilized samples for based severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) RNA detection, collecting these specimens requires healthcare workers and necessitates the use of personal protective equipment as it presents a nosocomial transmission risk. We aimed to assess the diagnostic value of saliva samples in mildly symptomatic and asymptomatic patients with confirmed Covid‐19.Methods: We performed a cohort study to validate the use of saliva for SARS‐CoV‐2 detection in mildly symptomatic and asymptomatic patients with a confirmed diagnosis of Covid‐19. Saliva samples of the patients were analyzed by reverse‐transcriptase polymerase chain reaction (RT‐PCR).Results: In May 2020, 28 asymptomatic and 25 mildly symptomatic patients were enrolled in the study. The median age was 37 years (range 4–70). None of the patients had a fever on presentation. Among 53 patients with SARS‐CoV‐2 detected in the nasopharyngeal sample, the real‐time RT‐PCR was positive in the saliva specimens in 48 (90.56%) patients. The mean cycle threshold (CT) values for nasopharyngeal and saliva specimens (27.80 ± 3.44 and 30.64 ± 2.83, respectively) were significantly correlated between the two sample types (p = .016). The mean CT values of nasopharyngeal and saliva samples in mildly symptomatic and asymptomatic patients (27.18 ± 3.53 and 30.24 ± 3.29 vs. 28.36 ± 3.31 and 30.98 ± 2.39, respectively) were not significantly different (p = .236 and p = .733, respectively).Conclusions: Saliva specimens can be considered as a reliable and less resource‐intensive alternative to nasopharyngeal specimens for screening asymptomatic SARS‐CoV‐2 infections.

Crimean Congo haemorrhagic fever (CCHF) is a viral haemorrhagic disease, mostly transmitted by tick bites. It is clear that ignorance of the necessary precautions results in nosocomial infections in health care settings. Post exposure ribavirin prophylaxis is not well described. We report 2 cases of nosocomial CCHF infections.

Background/Aims: Tumor necrosis factor-α (TNF-α) inhibitors and ustekunimab are widely used in autoimmune diseases. It is known that these biological agents cause the reactivation of hepatitis B virus (HBV). There is no standardized strategy to prevent the reactivation in patients with evidence of a previous HBV infection. In our study, anti-HBc IgG-positive patients who received a biological agent were evaluated in terms of HBV reactivation. Materials and Methods: Patients who were followed up for the use of biological agents in our clinic were evaluated retrospectively. Patients with isolated anti-HBc IgG positivity were included in the study. The HBV reactivation data were recorded from the patients’ files retrospectively. Results: Two hundred and seventy-eight patients who received biological treatment were evaluated. Twenty-nine patients with isolated anti-HBc IgG positivity or resolved HBV infection were included in the study. The HBV reactivation was seen in 5 patients (17.2%). Of these patients, 3 were using adalimumab, 1 infliximab, and 1 ustekunimab. It was controlled by antiviral therapy that was started in the early period. Conclusion: Drugs that block TNF-α and ustekunimab cause an increase in viral replication. In literature, the HBV reactivation rate was approximately 1% in HBsAg-negative, anti-HBC IgG-positive cases, whereas it was found to be as high as 17.2% in our study. Patients receiving the immunomodulator therapy should be evaluated for HBV serology before treatment and carefully monitored for HBV reactivation during and after treatment. Cite this article as: Solay AH, Acar A, Eser F, et al. Reactivation rates in patients using biological agents, with resolved HBV infection or isolated anti-HBc IgG positivity. Turk J Gastroenterol 2018; 29: 561-5.