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.

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.

Introduction: Brucellosis is a zoonotic disease distributed worldwide and very important public health problem especially in the developing countries. In this study, we aimed to evaluate the clinical/laboratory findings of brucellosis patients and contribute of coombs testing to diagnosis at Iğdır State Hospital infection diseases and clinical microbiology department. Materials and Methods: One hundred and forty-five brucellosis patients followed up in our clinic between September 2012 and February 2013 were evaluated retrospectively. Demographic characteristics, laboratory findings, diagnostic methods of the patients were presented. Results: The mean age of the patients were 39±15 (18-80) and 59% (n=86) of the patients were female, 41% (n=59) were male. Most frequent risk factors were animal breeding (n=115, 79%) and using underdone milk and milk products (n=98, 69%). Most reported complaints were weakness (92%), arthralgia (89%), sweating (74%), lack of appetite (70%) and fever (68%). Fifty-seven of the brucellosis patients could not diagnosed with standard tube agglutination. Therefore, Coombs test was used for these undiagnosed patients (39%, n=57). Eighty patients were evaluated as acute (55%), 53 as subacute (37%) and 12 as chronic (8%) brucellosis. Conclusions: Brucellosis can affect all organ systems and cause different clinical manifestations. Therefore, difficulties are encountered in the diagnosis of the disease. Brucellosis should be kept in mind in the differential diagnosis especially in the endemic regions. When the clinical suspicion exists detailed laboratory evaluation must be performed.