Evaluation of Hepatitis C in 20 Years: A Turkish Experience

Objective: Hepatitis C virus (HCV) infection still maintains its importance since it is one of the most important causes of liver cirrhosis and hepatocellular carcinoma. Our hospital, located in İstanbul, which is the 10t most crowded city in the world, has a patient cohort where epidemiological change can be observed due to its deep-rooted history and serving people of different nations in terms of settlement. Main aim in this study is to evaluate the change in HCV epidemiology in our country over the years. Methods: Patients who were at the age of 18 and above and whose HCV-RNA was positive between January 2001 and January 2021 were evaluated. Results: 1.166 patients whose HCV genotype was determined were evaluated. The mean age of the population is 52±14.75 years, 83.53% of all patients was infected with genotype 1 (GT1), 8.23% with GT3, 5.83% with GT2, 2.23% with GT4 and 0.17% of them with GT5. While the GT1 rate decreased in patients over the years, an increase was found in other GTs. GT1 and GT2 were more common in females (p<0.001); GT3 and GT4 were more dominant in males (p<0.001). The mean age of females was high in all genotypes. The mean age of GT3 was significantly lower than the other groups (p<0.001). Conclusion: Although GT1 is still dominant in our country, GT3 and GT4 have been increasingly seen over the years, suggesting that the genotype distribution may change in the coming years due to uncontrolled migration and effective direct-acting antivirals

In a Real-Life Setting, Direct-Acting Antivirals to People Who Inject Drugs with Chronic Hepatitis C in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naive patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization's objective of eliminating viral hepatitis

In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

What Does High Incidence of Sharp Injury Reports Indicate?

Aim: The aim of this study was to evaluate needlestick and sharps injuries in our hospital for the last six years and the effects of education on the prevention of exposure to sharp instruments. Methods: We retrospectively evaluated sharp injuries occurred in our hospital between January 2007 and January 2013. Results: It was found that 229 sharp injuries were sustained within six years. During this period, 1.386 health-care workers received education and training on sharps injury prevention. Conclusion: We concluded that education and training of healthcare workers will increase sharps injury reporting rates and raise awareness and reduce the risk of sharps injuries. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 98-102

Efficiency and safety of direct acting antivirals in chronic hepatitis C patients infected with genotype 2 and 3 in Turkey

International Liver Congress / 54th Annual Meeting of the European-Association-for-the-Study-of-the-Liver (EASL) -- APR 10-14, 2019 -- Vienna, AUSTRIAWOS: 000463481701006…European Assoc Study LiverGilead Sciences Ilac Ltd. Sti. (Istanbul, Turkey)This study was supported by Gilead Sciences Ilac Ltd. Sti. (Istanbul, Turkey). Company was not involved to the content of the study/publication; no involvement to the decision to submit for publication

Effectiveness and safety of direct-acting antiviral therapies in chronic hepatitis C infections patients with cirrhosis in Turkey

International Liver Congress (ILC) -- APR 11-15, 2018 -- Paris, FRANCEWOS: 000461068601206…European Assoc Study Live

Efficacy and safety of direct-acting antivirals in elderly patients with chronic Hepatitis C: A nationwide real-life, observational, multicenter study from Turkey

Background: The number and proportion of elderly patients living with chronic hepatitis C are expected to increase in the coming years. We aimed to compare the real-world efficacy and safety of direct-acting antiviral treatment in elderly and younger Turkish adults infected with chronic hepatitis C. Methods: In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (≥65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups. Results: The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P = .879, P = .508 for modified evaluable population and P = .058, P = .788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir+ribavirin had a significantly lower sustained virological response 12 rates (P < .001, P = .047, P = .013, and P = .025, respectively). Conclusion: Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults