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Crimean-Congo hemorrhagic fever (CCHF) is a disease with high fatality. To demonstrate the effectiveness of ribavirin against CCHF. The first group of 21 patients received ribavirin within 4 days of the onset of symptoms (early use of ribavirin, EUR); the second group of 20 patients received ribavirin > or =5 days after the onset of the symptoms of the disease (late use of ribavirin, LUR); and the last group of 11 patients did not receive ribavirin (no use of ribavirin, NUR). At 5-10 days from the onset of symptoms the mean platelet counts of the patients in the EUR group were significantly higher than those of the patients in LUR group, and at 7-9 days, they were significantly higher than that of the patients in the NUR group. The mean aspartate transferase levels in the EUR group were significantly lower than of the NUR group on days 8 and 9, and the mean alanine transferase level was significantly lower on day 8 after the onset of the symptoms. There is a beneficial effect of ribavirin if given at an early phase of the CCHF. We suggest ribavirin use especially in the early phase of the disease.

Three pediatric and two adult Turkish patients with Crimean Congo Hemorrhagic Fever (CCHF) induced hemophagocytic syndrome (HPS) were admitted to Ondokuz Mayis University Hospital, which is in the Middle Black Sea Region of Turkey. All of them had remarkable hemophagocytosis in the bone marrow with severe bleeding symptoms along with the other known clinical and laboratory findings of CCHF. We would like to present these patients and to discuss the pathophysiology and the effect of acquired HPS on the severity of the disease. Am. J. Hematol., 2008. © 2007 Wiley‐Liss, Inc.

HIV-1 replication is rapid and highly error-prone. Transmission of a drug-resistant HIV-1 strain is possible and occurs within the HIV-1-infected population. In this study, we aimed to determine the prevalence of transmitted drug resistance mutations (TDRMs) in 1,306 newly diagnosed untreated HIV-1-infected patients from 21 cities across six regions of Turkey between 2010 and 2015. TDRMs were identified according to the criteria provided by the World Health Organization's 2009 list of surveillance drug resistance mutations. The HIV-1 TDRM prevalence was 10.1% (133/1,306) in Turkey. Primary drug resistance mutations (K65R, M184V) and thymidine analogue-associated mutations (TAMs) were evaluated together as nucleos(t)ide reverse transcriptase inhibitor (NRTI) mutations. NRTI TDRMs were found in 8.1% (107/1,306) of patients. However, TAMs were divided into three categories and M41L, L210W, and T215Y mutations were found for TAM1 in 97 (7.4%) patients, D67N, K70R, K219E/Q/N/R, T215F, and T215C/D/S mutations were detected for TAM2 in 52 (3.9%) patients, and M41L + K219N and M41L + T215C/D/S mutations were detected for the TAM1 + TAM2 profile in 22 (1.7%) patients, respectively. Nonnucleoside reverse transcriptase inhibitor-associated TDRMs were detected in 3.3% (44/1,306) of patients (L100I, K101E/P, K103N/S, V179F, Y188H/L/M, Y181I/C, and G190A/E/S) and TDRMs to protease inhibitors were detected in 2.3% (30/1,306) of patients (M46L, I50V, I54V, Q58E, L76V, V82A/C/L/T, N83D, I84V, and L90M). In conclusion, long-term and large-scale monitoring of regional levels of HIV-1 TDRMs informs treatment guidelines and provides feedback on the success of HIV-1 prevention and treatment efforts.

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Here, we describe a 38-year-old male with an abrupt manifestation acute panniculitis as unusual presentation of brucellosis. Brucellosis is a reemerging disease in Turkey, and the disease is primarily transmitted from farm animals to humans. Farmers and shepherds are the major risk groups for brucellosis in Anatolia. Brucellosis may involve almost all systems and organs, including the skin, and may mimic a wide range of illness and syndromes. Although the cutaneous manifestation of brucellosis is not disease specific, but it occurs in about 6%-13% of patients with brucellosis. Some of these lesions including rashes, papules, ulcers, abscess, erythema nodosum, ecchymosed skin rash, purpura, and vasculitis may be seen frequently in brucellosis, but panniculitis is rarely described. The case confirmed by positive blood culture had manifest skin lesion as an initial finding represented by lobular panniculitis with vasculitis.

IntroductionHIV-TR is a recently established (2012) multicentre cohort in Turkey. The aim of this study is to analyze epidemiological, immunologic and virologic data of recently diagnosed HIV patients.Materials and MethodsEpidemiologic, clinical and laboratory data of all patients diagnosed in 2011 and 2012 were recorded by a web-based data collection system, retrospectively.ResultsA total of 693 patients (561 male, 132 female) at 24 sites were enrolled. The median age at first presentation for HIV care was 36. The proportion of patients presenting with advanced HIV disease (CD4 count<200/mm3 or presenting with an AIDS-defining event) was 30.6%; and 52.4% of patients were late presenters (CD4 count<350/mm3 or presenting with an AIDS-defining event). Median CD4 counts at presentation and before treatment were 344 (IQR: 175–540) and 295 (IQR: 150–430), respectively. Pretreatment CD4 count was >500 copies/mL in 18.5% of patients. Of 531 patients receiving ART, initial combinations consist of tenofovir/emtricitabine (TDF/FTC) plus efavirenz (EFV) in 48.2% and TDF/FTC plus lopinavir/ritonavir (LPV/r) in 37.5% and other combinations in 14.3% of the patients. Pre-treatment HIV-RNA was over 100.000 copies/mL in 52.3% of patients. At Weeks 24 and 48, HIV-RNA were<50 copies/mL in 63,4% of 385 patients and 82% of 311 patients reported to be still on ART and had a viral load measurement, respectively. Median pretreatment CD4 count was lower for TDF/FTC+LPV/r recipients than TDF/FTC+EFV recipients (250 vs 316) (p<0.05). The median increase from baseline CD4 cell count was 230 in TDF/FTC+LPV/r group, 193 in TDF/FTC+EFV group and 216 among all treated patients. Of 531 patients receiving ART, 11 had died and 19 were lost to follow-up.ConclusionDespite 52.4% of recently diagnosed patients were late presenters; a high rate of virologic suppression was achieved in HIV-TR Cohort. A national HIV testing strategy targeting subpopulations with higher risk is urgently needed.

NT was found to be a prognostic factor in patients with sepsis.