ÖZObjective: The objective of this study was to investigate the distribution of the clinic and demographic characteristics of hepatitis b surface antigen (HBsAg) positive patients in Şanlıurfa region. 49±15 years, range: 20-73) and 24 (83%) were male. Seventeen patients (5%) (mean age: 37.8±12.8 years, range: 16-60) were antihepatitis D virus (anti-HDV) positive, 11 (65%) were male, 5 of them were in the cirrhotic stage. Two patients (0.6%) had HBV/HCV coinfection, two patients (0.6%) had hepatocellular carcinoma (HCC). Seven patients were pregnant, three patients were given tenofovir in the 3 rd trimester, due to high viral load. Seventy one of 73 (26%) patients who were identified to have cirrhosis or chronic hepatitis due to HBV or HDV, 71 of (those who received or completed interferon treatment) received antiviral therapy, most commonly tenofovir. Liver transplantation was performed in two patients (0.6%) due to HBV related liver cirrhosis. Conclusion: Three-quarters HBsAg seropositive patients in Şanlıurfa region were inactive HBV carriers and one quarter were at the stage of chronic hepatitis or cirrhosis. Inactive carriers and chronic hepatitis patients are often in the 3 rd decade and cirrhotic patients were in the 4 th decade of life. Chronic HDV was observed in 5% of patients, HBV related HCC 0.6%, HBV/HCV co-infection was found in 0.6% of patients. Almost all patients with chronic hepatitis or cirrhosis were found to be received or/receiving antiviral treatment and the most commonly used medication was tenofovir.
Occult hepatitis B virus (HBV) infection is defined as the detection of HBV genome in the liver and/or serum in HBsAg(-) individuals. Most patients with occult HBV infection are asymptomatic and are usually diagnosed during screening. Occult HBV infection is clinically significant because it spreads through blood transfusion and organ transplantation and triggers the reactivation of HBV in immunosuppressive patients. In this paper, we present a 63-year-old patient with occult hepatitis B who was scheduled for chemotherapy due to Hodgkin's lymphoma, and developed hepatitis B reactivation after chemotherapy while being HBsAg(-) and anti-HBs(-) before chemotherapy.
Araştırma Makalesi / Research Article Öz. Amaç: Kliniğimize başvuran peptik ülserli, Helikobakter Pilori (HP) pozitif hastalarda klasik üçlü tedavi verilen hastalarla klasik üçlü tedaviye bizmut eklenen hastalar arasındaki HP eradikasyon oranının karşılaştırılması amaçlanmaktadır. Materyal ve Metod: Ocak 2012-Ocak 2013 tarihleri arası prospektif olarak, endoskopilerinde gastrik ve/veya duodenal ülser (peptik ülser) saptanan, histopatoloji, üre nefes testi ya da dışkıda HP antijeni sonuçlarından herhangi birinde pozitiflik saptanan 60 hasta ardışık olarak çalışmaya alındı. Grup 1 hastalara (n=30) klasik üçlü tedavi, grup 2 hastalara (n=30) klasik üçlü tedavi+bizmut tedavileri uygulandı. 3 ay sonra her iki grubun tedavi etkinliği istatistiksel olarak karşılaştırıldı. Bulgular: Dışkıda HP antijeni saptanması testi ile grup 1' de %83,3, grup 2' de %73,3 eradikasyon olduğu belirlendi. Dışkıda HP antijeni saptanması ile yapılan değerlendirmede her iki grup arasında tedavi etkinliği açısından herhangi bir fark saptanmadı (p=0,532). Üre nefes testi ile grup 1' de %56,7, grup 2' de %53,3 eradikasyon olduğu belirlendi. Üre nefes testi ile yapılan değerlendirmede her iki grup arasında tedavi etkinliği açısından herhangi bir fark saptanmadı (p=0,795). Tüm tedavi alanlarda dışkıda HP antijeni testi ile eradike olma oranı üre nefes testine göre daha fazla görüldü, istatiksel olarak anlamlı idi (p=0,011). Sonuç: Klasik üçlü tedavi ile klasik üçlü tedavi+ bizmut tedavisi arasında eradikasyon açısından herhangi bir farklılık saptanmamıştır. Bu yüzden klaritromisin direnci göz önünde bulundurularak seçilecek tedavi ona göre belirlenmelidir. Ayrıca tedavi sonrası etkinliği değerlendirmede dışkıda HP antijeni testi ile üre nefes testi arasında anlamlı fark bulunup dışkıda HP antijeni ile eradikasyon oranı daha yüksek görünmektedir.
lenfoma) gibi gastritle ilişkili hastalıkların en önemli nedenidir. H. pylori enfeksiyonu insanlarda sık görülen kronik bakteriyel bir enfeksiyondur (1, 2). İlk kez 1982'de iki patolog Marshall ve Waren kronik gastritli bir hastanın gastrik mukozasından spiral bir mikroorganizmayı başarılı bir şekilde kültürde üretmeyi başardı, böylece bakteri ve GİRİŞİnsan mide mukozasında gram-negatif bakteri varlığı 19. yüzyılın sonlarında tespit edilmiştir. Helicobacter pylori (H. pylori), kanserojen olduğu saptanan ilk bakteri olup dünya nüfusunun yarısından fazlasında midede kolonize olan bir patojendir. Gastrik ülser, gastrit, duodenal ülser, gastrik kanser, primer gastrik B-hücreli lenfoma (MALT Background and Aims: The eradication rate of Helicobacter pylori using standard triple therapy (amoxicillin+clarithromycin+proton pump inhibitor) as the first-line therapy has fallen below 50%. This prospective, randomized study was conducted to compare the 5+5 ( 10)-day and 7+7 ( 14)-day sequential treatment results in patients with peptic ulcer (gastric ulcer and/or duodenal ulcer) who were identified as histologically positive for Helicobacter pylori infection by gastroscopy. Materials and Methods: This study included 66 patients who had peptic ulcer diagnosed through gastroscopy, had at least two histopatholgically positive results, underwent urea breath test, had positive stool test for Helicobacter pylori antigen, and did not receive eradication therapy before. These patients were randomly divided into two groups and enrolled into the study between March 2014 and August 2015. Group 1 patients (n=33) were administered amoxicillin 1 g+esomeprazole 40 mg 2x1 for the first 5 days, followed by clarithromycin 500 mg+metronidazole 500 mg+esomeprazole 40 mg 2x1 for the next 5 days. Group 2 patients (n=33) were administered amoxicillin 1 g+esomeprazole 40 mg 2x1 for the first 7 days, followed by clarithromycin 500 mg+metronidazole 500 mg+esomeprazole 40 mg 2x1 for the next 7 days. Esomeprazole 40 mg (1x1) treatment was completed during 12 weeks in both groups. After a drug-free period of 15 days, the eradication rate was analyzed by urea breath test and Helicobacter pylori antigen stool test. Results: Ten patients in Group 1 (30.3%) were females, with a mean age of 38.0±13.1 years. Twelve patients in Group 2 (34.4%) were females, with a mean age of 39.0±15.6 years. After treatment, the urea breath test and Helicobacter pylori antigen stool test revealed an eradication rate of 70% in Group 1 and 72.7% in Group 2, with an overall eradication rate of 71.2% in all patients. No significant difference was observed between the two groups. Conclusion: At the end of the consecutive 5+5-day and 7+7-day treatment, an eradication rate of about 70% was achieved in all patients. Although not ideal, this eradication rate implies that the 5+5 (10)-day consecutive treatment could be used an alternative first-line therapy.
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