A genetically determined resistance or susceptibility to chronic hepatitis C virus (HCV) infection may make an important contribution to the course of liver disease and may be linked to the human major histocompatibility complex (MHC). The aim of this study was to investigate the HLA class II genotype profile in chronic hepatitis C and to determine the HLA-hepatitis C association. The experimental population was composed of 49 unrelated chronic HCV patients (31 females, 18 males; mean age, 54.4 ؎ 1.7 years; range, 34 to 73 years). The control population consisted of 43 ethnically matched healthy donors. HLA-DR and -DQ alleles were studied for patients and controls by a PCR-sequence-specific-primer low-resolution method. Anti-HCV was investigated with enzyme-linked immunosorbent assay II, and HCV RNA was investigated with reverse transcriptase nested PCR. The HLA class II allele, DRB1*11, was found at reduced frequency in 49 patients with chronic hepatitis C (anti-HCV and HCV RNA positive) compared to that for controls (22.4 versus 51.0%; P < 0.01, odds ratio ‫؍‬ 0.3, confidence interval ‫؍‬ 0.1 to 0.7). No further HLA associations with chronic HCV infection were observed, and there was no correlation between the stage of disease and HLA. DRB1*11 was also found at reduced frequency in all HCV antibody-positive patients compared to controls (corrected P ‫؍‬ not significant). DRB1*11 was associated with chronic HCV infection, and it is possible that HLA-DRB1*11 may have a protective feature in chronic HCV infection. In addition, DRB1*11 was associated with protection from HCV infection. These findings suggest that host HLA class II genotype is an important factor determining the outcome of infection with HCV.Hepatitis C virus (HCV) persists in the majority of infected individuals and is responsible for a wide spectrum of chronic liver lesions ranging from minimal inflammation to cirrhosis or hepatocellular carcinoma (8,18,19). The mechanisms whereby HCV establishes persistent infection and liver disease are still poorly understood. Both virus-related factors, such as viral heterogeneity and replicative activity (10,14), and the host's determinants, such as lack of efficient immune responses (13,15), are certainly involved in the pathogenesis of chronic hepatitis. Differences in the immunogenetic backgrounds of infected patients might in part account for the observed variation in the individual courses of disease. Indeed, polymorphisms of immune regulatory genes or HLA class I and II molecules are known to influence the host's ability to present or react to viral antigens (1, 7).Several studies have aimed to identify major histocompatibility complex class II alleles associated with different outcomes of HCV infection, but the results have not been consistent.In the present study, we have investigated the distribution of the HLA class II alleles in patients with chronic hepatitis C using the PCR-sequence-specific-primer low-resolution method. The aim of the present study was to investigate whether these alleles might...

Introduction: Hepatitis C virus infection is a major cause of cirrhosis and liver cancer worldwide. The knowledge of physicians about what should they do in case of any anti-HCV positivity in screening tests is of great importance. In this study the awareness and knowledge of physicians is evaluated by analyzing the rate of the referrals of anti-HCV positive patients to HCV RNA test and their treatment by different clinics. Methodology: The patients tested for anti-HCV in internal medicine, surgery, gastroenterology and infectious disease clinics between 1 January and 31 December 2017 were evaluated retrospectively in a tertiary care hospital. Results: Anti-HCV testing was performed in 32,803 patients. Anti-HCV positivity was detected in 95 (0.28%) patients aged 88 years of age or younger (mean 60.89 ± 16.96 years), 57.89% of them were female. HCV RNA was tested in 50 (%52,63) of anti-HCV positive patients and it was found positive in 18 (36%) patients. In anti-HCV positive patients HCV RNA testing was requested most by infectious disease (100%) and gastroenterology (70.58%) clinics and least by surgery and other clinics (21% and 25% respectively). These differences were found to be statistically significant ( =33.65, p < 001). Conclusions: Our study highlights the significant deficiencies existed in the referring patients with anti-HCV positivity for further examination and treatment by the attending physicians especially in surgical clinics. Performing HCV screening in the different steps of medical care and using electronic reminder systems directing physicians at appropriate diagnostic and treatment protocols can maximize the likelihood of the detection and treatment of HCV- infected patients.

Leuconostoc türleri streptokok ailesi üyesi olup bitkiler, sebzeler, süt ürünleri ve bazen insan gaita ve vajina örneklerinde bulunmaktadırlar. Bu mikroorganizmalar diğer streptokokların aksine vankomisine karşı intrinsik direnç gösterirler. İnsanlar için çok nadir bir patojen olmalarına rağmen özellikle immün sistemi baskılanmış hastalarda ciddi enfeksiyonlara neden olabildikleri bildirilmiştir. Burada daptomisin ile başarılı bir şekilde tedavi edilen, Leuconostoc pseudomesenteroides'in neden olduğu yumuşak doku enfeksiyonu kaynaklı bakteremi olgusu sunulmaktadır. Hasta, 49 yaşında obez kadın, ateş ve sağ kolda selülit tanısı ile hospitalize edildi. Öyküde, sağ meme invaziv duktal karsinom operasyonu ve kolda kronik lenfödem mevcuttu. Hastaya piperasilin-tazobaktam başlandı. Ateş ve selülit bulguları tedavinin 48. saatinde hala devam etmekte olan hastanın tedavisine teikoplanin eklendi. Yatışının 72. saatinde hala ateşi olan hastada selülit bulguları göğüs duvarına ilerleyip, elinde büllöz lezyonlar oluşmaya başladı. Aldığı antibiyotikler stoplanıp daptomisin başlandı. Alınan kan kültürlerinde Leuconostoc pseudomesenteroides izole edildi. İzole edilen mikroorganizma, linezolid, ampisilin minimum inhibitör konsantrasyon (MİK=2), siprofloksasin (MİK <0,5) ve eritromisin (MİK=0,25) duyarlı, vankomisin ve klindamisin (MİK=2) dirençli idi. Daptomisinin ikinci gününde hastanın ateşi düştü. Daptomisinin 14. gününde koldaki eritemi tama yakın gerileyen, büllöz lezyonları kurutlanan ve laboratuvar bulguları normale dönen hasta taburcu edildi. Sonuç olarak Leuconostoc türleri gibi nadir görülen bakteriler, özellikle risk faktörleri bulunan hastalarda ciddi enfeksiyonlara yol açabilmektedir. Mikrobiyolojik kültürlerde streptokoka benzeyen, Gram-olumlu vankomisin dirençli mikroorganizmalar izole edildiğinde, bu etkenin akla getirilmesi önemlidir.Leuconostoc spp. are members of Streptococcus family that can be found in plants and dairy products as well as in feces and vaginal flora of humans. Unlike other streptococci, they have intrinsic resistance to vancomycin. Although it is a very rare pathogen of humans, it may cause serious infections, especially in immunocompromised hosts. In this paper, we present a case of soft tissue infection with bacteremia caused by Leuconostoc pseudomesenteroides that was cured with daptomycin. A forty-year-old obese woman was admitted with fever and cellulitis of right arm. She had a history of invasive ductal carcinoma operation on her right breast and chronic right arm lymphedema. Piperacillin-tazobactam was initiated. After 48 hours, the clinical findings did not improve and teicoplanin was added to the therapy. At the 72 th hour, fever continued, cellulitis spread to the chest wall and bullous lesions appeared on the right hand. The treatment was switched to daptomycin. Leuconostoc pseudomesenteroides was isolated in blood cultures of the patient. It was susceptible to linezolid, ampicillin minimum inhibitory concentration (MIC=2), ciprofloxacin (MIC <0.5) and erythromycin (MIC=0.25). It ...