Objective: Treponema pallidum and HIV are transmitted frequently through sexual contact, these agents with epidemiological similarities coinfect the same host. The current number of HIV-infected cases in Turkey is increasing. For this reason, we aimed to reveal the characteristics of syphilis in HIV/AIDS cases. Methods: A retrospective longitudinal cohort study was performed, patients were followed up at 24 clinics in 16 cities from all seven regions of Turkey between January 2010 to April 2018. We examined the socio-demographic characteristics, laboratory parameters and neurosyphilis association in HIV/AIDS-syphilis co-infected cases. Results: Among 3,641 patients with HIV-1 infection, 291 (8%) patients were diagnosed with syphilis co-infection. Most patients were older than 25 years (92%), 96% were males, 74% were working, 23% unemployed, and 3% were students. The three highest prevalence of syphilis were in Black Sea (10.3%), Mediterranean (8.4%) and Marmara Regions (7.4%). As for sexual orientation, 46% were heterosexuals, 42% men who have sex with men (MSM), and no data available for 12%. Patients with the number of CD4+ ≤ 350 mm 3 reached 46%, 17% of the patients received antiretroviral therapy and neurosyphilis association reached 9%. Conclusion: Although HIV/AIDS-syphilis co-infection status appeared high in heterosexuals, MSM had a moderate level increase in cases. Our results suggested syphilis co-infection in HIV/AIDS cases should be integral part of monitoring in a national sexual transmitted diseases surveillance system. However, our data may provide base for HIV/syphilis prevention and treatment efforts in the future.

Objective: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of fatty liver without inflammatory infiltration, excessive alcohol consumption, viral hepatitis, and other liver diseases. NAFLD is a major health problem as it can lead to cirrhosis, liver cancer and mortality. In HIV-positive patients, the prevalence of NAFLD ranges from 28 to 48%. Currently, there is no information about the prevalence and related factors related to NAFLD in those with HIV infection in our country. In this study, we aimed to investigate the prevalence of NAFLD and the related factors in newly diagnosed HIV-infected patients. Methods: The demographic data and ultrasonography of 558 HIV-infected patients newly diagnosed between June 2015 and September 2019 were analyzed retrospectively. In hepatic echogenicity, fatty liver was diagnosed with hyper echogenicity of liver compared with renal cortex and diffusion. Uni- and multi-variate logistic regression analyses were applied to estimate factors associated with NAFLD. Results: Of 358 patients who met the study criteria, 118 (33%) were diagnosed as NAFLD. Obesity was found in 10.2% of the patients with NAFLD and in 3.1% of the patients without NAFLD (p=0.021). NAFLD rate was significantly higher in patients with diabetes mellitus and hypertension (p<0.05). In the multivariate analysis, age, 1 mg/dl increase in glucose and triglyceride values and 1 unit increase in ALT/AST were associated with NAFLD. Conclusions: The results highlight the importance of early recognition and management of NAFLD and traditional factors associated with NAFLD in Turkish patients with HIV infection. Additionally, precautions and treatments should be a priority in the follow-up of patients in order to ensure the reduction of liver-related morbidity and mortality, which is one of the non-AIDS causes of these newly diagnosed HIV-infected patients.

Background: In chronic hepatitis B patients with or exposed to the risk of osteoporosis or renal dysfunction, switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide fumarate (TAF) or entecavir (ETV) may be the right choice. Objectives: This study aimed to present real-life data in terms of the efficacy and safety of a TAF/ETV treatment change while receiving TDF. Methods: This retrospective study was conducted on 344 adult patients from 10 centers. The data of patients who had changed to ETV (n = 107) and TAF (n = 237) while receiving TDF were analyzed. The data collected at 0 and 6 months of treatment were analyzed. The virological response was assessed based on undetected hepatitis B virus (HBV) DNA. Serum alanine aminotransferase (ALT) values were used to evaluate the biochemical response. For renal function, serum creatinine and phosphorus, as well as estimated glomerular filtration rate (eGFR), were recorded. Moreover, lumbar spine and hip T-scores along with the serum lipid profile were evaluated. Results: The mean age of patients was 41.14 ± 13.46 years, and 224 (65.1%) of the participants were male. The treatment arms were not significantly different in terms of demographic characteristics, comorbid diseases, infection duration, family history of HBV infection, blood platelet count, serum biomarkers, such as ALT, phosphorus, creatinine, total bilirubin, albumin, lipid profile, and HBV DNA levels at the beginning. No statistically significant difference was found between the proportion of undetectable HBV DNA of the two treatment groups after 6 months (P = 0.221). The ALT normalization in the ETV and TAF groups at the sixth month compared to the baseline levels was not significantly different (P = 0.853, P = 0.330, respectively). There was no statistically significant difference between the two treatment arms regarding changes in eGFR, creatinine, phosphorus, hip, and spine T-scores from baseline to 6 months (P = 0.296, P = 0.78, P = 0.141, P = 0.832, P = 0.947, respectively). In those who switched to TAF or ETV, low-density lipoproteins cholesterol were observed to be significantly higher after 6 months compared to baseline values (P = 0.002, P = 0.049, respectively). The TC increased significantly in the TAF group (P = 0.035). Conclusions: Our study showed that switching to ETV and TAF sustained the viral suppression and biochemical response achieved by TDF therapy. The treatment switch to TAF of ETV can control renal dysfunction and reduce bone mineral density caused by TDF.

Aim: In the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), reverse transcriptase-PCR (RT-PCR) technique is often used. We evaluated the compatibility of SARS-CoV-2 RT-PCR kits containing different gene targets during the pandemic. Materials & methods: Samples were tested by Bio-Speddy® ( RdRp gene) and Diagnovital® ( RdRp + E genes). The correlation between two assays were determined by Deming regression analysis and chi-square analyses. Results: Diagnovital PCR kit showed amplification in a narrow Ct range and conveniently sharper exponential amplification curves than Bio-Speedy PCR kit. While the correlation between the findings of the two kits was apparent even with single gene target, this correlation increased when a secondary biomarker was added to the correlation calculations. Conclusion: We have observed high correlation between different PCR kits, however, using different PCR kits during the pandemic may provide a more accurate diagnosis of SARS-CoV-2, since despite correlation there are a number of patients showing contradicting diagnosis.

In chronic hepatitis C treatment, direct acting antivirals have a strong effect and are well tolerated since 2014, yet it is unclear whether resource-constrained countries have the same achievement. This study aimed at evaluating direct acting antivirals used to treat Turkish chronic hepatitis C patients between the years of 2016 to 2017. Within the one-year period, 101 out of 105 patients reached a sustained virological response rate. The type of direct acting antivirals and treatment length were chosen according to the Health Implementation Guideline of Turkey. The analyses of effectiveness according to therapeutic regimes showed the following sustained virological response rate: Ledipasvir/sofosbuvir and +/-; ribavirin (97%), ombitasvir/paritepravir/dasabuvir and +/-; ribavirin (100%) and sofosbuvir + ribavirin (100%). One patient had virological relapse on the 12th week by the end of the therapy. In this patient, cross-resistance mutation Y93H was specified for the NS5A region. On the other hand, amino acid changes, S282G and C316S, were determined in the NS5B region. The adverse effects were 22% in all patients. Most of them were mild or moderate. The researchers concluded that the results of the highly efficient and well-tolerated therapy with direct acting antivirals could be examples in resource-constrained countries. In addition, resistant variants should be detected after unsuccessful treatment in the management of new therapy options.