BackgroundPrevious trials have investigated the effect of hepatitis C on lung functions; however, the role of viral load levels is unclear. The aim of this study was to investigate the effect of HCV viremia status on lung functions.MethodsThis study was in 60 patients with chronic hepatitis C (CHC). Patients were classified into three groups (non-viremic, low-viremic and high-viremic) based on serum HCV RNA levels. Spirometric parameters (FEV1, FVC, FEV1/FVC) and the proportion of patients with spirometric abnormalities were compared between three groups.ResultsHigh-viremic and low-viremic patients showed a significantly higher prevalance of spirometric abnormality than observed in non-viremic patients (p=0.02). Moreover, there was a significant moderate correlation between viremia level and the percentage of spirometric abnormalities (Cramer's U value=0.452, p=0.002). High-viremic patients were 14.2 times more likely to exhibiting pulmonary dysfunction than non-viremic patients. Additionally, spirometric parameters FEV1 and FVC were significantly reduced in high-viremic and low-viremic patients compared to those in non-viremic patients (p=0.013 and p<0.001 respectively).ConclusionThese results indicate that persistent HCV infection may be associated with reduced pulmonary functions, especially in patients with high viremia levels. Therefore, these patients should be carefully monitored for lung function.

Background The core components (CCs) of infection prevention and control (IPC) from World Health Organization (WHO) are crucial for the safety and quality of health care. Our objective was to examine the level of implementation of WHO infection prevention and control core components (IPC CC) in a developing country. We also aimed to evaluate health care-associated infections (HAIs) and antimicrobial resistance (AMR) in intensive care units (ICUs) in association with implemented IPC CCs. Methods Members of the Turkish Infectious Diseases and Clinical Microbiology Specialization Association (EKMUD) were invited to the study via e-mail. Volunteer members of any healt care facilities (HCFs) participated in the study. The investigating doctor of each HCF filled out a questionnaire to collect data on IPC implementations, including the Infection Prevention and Control Assessment Framework (IPCAF) and HAIs/AMR in ICUs in 2021. Results A total of 68 HCFs from seven regions in Türkiye and the Turkish Republic of Northern Cyprus participated while 85% of these were tertiary care hospitals. Fifty (73.5%) HCFs had advanced IPC level, whereas 16 (23.5%) of the 68 hospitals had intermediate IPC levels. The hospitals’ median (IQR) IPCAF score was 668.8 (125.0) points. Workload, staffing and occupancy (CC7; median 70 points) and multimodal strategies (CC5; median 75 points) had the lowest scores. The limited number of nurses were the most important problems. Hospitals with a bed capacity of > 1000 beds had higher rates of HAIs. Certified IPC specialists, frequent feedback, and enough nurses reduced HAIs. The most common HAIs were central line-associated blood stream infections. Most HAIs were caused by gram negative bacteria, which have a high AMR. Conclusions Most HCFs had an advanced level of IPC implementation, for which staffing was an important driver. To further improve care quality and ensure everyone has access to safe care, it is a key element to have enough staff, the availability of certified IPC specialists, and frequent feedback. Although there is a significant decrease in HAI rates compared to previous years, HAI rates are still high and AMR is an important problem. Increasing nurses and reducing workload can prevent HAIs and AMR. Nationwide “Antibiotic Stewardship Programme” should be initiated.

Objectives: This study aimed to evaluate whether aspirin therapy is effective in protecting against hepatitis C virus (HCV) infection in maintenance hemodialysis patients, one of the high-risk groups for HCV infection. Materials and Methods: This retrospective cross-sectional study included 408 patients with end-stage renal failure who underwent maintenance hemodialysis for at least 3 months in four private hemodialysis units in Hatay, Turkey, in January 2017. The patients were classified into two groups according to their aspirin exposure status: non-users (n=228) and regular aspirin users (n=180). The proportion of patients with hemodialysis-related chronic hepatitis C (CHC) was compared between the groups. Irregular aspirin users, patients infected with HBV or diagnosed with CHC before initiation of hemodialysis therapy were excluded from the study. Results: The prevalence of hemodialysis-related CHC was 3.9% among the 408 patients. Hemodialysis-related CHC was not seen in any of the 180 regular aspirin users. Regular aspirin users showed a significantly lower prevalence of hemodialysis-related CHC than non-users (p<0.001). There was a significant (p<0.001), but weak (Cramer's V=0.180) correlation between hemodialysis-related CHC and aspirin exposure status. Conclusion: These results indicated that regular use of aspirin might be linked to a lower risk of hemodialysis-related CHC. However, further prospective studies are required to confirm this association.

ÖZHepatomegaly and steatosis are rare but potentially fatal side-effects of nucleoside analogues. Here, we present the case of development of hepatomegaly and steatosis in a 53-year-old male who had been treated with entecavir for five years. There were no symptoms of lactic acidosis. At three months after changing entecavir to tenofovir, the liver size returned to normal and maintained within the normal range during the 3-year follow-up. Therefore, it can be presumed that the hepatomegaly and steatosis were due to entecavir therapy.There are very few reports of hepatomegaly and steatosis caused by nucleoside analogues and the majority of the reported cases were associated with lactic acidosis. To the best of our knowledge, there are no previously reported cases of hepatomegaly and steatosis due to entecavir therapy without evidence of lactic acidosis. The aim of this clinical report was to point out a rare side-effect of entecavir and to share our treatment approach.

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