Browsing by Author "Idilman, Ramazan"

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A micro-elimination approach to addressing hepatitis C in Turkey
(BMC, 2020-01-01) Idilman, Ramazan; Razavi, Homie; Robbins-Scott, Sarah; Akarca, Ulus Salih; Ormeci, Necati; Kaymakoglu, Sabahattin; Aygen, Bilgehan; Tozun, Nurdan; Guner, Rahmet; Bodur, Hurrem; Lazarus, Jeffrey V.
Background In 2016, WHO passed the Global Health Sector Strategy on Viral Hepatitis (GHSS), calling for its elimination by 2030. Two years later, Turkey approved a strategy to reach the WHO targets. This study reports new national prevalence data, breaks it down by subpopulation, and models scenarios to reach HCV elimination. Methods Literature was reviewed for estimates of HCV disease burden in Turkey. They were discussed with stakeholders and used as inputs to develop a disease burden model. The infected population was estimated by sequelae for the years 2015-2030. Three scenarios were developed to evaluate the disease burden in Turkey: a Base 2017 scenario, representing the current standard of care in Turkey
Eliminating Viral Hepatitis in Turkey: Achievements and Challenges
(GALENOS PUBL HOUSE, 2022-01-01) Akarca, Ulus Salih; Baykam, Nurcan; Guner, Rahmet; Gunsar, Fulya; Idilman, Ramazan; Kaymakoglu, Sabahattin; Koksal, Iftihar; Tabak, Fehmi; Yamazhan, Tansu
After the declaration Global Health Sector Strategy on Viral Hepatitis by the World Health Organization in 2016, the Turkish Government defined a national strategy covering 2018-2023 to reach goals by 2030. Following a participatory decision process and a series of workshops, the strategy was built on eight separate subheadings. Apart from the official Prevention and Control Program, two separate road maps for hepatitis B and C were developed to obtain targets accessible with the cooperation of the Viral Hepatitis Society and the Turkish Association for the Study of the Liver in 2018 and 2020, respectively. Up to 2023, achievements and the current situation of the National Viral Hepatitis Prevention and Control Program and the hepatitis B virus and hepatitis C virus road maps were assessed in detail on June 28th, 2022, by the subject matter experts in Turkey. Besides the officially reported achievement rate (42\%) of the Program in 2021, participants mentioned undesirable effects of the coronavirus disease-2019 pandemic, unregulated migration, low levels of professional and public awareness, and barriers to access to anti-viral treatment. Recommendations focused on increasing the efficiency of screening and surveillance by integrating the viral carrier identity of individuals into the national health information system, simplifying the drug supplement and treatment initiation process and insisting on education to raise awareness.
Real-world efficacy and safety of Ledipasvir plus Sofosbuvir and Ombitasvir/Paritaprevir/Ritonavir +/- Dasabuvir combination therapies for chronic hepatitis C: A Turkish experience
(AVES, 2020-01-01) Degertekin, Bulent; Demir, Mehmet; Akarca, Ulus S.; Kani, Haluk Tarik; Ucbilek, Enver; Yildirim, Emre; Guzelbulut, Fatih; Balkan, Ayhan; Vatansever, Sezgin; Danis, Nilay; Demircan, Melek; Soylu, Aliye; Yaras, Serkan; Kartal, Aysun; Kefeli, Ayse; Gunduz, Feyza; Yalcin, Kendal; Erarslan, Elife; Aladag, Murat; Harputluoglu, Murat; Ozakyol, Aysegul; Temel, Tuncer; Akarsu, Mesut; Sumer, Hale; Akin, Mete; Albayrak, Bulent; Sen, Ilker; Alkim, Huseyin; Uyanikoglu, Ahmet; Irak, Kader; Oztaskin, Sinem; Ugurlu, Cagri Burak; Gunes, Sevkican; Gurel, Selim; Nuriyev, Kenan; Inci, Ismail; Kacar, Sabite; Dincer, Dinc; Doganay, Levent; Gokturk, Huseyin Savas; Mert, Ali; Cosar, Arif Mansur; Dursun, Hakan; Atalay, Roni; Akbulut, Sabiye; Balkan, Yasemin; Koklu, Hayrettin; Simsek, Halis; Ozdogan, Osman; Coban, Mehmet; Poturoglu, Sule; Ayyildiz, Talat; Yapali, Suna; Gunsar, Fulya; Akdogan, Meral; Ozenirler, Seren; Akyildiz, Murat; Sezgin, Orhan; Ozdogan, Osman; Kaymakoglu, Sabahattin; Besisik, Fatih; Karasu, Zeki; Idilman, Ramazan; Inter, T.A.S.L. Viral Hepatitis Special
Background/Aims: This study aimed to evaluate the real-life efficacy and tolerability of direct-acting antiviral treatments for patients with chronic hepatitis C (CHC) with/without cirrhosis in the Turkish population. Material and Methods: A total of 4,352 patients with CHC from 36 different institutions in Turkey were enrolled. They received ledipasvir (LDV) and sofosbuvir (SOF)+/- ribavirin (RBV) ombitasvir/paritaprevir/ritonavir +/- dasabuvir (PrOD)+/- RBV for 12 or 24 weeks. Sustained virologic response (SVR) rates, factors affecting SVR, safety profile, and hepatocellular cancer (HCC) occurrence were analyzed. Results: SVR12 was achieved in 92.8\% of the patients (4,040/4,352) according to intention-to-treat and in 98.3\% of the patients (4,040/4,108) according to per-protocol analysis. The SVR12 rates were similar between the treatment regimens (97.2\%-100\%) and genotypes (95.6\%-100\%). Patients achieving SVR showed a significant decrease in the mean serum alanine transaminase (ALT) levels (50.90 +/- 54.60 U/L to 17.00 +/- 14.50 U/L) and model for end-stage liver disease (MELD) scores (7.51 +/- 4.54 to 7.32 +/- 3.40) (p<0.05). Of the patients, 2 were diagnosed with HCC during the treatment and 14 were diagnosed with HCC 37.0 +/- 16.0 weeks post-treatment. Higher initial MELD score (odds ratio {[}OR]: 1.92, 95\% confidence interval {[}CI]: 1.22-2.38
SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis
(ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2022-01-01) Efe, Cumali; Tascilar, Koray; Gerussi, Alessio; Bolis, Francesca; Lammert, Craig; Ebik, Berat; Stattermayer, Albert Friedrich; Cengiz, Mustafa; Gokce, Dilara Turan; Cristoferi, Laura; Peralta, Mirta; Massoumi, Hatef; Montes, Pedro; Cerda, Eira; Rigamonti, Cristina; Yapali, Suna; Adali, Gupse; Caliskan, Ali Riza; Balaban, Yasemin; Eren, Fatih; Eskazan, Tugce; Barutcu, Sezgin; Lytvyak, Ellina; Zazueta, Godolfino Miranda; Kayhan, Meral Akdogan; Heurgue-Berlot, Alexandra; De Martin, Eleonora; Yavuz, Ahmet; Biyik, Murat; Narro, Graciela Castro; Duman, Serkan; Hernandez, Nelia; Gatselis, Nikolaos K.; Aguirre, Jonathan; Idilman, Ramazan; Silva, Marcelo; Mendizabal, Manuel; Atay, Kadri; Guzelbulut, Fatih; Dhanasekaran, Renumathy; Montano-Loza, Aldo J.; Dalekos, George N.; Ridruejo, Ezequiel; Invernizzi, Pietro; Wahlin, Staffan
Background: Data regarding outcome of Coronavirus disease 2019 (COVID-19) in vaccinated patients with autoimmune hepatitis (AIH) are lacking. We evaluated the outcome of COVID-19 in AIH patients who received at least one dose of Pfizer- BioNTech (BNT162b2), Moderna (mRNA-1273) or AstraZeneca (ChAdOx1-S) vaccine. Patients and methods: We performed a retrospective study on AIH patients with COVID-19. The outcomes of AIH patients who had acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infection after at least one dose of COVID-19 vaccine were compared to unvaccinated patients with AIH. COVID-19 outcome was classified according to clinical state during the disease course as: (i) no hospitalization, (ii) hospitalization without oxygen supplementation, (iii) hospitalization with oxygen supplementation by nasal cannula or mask, (iv) intensive care unit (ICU) admission with non-invasive mechanical ventilation, (v) ICU admission with invasive mechanical ventilation or (vi) death, and data was analyzed using ordinal logistic regression. Results: We included 413 (258 unvaccinated and 155 vaccinated) patients (81\%, female) with a median age of 52 (range: 17-85) years at COVID-19 diagnosis. The rates of hospitalization were (36.4\% vs. 14.2\%), need for any supplemental oxygen (29.5\% vs. 9\%) and mortality (7\% vs. 0.6\%) in unvaccinated and vaccinated AIH patients with COVID-19. Having received at least one dose of SARS-CoV-2 vaccine was associated with a significantly lower risk of worse COVID-19 severity, after adjusting for age, sex, comorbidities and presence of cirrhosis (adjusted odds ratio {[}aOR] 0.18, 95\% confidence interval {[}CI], 0.10-0.31). Overall, vaccination against SARSCoV-2 was associated with a significantly lower risk of mortality from COVID-19 (aOR 0.20, 95\% CI 0.11-0.35). Conclusions: SARS-CoV-2 vaccination significantly reduced the risk of COVID-19 severity and mortality in patients with AIH.