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    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
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    Prognostic factors in patients with advanced extrahepatic cholangiocarcinoma A single center experience
    (LIPPINCOTT WILLIAMS \& WILKINS, 2019-01-01) Aktas, Gokmen; Kus, Tulay; Balkan, Ayhan; Metin, Taylan; Gulsen, Murat Taner; Abali, Huseyin
    Extrahepatic cholangiocarcinoma (ECC) is an aggressive malignancy causing a lot of fatalities and comorbidities. Endoscopic biliary stenting (EBS) is mostly needed for ECC. In this study, we aimed to investigate the prognostic factors for the overall survival (OS) and the factors predicting the patients eligible for chemotherapy after EBS in ECC. We retrospectively screened 153 advanced ECC patients who underwent EBS for jaundice to make the patients eligible for chemotherapy. Patient's clinical and laboratory parameters were recorded. OS was estimated by the Kaplan-Meier method. All parameters were assessed by binary logistic regression analysis to predict which patients are eligible for chemotherapy. The median OS of all patients was 12.0 months (10.1-13.8). The median OS of the patients treated with chemotherapy was 13.0 months (12.0-14.0), while it was 4.0 months (2.3-5.7) for patients unable for chemotherapy after EBS. Albumin, aspartate aminotransferase (ALT) and carbohydrate antigen 19-9 (CA 19-9) values were independent prognostic factors for OS. Higher albumin and lower prothrombin time (PT) levels were independent parameters to predict the patients eligible for chemotherapy after EBS. Being suitable for chemotherapy was the main determinant for prolonged survival and albumin and PT levels were independent predictors for chemotherapy eligibility after EBS. Albumin, ALT, and CA 19-9 values were independent prognostic factors for OS in ECC.