Araştırma Çıktıları

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Author: search.filters.author.Gunsar, Fulya

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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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    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.