Explore the vast range of titles available.

Tuberculosis (TB) is one of the most common opportunistic infections in people living with HIV (PLHIV). Mycobacterium tuberculosis may cause more TB in all stages of HIV infection than in the general population, with the incidence of TB and the spread of pulmonary TB to other organs increasing as the CD4 count decreases. In this HIV cohort study, we aimed to evaluate the clinical features, diagnosis, and prognosis of TB among PLHIV in Türkiye. We conducted a retrospective cohort study to analyze clinical outcomes and identify determinants of mortality among people living with HIV (PLHIV) co-infected with tuberculosis. We included 264 patients diagnosed and treated for TB across six centers in Türkiye. We extracted clinical, demographic, laboratory, microbiological, and radiological data from patient medical records. To identify independent predictors of mortality, we performed multivariable logistic regression and reported the results as odds ratios (ORs) with 95% confidence intervals (CIs). Of the 9,687 PLHIV who were followed for 10 years, 2.7% (264 individuals) developed TB. The median age of these individuals was 40 years, and 89% were male. The prevalence of pulmonary TB only, extrapulmonary TB only, and the coexistence of pulmonary and extrapulmonary TB were 42.4%, 48.8%, and 8.7%, respectively. Opportunistic infections and cancers were found in 23% (62 out of 264) of patients with HIV/TB co-infection. Among patients with HIV/TB co-infection, 42% showed lymphadenopathy, with 70% of these cases being generalized. In patients who underwent chest CT scans (n=200), radiological patterns revealed post primary TB in 46%, primary TB in 36%, and miliary TB in 18%. The positivity rates of Ehrlich-Ziehl-Neelsen staining (EZN), polymerase chain reaction (PCR), and TB cultures in clinical samples were found to be 47.5%, 72.5%, and 53%, respectively. Most of our patients (95%) were given the standard TB treatment regimen (HRZE), with a paradoxical reaction observed in 11.6% of cases and hepatotoxicity occurring in 18% of cases. Age, CD4 count (<200 cells/mm3-late presenters), and thrombocytopenia were identified as independent risk factors for mortality in the 58 patients (22%) who died after diagnosis. Even today, more than one fifth of patients with HIV-TB co-infection in our cohort died. Mortality was higher among individuals who presented late with tuberculosis disease, especially those with advanced immunosuppression (CD4 <200 cells/μL). These findings underscore the urgent need for early HIV diagnosis and systematic TB screening to reduce co-infection-related mortality and improve clinical outcomes.

Human immunodeficiency virus (HIV) is still a challenge for children. About 15 to 45% of the HIV positive pregnant women can transmit the virus to their children during pregnancy, delivery and/or breastfeeding. The risk of transmission can be decreased my several measures. In this study, we aimed to determine the factors associated with HIV infection among children born to mothers. We performed a ten-year retrospective cohort study in five dedicated HIV centers. The 325 women in our cohort were between the ages of 18 and 45. During study period, 44 of these women (13.5%) gave birth. 51 infants were born to 44 mothers living with HIV/AIDS. During the study period, 7 out of 51 infants (13.7%) born to mothers living with HIV/AIDS were HIV-positive. Among the factors studied, breastfeeding, having a HIV-positive sibling and being on antiretroviral treatment during pregnancy and detectable HIV-RNA during delivery were found statistically significant. A multivariable logistic regression analysis showed that being on antiretroviral treatment during pregnancy is the most important predictor of mother-to-child transmission. We concluded that mother-to-child transmission (MTCT) is still a considerable way of HIV transmission in Turkey. The key factors to decrease MTCT seem detecting HIV-positive mothers, initiating antiretroviral therapy, and counseling mothers to sustain their adherence.

Introduction: This study aimed to investigate the prevalence of Coronavirus disease-2019 (COVID-19) infection among healthcare workers in our hospital with the risk factors affecting the transmission and course of the disease and to determine the control measures. Methods: Medical records of healthcare workers diagnosed with COVID-19, confirmed by polymerase chain reaction (PCR) between 11 March and 30 April 2020, were retrospectively analyzed in our hospital in the center of İstanbul, the city with the highest number of cases in our country. Realtime PCR detection was used to verify the diagnosis of the healthcare workers. A rapid diagnostic test kit for COVID-19 immunoglobulin M (IgM) and IgG antibodies was used in seroconversion analysis. Results: In our hospital, 4,177 COVID-19 cases confirmed by the laboratory between March 11 and April 30 2020 were followed. Of the 4177 cases, 165 (3.95%) were healthcare workers. The majority of healthcare workers with positive test results were nurses (36.3%), and 118 (71.5%) of the healthcare workers worked 40 h or more per week. Thoracic tomography examinations were performed in all infected healthcare workers, and 69 (41.8%) were diagnosed with pneumonia by the detection of ground patchy lesions. Conclusion: During the epidemic, early training of healthcare workers on the disease, use of personal protective equipment, and infection control are extremely important to reduce the risk of infection among healthcare workers. Periodic screening of asymptomatic healthcare workers can also help protect patients and hospital staff and prevent loss of workforce.

Toxoplasmosis is a common opportunistic infection in patients with HIV/AIDS and may cause life-threatening clinical courses, such as encephalitis and pneumonia. Patients admitted between January 2006 and August 2017 with anti-HIV positivity confirmed by Western blotting were included in the study. Demographic data, CD4+ T-lymphocyte counts, and Toxoplasma gondii IgG/IgM levels were retrospectively obtained from patient records. T. gondii IgM positivity was not detected in patients, whereas T. gondii IgG positivity was detected in 267 (43.5%) patients. The T. gondii IgG positivity rate was 37.6% in men who had sex with men (MSM) and 48.4% in heterosexual patients. Furthermore, 42.6% of MSM and 21% of heterosexual patients were university graduates, of which T. gondii IgG positivity was detected in only 33.6% of MSM patients and 42.3% of heterosexual patients. In our study, high seronegativity was remarkable in MSM patients, particularly those who were highly educated, thus emphasizing the importance of prevention of primary infection in seronegative patients; necessity of prophylaxis in appropriate patients due to encephalitis, which has a high mortality rate and almost always develops after a latent infection; and necessity of screening for toxoplasmosis seropositivity at the time of diagnosis.

Data on syphilis seroprevalence among human immunodeficiency virus (HIV)/Acquired immunodeficiency syndrome (AIDS) patients are unavailable in Turkey although they have common transmission routes. Our study is oriented towards the assessment of the seroprevalence of syphilis and the related risk factors in the HIV/AIDS patients followed in our outpatient clinic. Newly diagnosed HIV/AIDS cases (n = 308) who attended our outpatient clinic between January 2006 and April 2013 were included in the study. Patient characteristics, medical history, physical examination findings, CD4+ T lymphocyte count, HIV RNA level, rapid plasma reagent (RPR) and Treponema pallidum hemagglutination (TPHA) test results were analyzed retrospectively. TPHA positivity was considered indicative of syphilis-causing T pallidum exposure. HIV infection was transmitted through heterosexual (n = 176) or homosexual (n =131) contact (266 male, 86.3%; age 38.3 ± 11.7 years; CD4+ T lymphocyte count, 330.6 ± 15.17/mm3). 50.7% of the patients attained only primary education. Out of the 245 cases, who were asked about the number of their sexual partners, 40 patients (26 women) lived in a monogamous relationship. Condom usage was not practiced (57.2%) or was only occasional (34.4% - particularly with their legal spouses and for contraception). Physical exam revealed no signs of syphilis or other STIs. TPHA (+/- RPR) positivity was determined in 40 patients (12.9%), indicating T pallidum exposure. All patients with positive syphilis serology were male (p= 0.0026). T pallidum exposure was determined in 21.3% of homosexual and 6.8% of heterosexual cases (p = 0.0003). Since sexual contact is the most common route of transmission for both infections, syphilis seroprevalence was relatively high in our HIV/AIDS patients. Male and homosexual HIV/AIDS patients constituted a group at the highest risk for syphilis.

Introduction: This study was planned to understand the continuity of the follow-up and treatment of people newly diagnosed with HIV infection during the COVID-19 pandemic. We compared the pre-pandemic to the pandemic period, focusing on factors such as diagnosis, accessing treatment, staying on treatment, and viral suppression, as the pandemic had the potential to disrupt HIV care. Methodology: The one-year follow-up data of patients diagnosed in 2018 (pre-pandemic era) and 2020 (pandemic era) were compared. Each patient’s age, gender, employment and educational status, sexual orientation, comorbidities, quantitative HIV RNA levels (qRT-PCR), and CD4+ cell counts during outpatient follow-up visits, regular use of the treatment, and regular visits to the outpatient clinic were investigated retrospectively. Results: We had 192 new patients during the pre-pandemic period in 2018 (Group A) and 118 new patients during the pandemic in 2020 (Group B). There was no difference between the two groups regarding patient age and gender. The number of newly diagnosed HIV patients during the pandemic period decreased compared to the previous period (p < 0.001). Compliance with treatment rates was similar in both periods. There was no statistical difference in HIV RNA between the two groups after one year of treatment. Conclusions: The COVID-19 pandemic has had the potential to disrupt the continuity of HIV care among individuals. Although the COVID pandemic had a statistically significant effect on attendance at HIV care programs, treatment compliance was not impaired due to rapid action on drug supply and correct policy implementation during the pandemic.

Objectives: The study aimed to investigate the seroprevalence of hepatitis B surface antigen (HBsAg) and hepatitis C virus (anti- HCV) in human immunodeficiency virus (HIV) infected patients and to evaluate the results according to risk factors in our hospital in İstanbul, which was one of the centers where HIV-infected patients were followed up the most in our country. Materials and Methods: The medical files of 611 HIV-infected patients who were followed up in our infectious diseases and clinical microbiology outpatient clinic between 1999 and 2016, were analyzed to determine the seroprevalence of HBsAg and anti-HCV retrospectively. HIV-monoinfected patients, HIV+HBV-coinfected patients, and HIV+HCV-coinfected patients were examined separately in terms of demographic characteristics and risk factors, and compared with each other. Results: Of the patients 86.6% were male. The mean age of the patients was 37.0±11.2 (16-83). More than one-third of patients were 30-39 years old. Of the patients 43.7% were men who had sex with men (MSM). Of the patients, 5.8% were HBsAg-positive and 14.7% (236) of patients were positive for isolated anti-HBc IgG. The HBV-DNA positivity ratio was determined as 8.7% in the isolated anti-HBc IgG positive group. Of the patients 2% were anti-HCV positive, and 0.9% were HCV-RNA positive. The prevalence of HIV/ HCV coinfection was statistically significantly higher in intravenous (IV) drug users than HIV-monoinfected patients (p<0.001). Conclusion: It is not sufficient to evaluate HBsAg alone in HIVinfected individuals. Anti-HBc IgG and HBV-DNA should also be evaluated. Anti-HCV antibody must be tested especially in patients with IV drug addiction.

This study aimed to describe the epidemiological and clinical features of patients admitted to non-intensive care hospital wards due to Staphylococcus aureus bacteremia (SAB) and to identify predictors of mortality to improve patient outcomes. This single-center retrospective study included hospitalized patients with SAB between 2016 and 2024. We retrieved clinical and microbiological data retrospectively from the electronic medical record system. The research comprised 356 patients with SAB. The 30-day and in-hospital mortality rates were 7.3% ( n  = 26) and 9.8% ( n  = 35), respectively. The multivariate analysis revealed neutrophil-to-lymphocyte ratio (NLR) (HR = 1.08; 95% CI = 1.02–1.13; p  = 0.002), CRP (HR = 1.01; 95% CI = 1-1.02 ; p  = 0.04), and albumin (HR = 0.83; 95% CI = 0.73-0.95; p  = 0.008) as predictors for 30-day mortality. Pneumonia (HR = 15.03; 95% CI = 2.05–109.71; p  = 0.008), leukemia (HR = 28.72; 95% CI = 1.56-525.92; p  = 0.002), and sepsis (HR = 7.06; 95% CI = 1.02–48.53; p  = 0.002) were identified as significant risk factors for mortality. Using the Cox regression analysis, age (HR: 1.05, CI:1.01–1.10, p  = 0.01), leukemia (HR: 0.80, CI:0.71–0.90, p  < 0.001), and low albumin level (HR: 11.76; CI:1.76–78.42, p  = 0.01) were identified as independent risk factors affecting in-hospital mortality. We used the receiver operating characteristic (ROC) curve to predict the30-day mortality. The area under the ROC curve values were 0.619 ( p  = 0.044) for NLR, 0.692 ( p  = 0.001) for CRP, and 0.791 ( p  < 0.001) for albumin. The highest sensitivity and specificity at 30-day mortality were obtained from CRP and albumin, with a sensitivity of 65.4% and a specificity of 78.5% for albumin. Elevated NLR and CRP levels, along with decreased albumin levels, may predict poor clinical outcomes and could assist clinicians in optimizing the management of this bacterial infection. As a result, early diagnosis and appropriate antibiotic treatments are crucial in reducing mortality in SAB.

Objective Coronavirus disease 2019 (COVID-19) causes a wide spectrum of symptoms, from asymptomatic conditions to severe inflammatory response. Hemodialysis (HD) patients have a higher risk for developing severe COVID-19 because of older age, multiple co-morbid conditions, and impaired immune system compared to the general population. As little is known about these special groups, we evaluated the clinical characteristics and outcomes of HD patients with COVID-19. Methods All hospitalized HD patients with COVID 19 between March 11, 2020 and May 31, 2020 were included in the study. The composite end-points consisted of admission to the intensive care unit (ICU), discharging or death were analysed. Demographic, clinical, laboratory, and treatment data were retrieved and compared between survivors and nonsurvivors. Results A total of 45 patients (median age 65.33 ± 12.22, 24 female, 53.96 ± 40.68) were enrolled and of whom 14 were admitted to ICU and overall 14 (31.1%) have died. Hypertension was the most common comorbidity and fever (60%), dyspnea (55.6%) and cough (53.3%) were predominant symptoms at admission. 8.8% of patients developed severe complications (acute respiratory distress syndrome, macrophage activation syndrome) and secondary infection was observed in 51.1% of the patients. Elevation in the level of inflammatory markers, lactate dehydrogenase, liver enzymes, troponin, creatine kinase, and decrease in lymphocyte count and serum albumin level were observed in non-survivors compared with survivors throughout the clinical course. No significant difference was observed in the score of chest CT performed on the day of hospitalization for the survivors and non-survivors. Conclusion Mortality of COVID-19 in HD patients is high and follow up of certain laboratory parameters can help to predict the prognosis of the patients.

Introduction: In this study, we aimed to compare the HBV seroprevalances of voluntary blood donors and the healthy persons who required premarital screening. Methodology: HBsAg ELISA results were collected retrospectively from the records of 9,949 blood donors and 954 healthy persons who required premarital screening. Results: HBsAg was detected in 182 of  9,949 (%1.8)  voluntary blood donors and  32 of  954 (%3.4)  healthy persons who required premarital screening. HBsAg seropositivity was significiantly higher in the healthy persons who required premarital screening than in blood donors (p = 0.0016). Conclusion: Premarital screening is mandatory in our country, and it may provide more accurate epidemiological data to determine HBV seroprevalence than in other selected groups such as blood donors.