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    Investigation of hepatitis B virus prevalence and reactivation frequency in malignancy patients administering chemotherapy
    (2021) Cengiz, Muhammet; Seckin, Yuksel; Cagin, Yasir; Nuransoy Cengiz, Ayse
    Aim: This study aimed to investigate the frequency at which physicians test hepatitis B virus (HBV) serology before treatment and the rate of hepatitis B virus reactivation (HBVr) after treatment in patients undergoing chemotherapy (CT) due to a solid organ malignancy (SOM) or hematological malignancy (HM). Materials and Methods: Baseline clinical feature, HBV serology, and liver function test data for 1275 patients ≥ 18 years of age who underwent CT for the first time due to various SOMs and HMs from 2015-2017 were obtained from the database and retrospectively analyzed. HBV serology was studied in 296 (201 HM, 95 SOM) of the 1275 patients retrieved from the database. Results: The prevalence of HBV was 9.5% (121 patients). Only 49 (40.4%) HBV-positive patients had HBV DNA. Of those, 72 (59.5%) underwent prophylactic antiviral therapy. HBVr was detected in only 3 patients (1.5%), and all of those patients had HMs and were recommended oral antiviral therapy but did not. Conclusion: In patients with SOMs, the screening rates of HBV serology, as well as prophylaxis and follow-up HMs were extremely low. Therefore, these patients should be screened for HBV serology and prophylactic treatment should be given when necessary for HBVr.
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    Therapeutic Effects of Plasmapheresis on Acute Exacerbations of Chronic Hepatitis B Infection
    (Springernature, 2021) Bilgic, Yilmaz; Akbulut, Sami; Cengiz, Ayse; Sarici, Ahmet; Cagin, Yasir; Harputluoglu, Murat
    Objective In this study, we aimed to demonstrate the effectiveness of plasmapheresis therapy in patients with acute exacerbation of chronic Hepatitis B (CHB) infection. Methods We selected 48 patients with acute exacerbation of CHB infection who were treated by plasmapheresis in our intensive care unit between 2009 and 2016. The patients' demographic characteristics and biochemical and hematological parameters, which were recorded before and after plasmapheresis, were assessed, and the effect of plasmapheresis on the course of patients' treatment was examined. The patients were also divided into three groups according to their clinical course (discharged: 24; transplanted: six; exitus: eight). The patients were further divided into four groups and compared based on the underlying causes that led to the exacerbation (spontaneous exacerbation: 25; caused by immunosuppressive drugs: nine; hepatotoxic drugs: six; other agents: eight). Results We observed significant improvements in terms of international normalized ratio (INR), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), total bilirubin, direct bilirubin, blood urea nitrogen (BUN), ammonia, and the Model for End-Stage Liver Disease (MELD) score after plasmapheresis therapy. However, there was no significant improvement in hemoglobin (Hb), white blood cell (WBC) count, platelets, albumin, and lactate values. Also, INR, ALP, and ALT values were found to be significantly correlated with transplants and exitus in patients. Conclusion Plasmapheresis therapy is a reliable treatment method that provides clinical recovery and improvement in laboratory parameters in patients with exacerbation of CHB infection.