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    Evaluation of 2015-2016 MOTAKK HBV DNA and HCV RNA External Quality Assessment National Program Results
    (Ankara Microbiology Soc, 2018) Karatayli, Ersin; Soydemir, Ege; Aksoy, Zeynep Busra; Kizilpinar, Mehtap; Altay Kocak, Aylin; Karatayli, Senem Ceren; Yurdcu, Esra; Yildirim, Umut; Guriz, Haluk; Bozdayi, Gulendam; Yurdaydin, Cihan; Ilhan, Osman; Yildirim, Yasin; Bozdayi, A. Mithat; Oguz, Acelya Yalcintas; Baris, Ahmet; Alp, Alpaslan; Aksozek, Alper; Sayiner, Arzu; Karagul, Aydan; Ordu, Aylin; Istanbullu, Aye; Otlu, Baris; Aridogan, Buket; Aksu, Burak; Buruk, C. Kurtulus; Karahan, Ceren; Guney, Cakir; Toksoz, Devrim; Yildirim, Dilara; Colak, Dilek; Daglar, Duygu Eren; Findik, Duygu; Kas, Elif; Caliskan, Emel; Zeyrek, Fadile Yildiz; Arslan, Fatma; Demir, Feyza; Milletli, Fikriye; Kibar, Filiz; Ozdincer, Furkan; Dundar, Gulnur; Arslan, Hande; Agca, Harun; Aliskan, Hikmet Eda; Guducuoglu, Huseyin; Fidan, Isil; Akyar, Isin; Afsar, Ilhan; Kaleli, Ilknur; Donmez, Ismail; Yanik, Kemalettin; Midilli, Kenan; Cubukcu, Kivanc; Ozdemir, Mehmet; Acar, Melek; Yalinay, Meltem; Kuskucu, Mert Ahmet; Bakici, Mustafa Zahir; Aydin, Neriman; Yilmaz, Neziha; Ceken, Nihan; Ziyade, Nihan; Yilmaz, Nisel; Ozgumus, Osman Birol; Gitmisoglu, Ozlem; Demirgan, Recep; Kesli, Recep; Guckan, Ridvan; Sertoz, Ruchan; Akgun, Sadik; Aksaray, Sebahat; Tezcan, Seda; Kaygusuz, Sedat; Gokahmetoglu, Selma; Mese, Sevim; Bayik, Seyit Ahmet; Akcali, Sinem; Gurcan, Saban; Karsligil, Tekin; Us, Tercan; Ozekinci, Tuncer; Pilgir, Tulin; Aslan, Ugur; Dinc, Ugur; Coskun, Umut Safiye Say; Cetinkol, Yeliz; Keskin, Yusuf; Ayaydin, Zeynep; Toraman, Zulal Asci
    MOTAKK, as a national external quality control program has been launched to evaluate the molecular detection of viral infections including HBV DNA and HCV RNA in molecular microbiology diagnostic laboratories in Turkey. This program is prepared in compliance with ISO 17043:2010 (Conformity assessment general requirements for proficiency testing) standards, and aims to take the place of external quality control programs from abroad, contributing to standardization and accuracy of molecular diagnostic tests in our country. The aim of this study was to evaluate 2015 and 2016 results of the MOTAKK External Quality Control Program for HBV DNA and HCV RNA viral load. The calls were announced on the web page of MOTAKK (www.motakk.org). The quality control samples were sent to participating laboratories in 2015 and 2016. Main stocks were prepared from patients with chronic hepatitis B and C who had viral load detection with reference methods according to WHO reference materials for viral load studies to improve quality control sera. From these main stocks, samples with different viral loads were prepared from dilutions of plasma with HBV, HCV, HAV, HIV, Parvovirus B19 and CMV negative serologic markers. Quality control samples were sent to the participating laboratories along with the negative samples in the cold chain. The laboratories accomplished the related tests within 2-3 weeks and entered their results on the MOTAKK web page. These results were analysed according to ISO 13528 (Statistical methods for use in proficiency testing by interlaboratory comparison) and scoring reports were created by a software developed by MOTAKK and sent to participating labs. Each laboratory evaluated their own results in comparison with the other laboratory results, reassessed the tests via observing the distance from the mean result and the reference values. The number of laboratories participating in the HBV DNA and HCV RNA external quality control program was 70-73 in 2015-2016. Participants were able to comply with the program tools, registering, entering results and receiving the results reports problem. In HBV panel, 72.6-89.1% and 84.7-90.3% of the participant laboratories were in 1 standard deviation (SD) in 2015-2016, respectively. In HCV panel, 70.8-89.1% and 84.7-90.3% of the participant laboratories were in 1 SD in 2015-2016, respectively. A national external quality control program for HBV DNA and HCV RNA in Turkey has been prepared for the first time with this project and implemented successfully. All the data provided in the MOTAKK external quality control program final report, compensate all the data provided by the quality control program final reports from abroad; additionally, the report allows comparison of used technologies and commercial products.
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    Hepatitis E Infection in Solid Organ Transplant Recipients in Turkey
    (Aves, 2022) Ogut, Seval; Sayiner, Ayca Arzu; Otlu, Baris; Bozdayi, Gulendam; Zeytinoglu, Aysin; Aksaray, Sebahat; Colak, Dilek
    Background: Hepatitis E virus is a re-emerging pathogen with an increase in human cases that can lead to chronic infection in immunosuppressed patients. Turkey is located between Asia and Europe, 2 regions with distinct epidemiological and clinical features of hepatitis E virus infection. This multicenter cross-sectional study aimed to investigate the prevalence of hepatitis E virus infection in liver and kidney transplant recipients in Turkey and to determine the role of possible transmission factors. Methods: A total of 485 plasma samples of solid organ recipients were collected from 7 transplantation centers in Turkey. Samples were tested for anti-hepatitis E virus immunoglobin M, immunoglobin G, and hepatitis E virus ribonucleic acid. Water- and food-related risk factors were evaluated by a questionnaire. Results: Samples of 300 kidney and 185 liver recipients were collected. Hepatitis E virus ribonucleic acid was tested in 472 samples and none were positive. Anti-hepatitis E virus immunoglobin G and immunoglobin M were detected in 84 (17.3%) and 3 (0.6%) patients, respectively. Seropositivity was associated with older age, male gender, being a liver recipient, and being infected with hepatitis B virus and/or hepatitis C virus. None of the patients under the age of 30 were seropositive. Hepatitis E virus immunoglobin G prevalence was higher in the Central East and Southeast Anatolia. Eating raw meat was the only independent variable associated with hepatitis E virus seropositivity. Conclusion: This is the first prevalence study of hepatitis E virus infection in solid organ recipients in Turkey. Anti-hepatitis E virus immunoglobin G prevalence was 17.3% which was higher than the previously reported rate in blood donors. Seropositivity was significantly higher in liver recipients. Despite the high antibody prevalence, none of the patients were viremic.
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    The Prevalence of Mixed Genotype Infections in Turkish Patients with Hepatitis C: a Multicentered Assessment
    (Clin Lab Publ, 2019) Kulah, Canan; Altindis, Mustafa; Akyar, Isin; Gokahmetoglu, Selma; Sayiner, Arzu; Kaleli, Ilknur; Fidan, Isil; Altuglu, Imre; Aydin, Faruk; Topkaya, Aynur; Us, Tercan; Findik, Duygu; Ozdemir, Mehmet; Ozturk, Elif; Ulger, Seda Tezcan; Karsligil, Tekin; Cekin, Yesim; Aksaray, Sebahat; Uzunoglu, Emel; Aktas, Osman; Uslu, Hakan; Cetinkol, Yeliz; Gureser, Ayse Semra; Ece, Gulfem; Toptan, Hande; Koroglu, Mehmet; Comert, Fusun
    Background: HCV virus infections are one of the major health problems in the world that can cause cirrhosis and liver cancer at a higher rate than other hepatitis data. The aim of this study was to determine the prevalence of mixed infections with different HCV genotypes in Turkey and also to evaluate the current HCV genot pe and subtype distributions by a multicentered assessment. Methods: The HCV genotype data of 17,578 hepatitis C patients collected from 23 centers from different geographic regions covering all Turkey were collected. The data included information about the HCV genotypes in the last 10 years (bail een 2007 and 2016), demographic properties of the patients and the methods/systems used to determine the genotypes. Results: Two hundred twenty-eight of the patients (1.3%) had mixed genotype. The most common mixed genotype combination was 1b + 4 (0.83%) followed by 1a + 1b (0.26%). Genotype distribution varies according to geographical regions. However, genotype 1 (82.92%) was the most common genotype in all regions and all years. This was followed by genotype 3 (7.07%) and genotype 4 (5.43%). A variety of methods were used by the centers including sequencing, pyrosequencing, real-time PCR, in-house RFLP, reverse hybridization (LIPA), and hybridization. Conclusions: Infection with mixed HCV genotypes in Turkey is uncommon. Genotype distribution varies according to geographic regions; the most common genotype 1 is encountered all oN er the country, while genotypes 3 and 4 are only in some of the centers. Since there is limited information about mixed HCV infection, further investigations are needed to determine the clinical importance of mixed HCV infection.