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    Clinical significance of basal core promoter and precore mutations in chronic hepatitis B
    (H G E Update Medical Publishing S A, 2007) Ozgenc, O.; Ozacar, T.; Erensoy, S.; Inan, N.; Ari, A.; Kuruuzum, Z.; Bilgic, A.
    Background/Aims: The mutations in the basal core promoter and precore region of hepatitis B virus genome in hepatitis B e antigen-positive and -negative chronic hepatitis B patients have been described. The reports about their prevalence and clinical significance in the Mediterranean region where D is the predominant genotype, are very limited. Methodology: The serum samples were collected from 44 naive chronic hepatitis B patients. For detection of the mutations basal core promoter and precore regions of HBV genome were amplified and sequenced. Results: All samples were determined as genotype D. Before initiation of treatment basal core promoter mutations were found as 55% (11/20) and 46% (11/24) in HBeAg-positive and -negative patients, respectively (p > 0.5). HBeAg-negative samples were associated with precore mutations (G1896(A) and G1899(A)). Three of 20 (15%) patients of HBeAg-positive and seven of 24 (29%) of HBeAg-negative populations showed sustained response to therapy at the 24th month of initiation. Conclusions: The presence of precore stop codon mutant in those with sustained response was 89%, overall at the end of therapy. At initiation of therapy basal core promoter mutations were more common in non-responders than responders (65% vs. 20%; p < 0.001). While 23% of cases totally showing sustained response, absence of mutations in the basal core promoter region of hepatitis B virus genotype D may be related to sustained response in patients with chronic hepatitis B.
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    Lamivudine monoprophylaxis prevents HBV infection in recipients undergoing live donor liver transplantation because of non-HBV related diseases, having their grafts from core-antibody positive donors
    (Elsevier Science Bv, 2007) Karasu, Z.; Akyildiz, M.; Ozacar, T.; Yilmaz, F.; Akarca, U. S.; Ersoz, G.; Gunsar, F.; Aydin, U.; Kilic, M.; Ilter, T.
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    Living donor liver transplantation from hepatitis B core antibody positive donors
    (Elsevier Science Inc, 2007) Kobak, A. Celebi; Karasu, Z.; Kilic, M.; Ozacar, T.; Tekin, F.; Gunsar, F.; Ersoz, G.; Yuzer, Y.; Tokat, Y.
    Liver allografts from donors previously exposed to hepatitis B virus (HBV) carry the risk of transmission of HBV infection to immunosuppressed recipients. However, exclusion of donor candidates with the serologic evidence of resolved hepatitis B-HBV surface antigen (HbsAg) negative and HBV core antibody (anti-HBc) positive-is not feasible in countries endemic for HBV. Aim. Our aim was to assess the safety of living donor liver transplantation from anti-HBc positive donors. Materials and Methods. In our institution, 152 transplants were performed between June 1999 and April 2004. Fifty-six (37%) of the living donors were anti-HBc positive. Twenty of these liver grafts were transplanted to HbsAg-negative recipients. We excluded four HBsAg negative recipients who died because of early complications after transplantation. Lamivudine (100 mg/day) was given for prophylaxis of de novo HBV infection. Results. The mean follow-up time for 16 HBsAg-negative recipients was 21.7 (7-48) months. None of them experienced de novo HBV infection. Conclusion. The use of liver allografts from anti-HBc-positive living donors is reasonably safe in HBsAg-negative recipients under lamivudine prophylaxis.