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Background: Socioeconomic disadvantage may influence the chronic hepatitis B (CHB) care continuum and the stage at which clinically relevant liver disease is recognised. However, evidence linking both individual- and area-level socioeconomic disadvantage to histologically assessed liver fibrosis in CHB remains limited. We examined whether socioeconomic disadvantage at the individual and area levels was associated with liver fibrosis severity in adults with CHB in Türkiye. Methods: In this nationwide multicentre observational study, adults with CHB who underwent liver biopsy in routine care between 1 January 2019 and 31 December 2024 across 24 centres in Türkiye were screened. Clinical and histopathological data were obtained retrospectively from medical records, while socioeconomic data were collected after biopsy through structured face-to-face interviews. Fibrosis was staged using the Ishak system. Individual socioeconomic indicators and province-level categories of the socioeconomic development index (SEDI) were examined. The primary analysis used ordinal logistic regression. Supportive analyses included multivariable logistic regression, 1:1 propensity score matching with conditional logistic regression, overlap weighting, likelihood-ratio tests for interaction, chi-square or Fisher’s exact tests, Kruskal–Wallis tests, and Wilcoxon rank-sum tests, with Benjamini–Hochberg adjustment for post-hoc comparisons. Results: The analytic cohort included 956 adults, of whom 53.7% were male. Mild fibrosis (Ishak 0–2) was present in 73.1%, moderate fibrosis (3–4) in 21.7%, and advanced fibrosis/cirrhosis (5–6) in 5.2%. In multivariable ordinal regression, higher fibrosis stage was associated with older age at biopsy (adjusted OR = 1.12 per 10-year increase, 95% CI : 1.02–1.24; P = 0.019), longer travel time to a centre capable of CHB follow-up (adjusted OR = 1.53 per category, 95% CI : 1.30–1.79; P < 0.001), longer duration of residence in the current place of residence (adjusted OR = 1.21 per 5-year increase, 95% CI : 1.03–1.42; P = 0.023), and lower residential socioeconomic development (adjusted OR = 1.97 per one-level decrease, 95% CI : 1.82–2.15; P < 0.001). In matched and overlap-weighted comparisons of SEDI 6 versus SEDI 1, the corresponding estimates were OR = 26.00 (95% CI : 8.21–82.37; P < 0.001) and OR = 24.75 (95% CI : 8.96–68.36; P < 0.001), respectively. Conclusions: Liver fibrosis severity in adults with CHB was associated more consistently with area-level socioeconomic disadvantage of the current place of residence than with birthplace socioeconomic context or most individual socioeconomic indicators. These findings support a social epidemiological interpretation in which place-based disadvantage may be more closely linked to fibrosis severity at clinical presentation, potentially through unequal access to timely follow-up and specialist assessment.

Purpose: Mucormycosis is a rapidly progressive angioinvasive fungal infection with limited large-scale outcome data. We aimed to describe the epidemiology, clinical spectrum, treatment strategies, and predictors of outcomes in adult patients with proven mucormycosis in Türkiye. Methods: We conducted a nationwide, retrospective study of 280 adults diagnosed with proven mucormycosis between 2004 and 2024 across 27 tertiary centers. Case definitions were applied according to the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clinical characteristics, antifungal management, surgical interventions, and outcomes were systematically analyzed. Results: The median age of the cohort was 60 years, and diabetes mellitus, frequently complicated by ketoacidosis, was the most common underlying condition. Rhino-orbital-cerebral disease represented the predominant clinical form, whereas pulmonary, gastrointestinal, and disseminated presentations were less frequent but carried less favorable prognoses. Liposomal amphotericin B was the main first-line therapy, often combined with surgery, although antifungal treatment was initiated at a median of five days after symptom onset. Ninety-day mortality was 42.1% by Kaplan–Meier estimation (crude 49.3%) and reached 49.3% (crude 55.0%) at 365 days. Crude mortality was lowest in patients who did not undergo surgery; however, this association was not significant in the time-dependent Cox regression analysis, suggesting confounding by baseline severity. Poor outcomes were associated with corticosteroid exposure, prolonged neutropenia, and neurological manifestations, while a history of sinusitis appeared to be associated with improved survival. Conclusion: In this multicenter study, survival was mainly determined by host-related factors rather than the choice of antifungal agent. Corticosteroid exposure, prolonged neutropenia, and neurological involvement independently predicted poor outcomes, whereas a prior history of sinusitis was linked to improved survival, likely reflecting earlier diagnosis and intervention. These findings reinforce the need for heightened clinical awareness, rapid recognition, and prompt multidisciplinary management to improve outcomes in patients with mucormycosis.

Introduction: Tuberculous lymphadenitis (TBLN) is the most common infectious etiology of peripheral lymphadenopathy in adults, in Turkiye. This study aimed to identify the demographic, clinical, and laboratory variables that differentiate TBLN from non-tuberculous lymphadenitis (NTBLN), as well as the etiology of lymphadenopathy in adults. Methodology: Patients who were over 18 years old and were referred to the infectious disease outpatient clinics with complaints of swollen peripheral lymph nodes, and who underwent lymph node biopsy between 1 January 2010 and 1 March 2021, were included in this multicenter, nested case-control study. Results: A total of 812 patients at 17 tertiary teaching and research hospitals in Turkiye were included in the study. TBLN was the most frequent diagnosis (53.69%). The proportion of patients diagnosed with TBLN was higher among females; and among those who had a higher erythrocyte sedimentation rate, positive purified protein derivative test, and positive interferon-gamma release test result (p < 0.05). However, TBLN was less frequent among patients with generalized lymphadenopathy, bilateral lymphadenopathy, axillary lymphadenopathy, inguinal lymphadenopathy, hepatomegaly, splenomegaly, leukocytosis, and moderately increased C reactive protein levels (p < 0.05). Conclusions: Identifying the variables that predict TBLN or discriminate TBLN from NTBLN will help clinicians establish optimal clinical strategies for the diagnosis of adult lymphadenopathy.

Objective: We aimed to investigate the vaccination status and the risk factors for the intensive care unit (ICU) support need of the laboratory-confirmed breakthrough COVID-19 infection inpatients. Materials and Methods: This multi-center point-prevalence study was conducted on inpatients, divided into two groups as ‘fully’ and ‘partially’ vaccinated according to COVID-19 vaccination status. Results: Totally 516 patients were included in the study. The median age was 65 (55-77), and 53.5% (n=276) of the patients were male. Hypertension (41.9%, n=216), diabetes mellitus (DM) (31.8%, n=164), and coronary artery disease (CAD) (16.3%, n=84) were the predominant comorbidities. Patients were divided into two groups ICU (n=196) and non-ICU (n=301). Hypertension (p=0.026), DM (p=0.048), and congestive heart failure (CHF) (p=0.005) were significantly higher in ICU patients and the median age was younger among non-ICU patients (p=0.033). Of patients, 16.9% (n=87) were fully vaccinated, and this group’s need for ICU support was statistically significantly lower (p=0.021). Conclusion: We conclude that older age, hypertension, DM, CHF, and being partially vaccinated were associated with the need for ICU support. Therefore, all countries should continuously monitor post-vaccination breakthrough COVID-19 infections to determine the national booster vaccine administration approach that will provide vulnerable individuals the highest protection. Keywords: COVID-19 vaccine, intensive care unit, risk factor, SARS-CoV-2 infection, vaccine breakthrough infections, variant of concerns

Objective: Tetanus, a vaccine-preventable disease, still has the potential to threaten human health. Immunization, especially in pregnant women, is critical as it protects both mother and baby. This study aims to evaluate the tetanus immunization status of pregnant women, their approach to the vaccine, and the factors affecting these.Methods: A 19-item questionnaire was applied to pregnant women from all over Turkey who applied to the hospital for any reason and agreed to participate.Results: A total of 5000 pregnant women from seven geographical regions, aged between 15 and 44 (mean 28 +/- 5.7) and whose gestational age was between 8 and 40 weeks (mean 22.07 +/- 8.5), participated in the study. %88.2 of them did not get vaccinated in their current pregnancy, and %23.2 of them didn't plan to get vaccinated. When the reasons for not being vaccinated were questioned, %28.6 and %15.4 of them were afraid of side effects and harming the baby, respectively. In addition, %23.9 of them thought they didn't need to be vaccinated, and %7.1 of them stated that the vaccine didn't provide any protection. In univariate analysis, regions, age, gestational week, and the number of pregnancies resulting in delivery were found as factors that statistically significantly affected getting vaccinated, but in multivariate analysis, gestational week, education until secondary school, being followed by a family physician, history of more than three pregnancies, and being vaccinated in a previous pregnancy was found as an independent factor.Conclusions: Neonatal tetanus should be prevented not only because of its high mortality but also, the sequelae, and it can be prevented, minimized, or even completely eradicated by vaccination of pregnant women. For this purpose, every pregnant woman should be informed, and education and counseling support should be provided for vaccina-tion against tetanus.

Objective Occult hepatitis B infection (OHBI) appears to have a higher prevalence in populations at high risk for hepatitis B virus (HBV) infection with concomitant liver disease. The aim was to assess the prevalence of OHBI in a sample of human immunodeficiency virus ‐1 positive and HBV surface antigen negative (HIV‐1+/HBsAg‐) Turkish patients. Methods Ten centers in Turkey were included in the study. Patients were selected on the basis of a power calculation with a known population size of HIV positive patients and a reported prevalence of OHBI. Gender, age, occupation, place of residence, treatment and clinical status, and laboratory results, including immunodeficiency panel, antibody tests, hemogram, biochemistry and coagulation studies, were evaluated retrospectively. Results The number of HIV‐infected patients followed in these centers was 3172 and the sample population numbered 278. All 278 were HBsAg negative. The mean age of the sample was 37.2±13.1 years and 235 (84.5%) were male. All but one patient (99.6%) had been treated with antiretroviral therapy. Of the 278 patients, 169 (60.6%) were positive for Anti‐HBs and 125 (44.8%) were positive for Anti‐HBc IgG. HIV RNA was detected in 203/278 (73%) of the patients. Four HBV DNA (1.4%) were diagnosed with OHBI. There was no significant difference in hemogram, hemoglobin or bilirubin concentrations in those with OHBI compared to the other patients. Conclusion In a representative sample of HIV+ patients from ten Turkish centers, the prevalence of OHBI was found to be 1.4%. In HIV positive patients it is important to identify those with OHBI for optimal clinical management and prognosis

Research of Occult Hepatitis B Infection in HIV-infected Patients, Schindler Study ABSTRACT Objective: Occult hepatitis B infection seems to be more prevalent among subjects at high risk for HBV infection and with concomitant liver disease. The aim of this study was to assess the prevalence of OHBI in group of HIV-1+/HBsAg- Turkish patients. Methods: Ten centers in Turkey have been included in the study. Gender, age, occupation, place of residence, treatment status, clinic, immunodeficiency panel, eliza tests, hemogram, biochemistry and coagulation laboratory results of the patients were evaluated retrospectively. Results: The number of HIV-infected patients followed in these centers is 3172. The mean age of the patients was 37.2 ± 13.1, and they were 235 males (84.5%) and 43 (15.5%) females. 278 (99.6%) of the patients are patients who received antiretroviral treatment. included in the s Of the 279 patients included in the study, it was determined that HBsAg was negative in all of them, 169 were positive for Anti HBs and 125 were positive for Anti HBc IgG. HIV RNA (203/278) was detected in 203 of the patients. 4 (1.4%) of the patients were diagnosed with OHB. In our study, no significant difference was found in hemoglobin and bilirubin levels and complete blood count in patients with HIV-OHB co-infection. However, albumin values were found to be <3.5 in three OHD patients (p = 0.043). Conclusion: Reasearch the presence of OHB infection in HIV-infected patients is important in determining treatment options and predicting the survival of patient. Hypoalbuminemia could be showing hepatic failure and we can suggest the importance of treatment that diseases.