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    Is the neutrophil to lymphocyte ratio associated with liver fibrosis in patients with chronic hepatitis B?
    (Baishideng Publishing Group Inc., 2015) Kekilli, Murat; Tanoğlu, Alpaslan; Sakin, Yusuf Serdar; Kurt, Mevlüt; Öcal, Serkan; Bağcı, Sait
    AIM: To determine the association between the neutrophil to lymphocyte (N/L) ratio and the degree of liver fibrosis in patients with chronic hepatitis B (CHB) infection. METHODS: Between December 2011 and February 2013, 129 consecutive CHB patients who were admitted to the study hospitals for histological evaluation of chronic hepatitis B-related liver fibrosis were included in this retrospective study. The patients were divided into two groups based on the fibrosis score: individuals with a fibrosis score of F0 or F1 were included in the "no/minimal liver fibrosis" group, whereas patients with a fibrosis score of F2, F3, or F4 were included in the "advanced liver fibrosis" group. The Statistical Package for Social Sciences 18.0 for Windows was used to analyze the data. A P value of < 0.05 was accepted as statistically significant. RESULTS: Three experienced and blinded pathologists evaluated the fibrotic status and inflammatory activity of 129 liver biopsy samples from the CHB patients. Following histopathological examination, the "no/minimal fibrosis" group included 79 individuals, while the "advanced fibrosis" group included 50 individuals. Mean (N/L) ratio levels were notably lower in patients with advanced fibrosis when compared with patients with no/minimal fibrosis. The mean value of the aspartate aminotransferase-platelet ratio index was markedly higher in cases with advanced fibrosis compared to those with no/minimal fibrosis. CONCLUSION: Reduced levels of the peripheral blood N/L ratio were found to give high sensitivity, specificity and predictive values in CHB patients with significant fibrosis. The prominent finding of our research suggests that the N/L ratio can be used as a novel noninvasive marker of fibrosis in patients with CHB. © The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
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    Reply to: Renal impairment during the treatment of telaprevir with peginterferon and ribavirin in patients with chronic hepatitis C
    (Blackwell Publishing Ltd, 2014) Sakin, Yusuf Serdar; Polat, Zülfikar; Demirci, Hakan; Kekilli, Murat; Uygun, Ahmet; Bağcı, Sait
    Dear Editor, We read with great interest the recently published article by Fukuda et al. 1 The authors indicate that there is significant correlation between serum telaprevir (TVR) level and bodyweight and suggest that adjustment of TVR dose according to bodyweight would avoid renal impairment during treatment. Herein, we want to present a case in which renal impairment completely reversed after discontinuation of TVR, and ribavirin dose reduction seemed to be important in improving renal impairment until therapy.