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Montes ML, Busca C, Espinosa N, Bernardino JI, Ibarra-Ugarte S, Martín-Carbonero L, Moreno C, Macias J, Rivero A, Cervero-Jiménez M, González-García J. Incidence of Diabetes Mellitus and Associated Factors in the Era of Antiretroviral Drugs With a Low Metabolic Toxicity Profile. Open Forum Infect Dis 2024; 11:ofae112. [PMID: 38560607 PMCID: PMC10981392 DOI: 10.1093/ofid/ofae112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Objective The incidence of type 2 diabetes mellitus (T2DM) has risen dramatically. Among people living with HIV (PLHIV), chronic disease (now >15 cases/1000 in the general population worldwide) and long-term exposure to antiretroviral therapy (ART) can alter metabolic processes early, favoring insulin resistance and T2DM. We retrospectively studied the incidence of T2DM and associated factors in the Cohort of the Spanish AIDS Research Network, a prospective cohort of PLHIV enrolled at diagnosis and before initiation of ART. Methods PLHIV were aged >18 years and ART naive at inclusion. The incidence of new diagnoses of T2DM after initiation of ART (per 1000 person-years) was calculated. Predictors of a diagnosis of T2DM were identified by a Cox proportional hazards model adjusted for statistically significant and clinically relevant variables. Results Cumulative incidence was 5.9 (95% CI, 5.1-6.7) per 1000 person-years, increasing significantly in persons aged >50 years to 14.4 (95% CI, 10.4-19.3). Median time to diagnosis of T2DM was 27 months. Only age and higher education were significant. Interestingly, higher education was associated with a 33% reduction in the incidence of T2DM. Having received tenofovir disoproxil fumarate + (lamivudine or emtricitabine) + rilpivirine was almost significant as a protective factor (hazard ratio, 0.49; 95% CI, .24-1.01; P = .05). Conclusions The incidence of T2DM in PLHIV in Spain was high, especially in persons aged >50 years. Age was the factor most closely associated with onset, and educational level was the factor most associated with reduced risk. We highlight the lack of association between HIV-related factors and T2DM and show that, within nonnucleoside reverse transcriptase inhibitors, rilpivirine could prove more benign for metabolic comorbidities.
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Affiliation(s)
- Maria Luisa Montes
- Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Institute for Health Research, Madrid, Spain
- Centre for Biomedical Research on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Carmen Busca
- Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Institute for Health Research, Madrid, Spain
- Centre for Biomedical Research on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Nuria Espinosa
- Infectious Diseases and Microbiology Clinical Unit, Instituto de Biomedicina de Sevilla, University Hospital Virgen del Rocío, CSIC, Universidad de Sevilla, Seville, Spain
| | - José Ignacio Bernardino
- Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Institute for Health Research, Madrid, Spain
- Centre for Biomedical Research on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Sofia Ibarra-Ugarte
- Servicio de Enfermedades Infecciosas, Hospital Universitario Basurto, Bilbao, Spain
| | - Luz Martín-Carbonero
- Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Institute for Health Research, Madrid, Spain
| | - Cristina Moreno
- Centre for Biomedical Research on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Macias
- Centre for Biomedical Research on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina, IBiS, Universidad de Sevilla, Hospital Universitario Virgen de Valme, Seville, Spain
| | - Antonio Rivero
- Centre for Biomedical Research on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Department of Infectious Diseases, Hospital Universitario Reina Sofia, Instituto Maimonides de Investigación Biomédica de Córdoba, Universidad de Córdoba, Cordoba, Spain
| | | | - Juan González-García
- Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Institute for Health Research, Madrid, Spain
- Centre for Biomedical Research on Infectious Diseases (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Berenguer J, Aldámiz-Echevarría T, Hontañón V, Fanciulli C, Quereda C, Busca C, Domínguez L, Hernández C, Vergas J, Gaspar G, García-Fraile LJ, Díez C, De Miguel M, Bellón JM, Bañares R, González-García J. Clinical outcomes and prognostic factors after HCV clearance with DAA in HIV/HCV-coinfected patients with advanced fibrosis/cirrhosis. Hepatology 2024:01515467-990000000-00792. [PMID: 38452004 DOI: 10.1097/hep.0000000000000838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 02/18/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND AIMS We assessed long-term clinical outcomes and prognostic factors for liver disease progression after sustained viral response with direct-acting antivirals in patients coinfected with HIV/HCV with advanced fibrosis or cirrhosis. APPROACH AND RESULTS A total of 1300 patients who achieved sustained viral response with direct-acting antivirals from 2014 to 2017 in Spain were included: 1145 with compensated advanced chronic liver disease (384 advanced fibrosis and 761 compensated cirrhosis) and 155 with decompensated cirrhosis. The median follow-up was 40.9 months. Overall, 85 deaths occurred, 61 due to non-liver non-AIDS-related causes that were the leading cause of death across all stages of liver disease. The incidence (95% CI) of decompensation per 100 person-years (py) was 0 in patients with advanced fibrosis, 1.01 (0.68-1.51) in patients with compensated cirrhosis, and 8.35 (6.05-11.53) in patients with decompensated cirrhosis. The incidence (95% CI) of HCC per 100 py was 0.34 (0.13-0.91) in patients with advanced fibrosis, 0.73 (0.45-1.18) in patients with compensated cirrhosis, and 1.92 (1.00-3.70) per 100 py in patients with decompensated cirrhosis. Prognostic factors for decompensation in patients with compensated advanced chronic liver disease included serum albumin, liver stiffness measurement (LSM), and fibrosis 4. In this population, LSM and LSM-based posttreatment risk stratification models showed their predictive ability for decompensation and HCC. CONCLUSIONS Non-liver non-AIDS-related events were the leading causes of morbidity and mortality after direct-acting antiviral cure among coinfected patients with advanced fibrosis/cirrhosis. Among those with compensated advanced chronic liver disease, baseline LSM and posttreatment LSM-based models helped to assess decompensation and HCC risk.
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Affiliation(s)
- Juan Berenguer
- Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Teresa Aldámiz-Echevarría
- Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Víctor Hontañón
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- HIV Unit/Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Chiara Fanciulli
- Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Carmen Quereda
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Carmen Busca
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- HIV Unit/Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Lourdes Domínguez
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- HIV Unit/Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital 12 de Octubre (I+12), Madrid, Spain
| | - Cristina Hernández
- Infectious Diseases/Internal Medicine, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Jorge Vergas
- Infectious Diseases/Internal Medicine, Hospital Clínico de San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Gabriel Gaspar
- Internal Medicine, Hospital Universitario de Getafe, Getafe, Spain
| | - Lucio J García-Fraile
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases, Hospital Universitario de la Princesa, Madrid, Spain
- Instituto de Investigación del Hospital de La Princesa (IIS-Princesa), Madrid, Spain
| | - Cristina Díez
- Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | | | - José M Bellón
- Infectious Diseases/Clinical Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Rafael Bañares
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- Departamento de Medicina Universidad Complutense, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
- Liver Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Juan González-García
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- HIV Unit/Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
- Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
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Palmier E, De Miguel R, Montejano R, Busca C, Micán R, Ramos L, Cadiñanos J, Serrano L, Bernardino JI, Pérez-Valero I, Valencia E, Arribas JR, Montes ML, González-García J, Martín-Carbonero L. Three-year efficacy of switching to dolutegravir plus lamivudine: A real-world study. HIV Med 2023; 24:1013-1019. [PMID: 37194419 DOI: 10.1111/hiv.13500] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/18/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Dolutegravir (DTG) plus lamivudine (3TC) has proven highly efficacious as a switching strategy in virologically suppressed people with HIV (PWH). As this strategy was introduced relatively recently, real-world, long-term durability studies are lacking. METHODS We performed a retrospective review of treatment-experienced patients who started DTG + 3TC in a cohort of PWH. HIV-RNA <50 copies/mL was analysed at 144 weeks in an intention-to-treat (ITT) analysis (missing = failure) and a per-protocol (PP) analysis (patients with missing data or changes for reasons other than virological failure were excluded). RESULTS The study population comprised 358 PWH (19% women). Median age and time with HIV infection were 51.7 and 13.4 years, respectively. The median number of previous antiretroviral combinations was three. Previous virological failure was reported in 27.1% of patients, and the M184V resistance mutation was detected in 17 patients. At 144 weeks, the percentage of individuals with HIV-RNA <50 copies/mL was 77.4% (277/358) in the ITT analysis and 95.5% (277/290) in the PP analysis. A total of 68 participants were excluded from the PP analysis (data missing, 25, discontinuation due to toxicity, 19; other, 16; death, 8). Two people with virological failure selected resistance-associated mutations (M184V and M184V + R263K). HIV-RNA remained undetectable in 17 patients with a previous history of the M184V mutation. CONCLUSION Our results confirm the real-world, long-term efficacy, tolerability and high genetic barrier of DTG + 3TC in treatment-experienced PWH. Although scarce, mutations causing resistance to nucleosides and integrase can emerge.
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Affiliation(s)
- E Palmier
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - R De Miguel
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - R Montejano
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - C Busca
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - R Micán
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - L Ramos
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - J Cadiñanos
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - L Serrano
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - J I Bernardino
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
| | | | - E Valencia
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | - J R Arribas
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - M L Montes
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - J González-García
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
- CIBER Infectious Diseases (CIBERINFEC), Madrid, Spain
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Ramos-Ruperto L, Busca C, Díez-Vidal A, Robles-Marhuenda Á, Díaz-Almirón M, Mican R, Montejano R, Valencia ME, Montes ML, Martin-Carbonero L, Delgado-Hierro A, Bernardino JI. Prevalence and Temporal Trends of Autoimmune Diseases in People Living with HIV. AIDS Res Hum Retroviruses 2023; 39:130-135. [PMID: 36594538 DOI: 10.1089/aid.2022.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Since the introduction of modern antiretroviral treatment for HIV and hepatitis C virus (HCV), the pattern of autoimmune diseases (ADs) in people living with HIV (PWH) might have changed. This is a retrospective study in a cohort of 5,665 PWH at the HIV Clinic of Hospital Universitario La Paz (Spain) to estimate the prevalence of ADs from January 1990 to June 2020. We divided the timeline into four periods: <1996, 1996-2006, 2006-2015, and 2015-2020. In total 369 participants were diagnosed with at least one AD, with a prevalence of 5.3% (95% confidence interval 4.7-5.9). In total, 302 (81%) participants were diagnosed simultaneously or after HIV diagnosis. Most prevalent diseases were immune thrombopenia (IT) (n = 90), cutaneous psoriasis (n = 52), autoimmune thyroid disorders (n = 36), spondylarthritis (n = 24), and inflammatory bowel disease (IBD) (n = 21). There was a significant trend for more ADs in recent periods (p = .037). In recent years, participants with ADs were older, had a long time since HIV diagnosis, and had higher CD4+ T cell count and higher CD4+ T cell nadir (temporal linear trend p < .001). There was a change in the pattern of ADs over time with a decrease in IT and an increase in spondylarthritis, arthritis, IBD, and thyroid disorders. One hundred thirty-nine participants (46%) were coinfected with HCV, with a steady decline throughout the study period. Only cryoglobulinemia was statistically associated with HCV infection. AD increases over time in PWH with reasonable immune virological control. We observed a higher frequency of spondylarthritis, arthritis, autoimmune thyroid disorders, and IBD in recent years.
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Affiliation(s)
- Luis Ramos-Ruperto
- HIV and Infectious Diseases Unit, Hospital Universitario La Paz, IdiPAZ, CIBER Enfermedades Infecciosas, Madrid, Spain
| | - Carmen Busca
- HIV and Infectious Diseases Unit, Hospital Universitario La Paz, IdiPAZ, CIBER Enfermedades Infecciosas, Madrid, Spain
| | | | | | | | - Rafael Mican
- HIV and Infectious Diseases Unit, Hospital Universitario La Paz, IdiPAZ, CIBER Enfermedades Infecciosas, Madrid, Spain
| | - Rocio Montejano
- HIV and Infectious Diseases Unit, Hospital Universitario La Paz, IdiPAZ, CIBER Enfermedades Infecciosas, Madrid, Spain
| | - M Eulalia Valencia
- HIV and Infectious Diseases Unit, Hospital Universitario La Paz, IdiPAZ, CIBER Enfermedades Infecciosas, Madrid, Spain
| | - Marisa L Montes
- HIV and Infectious Diseases Unit, Hospital Universitario La Paz, IdiPAZ, CIBER Enfermedades Infecciosas, Madrid, Spain
| | - Luz Martin-Carbonero
- HIV and Infectious Diseases Unit, Hospital Universitario La Paz, IdiPAZ, CIBER Enfermedades Infecciosas, Madrid, Spain
| | - Ana Delgado-Hierro
- HIV and Infectious Diseases Unit, Hospital Universitario La Paz, IdiPAZ, CIBER Enfermedades Infecciosas, Madrid, Spain
| | - Jose I Bernardino
- HIV and Infectious Diseases Unit, Hospital Universitario La Paz, IdiPAZ, CIBER Enfermedades Infecciosas, Madrid, Spain
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Bendala‐Estrada AD, Diaz‐Almiron M, Busca C, Mican R, Cadiñanos J, Montes ML, Martin‐Carbonero L, Valencia E, Montejano R, Delgado‐Hierro A, Bernardino JI. Change in metabolic parameters after switching from triple regimens with tenofovir alafenamide to dolutegravir‐based dual therapy. Bi‐lipid study. HIV Med 2022; 24:558-567. [PMID: 36394195 DOI: 10.1111/hiv.13432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 10/14/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The use of tenofovir alafenamide (TAF) has been associated with increased cholesterol and body weight. Real-life data on the metabolic effects of switching from a TAF-based triple regimen to a dolutegravir (DTG)-based two-drug regimen (2-DR) are scarce. METHODS A retrospective cohort study of patients who have switched from a triple TAF-based regimen to a 2-DR [DTG-lamivudine (DTG-3TC) or DTG- rilpivirine (DTG-RPV]) with at least 6 months of follow-up. The primary endpoint was the absolute change in lipid fractions at 6 months. Secondary outcomes were percentage changes in lipid fraction, effectiveness and safety at 6 and 12 months [intention to treat (ITT), missing = failures]. RESULTS A total of 118 patients (87 on DTG-3TC, 31 on DTG-RPV) were included. Median age was 51 years (interquartile range: 43-59), 86% were male, CD4 T-cell count was 692 cells/μL, and 98% viral load (VL) < 50 copies/mL. At 6 months there was a decrease in total and low-density lipoprotein cholesterol of 10.7 mg/dL [95% confidence interval (CI): 2.2-19.1; p ≤ 0.001] and 8.3 mg/dL (95% CI: 0.74-15.9; p = 0.026), respectively. There was a reduction in cardiovascular risk from 4.5% at baseline to 4% at 12 months (p = 0.040). Virological effectiveness as determined by ITT analysis was 85.6% at 6 months and 66.1% at 12 months. Seven patients (5.9%) withdrew from the 2-DR and there was no virological failure. CONCLUSIONS In real life, switching from a triple regimen with TAF to DTG-3TC or DTG-RPV dual therapy improves the lipid profile and is an effective and well-tolerated strategy.
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Affiliation(s)
| | | | - Carmen Busca
- HIV and infectious diseases Unit La Paz University Hospital, IdiPAZ, CIBER of Infectious Diseases (CIBERINFEC) Madrid Spain
| | - Rafael Mican
- HIV and infectious diseases Unit La Paz University Hospital, IdiPAZ, CIBER of Infectious Diseases (CIBERINFEC) Madrid Spain
| | - Julen Cadiñanos
- HIV and infectious diseases Unit La Paz University Hospital, IdiPAZ, CIBER of Infectious Diseases (CIBERINFEC) Madrid Spain
| | - Maria Luisa Montes
- HIV and infectious diseases Unit La Paz University Hospital, IdiPAZ, CIBER of Infectious Diseases (CIBERINFEC) Madrid Spain
| | - Luz Martin‐Carbonero
- HIV and infectious diseases Unit La Paz University Hospital, IdiPAZ, CIBER of Infectious Diseases (CIBERINFEC) Madrid Spain
| | - Eulalia Valencia
- HIV and infectious diseases Unit La Paz University Hospital, IdiPAZ, CIBER of Infectious Diseases (CIBERINFEC) Madrid Spain
| | - Rocío Montejano
- HIV and infectious diseases Unit La Paz University Hospital, IdiPAZ, CIBER of Infectious Diseases (CIBERINFEC) Madrid Spain
| | - Ana Delgado‐Hierro
- HIV and infectious diseases Unit La Paz University Hospital, IdiPAZ, CIBER of Infectious Diseases (CIBERINFEC) Madrid Spain
| | - Jose I. Bernardino
- HIV and infectious diseases Unit La Paz University Hospital, IdiPAZ, CIBER of Infectious Diseases (CIBERINFEC) Madrid Spain
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Micán R, de Gea Grela A, Cadiñanos J, de Miguel R, Busca C, Bernardino JI, Valencia E, Montes ML, Montejano R, Moreno V, Pérez Valero I, Serrano L, González-García J, Arribas JR, Martín-Carbonero L. Impact of preexisting nucleos(t)ide reverse transcriptase inhibitor resistance on the effectiveness of bictegravir/emtricitabine/tenofovir alafenamide in treatment experience patients. AIDS 2022; 36:1941-1947. [PMID: 35848506 PMCID: PMC9612675 DOI: 10.1097/qad.0000000000003311] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 06/02/2022] [Accepted: 06/12/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Few clinical trials and cohort studies have evaluated the efficacy of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with HIV (PWH) with preexisting M184V/I or other nucleos(t)ide reverse transcriptase inhibitor (NRTI) resistance-associated mutations (RAMs). Real-world data are also scarce. METHODS Retrospective review of treatment-experienced patients who started B/F/TAF in a cohort of PWH. HIV-RNA less than 50 copies/ml was analyzed at 48 weeks in an intention-to-treat (ITT) analysis (missing=failure) and per protocol analysis (patients with missing data or changes for reasons other than virological failure were excluded). Results were compared in patients with and without previous NRTI-RAMs. RESULTS Five hundred and six PWH were included (16.2% women). Median age and time with HIV infection were 52.3 and 18.9 years, respectively. At baseline, viral load was less than 50 copies/ml in 440 patients (86.6%). Overall, 69 (13.6%) participants had documented preexisting NRTI-RAMs: 57 (11.2%) M184V/I and 30 (5.9%) tenofovir RAMs. In the ITT analysis, 83% (420/506) had HIV-RNA less than 50 copies/ml [82.2% (359/437) and 88.4% (61/69) in persons without and with NRTI-RAMs, respectively ( P = 0.2)]. In the per protocol analysis 94.2% (420/445) had HIV-RNA less than 50 copies/ml [94.4% (359/380) vs. 93.8% (61/65); P = 0.2]. A total of 61 participants were excluded from the per protocol analysis (23 missing data, 19 discontinued B/F/TAF because of toxicity, 13 for other reasons, and 6 died). CONCLUSION Switching to B/F/TAF is well tolerated and effective in the real-world setting, even in patients with preexisting NRTI RAMs, such as M184V and RAMs conferring resistance to tenofovir. These results confirm the robustness of this combination.
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Affiliation(s)
- Rafael Micán
- HIV Unit, Internal Medicine Department
- CIBERINFECC
| | | | - Julen Cadiñanos
- Infectious diseases Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- CIBERINFECC
| | - Rosa de Miguel
- Infectious diseases Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- CIBERINFECC
| | - Carmen Busca
- HIV Unit, Internal Medicine Department
- CIBERINFECC
| | | | | | | | - Rocío Montejano
- Infectious diseases Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- CIBERINFECC
| | | | | | | | | | - Jose R. Arribas
- Infectious diseases Unit, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain
- CIBERINFECC
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7
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Busca C, Arias P, Sánchez-Conde M, Rico M, Montejano R, Martín-Carbonero L, Valencia E, Moreno V, Bernardino JI, Olveira A, Abadía M, González-García J, Montes ML. Genetic variants associated with steatohepatitis and liver fibrosis in HIV-infected patients with NAFLD. Front Pharmacol 2022; 13:905126. [PMID: 36110512 PMCID: PMC9468702 DOI: 10.3389/fphar.2022.905126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/08/2022] [Indexed: 12/04/2022] Open
Abstract
Background and aims: Nonalcoholic fatty liver disease (NAFLD) is a common cause of liver damage in people living with HIV (PLWHIV). Several studies have investigated candidate genes for susceptibility to NAFLD and to steatohepatitis. PNPLA3, TM6SF2, and MBOAT7-TMC4 have been reported to be associated with elevated ALT levels and the histologic parameters of nonalcoholic steatohepatitis and severity of fibrosis. Our objective was to analyze the relationship between PNPLA3, TM6SF2, and MBOAT7-TMC4 and steatosis, steatohepatitis, and liver fibrosis in PLWHIV with NAFLD. Method: A cohort of PLWHIV with persistently elevated aminotransferase levels and suspected NAFLD who underwent liver biopsy and determination of genetic variants was assessed at two large centers in Spain. All participants included in the current study were genotyped for rs738409 (PNPLA3), rs58542926 (TM6SF2), and rs641738 (MBOAT7-TMC4). Results: The study population comprised PLWHIV who were on stable antiretroviral therapy [7.7% women; median age, 49.3 years (44–53.4)]. The median CD4 count was 829 (650–980), 60% had metabolic syndrome, and 18.5% were diabetic. The median BMI was 28.9 (25.5–30.8). Patients with liver steatosis (any grade) vs. nonsteatosis tended to harbor the PNPLA3 G allele variant [57.6% vs. 16.7% (p = 0.09)], but not TM6SF2 or MBOAT7-TMC4 variants. However, those with steatohepatitis vs. nonsteatohepatitis significantly more frequently had the PNPLA3 G allele variant [69.4% vs. 39.1% (p < 0.05)] and the MBOAT7-TMC4 A allele variant [75% vs. 42% (p < 0.05)]. In our cohort, the TM6SF2 gene variant was not associated with steatosis or steatohepatitis. The PNPLA3 G allele variant was associated with steatohepatitis [OR 4.9 (1.3–18); p 0.02] and liver fibrosis [OR 4.3 (1.1–17.4); p 0.04], and the MBOAT7-TMC4 A allele variant was associated with steatohepatitis [OR 6.6 (1.6–27.6); p 0.01]. Conclusion: The PNPLA3 G allele variant and MBOAT7-TMC4 A allele variant were associated with steatohepatitis and liver fibrosis in PLWHIV with persistently elevated aminotransferases and NAFLD. We recommend routine genotyping for PNPLA3 and MBOAT7-TMC4 in PLWHIV with NAFLD to identify those at higher risk of progression.
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Affiliation(s)
- C. Busca
- Unidad VIH, Servicio Medicina Interna, IdiPAz, Hospital Universitario La Paz, Madrid, Spain
| | - P. Arias
- Instituto de Genética Médica y Molecular (INGEMM), IdiPaz, Hospital Universitario La Paz, Madrid, Spain
| | - M. Sánchez-Conde
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M. Rico
- Unidad VIH, Servicio Medicina Interna, IdiPAz, Hospital Universitario La Paz, Madrid, Spain
| | - R. Montejano
- Unidad VIH, Servicio Medicina Interna, IdiPAz, Hospital Universitario La Paz, Madrid, Spain
| | - L. Martín-Carbonero
- Unidad VIH, Servicio Medicina Interna, IdiPAz, Hospital Universitario La Paz, Madrid, Spain
| | - E. Valencia
- Unidad VIH, Servicio Medicina Interna, IdiPAz, Hospital Universitario La Paz, Madrid, Spain
| | - V. Moreno
- Unidad VIH, Servicio Medicina Interna, IdiPAz, Hospital Universitario La Paz, Madrid, Spain
| | - J. I. Bernardino
- Unidad VIH, Servicio Medicina Interna, IdiPAz, Hospital Universitario La Paz, Madrid, Spain
| | - A. Olveira
- Gastroenterology, Hospital La Paz, Madrid, Spain
| | - M. Abadía
- Gastroenterology, Hospital La Paz, Madrid, Spain
| | - J. González-García
- Unidad VIH, Servicio Medicina Interna, IdiPAz, Hospital Universitario La Paz, Madrid, Spain
| | - M. L. Montes
- Unidad VIH, Servicio Medicina Interna, IdiPAz, Hospital Universitario La Paz, Madrid, Spain
- *Correspondence: M. L. Montes,
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Carrasco I, Olveira A, Lancharro Á, Escosa L, Mellado MJ, Busca C, Montes ML, Díez C, Alcolea-Ruiz S, Navarro ML, Sáinz T. Fatty liver disease in children living with HIV: a ghostly iceberg. AIDS 2022; 36:1471-1472. [PMID: 35876708 DOI: 10.1097/qad.0000000000003250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Itzíar Carrasco
- Servicio de Pediatría, Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Madrid
- Universidad Complutense de Madrid
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
| | - Antonio Olveira
- Gastroenterology Department, Hospital Universitario La Paz y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - Ángel Lancharro
- Servicio de Radiología, Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Madrid
| | - Luis Escosa
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- Gastroenterology Department, Hospital Universitario La Paz y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - María José Mellado
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz Y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - Carmen Busca
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- HIV Unit, Infectious Diseases and Internal Medicine Department, Hospital Universitario La Paz y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - María Luisa Montes
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- HIV Unit, Infectious Diseases and Internal Medicine Department, Hospital Universitario La Paz y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - Cristina Díez
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Sonia Alcolea-Ruiz
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz Y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - María Luisa Navarro
- Servicio de Pediatría, Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Madrid
- Universidad Complutense de Madrid
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
| | - Talía Sáinz
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz Y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
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9
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Busca C, Sánchez-Conde M, Rico G, Rosas M, Valencia E, Moreno A, Moreno V, Martín-Carbonero L, Moreno S, Pérez-Valero I, Bernardino JI, Arribas JR, González J, Olveira A, Castillo P, Abadía M, Guerra L, Mendez C, Montes ML. Assessment of Noninvasive Markers of Steatosis and Liver Fibrosis in HIV-monoinfected Patients on Stable Antiretroviral Regimens. Open Forum Infect Dis 2022; 9:ofac279. [PMID: 35873289 PMCID: PMC9297309 DOI: 10.1093/ofid/ofac279] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/06/2022] [Indexed: 11/12/2022] Open
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) is a major nonacquired immune deficiency syndrome-defining condition for persons with human immunodeficiency virus (PWH). We aimed to validate noninvasive tests for the diagnosis of NAFLD in PWH. Methods This is a cross-sectional study of PWH on stable antiretroviral therapy with persistently elevated transaminases and no known liver disease. The area under the receiver operating characteristic curve (AUROC) was calculated to compare the diagnostic accuracy of liver biopsy with abdominal ultrasound, transient elastography (TE) (including controlled attenuation parameter [CAP]), and noninvasive markers of steatosis (triglyceride and glucose index [TyG], hepatic steatosis index [HSI], fatty liver index [FLI]) and fibrosis ([FIB]-4, aminotransferase-to-platelet ratio index [APRI], NAFLD fibrosis score). We developed a diagnostic algorithm with serial combinations of markers. Results Of 146 patients with increased transaminase levels, 69 underwent liver biopsy (90% steatosis, 61% steatohepatitis, and 4% F ≥3). The AUROC for steatosis was as follows: ultrasound, 0.90 (0.75–1); CAP, 0.94 (0.88–1); FLI, 0.81 (0.58–1); HSI, 0.74 (0.62–0.87); and TyG, 0.75 (0.49–1). For liver fibrosis ≥F3, the AUROC for TE, APRI, FIB-4, and NAFLD fibrosis score was 0.92 (0.82–1), 0.96 (0.90–1), 0.97 (0.93–1), and 0.85 (0.68–1). Optimal diagnostic performance for liver steatosis was for 2 noninvasive combined models of tests with TyG and FLI/HSI as the first tests and ultrasound or CAP as the second tests: AUROC = 0.99 (0.97–1, P < .001) and 0.92 (0.77–1, P < .001). Conclusions Ultrasound and CAP performed best in diagnosing liver steatosis, and FLI, TyG, and HSI performed well. We propose an easy-to-implement algorithm with TyG or FLI as the first test and ultrasound or CAP as the second test to accurately diagnose or exclude NAFLD.
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Affiliation(s)
- C Busca
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
| | - M Sánchez-Conde
- Unidad de VIH, Servicio Enfermedades Infecciosas, Hospital Ramón y Cajal , Madrid , Spain
| | - G Rico
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
| | - Marta Rosas
- Unidad de VIH, Servicio Enfermedades Infecciosas, Hospital Ramón y Cajal , Madrid , Spain
| | - E Valencia
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
| | - A Moreno
- Unidad de VIH, Servicio Enfermedades Infecciosas, Hospital Ramón y Cajal , Madrid , Spain
| | - V Moreno
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
| | - L Martín-Carbonero
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
| | - S Moreno
- Unidad de VIH, Servicio Enfermedades Infecciosas, Hospital Ramón y Cajal , Madrid , Spain
| | - I Pérez-Valero
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
| | - JI Bernardino
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
| | - JR Arribas
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
| | - J González
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
| | - A Olveira
- Unidad de hígado, Servicio de Anatomía Patológica, Hospital Universitario La Paz , Madrid , Spain
| | - P Castillo
- Unidad Hepatología, Servicio Gastroenterología, Hospital Universitario La Paz , Madrid , Spain
| | - M Abadía
- Unidad Hepatología, Servicio Gastroenterología, Hospital Universitario La Paz , Madrid , Spain
| | - L Guerra
- Unidad de hígado, Servicio de Anatomía Patológica, Hospital Universitario La Paz , Madrid , Spain
| | - C Mendez
- Unidad de hígado, Servicio de Anatomía Patológica, Hospital Universitario La Paz , Madrid , Spain
| | - ML Montes
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz , IdiPAZ, Madrid , Spain
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10
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Carrasco I, Olveira A, Lancharro Á, Escosa L, Mellado MJ, Busca C, Montes ML, Díez C, Alcolea-Ruiz S, Navarro ML, Sainz T. Prevalence of nonalcoholic fatty liver disease using noninvasive techniques among children, adolescents, and youths living with HIV. AIDS 2022; 36:805-814. [PMID: 35013082 DOI: 10.1097/qad.0000000000003170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The prevalence of subclinical liver abnormalities is high among people with HIV, but data regarding perinatally HIV-infected children and adolescents (PHIV) are scarce. Noninvasive image techniques offer an opportunity to address nonalcoholic fatty liver disease (NAFLD) in a population in which the scores validated for adults have not been tested. DESIGN Prospective cross-sectional study including PHIV and uninfected controls. METHODS Noninvasive imaging techniques for the diagnosis of NAFLD and/or fibrosis were performed, and four scores to predict NAFLD were evaluated. RESULTS Seventy-six participants (59.2% women) with a median of 19 years old (interquartile range: 15.5-25.6) were included, 38 were PHIV and 38 were age and sex-matched controls. All HIV participants were on ART at the moment of inclusion, and 86.8% were virologically suppressed. A total of 11 PHIV and three controls were diagnosed with NAFLD (28.9% vs. 7.9%; P = 0.02) by noninvasive imaging techniques. The performance of scores based on clinical and analytical parameters was very poor. Although nonsignificant, overweight was more common among participants with NAFLD, who had a significantly higher BMI. Differences in HIV-related parameters between the groups were nonsignificant, except for the CD4+/CD8+ T-cells ratio, decreased among PHIV diagnosed with NAFLD (P = 0.04). CONCLUSIONS The prevalence of NAFLD was high (28.9%) among PHIV, and only partially explained by overweight and metabolic syndrome defining factors. The scores based on clinical and analytical parameters did not accurately identify participants at risk. Therefore, liver ultrasound assessment should be considered for the screening of NAFLD among PHIV in routine clinical practice.
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Affiliation(s)
- Itzíar Carrasco
- Servicio de Pediatría, Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Madrid
- Universidad Complutense de Madrid
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
| | - Antonio Olveira
- Gastroenterology Department. Hospital Universitario La Paz y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - Ángel Lancharro
- Servicio de Radiología, Hospital General Universitario Gregorio Maranón e Instituto de Investigación Sanitaria Gregorio Maran on, Madrid
| | - Luis Escosa
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz Y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - María José Mellado
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz Y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - Carmen Busca
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- IV Unit, Infectious Diseases and Internal Medicine Department. Hospital Universitario La Paz y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - María Luisa Montes
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- IV Unit, Infectious Diseases and Internal Medicine Department. Hospital Universitario La Paz y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - Cristina Díez
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Maranon, Madrid, Spain
| | - Sonia Alcolea-Ruiz
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz Y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
| | - María Luisa Navarro
- Servicio de Pediatría, Hospital General Universitario Gregorio Marañón e Instituto de Investigación Sanitaria Gregorio Marañón, Madrid
- Universidad Complutense de Madrid
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
| | - Talía Sainz
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III
- Servicio de Pediatría, Enfermedades Infecciosas y Tropicales, Hospital Universitario La Paz Y La Paz Research Institute (IdiPAZ), Hospital Universitario La Paz, Madrid
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11
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Serrano-Villar S, López-Huertas MR, Jiménez D, Galera C, Martínez-Sanz J, Moreno E, Muriel A, Gutiérrez F, Busca C, Portilla J, Bisbal O, Iribarren JA, Tejerina F, de Los Santos I, Moreno S. Long-Term Changes of Inflammatory Biomarkers in Individuals on Suppressive Three-Drug or Two-Drug Antiretroviral Regimens. Front Immunol 2022; 13:848630. [PMID: 35359950 PMCID: PMC8964183 DOI: 10.3389/fimmu.2022.848630] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/11/2022] [Indexed: 11/30/2022] Open
Abstract
Background Because inflammation is associated with mortality and has been linked to HIV transcription in lymphoid tissues during ART, it is necessary to address the long-term effects of switching 3-drug (3DR) to 2-drug regimens (2DR) on inflammation. Methods Nested study in the Spanish AIDS Research Network. We selected PWH ART-naive initiating 3DR who achieved viral suppression in the first 48 weeks and either remained on 3DR or switched to 2DR (3TC+bPI; 3TC+DTG; DTG+RPV). We assessed the trajectories on inflammatory markers during ART using multivariate piecewise mixed models. Results We analyzed 619 plasma samples from 148 patients (3DR, N=90; 2DR, N=58), the median follow-up was 4.6 (IQR 3.2-6.2) years. There were no significant differences in baseline characteristics between groups. After adjusting for potential confounders, patients with 3DR experienced a slow decline of IL6, hs-CRP, sCD14, sCD163, and D-dimer over time. In contrast, compared to 3DR, switching to 2DR was associated with increases in IL-6 (p=0.001), hs-CRP (p=0.003), and D-dimer (p=0.001) after year 3 from virologic suppression. 2DR was associated with a higher risk of hs-CRP quartile increase (aOR 3.3, 95%CI 1.1-10) and D-dimer quartile increase (aOR 3.7, 95%CI 1.1-13). The adjusted biomarker trajectories did not reveal a distinct pattern according to the type of 2DR used (bPI vs DTG). Conclusions In this study in virally suppressed individuals, maintaining 3DR was associated with a more favorable long-term inflammatory profile than switching to 2DR. The potential clinical implications of these findings on the development of non-AIDS events deserve further investigation.
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Affiliation(s)
- Sergio Serrano-Villar
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, Instituto de Investivestigación Ramón y Cajal (IRYCIS), Madrid, Spain.,CIBER de Enfermedades Infecciosas CIBER-Infec, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Daniel Jiménez
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, Instituto de Investivestigación Ramón y Cajal (IRYCIS), Madrid, Spain.,CIBER de Enfermedades Infecciosas CIBER-Infec, Instituto de Salud Carlos III, Madrid, Spain
| | - Carlos Galera
- HIV Unit, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Javier Martínez-Sanz
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, Instituto de Investivestigación Ramón y Cajal (IRYCIS), Madrid, Spain.,CIBER de Enfermedades Infecciosas CIBER-Infec, Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, Instituto de Investivestigación Ramón y Cajal (IRYCIS), Madrid, Spain.,CIBER de Enfermedades Infecciosas CIBER-Infec, Instituto de Salud Carlos III, Madrid, Spain
| | - Alfonso Muriel
- Biostatistics Unit, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, IRYCIS, Madrid, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Félix Gutiérrez
- CIBER de Enfermedades Infecciosas CIBER-Infec, Instituto de Salud Carlos III, Madrid, Spain.,Hospital General Universitario de Elche and Universidad Miguel Hernández, Alicante, Spain
| | - Carmen Busca
- CIBER de Enfermedades Infecciosas CIBER-Infec, Instituto de Salud Carlos III, Madrid, Spain.,HIV Unit, Hospital Universitario La Paz, Madrid, Spain
| | - Joaquín Portilla
- Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain
| | - Otilia Bisbal
- HIV Unit, Hospital Universitario Doce de Octubre, Madrid, Spain
| | | | | | | | - Santiago Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá, Instituto de Investivestigación Ramón y Cajal (IRYCIS), Madrid, Spain.,CIBER de Enfermedades Infecciosas CIBER-Infec, Instituto de Salud Carlos III, Madrid, Spain
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12
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Martín-Carbonero L, de Miguel R, Serrano L, Bernardino JI, Valencia E, Busca C, Micán R, Montejano R, Moreno V, Pérez-Valero I, Arribas JR, González-García J, Montes M. Acute hepatitis B among HIV positive persons: A two-decade review of cases from a Spanish cohort. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:121-124. [PMID: 35249671 DOI: 10.1016/j.eimce.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/09/2020] [Indexed: 06/14/2023]
Abstract
PURPOSE To review the incidence and characteristics of acute hepatitis B (AHB) in a large cohort of HIV infected persons from a low prevalence region during the last two decades. METHODS Retrospective review of an HIV Cohort from a single reference centre in Madrid, Spain, between 2000 and 2018. AHB was diagnosed in persons with newly acquired HBAgS and acute hepatitis with positive IgM anti-HBc. RESULTS Out of 5443 HIV+ patients in our cohort (3098 anti-HBc negative), 18 developed AHB from 2000 to 2018. The global incidence was 0.02 (0.01-0.04) per 100 patient-year in the entire population and 0.06 (0.01-0.1) per 100 patient-year in the anti-HBc negative population. A statistically significant decrease in AHB incidence was observed during these years (β=-0.006; p=0.047). All 18 patients diagnosed with AHB were men, the majority (16) occurred in men who have sex with men. AHB was observed in 4 persons previously unresponsive to vaccination. Regarding antiretroviral treatment (ART), 15 were not receiving ART, two persons were on ART with any HBV active drugs and one person had lamivudine in the regimen. Two persons (11%) developed chronic hepatitis B. There were no cases of fulminant hepatitis. CONCLUSION The incidence of AHB in HIV positive persons in our cohort was low and shows a progressive decline in the last 20 years. Cases occurred in persons not protected against VHB: not vaccinated or non-responders to vaccine that were not receiving tenofovir.
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Affiliation(s)
- Luz Martín-Carbonero
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain.
| | - Rosa de Miguel
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Lucía Serrano
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Jose I Bernardino
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Eulalia Valencia
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Carmen Busca
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Rafael Micán
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Rocío Montejano
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Victoria Moreno
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Ignacio Pérez-Valero
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Jose Ramón Arribas
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Juan González-García
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Marisa Montes
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
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13
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Fanciulli C, Berenguer J, Busca C, Vivancos MJ, Téllez MJ, Domínguez L, Domingo P, Navarro J, Santos J, Iribarren JA, Morano L, Artero A, Moreno J, Rivero-Román A, Santos I, Giner L, Armiñanzas C, Montero M, Manzardo C, Cifuentes C, García C, Galindo MJ, Ferrero OL, Sanz J, de la Fuente B, Rodríguez C, Gaspar G, Pérez L, Losa JE, Force L, Veloso S, Martínez-Alfaro E, Jarrín I, De Miguel M, González Garcia J. Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019. HIV Med 2022; 23:705-716. [PMID: 35037379 PMCID: PMC9543728 DOI: 10.1111/hiv.13229] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 01/03/2023]
Abstract
Objectives We assessed the prevalence of anti‐hepatitis C virus (HCV) antibodies and active HCV infection (HCV‐RNA‐positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015–2018. Methods The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)‐positive (78.7% were prior injection drug users); 29 were HCV‐RNA‐positive (2.2%). Of the 29 HCV‐RNA‐positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV‐RNA‐positive patients and 68 (23.4%) of those who cleared HCV after anti‐HCV therapy (p = 0.04). The prevalence of anti‐HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti‐HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct‐acting antiviral agents, HCV‐related cirrhosis remains significant in this population.
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Affiliation(s)
- Chiara Fanciulli
- Infectious Diseases and Clinical Microbiology, Hospital General Universitario Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERINFEC, Madrid, Spain
| | - Juan Berenguer
- Infectious Diseases and Clinical Microbiology, Hospital General Universitario Gregorio Marañón (IiSGM), Madrid, Spain.,CIBERINFEC, Madrid, Spain
| | - Carmen Busca
- CIBERINFEC, Madrid, Spain.,HIV Unit, Internal Medicine, Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - María J Vivancos
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Ramón y Cajal (Irycis), Madrid, Spain
| | - María J Téllez
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Clínico San Carlos, Madrid, Spain
| | - Lourdes Domínguez
- CIBERINFEC, Madrid, Spain.,HIV Unit, Internal Medicine, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Pere Domingo
- Infectious Diseases, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jordi Navarro
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Universitari Vall d´Hebrón, Barcelona, Spain
| | - Jesús Santos
- Infectious Diseases, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | | | - Luis Morano
- Infectious Diseases, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - Arturo Artero
- Internal Medicine and Infectious Diseases, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Javier Moreno
- Infectious Diseases, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Antonio Rivero-Román
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Ignacio Santos
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Universitario de la Princesa, Madrid, Spain
| | - Livia Giner
- Infectious Diseases, Hospital General Universitario de Alicante, Alicante, Spain
| | - Carlos Armiñanzas
- CIBERINFEC, Madrid, Spain.,Infectious Diseases, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Marta Montero
- Infectious Diseases, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Christian Manzardo
- Infectious Diseases, Hospital Arnau de Vilanova, Lleida, Spain.,Infectious Diseases, Hospital Santa María, Lleida, Spain
| | - Carmen Cifuentes
- Infectious Diseases, Hospital Son Llàtzer, Palma de Mallorca, Mallorca, Spain
| | - Coral García
- Infectious Diseases, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - María J Galindo
- Internal Medicine and Infectious Diseases, Hospital Clínico de Valencia, Valencia, Spain
| | - Oscar L Ferrero
- Infectious Diseases, Hospital Universitario de Basurto, Bilbao, Spain
| | - José Sanz
- Infectious Diseases, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | | | | | - Gabriel Gaspar
- Internal Medicine and Infectious Diseases, Hospital Universitario de Getafe, Getafe, Spain
| | - Laura Pérez
- Infectious Diseases, Hospital San Pedro, Logroño, Spain
| | - Juan E Losa
- Infectious Diseases, Fundación Hospital Alcorcón, Alcorcón, Spain
| | - Luis Force
- Internal Medicine and Infectious Diseases, Hospital de Mataró, Mataró, Spain
| | - Sergio Veloso
- Infectious Diseases, Hospital Universitario Joan XXIII, Tarragona, Spain
| | - Elisa Martínez-Alfaro
- Infectious Diseases, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Inmaculada Jarrín
- CIBERINFEC, Madrid, Spain.,Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Juan González Garcia
- CIBERINFEC, Madrid, Spain.,HIV Unit, Internal Medicine, Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
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14
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Rava M, Domínguez-Domínguez L, Bisbal O, López-Cortés LF, Busca C, Antela A, González-Ruano P, Hernández C, Iribarren JA, Rubio R, Moreno S, Jarrín I. Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018. PLoS One 2021; 16:e0249864. [PMID: 33882093 PMCID: PMC8059864 DOI: 10.1371/journal.pone.0249864] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/26/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES With the purpose of reducing the well-known negative impact of late presentation (LP) on people living with HIV (PLWH), guidelines on early HIV diagnosis were published in 2014 in Spain, but since then no data on LP prevalence have been published. To estimate prevalence and risk factors of LP and to evaluate their impact on the development of clinical outcomes in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) during 2004-2018. METHODS CoRIS is an open prospective multicenter cohort of PLWH, adults, naive to ART at entry. LP was defined as HIV diagnosis with CD4 count ≤350 cells/μL or an AIDS defining event (ADE). Multivariable Poisson regression models were used to estimate both prevalence ratios (PR) for the association of potential risk factors with LP and Incidence rate ratios (IRRs) for its impact on the development of the composite endpoint (first ADE, first serious non-AIDS event [SNAE] or overall mortality). RESULTS 14,876 individuals were included. Overall, LP prevalence in 2004-2018 was 44.6%. Risk factors for LP included older age, having been infected through injection drug use or heterosexual intercourse, low educational level and originating from non-European countries. LP was associated with an increased risk of the composite endpoint (IRR: 1.34; 95%CI 1.20, 1.50), ADE (1.39; 1.18, 1.64), SNAE (1.22; 1.01, 1.47) and mortality (1.71; 1.41, 2.08). CONCLUSIONS LP remains a health problem in Spain, mainly among certain populations, and is associated with greater morbidity and mortality. Public policies should be implemented to expand screening and early diagnosis of HIV infection, for a focus on those at greatest risk of LP.
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Affiliation(s)
- Marta Rava
- Unit AIDS Research Network Cohort (CoRIS), National Center of Epidemiology (CNE), Health Institute Carlos III (ISCIII), Madrid, Spain
| | | | | | | | | | - Antonio Antela
- University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Cristina Hernández
- Príncipe de Asturias University Hospital, Alcalá de Henares, Madrid, Spain
| | - Josè-Antonio Iribarren
- Department of Infectious Diseases, University Hospital, IIS Biodonostia, San Sebastián, Spain
| | - Rafael Rubio
- 12 de Octubre University Hospital, Madrid, Spain
| | | | - Inmaculada Jarrín
- Unit AIDS Research Network Cohort (CoRIS), National Center of Epidemiology (CNE), Health Institute Carlos III (ISCIII), Madrid, Spain
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15
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Martín-Carbonero L, de Miguel R, Serrano L, Bernardino JI, Valencia E, Busca C, Micán R, Montejano R, Moreno V, Pérez-Valero I, Arribas JR, González-García J, Montes M. Acute hepatitis B among HIV positive persons: A two-decade review of cases from a Spanish cohort. Enferm Infecc Microbiol Clin 2020; 40:S0213-005X(20)30302-5. [PMID: 33268188 DOI: 10.1016/j.eimc.2020.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE To review the incidence and characteristics of acute hepatitis B (AHB) in a large cohort of HIV infected persons from a low prevalence region during the last two decades. METHODS Retrospective review of an HIV Cohort from a single reference centre in Madrid, Spain, between 2000 and 2018. AHB was diagnosed in persons with newly acquired HBAgS and acute hepatitis with positive IgM anti-HBc. RESULTS Out of 5443 HIV+ patients in our cohort (3098 anti-HBc negative), 18 developed AHB from 2000 to 2018. The global incidence was 0.02 (0.01-0.04) per 100 patient-year in the entire population and 0.06 (0.01-0.1) per 100 patient-year in the anti-HBc negative population. A statistically significant decrease in AHB incidence was observed during these years (β=-0.006; p=0.047). All 18 patients diagnosed with AHB were men, the majority (16) occurred in men who have sex with men. AHB was observed in 4 persons previously unresponsive to vaccination. Regarding antiretroviral treatment (ART), 15 were not receiving ART, two persons were on ART with any HBV active drugs and one person had lamivudine in the regimen. Two persons (11%) developed chronic hepatitis B. There were no cases of fulminant hepatitis. CONCLUSION The incidence of AHB in HIV positive persons in our cohort was low and shows a progressive decline in the last 20 years. Cases occurred in persons not protected against VHB: not vaccinated or non-responders to vaccine that were not receiving tenofovir.
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Affiliation(s)
- Luz Martín-Carbonero
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain.
| | - Rosa de Miguel
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Lucía Serrano
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Jose I Bernardino
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Eulalia Valencia
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Carmen Busca
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Rafael Micán
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Rocío Montejano
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Victoria Moreno
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Ignacio Pérez-Valero
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Jose Ramón Arribas
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Juan González-García
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Marisa Montes
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
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16
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Ramos L, Busca C, Robles A. Esteatonecrosis aséptica en una paciente con esclerosis múltiple y tratamiento con interferón beta 1b. Med Clin (Barc) 2018; 150:122. [DOI: 10.1016/j.medcli.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Revised: 07/03/2017] [Accepted: 07/09/2017] [Indexed: 10/18/2022]
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17
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Reichenbach P, Busca C, Mondini AC, Rossi M. The influence of land use change on landslide susceptibility zonation: the Briga catchment test site (Messina, Italy). Environ Manage 2014; 54:1372-1384. [PMID: 25164982 PMCID: PMC4232744 DOI: 10.1007/s00267-014-0357-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 08/14/2014] [Indexed: 06/03/2023]
Abstract
The spatial distribution of landslides is influenced by different climatic conditions and environmental settings including topography, morphology, hydrology, lithology, and land use. In this work, we have attempted to evaluate the influence of land use change on landslide susceptibility (LS) for a small study area located in the southern part of the Briga catchment, along the Ionian coast of Sicily (Italy). On October 1, 2009, the area was hit by an intense rainfall event that triggered abundant slope failures and resulted in widespread erosion. After the storm, an inventory map showing the distribution of pre-event and event landslides was prepared for the area. Moreover, two different land use maps were developed: the first was obtained through a semi-automatic classification of digitized aerial photographs acquired in 1954, the second through the combination of supervised classifications of two recent QuickBird images. Exploiting the two land use maps and different land use scenarios, LS zonations were prepared through multivariate statistical analyses. Differences in the susceptibility models were analyzed and quantified to evaluate the effects of land use change on the susceptibility zonation. Susceptibility maps show an increase in the areal percentage and number of slope units classified as unstable related to the increase in bare soils to the detriment of forested areas.
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Affiliation(s)
- P Reichenbach
- Consiglio Nazionale delle Ricerche, Istituto di Ricerca per la Protezione Idrogeologica, Perugia, Italy,
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