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de Sousa D, Garrido P, Nunes D, Lemos C, Borges-Costa J. Ten Years of HIV Diagnosis in a Dermatology and Venereology Department: A Retrospective Study on Demographic, Clinical, and Laboratory Characteristics. Actas Dermosifiliogr 2024:S0001-7310(24)00357-0. [PMID: 38648929 DOI: 10.1016/j.ad.2024.04.016] [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: 06/13/2023] [Accepted: 09/19/2023] [Indexed: 04/25/2024] Open
Abstract
Human immunodeficiency virus (HIV) transmission remains an important health issue, with a high burden that is felt across the world. This work aims to analyze the demographic, clinical, and laboratory characteristics of newly diagnosed patients with HIV in a Department of Dermatology and Venereology. A retrospective observational study was conducted from all health records of newly diagnosed patients with HIV from a Dermatology unit from January 2011 through December 2020. A total of 134 patients with new HIV diagnoses were included in the analysis. Concurrent dermatological or venereal diseases were diagnosed in 91.0% of the patients (n = 122), being the most common conditions syphilis (22.4%, n = 30) and urethritis (14.9%, n = 20). Out of all the patients with diagnoses of concurrent sexually transmitted infection (STI) (41.0%, n = 55), syphilis was reported in 81.8% of the patients (n = 45), gonorrhea in 9.1% (n = 5), and chlamydia in 5.5% (n = 3). We present a large patient database on the clinical conditions associated with newly diagnosed HIV, concluding that infectious diseases were the most common conditions associated with newly diagnosed HIV.
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Affiliation(s)
- Diogo de Sousa
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
| | - Pedro Garrido
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Daniel Nunes
- Clinical Pathology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Carlos Lemos
- Clinical Pathology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - João Borges-Costa
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Dermatology Universitary Clinic, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal; Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
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Benchetrit A, Messina F, Matteo M, Vázquez M, Paul R, Gil Zbinden G, Costa N, Santiso G. Microsporum canis pseudomycetoma and disseminated Mycobacterium genavense infection in an HIV/AIDS patient, an unusual combination. Rev Argent Microbiol 2024:S0325-7541(24)00037-3. [PMID: 38644065 DOI: 10.1016/j.ram.2024.02.005] [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: 10/26/2023] [Revised: 12/27/2023] [Accepted: 02/23/2024] [Indexed: 04/23/2024] Open
Abstract
Pseudomycetomas are rare fungal subcutaneous infections caused by dermatophytes, which are mainly observed in immunocompromised patients. Mycobacterium genavense is considered an opportunistic pathogen in people living with HIV/AIDS (PLWHA), clinically resembling the presentation of Mycobacterium avium complex (MAC). Here, we describe the case of a 26-year-old PLWHA with a 3-month history of a 4cm tumoral, duroelastic and painful lesion located on the back. Histopathology of the tumoral lesion revealed chronic granulomatous inflammation with grains composed of PAS-positive and Grocott-positive septate hyphae, as well as acid-fast bacilli (AFB). Culture on Sabouraud and lactrimel agar developed colonies that were later identified as Microsporum canis. In successive samples, the AFB were identified as M. genavense by restriction analysis of PCR products. Immunocompromised PLWHA not only suffer increased susceptibility to diseases due to unusual pathogens but also atypical clinical presentation of frequently encountered pathogens.
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Affiliation(s)
- Andrés Benchetrit
- Sala 21, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernando Messina
- Unidad Micología, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mario Matteo
- Sección de Bacteriología de la Tuberculosis, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Mariana Vázquez
- Sección de Bacteriología de la Tuberculosis, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Roxana Paul
- Instituto Nacional de Enfermedades Infecciosas-ANLIS Carlos Malbrán, Buenos Aires, Argentina
| | - Germán Gil Zbinden
- Servicio de Anatomía Patológica, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Nora Costa
- Sección de Bacteriología de la Tuberculosis, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina
| | - Gabriela Santiso
- Unidad Micología, Hospital de Infecciosas Francisco Javier Muñiz, Ciudad Autónoma de Buenos Aires, Argentina.
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Ramírez López GA, Gómez Galicia DL, Zagal Jiménez TX, Toledano Jaimes CD, Díaz de León Castañeda C. Digital health to promote adherence to antiretroviral treatment in patients with HIV/AIDS: Meta review. Farm Hosp 2024:S1130-6343(24)00025-4. [PMID: 38570211 DOI: 10.1016/j.farma.2024.02.005] [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: 10/13/2023] [Revised: 12/26/2023] [Accepted: 02/13/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Digital health or "e-Health" is a set of applications based on Information and Communication Technologies that can be used to promote self-care and medication adherence in patients with chronic diseases. The aim of this study was to carry out a review of systematic reviews (meta-review) on efficacy studies of e-Health interventions to promote adherence to antiretroviral therapy in people living with HIV/AIDS. METHOD A review of systematic reviews ("meta-review") was performed using the Medline-PubMed database on efficacy studies of e-Health components to promote adherence to antirretroviral therapy, in patients with HIV/AIDS, proposing a structured search strategy (PICO question). A selection process for systematic reviews was conducted based on inclusion and exclusion criteria. Subsequently, the corresponding data were extracted, and the analysis was accomplished in descriptive tables. RESULTS A total of 29 systematic reviews were identified, from which 11 were selected. These reviews comprised 55 randomized controlled therapies with different e-Health interventions and enrolled a total of 15,311 HIV/AIDS patients. Studies included a total of 66 comparisons (experimental group vs. control group) in indirect adherence measurements based on different measurement techniques (36 statistically significant); 21 comparisons of viral load measurements (10 statistically significant); and 8 comparisons of CD4+ cell count measurements (3 statistically significant). m-Health was the most studied component followed by the telephone call and e-Learning. CONCLUSIONS Evidence was found that supports that some e-Health interventions are effective in promoting adherence to antirretroviral therapy and improving health outcomes in patients with HIV/AIDS, although it is identified that more studies are needed for more robust evidence.
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Affiliation(s)
- Griselda Areli Ramírez López
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos (UAEM), Morelos, México; Instituto Nacional de Enfermedades Respiratorias (INER) «Ismael Cosío Villegas», Secretaría de Salud, Ciudad de México, México
| | | | - Tania Ximena Zagal Jiménez
- Instituto Nacional de Enfermedades Respiratorias (INER) «Ismael Cosío Villegas», Secretaría de Salud, Ciudad de México, México
| | | | - Christian Díaz de León Castañeda
- Investigadoras e Investigadores por México, Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT), Ciudad de México, México; Facultad de Enfermería, Universidad Michoacana de San Nicolás de Hidalgo (UMSNH), Michoacán, México.
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Martín-Zaragoza L, Sánchez-Rubio-Ferrández J, Onteniente-González A, Gómez-Bermejo M, Rodríguez-Álvarez SJ, Monereo-Alonso A, Molina-García T. Real-world persistence with dolutegravir/lamivudine versus bictegravir/emtricitabina/tenofovir-alafenamide among people with HIV. Farm Hosp 2024:S1130-6343(24)00022-9. [PMID: 38448360 DOI: 10.1016/j.farma.2024.02.002] [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: 10/17/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 03/08/2024] Open
Abstract
OBJETIVES The main objective was to compare the persistence between dolutegravir/lamivudine (DTG/3TC) and bictegravir/emtricitabine/tenofovir-alafenamide (BIC/FTC/TAF) and to analyze reasons for discontinuation. METHODS We conducted a retrospective, non-interventional, descriptive and longitudinal study. All human immunodeficiency virus (HIV) patients over 18 years treated with DTG/3TC or BIC/FTC/TAF in our center were included. Persistence after first year was compared using the χ2 test. Kaplan-Meier survival analysis was performed. RESULTS Three hundred fifty-eight patients were included. 99.5% versus 90.99% of patients were persistent after the first year for DTG/3TC and BIC/FTC/TAF respectively (p = 0.001). Persistence with DGT/3TC was 1,237 days (IC95% 1,216-1,258) and persistence with BIC/FTC/TAF was 986 days ([IC95% 950-1,021]; p < 0.001). The difference was remained after adjusting for covariates with the cox regression model (HR= 8.2 [IC95% 1.03-64.9], p = 0.047). The main reasons for discontinuation for BIC/FTC/TAF were toxicity/tolerability. CONCLUSION In our study patients had a high persistence. Patients on DTG/3TC treatment were more persistent compared to BIC/FTC/TAF, although BIC/FTC/TAF have worse baseline characteristics. The main reason for discontinuation of BIC/FTC/TAF was tolerability/toxicity.
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García de Lomas-Guerrero JMA, Jiménez-García N, Fernández-Sánchez F, Del Arco-Jiménez A, Prada-Pardal JL, de la Torre-Lima J. Missed opportunities in the early detection of HIV infection in patients with sexually transmitted infections: A real-life study. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:146-148. [PMID: 38302371 DOI: 10.1016/j.eimce.2024.01.004] [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: 05/31/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Sexually transmitted diseases such as cervicitis, proctitis and urethritis are associated with high rates of HIV infection. When these pathologies are suspected, HIV serology should be requested. MATERIAL AND METHODS A retrospective study was performed during 2018 at the Hospital Costa del Sol (Marbella, Málaga, Spain). HIV serologies requested in patients who were asked for PCR for Chlamydia trachomatis and Neisseria gonorrhoeae were reviewed. RESULTS A total of 1818 patients were evaluated, in which HIV serology was performed in 44.7%, of which 14 (1.7%) were positive. The remaining 55.3% were missed diagnostic opportunities. CONCLUSIONS C. trachomatis and N. gonorrhoeae infections are associated with a high rate of occult HIV infection. The degree of suspicion of HIV in this population remains low and it is essential that it be reinforced in the presence of the possibility of infection by these pathologies.
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de la Mora L, Mallolas J, Ambrosioni J. Epidemiology, treatment and prognosis of HIV infection in 2024: A practical review. Med Clin (Barc) 2024:S0025-7753(24)00006-X. [PMID: 38383266 DOI: 10.1016/j.medcli.2023.12.007] [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: 08/30/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 02/23/2024]
Abstract
In recent years, the epidemiology and prognosis of HIV infection have undergone significant changes thanks to the recommendation of antiretroviral therapy (ART) for all infected persons, the development of more effective and better tolerated drugs, and preventive measures such as pre-exposure prophylaxis (PrEP). The evolution of ART, now with simple oral and injectable options, has also contributed to improvements in comprehensive HIV treatment and care. With early diagnosis and early initiation of ART, the life expectancy of people with HIV has reached the same as the general population. However, many people with HIV remain undiagnosed or are diagnosed late, and some population groups experience greater vulnerability, affecting individual and collective health. In this review we review the current epidemiology, treatment and prognosis of HIV infection.
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Affiliation(s)
- Lorena de la Mora
- Unitat de VIH-sida, Servei de Malalties Infeccioses, Hospital Clínic-Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, España.
| | - Josep Mallolas
- Unitat de VIH-sida, Servei de Malalties Infeccioses, Hospital Clínic-Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, España
| | - Juan Ambrosioni
- Unitat de VIH-sida, Servei de Malalties Infeccioses, Hospital Clínic-Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS), Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, España
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Moreno-García S, Belza MJ, Iniesta C, González-Recio P, Palma D, Sordo L, Pulido J, Guerras JM. [Daily use of HIV pre-exposure prophylaxis among gay, bisexual and other men who have sex with men in Spain: Prevalence and associated factors]. Med Clin (Barc) 2024; 162:95-102. [PMID: 37813725 DOI: 10.1016/j.medcli.2023.08.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE We aim to estimate the prevalence of daily HIV pre-exposure prophylaxis (PrEP) use 6 months after public funding approval in Spain and identify associated factors in a national sample of gay, bisexual and other men who have sex with men (GBMSM). MATERIAL AND METHODS We analysed 4692 HIV-undiagnosed GBMSM men recruited via an online questionnaire distributed nationally via gay contact apps and websites between May and July 2020. We estimated the proportion of participants using daily PrEP and identified associated factors using Poisson regression with robust variance. RESULTS Daily PrEP use was reported by 2.8% (95% CI 2.3-3.3) of all participants. Daily PrEP use was independently associated with being recruited into community programmes, being older than 30 years, living in a large city, living with men, having condomless anal intercourse with more than 10 sexual partners, using drugs for sex, especially chemsex drugs, and being diagnosed with a sexually transmitted infection. CONCLUSION Six months after PrEP was approved in Spain, the prevalence of daily use is low in a national sample of GBMSM men. There is a need to promote access, demand and interest in PrEP, especially among young GBMSM men, those living in small and medium-sized cities, and those who hide their relationships with other men.
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Affiliation(s)
- Sara Moreno-García
- Servicio de Medicina Preventiva, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - M José Belza
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España.
| | - Carlos Iniesta
- Sociedad Española Interdisciplinaria del Sida (SEISIDA), Madrid, España
| | - Paule González-Recio
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - David Palma
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España; Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, España
| | - Luis Sordo
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España; Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, Madrid, España
| | - Jose Pulido
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España; Departamento de Salud Pública y Materno-Infantil, Universidad Complutense de Madrid, Madrid, España
| | - Juan Miguel Guerras
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España
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de Sousa D, Garrido P, Nunes D, Lemos C, Borges-Costa J. Ten Years of HIV Diagnosis in a Dermatology and Venereology Department: A Retrospective Study on Demographic, Clinical, and Laboratory Characteristics. Actas Dermosifiliogr 2024:S0001-7310(24)00053-X. [PMID: 38311223 DOI: 10.1016/j.ad.2023.09.024] [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: 06/13/2023] [Revised: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 02/10/2024] Open
Abstract
Human immunodeficiency virus (HIV) transmission remains an important health issue, with a high burden that is felt across the world. This work aims to analyze the demographic, clinical, and laboratory characteristics of newly diagnosed patients with HIV in a Department of Dermatology and Venereology. A retrospective observational study was conducted from all health records of newly diagnosed patients with HIV from a Dermatology unit from January 2011 to December 2020. A total of 134 patients with new HIV diagnoses were included in the analysis. Concurrent dermatological or venereal diseases were diagnosed in 91.0% of the patients (n=122), being the most common conditions syphilis (22.4%, n=30) and urethritis (14.9%, n=20). Out of all the patients with diagnoses of concurrent sexually transmitted infection (STI) (41.0%, n=55), syphilis was reported in 81.8% of the patients (n=45), gonorrhea in 9.1% (n=5), and chlamydia in 5.5% (n=3). We present a large patient database on the clinical conditions associated with newly diagnosed HIV, concluding that infectious diseases were the most common conditions associated with newly diagnosed HIV.
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Affiliation(s)
- D de Sousa
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.
| | - P Garrido
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - D Nunes
- Clinical Pathology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - C Lemos
- Clinical Pathology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - J Borges-Costa
- Dermatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Dermatology Universitary Clinic, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal; Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
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Hernández Requejo D, de Armas Y, Iglesias E, Díaz HM, Gravier R, Godínez López MC, Fonte L, Plascencia-Cruz M, Pacheco-Quijano K, Palomares J, Pérez-Gómez HR, Plascencia-Hernández A, Calderón EJ. Polymorphisms of CCR5, IL-6, IFN-γ and IL-10 genes in Cuban HIV/AIDS patients. Rev Clin Esp 2024; 224:96-104. [PMID: 38253256 DOI: 10.1016/j.rceng.2023.12.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
INTRODUCTION Genetic studies have shown associations of several single nucleotide polymorphisms (SNP) with different rates of progression and variation in susceptibility to HIV infection. This study aimed to estimate the frequency of ccr5Δ32, IL-6-174G/C, IFN-γ+874T/A and IL-10-1082A/G polymorphisms in Cuban HIV-infected patients and a group of sero-discordant couples to assess their influence on risk and disease progression. METHODS A cross-sectional study was carried out on 120 subjects registered at the Institute of Tropical Medicine «Pedro Kour» (IPK) and the Ameijeiras Hospital from June 2018 until December 2019. The amplification of fragments of the ccr5, IL-6, IFN-γ and IL-10 genes was performed by polymerase chain reaction followed by identification of polymorphisms using the restriction fragment length polymorphism analysis for IL-6 with the restriction enzymes Nla III. Amplification Refractory Mutation System was used for IFN-γ and IL-10 genes. RESULTS The allelic and genotypic distributions of the genes ccr5, IL-6, IFN-γ and IL-10 did not differ significantly between the two groups. Cell counts and plasma viral load values did not differ significantly between genotypes of the ccr5, IL-6, IFN-γ and IL-10 genes. Only the IL-6 GC genotype was associated with higher viral load values. The combination of alleles of the four considered SNPs showed a highly significant increase in the risk of HIV infection for one of them, but with a very low frequency (<1%). CONCLUSION This study contributes to evaluating the frequency of these polymorphisms and their influence on biomarkers of the progression of HIV infection in the Cuban HIV-population.
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Affiliation(s)
- D Hernández Requejo
- Departamento de Laboratorio Clínico, Centro Hospitalario, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - Y de Armas
- Departamento de Patología, Centro Hospitalario, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba; Departamento de Diagnóstico Microbiológico Clínico, Centro Hospitalario, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - E Iglesias
- Centro de Ingeniería Genética y Biotecnología, La Habana, Cuba
| | - H M Díaz
- Hospital Clínico Quirúrgico «Hermanos Ameijeiras», La Habana, Cuba
| | - R Gravier
- Departamento de Farmacología, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - M C Godínez López
- Departamento de Laboratorio Clínico, Centro Hospitalario, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - L Fonte
- Departamento de Parasitología, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - M Plascencia-Cruz
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - K Pacheco-Quijano
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - J Palomares
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - H R Pérez-Gómez
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - A Plascencia-Hernández
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.
| | - E J Calderón
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.
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Busca Arenzana C, González-García J, Blas-García A, Esplugues JV, Olveira Martín A, Montes Ramírez ML. Benefits of rilpivirine for liver stiffness in HIV/HCV-coinfected patients. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:74-79. [PMID: 36737372 DOI: 10.1016/j.eimce.2022.08.015] [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: 03/17/2022] [Accepted: 08/04/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Rilpivirine (RPV) is an antiretroviral drug characterized by good tolerability and a favorable liver safety profile. Recent research has shown that RPV ameliorates liver fibrosis in animal models of various chronic liver diseases. Our study aimed to analyze the effect of RPV on liver fibrosis by assessing changes in liver stiffness using transient elastography. METHODS Retrospective cohort study of HIV-infected patients who were exposed and not exposed to RPV. The change in liver stiffness during the period between two transient elastography measurements was analyzed and compared for patients exposed and not exposed to RPV. RESULTS We selected 118 RPV-exposed and 118 non-RPV-exposed HIV-infected patients. Median time between transient elastography (TE) measurements was 50 (29-68) months. A repeated-measures general linear model based on the main clinical characteristics revealed a significant decrease in the TE value of -0.8kPa in non-RPV-exposed patients (p=0.254) and -1.6kPa in the RPV-exposed group (p<0.001). The subgroup analysis showed a significant reduction in the TE value only patients cured of hepatitis C (RPV-exposed, -2.8kPa [p<0.001]; non-RPV-exposed, -1.1kPa [p=0.22]). CONCLUSION RPV-based antiretroviral regimens significantly reduced liver stiffness, as measured by TE, in patients cured of chronic hepatitis C.
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Affiliation(s)
- Carmen Busca Arenzana
- Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain.
| | - Juan González-García
- Unidad VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Ana Blas-García
- Departamento de Fisiología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Valencia, Spain
| | - Juan V Esplugues
- Departamento de Fisiología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Valencia, Spain; Departamento de Farmacología, Facultad de Medicina, Universidad de Valencia, Valencia, Spain; FISABIO-Hospital Universitario Dr. Peset, Valencia, Spain
| | - Antonio Olveira Martín
- Unidad Hepatología, Servicio de Gastroenterología, Hospital Universitario La Paz, Madrid, Spain
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Martínez-Sanz J, Losa-García JE, Orozco N, Alastrué I, Mascort J, Pérez-Elías MJ. Executive summary of the consensus document on the shared care of patients with HIV infection between primary and hospital care. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:102-107. [PMID: 37919199 DOI: 10.1016/j.eimce.2023.05.009] [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: 05/12/2023] [Accepted: 05/24/2023] [Indexed: 11/04/2023]
Abstract
The current reality of the diagnosis and treatment of HIV infection justifies a multidisciplinary and coordinated approach between Primary Care and Hospital Care, contemplating bidirectionality and communication between the two care settings. The consensus document, coordinated by the AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC-GeSIDA) and the Spanish Society of Family and Community Medicine (semFYC), was born out of this need. Here, the recommendations of the four sections that comprise it are summarized: the first deals with aspects of prevention and diagnosis of HIV infection; the second contemplates the clinical care of people living with HIV; the third deals with social factors, including legal and confidentiality issues, quality of life, and the role of NGOs; finally, the fourth block addresses bidirectional and shared training/teaching and research.
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Affiliation(s)
- Javier Martínez-Sanz
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERINFEC, Madrid, Spain.
| | - Juan E Losa-García
- Unidad de Enfermedades Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | - Ignacio Alastrué
- Centro de Información y Prevención del Sida y otras ITS, Valencia, Spain
| | - Juanjo Mascort
- Centro de Salud La Florida Sud, ICS, L'Hospitalet de Llobregat, Barcelona, Spain
| | - María Jesús Pérez-Elías
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERINFEC, Madrid, Spain
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12
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Gutiérrez F, Padilla S, García-Abellán J, Gutiérrez-Ortiz de la Tabla A, Ledesma C, Masiá M. Cancer screening in people with HIV: Implementation in clinical practice and barriers perceived by medical specialists in Spain. Enferm Infecc Microbiol Clin (Engl Ed) 2024:S2529-993X(24)00013-3. [PMID: 38262880 DOI: 10.1016/j.eimce.2024.01.007] [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] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVE To assess the degree of implementation of cancer screening recommendations in people living with HIV (PLHIV) in Spain. METHODS A self-administered questionnaire was designed on the strategies used for early detection of the main types of cancer in PLHIV. The survey was distributed electronically to HIV physicians participating in the Spanish CoRIS cohort. RESULTS 106 questionnaires were received from 12 different Spanish Autonomous Communities, with an overall response rate among those who accessed the questionnaire of 60.2%. The majority responded that they followed the CPGs recommendations for the early detection of liver (94.3%), cervical (93.2%) and breast (85.8%) cancers. In colorectal and anal cancer, the proportion was 68.9% and 63.2%, and in prostate and lung cancer of 46.2% and 19.8%, respectively. In hospitals with a greater number of beds, a tendency to perform more cancer screening and greater participation of the Infectious Diseases/HIV Services in the screening programmes was observed. Significant differences were observed in the frequency of colorectal and anal cancer screening among the different Autonomous Communities. The most frequent reasons for not performing screening were the scarcity of material and/or human resources and not being aware of what is recommended in the CPGs. CONCLUSIONS There are barriers and opportunities to expand cancer screening programmes in PLHIV, especially in colorectal, anal and lung cancers. It is necessary to allocate resources for the early detection of cancer in PLHIV, but also to disseminate CPGs screening recommendations among medical specialists.
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Affiliation(s)
- Félix Gutiérrez
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Elche, Alicante, Spain; Universidad Miguel Hernández, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.
| | - Sergio Padilla
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Elche, Alicante, Spain; Universidad Miguel Hernández, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier García-Abellán
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Elche, Alicante, Spain; Universidad Miguel Hernández, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Christian Ledesma
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | - Mar Masiá
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Elche, Alicante, Spain; Universidad Miguel Hernández, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
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13
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Pan YH, Nomah DK, Montoro-Fernandez M, Moreno-Fornés S, Díaz Y, Aceitón J, Bruguera A, Llibre JM, Domingo P, Imaz A, Vilaró I, Falcó V, Reyes-Urueña J, Miro JM, Casabona J. The impact of the COVID-19 pandemic on healthcare services utilization among people living with HIV in Catalonia, Spain: A population-based cohort study. Enferm Infecc Microbiol Clin (Engl Ed) 2024:S2529-993X(24)00001-7. [PMID: 38218704 DOI: 10.1016/j.eimce.2023.09.004] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/23/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND The COVID-19 pandemic disrupted healthcare services usage. We estimated the impact of the COVID-19 pandemic on healthcare services utilization among people living with HIV (PLWH) in Catalonia, Spain. METHODS We accessed public healthcare usage in HIV units, primary care, hospitals, and emergency departments among 17,738 PLWH in the PISCIS cohort from January 1, 2017, to December 31, 2020. We performed an interrupted time series analysis using the autoregressive integrated moving average to estimate the effect of COVID-19 on medical visits and HIV monitoring among PLWH. RESULTS A non-significant decrease of 17.1% (95% CI: [-29.4, 0.4]) in overall medical visits was observed during the lockdown, followed by a steady resumption until the end of 2020. Three health facilities presented statistically significant declines in visits during the lockdown: HIV units (-44.8% [-56.7, -23.6]), hospitals (-40.4% [-52.8, -18.1]), and emergency departments (-36.9% [-47.0, -21.9]); thereafter, the visits have begun to increase steadily but not to previous levels as of December 2020. In contrast, primary care visits remained unchanged during the lockdown by 1.9% (95% CI: -13.5, 23.9). CD4 cell (54.2% [95% CI: -64.4, -36.0]) and HIV RNA viral load (53.1% [95% CI: -62.9, -36.1]) laboratory monitoring reduced significantly during the lockdown. CONCLUSION COVID-19 lockdowns significantly disrupted in-person healthcare services usage among PLWH. The reduction in healthcare utilization however did not affect primary care services. Despite services gradually rebounding to pre-pandemic levels, it is imperative to effectively prepare for future pandemics and implement measures to ensure continuous provision of care to PLWH during pandemic lockdowns.
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Affiliation(s)
- Yi-Hua Pan
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain
| | - Daniel K Nomah
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain.
| | - Marcos Montoro-Fernandez
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain
| | - Sergio Moreno-Fornés
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Yesika Díaz
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jordi Aceitón
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain
| | - Andreu Bruguera
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Josep M Llibre
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Pere Domingo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Arkaitz Imaz
- Department of Infectious Diseases, Hospital Universitari de Bellvitge, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain
| | | | - Vicenç Falcó
- Vall d'Hebron Research Institute (VHIR), Hospital de Vall d'Hebron, Barcelona, Spain
| | - Juliana Reyes-Urueña
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain
| | - José M Miro
- Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain.
| | - Jordi Casabona
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
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14
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Al-Hayani AW, Cabello-Ubeda A, Ramírez Verdyguer M, Téllez Pérez R, Castaño Núñez ÁL, de Górgolas Hernández-Mora M. [Demographic study of persons living with HIV (PLWH) newly diagnosed in the healthcare area of a tertiary-level hospital]. Semergen 2024; 50:102088. [PMID: 37827046 DOI: 10.1016/j.semerg.2023.102088] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/21/2023] [Accepted: 08/04/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Countering HIV infection remains a primary objective of the Spanish National Health System. Emergency services play a crucial role in reducing missed diagnostic opportunities, with estimates suggesting that one in 3 such opportunities occur here. The aim of the study is to examine the geographical dispersion of newly diagnosed HIV cases, within a downtown Madrid hospital. METHODS This is an observational, descriptive, retrospective study evaluating the geographical distribution of new HIV diagnoses in the care area of a tertiary University Hospital in the Community of Madrid. RESULTS Three hundred and eighty-seven individuals with a new diagnosis of HIV infection between 2018 and 2020 were analysed, the majority being young people with an average age of 36±9 years. 86% were gay, bisexual and other men who have sex with men and 48.6% were immigrants. 15.3% presented with CD4+<200cells/mm3 and 9.5% with an AIDS-defining illness. 32.7% and 5.1% had an RNA-HIV-1>100,000copies/mL and >500,000copies/mL, respectively, with up to 13.7% of subjects presenting resistance mutations at diagnosis. Geographically, 51.4% of individuals came from 4 Health Centres and more than 70% of the new diagnoses were included in nine Health Centres. CONCLUSION Better understanding the geographical distribution of new HIV diagnoses by health areas allows us to identify areas of higher transmission risk, thereby directing and implementing prevention, early diagnosis, and treatment measures.
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Affiliation(s)
- A W Al-Hayani
- Servicio de Medicina Interna, División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, Madrid, España; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), Madrid, España.
| | - A Cabello-Ubeda
- Servicio de Medicina Interna, División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, Madrid, España; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), Madrid, España
| | - M Ramírez Verdyguer
- Servicio de Medicina Interna, División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, Madrid, España; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), Madrid, España
| | - R Téllez Pérez
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), Madrid, España; Servicio de Inmunología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - Á L Castaño Núñez
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), Madrid, España; Servicio de Inmunología, Hospital Universitario Fundación Jiménez Díaz, Madrid, España
| | - M de Górgolas Hernández-Mora
- Servicio de Medicina Interna, División de Enfermedades Infecciosas, Hospital Universitario Fundación Jiménez Díaz, Madrid, España; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), Madrid, España
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15
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Coll P, Jarrín I, Martínez E, Martínez-Sesmero JM, Domínguez-Hernández R, Castro-Gómez A, Casado MŸ. Achieving the UNAIDS goals by 2030 in people living with HIV: A simulation model to support the prioritization of health care interventions. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:589-595. [PMID: 36710166 DOI: 10.1016/j.eimce.2022.07.011] [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: 06/08/2022] [Accepted: 07/29/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE We simulated the impact of implementing different health interventions to improve the HIV continuum of care for people diagnosed, on treatment, and virologically suppressed in Spain for the 2020-2030 period. METHODS The model was carried out in four phases involving a multidisciplinary expert panel: (1) literature review; (2) selection/definition of the interventions and their effectiveness; (3) consensus meeting; and (4) development of an analytical decision model to project the impact of implementing/strengthening these interventions to improve the HIV continuum of care, corresponding to 2017-2019 (87% diagnosed, 97% on treatment, 90% with viral suppression), through the creation of different scenarios for 2020-2030. A total of 19 interventions were selected based on expanding the offer of HIV rapid tests and implementing training/peer programmes, electronic alerts, multidisciplinary care, and mHealth, among others. The effectiveness of the interventions was defined by the percentage increases in diagnosis, treatment, and viral suppression after their implementation, targeting the entire population and specific groups at high-risk (men who have sex with men, migrants, female sex workers, transgender people, and people who inject drugs). RESULTS Implementing eight interventions for diagnosis, three for treatment, and eight for viral suppression for the target populations during 2020-2030 would increase the continuum of care to approximately 100% diagnosed (remaining residual undetectable cases), 98% treated, and 96% virologically suppressed. CONCLUSIONS Planification, prioritization, and implementation of selected interventions based on the current HIV continuum of care could allow achievement of the 95-95-95 UNAIDS goals in Spain by 2030.
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Affiliation(s)
- Pep Coll
- IrsiCaixa-AIDS Research Institute, Germans Trias I Pujol Hospital, Badalona, Barcelona, Spain
| | - Inma Jarrín
- National Center for Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain; Spanish HIV/AIDS Research Network (CoRIS), Madrid, Spain; CIBER de Enfermedades Infecciosas, Madrid, Spain
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16
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De la Torre-Lima J, Oteo JA, Pinilla J, Mansilla R, Zamora C, Ayala Vargas V, Morillo-Verdugo R, Moreno S, Fuster-Ruiz de Apodaca MJ, Pérez-Molina JA, Colom J. Study on the approach to HIV: health management and the healthcare process in Spain. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:604-611. [PMID: 36624033 DOI: 10.1016/j.eimce.2022.12.008] [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: 02/11/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION HIV continues to represent a problem of great relevance for public health in Spain. This study aims to carry out an analysis that will provide in-depth knowledge of the resources, clinical care, and management during the diagnosis, follow-up, and treatment phases of HIV infection in Spain. METHODS In the first phase, a multidisciplinary Scientific Committee designed an information collection tool in the form of a survey. In the second phase, carried out in the autonomous communities of Andalusia, Catalonia, and La Rioja, a multidisciplinary group of 42 experts, representatives of the public administration, clinical profiles, and representatives of NGOs in the field of HIV answered the survey. RESULTS The assessment of HIV resources is generally positive. As regards diagnosis, the experts considered that there was good coordination between Primary and Hospital care. Regarding treatment, the evaluations reflected good opinions on therapeutic conciliation and adherence, with a negative opinion in the evaluation of drug interactions with antiretroviral treatment. Regarding follow-up, the perception expressed was disparate concerning the coordination between Hospital and Primary Care as well as the adaptation of care to chronicity, aging, fragility, mental health, and oncological processes. CONCLUSION There are certain processes that can be improved in the management of HIV infection in people with HIV in Spain, including protocols for follow-up and coordination between primary and hospital care in the treatment and follow-up of the disease.
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Affiliation(s)
- Javier De la Torre-Lima
- Plan Andaluz frente al VIH/sida y otras ITS, Consejería de Salud y Consumo de la Junta de Andalucía, Spain; Grupo de Enfermedades Infecciosas de la Unidad de Medicina Interna, Hospital Costa del Sol, Málaga, Spain.
| | - José Antonio Oteo
- Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores, Departamento de Enfermedades Infecciosas, Hospital Universitario San Pedro-Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, La Rioja, Spain
| | - Javier Pinilla
- Servicio de Medicina Interna, Complejo Hospitalario San Millán-San Pedro, Logroño, Spain; Comisión Ciudadana Anti-Sida de La Rioja (CCASLR), Logroño, La Rioja, Spain
| | - Rosa Mansilla
- Vigilancia, Prevención y Control de las Infecciones de Transmisión Sexual y el VIH, Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública de Cataluña, Departamento de Salud, Generalidad de Cataluña, Barcelona, Spain
| | - Carmen Zamora
- Plan Andaluz frente al VIH y otras ITS, Consejería de Salud y Consumo de la Junta de Andalucía, Spain
| | | | - Ramón Morillo-Verdugo
- Servicio de Farmacia, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain
| | - Santiago Moreno
- Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - María José Fuster-Ruiz de Apodaca
- Departamento de Psicología Social y de las Organizaciones, UNED, Madrid, Spain; Sociedad Española Interdisciplinaria del Sida (SEISIDA), Madrid, Spain
| | - José A Pérez-Molina
- CSUR de Enfermedades Tropicales, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Joan Colom
- Programa de Prevención, Control y Atención al VIH, las ETS y las Hepatitis Víricas de la Agencia de Salud Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain
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17
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Lemaire V. [AMMA seated massage for people living with HIV, the relationship at your fingertips]. Rev Infirm 2023; 72:43-45. [PMID: 38071018 DOI: 10.1016/j.revinf.2023.10.014] [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] [Indexed: 12/18/2023]
Abstract
As part of a care program for patients with the human immunodeficiency virus (HIV), a hospital nurse with a university diploma in "body-psychological practice and integrative health" offers a program of five seated massage sessions. Patients can also be referred to her by the site's infectious diseases physicians, psychiatrist or psychologist, for nursing support and to assess the impact of their pathology, reinforcing their follow-up by promoting links between physical and psychological care. An innovative approach designed to help patients live better with their illness.
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Affiliation(s)
- Vanessa Lemaire
- Comité Sida Sexualités Prévention de l'EPS Ville-Évrard, Détachée sur le GHI Le Raincy-Montfermeil, 10, rue du Général-Leclerc, 93370 Montfermeil, France.
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18
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Serrano-Villar S, Moltó-Marhuenda J, Montero-Alonso M, Diaz-Torné C, López-Cavanillas M, Pérez de Isla L. Knowledge, attitudes and practices in HIV-related chronic inflammation and cardiovascular risk in Spain. Enferm Infecc Microbiol Clin (Engl Ed) 2023:S2529-993X(23)00261-7. [PMID: 37945466 DOI: 10.1016/j.eimce.2023.07.009] [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] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/27/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND People with HIV (PWH) in suppressive antiretroviral treatment suffer from chronic inflammation-related comorbidities, mainly cardiovascular diseases. However, given the lack of specific evidence about inflammation in PWH, clinical guidelines do not provide recommendations for the management of this issue. To date, physician awareness of inflammation in PWH remains unclear. We analyzed the knowledge, attitudes, and practices (KAP) related to inflammation, particularly in the clinical management of PWH, of infectious disease specialists (IDS)/internists compared to other specialists treating inflammation directly (rheumatologists) or its cardiovascular consequences (cardiologists). METHODS A committee of IDS/internists treating PWH, cardiologists, and rheumatologists designed the KAP questionnaire. The survey was completed by 405 participants (135 physicians per specialty) stratified by Spanish geography, hospital size, and number of PWH under care (IDS/internists only). RESULTS IDS/internists treating PWH scored higher than cardiologists and rheumatologists on knowledge of inflammation (5.5±1.4 out of 8 points vs. 5.2±1.3 and 4.6±1.4 points, respectively; p<0.05). Nevertheless, rheumatologists showed the most proactive attitude toward inflammation (i.e., biomarkers monitoring, anti-inflammatory drug prescription and cardiologist referral), followed by cardiologists and IDS/internists (13±3 of a total of 16 points vs. 11±3 and 10±3.3 points, respectively; p<0.05), irrespective of hospital size and years of experience. Most IDS/internists (59%) include inflammation in their therapeutic recommendations. However, in IDS/internists treating PWH, we observed a negative correlation between years of experience and concern about the clinical consequences of inflammation. CONCLUSION Our findings show that, compared to other specialists, infectious disease specialists/internists have high knowledge about inflammation in HIV infection, but, in the absence of scientific evidence to base their decisions on inflammatory markers, the therapeutic implications are scarce. The results support the need for more evidence on the monitoring and treatment of inflammation in PWH.
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Affiliation(s)
- Sergio Serrano-Villar
- Department of Infectious Diseases, Ramon y Cajal Hospital and IRYCIS, Madrid, Spain; Centro de Investigación en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
| | - José Moltó-Marhuenda
- Centro de Investigación en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain; Fight AIDS and Infectious Diseases Foundation, Badalona, Barcelona, Spain
| | | | - Cesar Diaz-Torné
- Rheumatology Department, Sant Pau i Santa Creu Hospital, Barcelona, Spain
| | | | - Leopoldo Pérez de Isla
- Cardiology Department, San Carlos Clinic Hospital, Universidad Complutense, Madrid, Spain
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Martín-Carbonero L, Gutierrez Á, Bisbal O, Vergas J, González-Baeza A, Rodríguez Martín C, Vivancos MJ, Sanz J, Álvarez B, Palomar M, de Los Santos I, Sepúlveda-Crespo D, Resino S, Berenguer J, Cano-Smith J, González-García J, Ryan P. Recently acquired hepatitis C: Epidemiological characteristics and treatment response in a large cohort of MSM living with HIV in Madrid. Enferm Infecc Microbiol Clin (Engl Ed) 2023:S2529-993X(23)00258-7. [PMID: 37945463 DOI: 10.1016/j.eimce.2023.06.011] [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] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/30/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION We analyzed epidemiological, clinical characteristics, and the response to treatment in people living with HIV (PLHIV) who recently acquired hepatitis C (RAHC) in a multicentre study in Madrid (Spain). METHODS Multicenter, ambispective, observational study of RAHC in men who have sex with men (MSM) infected with HIV. Clinical, epidemiological, and RAHC evolution were recorded prospectively in 2019 and 2020 and retrospectively in 2017 and 2018. In patients who received HCV treatment, sustained virological response (SVR) was provided 12 weeks after the end of treatment in an intention to treat analysis (ITT): all treated patients were included; and in analysis per-protocol (PP): missing patients were excluded. RESULTS Overall, 133 patients were included. Median (IQR) age was 40 (34.3-46.1) years, 90.9% had at least one previous sexual transmission disease (STD), and 33.6% had previously hepatitis C. More than half of the prospective sample included patients using chemsex related drugs (57.3%), 45.7% of them intravenously. The most prevalent genotype was G1a (66.2%), followed by G4 (11.3%). Ten of 90 patients evaluated for spontaneous cure (11%) cured the infection spontaneously, and 119 had treatment after a median time of 1.8 (0.7-4.6) months: sustained virological response (SVR) was achieved in 90.7% in the ITT and 94.7% in the PP analysis, with no differences regarding the direct-acting antiviral agents (DAA) combination used. CONCLUSIONS MSM infected by HIV with a RAHC were exposed to high-risk sexual behavior. Spontaneous cure rate was low, while SVR after treatment was achieved by more than 90%.
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Affiliation(s)
- Luz Martín-Carbonero
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain.
| | - Ángela Gutierrez
- Servicio de Medicina Interna-Infecciosas, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain
| | - Otilia Bisbal
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario 12 de Octubre - Imas 12, Madrid, Spain; CIBERINFECC, Spain
| | - Jorge Vergas
- Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Alicia González-Baeza
- Departamento Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Spain
| | - Carmen Rodríguez Martín
- Hospital Clínico San Carlos, IdISSC, Madrid, Spain; Centro Sanitario Sandoval, Madrid, Spain
| | - María Jesús Vivancos
- Departamento de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal - IRYCIS, Madrid, Spain
| | - José Sanz
- Unidad de Enfermedades Infecciosas, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Beatriz Álvarez
- Unidad de Enfermedades Infecciosas, Fundacion Jimenez Diaz, Madrid, Spain
| | - Marina Palomar
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, Idipaz, Madrid, Spain
| | - Ignacio de Los Santos
- Servicio de Medicina Interna-Infecciosas, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, Madrid, Spain; CIBERINFECC, Spain
| | - Daniel Sepúlveda-Crespo
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Salvador Resino
- Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain
| | - Juan Berenguer
- Servicio de Enfermedades Infecciosas, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Joanna Cano-Smith
- 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; CIBERINFECC, Spain
| | - Pablo Ryan
- Servicio de Medicina Interna, Hospital Universitario Infanta Leonor, Madrid, Spain
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González-Alcaide G, Menchi-Elanzi M, Bolaños-Pizarro M, Gutiérrez-Rodero F, Ramos-Rincón JM. Bibliometric and thematic characterization of the research on HIV-AIDS in Spain (2010-2019). Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:535-544. [PMID: 37031066 DOI: 10.1016/j.eimce.2023.03.006] [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: 03/09/2022] [Revised: 04/26/2022] [Accepted: 05/02/2022] [Indexed: 04/10/2023]
Abstract
INTRODUCTION The establishment of the Spanish AIDS Research Network (RIS) was a milestone for the promotion of HIV research in Spain. We analyse Spanish HIV research, assessing the role that RIS has played in it. METHODS We identified publications on HIV-AIDS with the participation of Spanish institutions in the Web of Science over the period 2010-2019, characterising research activity by means of bibliometrics and identifying the thematic areas of research through a cluster analysis. RESULTS A total of 3960 documents have been identified (average of 396 documents/year), 42% of which have been signed in international collaboration. RIS researchers have participated in 60% of the documents, presenting a scientific production and citation significantly higher than authors not linked to the RIS. Five thematic clusters articulate the research, focusing on the clinical and therapeutic approach to people living with HIV, co-infection and co-morbidity with other diseases, the genetic characterisation of the virus, the development of vaccines and the study of its transmission in specific groups or associated with sexual behaviour. CONCLUSION Spanish HIV research, largely driven by RIS groups, has reached a stage of maturity, with a notable increase in scientific production, participation in international cooperative networks and an outstanding impact and visibility.
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Affiliation(s)
| | - Marouane Menchi-Elanzi
- Departamento de Medicina Interna, Hospital General Universitario de Alicante, Alicante, Spain
| | - Máxima Bolaños-Pizarro
- Departamento de Historia de la Ciencia y Documentación, Universitat de València, Valencia, Spain
| | - Félix Gutiérrez-Rodero
- Unidad de Enfermedades Infecciosas, Hospital General Universitario de Elche, Elche, Alicante, Spain; Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Sant Joan d'Alacant, Alicante, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - José-Manuel Ramos-Rincón
- Departamento de Medicina Interna, Hospital General Universitario de Alicante, Alicante, Spain; Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, Sant Joan d'Alacant, Alicante, Spain
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21
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Rotea-Salvo S, Giménez-Arufe V, Martínez-Pradeda A, Fernández-Oliveira C, Mena-de-Cea Á, Margusino-Framiñán L, Martín-Herranz I, Cid-Silva P. Lipid profile changes associated with antiretroviral therapies in a real-world cohort. Farm Hosp 2023; 47:T210-T217. [PMID: 37673703 DOI: 10.1016/j.farma.2023.07.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/28/2023] [Accepted: 04/23/2023] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE To compare lipid profile changes and cardiovascular events among HIV naïve and experienced patients from a real-world cohort treated with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate or dolutegravir/abacavir/lamivudine. METHOD A retrospective cohort study in HIV naïve and experienced people at a reference hospital in Spain was done. During the follow-up (March 2015-June 2019), patients were treated with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate or dolutegravir/abacavir/lamivudine. Epidemiological, clinical and immunovirological variables were recorded. A statistical analysis of the lipid profile at baseline, 48 and 120 weeks after initiating the study therapy, cardiovascular events (myocardial infarction, heart failure, cerebrovascular accident, deep venous thrombosis, myocardiopathy, non-ST- segment elevation acute coronary syndrome, and ST-segment elevation myocardial infarction) and cardiovascular risks factors was performed. Data were analysed in naïve and experienced patients from each of the study treatments. The data was obtained from the medical history. The statistical analysis was performed with SPSS v.24 software. RESULTS A total of 266 and 191 patients receiving treatment with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate and dolutegravir/abacavir/lamivudine were included in the study, respectively. After 120 weeks of treatment, a worsening of the lipid profile was found in the elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate group, both in naïve and experienced patients, whereas not so conspicuously observed in the dolutegravir/abacavir/lamivudine group. Statistically significant differences between both groups were found in experienced patients favoring dolutegravir/abacavir/lamivudine; in total cholesterol (204.1 ± 38.2 vs. 187.3 ± 29.4, p < 0.001) and LDL-C (126.1 ± 31.9 vs. 113.5 ± 28.5, p = 0.001) at week 48, and in total cholesterol (201.1 ± 33.4 vs. 188.7 ± 33.9, p = 0.013) and HDL-C (54.2 ± 15.6 vs. 48.3 ± 14.3, p = 0.01) at week 120. No significant differences in cardiovascular events were found, neither in naïve nor in experienced patients. CONCLUSIONS The lipid profile among elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate group worsened throughout the follow-up, both in naïve and experienced patients, not so remarkable in the dolutegravir/abacavir/lamivudine group. Both regimens were well tolerated, with similar rates of cardiovascular events.
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Affiliation(s)
- Sandra Rotea-Salvo
- Servicio de Farmacia, Hospital Universitario de A Coruña (CHUAC), A Coruña, España
| | - Víctor Giménez-Arufe
- Servicio de Farmacia, Hospital Universitario de A Coruña (CHUAC), A Coruña, España
| | | | | | - Álvaro Mena-de-Cea
- Servicio de Infecciosos, Unidad de Medicina Interna, Hospital Universitario de A Coruña (CHUAC), A Coruña, España; División de Virología Clínica, Instituto de Investigación Biomédica A Coruña (INIBIC), Hospital Universitario de A Coruña (CHUAC), Universidad de A Coruña (UDC), A Coruña, España
| | - Luis Margusino-Framiñán
- Servicio de Farmacia, Hospital Universitario de A Coruña (CHUAC), A Coruña, España; División de Virología Clínica, Instituto de Investigación Biomédica A Coruña (INIBIC), Hospital Universitario de A Coruña (CHUAC), Universidad de A Coruña (UDC), A Coruña, España
| | | | - Purificación Cid-Silva
- Servicio de Farmacia, Hospital Universitario de A Coruña (CHUAC), A Coruña, España; División de Virología Clínica, Instituto de Investigación Biomédica A Coruña (INIBIC), Hospital Universitario de A Coruña (CHUAC), Universidad de A Coruña (UDC), A Coruña, España.
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22
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Rotea-Salvo S, Giménez-Arufe V, Martínez-Pradeda A, Fernández-Oliveira C, Mena-de-Cea Á, Margusino-Framiñán L, Martín-Herranz I, Cid-Silva P. Lipid profile changes associated with antiretroviral therapies in a real-world cohort. Farm Hosp 2023; 47:210-217. [PMID: 37349200 DOI: 10.1016/j.farma.2023.04.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/28/2023] [Accepted: 04/23/2023] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVE To compare lipid profile changes and cardiovascular events among HIV naïve and experienced patients from a real-world cohort treated with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate or dolutegravir/abacavir/lamivudine. METHOD A retrospective cohort study in HIV naïve and experienced people at a reference hospital in Spain was done. During the follow-up (March 2015-June 2019), patients were treated with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate or dolutegravir/abacavir/lamivudine. Epidemiological, clinical, and immunovirological variables were recorded. A statistical analysis of the lipid profile at baseline, 48, and 120 weeks after initiating the study therapy, cardiovascular events (myocardial infarction, heart failure, cerebrovascular accident, deep venous thrombosis, myocardiopathy, non-ST-segment elevation acute coronary syndrome, and ST-segment elevation myocardial infarction), and cardiovascular risks factors was performed. Data were analysed in naïve and experienced patients from each of the study treatments. The data were obtained from the medical history. The statistical analysis was performed with SPSS v. 24 software. RESULTS A total of 266 and 191 patients receiving treatment with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate and dolutegravir/abacavir/lamivudine were included in the study, respectively. After 120 weeks of treatment, a worsening of the lipid profile was found in the elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate group, both in naïve and experienced patients, whereas not so conspicuously observed in the dolutegravir/abacavir/lamivudine group. Statistically significant differences between both groups were found in experienced patients favouring dolutegravir/abacavir/lamivudine; in total cholesterol (204.1±38.2 vs. 187.3±29.4, P < .001) and LDL-C (126.1±31.9 vs. 113.5±28.5, P = .001) at week 48, and in total cholesterol (201.1±33.4 vs. 188.7±33.9, P = .013) and HDL-C (54.2±15.6 vs. 48.3±14.3, P = .01) at week 120. No significant differences in cardiovascular events were found, neither in naïve nor in experienced patients. CONCLUSIONS The lipid profile among elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide fumarate group worsened throughout the follow-up, both in naïve and experienced patients, not so remarkable in the dolutegravir/abacavir/lamivudine group. Both regimens were well tolerated, with similar rates of cardiovascular events.
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Affiliation(s)
- Sandra Rotea-Salvo
- Service of Pharmacy, Universitary Hospital of A Coruña (CHUAC), Sergas, A Coruña, Spain
| | - Víctor Giménez-Arufe
- Service of Pharmacy, Universitary Hospital of A Coruña (CHUAC), Sergas, A Coruña, Spain
| | | | | | - Álvaro Mena-de-Cea
- Service of Infectious Internal Medicine, Universitary Hospital of A Coruña (CHUAC), Sergas, A Coruña, Spain; Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC)- Universitary Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), Spain
| | - Luis Margusino-Framiñán
- Service of Pharmacy, Universitary Hospital of A Coruña (CHUAC), Sergas, A Coruña, Spain; Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC)- Universitary Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), Spain
| | - Isabel Martín-Herranz
- Service of Pharmacy, Universitary Hospital of A Coruña (CHUAC), Sergas, A Coruña, Spain
| | - Purificación Cid-Silva
- Service of Pharmacy, Universitary Hospital of A Coruña (CHUAC), Sergas, A Coruña, Spain; Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC)- Universitary Hospital of A Coruña (CHUAC), Sergas, University of A Coruña (UDC), Spain.
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23
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Hernando V, Suárez L, Gutiérrez G, López JC, Navarro-Soler R, Cabello A, Sanz J, Suarez-García I, Fernández MT, Losa JE, Pérez JL, Ramos-Ruperto L, Pérez-Elías MJ, Aayuni WBCE, Cuesta M, González G, Izquierdo A, Viloria L, López I, Martínez E, Castrillejo D, Jaume Amengual MG, Belmonte MA, Arraiza A, de la Torre J, Miqueleiz E, Marcos H, Ruiz-Algueró M, Villegas T, Simón L, Diaz A. Vaccination trends in people with HIV infection participanting in the hospital-based survey of patients infected with HIV, 2006-2021. Enferm Infecc Microbiol Clin (Engl Ed) 2023:S2529-993X(23)00246-0. [PMID: 37573244 DOI: 10.1016/j.eimce.2023.07.006] [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] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/03/2023] [Indexed: 08/14/2023]
Abstract
OBJECTIVE To assess the trend in hepatitis A, hepatitis B, pneumococcal, tetanus and seasonal influenza vaccination in people with HIV infection and to analyse associated factors. METHODS The Hospital Survey of Patients with HIV, an annual cross-sectional study conducted on a fixed day (2006-2021), was used. Inpatients and outpatients were included. Trends in vaccination and associated factors were analysed using logistic regression. RESULTS A total of 8643 participants were included. Vaccination rates increased to 65.3% for hepatitis A, 83.7% for hepatitis B, 49.3% for tetanus, 68.9% for pneumococcal and 74.5% for seasonal influenza in 2021. Factors positively associated with vaccination were older age for pneumococcal and influenza vaccination; higher educational level for hepatitis A and tetanus; living in a closed institutions or prison for tetanus, pneumococcal and influenza; and having acquired HIV through sex between men for hepatitis A, B and pneumococcal. In addition, being on antiretroviral treatment and having a high CD4 count were positively associated with vaccination for all these diseases. Factors inversely associated with vaccination were being older (hepatitis A, B and tetanus), being an immigrant (tetanus and seasonal influenza) and being an injection drug user/ex-user for hepatitis A and B. CONCLUSIONS Vaccination in people with HIV has increased in the study period. The results are in line with the recommendations in this population, although there is still room to reach the established vaccination indicators.
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Affiliation(s)
- Victoria Hernando
- Unidad de Vigilancia de VIH, ITS y Hepatitis B y C. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
| | - Lucia Suárez
- Servicio de Medicina Preventiva y Salud Pública, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Gonzalo Gutiérrez
- Servicio de Epidemiología, DG de Salud Pública, Consejería de Sanidad, Toledo, Spain
| | - Juan Carlos López
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Servicio de Enfermedades Infecciosas, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | - Alfonso Cabello
- Unidad de Enfermedades Infecciosas y VIH, Fundación Jimenez Díaz, Madrid, Spain
| | - Jesús Sanz
- Unidad de Enfermedades Infecciosas, Hospital Universitario de la Princesa, Madrid, Spain
| | - Inés Suarez-García
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain; Grupo de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | | | - Juan Emilio Losa
- Unidad de Enfermedades Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | - Jose Luis Pérez
- Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain
| | - Luis Ramos-Ruperto
- Servicio de Medicina Interna, Hospital Universitario La Paz/IdiPAZ, Madrid, Spain
| | | | - Wafa Ben Cheikh El Aayuni
- Coordinación de VIH/sida, Servicio de Promoción de la Salud y Prevención de la Enfermedad, Dirección General de Salud Pública, Zaragoza, Spain
| | - Mar Cuesta
- Servicio de Salud Poblacional, Dirección General de Salud Pública, Consejería de Salud, Oviedo, Asturias, Spain
| | - Gustavo González
- Oficina de Coordinación VIH en Extremadura, Dirección General de Salud Pública, Servicio Extremeño de Salud, Mérida, Badajoz, Spain
| | - Ana Izquierdo
- Servicio de Epidemiología y Promoción de la Salud, Dirección General de Salud Pública, Servicio Canario de la Salud, Santa Cruz de Tenerife, Canary Islands, Spain
| | - Luis Viloria
- Servicio de Vigilancia Epidemiológica, Dirección General de Salud Pública, Santander, Cantabria, Spain
| | - Irene López
- Servicio de Prevención y Epidemiología del Plan Sobre Sida, Consejería de Sanidad y Consumo, Ceuta, Spain
| | - Eva Martínez
- Sección de Vigilancia Epidemiológica y Control de Enfermedades Transmisibles, Dirección General de Salud Pública y Consumo, Logroño, La Rioja, Spain
| | - Daniel Castrillejo
- Servicio de Epidemiología, Dirección General de Sanidad y Consumo, Consejería de Bienestar Social y Sanidad, Melilla, Spain
| | - Maria Glòria Jaume Amengual
- Coordinación Autonómica de Drogas y de la Estrategia de Sida, Dirección General de Salut Pública i Consum, Conselleria de Salut, Família i Bienestar Social, Palma de Mallorca, Balearic Islands, Spain
| | - Maria Antonia Belmonte
- Servicio de Promoción y Educación para la Salud, Dirección General de Salud Pública y Adicciones, Consejería de Salud, Murcia, Spain
| | - Antonio Arraiza
- Programas de Salud, Dirección General, Osakidetza, San Sebastián, Guipúzcoa, Spain
| | - Javier de la Torre
- Coordinación del Plan Andaluz frente al VIH/SIDA y otras ITS, Dirección General de Salud Pública y Ordenación Farmacéutica, Consejería de Salud y Familias, Sevilla, Spain
| | - Estrella Miqueleiz
- Coordinación del Programa VIH/sida, Sección de Promoción de la Salud, Instituto de Salud Pública y Laboral, Pamplona, Navarra, Spain
| | - Henar Marcos
- Servicio de Vigilancia Epidemiológica y Enfermedades Transmisibles, Dirección General de Salud Pública, Consejería de Sanidad, Valladolid, Spain
| | - Marta Ruiz-Algueró
- Unidad de Vigilancia de VIH, ITS y Hepatitis B y C. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Teresa Villegas
- Unidad de Vigilancia de VIH, ITS y Hepatitis B y C. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Lorena Simón
- Unidad de Vigilancia de VIH, ITS y Hepatitis B y C. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Asuncion Diaz
- Unidad de Vigilancia de VIH, ITS y Hepatitis B y C. Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Bitnun A, Sauvé L, Fanella S. La réduction du risque d'infection périnatale chez les nouveau-nés de mères dont les soins prénatals étaient inappropriés. Paediatr Child Health 2023; 28:307-323. [PMID: 37484035 PMCID: PMC10362960 DOI: 10.1093/pch/pxad015] [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: 11/25/2021] [Accepted: 11/23/2022] [Indexed: 07/25/2023] Open
Abstract
Le risque que des infections maternelles ne soient ni décelées ni traitées augmente lorsque les soins prénatals sont inappropriés, ce qui met la santé de la mère et de son nouveau-né à risque. Lorsqu'une femme enceinte se présente tardivement pour recevoir des soins, les tests systématiques qui influent sur la prise en charge du nouveau-né devraient inclure l'antigène de surface de l'hépatite B (AgHBs), la sérologie du virus de l'hépatite C (VHC), du virus de l'immunodéficience humaine (VIH) et de la syphilis, de même que le dépistage de la Chlamydia trachomatis et de la Neisseria gonorrhoeae. Si la mère ne s'est pas soumise aux dépistages avant ou après l'accouchement et qu'elle n'est pas disponible pour s'y soumettre, il faudrait procéder au dépistage du VIH, du virus de l'hépatite B (VHB), du VHC et de la syphilis chez le nouveau-né. Le dépistage de la C. trachomatis et de la N. gonorrhoeae est toutefois réservé aux cas où le nouveau-né démontre des manifestations cliniques compatibles avec ces infections. Il est optimal d'obtenir rapidement les résultats du dépistage du VIH, du VHB et de la syphilis, car l'utilisation des traitements préventifs est circonscrite dans le temps. Il existe des interventions préventives précoces et efficaces pour les nouveau-nés à risque de VIH, de VHB, de syphilis ou de gonorrhée. Un suivi clinique étroit et des tests de suivi s'imposent auprès des nouveau-nés de mères dont les soins prénatals étaient inappropriés, car il est impossible d'exclure pleinement toutes les infections pendant la période périnatale.
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Affiliation(s)
- Ari Bitnun
- Société canadienne de pédiatrie, comité des maladies infectieuses et d'immunisation, Ottawa (Ontario)Canada
| | - Laura Sauvé
- Société canadienne de pédiatrie, comité des maladies infectieuses et d'immunisation, Ottawa (Ontario)Canada
| | - Sergio Fanella
- Société canadienne de pédiatrie, comité des maladies infectieuses et d'immunisation, Ottawa (Ontario)Canada
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Lao-Domínguez FÁ, Robustillo-Cortés MDLA, Morillo-Verdugo R. Drug burden index in people living with HIV over 50 years of age in a real clinical practice cohort. Enferm Infecc Microbiol Clin (Engl Ed) 2023:S2529-993X(23)00189-2. [PMID: 37394403 DOI: 10.1016/j.eimce.2023.04.023] [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] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 04/30/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES To determine DBI and its relationship with polypharmacy and pharmacotherapeutic complexity (PC) in a cohort of PLWH over 50 years of age at follow-up of pharmacotherapy in a tertiary hospital. METHODS Observational and retrospective study that included PLWH in active antiretroviral treatment over 50 years of age who have been followed up in outpatient pharmacy services. Pharmacotherapeutic complexity was estimated through Medication Regimen Complexity Index (MRCI). Collected variables included comorbidities, current prescriptions and its classification according to anticholinergic and sedative activity and associated risk of falls. RESULTS Studied population included 251 patients (85.7% men; median age: 58 years, interquartile range: 54-61). There was a high prevalence of high DBI scores (49.2%). High DBI was significantly correlated with a high PC, polypharmacy, psychiatric comorbidity and substances abuse (p<0.05). Among sedative drugs, the most prescribed were anxiolytic drugs (N05B) (n=85), antidepressant drugs (N06A) (n=41) and antiepileptic drugs (N03A) (n=29). For anticholinergic drugs, alpha-adrenergic antagonist drugs (G04C) were the most prescribed (n=18). Most frequent drugs associated with risk of falls were anxiolytics (N05B) (n=85), angiotensin-converting enzyme inhibitors (C09A) (n=61) and antidepressants (N06A) (n=41). CONCLUSION The DBI score in older PLWH is high and it is related to PC, polypharmacy, mental diseases and substance abuse as is the prevalence of fall-related drugs. Control of these parameters as well as the reduction of the sedative and anticholinergic load should be included in the lines of work in the pharmaceutical care of people living with HIV+.
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González Del Castillo J, Perez Elias MJ, Miguens I, Espinosa B, Juárez R, Piedrafita Lozoya L, Trenc P, Alvarez Manzanares J, Marchena MJ, Rodríguez R, Cabrera N, Grajal P, Navarro C, Piñera P, García F, Moreno S, Miro O. Decalogue to promote the implementation and improvement of recommendations for the early diagnosis of HIV in Emergency Departments. Enferm Infecc Microbiol Clin (Engl Ed) 2023:S2529-993X(23)00156-9. [PMID: 37328343 DOI: 10.1016/j.eimce.2023.06.001] [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] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/21/2023] [Indexed: 06/18/2023]
Abstract
Early diagnosis of HIV is still a challenge. Emergency Departments (EDs) suppose ideal settings for the early detection of HIV, since patients with high prevalence of hidden HIV infection are frequently attending those services. In 2020, the Spanish Society of Emergency and Emergency Medicine (SEMES) published a series of recommendations for the early diagnosis of patients with suspected HIV infection and their referral and follow-up in the EDs as part of its "Deja tu huella" program. However, the application of these recommendations has been very heterogeneous in our country. Considering this, the working group of the HIV hospital network led by the SEMES has motivated the drafting of a decalogue, with the aim of promoting the implementation and improvement of protocols for the early diagnosis of HIV in Spanish EDs.
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Affiliation(s)
| | - Maria Jesus Perez Elias
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERINFECC, Madrid, Spain
| | - Iría Miguens
- Servicio de Urgencias, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Begoña Espinosa
- Servicio de Urgencias, Hospital General Universitario Dr. Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - Ricardo Juárez
- Servicio de Urgencias, Hospital de Talavera, Talavera de la Reina, Toledo, Spain
| | | | - Patricia Trenc
- Servicio de Urgencias, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Raquel Rodríguez
- Servicio de Urgencias, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | - Nayra Cabrera
- Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Pilar Grajal
- Servicio de Urgencias, Hospital San Pedro, Logroño, La Rioja, Spain
| | - Carmen Navarro
- Servicio de Urgencias, Hospital Universitario Virgen de la Macarena, Sevilla, Spain
| | - Pascual Piñera
- Servicio de Urgencias, Hospital Universitario Reina Sofía, Murcia, Spain
| | - Federico García
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERINFECC, Madrid, Spain
| | - Santiago Moreno
- Servicio de Microbiología Clínica, Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - Oscar Miro
- Servicio de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Contreras-Macías E, Gutiérrez-Pizarraya A, Morillo-Verdugo R. Influence of polypharmacy in the simultaneous presence of high pharmacotherapeutic complexity, drug interactions and non-adherence to medication in patients with HIV infection. Project 3-HIT. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:342-347. [PMID: 36175284 DOI: 10.1016/j.eimce.2022.09.007] [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] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/08/2021] [Accepted: 12/20/2021] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The high pharmacotherapeutic complexity, drug interactions and lack of adherence to concomitant medication are circumstances with negative consequences in the clinical evolution of patients with HIV infection. The 3-HIT phenomenon refers to the simultaneous occurrence of these situations. The objective of the study is to determine the prevalence of the phenomenon 3-HIT in the polymedicated HIV population as well as to determine factors related to its occurrence. METHODS Observational, retrospective and single-center study that included all elderly patients on active antiretroviral treatment in pharmacotherapeutic follow-up between January and March 2020. A logistic regression model was carried out to evaluate the factors associated with the occurrence of the 3-HIT concept with the variables significantly associated with this phenomenon and those considered clinically relevant. RESULTS 428 patients were included, registering a prevalence of polypharmacy in 25.9% of the study sample. The 3-HIT phenomenon was detected in 6.3% of the patients. For each concomitant drug prescribed the risk of developing the phenomenon 3-HIT increases 1.5 times. CONCLUSION Prevalence of the phenomenon 3-HIT is high in HIV patients with polymedication. A change in the pharmaceutical care model to a multidimensional setting is essential, together with pharmacotherapeutic optimization strategies to improve patient health outcomes.
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Clarke A, Mannette J, Hamilton-Hinch B, Lynch M, Williams P, Grant S, Joy P. The Cost of a Nutritious Diet for Households Including People Living with HIV/AIDS in Nova Scotia: Findings and Lessons Learned by FoodNOW 2020 to 2022. CAN J DIET PRACT RES 2023; 84:98-106. [PMID: 36876852 DOI: 10.3148/cjdpr-2022-037] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Purpose: FoodNOW (Food to eNhance Our Wellness) engaged in assessment of simulated households that include a person living with HIV/AIDS (PLWHA) in Nova Scotia to determine if a basic nutritious diet is affordable.Methods: We used supermarket websites to cost food and beverage items listed in the National Nutritious Food Basket (NNFB) for simulated households, each with a PLWHA. Food costing methodologies were co-developed and adapted with community members in response to barriers presented by the COVID-19 pandemic.Results: We found that simulated households, each with one PLWHA, that had a potential deficit after monthly expenses were a household of four on Income Assistance (-$1,058.70), a lone mother with two children on Income Assistance (-$973.65), a lone man on Income Assistance (-$677.40), and a household of four with one minimum-wage earner (-$383.45).Conclusions: Nova Scotia households with a PLWHA living on Income Assistance or with a minimum-wage earner cannot reasonably afford a nutritious diet in addition to basic household expenses. Using these food costing data can allow dietitians to efficiently inform government action and policy change to improve the health and wellness of individuals and families.
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Affiliation(s)
- Abigail Clarke
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Jessica Mannette
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Barb Hamilton-Hinch
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Mary Lynch
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
- QEII Health Sciences Centre, Halifax, NS, Canada
- Founder (Pain Medicine), The Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | | | - Shannan Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
- Departments Obstetrics and Gynaecology, IWK Health Centre, Halifax, NS, Canada
- Departments Pediatrics, Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
| | - Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
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De Gea-Grela A, Maldonado-Barrueco A, Cabañuz C, Díaz-Almiron M, Rico A, Ruíz-Carrascoso G, Palacios ME, Martín-Arranz E, Escudero-Nieto R, Bernardino JI. Human intestinal spirochetosis: an entity associated with sexual transmitted infections. Enferm Infecc Microbiol Clin (Engl Ed) 2023:S2529-993X(23)00152-1. [PMID: 37248154 DOI: 10.1016/j.eimce.2023.05.003] [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] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/03/2023] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Human intestinal spirochetosis (HIE) is a poorly studied clinical entity with variable clinical manifestations. However, in recent years it has gained special relevance because an increasing number of cases have been described in people living with HIV (PWH) and in patients with a history of sexually transmitted infections (STI) or immunosuppression. METHODS Retrospective review of all HIE cases identified in a tertiary level hospital (Hospital Universitario la Paz, Madrid) between 2014 and 2021. RESULTS 36 Cases of HIE were identified. Most cases corresponded to males (94%) with a median age of 45 years. 10 patients (29.4%) were PWH and 20 (56%) were men who had sex with men. Although the clinical manifestations were very heterogeneous, the most frequent was chronic diarrhea (47%), and up to 25% of the subjects had clinical proctitis. 39% percent of patients had been diagnosed with an STI in the previous two years, this characteristic being more frequent in PWH (90% vs. 28%; p < 0.01) than in patients without HIV infection. The STI most frequently associated with a diagnosis of HIE was syphilis (31%). CONCLUSION HIE is frequently diagnosed with other STIs and affects mostly men who have sex with men, which supports that this entity could be considered as a new STI.
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Affiliation(s)
- Alejandro De Gea-Grela
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | | | - Clara Cabañuz
- Servicio de Anatomía Patológica, Hospital Universitario La Paz, Madrid, Spain
| | - Mariana Díaz-Almiron
- Unidad de Bioestadística, Fundación para la Investigación Biomédica Hospital, Madrid, Spain
| | - Alicia Rico
- Servicio de Microbiología y Parasitología, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | - Raquel Escudero-Nieto
- Laboratorio de Referencia e Investigación en Patógenos Especiales, Centro Nacional de Microbiología, Majadahonda, Spain
| | - José I Bernardino
- Unidad de VIH, Servicio de Medicina Interna, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; CIBER Enfermedades Infecciosas, CIBERINFEC, Madrid, Spain.
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Fernandez-Fuertes M, Macias J, Corma-Gomez A, Salazar-Gonzalez A, Gonzalez-Serna A, Rincon P, Arriaza-Estevez MJ, Fuentes-Lopez A, Real LM, Pineda JA. Low rate of vaccination and risk of incident hepatitis A among HIV-infected men who have sex with men in Seville, Southern Spain. Enferm Infecc Microbiol Clin (Engl Ed) 2023:S2529-993X(23)00134-X. [PMID: 37230839 DOI: 10.1016/j.eimce.2023.03.007] [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] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 03/08/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Periodic outbreaks of hepatitis A (HAV) infection in men who have sex with men (MSM) have been reported. Low vaccination uptake in HIV-infected individuals could drive new outbreaks. We aimed at evaluating the incidence of and risk factors for HAV infection in people living with HIV (PLWH) in our area. We also assessed the rates of HAV vaccination. METHODS This was a prospective cohort study. 915 patients were included, 272 (30%) of them were anti-HAV seronegative at baseline. RESULTS Twenty-six (9.6%) susceptible individuals became infected. Incident cases peaked in 2009-2010 and 2017-2018. Incident HAV infection was independently associated with MSM [adjusted odds ratio (95% confidence ratio): 4.39 (1.35-14.27), p=0.014]. One hundred and five (38.6%) HAV seronegative patients were vaccinated, 21 (20%) of them did not respond, and one (1%) patient lost immunity against HAV. Four (29%) non-responders to vaccination showed incident HAV 5-9 years afterwards. CONCLUSIONS The incidence of HAV infection in a cohort of well-controlled PLWH remains low and stable, with intermittent outbreaks involving mainly non-immunized MSM. A significant proportion of PLWH remain susceptible to HAV infection due to insufficient vaccine uptake and limited response to vaccination. Importantly, patients not responding to HAV vaccination continue at risk of infection.
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Affiliation(s)
- Marta Fernandez-Fuertes
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen de Valme, Sevilla, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Macias
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen de Valme, Sevilla, Spain; Department of Medicine, University of Sevilla, Sevilla, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain.
| | - Anaïs Corma-Gomez
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen de Valme, Sevilla, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Alejandro Gonzalez-Serna
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen de Valme, Sevilla, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Pilar Rincon
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen de Valme, Sevilla, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria J Arriaza-Estevez
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen de Valme, Sevilla, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Fuentes-Lopez
- Microbiology Service, Hospital Universitario San Cecilio, Granada, Spain
| | - Luis M Real
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen de Valme, Sevilla, Spain; Department of Surgery, Biochemistry and Immunology, School of Medicine, University of Malaga, Malaga, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | - Juan A Pineda
- Institute of Biomedicine of Seville (IBiS), Hospital Universitario Virgen de Valme, Sevilla, Spain; Department of Medicine, University of Sevilla, Sevilla, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
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Cáceres DH, Gómez BL, Tobón ÁM, Restrepo Á, Chiller T, Lindsley MD, Meis JF, Verweij PE. Tackling Histoplasmosis Infection in People Living with HIV from Latin America: From Diagnostic Strategy to Public Health Solutions. J Fungi (Basel) 2023; 9:jof9050558. [PMID: 37233269 DOI: 10.3390/jof9050558] [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: 04/09/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/27/2023] Open
Abstract
Histoplasmosis, caused by the thermally dimorphic fungus Histoplasma spp., is a disease with a broad clinical spectrum, presenting from asymptomatic/flu-like symptoms to progressive disseminated disease in people with immunosuppression. In recent years, the concept of histoplasmosis as a disease restricted to the American continent has changed, as now histoplasmosis is reported in many regions around the world. In Latin America, histoplasmosis represents a threat, especially in people with advanced HIV disease (AHD). Diagnosis of histoplasmosis in people living with HIV (PLHIV) is challenging due to the low index of suspicion of the disease, non-specificity of signs and symptoms, and limited access to specific laboratory testing, while the diagnostic delay is significantly associated with mortality. In the last decade, novel diagnostic tests have been developed for the rapid detection of histoplasmosis, such as commercial kits for antigen detection. Furthermore, advocacy groups were created that presented histoplasmosis as a public health problem, with emphasis on patients at risk of progressive disseminated disease. This review aims to discuss the impact of histoplasmosis associated with AHD in Latin America and the strategies employed to tackle histoplasmosis, from the implementation of laboratory testing to disease advocacy and public health interventions.
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Affiliation(s)
- Diego H Cáceres
- Center of Expertise in Mycology Radboudumc/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
- IMMY, Norman, OK 73069, USA
| | - Beatriz L Gómez
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
| | - Ángela M Tobón
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín 055450, Colombia
| | - Ángela Restrepo
- COLCIENCIAS Emeritus Researcher, Ministerio de Ciencias, Tecnología e Innovación, Bogota 111321, Colombia
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Mark D Lindsley
- Mycotic Diseases Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Jacques F Meis
- Center of Expertise in Mycology Radboudumc/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
- Department I of Internal Medicine, Excellence Center for Medical Mycology, University Hospital Cologne, 50931 Cologne, Germany
| | - Paul E Verweij
- Center of Expertise in Mycology Radboudumc/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
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Martin Conde MT, Monte Boquet E, Navarro Aznares H, Robustillo Cortes MDLA, Rodríguez González C, Serrano López de Las Hazas JI, Morillo-Verdugo R. 2022 update of the indicators for quality of care and pharmaceutical care for people living with human immunodeficiency virus. Farm Hosp 2023; 47:113-120. [PMID: 37029055 DOI: 10.1016/j.farma.2023.01.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 04/09/2023] Open
Abstract
OBJECTIVE To update and define indicators for improving the quality of care and pharmaceutical care for people living with HIV infection in Spain. METHOD The present project, which updates the previous version of the 2013 document, was developed in four work phases carried out between January and June 2022. In phase 1, the organization phase, a working group was created, made up of seven hospital pharmacy specialists with extensive experience in pharmaceutical care and from different SFHs in Spain. In addition, another 34 specialists participated in the evaluation of the indicators through two rounds of online evaluation to generate consensus. For phase 2, initially, a review of the identified reference literature was carried out with the aim of establishing a basis from which to define a proposal for quality criteria and indicators. Then, a preliminary proposal of criteria was made and revisions were established for their adjustment in several telematic work meetings. In phase 3, consensus was established based on the Delphi-Rand/UCLA consensus methodology. In addition, all the indicators classified as appropriate and necessary were grouped according to two levels of monitoring recommendation, so as to guide the hospital pharmacy services in the priority of their measurement: key and advanced. Finally, in phase 4, the final project document was prepared, along with the corresponding descriptive sheets for each indicator in order to facilitate the measurement and evaluation of the indicators by the hospital pharmacy services. RESULTS Following the consensus methodology used, a list of items made up of 79 appropriate and necessary indicators was drawn up to establish a follow-up and monitoring of the quality and activity of pharmaceutical care for people living with HIV. Of these, 60 were established as key and 19 advanced. CONCLUSIONS The indicators defined and updated, since the previous version of 2013, are intended to be a tool for professionals to guide decision-making and facilitate the measurement and assessment of the most relevant aspects of the quality and pharmaceutical care of people living with HIV.
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Affiliation(s)
| | | | | | | | | | | | - Ramón Morillo-Verdugo
- Hospital Universitario de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, España
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Barata R, Marques da Costa B, Navarro D, Mendes M, Silva C, Góis M, Sousa H, Nolasco F. Acute interstitial nephritis due to dolutegravir: The first case reported. Nefrologia 2023; 43:370-373. [PMID: 36437200 DOI: 10.1016/j.nefroe.2022.11.012] [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: 02/07/2021] [Accepted: 07/09/2021] [Indexed: 06/16/2023] Open
Abstract
Kidney disease is frequent in HIV-patients. We present a case of a 44-year-old woman, with known uncontrolled HIV infection and chronic kidney disease due to HIV-associated nephropathy. After starting dolutegravir, the patient developed eosinophilia and worsening kidney function. A kidney biopsy confirmed the diagnosis of acute interstitial nephritis. Given the time relation with dolutegravir introduction, it was deemed the culprit medication. Dolutegravir was stopped, and corticosteroids were initiated, with moderate improvement in renal function. To our knowledge, this is the first reported case of acute interstitial nephritis to dolutegravir, which should raise awareness of previously undocumented renal effects of antiretroviral therapy.
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Affiliation(s)
- Rui Barata
- Nephrology Department, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.
| | - Bernardo Marques da Costa
- Nephrology Department, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - David Navarro
- Nephrology Department, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Marco Mendes
- Nephrology Department, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Cecília Silva
- Nephrology Department, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Mário Góis
- Nephrology Department, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal; Laboratory of Renal Morphology, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Helena Sousa
- Nephrology Department, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal; Laboratory of Renal Morphology, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Fernando Nolasco
- Nephrology Department, Hospital Curry Cabral - Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
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Martin Conde MT, Monte Boquet E, Navarro Aznares H, Robustillo Cortes MDLA, Rodríguez González C, Serrano López de Las Hazas JI, Morillo-Verdugo R. [Translated article] 2022 update of the indicators for quality of care and pharmaceutical care for people living with human immunodeficiency virus. Farm Hosp 2023; 47:T113-T120. [PMID: 37236838 DOI: 10.1016/j.farma.2023.04.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVE To update and define indicators for improving the quality of care and Pharmaceutical Care for people living with HIV infection in Spain. METHOD The present project, which updates the previous version of the 2013 document, was developed in four work phases carried out between January and June 2022. In phase 1, the organization phase, a working group was created, made up of seven hospital pharmacy specialists with extensive experience in pharmaceutical care and from different SFHs in Spain. In addition, another 34 specialists participated in the evaluation of the indicators through two rounds of online evaluation to generate consensus. For phase 2, initially, a review of the identified reference literature was carried out with the aim of establishing a basis from which to define a proposal for quality criteria and indicators. Then, a preliminary proposal of criteria was made and revisions were established for their adjustment in several telematic work meetings. In phase 3, consensus was established based on the Delphi-Rand/UCLA consensus methodology. In addition, all the indicators classified as appropriate and necessary were grouped according to two levels of monitoring recommendation, so as to guide the hospital pharmacy services in the priority of their measurement: key and advanced. Finally, in phase 4, the final project document was prepared, along with the corresponding descriptive sheets for each indicator in order to facilitate the measurement and evaluation of the indicators by the hospital pharmacy services. RESULTS Following the consensus methodology used, a list of items made up of 79 appropriate and necessary indicators was drawn up to establish a follow-up and monitoring of the quality and activity of Pharmaceutical Care for people living with HIV. Of these, 60 were established as key and 19 advanced. CONCLUSIONS The indicators defined and updated, since the previous version of 2013, are intended to be a tool for professionals to guide decision-making and facilitate the measurement and assessment of the most relevant aspects of the quality and pharmaceutical care of people living with HIV.
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Affiliation(s)
| | - Emilio Monte Boquet
- Jefe de Sección Farmacia Hospitalaria, Servicio Farmacia, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | - Herminia Navarro Aznares
- Jefe de Sección Farmacia Hospitalaria, Servicio Farmacia, Hospital Miguel Servet, Zaragoza, Spain
| | | | | | | | - Ramón Morillo-Verdugo
- FEA Farmacia Hospitalaria, Hospital Universitario de Valme, AGS Sur de Sevilla, Spain.
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Nomah DK, Díaz Y, Vivanco-Hidalgo RM, Casabona J, Miro JM, Reyes-Urueña J. Population-based assessment of SARS-CoV-2 infection among people living with HIV and the general population of Catalonia (March-December, 2020). Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:294-297. [PMID: 37076329 PMCID: PMC10107078 DOI: 10.1016/j.eimce.2022.02.017] [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] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/15/2022] [Indexed: 04/21/2023]
Abstract
INTRODUCTION It is unclear if SARS-CoV-2 has affected people living with HIV (PLWH) more. METHODS We compared SARS-CoV-2 testing, test positivity, hospitalisation, intensive care unit (ICU) admission, and mortality between PLWH and the general HIV-negative population of Catalonia, Spain from March 1 to December 15, 2020. RESULTS SARS-CoV-2 testing was lower among PLWH 3556/13,142 (27.06%) compared to the general HIV-negative population 1,954,902/6,446,672 (30.32%) (p<0.001) but test positivity was higher among PLWH (21.06% vs. 15.82%, p<0.001). We observed no significant differences between PLWH and the general population in terms of hospitalisation (13.75% vs. 14.97%, p=0.174) and ICU admission (0.93% vs. 1.66%, p=0.059). Among positive cases, we found a lower mortality rate among PLWH compared to the general population (1.74% vs 3.64%, p=0.002). CONCLUSION PLWH tested less frequently for SARS-CoV-2, had a higher test positivity, similar ICU admission and hospitalisation rates, and lower SARS-CoV-2-associated mortality compared to the general HIV-negative population.
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Affiliation(s)
- Daniel K Nomah
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain
| | - Yesika Díaz
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain
| | | | - Jordi Casabona
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva i de Salut Publica, Universitat Autònoma de Barcelona, Bellaterra, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jose M Miro
- Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain.
| | - Juliana Reyes-Urueña
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Dept Salut, Generalitat de Catalunya, Badalona, Spain; Institut d'Investigació Germans Trias i Pujol (IGTP), Barcelona, Spain; CIBER Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain.
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Dania E, Stiegler N, Bouchard JP. [Tuberculosis remains a public health issue in South Africa]. Rev Infirm 2023; 72:39-40. [PMID: 37088495 DOI: 10.1016/j.revinf.2023.03.010] [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] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Tuberculosis is an airborne infectious disease that can damage the lungs and other body organs. Early detection of people infected with Koch's bacillus is important because tuberculosis is a contagious disease. It can be cured. It is still a very common disease in South Africa and is fatal for sixty thousand people per year. Tuberculosis remains a major health problem for which the public authorities must put in place more effective prevention and management policies, particularly by improving the training of nurses and doctors.
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Affiliation(s)
- Elizabeth Dania
- Statistics and Population Studies Department, Faculty of Natural Sciences, University of the Western Cape, RobertSobukwe road, Bellville, 7535 Cape Town, South Africa
| | - Nancy Stiegler
- Statistics and Population Studies Department, Faculty of Natural Sciences, University of the Western Cape, RobertSobukwe road, Bellville, 7535 Cape Town, South Africa
| | - Jean-Pierre Bouchard
- Statistics and Population Studies Department, Faculty of Natural Sciences, University of the Western Cape, RobertSobukwe road, Bellville, 7535 Cape Town, South Africa; Psychologie-Criminologie-Victimologie (PCV), 33000 Bordeaux, France; Centre hospitalier de Cadillac, 33410 Cadillac, France.
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Bentounes NK, Le Hingrat Q, Planquette B, Darnige L, Khider L, Sanchez O, Smadja DM, Mauge L, Lê MP, Mirault T, Gendron N. [Human immunodeficiency virus and venous thromboembolism: Role of direct oral anticoagulants]. Rev Med Interne 2023; 44:181-189. [PMID: 36878744 DOI: 10.1016/j.revmed.2023.01.006] [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: 10/17/2022] [Revised: 12/16/2022] [Accepted: 01/08/2023] [Indexed: 03/07/2023]
Abstract
Nowadays, thanks to highly active antiretroviral therapy (HAART), human immunodeficiency virus (HIV) infection is transforming into a chronic disease. The life expectancy of people living with HIV (PWH) has increased, as well as their risk of developing several co-morbidities, in particular cardiovascular diseases. In addition, the incidence of venous thromboembolism (VTE) is increased in PWH with a 2 to 10 times higher incidence when compared to the general population. Over the last decade, direct oral anticoagulants (DOACs) have been widely used in the treatment and prevention of VTE and non-valvular atrial fibrillation. DOACs are characterized by a rapid onset of activity, a predictable response and a relatively wide therapeutic window. Nevertheless, drug interactions exist between HAART and DOACs, exposing PWH to a theoretically increased bleeding or thrombotic risk. DOACs are substrates of the transport protein P-glycoprotein and/or of isoforms of cytochromes P450 pathway, which can be affected by some antiretroviral drugs. Limited guidelines are available to assist physicians with the complexity of those drug-drug interactions. The aim of this paper is to provide an updated review on the evidence of the high risk of VTE in PWH and the place of DOAC therapy in this population.
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Affiliation(s)
- N K Bentounes
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 20, rue Leblanc, 75015 Paris, France
| | - Q Le Hingrat
- Inserm, UMR 1137 IAME, Virology dDepartment, Université Paris Cité, Hôpital Bichat-Claude-Bernard, AP-HP, 75018 Paris, France
| | - B Planquette
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Respiratory Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France
| | - L Darnige
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 20, rue Leblanc, 75015 Paris, France
| | - L Khider
- Vascular medicine department, AP-HP Centre Université Paris Cité, 75015 Paris, France
| | - O Sanchez
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Respiratory Medicine Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France
| | - D M Smadja
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 20, rue Leblanc, 75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France
| | - L Mauge
- PARCC Inserm U970, Hematology Department, Université Paris Cité, AP-HP Centre Université Paris Cité, 75015 Paris, France
| | - M P Lê
- Inserm, Laboratoire de Pharmacologie, Université Paris Cité, UMRS 1144, Hôpital Bichat Claude-Bernard, AP-HP, 75018 Paris, France
| | - T Mirault
- PARCC Inserm U970, Hematology Department, Université Paris Cité, AP-HP Centre Université Paris Cité, 75015 Paris, France; Inserm U970, Université Paris Cité, PARCC, Paris, France
| | - N Gendron
- Inserm, Innovative Therapies in Haemostasis, Université Paris Cité, 75006 Paris, France; Hematology Department and Biosurgical Research Lab (Carpentier Foundation), AP-HP Centre Université Paris Cité, 20, rue Leblanc, 75015 Paris, France.
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Corma-Gómez A, Real LM, Fernández-Fuertes M, González-Serna A, Oliver N, Ortega J, Rincón P, Rodríguez-Pineda E, Santos M, Trigo-Rodríguez M, Macías J, Pineda JA. Poor increase on HAV vaccination coverage among people living with HIV after an immunization-based intervention. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:144-148. [PMID: 36870731 DOI: 10.1016/j.eimce.2022.01.006] [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] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 01/12/2022] [Indexed: 03/06/2023]
Abstract
OBJECTIVES To assess HAV serologic and vaccination status among people who live with HIV (PLWH), and to evaluate the impact of a vaccination-based strategy on HAV-negative patients in Seville, Spain. METHODS Study with two time-overlapping phases: (i) cross-sectional study of HAV immunity prevalence among PLWH followed at a Spanish hospital between August 2019 and March 2020. (ii) Patients seronegative for HAV, reliably unvaccinated were included in a before-and-after quasi-experimental study, with an intervention focused on HAV vaccination according to national recommendations in force. RESULTS Six hundred and fifty-six patients were included, of which 111 [17%, 95% confidence interval (95% CI) 14-20%] were seronegative for HAV. Of these, 48 [43% (95% CI, 34-53%)] individuals were MSM. The absence of HAV immunity was attributed in 69 [62% (95% CI, 52-71%)] patients to non-referral to vaccination, followed by lack of achievement of a correct vaccination scheme [n=26; 23% (95% CI, 16-32%)]. After the program implementation, 96 [15% (95% CI, 12-18%)] individuals were seronegative (17% vs. 15%, p=0.256), of whom 42 [41% (95% CI, 32-51%)] were MSM. The absence of immunity after the intervention was mainly attributed to: adherence failure in 23 [24.0% (95% CI, 15.8-33.7%)] patients, on-course immunization scheme in 34 [33% (95% CI, 24-43%)] individuals and pending appointment at the vaccine delivery unit in 20 [20.8% (95% CI, 13.2-30.3%)] patients. CONCLUSIONS A sizeable proportion of PLWH remains susceptible for HAV infection in future outbreaks. A program based on referral to the vaccine delivery unit yields poor results, largely due to program adherence failures. New strategies are needed to increase HAV vaccination coverage.
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Affiliation(s)
- Anaïs Corma-Gómez
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Luis M Real
- Unit of Immunology, Biochemistry, Molecular Biology and Surgery, Faculty of Medicine, Universidad de Málaga, Spain
| | | | | | - Noemi Oliver
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Jesús Ortega
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Pilar Rincón
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | | | - Marta Santos
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Marta Trigo-Rodríguez
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Juan Macías
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain; Unit of Medicine, Faculty of Medicine, Universidad de Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC.
| | - Juan A Pineda
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain; Unit of Medicine, Faculty of Medicine, Universidad de Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC
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Quirós-González V, Rubio R, Pulido F, Rial-Crestelo D, Martín-Jurado C, Hernández-Ros MÁ, López-Jiménez EA, Ferrari JM, Caro-Teller JM, Pinar Ó, Pedrera-Jiménez M, García-Barrio N, Serrano P, Bernal JL. Healthcare outcomes in patients with HIV infection at a tertiary hospital during the COVID-19 pandemic. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:149-154. [PMID: 36870732 PMCID: PMC9977934 DOI: 10.1016/j.eimce.2021.07.011] [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] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/25/2021] [Indexed: 03/05/2023]
Abstract
BACKGROUND The COVID-19 pandemic has affected the care of patients with other diseases. Difficulty in access to healthcare during these months has been especially relevant for persons with HIV infection (PWH). This study therefore sought to ascertain the clinical outcomes and effectiveness of the measures implemented among PWH in a region with one of the highest incidence rates in Europe. METHODS Retrospective, observational, pre-post intervention study to compare the outcomes of PWH attended at a high-complexity healthcare hospital from March to October 2020 and during the same months across the period 2016-2019. The intervention consisted of home drug deliveries and preferential use of non face-to-face consultations. The effectiveness of the measures implemented was determined by reference to the number of emergency visits, hospitalisations, mortality rate, and percentage of PWH with viral load >50copies, before and after the two pandemic waves. RESULTS A total of 2760 PWH were attended from January 2016 to October 2020. During the pandemic, there was a monthly mean of 106.87 telephone consultations and 2075 home deliveries of medical drugs dispensed to ambulatory patients. No statistically significant differences were found between the rate of admission of patients with COVID-HIV co-infection and that of the remaining patients (1172.76 admissions/100,000 population vs. 1424.29, p=0.401) or in mortality (11.54% vs. 12.96%, p=0.939). The percentage of PWH with viral load >50copies was similar before and after the pandemic (1.20% pre-pandemic vs. 0.51% in 2020, p=0.078). CONCLUSION Our results show that the strategies implemented during the first 8 months of the pandemic prevented any deterioration in the control and follow-up parameters routinely used on PWH. Furthermore, they contribute to the debate about how telemedicine and telepharmacy can fit into future healthcare models.
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Affiliation(s)
| | - Rafael Rubio
- Unidad de Infección VIH, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Federico Pulido
- Unidad de Infección VIH, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - David Rial-Crestelo
- Unidad de Infección VIH, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Carlos Martín-Jurado
- Servicio de Análisis de Información y Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - María Ángeles Hernández-Ros
- Servicio de Análisis de Información y Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | - Óscar Pinar
- Servicio de Farmacia, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Pablo Serrano
- Dirección de Planificación, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José Luis Bernal
- Servicio de Análisis de Información y Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain
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Maldonado-Barrueco A, Grasa CD, Grandioso-Vas D, Del Rosal T, Sánchez-Holgado M, Sánchez-García L, López-Ortego P, Falces-Romero I, García-Rodríguez J, Quiles-Melero I. Treponema pallidum causing congenital syphilis with severe multisystem involvement. J Travel Med 2023; 30:6967000. [PMID: 36591923 DOI: 10.1093/jtm/taac152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/03/2023]
Affiliation(s)
- Alfredo Maldonado-Barrueco
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
| | - Carlos Daniel Grasa
- Pediatric Infectious Disease Unit, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid, Spain
| | - David Grandioso-Vas
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
| | - Teresa Del Rosal
- Pediatric Infectious Disease Unit, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
- Neonatology Department, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
| | - María Sánchez-Holgado
- Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Madrid, Spain
| | - Laura Sánchez-García
- Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Madrid, Spain
| | - Paloma López-Ortego
- Center for Biomedical Network Research on Rare Diseases (CIBERER U767), Madrid, Spain
| | - Iker Falces-Romero
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid, Spain
| | - Julio García-Rodríguez
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
- CIBERINFEC ISCIII, Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Quiles-Melero
- Clinical Microbiology and Parasitology Department, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
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Briand Madrid L, Donadille C, Célerier I, Gutowski M, Grelli N, Maradan G, Jauffret-Roustide M, Lalanne L, Auriacombe M, Roux P. [Drug Consumption Rooms : Opinion and willingness among people who inject drugs in Marseille, France]. Rev Epidemiol Sante Publique 2023; 71:101421. [PMID: 36571957 DOI: 10.1016/j.respe.2022.101421] [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: 04/04/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In France, people who inject drugs (PWID) are still one of the most at risk population for contracting hepatitis C virus (HCV). Drug consumption rooms (DCR) have shown their effectiveness on HCV risk behaviors abroad and in France, where they have been recently evaluated with the COSINUS study. In France, two DCRs opened in 2016, one in Paris and another in Strasbourg. The objective of this sub-analysis was to explore the willingness to use a DCR in PWID living in Marseille, where no DCR is opened. METHODS The COSINUS study is a prospective multicenter cohort that included 665 PWID recruited in Bordeaux, Marseille, Paris and Strasbourg between 2016 and 2019. Investigators administered questionnaires face-to-face at regular intervals at baseline, 3 months, 6 months and 12 months. In Marseille, 199 PWID were recruited. A multivariable logistic regression model was performed to assess factors associated with willingness to use DCR among this population. RESULTS Among 545 observations corresponding to 195 distinct participants selected for analyses, 57% declared they were willing to attend a DCR. The main reason given was "to consume more cleanly". Receiving allowances (OR = 2.38; 95% confidence interval (CI) (95% CI) = 1.17-4.81), not having health insurance (OR = 3.61; 95% CI = 1.49-8.75), injecting daily (OR = 1.97; 95% CI = 1.05-3.70) and in a public space (OR = 2.66; 95% CI = 1.29-5.47) were all positively associated with willingness to use a DCR. CONCLUSIONS DCR are devices that target PWID exposed to high sanitary or social risks, i.e. people living in precarious conditions, who have to inject in public spaces, in deleterious sanitary environments and with rapid gestures in order not to be seen. These analyzes highlight that the people who most want to attend a DCR are aware of the harms associated with their practices and show a desire to seek protection from street-based drug scenes.
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Affiliation(s)
- L Briand Madrid
- Aix Marseille Université, Inserm, IRD, SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France.
| | - C Donadille
- Aix Marseille Université, Inserm, IRD, SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France
| | | | | | - N Grelli
- Nouvelle Aube, Marseille, France
| | - G Maradan
- ORS PACA, Observatoire régional de la santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - M Jauffret-Roustide
- British Columbia Center on Substance Use (BCCSU), Vancouver, Canada; Baldy Center on Law and Social Policy, Buffalo University, New York, USA; Centre d'étude des mouvements sociaux, Inserm U1276/CNRS UMR 8044/EHESS, Paris, France
| | - L Lalanne
- Inserm 1114, Department of Psychiatry and Addictology, University Hospital of Strasbourg, Fédération de médecine translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France; Department of Addictology, University Hospital of Strasbourg, Fédération de médecine translationnelle de Strasbourg (FMTS), 67000 Strasbourg, France
| | - M Auriacombe
- Bordeaux University, SANPSY, CNRS UMR 6033, Bordeaux, France; Addiction Clinic (Pôle interétablissement d'addictologie), CHU Bordeaux and CH Charles Perrens, Bordeaux, France
| | - P Roux
- Aix Marseille Université, Inserm, IRD, SESSTIM, Sciences économiques & sociales de la santé & traitement de l'information médicale, ISSPAM, Marseille, France
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Garenne M, Stiegler N, Bouchard JP. [Circumcision and HIV Prevention in Southern Africa: WHO Recommendations Questioned]. Rev Infirm 2023; 72:34-36. [PMID: 36870774 DOI: 10.1016/j.revinf.2023.01.030] [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] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The relationship between human immunodeficiency virus (HIV) infection and male circumcision, medical or traditional, remains controversial. Randomized clinical trials indicate that medical circumcision reduces the incidence in the months following surgery. But population-based studies show that the prevalence is the same over the long term. This paper summarizes the results of large population-based surveys conducted in southern African countries, the region most affected by AIDS worldwide. These surveys show that HIV prevalence among men aged 40-59 years is the same regardless of circumcision status and type. These results call into question the recommendations of the World Health Organization.
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Affiliation(s)
- Michel Garenne
- Department of Statistics and Population Studies, Faculty of Natural Sciences, University of Western Cape, Bellville, 7535 Cape-Town, South Africa; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, 2193 Johannesburg, South Africa; Institut de recherche pour le développement (IRD), UMI Résiliences, 93140 Bondy, France; Senior Fellow, Ferdi, Université d'Auvergne, 63000 Clermont-Ferrand, France
| | - Nancy Stiegler
- Department of Statistics and Population Studies, Faculty of Natural Sciences, University of Western Cape, Bellville, 7535 Cape-Town, South Africa
| | - Jean-Pierre Bouchard
- Department of Statistics and Population Studies, Faculty of Natural Sciences, University of Western Cape, Bellville, 7535 Cape-Town, South Africa; Institut psycho-judiciaire et de psychopathologie (IPJP), Centre hospitalier de Cadillac, 33410 Cadillac, France; Unité pour malades difficiles, Pôle de psychiatrie médico-légale, Centre hospitalier de Cadillac, 33410 Cadillac, France; Psychologie- Criminologie-Victimologie (PCV), 33000 Bordeaux, France.
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Grebely J, Robaeys G, Bruggmann P, Aghemo A, Backmund M, Bruneau J, Byrne J, Dalgard O, Feld JJ, Hellard M, Hickman M, Kautz A, Litwin A, Lloyd AR, Mauss S, Prins M, Swan T, Schaefer M, Taylor LE, Dore GJ. Recommandations pour la prise en charge de l'infection par le virus de l'hépatite C chez les usagers de drogues par injection. Int J Drug Policy 2023; 111:101669. [PMID: 26847504 DOI: 10.1016/j.drugpo.2015.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
| | - Geert Robaeys
- Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Belgium; Department of Hepatology, UZ Leuven, Leuven, Belgium; Faculty of Medicine and Life Sciences, Limburg Clinical Research Program, Hasselt University, Hasselt, Belgium
| | | | - Alessio Aghemo
- A.M. Migliavacca Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Markus Backmund
- Ludwig-Maximilians-University, Munich, Germany; Praxiszentrum im Tal Munich, Munich, Germany
| | | | - Jude Byrne
- International Network of People who Use Drugs, Canberra, Australia
| | - Olav Dalgard
- Department of Infectious Diseases, Akershus University Hospital, Lørenskog, Norway
| | | | - Margaret Hellard
- Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Matthew Hickman
- School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Achim Kautz
- European Liver Patients Association, Cologne, Germany
| | - Alain Litwin
- Division of General Internal Medicine, Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, United States
| | - Andrew R Lloyd
- Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Australia, Sydney, Australia
| | - Stefan Mauss
- Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
| | - Maria Prins
- Department of Research, Cluster Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands; Department of Internal Medicine, CINIMA, Academic Medical Centre, Amsterdam, The Netherlands
| | - Tracy Swan
- Treatment Action Group, New York, United States
| | - Martin Schaefer
- Department of Psychiatry, Psychotherapy and Addiction Medicine, Kliniken Essen-Mitte, Essen, Germany; Department of Psychiatry and Psychotherapy-CCM, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lynn E Taylor
- Department of Medicine, Brown University, Providence, RI, United States
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Abstract
HIV is not exclusive to the young population. Emotional life continues with age, and 20% of new cases of infection in France are among people over 50. This is therefore a public health issue for "seniors".
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Affiliation(s)
- Richard Pougnet
- Faculté de médecine et des sciences de la santé, Université de Bretagne occidentale, 22, rue Camille Desmoulins, 29238 Brest, France.
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Prieto LM, Blázquez Gamero D, Rubio Mancha I, Torres Pastor B, Epalza Ibarrondo C, Rojo Conejo P, Ramos Amador JT. Congenital cytomegalovirus infection in newborns born to HIV-infected mothers. Enferm Infecc Microbiol Clin (Engl Ed) 2022; 40:557-561. [PMID: 36274043 DOI: 10.1016/j.eimce.2022.03.014] [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: 01/01/2022] [Accepted: 03/31/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Congenital citomegalovirus (CMVc) infection is more common in children exposed to HIV during pregnancy, with reported rates in pre-ART era from 2 to 7%. The use of combined antiretroviral treatment (ARTc) could be a determining factor in reducing this risk of CMV transmission. The aim of this study was to describe the epidemiology of CMVc infection in newborns of HIV-infected mothers at Hospital Universitario 12 de Octubre, Madrid, Spain, from 2000 to 2017. MATERIAL AND METHODS An observational and retrospective study was carried out. Epidemiological and clinical variables were collected. Statistical analysis was performed with the SPSS 24.0 computer program. RESULTS 288 mother-infant pairs were included in the study. We observed a CMVc rate of 2.1% (95% CI 0.9-4.9). CONCLUSIONS The rate of CMVc in HIV-exposed children observed was lower than that reported in pre-ARTc era but seems higher than those described in general population.
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Affiliation(s)
- Luis M Prieto
- Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre (imas12), Universidad Complutense, Madrid, Spain.
| | - Daniel Blázquez Gamero
- Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre (imas12), Universidad Complutense, Madrid, Spain
| | - Irene Rubio Mancha
- Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Belén Torres Pastor
- Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Cristina Epalza Ibarrondo
- Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre (imas12), Universidad Complutense, Madrid, Spain
| | - Pablo Rojo Conejo
- Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, Spain; Instituto de Investigación Hospital 12 de Octubre (imas12), Universidad Complutense, Madrid, Spain
| | - José Tomás Ramos Amador
- Unidad de Enfermedades Infecciosas, Servicio de Pediatría, Hospital Universitario Clínico San Carlos, Madrid, Spain
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46
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Pougnet R, Troadec MB. [Risks and opportunities of reproduction with HIV]. Rev Infirm 2022; 71:38-9. [PMID: 36642473 DOI: 10.1016/j.revinf.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
As the human immunodeficiency virus (HIV) infection has become a chronic disease, the question of becoming a parent arises for HIV-positive people. There are several answers to this question, depending on the situation. Here is an overview of the risks and possibilities of procreation with HIV.
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47
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Kerdivel AS. [Listening to the patient living with HIV]. Rev Infirm 2022; 71:33-34. [PMID: 36642470 DOI: 10.1016/j.revinf.2022.12.009] [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] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Our experience within a CHRU on a specific consultation time with patients living with HIV allows us here to testify of a practice of the clinical psychologist. What does listening to our patients teach us?
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Affiliation(s)
- Anne-Solène Kerdivel
- CHRU de Brest, Hôpital de Bohars, Pôle de Psychiatrie, route de Ploudalmézeau, 29820 Bohars, France; CMP Bellevue, 40 rue de Provence, 29200 Brest, France; CMP Plabennec, 11 rue Hélène Boucher, 29860 Plabennec, France.
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48
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Cornec G, Le Menn R, Bellein V, Pougnet R. [The place of therapeutic education in the care of an HIV-positive patient]. Rev Infirm 2022; 71:35-36. [PMID: 36642471 DOI: 10.1016/j.revinf.2022.12.010] [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] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Since the advent of triple therapy, HIV has become a chronic disease. Therapeutic patient education (TPE) seems to have a place in this accompaniment, which has sometimes lasted several decades. The role of a nurse in TPE is still essential for the accompaniment of an HIV positive patient.
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Affiliation(s)
- Gaëlle Cornec
- Consultations VIH, CHRU Morvan, 2 avenue Foch, 29200 Brest, France.
| | - Romain Le Menn
- Consultations VIH, CHRU Morvan, 2 avenue Foch, 29200 Brest, France
| | | | - Richard Pougnet
- Faculté de médecine et des sciences de la santé, Université de Bretagne occidentale, 22 rue CamilleDesmoulins, 29238 Brest, France
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Derbez B. [Therapeutic activism and health democracy: lessons from the fight against AIDS]. Rev Infirm 2022; 71:22-4. [PMID: 36642466 DOI: 10.1016/j.revinf.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The "great AIDS patient revolt" had a major impact on the world of health care in Western countries. It is considered to be one of the social factors that led to the emergence of the notion of health democracy at the turn of the century. A look back at a historic struggle.
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50
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Pougnet Di Costanzo L, Pougnet R. [Memories of the dark years]. Rev Infirm 2022; 71:19-21. [PMID: 36642465 DOI: 10.1016/j.revinf.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Without claiming to circumscribe the human experience and the distress of patients and caregivers, health professionals who lived through the "dark years" before 1996 and the advent of triple therapy testify and share their memories.
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