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Buffoni L, Cano-Terriza D, Jiménez-Martín D, Jiménez-Ruiz S, Martínez-Moreno Á, Martínez-Moreno FJ, Zafra R, Pérez-Caballero R, Risalde MÁ, Gómez-Guillamón F, García-Bocanegra I. Serosurveillance of Trichinella sp. in wild boar and Iberian domestic suids in Mediterranean ecosystems of southwestern Spain. Zoonoses Public Health 2024; 71:191-199. [PMID: 38009293 DOI: 10.1111/zph.13098] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 11/28/2023]
Abstract
AIMS A cross-sectional study was carried out to assess the seroprevalence and risk factors associated with Trichinella spp. exposure in wild boar and Iberian domestic pigs from Mediterranean ecosystems of southwestern Spain. METHODS AND RESULTS Serum samples from 1360 wild boar and 439 Iberian domestic pigs were obtained during 2015-2020, from regions where Iberian pigs are raised under extensive conditions, hence sharing habitat with wild boar. Seropositivity was found in 7.4% (100/1360; 95% CI: 6.1-8.9) of the wild boar analysed. In this species, the individual seroprevalence ranged from 3.6% (8/223) (hunting season 2016-2017) to 11.4% (37/326) (2018-2019). A significant higher seropositivity was observed during the hunting season 2018-2019 (p < 0.009: OR = 3.07; 95% CI = 1.32-7.18) and one statistically significant cluster was detected within the studied area, in south central Andalusia [Relative Risk (RR) = 2.9; p = 0.037]. Females showed a significantly higher seroprevalence than males (8.7% vs. 5.8%) (p < 0.001: OR = 1.58; 95% CI = 1.08-2.32). No seropositivity to Trichinella spp. was detected in Iberian domestic pigs (0.0%; 95% CI: 0.0-0.9). CONCLUSIONS Although wild boar play an important role as a reservoir of Trichinella sp. in the Mediterranean ecosystems of southwestern Spain, our results suggest that the wild boar production system does not seem to pose a risk of Trichinella exposure to domestic pigs, despite sharing habitats in these ecosystems.
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Affiliation(s)
- Leandro Buffoni
- Departamento de Sanidad Animal (Parasitología y Enfermedades Parasitarias), Universidad de Córdoba, Córdoba, Spain
| | - David Cano-Terriza
- Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Débora Jiménez-Martín
- Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - Saúl Jiménez-Ruiz
- Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
- Centro de Investigação em Biodiversidade e Recursos Genéticos (CIBIO)-Laboratório Associado (InBIO), Vairão, Portugal
| | - Álvaro Martínez-Moreno
- Departamento de Sanidad Animal (Parasitología y Enfermedades Parasitarias), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - Francisco Javier Martínez-Moreno
- Departamento de Sanidad Animal (Parasitología y Enfermedades Parasitarias), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - Rafael Zafra
- Departamento de Sanidad Animal (Parasitología y Enfermedades Parasitarias), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - Raúl Pérez-Caballero
- Departamento de Sanidad Animal (Parasitología y Enfermedades Parasitarias), Universidad de Córdoba, Córdoba, Spain
- Instituto de Investigación del SIDA, Fundación IrsiCaixa, Barcelona, Spain
| | - María Ángeles Risalde
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Departamento de Anatomía y Anatomía Patológica Comparadas y Toxicología, Grupo de Investigación GISAZ, UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
| | - Félix Gómez-Guillamón
- Programa de Vigilancia Epidemiológica en Fauna Silvestre (PVE), Consejería de Sostenibilidad, Medio Ambiente y Economía Azul, Junta de Andalucía, Málaga, Spain
| | - Ignacio García-Bocanegra
- Departamento de Sanidad Animal, Grupo de Investigación en Sanidad Animal y Zoonosis (GISAZ), UIC Zoonosis y Enfermedades Emergentes ENZOEM, Universidad de Córdoba, Córdoba, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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2
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Borjabad B, Inciarte A, Chivite I, Gonzalez-Cordon A, Mosquera M, Hurtado C, Rovira C, Gonzalez T, Sempere A, Torres B, Calvo J, De La Mora L, Martinez-Rebollar M, Laguno M, Foncillas A, Ambrosioni J, Blanch J, Rodriguez A, Solbes E, Llobet R, Berrocal L, Mallolas J, Miro JM, Alcami J, Blanco JL, Sanchez-Palomino S, De Lazzari E, Martinez E. Efficacy and safety of raltegravir plus lamivudine maintenance therapy. J Antimicrob Chemother 2024; 79:255-261. [PMID: 38039097 DOI: 10.1093/jac/dkad364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/14/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Decreasing medication burden with raltegravir plus lamivudine in virologically suppressed persons with HIV (PWH) maintained efficacy and was well tolerated at 24 weeks, but more comprehensive data over longer follow-up are required. METHODS Prospective 48 week extension phase of the raltegravir plus lamivudine arm from a previous 24 week pilot randomized clinical trial in which virologically suppressed PWH were randomized 2:1 to switch to fixed-dose combination 150 mg lamivudine/300 mg raltegravir twice daily or to continue therapy. In this 48 week extension phase, raltegravir was dosed at 1200 mg/day and lamivudine 300 mg/day. Primary outcome was the proportion of PWH with treatment failure at Week 48. Secondary outcomes were changes in ultrasensitive plasma HIV RNA, HIV DNA in CD4 cells, serum IL-6, ultrasensitive C-reactive protein and sCD14, body composition, sleep quality, quality of life and adverse effects. RESULTS Between May 2018 and June 2019, 33 PWH were enrolled. One participant experienced virological failure without resistance mutations and re-achieved sustained virological suppression without therapy discontinuation, and two others discontinued therapy due to adverse effects. Treatment failure was 9% (95% CI 2%-24%) and 3% (95% CI 0%-17%) in the ITT and on-treatment populations. There were significant changes between baseline and Week 48 in serum cytokines but not in other secondary outcomes. CONCLUSIONS Switching to raltegravir and lamivudine in PWH with virological suppression maintains efficacy and is well tolerated. This maintenance regimen might be a cost-effective option for PWH at risk of drug-drug interactions or needing to avoid specific toxicities of certain antiretroviral drugs or their negative impact on comorbidities.
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Affiliation(s)
- Beatriz Borjabad
- Internal Medicine Service, Hospital Moises Broggi, Sant Joan Despí, Spain
| | - Alexy Inciarte
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Ivan Chivite
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Ana Gonzalez-Cordon
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Mar Mosquera
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Carmen Hurtado
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Cristina Rovira
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Tania Gonzalez
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Abiu Sempere
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Berta Torres
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Julia Calvo
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Lorena De La Mora
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Martinez-Rebollar
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Montserrat Laguno
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Alberto Foncillas
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Juan Ambrosioni
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Blanch
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- Internal Medicine Service, Hospital Universitari de Santa Maria, Lleida, Spain
- CIBER de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Rodriguez
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Estela Solbes
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Roger Llobet
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Leire Berrocal
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
| | - Josep Mallolas
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose M Miro
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Alcami
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Acquired Immunodeficiency Syndrome (AIDS) Immunopathology Unit, National Center for Microbiology, Institute of Health Carlos III, Majadahonda, Spain
| | - Jose L Blanco
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Sonsoles Sanchez-Palomino
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Elisa De Lazzari
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Esteban Martinez
- Infectious Diseases Unit, Hospital Clínic, University of Barcelona 08036, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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3
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Rocabert A, Borjabad B, Berrocal L, Blanch J, Inciarte A, Chivite I, Gonzalez-Cordon A, Torres B, Ambrosioni J, Martinez-Rebollar M, Laguno M, De La Mora L, Foncillas A, Sempere A, Rodriguez A, Solbes E, Llobet R, Miro JM, Mallolas J, Blanco JL, De Lazzari E, Martinez E. Tolerability of bictegravir/tenofovir alafenamide/emtricitabine versus dolutegravir/lamivudine as maintenance therapy in a real-life setting. J Antimicrob Chemother 2023; 78:2961-2967. [PMID: 37875023 DOI: 10.1093/jac/dkad338] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND While both the burden of therapy and the individual drugs in bictegravir/tenofovir alafenamide/emtricitabine (BIC/TAF/FTC) and dolutegravir/lamivudine differ, it is unclear whether their real-life tolerability may be also different. METHODS Single-centre, clinical cohort analysis of all virologically suppressed persons with HIV (PWH) who were first prescribed bictegravir as BIC/TAF/FTC or dolutegravir as dolutegravir/lamivudine and had taken ≥1 dose of study medication. Major outcomes were discontinuations either for any reason or due to toxicity. Incidence was calculated as number of episodes per 100 person-years adjusted through propensity score analysis. RESULTS Relative to persons treated with BIC/TAF/FTC (n = 1231), persons treated with dolutegravir/lamivudine (n = 821) were older and had more AIDS-defining conditions although better HIV control. After a median follow-up of 52 weeks, adjusted incidence rates for discontinuation were 6.68 (95% CI 5.18-8.19) and 8.44 (95% CI 6.29-10.60) episodes per 100 person-years for BIC/TAF/FTC and dolutegravir/lamivudine, respectively; adjusted incidence rate ratio for dolutegravir/lamivudine was 1.26 (95% CI 0.89-1.78) relative to BIC/TAF/FTC (P = 0.1847). Adjusted incidence rates for discontinuation due to toxicity were 3.88 (95% CI 2.70-5.06) and 4.62 (95% CI 3.05-6.19) episodes per 100 person-years for BIC/TAF/FTC and dolutegravir/lamivudine, respectively; adjusted incidence rate ratio for dolutegravir/lamivudine was 1.19 (95% CI 0.75-1.90) relative to BIC/TAF/FTC (P = 0. 4620). Adverse events leading to discontinuation were neuropsychiatric (n = 42; 2%), followed by gastrointestinal (n = 23; 1%), dermatological (n = 15; 1%) and weight increase (n = 15; 1%), without differences between regimens. CONCLUSIONS Switching to BIC/TAF/FTC or dolutegravir/lamivudine showed no difference in the risks of overall or toxicity-related discontinuations or in the profile of adverse events leading to discontinuation.
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Affiliation(s)
- Alba Rocabert
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Beatriz Borjabad
- Service of Internal Medicine, Hospital Moises Broggi, Sant Joan Despí, Spain
| | - Leire Berrocal
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Jordi Blanch
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Alexy Inciarte
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ivan Chivite
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | - Berta Torres
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Juan Ambrosioni
- Hospital Clínic, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Martinez-Rebollar
- Hospital Clínic, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Montserrat Laguno
- Hospital Clínic, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Abiu Sempere
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Ana Rodriguez
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Estela Solbes
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Roger Llobet
- Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Jose M Miro
- Hospital Clínic, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Mallolas
- Hospital Clínic, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose L Blanco
- Hospital Clínic, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Elisa De Lazzari
- Hospital Clínic, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Esteban Martinez
- Hospital Clínic, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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4
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Norman FF, Gonzalez-Sanz M, Gullón-Peña B, Chamorro-Tojeiro S, Rosas M, Crespillo-Andujar C, Monge-Maillo B, Comeche B, Corbacho-Loarte MD, Arcas C, Peña I, Tenorio MC, Lopez-Vélez R, Pérez-Molina JA. Haemoglobinopathies in mobile populations from sub-Saharan Africa. J Travel Med 2023; 30:taad115. [PMID: 37615968 DOI: 10.1093/jtm/taad115] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 08/25/2023]
Abstract
A frequency of HbS or haemoglobin C trait of 15% was found in a cohort of recently arrived, mainly asymptomatic, young sub-Saharan Africans, using a simple point-of-care screening test. Screening allows early diagnosis of haemoglobinopathies in vulnerable populations facilitating linkage to care, genetic counselling and implementation of treatment and prevention strategies.
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Affiliation(s)
- Francesca F Norman
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Marta Gonzalez-Sanz
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Beatriz Gullón-Peña
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Sandra Chamorro-Tojeiro
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Marta Rosas
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Clara Crespillo-Andujar
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Begoña Monge-Maillo
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Belen Comeche
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Maria-Dolores Corbacho-Loarte
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Cristina Arcas
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Ignacio Peña
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Maria C Tenorio
- Hematology Department, Ramón y Cajal University Hospital, IRYCIS, Madrid 28034, Spain
| | - Rogelio Lopez-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
| | - Jose A Pérez-Molina
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, Universidad de Alcalá, CIBER de Enfermedades Infecciosas, Madrid 28034, Spain
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5
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Sempere A, Assoumou L, González-Cordón A, Waters L, Rusconi S, Domingo P, Gompels M, de Wit S, Raffi F, Stephan C, Masiá M, Rockstroh J, Katlama C, Behrens GMN, Moyle G, Johnson M, Fox J, Stellbrink HJ, Guaraldi G, Florence E, Esser S, Gatell J, Pozniak A, Martínez E. Incidence of Hypertension and Blood Pressure Changes in Persons With Human Immunodeficiency Virus at High Risk for Cardiovascular Disease Switching From Boosted Protease Inhibitors to Dolutegravir: A Post-hoc Analysis of the 96-week Randomised NEAT-022 Trial. Clin Infect Dis 2023; 77:991-1009. [PMID: 37207617 DOI: 10.1093/cid/ciad297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/11/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Integrase inhibitors have been recently linked to a higher risk for hypertension. In NEAT022 randomized trial, virologically suppressed persons with human immunodeficiency virus (HIV, PWH) with high cardiovascular risk switched from protease inhibitors to dolutegravir either immediately (DTG-I) or after 48 weeks (DTG-D). METHODS Primary endpoint was incident hypertension at 48 weeks. Secondary endpoints were changes in systolic (SBP) and diastolic (DBP) blood pressure; adverse events and discontinuations associated with high blood pressure; and factors associated with incident hypertension. RESULTS At baseline, 191 (46.4%) participants had hypertension and 24 persons without hypertension were receiving antihypertensive medications for other reasons. In the 197 PWH (n = 98, DTG-I arm; n = 99, DTG-D arm) without hypertension or antihypertensive agents at baseline, incidence rates per 100 person-years were 40.3 and 36.3 (DTG-I) and 34.7 and 52.0 (DTG-D) at 48 (P = .5755) and 96 (P = .2347) weeks. SBP or DBP changes did not differed between arms. DBP (mean, 95% confidence interval) significantly increased in both DTG-I (+2.78 mmHg [1.07-4.50], P = .0016) and DTG-D (+2.29 mmHg [0.35-4.23], P = .0211) arms in the first 48 weeks of exposure to dolutegravir. Four (3 under dolutegravir, 1 under protease inhibitors) participants discontinued study drugs due to adverse events associated with high blood pressure. Classical factors, but not treatment arm, were independently associated with incident hypertension. CONCLUSIONS PWH at high risk for cardiovascular disease showed high rates of hypertension at baseline and after 96 weeks. Switching to dolutegravir did not negatively impact on the incidence of hypertension or blood pressure changes relative to continuing protease inhibitors.
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Affiliation(s)
- Abiu Sempere
- Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Lambert Assoumou
- Département d'Epidémiologie, Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - Ana González-Cordón
- Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Waters
- Mortimer Market Centre, Central & North West London National Health Service (NHS) Foundation Trust, London, United Kingdom
| | | | - Pere Domingo
- Mortimer Market Centre, Central & North West London National Health Service (NHS) Foundation Trust, London, United Kingdom
- Hospital de Sant Pau, Barcelona, Spain
| | - Mark Gompels
- North Bristol NHS Trust, Bristol, United Kingdom
| | - Stephane de Wit
- Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
| | | | | | - Mar Masiá
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Hospital General Universitario de Elche, Elche, Spain
| | | | - Christine Katlama
- Hôpital Universitaire Pitié Salpêtrière, Service des Maladies Infectieuses et Tropicales, France
| | | | - Graeme Moyle
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Julie Fox
- Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom
| | | | | | | | - Stefan Esser
- Universitätsklinikum, Universität Duisburg-Essen, Essen, Germany
| | | | - Anton Pozniak
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Esteban Martínez
- Département d'Epidémiologie, Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
- Mortimer Market Centre, Central & North West London National Health Service (NHS) Foundation Trust, London, United Kingdom
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