151
|
Bravo R, Soriano V, García-Samaniego J, Gómez-Cano M, González-Lahoz J, Altisent C, Ruiz I. Impact of antiretroviral therapy on hepatitis C viraemia in HIV-infected patients. Antivir Ther 1996; 1:194. [PMID: 11322254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
152
|
Soriano V, García-Samaniego J. [Management of viral hepatitis in patients with HIV infection]. Rev Clin Esp 1996; 196:479-87. [PMID: 8927770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
153
|
Soriano V, Bravo R, Mas A, García-Samaniego J. Hepatitis C viraemia in HIV-infected patients. Hepatitis-HIV Spanish Study Group. AIDS 1996; 10:922-3. [PMID: 8828752 DOI: 10.1097/00002030-199607000-00018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
154
|
Soriano V, García-Samaniego J, Castilla J, Bravo R, Hermida M, González J, Colmenero M, Castro A, Carballo E. [Proposal of a rule for deciding the therapeutic option in chronic hepatitis C in HIV-infected patients. Spanish Group for the Study of Viral Hepatitis in HIV-infected Patients]. Rev Clin Esp 1996; 196:488-91. [PMID: 8927771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
|
155
|
Soriano V, García-Samaniego J, Bravo R, González J, Castro A, Martńez-Odriozola P, Colmenero M, Carballo E, Suárez D, Castilla J, Rodriguez-Piñero FJ, Moreno A, del Romero J, Pedreira J, González-Lahoz J. [The treatment of chronic hepatitis C with interferon in patients infected with the human immunodeficiency virus. The Spanish Group for the Study of Viral Hepatitis in HIV+ Patients]. Med Clin (Barc) 1996; 106:486-90. [PMID: 8992129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Alfa-interferon (aIFN) is widely recommended for the treatment of chronic hepatitis C (CHC). Hepatitis C virus (HCV) infection is very common in injecting drug users (IDUs), which in Spain represent the large number of HIV-infected persons. Interaction between human immunodeficiency virus (HIV) and HCV in coinfected patients might accelerate the clinical course of HCV-associated liver disease. The efficacy and safety of aIFN therapy in HIV-infected patients with CHC is not well known. PATIENTS AND METHODS In a multicenter, prospective, open, non randomized and partially controlled study, we compared the efficacy and safety of aIFN therapy in 119 patients with CHC, of whom 90 were HIV-positive and 29 HIV-negative. Interferon was started at 5 mega U tiw for 3 months, followed in responders by 3 megaU tiw for additional 9 months. RESULTS One hundred seven patients completed the study. A normalization of the aminotransferase values at the end of treatment (complete response, CR) was observed in 26/80 (32.5%) HIV-positive and 10/27 (37.0%) HIV-negative individuals (p = 0.666). Relapses at 12 months of stopping aIFN were seen in 30.8% of HIV-positive subjects and 12.5% of HIV-negatives (p = 0.403). Side effects were uncommon and did not have severity; only one patient required to stop the medication. However, 3 HIV-positive subjects treated with aIFN (3.5% of them) showed an irreversible fall of CD4+ T-cells below half the baseline values. CONCLUSION HIV-infected patients with CHC seems to respond to aIFN with a similar rate than HIV-negatives. Moreover, the drug is similarly well tolerated in both groups of patients, although a fall of CD4+ T-cells is an unusual side effect of particular relevance observed in HIV-infected patients.
Collapse
|
156
|
Soriano V, Bravo R, García-Samaniego J, Castro A, Carballo E, González-Anglada I, Martínez-Odriozola P, Colmenero M, Pedreira J. Circulating hepatitis C virus genotypes in Spain. The Hepatitis/HIV Spanish Study Group. Vox Sang 1996; 70:180-1. [PMID: 8740013 DOI: 10.1111/j.1423-0410.1996.tb01320.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|
157
|
Bravo R, Soriano V, García-Samaniego J, González J, Castro A, Colmenero M, Carballo E, Mas A, González-Lahoz J. Hepatitis C virus genotypes in different risk populations in Spain. The Hepatitis-HIV Spanish Study Group. J Infect Dis 1996; 173:509-12. [PMID: 8568326 DOI: 10.1093/infdis/173.2.509-a] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
|
158
|
De Pouplana M, Soriano V, García-Samaniego J, Enríquez A, Muñoz F, González-Lahoz J. [Characteristics of chronic delta hepatitis in patients wih HIV infection]. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE PATOLOGIA DIGESTIVA 1995; 87:721-4. [PMID: 8519538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Hepatitis Delta virus (HDV) induces severe liver disease in HBsAg carriers. In regions such as Spain, drug addicts make-up a large part of the HIV-positive population and they are at risk of HDV infection. Natural history of chronic hepatitis D is not well known in HIV-infected patients. METHODS We reviewed the clinical charts of 37 patients attending our institution from 1989 to 1993, fulfilling the criteria for chronic hepatitis D. We compared all clinical, epidemiological, serological and histological findings between both HIV-positive and HIV-negative patients. RESULTS All the following parameters showed significant statistical differences between the both groups: mean ALT levels (175 vs 79 respectively, p < 0.05), previous episodes of hepatic decompensation (37% vs 10%, p < 0.01), the circulating Delta antigen (26% vs 10%, p < 0.05), the presence of HBeAg in serum (41% vs 0%, p < 0.01) and the HCV coinfection (85% vs 20%, p < 0.01). Histological findings were not significantly different comparing both groups, as chronic active hepatitis with cirrhosis was the most common diagnosis. CONCLUSION Chronic hepatitis D may present a more severe course in HIV-infected patients. The higher replication of HDV and the presence of HCV coinfection could explain this worst outcome.
Collapse
|
159
|
Soriano V, Bravo R, Mas A, García-Samaniego J, Guiérrez M, González-Lahoz J. Impact of immunosuppression caused by HIV infection on the replication of hepatitis C virus. Vox Sang 1995; 69:259-60. [PMID: 8578743 DOI: 10.1111/j.1423-0410.1995.tb02607.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
|
160
|
Carbó J, Laguna F, García-Samaniego J, Redondo C, Valencia E, Muñoz F, González-Lahoz JM. [Gastrointestinal disease due to cytomegalovirus in patients infected with the human immunodeficiency virus]. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE PATOLOGIA DIGESTIVA 1995; 87:499-504. [PMID: 7662417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To describe all the clinical settings, endoscopic findings and response to therapy in a series of HIV-positive patients with biopsy proven gastrointestinal CMV disease. PATIENTS We retrospectively reviewed the medical records of all HIV-infected patients who underwent digestive endoscopies at our Hospital from June 1990 to October 1993. RESULTS Twelve (7.5%) of 158 HIV-positive patients had gastrointestinal CMV disease. Sites of prove infection included the esophagus (n = 6, 50%), stomach (n = 2, 17%), duodenum (n = 4, 33.3%), ileum (n = 1, 8.5%) and colon (n = 2, 17%). The most common endoscopic findings were focal or diffuse mucosal ulcers. Three patients had pseudotumoral mucosal lesions. Cytomegalic cells were observed in 11 patients (91.6%) and immunohistochemical staining was positive in 9 (81.8%) of 11 patients tested. Eight patients completed a course of treatment with ganciclovir or foscarnet and all of them showed clinical improvement. The median survival time of our AIDS patients with CMV gastrointestinal disease was 7 weeks (range 1-39 weeks). CONCLUSIONS Gastrointestinal CMV disease may damage any site of the digestive tract in AIDS patients. Routine histopathologic examination was better than immunohistochemical staining for the diagnosis. Treatment improves the clinical situation in most of them. The mean survival is low and it is related to the degree of immunosuppression.
Collapse
|
161
|
Soriano V, García-Samaniego J, Bravo R, Castro A, Odriozola PM, González J, Colmenero M, Carballo E, Suárez D, Llibre JM. Efficacy and safety of alpha-interferon treatment for chronic hepatitis C in HIV-infected patients. HIV-Hepatitis Spanish Study Group. J Infect 1995; 31:9-13. [PMID: 8522850 DOI: 10.1016/s0163-4453(95)91178-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The efficacy and safety of recombinant alpha-interferon (IFN) therapy for chronic hepatitis C (CHC) was assessed in 57 HIV-infected individuals with CD4+ T cells above 200/mm3 and compared to the response obtained in 21 HIV-negative patients with CHC. IFN 5 megaU was given three times a week subcutaneously for 3 months. In responding patients, IFN 3 megaU three times a week was additionally administered for 9 months. After 8 months follow-up in HIV-infected patients, 38% (22/57) achieved normal (complete response, CR) alanine aminotransferase (ALT) values. Partial response (PR) was seen in 21% (12/57), and 40% (23/57) did not respond. Patients with CD4+ cells above 500/mm3 achieved CR in 58% (14/24) of cases compared to 24% (8/33) among those having a lower CD4+ count (P < 0.01). Females attained CR in 60% (9/15) of cases, and men in only 30.9% (13/42) (P < 0.01). No serious side effects or opportunistic infections were observed during the study period. However, three (5.2%) patients showed a dramatic fall in total CD4+ T cell count after beginning IFN therapy. Among 21 HIV-negative patients, after 8 months follow-up, CR was achieved in 10 (47%), PR in four (19%), and seven (33%) did not respond. We concluded that IFN therapy seems to be well tolerated and useful in HIV-infected patients suffering CHC. The rate of CR was not significantly different compared to that observed in HIV-negative patients (38% vs. 47%), relative risk (RR) = 0.67 (0.19-2.37).(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
|
162
|
Soriano V, García-Samaniego J, Bravo R, Valencia E, Laguna F, de Pouplana M, Iñíguez A, Muñoz F, González-Lahoz J. [Morbidity and mortality associated with chronic viral hepatopathy in patients infected with the human immunodeficiency virus]. Med Clin (Barc) 1995; 104:641-4. [PMID: 7623489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Hepatitis B, C and D virus infection is frequent in HIV-infected individuals, particularly in drug addicts. However, chronic liver disease of viral etiology has been little studied in AIDS. METHODS The impact of infection by hepatotropic viruses on hospital morbidity/mortality was analyzed in a group of HIV positive (HIV+) patients over the period from October 1991 to April 1994. RESULTS Viral liver disease was the cause of hospitalization in 94 (8.6%) out of 1,082 HIV+ patient admissions. Only 4 admissions were for severe or fulminant cases of acute viral hepatitis. Complicated (gastrointestinal bleeding, and spontaneous bacterial infection) or decompensated (ascites, jaundice and encephalopathy) viral liver disease was the diagnosis in the 90 remaining cases. Death directly associated to liver diseases was observed in 9 (9.5%) of these patients, globally representing 4.3% (9 out of 207) of the causes of hospital mortality during the study period, and the fifth in order of frequency. Hospital stay was significantly longer in patients admitted for decompensated or complicated chronic viral liver disease in comparison with the remaining patients (27.9 +/- 9 versus 18.4 +/- 8 days) (p < 0.05). Infection by the hepatitis C virus was observed in 88% (80 out of 90) of the hospital admissions for chronic liver disease although half presented coinfection by B or delta viruses. CONCLUSIONS Chronic liver disease of viral etiology, mainly by the hepatitis C virus, represents an important cause of hospital morbidity and mortality in Spanish HIV+ patients.
Collapse
|
163
|
Soriano V, Nedjar S, García-Samaniego J, Bravo R, Castro A, González J, Martínez-Odriozola P, Pedreira J, del Romero J, Suárez D. High rate of co-infection with different hepatitis C virus subtypes in HIV-infected intravenous drug addicts in Spain. Hepatitis HIV Spanish Study Group. J Hepatol 1995; 22:598-9. [PMID: 7650343 DOI: 10.1016/0168-8278(95)80460-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
164
|
Soriano V, Bravo R, Mas A, García-Samaniego J, Gutiérrez M, González-Lahoz J. Impact of Immunosuppression Caused by HIV Infection on the Replication of Hepatitis C Virus. Vox Sang 1995. [DOI: 10.1159/000462851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
165
|
García-Samaniego J, Soriano V, Soto J, Muñoz F. [Phenytoin hypersensitivity syndrome]. ANALES DE MEDICINA INTERNA (MADRID, SPAIN : 1984) 1994; 11:541-2. [PMID: 7654902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Diphenylhydantoine is a drug frequently used in the treatment of epilepsia. In rare occasions, it produces a mulsisystemic manifestation characterized by fever, lymphadenopathy, hepatitis, eosinophilia and desquamative cutaneous eruption, which typically develops within 4-8 weeks after the beginning of the treatment. Mortality rates may reach up to 40% in patients with severe hepatic affection, although the response to steroid therapy is usually frequent. We present the case of a patient which developed a syndrome of hypersensibility to diphenylhydantoine with mononucleosic manifestations, icteric hepatitis and exfoliative dermatitis, who completely recovered a few days after his hospitalization.
Collapse
|
166
|
Soriano V, García-Samaniego J. [Therapy with interferon in HIV-infected patients with chronic viral hepatitis]. Rev Clin Esp 1994; 194:887-9. [PMID: 7528439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
167
|
Laguna F, García-Samaniego J, Moreno V, González-Lahoz JM. Prevalence of gastrointestinal leishmaniasis in Spanish HIV-positive patients with digestive symptoms. Am J Gastroenterol 1994; 89:1606. [PMID: 8079964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
168
|
García-Samaniego J, Soriano V, Bravo R, González-Lahoz J, Muñoz F. Viral replication in patients with multiple hepatitis virus infections. Gastroenterology 1994; 107:322-3. [PMID: 8020685 DOI: 10.1016/0016-5085(94)90104-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
169
|
Laguna F, García-Samaniego J, Soriano V, Valencia E, Redondo C, Alonso MJ, González-Lahoz JM. Gastrointestinal leishmaniasis in human immunodeficiency virus-infected patients: report of five cases and review. Clin Infect Dis 1994; 19:48-53. [PMID: 7948557 DOI: 10.1093/clinids/19.1.48] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
We describe five cases of gastrointestinal leishmaniasis in patients with human immunodeficiency virus infection and review 10 additional cases reported in the literature. All of the patients had CD4+ cell counts of < 200/mm3, and AIDS had been previously diagnosed for 12 patients. Fever and splenomegaly were present in 46% of cases. Thirteen patients had digestive symptoms; these symptoms included diarrhea (6), dysphagia and/or odynophagia (6), abdominal pain (2), epigastric pain (2), gastrointestinal hemorrhage (1), and rectal discomfort (1). The regions of the digestive tract most frequently affected by Leishmania organisms were the duodenal mucosa (90%) and the gastric mucosa (75%). Endoscopy showed normal-appearing mucosa in 45% of cases. In 10 cases the diagnosis of visceral leishmaniasis was first made by biopsy of the gastrointestinal mucosa. In most cases treatment with antimonial agents was not effective.
Collapse
|
170
|
García-Samaniego J, Soriano V, Silva E, Enríquez A, Muñoz F, González-Lahoz J, Di Bisceglie A. Significance of HCV RIBA-2 indeterminate results in high-risk individuals: assessment by a new third-generation RIBA assay and PCR. Vox Sang 1994; 66:148-9. [PMID: 7514325 DOI: 10.1111/j.1423-0410.1994.tb00298.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
171
|
Soriano V, García-Samaniego J, Gutiérrez M, Bravo R, Gonzalez-Lahoz J. High morbidity and mortality of chronic viral liver disease in HIV-infected individuals in Spain. J Infect 1994; 28:100-2. [PMID: 8163820 DOI: 10.1016/s0163-4453(94)94440-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
172
|
García-Samaniego J, Soriano V, Silva E, Enríquez A, Muñoz F, González-Lahoz J, Di Bisceglie A. Significance of HCV RIBA-2 Indeterminate Results in High-Risk Individuals: Assessment by a New Third-Generation RIBA Assay and PCR. Vox Sang 1994. [DOI: 10.1159/000462495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
173
|
Soriano V, Valencia E, Alba A, Laguna F, Moreno V, Alberdi JC, García-Samaniego J, González-Lahoz J. [Changes in the spectrum of the diseases in patients hospitalized with HIV infection]. Med Clin (Barc) 1993; 101:736-40. [PMID: 8289522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Infections in subjects with HIV-1 infection are a frequent cause of hospital admission. Knowledge of the entities which most often motivate hospitalization may aid in designing the most appropriate diagnostic and prophylactic strategies. The causes of hospital admission in individuals with risk practices for HIV-1 infection attended in a Department of Infectious Diseases in Madrid over a period of 4 years were analyzed. METHODS The records of the patients admitted from 1989 to 1992 were retrospectively reviewed. The principal and associated diagnoses which led to hospitalization were considered. The admissions of the two years were compared. RESULTS Bacterial pneumonias were the principal cause of hospitalization in the 2 years studied. Forty-five percent of the infections leading to hospital admission were not included among those defining AIDS. Tuberculosis was the most frequent opportunistic infection. Admissions due to pulmonary pneumocystosis, tuberculosis, toxoplasmosis, esophageal candidiasis and Kaposi's sarcoma decreased from 1989-1992. To the contrary, disseminated Mycobacterium avium complex infection and systemic infection by cytomegalovirus significantly increased over the same period. The incidence of other diseases such as endocarditis or leishmaniasis remained stable. More than half of the diseases were diagnosed in association with another entity during the same admission. Likewise, an increase in atypical forms of infections thus making diagnosis and treatment more difficult was observed. The first cases of multiresistant tuberculosis, all of rapidly fatal evolution, were identified in 1992. Mean hospital stay increased 30% and the rate of mortality was of 9% in 1989 and rose to 20% in 1992. CONCLUSIONS The spectrum of infections which led to hospital admission of patients with HIV-1 infection has significantly modified over the last 4 years being related with the generalization of prophylactic medication for some opportunistic infections, the improvement of certain diagnostic techniques and more frequent ambulatory treatment of some diseases. The mean length of stay and hospital mortality have increased in the HIV+ population.
Collapse
|
174
|
García-Samaniego J, Enríquez A, Soriano V, Gutierrez M, Baquero M, Muñoz F. Third-generation recombinant immunoblot assay to confirm hepatitis C virus-indeterminate serological samples. Vox Sang 1993; 64:191-2. [PMID: 8387234 DOI: 10.1111/j.1423-0410.1993.tb05384.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
|
175
|
García-Samaniego J, Enríquez A, Soriano V, Baquero M, Muñoz F, Gutierrez M. Third-Generation Recombinant Immunoblot Assay to Confirm Hepatitis C Virus-Indeterminate Serological Samples. Vox Sang 1993. [DOI: 10.1159/000462344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|