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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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Santos M, Corma-Gómez A, Fernandez-Fuertes M, González-Serna A, Rincón P, Real LM, Pineda JA, Macías J. Burden of significant liver damage in people living with HIV after microelimination of the hepatitis C virus. J Infect 2023; 86:41-46. [PMID: 36410455 DOI: 10.1016/j.jinf.2022.11.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Once HIV/HCV-coinfection microelimination has been virtually achieved in some countries, there is no information about the burden of liver disease among people living with HIV (PLWH). The aim of this study was to define the current prevalence and causes of significant liver damage (SLD) in PLWH. METHODS Cross-sectional study including 619 PLWH. SLD was defined as liver stiffness (LS) ≥ 7.2 kPa measured by transient elastography. Nonviral liver damage (NVLD) was considered if there was no evidence injury due to chronic hepatitis C virus (HCV) infection, active hepatitis B (HBV) or E virus infections. RESULTS One hundred and twelve of 619 (18.2%) PLWH showed SLD, including 34/112 (5.5%) with LS ≥14 kPa. 72/112 (64.3%) had cured HCV infection, 4/112 (3.6%) active HBV infection, and 2/112 HBV/prior HCV coinfection. Thus, 40 (35.7%) showed NVLD. Metabolic associated steatohepatitis (MASH) was present in 29/40 (72.5%) of patients with NVLD, alcoholic liver damage in 2/40 (2.5%) and mixed steatohepatitis in 5/40 (12.5%). CONCLUSIONS After HIV/HCV microelimination the burden of liver damage is high among PLWH. Persistent injury after HCV is a very frequent cause of SLD. However, NVLD, mainly due to MASH, is also a common condition in this population.
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Affiliation(s)
- M Santos
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain
| | - A Corma-Gómez
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain
| | - M Fernandez-Fuertes
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain
| | - A González-Serna
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain; Department of Physiology, University of Sevilla. Sevilla, Spain
| | - P Rincón
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain
| | - L M Real
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain; Department of Surgical Specialties, Biochemistry and Immunology. University of Málaga, Málaga, Spain
| | - J A Pineda
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; CIBERINFEC. Spain; Department of Medicine. University of Sevilla. Sevilla, Spain.
| | - J Macías
- Unidad de Enfermedades Infecciosas y Microbiología. Hospital Universitario Virgen de Valme. Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC. Spain; Department of Medicine. University of Sevilla. Sevilla, Spain
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3
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Howe AY, Rodrigo C, Cunningham E, Douglas MW, Dietz J, Grebely J, Popping S, Sfalcin JA, Parczewski M, Sarrazin C, de Salazar A, Fuentes A, Sayan M, Quer J, Kjellin M, Kileng H, Mor O, Lennerstrand J, Fourati S, di Maio VC, Chulanov V, Pawlotsky JM, Harrigan PR, Ceccherini-Silberstein F, Garcia F, Martinello M, Matthews G, Fernando FF, Esteban JI, Müllhaupt B, Wiesch JSZ, Buggisch P, Neumann-Haefelin C, Berg T, Berg CP, Schattenberg JM, Moreno C, Stauber R, Lloyd A, Dore G, Applegate T, Ignacio J, Garcia-Cehic D, Gregori J, Rodriguez-Frias F, Rando A, Angelico M, Andreoni M, Babudieri S, Bertoli A, Cento V, Coppola N, Craxì A, Paolucci S, Parruti G, Pasquazzi C, Perno CF, Teti E, Vironet C, Lannergård A, Duberg AS, Aleman S, Gutteberg T, Soulier A, Gourgeon A, Chevaliez S, Pol S, Carrat F, Salmon D, Kaiser R, Knopes E, Gomes P, de Kneght R, Rijnders B, Poljak M, Lunar M, Usubillaga R, Seguin C, Tay E, Wilson C, Wang DS, George J, Kok J, Pérez AB, Chueca N, García-Deltoro M, Martínez-Sapiña AM, Lara-Pérez MM, García-Bujalance S, Aldámiz-Echevarría T, Vera-Méndez FJ, Pineda JA, Casado M, Pascasio JM, Salmerón J, Alados-Arboledas JC, Poyato A, Téllez F, Rivero-Juárez A, Merino D, Vivancos-Gallego MJ, Rosales-Zábal JM, Ocete MD, Simón MÁ, Rincón P, Reus S, De la Iglesia A, García-Arata I, Jiménez M, Jiménez F, Hernández-Quero J, Galera C, Balghata MO, Primo J, Masiá M, Espinosa N, Delgado M, von-Wichmann MÁ, Collado A, Santos J, Mínguez C, Díaz-Flores F, Fernández E, Bernal E, De Juan J, Antón JJ, Vélez M, Aguilera A, Navarro D, Arenas JI, Fernández C, Espinosa MD, Ríos MJ, Alonso R, Hidalgo C, Hernández R, Téllez MJ, Rodríguez FJ, Antequera P, Delgado C, Martín P, Crespo J, Becerril B, Pérez O, García-Herola A, Montero J, Freyre C, Grau C, Cabezas J, Jimenez M, Rodriguez MAM, Quilez C, Pardo MR, Muñoz-Medina L, Figueruela B. Characteristics of hepatitis C virus resistance in an international cohort after a decade of direct-acting antivirals. JHEP Rep 2022; 4:100462. [PMID: 35434589 PMCID: PMC9010635 DOI: 10.1016/j.jhepr.2022.100462] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 10/24/2022] Open
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Cantudo-Cuenca MD, Gutiérrez-Pizarraya A, Pinilla-Fernández A, Contreras-Macías E, Fernández-Fuertes M, Lao-Domínguez FA, Rincón P, Pineda JA, Macías J, Morillo-Verdugo R. Drug-drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain. Sci Rep 2021; 11:12414. [PMID: 34127740 PMCID: PMC8203634 DOI: 10.1038/s41598-021-91953-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/31/2021] [Indexed: 12/15/2022] Open
Abstract
Primary aim was to assess prevalence and severity of potential and real drug-drug interactions (DDIs) among therapies for COVID-19 and concomitant medications in hospitalized patients with confirmed SARS-CoV-2 infection. The secondary aim was to analyze factors associated with rDDIs. An observational single center cohort study conducted at a tertiary hospital in Spain from March 1st to April 30th. rDDIs refer to interaction with concomitant drugs prescribed during hospital stay whereas potential DDIs (pDDIs) refer to those with domiciliary medication. DDIs checked with The University of Liverpool resource. Concomitant medications were categorized according to the Anatomical Therapeutic Chemical classification system. Binomial logistic regression was carried out to identify factors associated with rDDIs. A total of 174 patients were analyzed. DDIs were detected in 152 patients (87.4%) with a total of 417 rDDIs between COVID19-related drugs and involved hospital concomitant medication (60 different drugs) while pDDIs were detected in 105 patients (72.9%) with a total of 553 pDDIs. From all 417 rDDIs, 43.2% (n = 180) were associated with lopinavir/ritonavir and 52.9% (n = 221) with hydroxychloroquine, both of them the most prescribed (106 and 165 patients, respectively). The main mechanism of interaction observed was QTc prolongation. Clinically relevant rDDIs were identified among 81.1% (n = 338) ('potential interactions') and 14.6% (n = 61) (contraindicated) of the patients. Charlson index (OR 1.34, 95% IC 1.02-1.76) and number of drugs prescribed during admission (OR 1.42, 95% IC 1.12-1.81) were independently associated with rDDIs. Prevalence of patients with real and pDDIs was high, especially those clinically relevant. Both comorbidities and polypharmacy were found as risk factors independently associated with DDIs development.
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Affiliation(s)
- M D Cantudo-Cuenca
- Pharmacy Unit, Hospital Universitario Virgen de Valme, Ctra. de Cádiz Km. 548,9, Seville, Spain
| | | | - Ana Pinilla-Fernández
- Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen de Valme, Avda. Bellavista s/n, 41014, Seville, Spain
| | | | - M Fernández-Fuertes
- Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen de Valme, Avda. Bellavista s/n, 41014, Seville, Spain
| | - F A Lao-Domínguez
- Pharmacy Unit, Hospital Universitario Virgen de Valme, Ctra. de Cádiz Km. 548,9, Seville, Spain
| | - Pilar Rincón
- Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen de Valme, Avda. Bellavista s/n, 41014, Seville, Spain
| | - Juan Antonio Pineda
- Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen de Valme, Avda. Bellavista s/n, 41014, Seville, Spain
| | - Juan Macías
- Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen de Valme, Avda. Bellavista s/n, 41014, Seville, Spain
| | - Ramón Morillo-Verdugo
- Pharmacy Unit, Hospital Universitario Virgen de Valme, Ctra. de Cádiz Km. 548,9, Seville, Spain
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Fernandez-Fuertes M, Macías J, Corma-Gómez A, Rincón P, Merchante N, Gómez-Mateos J, Pineda JA, Real LM. Similar prevalence of hepatic steatosis among patients with chronic hepatitis C with and without HIV coinfection. Sci Rep 2020; 10:6736. [PMID: 32317646 PMCID: PMC7174281 DOI: 10.1038/s41598-020-62671-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/17/2020] [Indexed: 12/15/2022] Open
Abstract
Hepatic steatosis (HS) is frequently observed in HIV-infected patients. It is not known whether HIV infection is an independent risk factor for HS development. We aimed to analyze whether HIV coinfection was associated with a higher frequency of HS in patients with chronic hepatitis C. This was a retrospective cross-sectional study. 574 subjects with chronic hepatitis C virus (HCV) infection were included, 246 (43%) of them coinfected with HIV. All of them underwent transient elastography with controlled attenuation parameter (CAP) measurement. HS was defined as CAP ≥ 248 dB/m. 147 individuals (45%) showed HS in the HCV-monoinfected group and 100 (40.7%) in the HIV/HCV-coinfected group (p = 0.318). HS was associated with body mass index (BMI) [<25 Kg/m2 vs. ≥25 Kg/m2, 67 (23.5%) vs. 171 (62.9%); p = 0.001], with plasma HDL-cholesterol [<50 mg/dL vs. ≥50 mg/dL, 122 (48.6%) vs. 95 (37.5%), p = 0.012], with plasma triglycerides [<150 mg/dL vs. ≥150 mg/dL, 168 (40.2%) vs. 65 (52.4%); p = 0.016] and with plasma total cholesterol [<200 mg/dL vs. ≥200 mg/dL, 181 (41%) vs. 53 (52.5%); p = 0.035]. In the multivariate analysis, HS was associated with BMI [adjusted OR (AOR) = 1.264 (1.194–1.339); p = 0.001], age [AOR = 1.029 (1.001–1.058); p = 0.047] and HCV genotype 3 infection [AOR = 1.901 (1.081–2.594); p = 0.026]. HIV coinfection was not associated with HS [AOR = 1.166 (0.719–1.892); p = 0.534]. In conclusion, HIV coinfection is not related with an increased frequency of HS in HCV-infected patients.
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Affiliation(s)
- M Fernandez-Fuertes
- Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen de Valme, Sevilla, 41014, Spain
| | - J Macías
- Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen de Valme, Sevilla, 41014, Spain.
| | - A Corma-Gómez
- Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen de Valme, Sevilla, 41014, Spain
| | - P Rincón
- Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen de Valme, Sevilla, 41014, Spain
| | - N Merchante
- Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen de Valme, Sevilla, 41014, Spain
| | - J Gómez-Mateos
- Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen de Valme, Sevilla, 41014, Spain
| | - J A Pineda
- Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen de Valme, Sevilla, 41014, Spain
| | - L M Real
- Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen de Valme, Sevilla, 41014, Spain
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Vrancken B, Cuypers L, Pérez AB, Chueca N, Anton-Basantas J, de la Iglesia A, Fuentes J, Pineda JA, Téllez F, Bernal E, Rincón P, Von Wichman MA, Fuentes A, Vera F, Rivero-Juárez A, Jiménez M, Vandamme AM, García F. Cross-country migration linked to people who inject drugs challenges the long-term impact of national HCV elimination programmes. J Hepatol 2019; 71:1270-1272. [PMID: 31585736 DOI: 10.1016/j.jhep.2019.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/26/2019] [Accepted: 08/07/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Bram Vrancken
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium.
| | - Lize Cuypers
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium.
| | - Ana Belen Pérez
- Clinical Microbiology, University Hospital San Cecilio, Research Institute Ibs, Granada, Spain
| | - Natalia Chueca
- Clinical Microbiology, University Hospital San Cecilio, Research Institute Ibs, Granada, Spain
| | | | | | - Javier Fuentes
- Hepatology Unit, Hospital Miguel Servet, Zaragoza, Spain
| | | | - Francisco Téllez
- Infectious Diseases Unit, University Hospital of Puerto Real, Cádiz, Spain
| | - Enrique Bernal
- Infectious Diseases, University Hospital Reina Sofía, Murcia, Spain
| | - Pilar Rincón
- Infectious Diseases Unit, University Hospital of Valme, Sevilla, Spain
| | | | - Ana Fuentes
- Clinical Microbiology, University Hospital San Cecilio, Research Institute Ibs, Granada, Spain
| | - Francisco Vera
- Infectious Disease Unit, University Hospital Santa Lucía, Cartagena, Murcia, Spain
| | | | | | - Anne-Mieke Vandamme
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Leuven, Belgium; Center for Global Health and Tropical Medicine, Microbiology Unit, Institute of Hygiene and Tropical Medicine, University Nova Lisbon, Lisbon, Portugal
| | - Federico García
- Clinical Microbiology, University Hospital San Cecilio, Research Institute Ibs, Granada, Spain
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Merchante N, Rivero-Juárez A, Téllez F, Merino D, Ríos-Villegas MJ, Villalobos M, Omar M, Rincón P, Rivero A, Pérez-Pérez M, Raffo M, López-Montesinos I, Palacios R, Gómez-Vidal MA, Macías J, Pineda JA. Sustained virological response to direct-acting antiviral regimens reduces the risk of hepatocellular carcinoma in HIV/HCV-coinfected patients with cirrhosis. J Antimicrob Chemother 2019; 73:2435-2443. [PMID: 29982683 DOI: 10.1093/jac/dky234] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 05/22/2018] [Indexed: 12/30/2022] Open
Abstract
Objectives To assess the impact of all-oral direct-acting antiviral agent (DAA) regimens on the risk of hepatocellular carcinoma (HCC) in HIV/HCV-coinfected patients with cirrhosis. Methods This was a multicentre prospective cohort study recruiting HIV/HCV-coinfected patients with a new diagnosis of compensated cirrhosis. Patients were followed up until HCC, death or the censoring date (March 2017). The primary endpoint was the emergence of HCC. The incidence rate (IR) (95% CI) of HCC in different groups was computed. Time-to-event analyses were performed to identify predictors of HCC emergence. Results The study included 495 HIV/HCV-coinfected patients with cirrhosis. After a median (IQR) follow-up of 59 (27-84) months, 22 (4.4%; 95% CI 2.6-6.3) patients developed an HCC. The IR (95% CI) of HCC was 0.93 (0.06-1.42) per 100 person-years (PY). Three hundred and three (61%) patients achieved sustained virological response (SVR) during follow-up, 79 after interferon (IFN)-based regimens and 224 after an all-oral DAA regimen. The IR (95% CI) of HCC after all-oral DAA was 0.35 (0.14-0.85) per 100 PY whereas it was 1.79 (1.11-2.88) per 100 PY in the remaining cohort (P = 0.0005). When only patients with SVR were considered, the IR (95% CI) of HCC after all-oral DAA was 0.32 (0.12-0.86) whereas it was 0 per 100 PY among those with SVR after IFN-based therapies (P = 0.27). Achieving SVR with an all-oral DAA regimen during follow-up was independently associated with a lower risk of HCC emergence (subhazard ratio 0.264; 95% CI 0.070-0.991; P = 0.049). Conclusions SVR with all-oral DAA regimens reduces the risk of HCC in HIV/HCV-coinfected patients with compensated cirrhosis.
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Affiliation(s)
- Nicolás Merchante
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain
| | - Antonio Rivero-Juárez
- Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Francisco Téllez
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Puerto Real, Cádiz, Spain
| | - Dolores Merino
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Hospitales Juan Ramón Jiménez e Infanta Elena, Huelva, Spain
| | - María J Ríos-Villegas
- Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Marina Villalobos
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Málaga (IBIMA), Hospital Virgen de la Victoria, Málaga, Spain
| | - Mohamed Omar
- Unidad de Enfermedades Infecciosas, Complejo Hospitalario de Jaén, Jaén, Spain
| | - Pilar Rincón
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain
| | - Antonio Rivero
- Unidad de Enfermedades Infecciosas, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba (UCO), Córdoba, Spain
| | - Montserrat Pérez-Pérez
- Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología, Hospital de La Línea de la Concepción, AGS Campo de Gibraltar, Cádiz, Spain
| | - Miguel Raffo
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Hospitales Juan Ramón Jiménez e Infanta Elena, Huelva, Spain
| | | | - Rosario Palacios
- Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Málaga (IBIMA), Hospital Virgen de la Victoria, Málaga, Spain
| | - María A Gómez-Vidal
- Unidad de Enfermedades Infecciosas, Complejo Hospitalario de Jaén, Jaén, Spain
| | - Juan Macías
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain
| | - Juan A Pineda
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario de Valme, Sevilla, Spain
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8
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Pérez AB, Chueca N, Macías J, Pineda JA, Salmerón J, Rivero-Juárez A, Hidalgo-Tenorio C, Espinosa MD, Téllez F, Von-Wichmann MÁ, Omar M, Santos J, Hernández-Quero J, Antón JJ, Collado A, Lozano AB, García-Deltoro M, Casado M, Pascasio JM, Selfa A, Rosales JM, De la Iglesia A, Arenas JI, García-Bujalance S, Ríos MJ, Bernal E, Martínez O, García-Herola A, Vélez M, Rincón P, García F. Prevalence of resistance associated substitutions and efficacy of baseline resistance-guided chronic hepatitis C treatment in Spain from the GEHEP-004 cohort. PLoS One 2019; 14:e0221231. [PMID: 31469856 PMCID: PMC6716636 DOI: 10.1371/journal.pone.0221231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 08/01/2019] [Indexed: 12/11/2022] Open
Abstract
Treatment guidelines differ in their recommendation to determine baseline resistance associated substitutions (RAS) before starting a first-line treatment with direct-acting antivirals (DAAs). Here we analyze the efficacy of DAA treatment with baseline RAS information. We conducted a prospective study involving 23 centers collaborating in the GEHEP-004 DAA resistance cohort. Baseline NS5A and NS3 RASs were studied by Sanger sequencing. After issuing a comprehensive resistance report, the treating physician decided the therapy, duration and ribavirin use. Sustained virological response (SVR12) data are available in 275 patients. Baseline NS5A RAS prevalence was between 4.3% and 26.8% according to genotype, and NS3 RASs prevalence (GT1a) was 6.3%. Overall, SVR12 was 97.8%. Amongst HCV-GT1a patients, 75.0% had >800,000 IU/ml and most of those that started grazoprevir/elbasvir were treated for 12 weeks. In genotype 3, NS5A Y93H was detected in 9 patients. 42.8% of the HCV-GT3 patients that started sofosbuvir/velpatasvir included ribavirin, although only 14.7% carried Y93H. The efficacy of baseline resistance-guided treatment in our cohort has been high across the most prevalent HCV genotypes in Spain. The duration of the grazoprevir/elbasvir treatment adhered mostly to AASLD/IDSA recommendations. In cirrhotic patients infected with GT-3 there has been a high use of ribavirin.
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Affiliation(s)
- Ana Belén Pérez
- Clinical Microbiology Unit, University Hospital Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Natalia Chueca
- Clinical Microbiology Unit, University Hospital San Cecilio, Instituto de Investigacion Ibs. Granada, Granada, Spain
| | - Juan Macías
- Infectious Diseases Unit, University Hospital Nuestra Señora de Valme, Sevilla, Spain
| | - Juan Antonio Pineda
- Infectious Diseases Unit, University Hospital Nuestra Señora de Valme, Sevilla, Spain
| | - Javier Salmerón
- Hepatology Unit, University Hospital San Cecilio Granada, Instituto de Investigación Ibs. CIBERehd, Granada, Spain
| | - Antonio Rivero-Juárez
- Infectious Diseases Unit, University Hospital Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain
| | | | | | - Francisco Téllez
- Infectious Diseases Unit, Hospital Puerto Real, Puerto Real, Cádiz, Spain
| | | | - Mohamed Omar
- Infectious Diseases Unit, Complejo Hospitalario de Jaén, Jáen, Spain
| | - Jesús Santos
- Infectious Diseases Unit, University Hospital Virgen de la Victoria, Málaga, Spain
| | | | | | - Antonio Collado
- Infectious Diseases Unit, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | - Ana Belén Lozano
- Infectious Diseases Unit, Hospital de Poniente, El Ejido, Almería, Spain
| | | | - Marta Casado
- Hepatology Unit, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | | | - Aida Selfa
- Hepatology Unit, Hospital Comarcal Santa Ana, Motril Granada, Spain
| | | | | | | | | | - María José Ríos
- Infectious Diseases Unit, University Hospital Virgen Macarena, Seville, Spain
| | - Enrique Bernal
- Infectious Diseases Unit, Hospital General Reina Sofía, Murcia, Spain
| | - Onofre Martínez
- Infectious Diseases Unit, University Hospital Santa Lucía, Cartagena, Spain
| | | | - Mónica Vélez
- Infectious Diseases Unit, Hospital General de La Palma, La Palma, Spain
| | - Pilar Rincón
- Infectious Diseases Unit, University Hospital Nuestra Señora de Valme, Sevilla, Spain
| | - Federico García
- Clinical Microbiology Unit, University Hospital San Cecilio, Instituto de Investigacion Ibs. Granada, Granada, Spain
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9
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Mancebo M, Macías J, Merchante N, Real LM, Lozano F, Domínguez L, Álvarez-Ossorio MJ, Saussol F, Rincón P, Pineda JA, Neukam K. Low incidence of acute hepatitis C virus infection among Southern Spanish HIV-infected individuals. J Infect 2017; 74:514-517. [DOI: 10.1016/j.jinf.2017.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 01/23/2017] [Accepted: 01/30/2017] [Indexed: 12/19/2022]
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10
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Tejedo JR, Ramírez R, Cahuana GM, Rincón P, Sobrino F, Bedoya FJ. Evidence for involvement of c-Src in the anti-apoptotic action of nitric oxide in serum-deprived RINm5F cells. Cell Signal 2001; 13:809-17. [PMID: 11583916 DOI: 10.1016/s0898-6568(01)00206-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The mechanism by which nitric oxide (NO) protects from apoptosis is a matter of debate. We have shown previously that phosphorylation of tyrosine residues participates in the protection from apoptosis in insulin-producing RINm5F cells (Inorg. Chem. Commun. 3 (2000) 32). Since NO has been reported to activate the tyrosine kinase c-Src and this kinase is involved in the activation of protein kinase G (PKG) in some cell systems, we aimed at studying the contribution of c-Src and PKG systems in anti-apoptotic actions of NO in serum-deprived RINm5F cells. Here we report that exposure of serum-deprived cells to 10 microM DETA/NO results in protection from degradation of the anti-apoptotic protein Bcl-2, together with a reduction of cytochrome c release from mitochondria and caspase-3 inhibition. Studies with the inhibitors ODQ and KT-5823 revealed that these actions are dependent on both activation of guanylate cyclase and PKG. DETA/NO was also able to induce autophosphorylation and activation c-Src protein both in vivo and in vitro and active c-Src was able to induce tyrosine phosphorylation of Bcl-2 in vitro. The c-Src kinase inhibitor PP1 abrogated the actions of DETA/NO on cGMP formation, PKG activation, caspase activation, cytochrome c release from mitochondria, and Bcl-2 phosphorylation and degradation in serum-deprived cells. We thus propose that activation of c-Src is an early step in the chain of events that signal cGMP-dependent anti-apoptotic actions of NO in mitocohondria.
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Affiliation(s)
- J R Tejedo
- Laboratory of Biochemistry of the Immune System, Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, University of Sevilla, Avenida Sanchez Pizjuan, 4, 41009, Seville, Spain
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11
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Bernabé JC, Tejedo JR, Rincón P, Cahuana GM, Ramírez R, Sobrino F, Bedoya FJ. Sodium nitroprusside-induced mitochondrial apoptotic events in insulin-secreting RINm5F cells are associated with MAP kinases activation. Exp Cell Res 2001; 269:222-9. [PMID: 11570814 DOI: 10.1006/excr.2001.5315] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Exposure of insulin-secreting RINm5F cells to the chemical nitric oxide donor sodium nitroprusside (SNP) resulted in apoptotic cell death, as detected by cytochrome c release from mitochondria and caspase 3 activation. SNP exposure also leads to phosphorylation and activation of enzymes involved in cellular response to stress such as signal-regulated kinase 2 (ERK2) and c-Jun NH(2)-terminal kinase 46 (JNK46). Both cytochrome c release and caspase 3 activation were abrogated in cells exposed to MEK and p38 inhibitors. Treatment of cells with the NO donors SNP, DETA-NO, GEA 5024, and SNAP resulted in phosphorylation of the antiapoptotic protein Bcl-2, which was resistant to blockade of MEK, p38, and JNK pathways and sensitive to phosphoinositide 3-kinase (PI3K) inhibition. In addition, transient transfection of cells with the wild-type PI3K gamma gene mimics the increased rate of Bcl-2 phosphorylation detected in NO-treated cells. The generation of phosphoinositides seems to participate in the process since Bcl-2 phosphorylation was not observed in cells overexpressing lipid-kinase-deficient PI3Kgamma. The potential of SNP toxicity directly from NO was supported by our finding that the NO scavenger carboxy-PTIO prevented cell death. We found no evidence to support the contention that oxygen radicals generated during cellular SNP metabolism mediate cell toxicity in RINm5F cells, since neither addition of catalase/superoxide dismutase nor transfection with superoxide dismutase prevented SNP-induced cell death. Thus, we propose that exposure to apoptotic concentrations of NO triggers ERK- and p38-dependent cytochrome c release, caspase 3 activation, and PI3K-dependent Bcl-2 phosphorylation.
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Affiliation(s)
- J C Bernabé
- Laboratory of Biochemistry of the Immune System, University of Sevilla, Spain
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12
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Maldonado M, Lombardía J, Rodríguez O, Rincón P, Sánchez Dehesa A. Hemorragias del tercer trimestre. Semergen 2000. [DOI: 10.1016/s1138-3593(00)73571-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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13
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Abstract
We report a case of transient nonketotic hyperglycinaemia in which radiography correlated closely with clinical and biochemical findings. Only 5 patients have been previously described with this transient from of nonketotic hyperglycinaemia. Among the radiographic findings, thinning of the corpus callosum is the most characteristic.
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14
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Vaquerizo J, Rincón P, Sánchez Alarcón J, Gómez Martín H, Alejo J, Cardesa JJ. [Non-ketotic hyperglycinemia. Transient neonatal form]. Rev Neurol 1996; 24:293-5. [PMID: 8742393] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
We report a patient with neonatal epilepsy, with no pattern of burst-suppression, secondary to the transient form of nonketotic hyperglycinemia. Biochemical normalization at two weeks of age was followed by a good clinical evolution and neurological normality at one year of age. The patient showed markedly retarded myelination and microcysts in the frontal white matter, both transitory and with subsequent neuroradiological normalization. Only five patients have been previously described with this clinical variant, there being suspicion of a glycine cleavage system deficiency due to neonatal enzymatic immaturity.
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Affiliation(s)
- J Vaquerizo
- Departamento de Pediatria, Hospital Universitario Regional, Infanta Cristina, Badajoz
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15
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Ruiz Moreno M, Gutiérrez Gutiérrez MT, Rincón P, Alvarez-Sala L, Camps MT. [Moderate hypercholesterolemia in children. An index of familial pathology?]. An Esp Pediatr 1986; 25:322-8. [PMID: 3813224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Out of 44 children (with 200 mg/dl cholesterol) 22, with constantly high levels of cholesterol were studied. All belong to a children population from Madrid which 95 percentile for cholesterol was 204 mg/dl. Fifty nine subjects, first degree relatives of these 22 children (17 families) plus probands were studied to determine if moderately elevated cholesterol levels during infancy are related to any form of familial lipidic disorder. Serum lipidic levels, anthropometric measurements, dietary habits a history of atherosclerotic cardiovascular disease (ACVD), were evaluated in all these 81 individuals. Hypercholesterolemia was encountered in 13 of the 59 non probands and high triglyceride levels in 6 people. More than one member of the family was to have some form of lipidic disorder in 12 of 17 families (71%) and in 10 the metabolic abnormality was of a type associated with a higher risk to suffer ACVD. Five families had a combined hyperlipidemia of the multiple lipoproteinemic (4 familiar heterozygotic hypercholesterolemia and one hyperlipidemia with a double phenotype II B and V). All family members were apparently healthy and had no knowledge of their underlying lipidic abnormality. In this group of families antecedents of morbi-mortality because of atherosclerosis were more frequent that in group control families. Authors conclude that a moderately elevated serum cholesterol level during infancy may be a marker for various familiar lipidic disorders. Detection in infantile population of serum cholesterol levels 200 mg/dl should prompt us to perform a more complete lipidic evaluation both in children as well as in their families.
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