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Masiá M, Padilla S, Estañ G, Portu J, Silva A, Rivero A, González-Cordón A, García-Fraile L, Martínez O, Bernal E, Galera C, Martínez VB, Macias J, Montero M, García-Rosado D, Vivancos-Gallego MJ, Llenas-García J, Torralba M, García JA, Agulló V, Fernández-González M, Gutiérrez F, Martínez E. Correction: Impact of an enhanced screening program on the detection of non-AIDS neoplasias in patients with human immunodeficiency virus infection. Trials 2023; 24:614. [PMID: 37759269 PMCID: PMC10523741 DOI: 10.1186/s13063-023-07655-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023] Open
Affiliation(s)
- M Masiá
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain
| | - S Padilla
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain
| | - G Estañ
- Hospital General Universitario de Elche, Elche, Spain
| | - J Portu
- Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | - A Silva
- Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - A Rivero
- Hospital Universitario Reina Sofía de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) and Universidad de Córdoba, Córdoba, Spain
| | - A González-Cordón
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | - O Martínez
- Hospital General Universitario Santa Lucía de Cartagena, Murcia, Spain
| | - E Bernal
- Hospital General Universitario Reina Sofía de Murcia, Murcia, Spain
| | - C Galera
- Hospital Virgen de La Arrixaca, Murcia, Spain
| | | | - J Macias
- Hospital Universitario de Valme, Seville, Spain
| | | | - D García-Rosado
- Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - M J Vivancos-Gallego
- Hospital Ramon y Cajal and Ramon y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | | | - M Torralba
- Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - J A García
- Hospital General Universitario de Elche, Elche, Spain
| | - V Agulló
- Hospital General Universitario de Elche, Elche, Spain
| | | | - F Gutiérrez
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain.
| | - E Martínez
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Ruiz-Algueró M, Izquierdo R, Suárez-García I, Moreno C, Alejos B, Rava M, Moreno S, Montero Alonso M, Gutiérrez F, Gutierrez Cuellar I, Curran A, Hernando V, Jarrín I. Unplanned pregnancies and social and partner support during pregnancy in Spanish women living with HIV. HIV Med 2023. [PMID: 36810955 DOI: 10.1111/hiv.13469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 02/01/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVES To describe prevalence and factors associated with unplanned pregnancies, and social and partner support during pregnancy among women from the Cohort of the Spanish HIV/AIDS Research Network (CoRIS). METHODS We included all women recruited in CoRIS from 2004 to 2019, aged 18-50 years at recruitment who were pregnant during 2020. We designed a questionnaire, organized into the following domains: sociodemographic characteristics, tobacco and alcohol consumption, pregnancy and reproductive health, and social and partner support. The information was gathered via telephone interviews conducted from June to December 2021. We calculated prevalence of unplanned pregnancies as well as odds ratios (ORs) of association and 95% confidence intervals (CIs) according to sociodemographic, clinical and reproductive characteristics. RESULTS Among 53 women who were pregnant during 2020, 38 (71.7%) answered the questionnaire. Median age at pregnancy was 36 years [interquartile range (IQR) 31-39], 27 (71.1%) women were born outside of Spain, mainly in sub-Saharan Africa (39.5%) and 17 (44.7%) were employed. Thirty-four (89.5%) women had been through previous pregnancies and 32 (84.2%) had experienced previous abortions/miscarriages. Seventeen (44.7%) women had shared with their clinician their desire to get pregnant. Thirty-four (89.5%) pregnancies were natural and four used assisted reproductive techniques (in vitro fertilizations; one additionally used oocyte donation). Of 34 women with natural pregnancies, pregnancy was unplanned in 21 (61.8%) and 25 (73.5%) had information on how to become pregnant avoiding HIV transmission to the baby and partner. Women who did not seek advice from their physician about becoming pregnant had a significantly increased risk of unplanned pregnancy (OR = 71.25, 95% CI: 8.96-566.67). Overall, 14 (36.8%) women reported having low social support during pregnancy and 27 (71.0%) had good/very good support by their partner. CONCLUSIONS Most pregnancies were natural and unplanned and very few women had talked with their clinician about their desire to become pregnant. A high proportion of women reported low social support during pregnancy.
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Affiliation(s)
- Marta Ruiz-Algueró
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Rebeca Izquierdo
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Ines Suárez-García
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.,Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain.,Universidad Europea de Madrid, Madrid, Spain
| | - Cristina Moreno
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Belen Alejos
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain
| | - Marta Rava
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Santiago Moreno
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.,Infectious Diseases Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Marta Montero Alonso
- Infectious Diseases Unit, Hospital Universitario y Politécnico de La Fe, Valencia, Spain
| | - Felix Gutiérrez
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.,Infectious Diseases Unit, Hospital General Universitario De Elche, Alicante, Spain.,University Miguel Hernandez, Alicante, Spain
| | | | - Adrián Curran
- Infectious Diseases Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Victoria Hernando
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Inma Jarrín
- National Centre for Epidemiology, Institute of Health Carlos III, Madrid, Spain.,CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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Orozco-Beltrán D, Merino-Torres JF, Pérez A, Cebrián-Cuenca AM, Párraga-Martínez I, Ávila-Lachica L, Rojo-Martínez G, Pomares-Gómez FJ, Álvarez-Guisasola F, Sánchez-Molla M, Gutiérrez F, Ortega FJ, Mata-Cases M, Carretero-Anibarro E, Vilaseca JM, Quesada JA. Diabetes Does Not Increase the Risk of Hospitalization Due to COVID-19 in Patients Aged 50 Years or Older in Primary Care—APHOSDIAB—COVID-19 Multicenter Study. J Clin Med 2022; 11:jcm11082092. [PMID: 35456185 PMCID: PMC9025638 DOI: 10.3390/jcm11082092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/22/2022] [Accepted: 03/30/2022] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study was to identify clinical, analytical, and sociodemographic variables associated with the need for hospital admission in people over 50 years infected with SARS-CoV-2 and to assess whether diabetes mellitus conditions the risk of hospitalization. A multicenter case-control study analyzing electronic medical records in patients with COVID-19 from 1 March 2020 to 30 April 2021 was conducted. We included 790 patients: 295 cases admitted to the hospital and 495 controls. Under half (n = 386, 48.8%) were women, and 8.5% were active smokers. The main comorbidities were hypertension (50.5%), dyslipidemia, obesity, and diabetes (37.5%). Multivariable logistic regression showed that hospital admission was associated with age above 65 years (OR from 2.45 to 3.89, ascending with age group); male sex (OR 2.15, 95% CI 1.47–3.15), fever (OR 4.31, 95% CI 2.87–6.47), cough (OR 1.89, 95% CI 1.28–2.80), asthenia/malaise (OR 2.04, 95% CI 1.38–3.03), dyspnea (4.69, 95% CI 3.00–7.33), confusion (OR 8.87, 95% CI 1.68–46.78), and a history of hypertension (OR 1.61, 95% CI 1.08–2.41) or immunosuppression (OR 4.97, 95% CI 1.45–17.09). Diabetes was not associated with increased risk of hospital admission (OR 1.18, 95% CI 0.80–1.72; p = 0.38). Diabetes did not increase the risk of hospital admission in people over 50 years old, but advanced age, male sex, fever, cough, asthenia, dyspnea/confusion, and hypertension or immunosuppression did.
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Affiliation(s)
- Domingo Orozco-Beltrán
- Health Center Cabo Huertas, Consejeria de Sanidad Univesal y Salud Pública, 03540 Alicante, Spain;
- Spanish Diabetes Society, 28002 Madrid, Spain;
- Clinical Medice Department, University Miguel Hernández, 03550 Alicante, Spain; (F.G.); (J.A.Q.)
| | - Juan Francisco Merino-Torres
- Endocrinology and Nutrition Service, University of Valencia, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain;
| | - Antonio Pérez
- Spanish Diabetes Society, 28002 Madrid, Spain;
- Medicine Department, Autonoums University of Barcelona, 08193 Barcelona, Spain
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), 20029 Madrid, Spain
- Hospital Santa Creu i Sant Pau, Servicio Catalán de Salud, 08041 Barcelona, Spain
- Correspondence: ; Tel.: +34-93-556-56-61
| | - Ana M. Cebrián-Cuenca
- Primary Care and Prediabetes Group of the Spanish Diabetes Society, 30201 Cartagena, Spain;
- Health Center Cartagena Casco, Servicio Murciano de Salud, 30201 Cartagena, Spain
- Primary Care Research Group, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain
| | - Ignacio Párraga-Martínez
- Spanish Society of Family and Community Medicine (semFyC), 28004 Madrid, Spain; (I.P.-M.); (F.Á.-G.)
- Health Center Zone VIII, Servicio de Salud Castilla la Mancha, 02006 Albacete, Spain
| | - Luis Ávila-Lachica
- Secretario GAPP-SED, Grupo DM-semFyC, 28004 Madrid, Spain;
- Consultorio de Almáchar, UGC Vélez Norte, 29718 Malaga, Spain
| | - Gemma Rojo-Martínez
- Spanish Diabetes Society, 28002 Madrid, Spain;
- Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), 20029 Madrid, Spain
- Biomedical Research Institute (IBIMA), Endocrinology and Nutrition Clinical Management Unit, Malaga Regional University Hospital, 29010 Malaga, Spain
| | - Francisco J. Pomares-Gómez
- Diabetes Mellitus Plan of the Valencian Community, University Hospital San Juan de Alicante, 03550 Alicante, Spain;
| | - Fernando Álvarez-Guisasola
- Spanish Society of Family and Community Medicine (semFyC), 28004 Madrid, Spain; (I.P.-M.); (F.Á.-G.)
- Health Center Ribera de Órbigo, Consejería de Salud Castilla León, 24280 León, Spain
| | | | - Felix Gutiérrez
- Clinical Medice Department, University Miguel Hernández, 03550 Alicante, Spain; (F.G.); (J.A.Q.)
- Internal Medicine, Elche General University Hospital, 03203 Elche, Spain
- CIBER Infectious Diseases, 28029 Madrid, Spain
| | - Francisco J. Ortega
- Health Center Campos-Lampreana, Conserjería de Salud Castilla y León, 49137 Zamora, Spain;
| | - Manel Mata-Cases
- Primary Care Center La Mina, Sant Adrià de Besòs, Servicio Catalán de Salud, 08930 Barcelona, Spain;
- Group DAP-Cat, Research Support Unit, Jordi Gol University Institute for Primary Healthcare Research, CIBERDEM, 08036 Barcelona, Spain
| | | | | | - Jose A. Quesada
- Clinical Medice Department, University Miguel Hernández, 03550 Alicante, Spain; (F.G.); (J.A.Q.)
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Masiá M, Padilla S, Estañ G, Portu J, Silva A, Rivero A, González-Cordón A, García-Fraile L, Martínez O, Bernal E, Galera C, Boix Martínez V, Macias J, Montero M, García-Rosado D, Vivancos-Gallego MJ, Llenas-García J, Torralba M, García JA, Agulló V, Fernández-González M, Gutiérrez F, Martínez E. Impact of an enhanced screening program on the detection of non-AIDS neoplasias in patients with human immunodeficiency virus infection. Trials 2021; 22:851. [PMID: 34838115 PMCID: PMC8626748 DOI: 10.1186/s13063-021-05777-6] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of non-AIDS defining cancer (NADC) is higher in people living with HIV (PLWH) than in the general population, and it is already one of the leading causes of death in the HIV-infected population. It is estimated that the situation will be aggravated by the progressive aging of PLWH. Early diagnosis through intensive cancer screening may improve the ability for therapeutic interventions and could be critical in reducing mortality, but it might also increase expenditure and harms associated with adverse events. The aim of this study is to evaluate an enhanced screening program for early diagnosis of cancer in PLWH compared to standard practice. The specific objectives are (1) to compare the frequency of cancer diagnosed at an early stage, (2) to analyze safety of the enhanced program: adverse events and unnecessary interventions, (3) to analyze the cost-utility of the program, and (4) to estimate the overall and site-specific incidence of NADC in PLWH. METHODS We will conduct a multicenter, non-blinded, randomized, controlled trial, comparing two parallel arms: conventional vs enhanced screening. Data will be recorded in an electronic data collection notebook. Conventional intervention group will follow the standard of care screening in the participating centers, according to the European AIDS Clinical Society recommendations, and the enhanced intervention group will follow an expanded screening aimed to early detection of lung, liver, anal, cervical, breast, prostate, colorectal, and skin cancer. The trial will be conducted within the framework of the Spanish AIDS Research Network Cohort (CoRIS). DISCUSSION The trial will evaluate the efficacy, safety, and efficiency of an enhanced screening program for the early diagnosis of cancer in HIV patients compared to standard of care practice. The information provided will be relevant since there are currently no studies on expanded cancer screening strategies in patients with HIV, and available data estimating cost effectiveness or cost-utility of such as programs are scarce. An enhanced program for NADC screening in patients with HIV could lead to early diagnosis and improve the prognosis of these patients, with an acceptable rate of unnecessary interventions, but it is critical to demonstrate that the benefits clearly outweigh the harms, before the strategy could be implemented. TRIAL REGISTRATION ClinicalTrials.gov NCT04735445. Registered on 25 June 2019.
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Affiliation(s)
- M Masiá
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain
| | - S Padilla
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain
| | - G Estañ
- Hospital General Universitario de Elche, Elche, Spain
| | - J Portu
- Hospital Universitario Araba, Vitoria-Gasteiz, Spain
| | - A Silva
- Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain
| | - A Rivero
- Hospital Universitario Reina Sofía de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) and Universidad de Córdoba, Córdoba, Spain
| | - A González-Cordón
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
| | | | - O Martínez
- Hospital General Universitario Santa Lucía de Cartagena, Murcia, Spain
| | - E Bernal
- Hospital General Universitario Reina Sofía de Murcia, Murcia, Spain
| | - C Galera
- Hospital Virgen de la Arrixaca, Murcia, Spain
| | | | - J Macias
- Hospital Universitario de Valme, Seville, Spain
| | | | - D García-Rosado
- Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - M J Vivancos-Gallego
- Hospital Ramon y Cajal and Ramon y Cajal Health Research Institute (IRYCIS), Madrid, Spain
| | | | - M Torralba
- Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - J A García
- Hospital General Universitario de Elche, Elche, Spain
| | - V Agulló
- Hospital General Universitario de Elche, Elche, Spain
| | | | - F Gutiérrez
- Hospital General Universitario de Elche and Universidad Miguel Hernández de Elche, Elche, Spain.
| | - E Martínez
- Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
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Palomo AG, Baldaquí N, Colomer L, Gutiérrez F, Pujal E, Barrio P, Bioque M, Vieta E, Pacchiarotti I. Clinical profile of patients admitted in an acute psychiatric ward before and during the COVID-19 lockdown. Eur Psychiatry 2021. [PMCID: PMC9470990 DOI: 10.1192/j.eurpsy.2021.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The COVID-19 pandemic entailed several changes in health and medical assistance, economy, and lifestyle. In the Acute Psychiatric Ward of the Hospital Clínic of Barcelona, the implementation of restrictive measures was necessary in order to ensure patients’ safety. Objectives To compare clinical profiles and course of hospitalization of patients admitted before and during the COVID-19 lockdown in our Acute Psychiatric Ward. Methods All patients admitted from January 7th to February 25th and from March 19th to May 7th of 2020 in the Acute Psychiatric Hospitalization Unit of Hospital Clínic of Barcelona, Spain, were retrospectively included for analysis and divided into two groups according to the period when they were admitted. Statistical analyses were performed using SPSS, 23.0 version. Results A total of 117 inpatients were included (73 admitted before lockdown and 44 during lockdown), being 50.4% male, with a mean age of 42.4 (SD 15.73). Patients from the first group presented a significantly higher proportion of antidepressants prescription at discharge (p<0.05) and more substance use disorders (p<0.05). Regarding the lockdown group, 51% of patients manifested COVID-19-related stress. Time of hospitalization was significantly lower in the lockdown group (p<0.05), even though a significantly higher proportion of patients were discharged at home (p<0.05) compared with the first group. Conclusions The situation of lockdown led to a series of changes in our unit and also in the profile of patients admitted, having shorter admissions, lower prescription of antidepressants, and often COVID-related stress. These differences should be considered in future situations in which restrictive measures may be necessary. Disclosure No significant relationships.
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Quesada JA, López-Pineda A, Gil-Guillén VF, Arriero-Marín JM, Gutiérrez F, Carratala-Munuera C. Incubation period of COVID-19: A systematic review and meta-analysis. Rev Clin Esp 2021; 221:109-117. [PMID: 38108501 PMCID: PMC7528969 DOI: 10.1016/j.rce.2020.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/30/2020] [Accepted: 08/17/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVE The incubation period of COVID-19 helps to determine the optimal duration of the quarantine and inform predictive models of incidence curves. Several emerging studies have produced varying results; this systematic review aims to provide a more accurate estimate of the incubation period of COVID-19. METHODS For this systematic review, a literature search was conducted using Pubmed, Scopus/EMBASE, and the Cochrane Library databases, covering all observational and experimental studies reporting the incubation period and published from 1 January 2020 to 21 March 2020.We estimated the mean and 95th percentile of the incubation period using meta-analysis, taking into account between-study heterogeneity, and the analysis with moderator variables. RESULTS We included seven studies (n = 792) in the meta-analysis. The heterogeneity (I2 83.0%, p < 0.001) was significantly decreased when we included the study quality and the statistical model used as moderator variables (I2 15%). The mean incubation period ranged from 5.6 (95% CI: 5.2 to 6.0) to 6.7 days (95% CI: 6.0 to 7.4) according to the statistical model. The 95th percentile was 12.5 days when the mean age of patients was 60 years, increasing 1 day for every 10 years. CONCLUSION Based on the published data reporting the incubation period of COVID-19, the mean time between exposure and onset of clinical symptoms depended on the statistical model used, and the 95th percentile depended on the mean age of the patients. It is advisable to record sex and age when collecting data in order to analyze possible differential patterns.
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Affiliation(s)
- J A Quesada
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España
| | - A López-Pineda
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España.
| | - V F Gil-Guillén
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España
| | - J M Arriero-Marín
- Departamento de Neumología, Universidad Hospital de San Juan de Alicante, San Juan de Alicante, España
| | - F Gutiérrez
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España; Departamento de Enfermedades Infecciosas, Universidad Hospital de Elche, Elche, España
| | - C Carratala-Munuera
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, España
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7
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Quesada JA, López-Pineda A, Gil-Guillén VF, Arriero-Marín JM, Gutiérrez F, Carratala-Munuera C. Incubation period of COVID-19: A systematic review and meta-analysis. Rev Clin Esp 2020; 221:109-117. [PMID: 33998486 PMCID: PMC7698828 DOI: 10.1016/j.rceng.2020.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/17/2020] [Indexed: 01/08/2023]
Abstract
Background and objective The incubation period of COVID-19 helps to determine the optimal duration of the quarantine and inform predictive models of incidence curves. Several emerging studies have produced varying results; this systematic review aims to provide a more accurate estimate of the incubation period of COVID-19. Methods For this systematic review, a literature search was conducted using Pubmed, Scopus/EMBASE, and the Cochrane Library databases, covering all observational and experimental studies reporting the incubation period and published from 1 January 2020 to 21 March 2020.We estimated the mean and 95th percentile of the incubation period using meta-analysis, taking into account between-study heterogeneity, and the analysis with moderator variables. Results We included seven studies (n = 792) in the meta-analysis. The heterogeneity (I2 83.0%, p < 0.001) was significantly decreased when we included the study quality and the statistical model used as moderator variables (I2 15%). The mean incubation period ranged from 5.6 (95% CI: 5.2–6.0) to 6.7 days (95% CI: 6.0–7.4) according to the statistical model. The 95th percentile was 12.5 days when the mean age of patients was 60 years, increasing 1 day for every 10 years. Conclusion Based on the published data reporting the incubation period of COVID-19, the mean time between exposure and onset of clinical symptoms depended on the statistical model used, and the 95th percentile depended on the mean age of the patients. It is advisable to record sex and age when collecting data in order to analyze possible differential patterns.
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Affiliation(s)
- J A Quesada
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
| | - A López-Pineda
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain.
| | - V F Gil-Guillén
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
| | - J M Arriero-Marín
- Departamento de Neumología, Universidad Hospital de San Juan de Alicante, San Juan de Alicante, Spain
| | - F Gutiérrez
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain; Departamento de Enfermedades Infecciosas, Universidad Hospital de Elche, Elche, Spain
| | - C Carratala-Munuera
- Departamento de Medicina Clínica, Universidad Miguel Hernández de Elche, San Juan de Alicante, Spain
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8
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Estrada V, Domingo P, Suarez-Lozano I, Gutiérrez F, Knobel H, Palacios R, Antela A, Blanco JR, Refoyo E. Risk of cardiovascular disease in patients with HIV infection undergoing antiretroviral therapy. Rev Clin Esp 2019; 220:149-154. [PMID: 31690452 DOI: 10.1016/j.rce.2019.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 01/20/2019] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND The increased survival of patients with HIV infection thanks to antiretroviral therapy (ART) is accompanied by a higher rate of cardiovascular disease (CVD). We analysed the prevalence of the cardiovascular risk factors (CRFs) and estimated the risk of CVD in a cohort of patients with HIV in Spain. METHODS We conducted a cross-sectional, observational study of CRFs in the Spanish VACH cohort of patients with HIV who undergo ART. RESULTS The study assessed 15,559 patients with HIV (76% men; mean age, 46 years). Some 3.7% had experienced at least 1 CVD event. The prevalence of CRFs was high (hyperlipidaemia, 64%; tobacco use, 47%; arterial hypertension, 22%; and diabetes, 16%). According to the Framingham scale, 10.9% of the patients presented a high CVD risk, and 28.8% presented a moderate risk. Of the patients with a high CVD risk, 49% took protease inhibitors and 43% took abacavir. Fifty-three percent of the patients diagnosed with arterial hypertension took antihypertensive drugs, and 2.6% of the patients with diabetes took antidiabetic agents. CONCLUSIONS Classical CRFs are common in patients with HIV undergoing ART in Spain, and a large proportion of them have a moderate-high risk of CVD. Therefore, controlling the modifiable CRFs in patients with HIV should be improved, and the use of drugs with a better cardiovascular risk profile should be assessed.
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Affiliation(s)
- V Estrada
- Hospital Clínico San Carlos-IdiSSC, Universidad Complutense de Madrid, Madrid, España.
| | - P Domingo
- Hospital Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | | | - F Gutiérrez
- Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, España
| | - H Knobel
- Hospital del Mar, Barcelona, España
| | - R Palacios
- Hospital Universitario Virgen de la Victoria, Málaga, España
| | - A Antela
- Hospital Clínico Universitario, Santiago de Compostela, España
| | - J R Blanco
- Hospital San Pedro-CIBIR, Logroño, España
| | - E Refoyo
- Hospital Universitario La Paz, Madrid, España
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9
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de Mendoza C, Roc L, Fernández‐Alonso M, Soriano V, Rodríguez C, Vera M, del Romero J, Marcaida G, Ocete M, Caballero E, Molina I, Aguilera A, Rodríguez‐Calviño J, Navarro D, Rivero C, Vilariño M, Benito R, Algarate S, Gil J, Ortiz de Lejarazu R, Rojo S, Eirós J, San Miguel A, Manzardo C, Miró J, García J, Paz I, Poveda E, Calderón E, Escudero D, Trigo M, Diz J, García‐Campello M, Rodríguez‐Iglesias M, Hernández‐Betancor A, Martín A, Ramos J, Gimeno A, Gutiérrez F, Rodríguez J, Sánchez V, Gómez‐Hernando C, Cilla G, Pérez‐Trallero E, López‐Aldeguer J, Fernández‐Pereira L, Niubó J, Hernández M, López‐Lirola A, Gómez‐Sirvent J, Force L, Cifuentes C, Pérez S, Morano L, Raya C, González‐Praetorius A, Pérez J, Peñaranda M, Hernáez‐Crespo S, Montejo J, Roc L, Martínez‐Sapiña A, Viciana I, Cabezas T, Lozano A, Fernández J, García‐Bermejo I, Gaspar G, García R, Górgolas M, Vegas C, Blas J, Miralles P, Valeiro M, Aldamiz T, Margall N, Guardia C, do Pico E, Polo I, Aguinaga A, Ezpeleta C, Sauleda S, Pirón M, González R, Barea L, Jiménez A, Blanco L, Suárez A, Rodríguez‐Avial I, Pérez‐Rivilla A, Parra P, Fernández M, Fernández‐Alonso M, Treviño A, Requena S, Benítez‐Gutiérrez L, Cuervas‐Mons V, de Mendoza C, Barreiro P, Soriano V, Corral O, Gómez‐Gallego F. HTLV testing of solid organ transplant donors. Clin Transplant 2019; 33:e13670. [DOI: 10.1111/ctr.13670] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 07/06/2019] [Accepted: 07/08/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Carmen de Mendoza
- Internal Medicine Laboratory Puerta de Hierro Research Institute & University Hospital Madrid Spain
- Microbiology section, Pharmaceutical and Health Science Department Pablo-CEU University Madrid Spain
| | - Lourdes Roc
- Microbiology Department Hospital Miguel Servet Zaragoza Spain
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10
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Rodger AJ, Cambiano V, Bruun T, Vernazza P, Collins S, Degen O, Corbelli GM, Estrada V, Geretti AM, Beloukas A, Raben D, Coll P, Antinori A, Nwokolo N, Rieger A, Prins JM, Blaxhult A, Weber R, Van Eeden A, Brockmeyer NH, Clarke A, Del Romero Guerrero J, Raffi F, Bogner JR, Wandeler G, Gerstoft J, Gutiérrez F, Brinkman K, Kitchen M, Ostergaard L, Leon A, Ristola M, Jessen H, Stellbrink HJ, Phillips AN, Lundgren J. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet 2019; 393:2428-2438. [PMID: 31056293 PMCID: PMC6584382 DOI: 10.1016/s0140-6736(19)30418-0] [Citation(s) in RCA: 515] [Impact Index Per Article: 103.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/09/2019] [Accepted: 02/14/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND The level of evidence for HIV transmission risk through condomless sex in serodifferent gay couples with the HIV-positive partner taking virally suppressive antiretroviral therapy (ART) is limited compared with the evidence available for transmission risk in heterosexual couples. The aim of the second phase of the PARTNER study (PARTNER2) was to provide precise estimates of transmission risk in gay serodifferent partnerships. METHODS The PARTNER study was a prospective observational study done at 75 sites in 14 European countries. The first phase of the study (PARTNER1; Sept 15, 2010, to May 31, 2014) recruited and followed up both heterosexual and gay serodifferent couples (HIV-positive partner taking suppressive ART) who reported condomless sex, whereas the PARTNER2 extension (to April 30, 2018) recruited and followed up gay couples only. At study visits, data collection included sexual behaviour questionnaires, HIV testing (HIV-negative partner), and HIV-1 viral load testing (HIV-positive partner). If a seroconversion occurred in the HIV-negative partner, anonymised phylogenetic analysis was done to compare HIV-1 pol and env sequences in both partners to identify linked transmissions. Couple-years of follow-up were eligible for inclusion if condomless sex was reported, use of pre-exposure prophylaxis or post-exposure prophylaxis was not reported by the HIV-negative partner, and the HIV-positive partner was virally suppressed (plasma HIV-1 RNA <200 copies per mL) at the most recent visit (within the past year). Incidence rate of HIV transmission was calculated as the number of phylogenetically linked HIV infections that occurred during eligible couple-years of follow-up divided by eligible couple-years of follow-up. Two-sided 95% CIs for the incidence rate of transmission were calculated using exact Poisson methods. FINDINGS Between Sept 15, 2010, and July 31, 2017, 972 gay couples were enrolled, of which 782 provided 1593 eligible couple-years of follow-up with a median follow-up of 2·0 years (IQR 1·1-3·5). At baseline, median age for HIV-positive partners was 40 years (IQR 33-46) and couples reported condomless sex for a median of 1·0 years (IQR 0·4-2·9). During eligible couple-years of follow-up, couples reported condomless anal sex a total of 76 088 times. 288 (37%) of 777 HIV-negative men reported condomless sex with other partners. 15 new HIV infections occurred during eligible couple-years of follow-up, but none were phylogenetically linked within-couple transmissions, resulting in an HIV transmission rate of zero (upper 95% CI 0·23 per 100 couple-years of follow-up). INTERPRETATION Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples and suggest that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. Our findings support the message of the U=U (undetectable equals untransmittable) campaign, and the benefits of early testing and treatment for HIV. FUNDING National Institute for Health Research.
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Affiliation(s)
- Alison J Rodger
- Institute for Global Health, University College London, London, UK.
| | | | - Tina Bruun
- Department of Infectious Diseases (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Pietro Vernazza
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital, St Gallen, Switzerland
| | | | - Olaf Degen
- University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Vicente Estrada
- Hospital Clinico San Carlos and Universidad Complutense, Madrid, Spain
| | - Anna Maria Geretti
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK
| | - Apostolos Beloukas
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK; Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | - Dorthe Raben
- Department of Infectious Diseases (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Pep Coll
- AIDS Research Institute-IrsiCaixa, Hospital Universitari Germans Trias i Pujol and BCN Checkpoint, Badalona and Barcelona, Spain
| | - Andrea Antinori
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani IRCCS, Rome, Italy
| | - Nneka Nwokolo
- Chelsea and Westminster NHS Foundation Trust, London, UK
| | | | - Jan M Prins
- Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Rainer Weber
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Norbert H Brockmeyer
- Centre for Sexual Health and Medicine, Walk in Ruhr, Ruhr University Bochum, Bochum, Germany
| | - Amanda Clarke
- Brighton and Sussex University Hospitals NHS Trust, and Brighton and Sussex Medical School, Brighton, UK
| | | | - Francois Raffi
- Infectious Diseases Department, University Hospital (Centre Hospitalier Universitaire de Nantes) Hotel-Dieu, and INSERM UIC 1413 Nantes University, Nantes, France
| | - Johannes R Bogner
- Medizinische Klinik und Poliklinik IV, University Hospital Munich, Munich, Germany
| | - Gilles Wandeler
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Felix Gutiérrez
- Hospital General de Elche and Universidad Miguel Hernández, Alicante, Spain
| | - Kees Brinkman
- Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, Netherlands
| | | | | | - Agathe Leon
- Hospital Clinic - IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Matti Ristola
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | | | | | - Jens Lundgren
- Department of Infectious Diseases (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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11
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Masiá M, Padilla S, García JA, Bernardino JI, Campins AA, Asensi V, Gutiérrez F. Decreasing rates of acute myocardial infarction in people living with HIV: a nationwide cohort study in Spain, 2004-2015. HIV Med 2018; 19:491-496. [PMID: 29683252 DOI: 10.1111/hiv.12616] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Contemporary data from country-wide cohorts are needed to reveal trends in the occurrence of acute myocardial infarction (AMI) in people living with HIV (PLWH). We analysed time trends in the standardized incidence rate (sIR) of AMI in PLWH in Spain from 2004 to 2015, and compared them with trends in the general population. METHODS A longitudinal study in a nationwide contemporary multicentre HIV-infected cohort was carried out. Data on all incident AMI events were collected, and age- and sex-standardized IRs calculated. To analyse the IR of AMI in the general population, the national rates of hospital discharges for AMI per 100 000 inhabitants stratified for age and sex from 2004 to 2015 were obtained using the morbidity report data from the National Statistics Institute. A Poisson regression model was fitted to assess the effect of covariates of interest on AMI occurrence. RESULTS The sIRs of AMI in 2004-2015 were 237.92 [95% confidence interval (CI) 225.95-249.90] and 66.75 (95% CI: 23.49-110.01) per 100 000 patient-years in male and female PLWH, respectively. There was a decrease in the sIR of AMI in male PLWH from 279.02 (95% CI: 265.46-292.59) per 100 000 person-years in 2004-2009 to 222.13 (95% CI: 210.83-233.42) per 100 000 person-years in 2010-2015. Compared with the general population, the sIR ratio was 1.41 (95% CI: 1.26-1.55) in 2004-2009, and 1.28 (95% CI: 1.15-1.43) in 2010-2014. AMI occurrence was associated with older age (P < 0.066 for each 10-year age stratum ≥ 35-years compared with the 25-34 year stratum), higher plasma HIV RNA (P < 0.001), lower CD4 count (P < 0.04 for CD4 strata > 350 cells/μL compared with the 0-100 cells/μL stratum), and the period 2004-2009 (P < 0.001). CONCLUSIONS There has been a decreasing incidence of AMI in PLWH in Spain, associated with improving immune and virological status, but the incidence of AMI has remained higher than in the general population.
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Affiliation(s)
- M Masiá
- Infectious Diseases Unit, Elche University General Hospital, University Miguel Hernández, Alicante, Spain
| | - S Padilla
- Infectious Diseases Unit, Elche University General Hospital, University Miguel Hernández, Alicante, Spain
| | - J A García
- Statistics, Operational Research Center, University Miguel Hernández, Elche, Alicante, Spain
| | - J I Bernardino
- Infectious Diseases Unit, La Paz-Carlos III-Cantoblanco Hospital, Madrid, Spain
| | - A A Campins
- Infectious Diseases Unit, Son Espases University Hospital, Palma de Mallorca, Spain
| | - V Asensi
- Infectious Diseases Unit, Asturias Central University Hospital, Oviedo, Spain
| | - F Gutiérrez
- Infectious Diseases Unit, Elche University General Hospital, University Miguel Hernández, Alicante, Spain
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12
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Gutiérrez F. HIV/AIDS infection: The beginning of the end for today's greatest pandemic? Rev Clin Esp 2017. [DOI: 10.1016/j.rceng.2017.04.004] [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: 10/19/2022]
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13
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Gutiérrez F, Badilla R, Cerda P. Mandibular ameloblastic fibroma: enucleation and 3 years follow up. Case report and literature review. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.1027] [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] [Indexed: 11/25/2022]
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14
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Poveda E, Hernández-Quero J, Pérez-Elías MJ, Ribas MA, Martínez-Madrid OJ, Flores J, Navarro J, Gutiérrez F, García-Deltoro M, Imaz A, Ocampo A, Artero A, Blanco F, Bernal E, Pasquau J, Mínguez-Gallego C, Pérez N, Aiestaran A, García F, Paredes R. Genotypic tropism testing of proviral DNA to guide maraviroc initiation in aviraemic subjects: 48-week analysis of results from the PROTEST study. HIV Med 2016; 18:482-489. [PMID: 28035758 DOI: 10.1111/hiv.12479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Maraviroc (MVC) is a suitable drug for aviraemic subjects on antiretroviral treatment (ART) developing toxicity. Its prescription requires prior tropism testing. It is unknown if proviral DNA genotypic tropism testing is reliable for guiding MVC initiation in aviraemic subjects, so this study was carried out to address this issue. METHODS PROTEST was a phase 4, prospective, single-arm clinical trial carried out in 24 HIV care centres in Spain. MVC-naïve HIV-1-infected patients with HIV-1 RNA < 50 copies/mL on stable ART during the previous 6 months who required an ART change because of toxicity and who had R5 HIV, as determined by proviral DNA genotypic tropism testing, initiated MVC with two nucleoside reverse transcriptase inhibitors (NRTIs) and were followed for 48 weeks. Virological failure was defined as two consecutive viral load measurements > 50 copies/mL. RESULTS Tropism results were available for 141 of 175 (80.6%) subjects screened: 60% had R5 and 85% of these (n = 74) were finally included in the study. Previous ART included protease inhibitors (PIs) in 62% of subjects, nonnucleoside reverse transcriptase inhibitors (NNRTIs) in 36%, and integrase inhibitors (INIs) in 2%. Main reasons for treatment change were dyslipidaemia (42%), gastrointestinal symptoms (22%) and liver toxicity (15%). MVC was given alongside tenofovir (TDF)/emtricitabine (FTC) (54%) and abacavir (ABC)/lamivudine (3TC) (40%) in most patients. Eighty-four per cent of patients maintained a viral load < 50 copies/mL to week 48, whereas 16% discontinued treatment: two withdrew informed consent, one had an R5 to X4 shift between screening and baseline, one was lost to follow-up, one developed an adverse event (rash), two died from non-study-related causes, and five developed protocol-defined virological failure. CONCLUSIONS Initiation of MVC plus two NRTIs in aviraemic subjects based on genotypic tropism testing of proviral HIV-1 DNA is associated with low rates of virological failure for up to 1 year.
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Affiliation(s)
- E Poveda
- Instituto de Investigación Biomédica de A Coruña (INIBIC)-Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain
| | | | | | - M A Ribas
- Hospital Son Espases, Palma de Mallorca, Spain
| | | | - J Flores
- Hospital Arnau de Vilanova, Valencia, Spain
| | - J Navarro
- Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - F Gutiérrez
- Hospital Universitario de Elche, Elche, Spain
| | | | - A Imaz
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - A Ocampo
- Hospital Xeral de Vigo, Vigo, Spain
| | - A Artero
- Hospital Universitario Dr. Peset, Valencia
| | - F Blanco
- Hospital Carlos III, Madrid, Spain
| | - E Bernal
- Hospital Reina Sofía, Murcia, Spain
| | - J Pasquau
- Hospital Virgen de la Nieves, Granada, Spain
| | | | - N Pérez
- Universitat Politécnica de Catalunya, Barcelona, Spain
| | - A Aiestaran
- Universitat Politécnica de Catalunya, Barcelona, Spain
| | - F García
- Hospital Universitario San Cecilio, Granada, Spain
| | - R Paredes
- HIV Unit and irsiCaixa AIDS Research Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
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Santoveña A, Sánchez-Negrín E, Gutiérrez F, Nazco J, Fariña JB. Assessment of bevacizumab quality and stability in repackaged syringes for clinical use. Eur J Hosp Pharm 2016; 23:343-347. [PMID: 31156880 DOI: 10.1136/ejhpharm-2015-000853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/10/2015] [Revised: 02/03/2016] [Accepted: 02/25/2016] [Indexed: 11/04/2022] Open
Abstract
Objectives Among measures taken to optimise financial resources, the off-label use of bevacizumab (Avastin) in the treatment of age-related macular degeneration (AMD) involves its repackaging from higher volume dosage forms. This use requires studies to analyse the viability of the repackaged preparations to ensure their quality, safety and efficacy. Our aim was to assess the structural stability and particle size of bevacizumab after it was repackaged from the original glass vials and stored in plastic syringes. Methods High performance liquid chromatography by size exclusion (HPLC-SE) was used to quantify the bevacizumab and determine its degradation products after stress stability testing, with a particle size counter employed after repackaging and subsequent storage. Results The syringes stored for 3 days at 4°C maintained the area of the main chromatographic peak above 100±10% of its initial value, and the observed particle size is the same as at baseline (20 nm) but with a double distribution towards larger sizes. Conclusions This study shows how the repackaging of Avastin in plastic syringes permits their use for 3 days if stored under normal refrigeration. In this way, hospital pharmacy services can help optimise health resources without compromising the pharmaceutical standards of the drug.
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Affiliation(s)
- A Santoveña
- Instituto de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - E Sánchez-Negrín
- Instituto de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, La Laguna, Tenerife, Spain
| | - F Gutiérrez
- Servicio de Farmacia Hospitalaria, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
| | - J Nazco
- Servicio de Farmacia Hospitalaria, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
| | - J B Fariña
- Instituto de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, La Laguna, Tenerife, Spain
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Capdevila JA, Guembe M, Barberán J, de Alarcón A, Bouza E, Fariñas MC, Gálvez J, Goenaga MA, Gutiérrez F, Kestler M, Llinares P, Miró JM, Montejo M, Muñoz P, Rodríguez-Creixems M, Sousa D, Cuenca J, Mestres CA. 2016 Expert consensus document on prevention, diagnosis and treatment of short-term peripheral venous catheter-related infections in adult. Rev Esp Quimioter 2016; 29:230-238. [PMID: 27580009] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. Short peripheral catheters have been found to be associated with the risk of nosocomial bacteremia resulting in morbidity and mortality. Staphyloccus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been elaborated by a panel of experts of the Spanish Society of Cardiovascular Infections in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy and Spanish Society of Thoracic-Cardiovascular Surgery and aims at define and establish the norm for management of short duration peripheral vascular catheters. The document addresses the indications for insertion, catheter maintenance and registry, diagnosis and treatment of infection, indications for removal and stresses on continuous education as a driver for quality. Implementation of this norm will allow uniformity in usage thus minimizing the risk of infection and its complications.
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Affiliation(s)
- J A Capdevila
- Josep A. Capdevila, Internal Medicine, Consorcio Hospitalario de Mataró, Barcelona (Spain).
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Bayón-Pérez C, Hernando A, Álvarez-Comino MJ, Cebolla S, Serrano L, Gutiérrez F, Montesinos F, Lagarde M, Bisbal O, Matarranz M, Rubio R, Pulido F. Toward a comprehensive care of HIV patients: finding a strategy to detect depression in a Spanish HIV cohort. AIDS Care 2016; 28:834-41. [PMID: 26885765 DOI: 10.1080/09540121.2016.1144868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Depression is a common but frequently undiagnosed feature in individuals with HIV infection. To find a strategy to detect depression in a non-specialized clinical setting, the overall performance of the Hospital Anxiety and Depression Scale (HADS) and the depression identification questions proposed by the European AIDS Clinical Society (EACS) guidelines were assessed in a descriptive cross-sectional study of 113 patients with HIV infection. The clinician asked the two screening questions that were proposed under the EACS guidelines and requested patients to complete the HADS. A psychiatrist or psychologist administered semi-structured clinical interviews to yield psychiatric diagnoses of depression (gold standard). A receiver operating characteristic (ROC) analysis for the HADS-Depression (HADS-D) subscale indicated that the best sensitivity and specificity were obtained between the cut-off points of 5 and 8, and the ROC curve for the HADS-Total (HADS-T) indicated that the best cut-off points were between 12 and 14. There were no statistically significant differences in the correlations of the EACS (considering positive responses to one [A] or both questions [B]), the HADS-D ≥ 8 or the HADS-T ≥ 12 with the gold standard. The study concludes that both approaches (the two EACS questions and the HADS-D subscale) are appropriate depression-screening methods in HIV population. We believe that using the EACS-B and the HADS-D subscale in a two-step approach allows for rapid, assumable and accurate clinical diagnosis in non-psychiatric hospital settings.
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Affiliation(s)
- C Bayón-Pérez
- a Department of Psychiatry, IdiPaz , Hospital Universitario La Paz ., Madrid , Spain
| | - A Hernando
- b Department of Medical Specialties , Universidad Europea de Madrid , Villaviciosa de Odón , Spain.,c HIV Unit , Instituto de Investigación Hospital 12 de Octubre (i+12) , Madrid , Spain
| | - M J Álvarez-Comino
- d Department of Psychology , Universidad Europea de Madrid , Villaviciosa de Odón , Spain
| | - S Cebolla
- e Department of Psychiatry , IdiPaz , SSM Tetuán, Madrid , Spain
| | - L Serrano
- f IdiPaz HIV Unit, Hospital Universitario La Paz , Madrid , Spain
| | - F Gutiérrez
- g Policlinica Valdemoro Plaza , Valdemoro , Spain
| | - F Montesinos
- d Department of Psychology , Universidad Europea de Madrid , Villaviciosa de Odón , Spain
| | - M Lagarde
- c HIV Unit , Instituto de Investigación Hospital 12 de Octubre (i+12) , Madrid , Spain
| | - O Bisbal
- c HIV Unit , Instituto de Investigación Hospital 12 de Octubre (i+12) , Madrid , Spain
| | - M Matarranz
- c HIV Unit , Instituto de Investigación Hospital 12 de Octubre (i+12) , Madrid , Spain
| | - R Rubio
- c HIV Unit , Instituto de Investigación Hospital 12 de Octubre (i+12) , Madrid , Spain
| | - F Pulido
- c HIV Unit , Instituto de Investigación Hospital 12 de Octubre (i+12) , Madrid , Spain
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Hofstra LM, Sauvageot N, Albert J, Alexiev I, Garcia F, Struck D, Van de Vijver DAMC, Åsjö B, Beshkov D, Coughlan S, Descamps D, Griskevicius A, Hamouda O, Horban A, Van Kasteren M, Kolupajeva T, Kostrikis LG, Liitsola K, Linka M, Mor O, Nielsen C, Otelea D, Paraskevis D, Paredes R, Poljak M, Puchhammer-Stöckl E, Sönnerborg A, Staneková D, Stanojevic M, Van Laethem K, Zazzi M, Zidovec Lepej S, Boucher CAB, Schmit JC, Wensing AMJ, Puchhammer-Stockl E, Sarcletti M, Schmied B, Geit M, Balluch G, Vandamme AM, Vercauteren J, Derdelinckx I, Sasse A, Bogaert M, Ceunen H, De Roo A, De Wit S, Echahidi F, Fransen K, Goffard JC, Goubau P, Goudeseune E, Yombi JC, Lacor P, Liesnard C, Moutschen M, Pierard D, Rens R, Schrooten Y, Vaira D, Vandekerckhove LPR, Van den Heuvel A, Van Der Gucht B, Van Ranst M, Van Wijngaerden E, Vandercam B, Vekemans M, Verhofstede C, Clumeck N, Van Laethem K, Beshkov D, Alexiev I, Lepej SZ, Begovac J, Kostrikis L, Demetriades I, Kousiappa I, Demetriou V, Hezka J, Linka M, Maly M, Machala L, Nielsen C, Jørgensen LB, Gerstoft J, Mathiesen L, Pedersen C, Nielsen H, Laursen A, Kvinesdal B, Liitsola K, Ristola M, Suni J, Sutinen J, Descamps D, Assoumou L, Castor G, Grude M, Flandre P, Storto A, Hamouda O, Kücherer C, Berg T, Braun P, Poggensee G, Däumer M, Eberle J, Heiken H, Kaiser R, Knechten H, Korn K, Müller H, Neifer S, Schmidt B, Walter H, Gunsenheimer-Bartmeyer B, Harrer T, Paraskevis D, Hatzakis A, Zavitsanou A, Vassilakis A, Lazanas M, Chini M, Lioni A, Sakka V, Kourkounti S, Paparizos V, Antoniadou A, Papadopoulos A, Poulakou G, Katsarolis I, Protopapas K, Chryssos G, Drimis S, Gargalianos P, Xylomenos G, Lourida G, Psichogiou M, Daikos GL, Sipsas NV, Kontos A, Gamaletsou MN, Koratzanis G, Sambatakou H, Mariolis H, Skoutelis A, Papastamopoulos V, Georgiou O, Panagopoulos P, Maltezos E, Coughlan S, De Gascun C, Byrne C, Duffy M, Bergin C, Reidy D, Farrell G, Lambert J, O'Connor E, Rochford A, Low J, Coakely P, O'Dea S, Hall W, Mor O, Levi I, Chemtob D, Grossman Z, Zazzi M, de Luca A, Balotta C, Riva C, Mussini C, Caramma I, Capetti A, Colombo MC, Rossi C, Prati F, Tramuto F, Vitale F, Ciccozzi M, Angarano G, Rezza G, Kolupajeva T, Vasins O, Griskevicius A, Lipnickiene V, Schmit JC, Struck D, Sauvageot N, Hemmer R, Arendt V, Michaux C, Staub T, Sequin-Devaux C, Wensing AMJ, Boucher CAB, van de Vijver DAMC, van Kessel A, van Bentum PHM, Brinkman K, Connell BJ, van der Ende ME, Hoepelman IM, van Kasteren M, Kuipers M, Langebeek N, Richter C, Santegoets RMWJ, Schrijnders-Gudde L, Schuurman R, van de Ven BJM, Åsjö B, Kran AMB, Ormaasen V, Aavitsland P, Horban A, Stanczak JJ, Stanczak GP, Firlag-Burkacka E, Wiercinska-Drapalo A, Jablonowska E, Maolepsza E, Leszczyszyn-Pynka M, Szata W, Camacho R, Palma C, Borges F, Paixão T, Duque V, Araújo F, Otelea D, Paraschiv S, Tudor AM, Cernat R, Chiriac C, Dumitrescu F, Prisecariu LJ, Stanojevic M, Jevtovic D, Salemovic D, Stanekova D, Habekova M, Chabadová Z, Drobkova T, Bukovinova P, Shunnar A, Truska P, Poljak M, Lunar M, Babic D, Tomazic J, Vidmar L, Vovko T, Karner P, Garcia F, Paredes R, Monge S, Moreno S, Del Amo J, Asensi V, Sirvent JL, de Mendoza C, Delgado R, Gutiérrez F, Berenguer J, Garcia-Bujalance S, Stella N, de Los Santos I, Blanco JR, Dalmau D, Rivero M, Segura F, Elías MJP, Alvarez M, Chueca N, Rodríguez-Martín C, Vidal C, Palomares JC, Viciana I, Viciana P, Cordoba J, Aguilera A, Domingo P, Galindo MJ, Miralles C, Del Pozo MA, Ribera E, Iribarren JA, Ruiz L, de la Torre J, Vidal F, Clotet B, Albert J, Heidarian A, Aperia-Peipke K, Axelsson M, Mild M, Karlsson A, Sönnerborg A, Thalme A, Navér L, Bratt G, Karlsson A, Blaxhult A, Gisslén M, Svennerholm B, Bergbrant I, Björkman P, Säll C, Mellgren Å, Lindholm A, Kuylenstierna N, Montelius R, Azimi F, Johansson B, Carlsson M, Johansson E, Ljungberg B, Ekvall H, Strand A, Mäkitalo S, Öberg S, Holmblad P, Höfer M, Holmberg H, Josefson P, Ryding U. Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe. Clin Infect Dis 2015; 62:655-663. [PMID: 26620652 PMCID: PMC4741360 DOI: 10.1093/cid/civ963] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 11/06/2015] [Indexed: 11/13/2022] Open
Abstract
Transmitted human immunodeficiency virus drug resistance in Europe is stable at around 8%. The impact of baseline mutation patterns on susceptibility to antiretroviral drugs should be addressed using clinical guidelines. The impact on baseline susceptibility is largest for nonnucleoside reverse transcriptase inhibitors. Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)–infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%–9.5%) in 2008–2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.
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Affiliation(s)
- L Marije Hofstra
- Luxembourg Institute of Health, Luxembourg.,Department of Virology, University Medical Center Utrecht, The Netherlands
| | | | - Jan Albert
- Karolinska Institute, Solna.,Karolinska University Hospital, Stockholm, Sweden
| | - Ivailo Alexiev
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Federico Garcia
- Complejo Hospitalario Universitario de Granada, Instituto de Investigación IBS Granada; on behalf of Cohorte de Adultos de la Red de Investigación en SIDA, Spain
| | | | | | | | - Danail Beshkov
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Diane Descamps
- AP-HP Groupe hospitalier Bichat-Claude Bernard, IAME INSERM UMR 1137, Université Paris Diderot Sorbonne Paris Cité, Paris, France
| | | | | | | | | | | | | | - Kirsi Liitsola
- Department of Infectious Diseases, National Institute for Health and Welfare, Helsinki, Finland
| | - Marek Linka
- National Reference Laboratory for HIV/AIDS, National Institute of Public Health, Prague, Czech Republic
| | - Orna Mor
- National HIV Reference Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Dan Otelea
- National Institute for Infectious Diseases "Prof. dr. Matei Bals", Bucharest, Romania
| | | | | | - Mario Poljak
- Faculty of Medicine, Slovenian HIV/AIDS Reference Centre, University of Ljubljana, Slovenia
| | | | - Anders Sönnerborg
- Karolinska Institute, Solna.,Karolinska University Hospital, Stockholm, Sweden
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Gutiérrez F, Zurita S, Pérez-Rivilla A, Delgado R. Evaluation of the automated Veris/DxN System for human immunodeficiency virus type-1 (HIV-1) and hepatitis C virus (HCV) viral load (VL) monitoring. J Clin Virol 2015. [DOI: 10.1016/j.jcv.2015.07.247] [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: 10/23/2022]
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Pacheco YM, Jarrin I, Rosado I, Campins AA, Berenguer J, Iribarren JA, Rivero M, Muñoz-Medina L, Bernal-Morell E, Gutiérrez F, Leal M. Increased risk of non-AIDS-related events in HIV subjects with persistent low CD4 counts despite cART in the CoRIS cohort. Antiviral Res 2015; 117:69-74. [PMID: 25766861 DOI: 10.1016/j.antiviral.2015.03.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [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: 12/05/2014] [Revised: 02/18/2015] [Accepted: 03/02/2015] [Indexed: 10/23/2022]
Abstract
The aim was to analyze clinical complications in HIV-infected subjects who persistently maintain low CD4 levels despite virological response to cART in the Spanish CoRIS cohort. The main inclusion criteria were CD4 counts <200cells/mm(3) at cART-initiation and at least 2years under cART achieving a viral load <500copies/mL. Those patients with CD4 counts <250cells/mm(3) 2years after cART were classified as the Low-CD4 group, and clinical events were collected from this time-point. Poisson regression models were used to calculate incidence rate ratios of death, AIDS-defining events, serious non-AIDS-defining events (NAE) and of each specific NAE category (non-AIDS-defining malignancies (non-ADM), cardiovascular, kidney- and liver-related events). Of 9667 patients in the cohort, a total of 1128 met the criteria and 287 (25.4%) were classified in the Low-CD4 group. A higher risk of death (aIRR: 4.71; 95% CI: 1.88-11.82; p-value=0.001) and of non-ADM were observed in this group (aIRR: 2.23; 95% CI: 1.07-4.63; p=0.03). Our results stress the need to control accelerated aging in this population to counter their increased risk of non-AIDS-defining diseases, particularly cancer, and are consistent with the concept that clinical complications are potentially affected by genetics and lifestyle.
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Affiliation(s)
- Y M Pacheco
- Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain.
| | - I Jarrin
- Institute of Health Carlos III, Madrid, Spain
| | - I Rosado
- Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain
| | - A A Campins
- Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - J Berenguer
- Infectious Diseases/HIV Unit, Gregorio Marañón General University Hospital, Madrid, Spain
| | - J A Iribarren
- Hospital Universitario de Donostia, San Sebastián, Spain
| | - M Rivero
- Navarra Hospital, Pamplona, Spain
| | - L Muñoz-Medina
- Unidad de Enfermedades Infecciosas, Hospital Universitario San Cecilio, Granada, Spain
| | - E Bernal-Morell
- Servicio de Enfermedades Infecciosas, Hospital General Universitario Reina Sofia, Madrid, Spain
| | - F Gutiérrez
- Infectious Diseases Unit, Hospital General Universitario de Elche, Clinical Medicine Department, Universidad Miguel Hernández, Alicante, Spain
| | - M Leal
- Laboratory of Immunovirology, Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville 41013, Spain
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Jarrin I, Hernández-Novoa B, Alejos B, Santos I, Lopez-Aldeguer J, Riera M, Gutiérrez F, Rubio R, Antela A, Blanco JR, Moreno S. Interpreting the reasons for the choice and changing of two drug regimens in an observational cohort: comparison of a ritonavir-boosted protease inhibitor-based versus a nonnucleoside reverse transcriptase inhibitor-based first-line regimen. HIV Med 2014; 15:547-56. [PMID: 24655804 DOI: 10.1111/hiv.12144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES We compared reasons for the choice of regimen, time to and reasons for third drug modification, virological response and change in CD4 T-cell counts in patients started on atazanavir/ritonavir (ATV/r)- vs. efavirenz (EFV)-based first-line regimens. METHODS We included patients from the Cohort of the Spanish HIV Research Network (CoRIS), a multicentre cohort of HIV-positive treatment-naïve subjects, in the study. We used logistic regression to assess factors associated with choosing ATV/r vs. EFV, proportional hazards models on the subdistribution hazard to estimate subdistribution hazard ratios (sHRs) for third drug modification, logistic regression to estimate odds ratios (ORs) for virological response and linear regression to assess mean differences in CD4 T-cell count increase from baseline. RESULTS Of 2167 patients, 10.7% started on ATV/r. ATV/r was more likely than EFV to be prescribed in injecting drug users [adjusted OR 1.85; 95% confidence interval (CI) 1.03-3.33], in 2009-2010 (adjusted OR 1.63; 95% CI 1.08-2.47) and combined with abacavir plus lamivudine (adjusted OR 1.53; 95% CI 0.98-2.43). Multivariate analyses showed no differences, comparing ATV/r vs. EFV, in the risk of third drug modification (sHR 1.04; 95% CI 0.74-1.46) or in virological response (OR 0.81; 95% CI 0.46-1.41); differences in mean CD4 T-cell count increase from baseline were at the limit of statistical significance (mean difference 29.8 cells/μL; 95% CI -4.1 to 63.6 cells/μL). In patients changing from EFV, 48% of changes were attributable to toxicity/adverse events, 16% to treatment failure/resistance, 3% to simplification, and 8 and 12%, respectively, to patients' and physicians' decisions; these percentages were 24, 6, 12, 14 and 24%, respectively, in those changing from ATV/r. CONCLUSIONS ATV/r- and EFV-based regimens meet the requirements of both efficacy and safety for initial combination antiretroviral regimen, which relate to better durability.
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Affiliation(s)
- I Jarrin
- Institute of Health Carlos III, Madrid, Spain
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Gutiérrez F, García L, Padilla S, Alvarez D, Moreno S, Navarro G, Gómez-Sirvent J, Vidal F, Asensi V, Masiá M. Risk of clinically significant depression in HIV-infected patients: effect of antiretroviral drugs. HIV Med 2013; 15:213-23. [PMID: 24215356 DOI: 10.1111/hiv.12104] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES We aimed to characterize depression in newly diagnosed HIV-infected patients, to determine the effect of antiretroviral therapy (ART) on its incidence, and to investigate whether efavirenz use was associated with a higher risk, compared with non-efavirenz-containing regimens, in the Spanish CoRIS cohort. METHODS CoRIS is a contemporary, multicentre cohort of HIV-infected patients, antiretroviral-naïve at entry, launched in 2004. Poisson regression models were used to investigate demographic, clinical and treatment-related factors associated with a higher incidence of clinically significant depression to October 2010. RESULTS In total, 5185 patients (13 089 person-years) participated in the study, of whom 3379 (65.2%) started ART during follow-up. The incidence rates of depression before and after starting ART were 11.68 [95% confidence interval (CI) 9.01-15.15] and 7.06 (95% CI 5.45-9.13) cases per 1000 person-years, respectively. After adjustment, there was an inverse association between the occurrence of depression and the initiation of ART [incidence rate ratio (IRR) 0.53; 95% CI 0.28-0.99], while the likelihood of depression increased in patients of age > 50 years (IRR 1.94; 95% CI 1.21-3.12). Longer exposure to ART was associated with a decreased IRR of depression in unadjusted and adjusted analyses. The IRR for patients receiving < 2, 2-4 and > 4 years of ART was 0.72 (95% CI 0.36-1.44), 0.10 (95% CI 0.04-0.25) and 0.05 (95% CI 0.01-0.17), respectively, compared with ART-naïve patients. This protective effect was also observed when durations of exposure to nonnucleoside reverse transcriptase inhibitor-based regimens and efavirenz-containing regimens were analysed separately. CONCLUSIONS The incidence of clinically significant depression was lower among HIV-infected patients on ART. The protective effect of ART was also observed with efavirenz-containing regimens.
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Affiliation(s)
- F Gutiérrez
- Infectious Diseases Unit, Clinical Medicine Department, Elche General University Hospital, University Miguel Hernández, Alicante, Spain
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Walmsley SL, Antela A, Clumeck N, Duiculescu D, Eberhard A, Gutiérrez F, Hocqueloux L, Maggiolo F, Sandkovsky U, Granier C, Pappa K, Wynne B, Min S, Nichols G. Dolutegravir plus abacavir-lamivudine for the treatment of HIV-1 infection. N Engl J Med 2013; 369:1807-18. [PMID: 24195548 DOI: 10.1056/nejmoa1215541] [Citation(s) in RCA: 611] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Dolutegravir (S/GSK1349572), a once-daily, unboosted integrase inhibitor, was recently approved in the United States for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in combination with other antiretroviral agents. Dolutegravir, in combination with abacavir-lamivudine, may provide a simplified regimen. METHODS We conducted a randomized, double-blind, phase 3 study involving adult participants who had not received previous therapy for HIV-1 infection and who had an HIV-1 RNA level of 1000 copies per milliliter or more. Participants were randomly assigned to dolutegravir at a dose of 50 mg plus abacavir-lamivudine once daily (DTG-ABC-3TC group) or combination therapy with efavirenz-tenofovir disoproxil fumarate (DF)-emtricitabine once daily (EFV-TDF-FTC group). The primary end point was the proportion of participants with an HIV-1 RNA level of less than 50 copies per milliliter at week 48. Secondary end points included the time to viral suppression, the change from baseline in CD4+ T-cell count, safety, and viral resistance. RESULTS A total of 833 participants received at least one dose of study drug. At week 48, the proportion of participants with an HIV-1 RNA level of less than 50 copies per milliliter was significantly higher in the DTG-ABC-3TC group than in the EFV-TDF-FTC group (88% vs. 81%, P=0.003), thus meeting the criterion for superiority. The DTG-ABC-3TC group had a shorter median time to viral suppression than did the EFV-TDF-FTC group (28 vs. 84 days, P<0.001), as well as greater increases in CD4+ T-cell count (267 vs. 208 per cubic millimeter, P<0.001). The proportion of participants who discontinued therapy owing to adverse events was lower in the DTG-ABC-3TC group than in the EFV-TDF-FTC group (2% vs. 10%); rash and neuropsychiatric events (including abnormal dreams, anxiety, dizziness, and somnolence) were significantly more common in the EFV-TDF-FTC group, whereas insomnia was reported more frequently in the DTG-ABC-3TC group. No participants in the DTG-ABC-3TC group had detectable antiviral resistance; one tenofovir DF-associated mutation and four efavirenz-associated mutations were detected in participants with virologic failure in the EFV-TDF-FTC group. CONCLUSIONS Dolutegravir plus abacavir-lamivudine had a better safety profile and was more effective through 48 weeks than the regimen with efavirenz-tenofovir DF-emtricitabine. (Funded by ViiV Healthcare; SINGLE ClinicalTrials.gov number, NCT01263015 .).
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Affiliation(s)
- Sharon L Walmsley
- From the University Health Network, Toronto (S.L.W.); Hospital Clinico Universitario, Santiago de Compostela (A.A.), and Hospital General de Elche and Universidad Miguel Hernández, Alicante (F.G.) - both in Spain; Centre Hospitalier Universitaire Saint-Pierre, Brussels (N.C.); Dr. Victor Babes Infectious and Tropical Diseases Hospital, Bucharest, Romania (D.D.); Medizinisches Versorgungszentrum Karlsplatz HIV Research and Clinical Care Center, Munich, Germany (A.E.); Centre Hospitalier Régional d'Orléans, Orléans, France (L.H.); Antiviral Therapy Unit, Ospedali Riuniti, Bergamo, Italy (F.M.); University of Nebraska Medical Center, Omaha (U.S.); GlaxoSmithKline, Stockley Park, United Kingdom (C.G.); and GlaxoSmithKline, Research Triangle Park, NC (K.P., B.W., S.M., G.N.)
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Franco D, Henao Y, Monsalve M, Gutiérrez F, Hincapie J, Amariles P. [Hypolipidemic agents drug interactions: approach to establish and assess its clinical significance. Structured review]. Farm Hosp 2013; 37:539-557. [PMID: 24256019 DOI: 10.7399/fh.2013.37.6.1077] [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: 06/02/2023] Open
Abstract
OBJECTIVE To carry out a structures review of drug interactions of hypolipidemic drugs and to assess their clinical relevance. METHOD Structured review of drug interactions of hypolipidemic drugs in humans through PubMed/Medline of published articles, without language restrictions and with full text access until June 30th of 2012. The following Mesh terms were used: Drug Interactions, Lipid Regulating Agents, Herb-Drug Interactions, Food-Drug Interactions y Hypolipidemic Agents (Pharmacological Action). The information was completed with those articles considered to be relevant. Finally, a method was used to assess the clinical relevance of the interaction, based on the likelihood of occurrence and the severity of the effect of the interaction. RESULTS 849 publications were gathered, of which 243 references were selected, among which 189 interactions were identified. Thirty-three of them were considered of very high risk (level 1) and 42 of high risk (level 2), basically associated to increased risk for rhabdomyolisis. Enzymatic inhibition of CYP450 was the most common mechanism for these interactions. CONCLUSIONS Of the interactions identified in patients on hypolipidemic drugs, 60.3% (128/189) are clinically relevant (very high or high risk), mainly associated to the occurrence of rhabdomyolisis. Most of these interactions are attributed to simultaneous use of CYP3A4 inhibitors. Therefore, statins metabolized through CYP3A4 (simvastatin, lovastatin and atorvastatin) are the ones with the highest number of clinically relevant interactions.
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Affiliation(s)
- D Franco
- Grupo de investigación, Promoción y Prevención Farmacéutica. Universidad de Antioquia. Medellín. Colombia. Grupo de Investigación en Atención Farmacéutica. Universidad de Granada. Granada. España
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Ramos JM, Torrús D, Amador C, Jover F, Pérez-Chacón F, Ponce Y, Arjona FJ, Caro E, Martínez-Peinado C, Gallegos I, Cuadrado JM, Tello A, Gutiérrez F. Multicenter epidemiological and clinical study on imported Chagas diseases in Alicante, Spain. Pathog Glob Health 2013. [PMID: 23182138 DOI: 10.1179/2047773212y.0000000039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Recently, there has been an increase in the number of patients with Chagas disease outside of areas that are generally considered endemic. The aim of this investigation is to describe the clinical profile of a series of patients with Chagas disease in Alicante, Spain, which is a province located on the coast of the Mediterranean Sea. This study was performed at four general hospitals in Alicante between January 2002 and May 2011. A total of 128 patients from seven countries were diagnosed with Trypanosoma cruzi. The main country of origin of these patients was Bolivia (n5101; 78.9%), and the median of age of these patients was 35 years (range: 0–72 years). Four (3.3%) patients were children under 14 years of age, and 81 (63.3%) were female. Polymerase chain reaction (PCR) was used to analyze 106 patients, 66.0% of whom demonstrated positive PCR results. Visceral involvement was diagnosed in 26.8%: 24.1% demonstrated cardiac involvement, 0.9% demonstrated gastrointestinal involvement, 0.9% demonstrated cardiac and gastrointestinal involvement, and 0.9% demonstrated involvement of the central nervous system. Syncope was found to be associated with cardiomyopathy (28.0% versus 5.2%) (odds ratio: 6.5; 95% confidence interval: 1.5–27.1). Seventy-six patients received treatment with benznidazole, of whom 57 (75.0%) completed the treatment course without significant adverse events and 17.1% discontinued benznidazole due to adverse events. In total, 50% of patients experienced documented adverse reactions. Among patients with positive PCR results before treatment, all demonstrated negative PCR results following treatment. In conclusion, majority of our patients were female Bolivians immigrants, one of four of our patients demonstrated cardiac involvement, and treatment tolerance was poor. It is important to improve the clinical and epidemiological knowledge of Chagas disease in nonendemic with additional multicenter studies in order to determine the magnitude of this problem and provide improved public health and health resource planning.
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Affiliation(s)
- José M Ramos
- Department of Internal Medicine, Hospital General Universitario de Alicante, C/Pintor Baeza 10, Alicante, Spain.
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Losada C, López M, Gutiérrez F, Guerra M. 2073 – Retinopathy induced by zuclopentixol depot: A case report. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76978-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Navinés R, Gutiérrez F, Subirà S, Obiols J, Binelly C, Martín-Santos R. 1872 – Comorbidity between panic disorder with and without co-occurring depression and personality disorders: a systematic review. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76831-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Abstract
Idiopathic cutaneous ulcers, oesophageal ulcers and severe ulcerative ileocolitis occurred in a human immunodeficiency virus (HIV)-infected patient early after the initiation of combination antiretroviral therapy. This massive inflammatory process led to acute colonic perforation on two occasions. The disease was refractory to standard therapy, but responded successfully to thalidomide. Here, we discuss the potential benefits of thalidomide in refractory inflammatory processes in HIV-infected patients.
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Affiliation(s)
- J M Ramos
- Infectious Diseases Unit, Hospital General Universitario de Elche, Camí de la Almazara 11, 03203 Elche
- Department of Clinical Medicine, School of Medicine, Universidad Miguel Hernández, Crta. Nacional 332, s/n, 03550 Sant Joan D'Alacant
| | - M Masiá
- Infectious Diseases Unit, Hospital General Universitario de Elche, Camí de la Almazara 11, 03203 Elche
- Department of Clinical Medicine, School of Medicine, Universidad Miguel Hernández, Crta. Nacional 332, s/n, 03550 Sant Joan D'Alacant
| | - R Durán
- Pathology Service, Hospital General Universitario de Elche, Camí de la Almazara 11, 03203 Elche, Spain
| | - F Gutiérrez
- Infectious Diseases Unit, Hospital General Universitario de Elche, Camí de la Almazara 11, 03203 Elche
- Department of Clinical Medicine, School of Medicine, Universidad Miguel Hernández, Crta. Nacional 332, s/n, 03550 Sant Joan D'Alacant
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Monge S, Guillot V, Alvarez M, Peña A, Viciana P, García-Bujalance S, Pérez Elias M, Iribarren J, Gutiérrez F, Itziar Casado M, Garcia F, CoRIS. Analysis of transmitted drug resistance in Spain in the years 2007–2010 documents a decline in mutations to the non-nucleoside drug class. Clin Microbiol Infect 2012; 18:E485-90. [DOI: 10.1111/1469-0691.12011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sánchez-Doblado F, Domingo C, Gómez F, Sánchez-Nieto B, Muñiz JL, García-Fusté MJ, Expósito MR, Barquero R, Hartmann G, Terrón JA, Pena J, Méndez R, Gutiérrez F, Guerre FX, Roselló J, Núñez L, Brualla-González L, Manchado F, Lorente A, Gallego E, Capote R, Planes D, Lagares JI, González-Soto X, Sansaloni F, Colmenares R, Amgarou K, Morales E, Bedogni R, Cano JP, Fernández F. Estimation of neutron-equivalent dose in organs of patients undergoing radiotherapy by the use of a novel online digital detector. Phys Med Biol 2012; 57:6167-91. [DOI: 10.1088/0031-9155/57/19/6167] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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García-Puente J, Arribas J, Gutiérrez F, Taboada R, Jiménez A, Lahoz A, Pérez-Andreu J, Albaladejo P, Lucas J, Lorenzo M, Ray V, Parra J, Arcas R. 300. Cirugía de recambio valvular aórtico con prótesis biológica autoexpandible perceval s. experiencia inicial. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70597-1] [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: 11/30/2022] Open
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García-Puente J, Arribas J, Gutiérrez F, Taboada R, Jiménez A, Lahoz A, Pérez-Andreu J, Albaladejo P, Lucas J, Lorenzo M, Ray V, Parra J, Arcas R. 335. Cirugía de recambio valvular aórtico con prótesis biológica autoexpandible Perceval S. experiencia inicial. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70632-0] [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: 11/17/2022] Open
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Olmo M, Saumoy M, Alonso-Villaverde C, Peñaranda M, Gutiérrez F, Romeu J, Larrousse M, Curto J, Domingo P, Oteo JA, Vila A, Podzamczer D. Impact of antiretroviral therapy interruption on plasma biomarkers of cardiovascular risk and lipids: 144-week final data from the STOPAR study. HIV Med 2012; 13:488-98. [PMID: 22416676 DOI: 10.1111/j.1468-1293.2012.01000.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of the study was to investigate changes in plasma biomarkers of cardiovascular risk and lipids in a CD4-guided antiretroviral therapy interruption study. METHODS This was a substudy of a prospective, randomized, multicentre treatment interruption study. At months 12, 24 and 36, monocyte chemotactic protein-1 (MCP-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), interleukin-6 (IL-6), interleukin-8 (IL-8), soluble CD40 ligand (sCD40L), soluble P-selectin (sP-selectin), and tissue plasminogen activator (t-PA) were measured using a multiplex cytometric bead-based assay. Total cholesterol (total-c), high-density lipoprotein cholesterol (HDL-c) and triglycerides (TG) were determined using standard methods. RESULTS Fifty-four patients were included in the study [34 in the treatment continuation (TC) arm and 20 in the treatment interruption (TI) arm]. There were no differences at baseline between the groups, except in CD4 cell count, which was higher in the TI arm (P = 0.026), and MCP-1, which was higher in the TC arm (P = 0.039). MCP-1 and sVCAM-1 were increased relative to baseline at the three study time-points in the TI arm, with no changes in the TC arm. Soluble CD40L and sP-selectin were increased at month 36 in both arms, with a greater increase in the TI arm (P = 0.02). t-PA was increased in both arms at the three time-points. Total-c, HDL-c and low-density lipoprotein cholesterol (LDL-c) were decreased in the TI arm at the three time-points, with no changes in the total-c/HDL-c ratio. HIV viral load positively correlated with MCP-1 at months 12 and 24. Regression analysis showed a significant negative association of HDL-c with MCP-1 and sVCAM-1. CONCLUSIONS A significant increase in cardiovascular risk biomarkers persisting over the prolonged study period was seen in the TI arm. This factor may contribute to the increased cardiovascular risk observed in previous studies.
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Affiliation(s)
- M Olmo
- Infectious Disease Service, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain
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Masiá M, Padilla S, Robledano C, López N, Ramos JM, Gutiérrez F. Early changes in parathyroid hormone concentrations in HIV-infected patients initiating antiretroviral therapy with tenofovir. AIDS Res Hum Retroviruses 2012; 28:242-6. [PMID: 21639815 DOI: 10.1089/aid.2011.0052] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Initiation of combined antiretroviral therapy (cART) is associated with bone loss, which may be more intense with regimens including tenofovir. The underlying mechanisms are not well understood. Cross-sectional data have linked tenofovir with higher parathyroid hormone (PTH) concentrations in patients with vitamin D deficiency. We performed a longitudinal study with a 48-week follow-up to evaluate sequential changes in PTH and 25-hydroxyvitamin D [25(OH)D] levels in patients starting cART with either tenofovir/emtricitabine or abacavir/lamivudine. Fifty-seven patients were included, 31 initiating tenofovir/emtricitabine and 26 initiating abacavir/lamivudine. Median PTH levels turned out to be significantly higher among tenofovir/emtricitabine users at week 4 (p=0.01), week 24 (p=0.008), and week 36 (p=0.02), and were above the upper limits of normal values (ULN) at weeks 24, 36, and 48 only in patients receiving tenofovir/emtricitabine. 25(OH)D, serum and urine calcium and phosphate, and renal-tubular maximum reabsorption of phosphate to the glomerular filtration rate (TmP/GFR) levels did not differ between the two treatment arms over the study period. Among tenofovir/emtricitabine users, median (interquartile range) PTH concentrations were significantly higher in patients with suboptimal 25(OH)D levels (<30 μg/liter) at week 24 [63 (57.8-82.4) ng/liter vs. 54.3 (34.4-63.067.5) ng/liter, p=0.05] and week 48 [67.5 (59.6-86.0) ng/liter vs. 41.9 (37.3-68.8) ng/liter, p=0.03]. A multivariable logistic regression model showed that tenofovir/emtricitabine use was an independent predictor of high PTH levels (≥53 ng/liter). Starting cART with tenofovir regimens is associated with an elevation in PTH plasma concentrations soon after introducing the drug. Suboptimal baseline 25(OH)D levels increase the risk of developing secondary hyperparathyroidism among tenofovir users.
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Affiliation(s)
- Mar Masiá
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
| | - Sergio Padilla
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
| | - Catalina Robledano
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
| | - Natividad López
- Biochemistry Section, Hospital General Universitario de Elche, Elche, Alicante, Spain
| | - José Manuel Ramos
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
| | - Felix Gutiérrez
- Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain
- Department of Clinical Medicine, University Miguel Hernández, Elche, Alicante, Spain
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Tejero-Delgado M, Guerrero A, Hernández E, Martín-Polo J, Martín-Serradilla J, Gutiérrez F, Iglesias F, Sánchez-Barranco F, Laherrán E. Neuropatía periférica como forma de presentación de poliangeítis microscópica. Neurologia 2011; 26:312-4. [DOI: 10.1016/j.nrl.2010.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Revised: 07/26/2010] [Accepted: 09/05/2010] [Indexed: 10/18/2022] Open
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Guerrero A, Tejero M, Gutiérrez F, Martín-Polo J, Iglesias F, Laherran E, Martín-Serradilla J, Merino S. Influence of APOE gene polymorphisms on interferon-beta treatment response in multiple sclerosis. Neurología (English Edition) 2011. [DOI: 10.1016/s2173-5808(11)70029-3] [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: 10/16/2022] Open
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Tejero-Delgado M, Guerrero A, Hernández E, Martín-Polo J, Martín-Serradilla J, Gutiérrez F, Iglesias F, Sánchez-Barranco F, Laherrán E. Peripheral neuropathy as a first sign of microscopic polyangiitis. Neurología (English Edition) 2011. [DOI: 10.1016/s2173-5808(11)70067-0] [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: 10/15/2022] Open
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Guerrero AL, Tejero MA, Gutiérrez F, Martín-Polo J, Iglesias F, Laherran E, Martín-Serradilla JI, Merino S. Influence of APOE gene polymorphisms on interferon-beta treatment response in multiple sclerosis. Neurologia 2010; 26:137-42. [PMID: 21163235 DOI: 10.1016/j.nrl.2010.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 05/25/2010] [Accepted: 06/03/2010] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Clinical trials with interferon beta in relapsing remitting multiple sclerosis (RRMS) have demonstrated a reduction in the relapse rate. Nevertheless, not all patients respond to this treatment, although there is no consensus regarding the definition of response to therapy. The reasons for this failure are not known but genetic factors probably influence this, as has been previously shown with Interleukin 10 or Interferon gamma polymorphisms. The role of apolipoprotein E (APOE) gene in MS has been investigated and does not appear to increase risk for MS or influence disease severity. Interestingly APOE variation influences response to cholinesterase inhibitor treatment in Alzheimer disease or to statins in hypercholesterolemia. This might have future implications for MS. MATERIAL AND METHODS We retrospectively reviewed 38 RRMS patients (32 females and 6 males) treated with interferon beta (INFbeta) over at least two years. Criteria for treatment were uniform accordingly to an "Advisory Committee for the Treatment of Multiple Sclerosis". We collected data variables including age, age of onset, clinical type or disease duration. Patients were classified, two years after the start of treatment, as responders and non-responders based upon clinical criteria available in the literature, which rely on the presence of relapses, increase of disability, or both. APOE genotype was determined from blood samples using validated polymerase chain reaction methods. Correlation between patient responding status with allele E2 or E4 was tested. RESULTS A total of 20 patients (52.6%) received subcutaneous INFbeta1b (Betaferón(®)), 13 (34.2%) INFbeta1a intramuscular (Avonex(®)), and 5 (13.2%) subcutaneous INFbeta1a (Rebif(®)). We found 2 patients (5.2%) heterozygous for the E2 allele and 9 (23.7%) for the E4 allele. No patient was homozygous for E2 or E4. Comparison of patients with and without E2 or E4 allele showed no significant differences in any of the ten therapy response variables assessed. CONCLUSION Findings of a recent meta-analysis have not supported a role for APOE in MS susceptibility or severity. We have not found, in our data, any influence of this gene in the RRMS response to INFbeta. However, larger series would be required to validate these results.
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Affiliation(s)
- A L Guerrero
- Sección de Neurología, Complejo Asistencial de Palencia, Palencia, Spain.
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Hurtado R, López-García P, Manuel-Ramos J, Gutiérrez F. Meningitis tras una mordedura de perro. Enferm Infecc Microbiol Clin 2010; 28:646-8. [DOI: 10.1016/j.eimc.2009.08.004] [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: 05/16/2009] [Revised: 08/19/2009] [Accepted: 08/26/2009] [Indexed: 11/28/2022]
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Aparicio R, Gutiérrez F, Rodríguez J. A chemometrics study of analytical panels in virgin olive oil. An approach for evaluating panels in training. Grasas y Aceites 2010. [DOI: 10.3989/gya.1991.v42.i3.1245] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ramos JM, García-Sepulcre MF, Masiá M, Brotons A, Grau MC, Gutiérrez F. Listeria monocytogenes infection in patients with inflammatory bowel diseases receiving anti-tumor necrosis factor therapy. Rev esp enferm dig 2010; 102:614-6. [DOI: 10.4321/s1130-01082010001000014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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de la Tabla VO, Antequera P, Masiá M, Ros P, Martin C, Gazquez G, Buñuel F, Sánchez V, Robledano C, Gutiérrez F. Clinical evaluation of rapid point-of-care testing for detection of novel influenza A (H1N1) virus in a population-based study in Spain. Clin Microbiol Infect 2010; 16:1358-61. [DOI: 10.1111/j.1469-0691.2010.03159.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Enríquez R, Sirvent A, Andrada E, Escolano C, Rodríguez J, Millán I, Gutiérrez F, Amorós F. Cryoglobulinemic glomerulonephritis in chronic hepatitis B infection. Ren Fail 2010; 32:518-22. [DOI: 10.3109/08860221003675252] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Torres A, Garcia-Esteve L, Navarro P, Tarragona M, Imaz M, Gutiérrez F, Santos C, Ascaso C, Martin-Santos R, Subirà S. P02-397 - Personality profile or postraumatic stress disorder? personality characteristics in women victim of chronic intimate partner violence. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71399-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Tabeada R, Albaladejo P, Arribas J, Valdés M, Saura D, Pinar E, Gutiérrez F, García-Puente J, Jiménez A, Ray V, Arcas R. 223. Experiencia inicial con el implante de prótesis aórticas vía transfemoral. Cirugía Cardiovascular 2010. [DOI: 10.1016/s1134-0096(10)70686-0] [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: 10/26/2022] Open
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Pérez Andreu J, Arribas J, Pascual D, Cabañas V, Gutiérrez F, García-Puente J, Jiménez A, Ray V, Parra J, García Real J, Arcas R. 116. Factores de riesgo para transfusión de concentrados de hematíes en cirugía de revascularización miocárdica. Cirugía Cardiovascular 2010. [DOI: 10.1016/s1134-0096(10)70767-1] [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: 10/26/2022] Open
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Verdes JM, Moraña JA, Battes D, Gutiérrez F, Guerrero F, Goicoa A, Fidalgo LE, Barbeito CG, Zanuzzi CN, Portiansky EL, Gimeno EJ. Calbindin D28k expression and the absence of apoptosis in the cerebellum of Solanum bonariense L-intoxicated bovines. Vet Pathol 2009; 47:569-72. [PMID: 20234028 DOI: 10.1177/0300985809358040] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Solanum bonariense intoxication is characterized by cerebellar neuronal vacuolation, degeneration, and necrosis. Cerebellar Purkinje cells seem especially susceptible, but more research is needed to determine the pathogenesis of neuronal necrosis and the mechanism of Purkinje cell susceptibility. Calbindin D28k (CbD28k) is highly expressed in Purkinje cells and has been used as a marker for normal and degenerative Purkinje cells. The goal of this study was to describe S bonariense-induced disease by ascertaining Purkinje cell-specific degenerative changes using CbD28k expression and to correlate this with apoptosis in Purkinje cells, as determined using TUNEL (transferase-mediated dUTP-biotin nick end-labeling) and ultrastructural changes. In all cases, an increase in both dose and duration of S bonariense intoxication resulted in a decrease in the number of Purkinje cells. CbD28k immunohistochemistry was an excellent marker for Purkinje cells because immunoreactivity did not change in normal or degenerative tissues. This finding suggests that excessive calcium excitatory stimulation does not induce rapid neuronal degeneration and death. As found in previous studies, TUNEL tests and electron microscopy suggest that Purkinje cell degeneration and death are not occurring via an apoptotic process. These findings suggest that S bonariense poisoning induces progressive Purkinje cell death that is not mediated by excitotoxicity or apoptotic activation.
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Affiliation(s)
- J M Verdes
- Department of Molecular and Cellular Biology (Biophysics), School of Veterinary, Universidad de la República, Av. A. Lasplaces 1550, CP 11600, Montevideo, Uruguay.
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