1
|
Monzón S, Varona S, Negredo A, Vidal-Freire S, Patiño-Galindo JA, Ferressini-Gerpe N, Zaballos A, Orviz E, Ayerdi O, Muñoz-Gómez A, Delgado-Iribarren A, Estrada V, García C, Molero F, Sánchez-Mora P, Torres M, Vázquez A, Galán JC, Torres I, Causse Del Río M, Merino-Diaz L, López M, Galar A, Cardeñoso L, Gutiérrez A, Loras C, Escribano I, Alvarez-Argüelles ME, Del Río L, Simón M, Meléndez MA, Camacho J, Herrero L, Jiménez P, Navarro-Rico ML, Jado I, Giannetti E, Kuhn JH, Sanchez-Lockhart M, Di Paola N, Kugelman JR, Guerra S, García-Sastre A, Cuesta I, Sánchez-Seco MP, Palacios G. Monkeypox virus genomic accordion strategies. Nat Commun 2024; 15:3059. [PMID: 38637500 PMCID: PMC11026394 DOI: 10.1038/s41467-024-46949-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Abstract
The 2023 monkeypox (mpox) epidemic was caused by a subclade IIb descendant of a monkeypox virus (MPXV) lineage traced back to Nigeria in 1971. Person-to-person transmission appears higher than for clade I or subclade IIa MPXV, possibly caused by genomic changes in subclade IIb MPXV. Key genomic changes could occur in the genome's low-complexity regions (LCRs), which are challenging to sequence and are often dismissed as uninformative. Here, using a combination of highly sensitive techniques, we determine a high-quality MPXV genome sequence of a representative of the current epidemic with LCRs resolved at unprecedented accuracy. This reveals significant variation in short tandem repeats within LCRs. We demonstrate that LCR entropy in the MPXV genome is significantly higher than that of single-nucleotide polymorphisms (SNPs) and that LCRs are not randomly distributed. In silico analyses indicate that expression, translation, stability, or function of MPXV orthologous poxvirus genes (OPGs), including OPG153, OPG204, and OPG208, could be affected in a manner consistent with the established "genomic accordion" evolutionary strategies of orthopoxviruses. We posit that genomic studies focusing on phenotypic MPXV differences should consider LCR variability.
Collapse
Affiliation(s)
- Sara Monzón
- Unidad de Bioinformática, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Sarai Varona
- Unidad de Bioinformática, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Escuela Internacional de Doctorado de la UNED (EIDUNED), Universidad Nacional de Educación a Distancia (UNED), 2832, Madrid, Spain
| | - Anabel Negredo
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Santiago Vidal-Freire
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | | | | | - Angel Zaballos
- Unidad de Genómica, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Eva Orviz
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, 28040, Madrid, Spain
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, 28040, Madrid, Spain
| | - Ana Muñoz-Gómez
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, 28040, Madrid, Spain
| | | | - Vicente Estrada
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, 28040, Madrid, Spain
| | - Cristina García
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Francisca Molero
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Patricia Sánchez-Mora
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Montserrat Torres
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Ana Vázquez
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Juan-Carlos Galán
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
| | - Ignacio Torres
- Servicio de Microbiología, Hospital Clínico Universitario, Instituto de Investigación INCLIVA, 46010, Valencia, Spain
| | - Manuel Causse Del Río
- Unidad de Microbiología, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba, 14004, Córdoba, Spain
| | - Laura Merino-Diaz
- Unidad Clínico de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, 41013, Sevilla, Spain
| | - Marcos López
- Servicio de Microbiología y Parasitología, Hospital Universitario Puerta de Hierro Majadahonda, 28222, Madrid, Spain
| | - Alicia Galar
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, 28007, Madrid, Spain
| | - Laura Cardeñoso
- Servicio de Microbiología, Instituto de Investigación Sanitaria, Hospital Universitario de la Princesa, 28006, Madrid, Spain
| | - Almudena Gutiérrez
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario La Paz, 28046, Madrid, Spain
| | - Cristina Loras
- Servicio de Microbiología, Hospital General y Universitario, 13005, Ciudad Real, Spain
| | - Isabel Escribano
- Servicio de Microbiología, Hospital General Universitario Dr. Balmis, 03010, Alicante, Spain
| | | | | | - María Simón
- Servicio de Microbiología, Hospital Central de la Defensa "Gómez Ulla", 28947, Madrid, Spain
| | - María Angeles Meléndez
- Servicio de Microbiología y Parasitología, Hospital Universitario 12 de Octubre, 28041, Madrid, Spain
| | - Juan Camacho
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Laura Herrero
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Pilar Jiménez
- Unidad de Genómica, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - María Luisa Navarro-Rico
- Unidad de Genómica, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Isabel Jado
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Elaina Giannetti
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, MD, 21702, USA
| | - Mariano Sanchez-Lockhart
- United States Army Research Institute for Infectious Disease, Fort Detrick, Frederick, MD, 21702, USA
| | - Nicholas Di Paola
- United States Army Research Institute for Infectious Disease, Fort Detrick, Frederick, MD, 21702, USA
| | - Jeffrey R Kugelman
- United States Army Research Institute for Infectious Disease, Fort Detrick, Frederick, MD, 21702, USA
| | - Susana Guerra
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Global Health Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Departmento de Medicina Preventiva, Salud Publica y Microbiología, Universidad Autónoma de Madrid, 28029, Madrid, Spain
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Global Health Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Isabel Cuesta
- Unidad de Bioinformática, Unidades Centrales Científico Técnicas, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Maripaz P Sánchez-Seco
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, 28029, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Gustavo Palacios
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
- Global Health Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
| |
Collapse
|
2
|
Ayerdi O, Orviz E, Valls Carbó A, Fernández Piñeiro N, Vera García M, Puerta López T, Ballesteros Martín J, Rodríguez Martín C, Baza Caraciolo B, Lejarraga Cañas C, Pérez-García JA, Carrió D, García Lotero M, Ferreras Forcada M, González Polo M, Raposo Utrilla M, Delgado-Iribarren A, Del Romero-Guerrero J, Estrada Pérez V. Incidence of sexually transmitted infections and screening models among pre-exposure prophylaxis users. Enferm Infecc Microbiol Clin (Engl Ed) 2024:S2529-993X(24)00065-0. [PMID: 38492988 DOI: 10.1016/j.eimce.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/02/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION There is discussion about the frequency of STI screening among pre-exposure prophylaxis (PrEP) users. The aim of this study was to analyse the incidence of STIs and to evaluate different screening models in order to optimise the follow-up. METHODOLOGY A prospective study was conducted between 2017 and 2023, including 138 PrEP users in a STI clinic. Participants were tested for STIs every three months. Unscheduled visits were performed for those with STI-related symptoms or for people who were notified for an STI by a sexual partner. We performed a survival analysis of repeated events, estimating the cumulative incidence (CI) and incidence rate (IR). RESULTS The overall CI by quarterly screening was 8.3 (95% CI: 7.6-9.1) infections per person over six years, with a decreasing trend. The most frequently diagnosed pathogen was Neisseria gonorrhoeae, with a IR of 0.76 (95% CI: 0.68-0.84). If the frequency of screening is reduced to every six months, the IR of STIs is reduced by (95% CI: 0.5-0.66) infections per user per year, and at 12 months by 0.82 (95% CI: 0.73-0.89). In the case of no pharyngeal or urethral screening, IR is reduced by 0.37 (95% CI: 0.32-0.42) infections per person per year and in those over 35 years of age by 0.33 (95% CI: 0.25-0.4). Eliminating unscheduled visits, the reduction in IR is 0.33 (95% CI: 0.24-0.42). CONCLUSIONS The incidence of STIs among PrEP users is high, especially in the rectum, but it does not increase over time. STI screening could be optimised reducing the frequency of pharyngeal and urethral testing, particularly in those over 35 years of age. It is essential to redistribute health resources for unscheduled visits, which have been shown to be the most cost-effective screening.
Collapse
Affiliation(s)
- Oskar Ayerdi
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Eva Orviz
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain.
| | - Adrián Valls Carbó
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Nuria Fernández Piñeiro
- Servicio de Farmacia, Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Mar Vera García
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - Teresa Puerta López
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | | | - Jorge-Alfredo Pérez-García
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain; Servicio Microbiología Clínica, Instituto Medicina del Laboratorio, Hospital Clínico San Carlos, Madrid, Spain
| | - Dulce Carrió
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | | | - Alberto Delgado-Iribarren
- Servicio Microbiología Clínica, Instituto Medicina del Laboratorio, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Vicente Estrada Pérez
- Hospital Clínico San Carlos, IdISSC, Universidad Complutense de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas CIBERINFEC, Madrid, Spain
| |
Collapse
|
3
|
Corma-Gómez A, Cabello A, Orviz E, Morante-Ruiz M, Ayerdi O, Al-Hayani A, Muñoz-Gómez A, Santos IDL, Gómez-Ayerbe C, Rodrigo D, Riestra SDLR, Reus-Bañuls S, Silva-Klug A, Galindo MJ, Santos M, Serrano-Fuentes M, Faro-Míguez N, Pérez-Camacho I, Corona-Mata D, Morano L, López-Ruz MÁ, Montero M, Anaya-Baz B, Merino D, Castillo-Navarro A, Pineda JA, Macías J. Long or complicated mpox in patients with uncontrolled HIV infection. J Med Virol 2024; 96:e29511. [PMID: 38469884 DOI: 10.1002/jmv.29511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/13/2024]
Abstract
To date, former research about the impact of HIV infection on mpox poor outcomes is still limited and controversial. Therefore, the aim of this study was to assess the impact of HIV on the clinical course of mpox, in a large population of patients from Spain. Nationwide case-series study. Patients from 18 Spanish hospitals, with PCR-confirmed mpox from April 27, 2022 to June 30, 2023 were included in this study. The main outcome was the development of long or complicated (LC) mpox, defined as: (i) duration of the clinical course ≥ 28 days, or; (ii) disseminated disease, or: (iii) emergence of severe complications. One thousand eight hundred twenty-three individuals were included. Seven hundred eighty-six (43%) were people living with HIV (PLWH), of whom 11 (1%) had a CD4 cell count < 200 cells/mm3 and 33 (3%) <350 cells/mm3 . HIV viral load ≥ 1000 cp/mL was found in 27 (3%) PLWH, none of them were on effective ART. Fifteen (60%) PLWH with HIV-RNA ≥ 1000 cp/mL showed LC versus 182 (29%) PLWH with plasma HIV-RNA load < 1000 copies/mL and 192 (24%) individuals without HIV infection (p < 0.001). In multivariate analysis, adjusted by age, sex, CD4 cell counts and HIV viral load at the time of mpox, only plasma HIV-RNA ≥ 1000 cp/mL was associated with a greater risk of developing LC mpox [adjusted OR = 4.06 (95% confidence interval 1.57-10.51), p = 0.004]. PLWH with uncontrolled HIV infection, due to lack of ART, are at a greater risk of developing LC mpox. Efforts should be made to ensure HIV testing is carried out in patients with mpox and to start ART without delay in those tested positive.
Collapse
Affiliation(s)
- Anaïs Corma-Gómez
- Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Sevilla, Spain
- Grupo de Virología Clínica e ITS, Hospital Universitario Virgen de Valme, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Alfonso Cabello
- Unit of Infectious Diseases, Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
| | - Eva Orviz
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid
| | - Miguel Morante-Ruiz
- Unit of Infectious Diseases, Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid
| | - Aws Al-Hayani
- Unit of Infectious Diseases, Hospital Universitario Fundación Jiménez Diaz, Madrid, Spain
| | - Ana Muñoz-Gómez
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid
| | - Ignacio De Los Santos
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Servicio de Medicina Interna-Enfermedades Infecciosas, Hospital Universitario de la Princesa, Madrid, Spain
| | - Cristina Gómez-Ayerbe
- Unit of Infectious Diseases, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - David Rodrigo
- Unit of Infectious Diseases, Consorcio Hospital General de Valencia, Valencia, Spain
| | - Sandra De la Rosa Riestra
- Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases and Microbiology Clinical Unit, University Hospital Virgen Macarena, Valencia, Spain
- Department of Medicine, School of Medicine, University of Sevilla, Sevilla, Spain
| | - Sergio Reus-Bañuls
- Unit of Infectious Diseases, Hospital General Universitario de Alicante, Sevilla, Spain
| | - Ana Silva-Klug
- Unit of Infectious Diseases, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Sevilla, Spain
| | - María José Galindo
- Unit of Infectious Diseases, Hospital Clínico Universitario de Valencia, Sevilla, Spain
| | - Marta Santos
- Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Sevilla, Spain
- Grupo de Virología Clínica e ITS, Hospital Universitario Virgen de Valme, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Miriam Serrano-Fuentes
- Servicio de Medicina Interna, Hospital de Gran Canaria Dr Negrín, Las Palmas De Gran Canaria, Spain
| | - Naya Faro-Míguez
- Unit of Infectious Diseases, Hospital Universitario San Cecilio, Granada, Spain
| | - Inés Pérez-Camacho
- Unit of Infectious Diseases· Hospital Regional Universitario Málaga, Sevilla, Spain
| | - Diana Corona-Mata
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Infectious Diseases Unit, Reina Sofía University Hospital of Córdoba, Spain
- Maimonides Institute of Biomedical Research of Córdoba (Instituto Maimónides de Investigación Biomédica de Córdoba IMIBIC), Cordoba, Spain
- Department of Medicine, University of Córdoba, Cordoba, Spain
| | - Luis Morano
- Unit of Infectious Diseases, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - Miguel Ángel López-Ruz
- Unit of infectious Diseases, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Marta Montero
- Unit of infectious Diseases, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Blanca Anaya-Baz
- Unit of Infectious diseases, Hospital Universitario Puerto Real, Spain
| | - Dolores Merino
- Unit of Infectious Diseases, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain
| | | | - Juan A Pineda
- Department of Medicine, School of Medicine, University of Sevilla, Sevilla, Spain
| | - Juan Macías
- Instituto de Biomedicina de Sevilla (IBiS)/CSIC, Sevilla, Spain
- Grupo de Virología Clínica e ITS, Hospital Universitario Virgen de Valme, Sevilla, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
- Department of Medicine, School of Medicine, University of Sevilla, Sevilla, Spain
| |
Collapse
|
4
|
Politi J, Donat M, Guerras JM, Ayerdi O, Palma D, García JN, Barrio G, Belza MJ. Gaps in HIV and Hepatitis C Testing Among 3486 HIV-Negative Men Who have Sex with Men in Spain in the Era of Highly Effective Antiviral Therapies. J Community Health 2024; 49:139-155. [PMID: 37561245 DOI: 10.1007/s10900-023-01259-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 08/11/2023]
Abstract
High uptake of HIV and hepatitis C (HCV) testing in Gay, bisexual, and other men who have sex with men (GBMSM) is needed to interrupt transmission. The objective was to identify subgroups with increased probability of lack of testing among HIV-negative GBMSM in Spain. Cross-sectional study including 3486 HIV-negative GBMSM attending prevention facilities in Madrid and Barcelona, 2018-2020. Data came from self-administered online sociodemographic, health, and risk behaviors questionnaires. Outcomes were lack of HCV (lifetime) and HIV (lifetime, last year) testing. Crude and adjusted prevalences and prevalence ratios were assessed for each outcome using negative binomial regression models. Lifetime lack of HIV and HCV testing prevalence was 6.3% and 35.8%, respectively, while lack of HIV testing in the last year was 22.4%. Prevalences were also substantial in GBMSM with high-risk behaviors. After sociodemographic adjustment, the highest probability of lack of HCV testing (lifetime) and HIV (last year) was among GBMSM with insufficient viral hepatitis knowledge, no history of STI, or HCV (or HIV) testing, aged < 25, non-outness about sex life with men, and less high-risk behaviors. Lack of HCV (lifetime) and HIV testing (last year) among HIV-negative GBMSM in Spain is still high, despite high-risk behaviors.
Collapse
Affiliation(s)
- Julieta Politi
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain
| | - Marta Donat
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Miguel Guerras
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain
| | - David Palma
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Servicio de Epidemiología, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Jorge Néstor García
- Unidad de ITS de Vall d'Hebron-Drassanes, Hospital Vall d'Hebron, Barcelona, Spain
| | - Gregorio Barrio
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María José Belza
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Av. Monforte de Lemos, 5, 28029, Madrid, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| |
Collapse
|
5
|
Ayerdi O, Benito R, Ortega D, Aguilera A, Montiel N, Pintos I, Díaz de Santiago A, Baza B, Soriano V, de Mendoza C. HTLV infection in persons with sexually transmitted diseases in Spain. Front Immunol 2023; 14:1277793. [PMID: 38143748 PMCID: PMC10740202 DOI: 10.3389/fimmu.2023.1277793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/13/2023] [Indexed: 12/26/2023] Open
Abstract
Background HTLV-1 infection is a neglected disease, despite estimates of 10 million people infected worldwide and producing life-threatening illnesses in 10% of carriers. Sexual transmission is the main route of contagion. However, HTLV-1 is not listed among sexually transmitted infections (STIs). Methods Serum from all consecutive individuals who had attended six STI clinics across Spain during the last 12 months were tested for HTLV antibodies using a commercial enzyme immunoassay (EIA). Reactive samples were confirmed by immunoblot. Results A total of 2,524 samples were examined. The majority (1,936; 76.7%) belonged to men, of whom 676 (34.9%) were men who have sex with men (MSM) receiving HIV pre-exposure prophylaxis. Although native Spaniards predominated (1,470; 58.2%), up to 593 (23.5%) came from Latin America and 139 (5.5%) were African. A total of 26 individuals were initially EIA reactive and immunoblot confirmed 5 as HTLV-1 and 7 as HTLV-2. All but one HTLV-1+ case came from Latin America. Three were men and two were women. Among Latin Americans, the HTLV-1 seroprevalence was 0.67%. In contrast, all seven HTLV-2+ were native Spaniards and former injection drug users, and all but one were HIV+. Conclusion The rate of HTLV infection among individuals with STIs in Spain is 0.5%, which is greater than in the general population. These results support the introduction of universal HTLV screening in persons who attend clinics for STIs.
Collapse
Affiliation(s)
- Oskar Ayerdi
- Sexually transmitted Infections Clinic, Centro Sanitario Sandoval, Madrid, Spain
| | - Rafael Benito
- Microbiology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Diego Ortega
- Microbiology Department, Hospital Miguel Servet, Zaragoza, Spain
| | - Antonio Aguilera
- Microbiology Department, University of Santiago, Santiago de Compostela, Spain
| | - Natalia Montiel
- Microbiology Department, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Ilduara Pintos
- Internal Medicine Laboratory, Puerta de Hierro University Hospital and Research Foundation-IDIPHISA, Madrid, Spain
| | - Alberto Díaz de Santiago
- Internal Medicine Laboratory, Puerta de Hierro University Hospital and Research Foundation-IDIPHISA, Madrid, Spain
| | - Begoña Baza
- Sexually transmitted Infections Clinic, Centro Sanitario Sandoval, Madrid, Spain
| | - Vicente Soriano
- Public Health Unit, UNIR Health Sciences School and Medical Center, Madrid, Spain
| | - Carmen de Mendoza
- Internal Medicine Laboratory, Puerta de Hierro University Hospital and Research Foundation-IDIPHISA, Madrid, Spain
| |
Collapse
|
6
|
Bernardino JI, Alejos B, Rodriguez-Centeno J, Esteban-Cantos A, Mora-Rojas B, Montejano R, De Miguel R, Montero-Alonso M, Ayerdi O, Hernández-Gutierrez C, Curran A, Arribas JR, Rodés B. Monocyte Activation and Ageing Biomarkers in the Development of Cardiovascular Ischaemic Events or Diabetes in People with HIV. Microorganisms 2023; 11:1818. [PMID: 37512990 PMCID: PMC10385988 DOI: 10.3390/microorganisms11071818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/05/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
We investigated whether blood telomere length (TL), epigenetic age acceleration (EAA), and soluble inflammatory monocyte cytokines are associated with cardiovascular events or diabetes (DM) in people living with HIV (PLHIV). This was a case-control study nested in the Spanish HIV/AIDS Cohort (CoRIS). Cases with myocardial infarction, stroke, sudden death, or diabetes after starting antiretroviral therapy were included with the available samples and controls matched for sex, age, tobacco use, pre-ART CD4 cell count, viral load, and sample time-point. TL (T/S ratio) was analysed by quantitative PCR and EAA with DNA methylation changes by next-generation sequencing using the Weidner formula. Conditional logistic regression was used to explore the association with cardiometabolic events. In total, 180 participants (94 cases (22 myocardial infarction/sudden death, 12 strokes, and 60 DM) and 94 controls) were included. Of these, 84% were male, median (IQR) age 46 years (40-56), 53% were current smokers, and 22% had CD4 count ≤ 200 cells/mm3 and a median (IQR) log viral load of 4.52 (3.77-5.09). TL and EAA were similar in the cases and controls. There were no significant associations between TL, EAA, and monocyte cytokines with cardiometabolic events. TL and EAA were mildly negatively correlated with sCD14 (rho = -0.23; p = 0.01) and CCL2/MCP-1 (rho = -0.17; p = 0.02). We found no associations between TL, EAA, and monocyte cytokines with cardiovascular events or diabetes. Further studies are needed to elucidate the clinical value of epigenetic biomarkers and TL in PLHIV.
Collapse
Affiliation(s)
- Jose I Bernardino
- Unidad de VIH, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain
- CIBERINFECC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Belen Alejos
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Javier Rodriguez-Centeno
- CIBERINFECC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- HIV/AIDS and Infectious Diseases Research Group, IdiPAZ, 28046 Madrid, Spain
| | - Andrés Esteban-Cantos
- CIBERINFECC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- HIV/AIDS and Infectious Diseases Research Group, IdiPAZ, 28046 Madrid, Spain
| | - Beatriz Mora-Rojas
- CIBERINFECC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- HIV/AIDS and Infectious Diseases Research Group, IdiPAZ, 28046 Madrid, Spain
| | - Rocío Montejano
- Unidad de VIH, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain
- CIBERINFECC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Rosa De Miguel
- Unidad de VIH, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain
- CIBERINFECC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marta Montero-Alonso
- Unidad de Enfermedades Infecciosas, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdiSSSC, 28010 Madrid, Spain
| | - Cristina Hernández-Gutierrez
- Departamento de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, 28805 Madrid, Spain
| | - Adriá Curran
- Departamento Enfermedades Infecciosas, Hospital Universitari Vall d'Hebron, VHIR, 08035 Barcelona, Spain
| | - Jose R Arribas
- Unidad de VIH, Hospital Universitario La Paz, IdiPAZ, 28046 Madrid, Spain
- CIBERINFECC, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Berta Rodés
- CIBERINFECC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- HIV/AIDS and Infectious Diseases Research Group, IdiPAZ, 28046 Madrid, Spain
| |
Collapse
|
7
|
Hernaez B, Muñoz-Gómez A, Sanchiz A, Orviz E, Valls-Carbo A, Sagastagoitia I, Ayerdi O, Martín R, Puerta T, Vera M, Cabello N, Vergas J, Prieto C, Pardo-Figuerez M, Negredo A, Lagarón JM, del Romero J, Estrada V, Alcamí A. Monitoring monkeypox virus in saliva and air samples in Spain: a cross-sectional study. Lancet Microbe 2023; 4:e21-e28. [PMID: 36436538 PMCID: PMC9691259 DOI: 10.1016/s2666-5247(22)00291-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/19/2022] [Accepted: 09/29/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The transmission of monkeypox virus occurs through direct contact, but transmission through saliva or exhaled droplets and aerosols has not yet been investigated. We aimed to assess the presence of monkeypox virus DNA and infectious virus in saliva samples and droplets and aerosols exhaled from patients infected with monkeypox virus. METHODS We did a cross-sectional study in patients with monkeypox confirmed by PCR who attended two health centres in Madrid, Spain. For each patient, we collected samples of saliva, exhaled droplets within a mask, and aerosols captured by air filtration through newly developed nanofiber filters. We evaluated the presence of monkeypox virus in the samples by viral DNA detection by quantitative PCR (qPCR) and isolation of infectious viruses in cell cultures. FINDINGS Between May 18 and July 15, 2022, 44 patients with symptomatic monkeypox attended two health centres in Madrid and were included in the study. All were cisgender men, with a median age of 35·0 years (IQR 11·3). We identified high loads of monkeypox virus DNA by qPCR in 35 (85%) of 41 saliva samples. Infectious monkeypox virus was recovered from 22 (67%) of 33 saliva samples positive for monkeypox virus DNA. We also found a significant association between the number of affected cutaneous areas or general symptoms and the viral load present in saliva samples. Droplets exhaled from patients with monkeypox, detected inside a mask, contained monkeypox virus DNA in 32 (71%) of 45 samples, with two of the 32 positive samples showing the presence of the infectious virus. Monkeypox virus DNA in aerosols, collected from the medical consultation room, were detected in 27 (64%) of 42 samples, despite patients wearing an FFP2 mask during the visit. Infectious virus was not recovered from aerosol samples. High levels of monkeypox virus DNA were identified in aerosols collected from a hospital isolation room housing a patient with monkeypox. INTERPRETATION The identification of high viable monkeypox virus loads in saliva in most patients with monkeypox and the finding of monkeypox virus DNA in droplets and aerosols warrants further epidemiological studies to evaluate the potential relevance of the respiratory route of infection in the 2022 monkeypox virus outbreak. FUNDING EU, Consejo Superior de Investigaciones Científicas, and Ciberinfec.
Collapse
Affiliation(s)
- Bruno Hernaez
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain
| | - Ana Muñoz-Gómez
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Africa Sanchiz
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain
| | - Eva Orviz
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | | | - Iñigo Sagastagoitia
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain,Ciber de Enfermedades Infecciosas, Madrid, Spain
| | - Oskar Ayerdi
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Rocío Martín
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain
| | - Teresa Puerta
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Mar Vera
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Noemi Cabello
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain,Ciber de Enfermedades Infecciosas, Madrid, Spain
| | - Jorge Vergas
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Cristina Prieto
- Instituto de Agroquímica y Tecnología de Alimentos, Valencia, Spain
| | | | - Anabel Negredo
- Ciber de Enfermedades Infecciosas, Madrid, Spain,Laboratorio de Arbovirus y Enfermedades Víricas Importadas, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jorge del Romero
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain
| | - Vicente Estrada
- Centro Sandoval and Hospital Universitario Clínico de San Carlos, IdISSC, Madrid, Spain; Ciber de Enfermedades Infecciosas, Madrid, Spain.
| | - Antonio Alcamí
- Centro de Biología Molecular Severo Ochoa (Consejo Superior de Investigaciones Científicas and Universidad Autónoma de Madrid), Madrid, Spain.
| |
Collapse
|
8
|
Guerras JM, Hoyos J, Donat M, de la Fuente L, Palma Díaz D, Ayerdi O, García-Pérez JN, García de Olalla P, Belza MJ. Sexualized drug use among men who have sex with men in Madrid and Barcelona: The gateway to new drug use? Front Public Health 2022; 10:997730. [PMID: 36457321 PMCID: PMC9705339 DOI: 10.3389/fpubh.2022.997730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/25/2022] [Indexed: 11/17/2022] Open
Abstract
This original study compares the prevalences of drug use for any purpose and for sexualized drug use (SDU) among MSM. It also describes relevant characteristics of first SDU, analyzes to what extent SDU has been the first experience (the gateway) with different drugs by age and explores the correlates of SDU. Study participants included 2,919 HIV-negative MSM attending four HIV/STI diagnosis services in Madrid and Barcelona. They answered an online, self-administered questionnaire. Poisson regression models with robust variance were used. About 81.4% had ever used any drug, and 71.9% had done so in the last-12-months, while 56% had ever engaged in SDU, and 50% had done so in the last-12-months. Participants under 25 years old had the lowest prevalences of SDU, and the 25-39 age group the highest, except for Viagra, which was higher among those over age 40. The most frequently used drugs for first SDU were poppers (53.6%), cannabis (19.6%) and Viagra (12.2%). These drugs were also the most ever consumed for SDU. Among sexualized users, methamphetamine (78.3%) and Mephedrone (75.4%) were used always/most of the times for sex in the last-12-months. Around 72.2% of Mephedrone sexualized users and 69.6% of Methamphetamine vs 23.1% of ecstasy users' first consumption of these drugs involved use for sex. These drugs were provided to them free where they have sex for 66.8, 79.1, and 31.9%, respectively. On that occasion, 8.1% of Mephedrone, 6.8% of Methamphetamine and 18.4% of ecstasy users had sex only with steady partner; with 50.2, 56.2, and 26.2% respectively using a condom with any partner. SDU in the first use was associated with similar variables for recreational and chemsex drugs. The highest prevalence ratios were for having ever been penetrated by >20 men and having ever injected drugs. It can be concluded that the prevalence of SDU was more than half of the prevalence for any purpose. Thus SDU was the gateway to use for many drugs in an important proportion of users, who frequently consumed drugs that were free and had condomless anal sex with occasional and multiple partners. These circumstances were much more common for chemsex than for recreational drugs.
Collapse
Affiliation(s)
- Juan-Miguel Guerras
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Hoyos
- Independent Researcher, Madrid, Spain,*Correspondence: Juan Hoyos
| | - Marta Donat
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Luis de la Fuente
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain,Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - David Palma Díaz
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain,Servicio de Epidemiología, Agència de Salut Pública de Barcelona, Barcelona, Spain
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain
| | | | - Patricia García de Olalla
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain,Servicio de Epidemiología, Agència de Salut Pública de Barcelona, Barcelona, Spain,Institut d'Investigació Biomèdica Sant Pau, Hospital Universitari Sant Pau, Barcelona, Spain
| | - María-José Belza
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| |
Collapse
|
9
|
Orviz E, Negredo A, Ayerdi O, Vázquez A, Muñoz-Gomez A, Monzón S, Clavo P, Zaballos A, Vera M, Sánchez P, Cabello N, Jiménez P, Pérez-García JA, Varona S, Del Romero J, Cuesta I, Delgado-Iribarren A, Torres M, Sagastagoitia I, Palacios G, Estrada V, Sánchez-Seco MP. Monkeypox outbreak in Madrid (Spain): Clinical and virological aspects. J Infect 2022; 85:412-417. [PMID: 35830908 PMCID: PMC9534097 DOI: 10.1016/j.jinf.2022.07.005] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Monkeypox is the most prevalent Orthopoxvirus zoonosis infection since the eradication of smallpox. The current multi-country outbreak involves five WHO regions affecting mainly Europe. Accurate clinical and virological aspects of the disease outside endemic areas are needed. METHODS We performed an observational study of cases diagnosed in Madrid (Spain) (May/June 2022). Confirmation from vesicular lesions swabs, Orthopoxvirus real-time PCR, sequencing, phylogenetic analysis, and direct detection by Electron microscopy was performed. In addition, a structured epidemiological questionnaire was completed systematically to gather sociodemographic, clinical, and behavioral data from all confirmed cases. FINDINGS We extracted data from 48 patients, all cisgender men. The median age was 35 years (IQR 29 - 44), and 87.5% were MSM. The most prevalent symptoms were the presence of vesicular-umbilicated and pseudo-pustular skin lesions (93.8%), asthenia (66.6%), and fever (52.1%). In addition, the location of the lesions in the genital or perianal area was related to the role in sexual intercourse (p<0.001). Sequencing analysis indicated the virus circulating in Spain belongs to the western African clade. Like the other European cases in the outbreak, the Spanish isolates are a direct descendant of viruses previously detected in Nigeria, the UK, Singapore, and Israel in 2017-2018. CONCLUSIONS Monkeypox is an emerging infectious disease in Europe where community transmission is reported, mainly in MSM. The first symptom was skin lesions instead of classical fever and rash. The disease follows a self-limited course, and there have been no cases with a serious presentation or severe complications.
Collapse
Affiliation(s)
- Eva Orviz
- Centro Sandoval/Hospital Clínico San Carlos, IdISSC
| | - Anabel Negredo
- Laboratorio de Arbovirus y Enfermedades Víricas importadas, Centro Nacional de Microbiología. Instituto de Salud Carlos III; CIBERINFEC
| | - Oskar Ayerdi
- Centro Sandoval/Hospital Clínico San Carlos, IdISSC
| | - Ana Vázquez
- Laboratorio de Arbovirus y Enfermedades Víricas importadas, Centro Nacional de Microbiología. Instituto de Salud Carlos III; CIBERINFEC
| | | | - Sara Monzón
- Unidad de Bioinformática, Instituto de Salud Carlos III
| | | | | | - Mar Vera
- Centro Sandoval/Hospital Clínico San Carlos, IdISSC
| | - Patricia Sánchez
- Laboratorio de Arbovirus y Enfermedades Víricas importadas, Centro Nacional de Microbiología. Instituto de Salud Carlos III; CIBERINFEC
| | - Noemi Cabello
- Centro Sandoval/Hospital Clínico San Carlos, IdISSC; CIBERINFEC
| | | | | | - Sarai Varona
- Unidad de Bioinformática, Instituto de Salud Carlos III
| | | | - Isabel Cuesta
- Unidad de Bioinformática, Instituto de Salud Carlos III
| | | | - Montse Torres
- Centro Nacional de Microbiología, Instituto de Salud Carlos III
| | | | | | - Vicente Estrada
- Centro Sandoval/Hospital Clínico San Carlos, IdISSC; CIBERINFEC.
| | - Maria Paz Sánchez-Seco
- Laboratorio de Arbovirus y Enfermedades Víricas importadas, Centro Nacional de Microbiología. Instituto de Salud Carlos III; CIBERINFEC
| |
Collapse
|
10
|
Ruiz-Algueró M, Alejos B, García Yubero C, Riera Jaume M, Antonio Iribarren J, Asensi V, Pasquau F, Galera CE, Pascual-Carrasco M, Muñoz A, Jarrín I, Suárez-García I, Moreno S, Jarrín I, Dalmau D, Navarro ML, González MI, Blanco JL, Garcia F, Rubio R, Iribarren JA, Gutiérrez F, Vidal F, Berenguer J, González J, Alejos B, Hernando V, Moreno C, Iniesta C, Garcia Sousa LM, Perez NS, Muñoz-Fernández MÁ, García-Merino IM, Fernández IC, Rico CG, de la Fuente JG, Concejo PP, Portilla J, Merino E, Reus S, Boix V, Giner L, Gadea C, Portilla I, Pampliega M, Díez M, Rodríguez JC, Sánchez-Payá J, Gómez JL, Hernández J, Alemán MR, del Mar Alonso M, Inmaculada Hernández M, Díaz-Flores F, García D, Pelazas R, Lirola AL, Moreno JS, Caso AA, Hernández Gutiérrez C, Novella Mena M, Rubio R, Pulido F, Bisbal O, Hernando A, Domínguez L, Crestelo DR, Bermejo L, Santacreu M, Antonio Iribarren J, Arrizabalaga J, Aramburu MJ, Camino X, Rodríguez-Arrondo F, von Wichmann MÁ, Tomé LP, Goenaga MÁ, Bustinduy MJ, Azkune H, Ibarguren M, Lizardi A, Kortajarena X, Gutiérrez F, Masiá M, Padilla S, Navarro A, Montolio F, Robledano C, Gregori Colomé J, Adsuar A, Pascual R, Fernández M, García E, García JA, Barber X, Muga R, Sanvisens A, Fuster D, Berenguer J, de Quirós JCLB, Gutiérrez I, Ramírez M, Padilla B, Gijón P, Aldamiz-Echevarría T, Tejerina F, José Parras F, Balsalobre P, Diez C, Latorre LP, Vidal F, Peraire J, Viladés C, Veloso S, Vargas M, López-Dupla M, Olona M, Rull A, Rodríguez-Gallego E, Alba V, Montero Alonso M, López Aldeguer J, Blanes Juliá M, Tasias Pitarch M, Hernández IC, Calabuig Muñoz E, Cuéllar Tovar S, Salavert Lletí M, Navarro JF, González-Garcia J, Arnalich F, Arribas JR, de la Serna JIB, Castro JM, Escosa L, Herranz P, Hontañón V, García-Bujalance S, López-Hortelano MG, González-Baeza A, Martín-Carbonero ML, Mayoral M, Mellado MJ, Micán RE, Montejano R, Luisa Montes M, Moreno V, Pérez-Valero I, Rodés B, Sainz T, Sendagorta E, Stella Alcáriz N, Valencia E, Ramón Blanco J, Antonio Oteo J, Ibarra V, Metola L, Sanz M, Pérez-Martínez L, Arazo P, Sampériz G, Dalmau D, Jaén A, Sanmartí M, Cairó M, Martinez-Lacasa J, Velli P, Font R, Xercavins M, Alonso N, Repáraz J, de Alda MGR, de León Cano MT, de Galarreta BPR, Segura F, José Amengual M, Navarro G, Sala M, Cervantes M, Pineda V, Calzado S, Navarro M, de los Santos I, Sanz Sanz J, Aparicio AS, Sarriá Cepeda C, Garcia-Fraile Fraile L, Martín Gayo E, Moreno S, Luis Casado J, Dronda F, Moreno A, Jesús Pérez Elías M, Gómez Ayerbe C, Gutiérrez C, Madrid N, del Campo Terrón S, Martí P, Ansa U, Serrano S, Jesús Vivancos M, Cano A, García AA, Bravo Urbieta J, Muñoz Á, Jose Alcaraz M, Villalba MDC, García F, Hernández J, Peña A, Muñoz L, Casas P, Alvarez M, Chueca N, Vinuesa D, Martinez-Montes C, Romero JD, Rodríguez C, Puerta T, Carlos Carrió J, Vera M, Ballesteros J, Ayerdi O, Antela A, Losada E, Riera M, Peñaranda M, Leyes M, Ribas MA, Campins AA, Vidal C, Fanjul F, Murillas J, Homar F, Santos J, Ayerbe CG, Viciana I, Palacios R, González CM, Viciana P, Espinosa N, López-Cortés LF, Podzamczer D, Ferrer E, Imaz A, Tiraboschi J, Silva A, Saumoy M, Ribera E, Curran A, Olalla J, del Arco A, de la torre J, Prada JL, de Lomas Guerrero JMG, Stachowski JP, Martínez OJ, Vera FJ, Martínez L, García J, Alcaraz B, Jimeno A, Iglesias AC, Souto BP, de Cea AM, Muñoz J, Zubero MZ, Baraia-Etxaburu JM, Ugarte SI, Beneitez OLF, de Munain JL, López MMC, de la Peña M, Lopez M, Galera C, Albendin H, Pérez A, Iborra A, Moreno A, Merlos MA, Vidal A, Amador C, Pasquau F, Ena J, Benito C, Fenoll V, Anguita CG, Rabasa JTA, Suárez-García I, Malmierca E, González-Ruano P, Rodrigo DM, Seco MPR, Vidal MAG, de Zarraga MA, Pérez VE, Molina MJT, García JV, Moreno JPS, Górgolas M, Cabello A, Álvarez B, Prieto L, Sanz Moreno J, Arranz Caso A, Gutiérrez CH, Novella Mena M, Galindo Puerto MJ, Fernando Vilalta R, Ferrer Ribera A, Román AR, Brieva Herrero MT, Juárez AR, López PL, Sánchez IM, Martínez JP, Jiménez MC, Perea RT, Ruiz-Capillas JJJ, Pineda JA. Use of Generic Antiretroviral Drugs and Single-Tablet Regimen De-Simplification for the Treatment of HIV Infection in Spain. AIDS Res Hum Retroviruses 2022; 38:433-440. [PMID: 35357907 DOI: 10.1089/aid.2021.0122] [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] [Indexed: 11/13/2022] Open
Abstract
The present study sought to describe the use of generic drugs and single-tablet regimen (STR) de-simplification for the treatment of human immunodeficiency virus (HIV) infection among 41 hospitals from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). In June 2018, we collected information on when generic antiretroviral drugs (ARVs) were introduced in the different hospitals, how the decisions to use them were made, and how the information was provided to the patients. Most of the nine available generic ARVs in Spain by June 2018 had been introduced in at least 85% of the participating hospitals, except for zidovudine (AZT)/lamivudine (3TC) and AZT. The time difference between the effective marketing date of each generic ARV and its first dispensing date in the hospitals was much shorter for the more recently approved generic ARV since the year 2017. However, only up to 20% of the hospitals de-simplified efavirenz (EFV)/tenofovir disoproxil (TDF)/emtricitabine (FTC), dolutegravir (DTG)/abacavir (ABC)/3TC, and rilpivirine (RPV)/TDF/FTC (to generic EFV+TDF/FTC, DTG+generic ABC/3TC, and RPV+generic TDF/FTC, respectively), whereas the generic STR EFV/TDF/FTC was introduced in 87.8% of the centers. The median times between the date of effective marketing of generic TDF/FTC and the date of de-simplification of EFV/TDF/FTC and RPV/TDF/FTC were 723 [interquartile range (IQR): 369-1,119] and 234 (IQR: 142-264) days, respectively; this time was 155 (IQR: 28-287) days for de-simplification of DTG/ABC/3TC. In conclusion, despite the widespread use of generic ARVs, STRs de-simplification was only undertaken in <20% of the hospitals. There was wide variability in the timing of the introduction of each generic ARV after they were available in the market.
Collapse
Affiliation(s)
- Marta Ruiz-Algueró
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
| | - Belén Alejos
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
| | | | | | - José Antonio Iribarren
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donostia, Instituto de Investigación BioDonostia, San Sebastián, Spain
| | - Víctor Asensi
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Mario Pascual-Carrasco
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Unidad de Investigación en Telemedicina y Salud Digital (UITes), Instituto de Salud Carlos III, Madrid, Spain
| | - Adolfo Muñoz
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Unidad de Investigación en Telemedicina y Salud Digital (UITes), Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Jarrín
- National Center for Epidemiology, Institute of Health Carlos, Madrid, Spain
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
| | - Inés Suárez-García
- CIBER de Enfermedades Infecciosas, Institute of Health CArlos III, Madrid, Spain
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario Infanta Sofía, Madrid, Spain
- Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Ayerdi O, Puerta T, Clavo P, Vera M, Ballesteros J, Fuentes ME, Estrada V, Rodríguez C, Del Romero J. Preventive Efficacy of Tenofovir/Emtricitabine Against Severe Acute Respiratory Syndrome Coronavirus 2 Among Pre-Exposure Prophylaxis Users. Open Forum Infect Dis 2020; 7:ofaa455. [PMID: 33200081 PMCID: PMC7543639 DOI: 10.1093/ofid/ofaa455] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [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: 09/03/2020] [Accepted: 09/23/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The preventive effect that tenofovir/emtricitabine (FTC) could have against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in human immunodeficiency virus-negative people is unknown. The objective of this study was to analyze the seroprevalence and clinical manifestations of COVID-19 among users of pre-exposure prophylaxis (PrEP), disoproxil fumarate/FTC (TDF/FTC), or tenofovir alafenamide (TAF)/FTC and to compare it to that of a control group. METHODS An observational descriptive study of the seroprevalence of antibodies for SARS-CoV-2 among men who have sex with men and transgender women without use of PrEP (Group 1; n = 250) and PrEP users with TDF/FTC (n = 409) or TAF/FTC (n = 91) (Group 2; n = 500) was conducted from May11, 2020 to June 27, 2020. All participants were provided with a structured questionnaire that collected information on the variables to be analyzed, and testing for immunoglobulin G antibodies to SARS-CoV-2 (chemiluminescent microparticle immunoassay) was then carried out. RESULTS The seroprevalence of SARS-CoV-2 was 9.2% (95% confidence interval [CI], 5.9-13.5) in the group without PrEP and 15.0% (95% CI, 12.0-18.4) in the group with PrEP (P = .026). Among users of TDF/FTC it was 14.7% (95% CI, 11.4-18.5), and in users of TAF/FTC it was 16.5% (95% CI, 9.5-25.7) (P = .661). In those who tested positive for SARS-CoV-2 and receiving PrEP, 57.4% manifested symptoms, compared with 78.3% in the control group (P = .070). In users of TDF/FTC the figure was 53.3% and in users of TAF/FTC the figure was 73.3% (P = .100). The duration of symptoms was 11.5 days in the control group, 9.0 days in PrEP users (P = .116), 7.0 days in users of TDF/FTC, and 13.0 days in users of TAF/FTC (P = .100). CONCLUSIONS Users of PrEP, TDF/FTC, or TAF/FTC presented a higher seroprevalence to SARS-CoV-2 than the control group. No statistically significant differences were found in relation to clinical manifestations. The PrEP users should use the same prevention measures as those indicated for the general population.
Collapse
Affiliation(s)
- Oskar Ayerdi
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Teresa Puerta
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Petunia Clavo
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Mar Vera
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Juan Ballesteros
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Manuel Enrique Fuentes
- Servicio de Medicina Preventiva, Instituto de Investigación Sanitaria San Carlos, Universidad Alfonso X el Sabio, Madrid, Spain
| | - Vicente Estrada
- Servicio de Infecciosas, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Carmen Rodríguez
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| | - Jorge Del Romero
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain
| |
Collapse
|
12
|
Casado C, Pernas M, Rava M, Ayerdi O, Vera M, Alenda R, Jiménez P, Docando F, Olivares I, Zaballos A, Vicario JL, Rodríguez C, Del Romero J, Lopez-Galindez C. High-Risk Sexual Practices Contribute to HIV-1 Double Infection Among Men Who Have Sex with Men in Madrid. AIDS Res Hum Retroviruses 2020; 36:896-904. [PMID: 32722915 DOI: 10.1089/aid.2020.0068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/12/2022] Open
Abstract
Data on the prevalence of double infection (DI) in HIV individuals are lacking in Spain. To fill this gap, we analyzed the prevalence of DI in a cohort of men who have sex with men (MSM) and examined factors contributing to DI. We selected 81 MSM attending Centro Sanitario Sandoval, a sexually transmitted diseases clinic in Madrid. We obtained by ultra-deep sequencing the proviral sequences in gag and env genes and performed a phylogenetic analysis for the identification of DI. Clinical, behavioral, host, and viral factors were studied for its association with DI. We detected six individuals with DI and one case of superinfection with a global prevalence of 8.6%. The genetic distance among the subtype B viruses in monoinfected individuals (24.4%) was lower than the distance between the two viruses in subtype B DI individuals (29.5%). Individuals with a high number of sexual contacts (>25 partners/year) had an 8.66 times higher risk of DI (p = .017). In this MSM cohort the prevalence of HIV DI was estimated at 8.6%. DI was strongly associated with the number of sexual partners. Because of the pathogenic consequences of HIV DI, this high prevalence should promote public health programs targeted at high-risk population such as MSM for the control of HIV infection and DI. HIV DI should be considered for a better clinical management of these individuals.
Collapse
Affiliation(s)
- Concepción Casado
- Unidad de Virología Molecular, Laboratorio de Referencia e Investigación en Retrovirus, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - María Pernas
- Unidad de Virología Molecular, Laboratorio de Referencia e Investigación en Retrovirus, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Rava
- Centro Nacional de Epidemiologia, Instituto Carlos III, Madrid, Spain
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Mar Vera
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Raquel Alenda
- Centro de Transfusiones de la Comunidad de Madrid, Madrid, Spain
| | - Pilar Jiménez
- Unidad de Genómica, Área de Unidades Centrales Científico-Técnicas, Instituto de Salud Carlos III, Madrid, Spain
| | - Félix Docando
- Unidad de Virología Molecular, Laboratorio de Referencia e Investigación en Retrovirus, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Olivares
- Unidad de Virología Molecular, Laboratorio de Referencia e Investigación en Retrovirus, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Angel Zaballos
- Unidad de Genómica, Área de Unidades Centrales Científico-Técnicas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Carmen Rodríguez
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Jorge Del Romero
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | - Cecilio Lopez-Galindez
- Unidad de Virología Molecular, Laboratorio de Referencia e Investigación en Retrovirus, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
13
|
Suárez-García I, Moreno C, Ruiz-Algueró M, Pérez-Elías MJ, Navarro M, Díez Martínez M, Viciana P, Pérez-Martínez L, Górgolas M, Amador C, de Zárraga MA, Jarrín I, Moreno S, Jarrín I, Dalmau D, Navarro ML, González MI, Garcia F, Poveda E, Iribarren JA, Gutiérrez F, Rubio R, Vidal F, Berenguer J, González J, Muñoz-Fernández MÁ, Jarrin I, Alejos B, Moreno C, Iniesta C, Sousa LMG, Perez NS, Rava M, Muñoz-Fernández MÁ, Fernández IC, Merino E, García G, Portilla I, Agea I, Portilla J, Sánchez-Payá J, Rodríguez JC, Gimeno L, Giner L, Díez M, Carreres M, Reus S, Boix V, Torrús D, Lirola AL, García D, Díaz-Flores F, Gómez JL, del Mar Alonso M, Pelazas R, Hernández J, Alemán MR, Hernández MI, Asensi V, Valle E, Carmenado MER, Secades TSZ, Is LP, Rubio R, Pulido F, Bisbal O, Hernando A, Domínguez L, Crestelo DR, Bermejo L, Santacreu M, Iribarren JA, Arrizabalaga J, Aramburu MJ, Camino X, Rodríguez-Arrondo F, von Wichmann MÁ, Tomé LP, Goenaga MÁ, Bustinduy MJ, Azkune H, Ibarguren M, Lizardi A, Kortajarena X, Oyaga MPC, Igartua MU, Gutiérrez F, Masiá M, Padilla S, Navarro A, Montolio F, Robledano C, Colomé JG, Adsuar A, Pascual R, Fernández M, García E, García JA, Barber X, Muga R, Sanvisens A, Fuster D, Berenguer J, de Quirós JCLB, Gutiérrez I, Ramírez M, Padilla B, Gijón P, Aldamiz-Echevarría T, Tejerina F, Parras FJ, Balsalobre P, Diez C, Latorre LP, Fanciulli C, Vidal F, Peraire J, Viladés C, Veloso S, Vargas M, Olona M, Rull A, Rodríguez-Gallego E, Alba V, Castellanos AJ, López-Dupla M, Alonso MM, Aldeguer JL, Juliá MB, Pitarch MT, Hernández IC, Muñoz EC, Tovar SC, Lletí MS, Navarro JF, González-Garcia J, Arnalich F, Arribas JR, de la Serna JIB, Castro JM, Escosa L, Herranz P, Hontañón V, García-Bujalance S, López-Hortelano MG, González-Baeza A, Martín-Carbonero ML, Mayoral M, Mellado MJ, Micán RE, Montejano R, Montes ML, Moreno V, Pérez-Valero I, Rodés B, Sainz T, Sendagorta E, Alcáriz NS, Valencia E, Blanco JR, Oteo JA, Ibarra V, Metola L, Sanz M, Pérez-Martínez L, Arazo P, Sampériz G, Dalmau D, Jaén A, Sanmartí M, Cairó M, Martinez-Lacasa J, Velli P, Font R, Xercavins M, Alonso N, Marcotegui MR, Repáraz J, de Alda MGR, de León Cano MT, de Galarreta BPR, Amengual MJ, Navarro G, Garcia MC, Isbert SC, Vilasaro MN, de los Santos I, Sanz JS, Aparicio AS, Cepeda CS, Fraile LGF, Gayo EM, Moreno S, Osorio JLC, Nuñez FD, Zamora AM, Elías MJP, Gutiérrez C, Madrid N, del Campo Terrón S, Villar SS, Gallego MJV, Sanz JM, Urroz UA, Velasco T, Bernal E, Sanchez AC, García AA, Urbieta JB, Perez AM, Alcaraz MJ, del Carmen Villalba M, García F, Quero JH, Medina LM, Alvarez M, Chueca N, García DV, Martinez-Montes C, Beltran CG, de Salazar Gonzalerz A, Lopez AF, Utrilla MR, Del Romero J, Rodríguez C, Puerta T, Carrió JC, Vera M, Ballesteros J, Ayerdi O, Antela A, Losada E, Riera M, Peñaranda M, Leyes M, Ribas MA, Campins AA, Vidal C, Fanjul F, Murillas J, Homar F, Santos J, Ayerbe CG, Viciana I, Palacios R, López CP, Gonzalez-Domenec CM, Viciana P, Espinosa N, López-Cortés LF, Podzamczer D, Imaz A, Tiraboschi J, Silva A, Saumoy M, Prieto P, Ribera E, Curran A, Sierra JO, Stachowski JP, del Arco A, de la torre J, Prada JL, de Lomas Guerrero JMG, Martínez OJ, Vera FJ, Martínez L, García J, Alcaraz B, Jimeno A, Iglesias AC, Souto BP, de Cea AM, Muñoz J, Zubero MZ, Baraia-Etxaburu JM, Ugarte SI, Beneitez OLF, de Munain JL, López MMC, de la Peña M, Lopez M, Azkarreta IL, Galera C, Albendin H, Pérez A, Iborra A, Moreno A, Merlos MA, Vidal A, Meca M, Amador C, Pasquau F, Ena J, Benito C, Fenoll V, Anguita CG, Rabasa JTA, Suárez-García I, Malmierca E, González-Ruano P, Rodrigo DM, Seco MPR, Mohamed-Balghata MO, Vidal MAG, de Zarraga MA, Pérez VE, Molina MJT, García JV, Moreno JPS, Górgolas M, Cabello A, Álvarez B, Prieto L, Moreno JS, Caso AA, Gutiérrez CH, Mena MN, Puerto MJG, Vilalta RF, Ribera AF, Román AR, Juárez AR, López PL, Sánchez IM, Casas MF, Espejo AC, Jiménez MC, Perea RT, Pineda JA, Mayo PR, Sanchez JM, Gutierrez NM, Real LM, Gomez AC, Fuertes MF, Gonzalez-Serna A, Poveda E, Pérez A, Crespo M, Morano L, Miralles C, Ocampo A, Pousada G. Effectiveness of the combination elvitegravir/cobicistat/tenofovir/emtricitabine (EVG/COB/TFV/FTC) plus darunavir among treatment-experienced patients in clinical practice: a multicentre cohort study. AIDS Res Ther 2020; 17:45. [PMID: 32690099 PMCID: PMC7372769 DOI: 10.1186/s12981-020-00302-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 07/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the effectiveness and tolerability of the combination elvitegravir/cobicistat/tenofovir/emtricitabine plus darunavir (EVG/COB/TFV/FTC + DRV) in treatment-experienced patients from the cohort of the Spanish HIV/AIDS Research Network (CoRIS). METHODS Treatment-experienced patients starting treatment with EVG/COB/TFV/FTC + DRV during the years 2014-2018 and with more than 24 weeks of follow-up were included. TFV could be administered either as tenofovir disoproxil fumarate or tenofovir alafenamide. We evaluated virological response, defined as viral load (VL) < 50 copies/ml and < 200 copies/ml at 24 and 48 weeks after starting this regimen, stratified by baseline VL (< 50 or ≥ 50 copies/ml at the start of the regimen). RESULTS We included 39 patients (12.8% women). At baseline, 10 (25.6%) patients had VL < 50 copies/ml and 29 (74.4%) had ≥ 50 copies/ml. Among patients with baseline VL < 50 copies/ml, 85.7% and 80.0% had VL < 50 copies/ml at 24 and 48 weeks, respectively, and 100% had VL < 200 copies/ml at 24 and 48 weeks. Among patients with baseline VL ≥ 50 copies/ml, 42.3% and 40.9% had VL < 50 copies/ml and 69.2% and 68.2% had VL < 200 copies/ml at 24 and 48 weeks. During the first 48 weeks, no patients changed their treatment due to toxicity, and 4 patients (all with baseline VL ≥ 50 copies/ml) changed due to virological failure. CONCLUSIONS EVG/COB/TFV/FTC + DRV was well tolerated and effective in treatment-experienced patients with undetectable viral load as a simplification strategy, allowing once-daily, two-pill regimen with three antiretroviral drug classes. Effectiveness was low in patients with detectable viral loads.
Collapse
|
14
|
Estrada V, Santiago E, Cabezas I, Cotano JL, Carrió JC, Fuentes-Ferrer M, Vera M, Ayerdi O, Rodríguez C, López L, Cabello N, Núñez MJ, Puerta T, Sagastagoitia I, Del Romero J. Tolerability of IM penicillin G benzathine diluted or not with local anesthetics, or different gauge needles for syphilis treatment: a randomized clinical trial. BMC Infect Dis 2019; 19:883. [PMID: 31646969 PMCID: PMC6813081 DOI: 10.1186/s12879-019-4490-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 09/23/2019] [Indexed: 11/25/2022] Open
Abstract
Background Penicillin G Benzathine (PGB) is the cornerstone of syphilis treatment. However, its intramuscular (IM) administration is associated with pain at the site of injection. The dilution of PGB with local anesthetics is recommended in some guidelines, but the evidence that supports it, particularly in adults and in HIV infection, is scarce. Preliminary clinical experience also suggests that the IM administration of PGB through increased needle gauges might improve its tolerability. The aim of the study to identify less painful ways of administering IM PGB in the treatment of syphilis in adults. Methods Multicenter, randomized, double-blinded clinical trial in patients diagnosed with primary syphilis that required a single IM injection of PGB 2400,00 IU. Patients were randomized to receive PGB diluted with 0.5 mL mepivacaine 1% (MV) or PGB alone, and both groups either with a long 19G or short 21G IM needle. The primary objective was the effect on local pain immediately after the administration through a visual scale questionnaire on pain (0 to 10). Results One hundred eight patients were included, 27 in each group. Ninety-four (94.4%) were male, and 41.7% were also HIV-infected. Mean age 36.6 years (SD 11). Significant differences in immediate pain intensity were observed when comparing the long 19G group with anesthesia (mean pain intensity, [MPI] 2.92 [CI 95% 1.08-4.07]) vs long 19G without anesthesia (MPI 5.56 [CI 95% 4.39-6.73), p < 0.001; and also between short 21G group with anesthesia (MPI 3.36 [CI 95% 2.22-4.50]) vs short 21G without anesthesia (MPI 5.06 [CI 95% 3.93-6.19]), p = 0.015). No significant differences in immediate pain were observed between 19G and 21G in the presence or absence of anesthesia (p = 1.0 in both cases). No differences were found between study arms after 6 and 24 h. Conclusions The IM administration of 1% mepivacaine-diluted PGB induces significantly less immediate local pain as compared to PGB alone. The needle gauge did not have any effect on the pain. Based on these results, we suggest anesthetic-diluted IM PGB as the standard treatment for primary syphilis. Trial registration EudraCT 2014-003969-24 (Date of registration 18/09/2014).
Collapse
Affiliation(s)
- Vicente Estrada
- Medicina Interna/enfermedades infecciosas, Hospital Clínico San Carlos, IdiSSC, Universidad Complutense, c/Martin Lagos SN, 28040, Madrid, Spain.
| | - Eva Santiago
- Medicina Interna/enfermedades infecciosas, Hospital Clínico San Carlos, IdiSSC, Universidad Complutense, c/Martin Lagos SN, 28040, Madrid, Spain
| | | | - Juan Luis Cotano
- Centro Sanitario Sandoval, IdiSSC, C/Sandoval, 7, 28010, Madrid, Spain
| | | | - Manuel Fuentes-Ferrer
- Medicina Interna/enfermedades infecciosas, Hospital Clínico San Carlos, IdiSSC, Universidad Complutense, c/Martin Lagos SN, 28040, Madrid, Spain
| | - Mar Vera
- Centro Sanitario Sandoval, IdiSSC, C/Sandoval, 7, 28010, Madrid, Spain
| | - Oskar Ayerdi
- Centro Sanitario Sandoval, IdiSSC, C/Sandoval, 7, 28010, Madrid, Spain
| | - Carmen Rodríguez
- Centro Sanitario Sandoval, IdiSSC, C/Sandoval, 7, 28010, Madrid, Spain
| | - Laura López
- Medicina Interna/enfermedades infecciosas, Hospital Clínico San Carlos, IdiSSC, Universidad Complutense, c/Martin Lagos SN, 28040, Madrid, Spain
| | - Noemí Cabello
- Medicina Interna/enfermedades infecciosas, Hospital Clínico San Carlos, IdiSSC, Universidad Complutense, c/Martin Lagos SN, 28040, Madrid, Spain
| | - María José Núñez
- Medicina Interna/enfermedades infecciosas, Hospital Clínico San Carlos, IdiSSC, Universidad Complutense, c/Martin Lagos SN, 28040, Madrid, Spain
| | - Teresa Puerta
- Centro Sanitario Sandoval, IdiSSC, C/Sandoval, 7, 28010, Madrid, Spain
| | - Iñigo Sagastagoitia
- Medicina Interna/enfermedades infecciosas, Hospital Clínico San Carlos, IdiSSC, Universidad Complutense, c/Martin Lagos SN, 28040, Madrid, Spain
| | - Jorge Del Romero
- Medicina Interna/enfermedades infecciosas, Hospital Clínico San Carlos, IdiSSC, Universidad Complutense, c/Martin Lagos SN, 28040, Madrid, Spain
| |
Collapse
|
15
|
Iniesta C, Álvarez-Del Arco D, García-Sousa LM, Alejos B, Díaz A, Sanz N, Garrido J, Meulbroek M, Pujol F, Moreno S, Fuster-RuizdeApodaca MJ, Coll P, Antela A, Del Romero J, Ayerdi O, Riera M, Hernández J, Del Amo J. Correction: Awareness, knowledge, use, willingness to use and need of Pre-Exposure Prophylaxis (PrEP) during World Gay Pride 2017. PLoS One 2019; 14:e0216376. [PMID: 31034518 PMCID: PMC6488067 DOI: 10.1371/journal.pone.0216376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
16
|
Iniesta C, Álvarez-del Arco D, García-Sousa LM, Alejos B, Díaz A, Sanz N, Garrido J, Meulbroek M, Pujol F, Moreno S, Fuster-Ruiz de Apocada MJ, Coll P, Antela A, del Romero J, Ayerdi O, Riera M, Hernández J, del Amo J. Awareness, knowledge, use, willingness to use and need of Pre-Exposure Prophylaxis (PrEP) during World Gay Pride 2017. PLoS One 2018; 13:e0204738. [PMID: 30339690 PMCID: PMC6195256 DOI: 10.1371/journal.pone.0204738] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 09/13/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess the awareness, knowledge, use, and willingness to use and need of PrEP among men who have sex with men (MSM) and transgender women (TW) who attended World Gay Pride (WGP) 2017 in Madrid. DESIGN AND METHODS Online survey. Participants were recruited through gay-oriented dating apps and HIV Non-Governmental Organizations´ social media. Inclusion criteria included being MSM or TW, age 18 years old or above, and having attended WGP in Madrid. Information regarding the participant's awareness and knowledge, use or willingness to use, and need for PrEP was collected, as well as sociodemographic characteristics. Participants were considered to be in need of PrEP if they met one of the following indication criteria: having practiced unprotected anal intercourse with more than 2 partners, having practiced chemsex, or having engaged in commercial sex-all in the preceding 6 months. Descriptive and multivariable analyses with logistic regression were conducted. RESULTS 472 participants met the inclusion criteria and completed the questionnaire. The mean age was 38, 97.7% were MSM, 77% had a university education, and 85% were living in Spain, mostly in big cities. Overall, 64% of participants were aware of PrEP, but only 33% knew correctly what PrEP was. 67% of HIV-negative participants were willing to take PrEP, although only 5% were taking it during WGP, mostly due to lack of access. 43% of HIV-negative respondents met at least one PrEP indication criteria. For HIV-negative men living in Spain, university education and living in big cities was associated with PrEP awareness. Lower education level and meeting PrEP criteria was associated with willingness to use PrEP. CONCLUSIONS Our study shows that among MSM attending WGP 2017 in Madrid, there was limited PrEP awareness, low accuracy of PrEP knowledge, and a high need and willingness to use PrEP. Health authorities should strengthen existing preventive strategies and implement PrEP.
Collapse
Affiliation(s)
- Carlos Iniesta
- National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Débora Álvarez-del Arco
- Universidad Complutense de Madrid, Madrid, Spain
- La Doctora Álvarez Communication Agency, Madrid, Spain
| | | | - Belén Alejos
- National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | - Asunción Díaz
- National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| | | | | | | | - Ferran Pujol
- Projecte dels NOMS, Hispanosida, Barcelona, Spain
| | - Santiago Moreno
- Hospital Universitario Ramón y Cajal, Madrid, Spain
- Universidad Alcalá de Henares, Madrid, Spain
| | | | - Pep Coll
- AIDS Research Institute-IrsiCaixa, Barcelona, Spain
| | - Antonio Antela
- Hospital Clinico Universitario de Santiago de Compostela, Infectious Diseases Department, Santiago de Compostela, Spain
| | | | - Oskar Ayerdi
- Centro Sanitario Sandoval IdISSC, Unidad ITS/VIH, Madrid, Spain
| | | | - Juanse Hernández
- Grupo de Trabajo sobre Tratamientos del VIH -gTt-VIH, Barcelona, Spain
| | - Julia del Amo
- National Center of Epidemiology, Carlos III Health Institute, Madrid, Spain
| |
Collapse
|