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EMEI- Últimos artículos científicos publicados:

• Opportunistic infections and organ-specific diseases in HIV-1-infected children: a cohort study (1990-2006). -

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  Opportunistic infections and organ-specific diseases in HIV-1-infected children: a cohort study (1990-2006).

  HIV Med. 2009 Dec 28;

  Authors: Guillén S, García San Miguel L, Resino S, Bellón JM, González I, Jiménez de Ory S, Muñoz-Fernández MA, Navarro ML, Gurbindo MD, de José MI, Mellado MJ, Martín-Fontelos P, Gonzalez-Tomé MI, Martinez J, Beceiro J, Roa MA, Ramos JT,

  Objectives Highly active antiretroviral therapy (HAART) has dramatically changed the natural history of HIV infection in children, but there are few studies in the literature about the incidence of clinical manifestations after HAART in this population, compared with adults. The aim of this study was to describe the influence of the widespread use of HAART on the development of opportunistic infections and organ-specific diseases in HIV-infected children. Methods An observational study of a cohort of 366 vertically HIV-infected children followed from 1990 to 2006 was carried out. According to the main antiretroviral protocol used, three calendar periods (CPs) were defined and compared: CP1 (1990-1996: no patients on HAART), CP2 (1997-1999: <60% on HAART) and CP3 (2000-2006: >60% on HAART). Results Children experienced a progressive increase in CD4 T cell count (P<0.05) and a decrease in HIV viral load from 1996 onwards (P<0.05). Similarly, rates of death, AIDS, opportunistic infections (bacteraemia, candidosis, cryptosporidiosis and bacterial pneumonia) and organ-specific diseases (wasting syndrome, thrombocytopenia, cardiomyopathy, lymphoid interstitial pneumonia and HIV-associated encephalopathy) were lower in CP2 and CP3 than in CP1. Conclusions This study provides evidence of improved clinical outcomes in HIV-infected children over time and shows that mortality, AIDS, opportunistic infections and organ-specific diseases declined as HAART was progressively instituted in this population.

  PMID: 20050937 [PubMed - as supplied by publisher]

• Association between plasma levels of eotaxin (CCL-11) and treatment response to interferon-alpha and ribavirin in HIV/HCV co-infected patients. -

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  Association between plasma levels of eotaxin (CCL-11) and treatment response to interferon-alpha and ribavirin in HIV/HCV co-infected patients.

  J Antimicrob Chemother. 2010 Feb;65(2):303-6

  Authors: Vargas A, Berenguer J, Catalán P, Miralles P, López JC, Cosín J, Resino S

  OBJECTIVES: To analyse the association between plasma chemokine levels at baseline and virological response to interferon-alpha (IFN-alpha) + ribavirin in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co-infected patients. METHODS: We carried out a retrospective study in 109 patients. Chemokines were measured using Multiplex kits using a Luminex 100 Analyzer. Logistic regression was used to evaluate the association between plasma chemokine levels before HCV therapy and virological response at weeks 48 and 72 after starting HCV therapy. RESULTS: Fifty-seven patients out of 103 achieved end of treatment virological response (ETR). In patients achieving ETR, the baseline levels of eotaxin, MCP-1 and MCP-3 were higher than non-responder (NR) patients. Similarly, 51 patients out of 106 achieved sustained virological response (SVR). In patients achieving SVR, the baseline levels of eotaxin and MCP-1 were higher than in NR patients. Plasma levels of eotaxin, MCP-1 and MCP-3 had a significant positive association with ETR, as well as eotaxin and MCP-1 with SVR. However, after stepwise multivariate logistic regression, eotaxin was the only chemokine selected capable of predicting ETR and SVR with odds ratio (OR) of 1.016 (95% CI: 1.004-1.029) and 1.015 (95% CI: 1.002-1.027) for ETR and SVR, respectively. CONCLUSIONS: Our preliminary data suggest that plasma eotaxin levels prior to HCV antiviral therapy may be useful in predicting virological response to HCV treatment with IFN-alpha + ribavirin in HIV/HCV co-infected patients. Further experimental research is necessary to corroborate this hypothesis.

  PMID: 20016018 [PubMed - in process]

• Rate and timing of hepatitis C virus relapse after a successful course of pegylated interferon plus ribavirin in HIV-infected and HIV-uninfected patients. -

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  Rate and timing of hepatitis C virus relapse after a successful course of pegylated interferon plus ribavirin in HIV-infected and HIV-uninfected patients.

  Clin Infect Dis. 2009 Nov 1;49(9):1397-401

  Authors: Medrano J, Barreiro P, Resino S, Tuma P, Rodríguez V, Vispo E, Labarga P, Madejón A, García-Samaniego J, Jiménez-Nácher I, Martín-Carbonero L, Soriano V

  Information on the rate and timing of hepatitis C virus (HCV) relapse after treatment with pegylated interferon plus ribavirin is scarce. Among 604 patients treated for chronic hepatitis C, the 386 who were human immunodeficiency virus (HIV) positive attained an end-of-treatment response less frequently and experienced relapse more often than did the 218 who were HIV negative. However, episodes of HCV relapse occurred before week 12 in most cases, regardless of HIV status.

  PMID: 19814621 [PubMed - indexed for MEDLINE]

• CD81 expression in peripheral blood lymphocytes before and after treatment with interferon and ribavirin in HIV/HCV coinfected patients. -

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  CD81 expression in peripheral blood lymphocytes before and after treatment with interferon and ribavirin in HIV/HCV coinfected patients.

  HIV Med. 2010 Mar;11(3):161-9

  Authors: Micheloud D, González-Nicolás J, Berenguer J, Lorente R, Miralles P, López JC, Cosín J, Catalán P, Muñoz-Fernández M, Resino S

  BACKGROUND: CD81 is expressed on lymphocytes and confers HCV viral infectivity support. The aim of our study was to quantify CD81 expression in peripheral blood B- and T-cells of HCV/HIV-coinfected patients and healthy subjects to examine its association with several HCV virological characteristics and the therapeutic responsiveness to HCV antiviral treatment. METHODS: We carried out a cross-sectional study on 122 naïve patients. For a duration of 48 weeks, 24 out of 122 patients underwent HCV antiviral therapy with interferon (IFN)-alpha and ribavirin. T- and B-cell subsets were analysed by flow cytometry. RESULTS: We found that HIV/HCV coinfected patients with HCV-RNA > or =850 000 IU/mL had lower values of %CD19+CD81-CD62L+ and %CD19+CD62L+; and higher values of CD19+CD81+CD62L- and CD19+CD81+ percentages and absolute counts than patients with HCV-RNA <850 000 IU/mL. Similarly, HIV/HCV coinfected patients with the genotype 1 had lower values of %CD19+CD81-CD62L+ and higher values of CD3+CD81+CD62L- and CD3+CD81+ percentages and absolute counts than patients without genotype 1. Moreover, we found that HIV/HCV coinfected patients had higher values of %CD19+HLA-DR+CD25+, %CD19+CD40+CD25+ and %CD19+CD25+ than healthy control patients. When we studied the B- and T-cell subset kinetics of 24 HIV/HCV coinfected patients on HCV antiviral therapy, we found a significant decrease in CD3+CD81+and CD3+CD81+CD62L- subsets and a significant increase in CD3+CD62L+ and CD3+CD81+CD62L+ percentages and absolute counts, but the variation in these markers disappeared several months after stopping the treatment. CONCLUSIONS: We observed a different pattern of CD81 T-cell and B-cell levels in naïve HIV/HCV coinfected patients according to HCV virological status and their subsequent variations during HCV antiviral treatment. CD81 expression might influence HCV pathogenesis and response to HCV antiviral treatment.

  PMID: 19780859 [PubMed - in process]

• Diagnosis of advanced fibrosis in HIV and hepatitis C virus-coinfected patients via a new noninvasive index: the HGM-3 index. -

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  Diagnosis of advanced fibrosis in HIV and hepatitis C virus-coinfected patients via a new noninvasive index: the HGM-3 index.

  HIV Med. 2010 Jan;11(1):64-73

  Authors: Resino S, Micheloud D, Miralles P, Bellón JM, Vargas A, Catalán P, Alvarez E, Cosín J, Lorente R, López JC, Muñoz-Fernández MA, Berenguer J

  BACKGROUND: Noninvasive tests are increasingly being used for the assessment of liver fibrosis. We aimed to develop a serum index for the identification of advanced fibrosis (F>or=3) in HIV/hepatitis C virus (HCV)-coinfected patients. METHODS: We carried out a cross-sectional study on a group of 195 patients comprised of an estimation group (EG; n=127) and a validation group (VG; n=68) who all underwent liver biopsy and had not received previous interferon therapy. Liver fibrosis was estimated using the METAVIR score. We developed a new serum index (HGM-3) dependent on levels of platelets, alkaline phosphatase, hepatic growth factor, tissue inhibitor of metalloproteinase-1 and hyaluronic acid. RESULTS: In the EG, the area under the receiver operating characteristic curve (AUC-ROC) of HGM-3 for identification of F>or=3 was 0.939 [95% confidence interval (CI) 0.899, 0.979] which was significantly higher than the AUC-ROC of the HGM-2, FIB-4, aspartate aminotransferase to platelet ratio (APRI) and Forns' indexes. With HGM-3 <0.135 for F<3, 57 patients were correctly identified and two patients were misclassified. We found the presence of F<3 with 96.6% certainty. The negative likelihood ratio (LR) was <0.1 and the diagnostic odds ratio (DOR) was >40. With HGM-3 >0.570 in the EG for F>or=3, 31 patients were correctly identified, and five patients were misclassified. We found the presence of F>or=3 with 86.1% certainty. The positive LR was >12 and the DOR was >40. For the VG, the diagnostic accuracy values were similar to the values for the EG. CONCLUSIONS: HGM-3 appears to be an accurate noninvasive method for the diagnosis of bridging fibrosis and cirrhosis in HIV/HCV-coinfected patients.

  PMID: 19686437 [PubMed - in process]

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