Urinary Tract Infection in HIV/AIDS Patients

Urinary tract infection (UTI) is a common condition around the world, even affecting immunocompromised hosts such as people with human immunodeficiency virus (HIV) infection or acquired immuodeficiency syndrome (AIDS). Due to the anatomical conditions of the urogenital tract, women are more susceptible to UTI. Risk factors throughout life are determinants in the appearance of UTI. The frequency increases especially in women and is associated with sexual activity and pregnancy. In older adults and the elderly, again the frequency of UTI in both genders increases. In women, it is usually related at anatomical and functional sequelae due to parity and gyneco-obstetric surgeries. In old men, prostatic enlargement is an important concern. Chronic degenerative diseases such as diabetes mellitus with complications explain the high frequency of UTI in this population. Currently, the increase in violence and accidents are the leading cause of traumatic injuries with neurological damage, which leads the use of permanent urinary catheter. In patients infected with HIV/AIDS, the disease can be severe and is associated with more complications. The etiology in this population can be diverse, including fungi, parasites, and virus; antimicrobial resistance is a therapeutic challenge. This chapter is a comprehensive review of the epidemiology, pathophysiology, clinical presentation, diagnosis approach, and current treatment of UTIs in HIV/AIDS patients

Alcohol and the Liver: The Return of the Prodigal Son

With the discovery of direct-acting antivirals and the prospective of viral hepatitis becoming curable, alcohol liver disease (ALD) is back to primetime. In the last 20 years, there have been many advances in the understanding of the biology, the psychology and the social and environmental factors associated with this long-known medical problem. Recent information about regional, ethnic, cultural and genetic factors seem to be relevant for the Latin American (LA) population. New approaches based on the new concepts and current information will render better results in the overall management of patients with this problem. Considering alcohol use disorder and ALD as part of the same entity managing it in a multidisciplinary approach seems to be best way to deal with this disease

50 years of Hepatology: The Royal Free Hospital School of Hepatology

Writing about the history of Hepatology would necessarily imply writing about the history of the Liver Unit and the School of Hepatology created by Dr. Sheila Scherlock at the Royal Free Hospital (London). On the 70th anniversary of the creation of the first liver unit (Hammersmith Hospital) this article presents a brief account of the history, organization, structure, educational program and contributions of perhaps the first and the most influential medical research models created for the study of liver diseases: the Royal Free Hospital Liver Unit

Milestones in the discovery of hepatitis C.

The discovery of hepatitis C has been a landmark in public health as it brought the opportunity to save millions of lives through the diagnosis, prevention and cure of the disease. The combined work of three researchers, Alter H, Houghton M and Rice C, which set the basis for the diagnosis, treatment and prevention of hepatitis C apart from laying the ground work for a new approach to study infections in general and developing new antiviral agents. This is a story of a transfusion-associated infection. A series of clinical studies demonstrated the existence of an infectious agent associated with hepatitis. That was followed by the identification of what was later known to be the hepatitis C virus (HCV) and the development of diagnostic tests. It all preceded the full molecular identification and demonstration of a causal effect. Finally it ended up with the development and discovery of a new class of therapeutic drugs, the direct acting antivirals, which are now used not only to cure the disease but most probably, to eliminate the problem. This work started with Dr Alter H who demonstrated that a new virus was responsible for the majority of post-transfusion hepatitis followed by Houghton M who cloned the virus and developed the blood test to identify those cases that carried the virus. Finally, the work of Rice C demonstrated that a cloned HCV produced after applying molecular biology techniques could cause long-standing infection and cause the same disease as the one observed in humans

Identification of hepatitis C virus (HCV) genotypes in infected patients from the west of Mexico

Information about genotypes and associated risk factors in hepatitis C virus (HCV) infected patients in Latin America is limited. The aim of this study was to identify the HCV genotypes and associated risk factors in a group of HCV infected patients from the west of Mexico. Genotyping analysis was performed in 90 patients with positive anti-HCV and HCV-RNA. Genotypes 1 and 2 were found in 61 (67.8%) and 28 (31.1%) patients, respectively, and one with 4c/d genotype (1.1%). The most frequent HCV genotype was la (42.2%), followed by 1b (21.1%) and 2a/c (20%). Coinfection was present in 6.6% in a similar population with genotypes 1a and 1b or with 2a/c and 2b. The most frequent associated risk factor was blood transfusion in 57.8% of cases. However, there was no statistically significant difference between the risk factors analyzed and the acquisition of HCV infection