Mortality due to non-AIDS-defining cancers among people living with HIV in Spain over 18 years of follow-up

Purpose: Our aim was to describe non-AIDS-defining cancer (NADC) mortality among people living with HIV (PLWH), to compare it with that of the general population, and to assess potential risk factors. Methods: We included antiretroviral-naive PLWH from the multicentre CoRIS cohort (2004-2021). We estimated mortality rates and standardised mortality ratios (SMRs). We used cause-specific Cox models to identify risk factors. Results: Among 17,978 PLWH, NADC caused 21% of all deaths observed during the follow-up. Mortality rate due to NADC was 1.58 (95%CI 1.36, 1.83) × 1000 person-years and lung and liver were the most frequent cancer-related causes of death. PLWH had 79% excess NADC mortality risk compared to the general population with the highest SMR found for Hodgkin lymphoma, anal and liver cancers. The SMRs decreased with age and were the highest in age groups under 50 years. The most important prognostic factor was low CD4 count, followed by smoking, viral hepatitis and HIV transmission through heterosexual contact or injection drug use. Conclusion: Non-AIDS cancers are an important cause of death among PLWH. The excess mortality related to certain malignancies and the association with immunodeficiency, smoking, and coinfections highlights the need for early detection and treatment of cancer in this population.Purpose: Our aim was to describe non-AIDS-defining cancer (NADC) mortality among people living with HIV (PLWH), to compare it with that of the general population, and to assess potential risk factors. Methods: We included antiretroviral-naive PLWH from the multicentre CoRIS cohort (2004-2021). We estimated mortality rates and standardised mortality ratios (SMRs). We used cause-specific Cox models to identify risk factors. Results: Among 17,978 PLWH, NADC caused 21% of all deaths observed during the follow-up. Mortality rate due to NADC was 1.58 (95%CI 1.36, 1.83) × 1000 person-years and lung and liver were the most frequent cancer-related causes of death. PLWH had 79% excess NADC mortality risk compared to the general population with the highest SMR found for Hodgkin lymphoma, anal and liver cancers. The SMRs decreased with age and were the highest in age groups under 50 years. The most important prognostic factor was low CD4 count, followed by smoking, viral hepatitis and HIV transmission through heterosexual contact or injection drug use. Conclusion: Non-AIDS cancers are an important cause of death among PLWH. The excess mortality related to certain malignancies and the association with immunodeficiency, smoking, and coinfections highlights the need for early detection and treatment of cancer in this population.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. This research was supported by CIBER -Consorcio Centro de Investigación Biomédica en Red- (CB21/13/00091), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea – NextGenerationEU, the Gilead Scholarship Program for Biomedical Research (GLD19_00106) and the ISCIII- Miguel Servet CP19CIII—00002 contract.S

Células en división mitótica de <i>Prosthenhystera</i> n. sp. (Digenea: Callodistomidae)

Diferentes estadios de la división celular de una nueva especie de Prosthenhystera.Centro de Estudios Parasitológicos y de Vectore

Mitotic stages of <i>Prosthenhystera</i> n. sp. (Digenea: Callodistomidae), a gallbladder parasite of <i>Bryconamericus ikaa</i> from the lower Iguazú River

Imágenes de la meiosis de Prosthenhystera.Centro de Estudios Parasitológicos y de Vectore

Células en división mitótica de <i>Prosthenhystera</i> n. sp. (Digenea: Callodistomidae)

Diferentes estadios de la división celular de una nueva especie de Prosthenhystera.Centro de Estudios Parasitológicos y de Vectore

Células en división mitótica de <i>Prosthenhystera</i> n. sp. (Digenea: Callodistomidae)

Diferentes estadios de la división celular de una nueva especie de Prosthenhystera.Centro de Estudios Parasitológicos y de Vectore

Mitotic stages of <i>Prosthenhystera</i> n. sp. (Digenea: Callodistomidae), a gallbladder parasite of <i>Bryconamericus ikaa</i> from the lower Iguazú River

Imágenes de la meiosis de Prosthenhystera.Centro de Estudios Parasitológicos y de Vectore

Células en división mitótica de <i>Prosthenhystera</i> n. sp. (Digenea: Callodistomidae)

Diferentes estadios de la división celular de una nueva especie de Prosthenhystera.Centro de Estudios Parasitológicos y de Vectore

Epidemiology and Diagnosis of Tuberculous Lymphadenitis in a Tuberculosis Low-Burden Country

The aim of this article is to describe epidemiological and clinical data of patients with tuberculous lymphadenitis (TL) and evaluate the yield of the diagnostic techniques employed. Retrospective observational study was performed at the Vall d'Hebron University Hospital, Barcelona, Spain. All adult patients with confirmed TL (microbiologically) or probable TL (suspected by clinical presentation, cyto/histopathological features, and clinical improvement after specific treatment) diagnosed from January 2001 to December 2013 were included. One hundred twenty-two patients were included: 78 (63.9%) patients with confirmed diagnosis and 44 (36.1%) patients with probable TL. Seventy (57.4%) patients were nonnative residents. From 83 fine-needle aspiration (FNA) specimens, 54.8% (40/73) showed granulomatous inflammation, 62.5% (40/64) had positive mycobacterial culture, and 73.3% (11/15) tested positive with Xpert MTB/RIF (Cepheid, Sunnyvale, CA). From 62 biopsy samples, 96.8% (60/62) showed granulomatous inflammation, 64.6% (31/48) had positive mycobacterial culture, and 46.1% (6/13) tested positive with Xpert MTB/RIF. TL has increasingly been diagnosed in our setting, mostly because of cases diagnosed in nonnative residents. FNA is an easy and safe technique for the diagnosis of suspected TL, and the yield regarding mycobacterial culture seems to be similar to the obtained with biopsy. The Xpert MTB/RIF test from FNA specimens may increase the accuracy of the TL diagnosis and provides quicker results

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts