Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population

Barriers to health care services for migrants living with HIV in Spain

BACKGROUND: In Spain, migrants are disproportionately affected by HIV and experience high rates of late diagnosis. We investigated barriers to health care access among migrants living with HIV (MLWH) in Spain. METHODS: Cross sectional electronic survey of 765 adult HIV-positive migrants recruited within 18 health care settings between July 2013 and July 2015. We collected epidemiological, demographic, behavioral and clinical data. We estimated the prevalence and risk factors of self-reported barriers to health care using multivariable logistic regression. RESULTS: Of those surveyed, 672 (88%) had information on health care access barriers: 23% were women, 63% from Latin America and Caribbean, 14% from Sub-Saharan Africa and 15% had an irregular immigration status. Men were more likely to report barriers than women (24% vs. 14%, P = 0.009). The main barriers were: lengthy waiting times for an appointment (9%) or in the clinic (7%) and lack of a health card (7%). Having an irregular immigration status was a risk factor for experiencing barriers for both men (OR: (4.0 [95%CI: 2.2–7.2]) and women (OR: 10.5 [95%CI: 3.1–34.8]). Men who experienced racial stigma (OR: 3.1 [95%CI: 1.9–5.1]) or food insecurity (OR: 2.1 [95%CI: 1.2–3.4]) were more likely to report barriers. Women who delayed treatment due to medication costs (6.3 [95%CI: 1.3–30.8]) or had a university degree (OR: 5.8 [95%CI: 1.3–25.1]) were more likely to report barriers. CONCLUSION: Health care barriers were present in one in five5 MLWH, were more common in men and were associated to legal entitlement to access care, perceived stigma and financial constraints

Intentos de suicidio atendidos en un centro de salud

ObjetivoDescribir las características de los intentos de suicidio producidos y atendidos en una zona básica de salud (ZBS) en 10 años (junio 1989-diciembre 1998).DiseñoEstudio descriptivo, transversal.EmplazamientoAtención primaria, zona básica de salud de un área rural.PacientesTodos aquellos atendidos por intento de suicidio (55 casos).Mediciones y resultados principalesLos datos se obtuvieron de los partes judiciales recogiendo las siguientes variables: sexo, edad, localidad de residencia, pronóstico, medios utilizados y año del intento. Un 51% era mujer y el 49% varón. La edad media fue 34,07 (DE, 3,82). La localidad de origen en un 96% fue la ZBS. Por lo que atañe al pronóstico, leves, 38%; graves, 49%; muy graves, 7%, y reservado, 4%. El medio utilizado fue en un 44% la ingesta de medicamentos. En los 5 últimos años ocurrió el 72% de los intentos.ConclusionesNo hay diferencias en cuanto a sexos. La mayoría de los sujetos eran menores de 35 años. El medio preferido fue, sobre todo, la ingesta de fármacos. Los intentos de suicidio constituyen un fenómeno en aumento. Es necesario concienciar a las autoridades y a los médicos de atención primaria para poder detectar posibles conductas suicidas.ObjectiveTo describe the characteristics of the suicide attempts attended in a health district over 10 years (June 1989 to December 1998).DesignCross-sectional, descriptive study.SettingPrimary care, rural health district.PatientsEveryone attended after a suicide attempt (55 cases).Main measurements and resultsData of the following variables were obtained from the legal reports: sex, age, place of residence, prognosis, means used and year of attempt. 51% were women and 49% men. Average age was 34.07, SD 3.82. 96% occurred in the health district. 38% had light prognosis, 49% serious, 7% very serious and 4% uncertain. The means used was ingestion of drugs in 44% of cases. 72% of the attempts occurred in the last 5 years.ConclusionsThere were no differences between the sexes. Most of the patients were under 35. Drug overdose was the method of choice. Suicide attempts are on the up. Primary care authorities and doctors need to become more conscious of potentially suicidal conduct

Enhanced electrochemical response of carbon quantum dot modified electrodes

A glassy carbon electrode (GCE) was surface-modified with carbon quantum dots (CQDs) and applied for the effective enhancement of the electrochemical signal for dopamine and uric acid determination. CQDs were prepared from graphite by a green modification of the Hummers method. They were characterized by FTIR-ATR, XPS, solid-state NMR, fluorescence and Raman spectroscopies. TPD-MS analysis was applied to characterize the functionalization of the surface. The CQDs were assembled on the glassy carbon electrode by adsorption because of the large number of carboxy groups on their surface warrants effective adsorption. The modified GCE exhibits a sensitivity that is almost 10 times better than of the bare GCE. The lower limits of detection are 1.3 μM for uric acid and 2.7 μM for dopamine.Fil: Algarra, M.. Universidad de Málaga; EspañaFil: González Calabuig, A.. Universitat Autònoma de Barcelona; EspañaFil: Radotić, K.. University Of Belgrade; SerbiaFil: Mutavdzic, D.. University Of Belgrade; SerbiaFil: Ania, C.O.. Universite D'orleans; FranciaFil: Lazaro Martinez, Juan Manuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Química y Metabolismo del Fármaco. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Instituto de Química y Metabolismo del Fármaco; ArgentinaFil: Jiménez Jiménez, J.. Universidad de Málaga; EspañaFil: Rodríguez Castellón, Enrique. Universidad de Málaga; EspañaFil: del Valle, M.. Universitat Autònoma de Barcelona; Españ

Enhanced electrochemical response of carbon quantum dot modified electrodes

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Enhanced electrochemical response of carbon quantum dot modified electrodes

A glassy carbon electrode (GCE) was surface-modified with carbon quantum dots (CQDs) and applied for the effective enhancement of the electrochemical signal for dopamine and uric acid determination. CQDs were prepared from graphite by a green modification of the Hummers method. They were characterized by FTIR-ATR, XPS, solid-state NMR, fluorescence and Raman spectroscopies. TPD-MS analysis was applied to characterize the functionalization of the surface. The CQDs were assembled on the glassy carbon electrode by adsorption because of the large number of carboxy groups on their surface warrants effective adsorption. The modified GCE exhibits a sensitivity that is almost 10 times better than of the bare GCE. The lower limits of detection are 1.3 μM for uric acid and 2.7 μM for dopamine