Manual de nutrición y VIH

Alimentació; Seropositius; DietesFeeding; Seropositive; DietsAlimentación; Seropositivos; DietasAquesta publicació pretén ser una eina específica per als professionals sanitaris que faciliti el seguiment mèdic i nutricional de les persones infectades pel virus de la inmunodeficiència humana (VIH) i que contribueixi a millorar la seva qualitat de vida, a més d’ajudar-les a conviure amb la malaltia.Esta publicación pretende ser una herramienta específica para los profesionales sanitarios que facilite el seguimiento médico y nutricional de las personas infectadas por el virus de la inmunodeficiencia humana (VIH) y que contribuya a mejorar su calidad de vida, además de ayudarlas a convivir con la enfermedad.This publication is intended as a specific tool for healthcare professionals who provide medical and nutritional monitoring of people infected with human immunodeficiency virus (HIV) and it aims to contribute to improving their quality of life as well as help them living with the disease

Epidemiological characteristics and predictors of late presentation of HIV infection in Barcelona (Spain) during the period 2001-2009

<p>Abstract</p> <p>Background</p> <p>Early diagnosis of HIV infection can prevent morbidity and mortality as well as reduce HIV transmission. The aim of the present study was to assess prevalence, describe trends and identify factors associated with late presentation of HIV infection in Barcelona (Spain) during the period 2001-09.</p> <p>Methods</p> <p>Demographic and epidemiological characteristics of cases reported to the Barcelona HIV surveillance system were analysed. Late presentation was defined for individuals with a CD4 count below 350 cells/ml upon HIV diagnosis or diagnosis of AIDS within 3 months of HIV diagnosis. Multivariate logistic regression were used to identify predictors of late presentation.</p> <p>Results</p> <p>Of the 2,938 newly diagnosed HIV-infected individuals, 2,507 (85,3%) had either a CD4 cell count or an AIDS diagnosis available. A total of 1,139 (55.6%) of the 2,507 studied cases over these nine years were late presenters varying from 48% among men who have sex with men to 70% among heterosexual men. The proportion of late presentation was 62.7% in 2001-2003, 51.9% in 2004-2005, 52.6% in 2006-2007 and 52.1% in 2008-2009. A decrease over time only was observed between 2001-2003 and 2004-2005 (p = 0.001) but remained constant thereafter (p = 0.9). Independent risk factors for late presentation were older age at diagnosis (p < 0.0001), use of injected drugs by men (p < 0.0001), being a heterosexual men (p < 0.0001), and being born in South America (p < 0.0001) or sub-Saharan Africa (p = 0.002).</p> <p>Conclusion</p> <p>Late presentation of HIV is still too frequent in all transmission groups in spite of a strong commitment with HIV prevention in our city. It is necessary to develop interventions that increase HIV testing and facilitate earlier entry into HIV care.</p

Manual de nutrición y VIH

Alimentació; Seropositius; DietesFeeding; Seropositive; DietsAlimentación; Seropositivos; DietasAquesta publicació pretén ser una eina específica per als professionals sanitaris que faciliti el seguiment mèdic i nutricional de les persones infectades pel virus de la inmunodeficiència humana (VIH) i que contribueixi a millorar la seva qualitat de vida, a més d’ajudar-les a conviure amb la malaltia.Esta publicación pretende ser una herramienta específica para los profesionales sanitarios que facilite el seguimiento médico y nutricional de las personas infectadas por el virus de la inmunodeficiencia humana (VIH) y que contribuya a mejorar su calidad de vida, además de ayudarlas a convivir con la enfermedad.This publication is intended as a specific tool for healthcare professionals who provide medical and nutritional monitoring of people infected with human immunodeficiency virus (HIV) and it aims to contribute to improving their quality of life as well as help them living with the disease

Development and validation of a risk score for predicting non-adherence to antiretroviral therapy

Several patient-related factors that influence adherence to antiretroviral therapy (ART) have been described. However, studies that propose a practical and simple tool to predict nonadherence after ART initiation are still scarce. In this study, we develop and validate a score to predict the risk of nonadherence in people starting ART. The model/score was developed and validated using a cohort of people living with HIV starting ART at the Hospital del Mar, Barcelona, between 2012 and 2015 (derivation cohort) and between 2016 and 2018 (validation cohort),. Adherence was evaluated every 2 months using both pharmacy refills and patient self-reports. Nonadherence was defined as taking <90% of the prescribed dose and/or ART interruption for more than 1 week. Predictive factors for nonadherence were identified by logistic regression. Beta coefficients were used to develop a predictive score. Optimal cutoffs were identified using the bootstrapping methodology, and performance was evaluated with the C statistic. Our study is based on 574 patients: 349 in the derivation cohort and 225 in the validation cohort. A total of 104 patients (29.8%) of the derivation cohort were nonadherent. Nonadherence predictors were patient prejudgment; previous medical appointment failures; cultural and/or idiomatic barriers; heavy alcohol use; substance abuse; unstable housing; and severe mental illness. The cutoff point (receiver operating characteristic curve) for nonadherence was 26.3 (sensitivity 0.87 and specificity 0.86). The C statistic (95% confidence interval) was 0.91 (0.87-0.94). These results were consistent with those predicted by the score in the validation cohort. This easy-to-use, highly sensitive, and specific tool could be easily used to identify patients at highest risk for nonadherence, thus allowing resource optimization and achieving optimal treatment goals

Switching to Dolutegravir/lamivudine or Bictegravir/Emtricitabine/Tenofovir alafenamide. A comparative real-world study

Background This real-world study compared the safety and effectiveness of Dolutegravir/lamivudine (D/L) and Bictegravir/Emtricitabine/Tenefovir alafenamide (B/F/T) switch therapy regimens for people living with HIV (PLWH) Methods The retrospective study conducted from April 2019 to November 2022, included PLWH with 200 copies/mL in two consecutive measurements) occurred in 1.1% and 0.9% of patients in the D/L and B/F/T groups, respectively. Notably, one patient in D/L group with severe non-adherence and virologic failure developed resistance mutations. Conclusions Switching to either B/T/F or D/L treatment for PLWH was effective and well tolerated in this real-world study. Treatment discontinuation rates did not significantly differ between the two regimens