27 research outputs found
Long-term benefits of nevirapine-containing regimens: multicenter study with 506 patients, followed-up a median of 9 years
[Abstract] OBJECTIVE: To evaluate long-term outcomes in patients maintaining a nevirapine (NVP)-based regimen.
METHODS: Retrospective, multicenter, cohort study including patients currently receiving an NVP regimen that had been started at least 5 years previously. Demographic, clinical, and analytical variables were recorded.
RESULTS: Median follow-up was 8.9 (5.7-11.3) years. Baseline characteristics: 74% men, 47 years old, 36% drug users, 40% AIDS, 40% HCV+, 51.4% detectable HIV-1 viral load, CD4 count 395 (4-1,421)/μL, 19% CD4 3.37 mmol/L significantly decreased in a subsample with available values. A significant decrease in transaminases, alkaline phosphatase, and Fib4 score was observed, mainly in HCV+ and ARV-naive patients.
CONCLUSIONS: In patients who tolerate NVP therapy, (even those with HCV coinfection), long term benefits may be significant in terms of a progressive improvement in general health status markers and CD4 response, a favorable lipid profile, and good liver tolerability
Effects of Spatial Dispersion on the Casimir Force between Graphene Sheets
The Casimir force between graphene sheets is investigated with emphasis on
the effect from spatial dispersion using a combination of factors, such as a
nonzero chemical potential and an induced energy gap. We distinguish between
two regimes for the interaction - T=0 and . It is found that
the quantum mechanical interaction (T=0 ) retains its distance dependence
regardless of the inclusion of dispersion. The spatial dispersion from the
finite temperature Casimir force is found to contribute for the most part from
Matsubara term. These effects become important as graphene is tailored to
become a poor conductor by inducing a band gap.Comment: 6 pages, 9 figures. Submitted to EP
HTLV-1 infection in solid organ transplant donors and recipients in Spain
Background: HTLV-1 infection is a neglected disease, despite infecting 10–15 million people worldwide and
severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1
associated illnesses due to immunosuppression, screening is being widely considered in the transplantation
setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ
transplants in a survey conducted in Spain.
Methods: All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV
antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients
attended since the year 2008.
Results: A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312
(42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards
represented nearly 80%.
Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients.
Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from
Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed
within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be
removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in
dialysis but otherwise asymptomatic.
Conclusion: The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in
Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ
transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along
with the rapid development of subacute myelopath
Rapid subacute myelopathy following kidney transplantation from HTLV-1 donors: role of immunosuppresors and failure of antiretrovirals
Two kidney transplant recipients from a single donor became infected with HTLV-1 (human T-lymphotropic virus type 1) in Spain. One developed myelopathy 8 months following surgery despite early prescription of antiretroviral therapy. The allograft was removed from the second recipient at month 8 due to rejection and immunosuppressors discontinued. To date, 3 years later, this patient remains infected but asymptomatic. HTLV-1 infection was recognized retrospectively in the donor, a native Spaniard who had sex partners from endemic regions. Our findings call for a reappraisal of screening policies on donor-recipient organ transplantation. Based on the high risk of disease development and the large flux of persons from HTLV-1 endemic regions, pre-transplant HTLV-1 testing should be mandatory in Spain
Prognostic factors of a lower CD4/CD8 ratio in long term viral suppression HIV infected children
Background
Combination antiretroviral therapy (cART) is associated with marked immune reconstitution. Although a long term viral suppression is achievable, not all children however, attain complete immunological recovery due to persistent immune activation. We use CD4/CD8 ratio like a marker of immune reconstitution.
Methods
Perinatal HIV-infected children who underwent a first-line cART, achieved viral suppression in the first year and maintained it for more than 5 years, with no viral rebound were included. Logistic models were applied to estimate the prognostic factors, clinical characteristics at cART start, of a lower CD4/CD8 ratio at the last visit.
Results
146 HIV-infected children were included: 77% Caucasian, 45% male and 28% CDC C. Median age at cART initiation was 2.3 years (IQR: 0.5-6.2). 42 (30%) children received mono-dual therapy previously to cART. Time of undetectable viral load was 9.5 years (IQR: 7.8, 12.5). 33% of the children not achieved CD4/CD8 ratio >1. Univariate analysis showed an association between CD4/CD8 <1 with lower CD4 nadir and baseline CD4; older age at diagnosis and at cART initiation; and a previous exposure to mono-dual therapy. Multivariate analysis also revealed relationship between CD4/CD8 <1 and lower CD4 nadir (OR: 1.002, CI 95% 1.000-1.004) as well as previous exposure to mono-dual therapy (OR: 0.16, CI 95% 0.003-0.720).
Conclusions
CD4/CD8 > 1 was not achieved in 33% of the children. Lower CD4 nadir and previous exposure to suboptimal therapy, before initiating cART, are factors showing independently association with a worse immune recovery (CD4/CD8 < 1)
Transverse emittance measurement in the CERN Proton Synchrotron in view of beam production for the High-Luminosity LHC
Boceprevir plus pegylated interferon/ribavirin to re-treat hepatitis C virus genotype 1 in HIV-HCV co-infected patients : final results of the Spanish BOC HIV-HCV Study
Boceprevir (BOC) was one of the first oral inhibitors of hepatitis C virus (HCV) NS3 protease to be developed. This study assessed the safety and efficacy of BOC + pegylated interferon-α2a/ribavirin (PEG-IFN/RBV) in the retreatment of HIV-HCV co-infected patients with HCV genotype 1. This was a phase III prospective trial. HIV-HCV (genotype 1) co-infected patients from 16 hospitals in Spain were included. These patients received 4 weeks of PEG-IFN/RBV (lead-in), followed by response-guided therapy with PEG-IFN/RBV plus BOC (a fixed 44 weeks was indicated in the case of cirrhosis). The primary endpoint was the sustained virological response (SVR) rate at 24 weeks post-treatment. Efficacy and safety were evaluated in all patients who received at least one dose of the study drug. From June 2013 to April 2014, 102 patients were enrolled, 98 of whom received at least one treatment dose. Seventy-three percent were male, 34% were cirrhotic, 23% had IL28b CC, 65% had genotype 1a, and 41% were previous null responders. The overall SVR rate was 67%. Previous null-responders and cirrhotic patients had lower SVR rates (57% and 51%, respectively). Seventy-six patients (78%) completed the therapy scheme; the most common reasons for discontinuation were lack of response at week 12 (12 patients) and adverse events (six patients). Response-guided therapy with BOC in combination with PEG-IFN/RBV led to an overall SVR rate of 67%, but an SVR rate of only 51% in patients with cirrhosis. The therapy was generally well tolerated. Although the current standards of care do not include BOC + PEG-IFN/RBV, the authors believe that this combination can be beneficial in situations where new HCV direct antiviral agent interferon-free therapies are not available yet