Hepatitis C virus resistance to the new direct-acting antivirals

Introduction: The treatment of hepatitis C virus (HCV) infection has dramatically improved in recent years with the widespread use of interferon-free combination regimens. Despite the high sustained virological response (SVR) rates (over 90%) obtained with direct-acting antivirals (DAAs), drug resistance has emerged as a potential challenge. The high replication rate of HCV and the low fidelity of its RNA polymerase result in a high degree of genetic variability in the HCV population, which ultimately explains the rapid selection of drug resistance associated variants (RAVs). Areas covered: Results from clinical trials and real-world experience have both provided important information on the rate and clinical significance of RAVs. They can be present in treatment-naive patients as natural polymorphisms although more frequently they are selected upon treatment failure. In patients engaged in high-risk behaviors, RAVs can be transmitted. Expert opinion: Although DAA failures generally occur in less than 10% of treated chronic hepatitis C patients, selection of drug resistance is the rule in most cases. HCV re-treatment options are available, but first-line therapeutic strategies should be optimized to efficiently prevent DAA failure due to baseline HCV resistance. Considerable progress is being made and next-generation DAAs are coming with pangenotypic activity and higher resistance barrier.Fil: Esposito, Isabella. Hospital Universitario La Paz; EspañaFil: Trinks, Julieta. Hospital Italiano. Instituto de Ciencias Básicas y Medicina Experimental; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Soriano, Vicente. Hospital Universitario La Paz; Españ

Propiedad y riesgo en los inicios de la expansión citrícola valenciana durante el último tercio del siglo XIX

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Response to: Prognostic factors in hospitalized HIV-positive patients with COVID-19: correspondence

[Abstract not available

Phage display selection of HIV specific conserved mimotopes with IgG from long-term non-progressors

Poster presentation Background The aim of this study is to identify conserved epitopes of HIV-1 neutralizing antibodies in polyclonal plasma from LTNP to finally derive vaccine candidates. Materials and methods The presence of neutralizing antibodies in 9 LTNP sera was proved by in vitro neutralization assays. Phage displayed peptide libraries were screened with LTNP IgG. HIV-specific mimotopes were analyzed for homology to the gp120 structure by a software (3DEX) especially developed for this purpose. Mice were immunized with interesting phages and their sera were analyzed for neutralizing activities against HIV-1. Results After biopannings, between 19% and 75% HIV-specific phage clones were identified by ELISA. Mimotope sequences were identified and could be aligned by 3DEX to linear or conformational epitopes on gp120. A peptide specific immune response was detected in sera of immunized mice. The first mice sera analyzed showed neutralizing activities against HIV-1. Conclusion Mimotopes could be selected from LTNP sera that represent conformational epitopes on gp120. Those ones inducing neutralizing antibodies upon immunization potentially are suited to derive vaccine candidates

Intervención psicológica en dolor oncológico: un estudio de revisión

OBJETIVO: Realización de una revisión de la literatura sobre aspectos psicológicos relacionados con el dolor en pacientes oncológicos, así como de los diferentes modelos de intervención psicológica que han mostrado su efectividad en el tratamiento del dolor. MÉTODO: La revisión bibliográfica se realizó a través de las bases de datos Medline y PsycINFO. RESULTADOS Y CONCLUSIONES: Las variables psicológicas relacionadas con el dolor en pacientes oncológicos se encuentran asociadas tanto a factores de personalidad (neuroticismo, introversión-extraversion, locus de control), como psicosociales (distress psicológico, ansiedad, depresión, apoyo social, estrategias de afrontamiento), siendo la intervención que más apoyo científico ha conseguido por su eficacia respecto al alivio del dolor, la que parte desde una perspectiva cognitivo-conductual, aunque también puede resultar de utilidad la empleada desde modelos psico-educativos y la psicoterapia de apoyo. En cualquier caso, la intervención psicológica debe estar encuadrada en el contexto de un tratamiento multidisciplinar, y debe entenderse como una terapia complementaria que facilita y complementa el efecto positivo de otras terapias más centradas en los aspectos físicos de la enfermedad.OBJECTIVE: To realize a review of the existent literature about the psychological aspects related with cancer pain patients as well as the different psychological intervention models that have showed its efficacy in pain treatment. METHODS: Medline and PsycINFO databases were reviewed. RESULTS AND CONCLUSIONS: The psychological variables related with cancer pain are associated with personality factors (neuroticism, introversion, extraversion) as well as psychosocial factors (psychologicaldistress, anxiety, depression, social support, coping strategies), and the cognitive conductual intervention is the perspective that has obtained the most scientific support due to its efficacy in the pain control, although psychoeducation models and support psychotherapy can be useful too. In any case, the psychological intervention must be framed in the context of a multidisciplinary treatment, and must be understood as a complementary therapy that facility and complement the positive effect of other therapies more centred in physical aspects of the illness