Hospitalization causes and outcomes in HIV patients in the late antiretroviral era in Colombia / Alicia Inés Hidrón Botero    

Público ISBD Título : Hospitalization causes and outcomes in HIV patients in the late antiretroviral era in Colombia Tipo de documento : documento electrónico Autores : Alicia Inés Hidrón Botero, Fecha de publicación : 2017 Títulos uniformes : AIDS Research and Therapy Idioma : Inglés (eng) Palabras clave : Acquired immune defciency syndrome  Human immunodefciency virus  Hospitalization  Opportunistic infections  Antiretroviral  Adherence Resumen : Background: Antiretroviral therapy (ART) has modifed the natural history of HIV-infection: the incidence of opportunistic nfections (OIs) has decreased and mortality associated to HIV has improved dramatically. The reasons for hospitalization have changed; OIs are no longer the most common reason for admission. This study describes the patient population, admission diagnosis and hospital course of HIV patients in Colombia in the ART era. Methods: Patients admitted with HIV/AIDS at six hospitals in Medellin, Colombia between August 1, 2014 and July 31, 2015 were included. Demographic, laboratory, and clinical data were prospectively collected. Results: 551 HIV-infected patients were admitted: 76.0% were male, the median age was 37 (30–49). A new diagnosis of HIV was made in 22.0% of patients during the index admission. 56.0% of patients of the entire cohort had been diagnosed with HIV for more than 1 year and 68.9% were diagnosed in an advanced stage of the disease. More than 50.0% of patients had CD4 counts less than 200 CD4 cells/μL and viral loads greater than 100,000 copies. The main reasons for hospital admissions were OIs, tuberculosis, esophageal candidiasis and Toxoplasma encephalitis. The median hospital stay was 14 days (IQR 8–23). Admission to the intensive care unit (ICU) was required in 10.3% of patients and 14.3% were readmitted to the hospital; mortality was 5.4%. Conclusions: Similar to other countries in the developing world, in Colombia, the leading cause of hospitalization among HIV-infected patients remain opportunistic infections. However, in-hospital mortality was low, similar to those described for high-income countries. Strategies to monitor and optimize the adherence and retention in HIV programs are fundamental to maximize the beneft of ART. Mención de responsabilidad : María Fernanda Álvarez Barreneche, Carlos Andrés Restrepo Castro, Alicia Hidrón Botero, Juan Pablo Villa Franco, Ivan Mauricio Trompa Romero, Laura Restrepo Carvajal, Alejandro Eusse García, Adriana Ocampo Mesa, Lina María Echeverri Toro, Glenys Patricia Porras Fernández de Castro, Jaime Mauricio Ramírez Rivera, Carlos Andrés Agudelo Restrepo Referencia : AIDS Res Ther. 2017 Nov 13;14(1):60. DOI (Digital Object Identifier) : 10.1186/s12981-017-0186-3 PMID : 29132400 Derechos de uso : CC BY En línea : https://aidsrestherapy.biomedcentral.com/articles/10.1186/s12981-017-0186-3 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Hospitalization causes and outcomes in HIV patients in the late antiretroviral era in Colombia [documento electrónico] / Alicia Inés Hidrón Botero,  . - 2017. Obra : AIDS Research and Therapy Idioma : Inglés (eng) Palabras clave : Acquired immune defciency syndrome  Human immunodefciency virus  Hospitalization  Opportunistic infections  Antiretroviral  Adherence Resumen : Background: Antiretroviral therapy (ART) has modifed the natural history of HIV-infection: the incidence of opportunistic nfections (OIs) has decreased and mortality associated to HIV has improved dramatically. The reasons for hospitalization have changed; OIs are no longer the most common reason for admission. This study describes the patient population, admission diagnosis and hospital course of HIV patients in Colombia in the ART era. Methods: Patients admitted with HIV/AIDS at six hospitals in Medellin, Colombia between August 1, 2014 and July 31, 2015 were included. Demographic, laboratory, and clinical data were prospectively collected. Results: 551 HIV-infected patients were admitted: 76.0% were male, the median age was 37 (30–49). A new diagnosis of HIV was made in 22.0% of patients during the index admission. 56.0% of patients of the entire cohort had been diagnosed with HIV for more than 1 year and 68.9% were diagnosed in an advanced stage of the disease. More than 50.0% of patients had CD4 counts less than 200 CD4 cells/μL and viral loads greater than 100,000 copies. The main reasons for hospital admissions were OIs, tuberculosis, esophageal candidiasis and Toxoplasma encephalitis. The median hospital stay was 14 days (IQR 8–23). Admission to the intensive care unit (ICU) was required in 10.3% of patients and 14.3% were readmitted to the hospital; mortality was 5.4%. Conclusions: Similar to other countries in the developing world, in Colombia, the leading cause of hospitalization among HIV-infected patients remain opportunistic infections. However, in-hospital mortality was low, similar to those described for high-income countries. Strategies to monitor and optimize the adherence and retention in HIV programs are fundamental to maximize the beneft of ART. Mención de responsabilidad : María Fernanda Álvarez Barreneche, Carlos Andrés Restrepo Castro, Alicia Hidrón Botero, Juan Pablo Villa Franco, Ivan Mauricio Trompa Romero, Laura Restrepo Carvajal, Alejandro Eusse García, Adriana Ocampo Mesa, Lina María Echeverri Toro, Glenys Patricia Porras Fernández de Castro, Jaime Mauricio Ramírez Rivera, Carlos Andrés Agudelo Restrepo Referencia : AIDS Res Ther. 2017 Nov 13;14(1):60. DOI (Digital Object Identifier) : 10.1186/s12981-017-0186-3 PMID : 29132400 Derechos de uso : CC BY En línea : https://aidsrestherapy.biomedcentral.com/articles/10.1186/s12981-017-0186-3 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis

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In vivo effect of statins on the expression of the HIV co-receptors CCR5 and CXCR4 / Fabián Alberto Jaimes Barragán    

Público ISBD Título : In vivo effect of statins on the expression of the HIV co-receptors CCR5 and CXCR4 Tipo de documento : documento electrónico Autores : Fabián Alberto Jaimes Barragán, Fecha de publicación : 2013 Títulos uniformes : AIDS Research and Therapy Idioma : Inglés (eng) Palabras clave : HIV infection  statins  CCR5  CXCR4  viral tropism  chemokines Resumen : Background: During the HIV-1 replication cycle, several molecules including chemokine receptors and cholesterol are crucial, and are therefore potential targets for therapeutic intervention. Indeed statins, compounds that inhibit cellular synthesis of cholesterol and have anti-inflammatory and immunomodulatory properties were shown to inhibit HIV-1 infection by R5 tropic strains but not by X4 strains in vitro, mainly by altering the chemokine receptor/ ligands axes. Therefore, the objective of this study was to characterize in vivo, the capacity of statins to modulate in HIV seronegative and chronically HIV-1-infected adults the expression of CCR5 and CXCR4, of their ligands and the tropism of circulating HIV-1 strains. Methods: Samples from asymptomatic HIV-1-infected adults enrolled in a clinical trial aimed at evaluating the antiretroviral activity of lovastatin were used to evaluate in vivo the modulation by lovastatin of CCR5, CXCR4, their ligands, and the shift in plasma viral tropism over one year of intervention. In addition, ten HIV negative adults received a daily oral dose of 40 mg of lovastatin or 20 mg of atorvastatin; seven other HIV negative individuals who received no treatment were followed as controls. The frequency and phenotype of immune cells were determined by flow-cytometry; mRNA levels of chemokine receptors and their ligands were determined by real-time PCR. Viral tropism was determined by PCR and sequencing, applying the clonal and clinical model of analyses. Results: Our study shows that long-term administration of lovastatin in HIV-infected individuals does not induce a shift in viral tropism, or induce a significant modulation of CCR5 and CXCR4 on immune cells in HIV-infected patients. Similar results were found in HIV seronegative control subjects, treated with lovastatin or atorvastatin, but a significant increase in CCL3 and CCL4 transcription was observed in these individuals. Conclusions: These findings suggest that long-term administration of statins at therapeutic doses, does not significantly affect the expression of HIV-1 co-receptors or of their ligands. In addition it is important to point out that based on the results obtained, therapeutic administration of statins in HIV-infected patients with lipid disorders is safe in terms of selecting X4 strains. Mención de responsabilidad : Edwin A Higuita, Fabián A Jaimes, Maria T Rugeles, Carlos J Montoya Referencia : AIDS Res Ther. 2013 May 1;10:10. DOI (Digital Object Identifier) : 10.1186/1742-6405-10-10 PMID : 23634877 Derechos de uso : CC BY En línea : https://aidsrestherapy.biomedcentral.com/articles/10.1186/1742-6405-10-10 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis In vivo effect of statins on the expression of the HIV co-receptors CCR5 and CXCR4 [documento electrónico] / Fabián Alberto Jaimes Barragán,  . - 2013. Obra : AIDS Research and Therapy Idioma : Inglés (eng) Palabras clave : HIV infection  statins  CCR5  CXCR4  viral tropism  chemokines Resumen : Background: During the HIV-1 replication cycle, several molecules including chemokine receptors and cholesterol are crucial, and are therefore potential targets for therapeutic intervention. Indeed statins, compounds that inhibit cellular synthesis of cholesterol and have anti-inflammatory and immunomodulatory properties were shown to inhibit HIV-1 infection by R5 tropic strains but not by X4 strains in vitro, mainly by altering the chemokine receptor/ ligands axes. Therefore, the objective of this study was to characterize in vivo, the capacity of statins to modulate in HIV seronegative and chronically HIV-1-infected adults the expression of CCR5 and CXCR4, of their ligands and the tropism of circulating HIV-1 strains. Methods: Samples from asymptomatic HIV-1-infected adults enrolled in a clinical trial aimed at evaluating the antiretroviral activity of lovastatin were used to evaluate in vivo the modulation by lovastatin of CCR5, CXCR4, their ligands, and the shift in plasma viral tropism over one year of intervention. In addition, ten HIV negative adults received a daily oral dose of 40 mg of lovastatin or 20 mg of atorvastatin; seven other HIV negative individuals who received no treatment were followed as controls. The frequency and phenotype of immune cells were determined by flow-cytometry; mRNA levels of chemokine receptors and their ligands were determined by real-time PCR. Viral tropism was determined by PCR and sequencing, applying the clonal and clinical model of analyses. Results: Our study shows that long-term administration of lovastatin in HIV-infected individuals does not induce a shift in viral tropism, or induce a significant modulation of CCR5 and CXCR4 on immune cells in HIV-infected patients. Similar results were found in HIV seronegative control subjects, treated with lovastatin or atorvastatin, but a significant increase in CCL3 and CCL4 transcription was observed in these individuals. Conclusions: These findings suggest that long-term administration of statins at therapeutic doses, does not significantly affect the expression of HIV-1 co-receptors or of their ligands. In addition it is important to point out that based on the results obtained, therapeutic administration of statins in HIV-infected patients with lipid disorders is safe in terms of selecting X4 strains. Mención de responsabilidad : Edwin A Higuita, Fabián A Jaimes, Maria T Rugeles, Carlos J Montoya Referencia : AIDS Res Ther. 2013 May 1;10:10. DOI (Digital Object Identifier) : 10.1186/1742-6405-10-10 PMID : 23634877 Derechos de uso : CC BY En línea : https://aidsrestherapy.biomedcentral.com/articles/10.1186/1742-6405-10-10 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis

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