[Hepatitis C: New diagnosis and seroconversions in a Madrid sexually transmitted diseases clinic]. / Hepatitis C: nuevos diagnósticos y seroconversiones en una clínica de infecciones de transmisión sexual en Madrid.

OBJECTIVE: The aim of this study was to evaluate the incidence of new hepatitis C virus (HCV) infections, based on their sexual orientation, human immunodeficiency virus (HIV) status, geographical regions and coinfection with other sexually transmitted diseases (STDs). METHODS: This study was carried out at the Sandoval Health Center, reference clinic of Sexually Transmitted Diseases (STDs) in Madrid. All HCV seronegative individuals who were reanalyzed for this virus were included, between January 2010 and December 2016. RESULTS: A total of 59 new diagnoses of HCV were diagnosed. The proportion of men who have sex with men (MSM) diagnosed with HCV was 37% in 2010 and 75% in 2016 and was even higher in the group of coinfected with HIV/HCV (94%). A total of 67 seroconverters for HCV were detected (1.2%) of which 100% were MSM. The proportion of HCV seroconverters with HIV was 89%. CONCLUSIONS: HCV infection continues to be a current health problem, especially in HIV-positive MSM.

Implementing pre-exposure prophylaxis could prevent most new HIV infections in transsexual women and men who have sex with men. / La implementación de la profilaxis preexposición podría evitar la mayoría de las nuevas infecciones por el VIH en hombres que tienen sexo con hombres y mujeres transexuales.

BACKGROUND: Pre-exposure prophylaxis (PrEP) consists of administering antiretroviral drugs to HIV-seronegative individuals who engage in high-risk practices, with the aim of reducing the probability of acquiring the infection. Despite its safety and efficacy, PrEP is still not available within Spain's public healthcare system. The aim of this study was to estimate the preventive impact of adding PrEP to the other preventive measures. We estimated the number of HIV seroconversions that could have been prevented (if PrEP had been available) among initially seronegative transsexual women and men who have sex with men. METHODS: We conducted a descriptive study of recent HIV seroconverters between 2014-2016 in a reference HIV/sexually transmitted infection clinic in Madrid. We analysed the individuals who were indicated PrEP, according to the guidelines of the 2016 AIDS Study Group. The statistical analysis to estimate the HIV infections that could have been prevented (if PrEP had been available) was conducted using Stata 14. RESULTS: We estimated that 195 of the 228 men who have sex with men and transsexual women, with documented HIV seroconversion, were indicated for PrEP. Considering the preventive efficacy reported in European studies, we estimated that 168 HIV seroconversions could have been prevented, which represents 73.7% of the diagnosed infections. CONCLUSIONS: The results confirm the need to promote combined preventive programs against HIV that integrate all possible measures, including PrEP.

[Lipid profile in untreated HIV positive patients. HIV infection: cardiovascular risk factor?]. / Perfil lipídico en pacientes VIH (+) no tratados. Infección VIH: ¿factor de riesgo cardiovascular?

INTRODUCTION: Some cases of HIV+ patients with unexplained vascular disease have been reported and many studies are being performed to determine whether HIV infected individuals have an increased cardio-vascular risk (CVR). We propose: to describe lipid profile of untreated HIV+ patients and to compare it with the HIV- and to assess whether any of the lipid abnormalities influence in CVR estimation. MATERIAL AND METHODS: 407 homosexual males: 251 untreated HIV+ and 156 HIV-. Biochemistry parameters: Total cholesterol (CHOL), HDL-cholesterol (HDL), VLDL-cholesterol, LDL-cholesterol (LDL), triglycerides (TG), apolipoproteins A1 and B (ApoA1 y ApoB) and lipoprotein A. Atherogenic rates: CHOL/HDL, LDL/HDL and log (TG/HDL). HIV+ patients were classified into three groups according to CD4 lymphocytes number. RESULTS: HIV+ patients had lower CHOL, HDL, and ApoA1 and higher CVR rates. These differences showed also between each HIV+ group according to CD4 number and control group HIV-. 76% of the HIV+ patients showed low levels of HDL (less than 40 mg/dL) as compared with 31% of HIV- subjects. CONCLUSION: Untreated HIV+ patients' lipid profile is different from the HIV- subjects; one. There are decreases in HDL and ApoA1 from the beginning of the infection that persis along all the CD4 levels. HDL decrease in HIV infection multiplies global CVR in HIV infected individuals, independently of other risk factors.