RESUMEN
BACKGROUND: Increased levels of markers of systemic inflammation have been associated with serious non-AIDS events even in patients on fully suppressive antiretroviral therapy. We explored residual viremia and systemic inflammation markers in patients effectively treated with ritonavir-boosted protease inhibitor monotherapy (PImono). METHODS: HIV-infected adults with persistent HIV-RNA<50 copies/ml and treated with either a) PImono or b) standard triple-drug cART were recruited for this cross-sectional, exploratory study. Plasma samples were tested for high-sensitivity CRP (hsCRP), Serum Amyloid A (SAA), soluble CD14, IL-6, IL-8 and Cytochrome C. HIV-RNA was measured by real-time PCR (detection limit of 10 copies/ml). RESULTS: 81 patients were recruited (31% on PImono). Two out of 25 (8%) and 3 of 56 (5.4%) patients from the PImono and cART groups respectively had detectable HIV-RNA. Significant correlation between SAA and hsCRP was observed (0.804). No difference between groups was found on prevalence of hsCRP>3 mg/l (21% vs 20% in the PImono and cART groups respectively; p=0.577) or SAA>6.4 mg/l (38% vs 22% in the PImono and cART groups respectively; P=0.172). In a univariate analysis IL6 and IL8 levels were associated with SAA>6.4 mg/l (OR=1.74 and 1.46; 95% CI=1.00-3.03 and 1.06-2.01; p=0.051 and 0.02 respectively) and hsCRP>3 mg/l in (OR=2.00 and 1.37; 95% CI=1.09-3.69 and 1.02-1.85; p=0.026 and 0.039 respectively). CONCLUSIONS: We found no evidence of increased levels of inflammatory biomarkers or higher prevalence of residual viraemia in patients effectively suppressed on PImono as compared with patients on standard cART.
Asunto(s)
Infecciones por VIH/tratamiento farmacológico , Inflamación/tratamiento farmacológico , Inhibidores de Proteasas/uso terapéutico , Ritonavir/uso terapéutico , Viremia/tratamiento farmacológico , Adulto , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Estudios Transversales , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/complicaciones , Infecciones por VIH/virología , Inhibidores de la Proteasa del VIH/uso terapéutico , Humanos , Inflamación/sangre , Inflamación/complicaciones , Inflamación/virología , Interleucina-6/sangre , Interleucina-8/sangre , Masculino , Persona de Mediana Edad , Proteína Amiloide A Sérica/análisis , Viremia/complicacionesRESUMEN
Atypical presentations of genital herpes simplex virus have been described in HIV. We report two cases with hypertrophic presentations which were effectively treated with imiquimod, one of which is the first reported case occurring in a patient with HIV-2.