[Clinical significance of the sodium content of intravenous antibiotic therapy]. / Trascendencia clínica del contenido en sodio de la antibioticoterapia intravenosa.

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Efectividad y seguridad de la terapia de rescate en pacientes VIH / Safety and effectiveness of salvage therapy in HIV patients

Introducción: En pacientes VIH el tratamiento aplicado tras el fracaso de al menos dos líneas de tratamiento antirretroviral se denomina pauta de rescate. El estudio pretende describir las características de pacientes VIH a los que se aplica pauta de rescate, y conocer la efectividad y seguridad del tratamiento con tipranavir (TPV), darunavir (DRV), enfuvirtida (ENF) y etravirina (ETR) combinados con un régimen antirretroviral optimizado. Pacientes y método Pacientes VIH en tratamiento con ENF, TPV, DRV o ETR, en el servicio de infecciosas de un hospital de tercer nivel, que han estado al menos 12semanas en tratamiento. Se describen las características de los pacientes y se analiza la efectividad, durabilidad y adherencia a los tratamientos. Resultados Se estudian 28 pacientes, con una media de 10 pautas de tratamiento antes del inicio con pauta de rescate (DE=3,5) (IC 95%: 8,9-11,1). En el 85,7% de las pautas los pacientes presentaron una adherencia del >90%. El 70,8% de las líneas con ENF se suspendieron durante el seguimiento. Tras la pauta de rescate se duplicó el porcentaje de casos con carga viral (CV)<400copias/ml y casi se triplicaron los casos con CV indetectable (<50copias/ml). Los tratamientos empleados no produjeron alteraciones a nivel hepático o renal, pero alteraron el perfil lipídico y aumentó el porcentaje de pacientes con hiperglucemia. Conclusiones Las pautas de rescate estudiadas han sido efectivas. La buena adherencia del paciente al tratamiento es primordial para la efectividad del mismo (AU)

Introduction: The treatment used after failure of at least two lines of antiretroviral treatment in HIV patients is called salvage therapy. The study aims to describe the characteristics of HIV patients subjected to such a regimen, and determine the safety and effectiveness of treatment with tipranavir (TPV), darunavir (DRV), enfuvirtide (ENF) and etravirine (ETR) combined with an optimised antiretroviral regimen. Patients and methods: HIV patients treated with ENF, TPV, DRV or ETR in a tertiary hospital infectious diseases department subjected to at least 12 weeks treatment. The patient characteristics are described and the effectiveness, durability and adherence to the treatment analysed. Results: There were 28 patients studied, with an average of 10 treatment regimens prior tostarting salvage therapy (SD = 3.5; 95 % CI, 8.9-11.1). A total of 85.7 % patients had treatment adherence > 90 %. For ENF, 70.8 % of the treatment lines were suspended during follow-up. After salvage therapy, the percentage of patients with viral load (VL) < 400 copies/ml doubled, and cases with undetectable CV (< 50 copies/ml) almost tripled. The treatments used did not change the liver or kidney profiles; however, they changed the lipid profile and increased the percentage of patients with hyperglycaemia. Conclusions: The salvage therapy studied was effective. Good adherence to the therapy is critical for its effectiveness (AU)

[Safety and effectiveness of salvage therapy in HIV patients]. / Efectividad y seguridad de la terapia de rescate en pacientes VIH.

INTRODUCTION: The treatment used after failure of at least two lines of antiretroviral treatment in HIV patients is called salvage therapy. The study aims to describe the characteristics of HIV patients subjected to such a regimen, and determine the safety and effectiveness of treatment with tipranavir (TPV), darunavir (DRV), enfuvirtide (ENF) and etravirine (ETR) combined with an optimised antiretroviral regimen. PATIENTS AND METHODS: HIV patients treated with ENF, TPV, DRV or ETR in a tertiary hospital infectious diseases department subjected to at least 12 weeks treatment. The patient characteristics are described and the effectiveness, durability and adherence to the treatment analysed. RESULTS: There were 28 patients studied, with an average of 10 treatment regimens prior to starting salvage therapy (SD=3.5; 95% CI, 8.9-11.1). A total of 85.7% patients had treatment adherence >90%. For ENF, 70.8% of the treatment lines were suspended during follow-up. After salvage therapy, the percentage of patients with viral load (VL) <400 copies/ml doubled, and cases with undetectable CV (<50 copies/ml) almost tripled. The treatments used did not change the liver or kidney profiles; however, they changed the lipid profile and increased the percentage of patients with hyperglycaemia. CONCLUSIONS: The salvage therapy studied was effective. Good adherence to the therapy is critical for its effectiveness.