Erratic enteric absorption of dolutegravir in a critically ill patient

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Influence of Cytokine Release Syndrome in Severe COVID-19 Patients Treated With Tocilizumab Over the Quantiferon TB Gold Plus Results / Influencia de la tormenta citoquímica de pacientes COVID-19 graves tratados con tocilizumab sobre los resultados del Quantiferon TB Gold Plus

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Validation Protocol of Vitamin D Supplementation in Patients with HIV-Infection.

Hypovitaminosis D and secondary hyperparathyroidism are frequent among HIV-infected patients. As there are no data about the best supplementation therapy both in treatment and in maintenance, we conducted an observational study of 300 HIV-infected patients for whom vitamin D and parathormone (PTH) had been measured in order to validate a protocol of vitamin D supplementation in patients with HIV-infection. Patients with vitamin D deficiency (defined as 25(OH)D < 10 ng/mL), insufficiency (defined as 25(OH)D < 20 ng/mL), or hyperparathyroidism (PTH > 65 pg/mL) were supplemented with cholecalciferol 16.000IU (0.266 mg) weekly (if deficiency) or fortnightly (if insufficiency or high PTH levels). Rates of normalization of 25(OH)D (levels above 20 ng/mL) and PTH levels (<65 pg/mL) were analyzed. Multivariate analysis of factors related to normalization was carried out. With a median follow-up of 2 years, 82.1% of patients with deficiency and 83.9% of cases with insufficiency reached levels above 20 ng/mL. However, only 67.2% of individuals with hyperparathyroidism at baseline reached target levels (<65 pg/mL). Independent factors for not achieving PTH objective were tenofovir (TDF) and protease inhibitors use. In HIV-infected patients with hypovitaminosis, the protocol of cholecalciferol supplementation normalized vitamin D levels regardless of antiretroviral regimen in a high proportion of patients but it was less effective to correct hyperparathyroidism.

Infección y enfermedad tuberculosa en relación con concentraciones plasmáticas de vitamina D / Tuberculosis: Plasma levels of vitamin D and its relation with infection and disease

Fundamento y objetivo: La vitamina D (vitD) interviene en el metabolismo fosfocálcico y la enfermedad ósea, pero también en procesos inflamatorio-infecciosos como la tuberculosis. En el presente estudio se evalúan aspectos clínicos y epidemiológicos de enfermos e infectados por Mycobacterium tuberculosis en quienes se obtuvieron concentraciones plasmáticas de vitD para determinar si existe relación entre el déficit de vitD y el riesgo de desarrollar tuberculosis activa, especialmente las formas más graves. Método: Estudio observacional retrospectivo que incluyó a 86 pacientes con tuberculosis activa y 80 contactos con infección latente, visitados en una unidad especializada, en un período de 2 años. Resultados: Al comparar enfermos con infectados, el déficit de vitD (valores de vitD < 10 ng/ml; odds ratio [OR] 2,02; intervalo de confianza del 95% [IC 95%] 1,04-3,93), el sexo varón (OR 1,9; IC 95% 0,96-3,71) y la raza no caucásica (OR 0,7; IC 95% 0,34-1,42) fueron los factores independientemente asociados al diagnóstico de tuberculosis. Conclusión: A pesar del limitado número de sujetos estudiados, se ha detectado una asociación entre el déficit grave de vitD y la forma de presentación de la tuberculosis (AU)

Background and objective: Vitamin D (vitD) is involved in the phosphor-calcium metabolism and bone pathology, but also in inflammatory and infectious processes such as tuberculosis. The present study evaluates the clinical and epidemiological aspects of active tuberculosis cases and latently infected contacts in whom plasma concentrations of vitD were obtained to determine whether the deficiency of vitD is a risk factor to develop active tuberculosis, especially the more severe forms. Method: Observational, retrospective study that included 86 tuberculosis patients and 80 contacts with latent infection in a 2-year period. Results: When comparing active tuberculosis cases with latent infection contacts, deficiency of vitD (vitD levels <10 ng/mL, odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.04 to 3.93), male sex (OR: 1.9, 95% CI: 0.96 to 3.71) and non-white race (OR: 0.7, 95% CI: 0.34 to 1.42) were factors independently associated with the diagnosis of tuberculosis. Conclusion: Despite the limited number of subjects studied, there was a association between severe deficit of vitD and the presentation of tuberculosis (AU)

[Tuberculosis: plasma levels of vitamin D and its relation with infection and disease]. / Infección y enfermedad tuberculosa en relación con concentraciones plasmáticas de vitamina D.

BACKGROUND AND OBJECTIVE: Vitamin D (vitD) is involved in the phosphor-calcium metabolism and bone pathology, but also in inflammatory and infectious processes such as tuberculosis. The present study evaluates the clinical and epidemiological aspects of active tuberculosis cases and latently infected contacts in whom plasma concentrations of vitD were obtained to determine whether the deficiency of vitD is a risk factor to develop active tuberculosis, especially the more severe forms. METHOD: Observational, retrospective study that included 86 tuberculosis patients and 80 contacts with latent infection in a 2-year period. RESULTS: When comparing active tuberculosis cases with latent infection contacts, deficiency of vitD (vitD levels <10 ng/mL, odds ratio [OR]: 2.02, 95% confidence interval [CI]: 1.04 to 3.93), male sex (OR: 1.9, 95% CI: 0.96 to 3.71) and non-white race (OR: 0.7, 95% CI: 0.34 to 1.42) were factors independently associated with the diagnosis of tuberculosis. CONCLUSION: Despite the limited number of subjects studied, there was a association between severe deficit of vitD and the presentation of tuberculosis.

Effect of probiotics (Saccharomyces boulardii) on microbial translocation and inflammation in HIV-treated patients: a double-blind, randomized, placebo-controlled trial.

BACKGROUND: Microbial translocation has been associated with an increase in immune activation and inflammation in HIV infection despite effective highly active antiretroviral therapy. It has been shown that some probiotics have a beneficial effect by reducing intestinal permeability and, consequently, microbial translocation. OBJECTIVES: To assess changes in microbial translocation and inflammation after treatment with probiotics (Saccharomyces boulardii) in HIV-1-infected patients with virologic suppression. METHODS: A double-blind, randomized, placebo-controlled trial was conducted in 44 nonconsecutive HIV-1-infected patients with viral load of <20 copies per milliliter for at least 2 years. Patients were randomized to oral supplementation with probiotics or placebo during 12 weeks. Markers of microbial translocation (lipopolysaccharide-binding protein [LBP] and soluble CD14), inflammation (interleukin 6 [IL-6], tumor necrosis factor alpha, interferon gamma, high-sensitivity C-reactive protein), and immunological and clinical data were determined before and after the intervention and 3 months after treatment discontinuation. Quantitative variables were compared using the Mann-Whitney U test, and categorical variables were compared using the Fisher exact test. RESULTS: After 12 weeks of treatment, differences between the probiotic arm and the placebo arm were observed in LBP values (-0.30 vs +0.70 pg/mL) and IL-6 (-0.60 vs +0.78 pg/mL). These differences were also noted at 3 months after treatment withdrawal. Qualitative analysis was performed, defining a variable as "decreased" or "increased" from baseline LBP. A significant decrease of LBP at 12 weeks of treatment was observed (57.9% patients in the probiotic group vs 6.2% in the placebo group, P = 0.002). CONCLUSIONS: Treatment with S. boulardii decreases microbial translocation (LBP) and inflammation parameters (IL-6) in HIV-1-infected patients with long-term virologic suppression.

Control de factores de riesgo cardiovascular en pacientes infectados por el VIH con cardiopatía isquémica / Control of cardiovascular risk factors in HIV-infected patients with ischemic heart disease

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Riesgo de necrosis avascular en pacientes con infección por el virus de la inmunodeficiencia humana / No disponible

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Insuficiencia renal aguda asociada al uso de tenofovir combinado con atazanavir en pacientes con infección por el VIH / Acute renal failure associated with the use of tenofovir combined with atazanavir in patients with HIV infection

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