Does the Recovery of Respiratory Viruses Impact Pulmonary Function at Baseline and 1-, 6-, and 12-Month Follow-Up in People Living with HIV and Pneumonia?

The frequency of respiratory viruses in people living with HIV (PLHIV) and their impact on lung function remain unclear. We aimed to determine the frequency of respiratory viruses in bronchoalveolar lavage and induced sputum samples in PLHIV and correlate their presence with lung function. A prospective cohort of adults hospitalized in Medellín between September 2016 and December 2018 included three groups: group 1 = people diagnosed with HIV and a diagnosis of community-acquired pneumonia (CAP), group 2 = HIV, and group 3 = CAP. People were followed up with at months 1, 6, and 12. Clinical, microbiological, and spirometric data were collected. Respiratory viruses were detected by multiplex RT-PCR. Sixty-five patients were included. At least 1 respiratory virus was identified in 51.9%, 45.1%, and 57.1% of groups 1, 2 and 3, respectively. Among these, 89% of respiratory viruses were detected with another pathogen, mainly Mycobacterium tuberculosis (40.7%) and Pneumocystis jirovecii (22.2%). The most frequent respiratory virus was rhinovirus (24/65, 37%). On admission, 30.4% of group 1, 16.6% of group 2, and 50% of group 3 had airflow limitation, with alteration in forced expiratory volume at first second in both groups with pneumonia compared to HIV. Respiratory viruses are frequent in people diagnosed with HIV, generally coexisting with other pathogens. Pulmonary function on admission was affected in patients with pneumonia, improving significantly in the 1st, 6th, and 12th months after CAP onset.

Markers of Inflammation, Tissue Damage, and Fibrosis in Individuals Diagnosed with Human Immunodeficiency Virus and Pneumonia: A Cohort Study.

Previous studies have noted that persons living with human immunodeficiency virus (HIV) experience persistent lung dysfunction after an episode of community-acquired pneumonia (CAP), although the underlying mechanisms remain unclear. We hypothesized that inflammation during pneumonia triggers increased tissue damage and accelerated pulmonary fibrosis, resulting in a gradual loss of lung function. We carried out a prospective cohort study of people diagnosed with CAP and/or HIV between 2016 and 2018 in three clinical institutions in Medellín, Colombia. Clinical data, blood samples, and pulmonary function tests (PFTs) were collected at baseline. Forty-one patients were included, divided into two groups: HIV and CAP (n = 17) and HIV alone (n = 24). We compared the concentrations of 17 molecules and PFT values between the groups. Patients with HIV and pneumonia presented elevated levels of cytokines and chemokines (IL-6, IL-8, IL-18, IL-1RA, IL-10, IP-10, MCP-1, and MIP-1ß) compared to those with only HIV. A marked pulmonary dysfunction was evidenced by significant reductions in FEF25, FEF25-75, and FEV1. The correlation between these immune mediators and lung function parameters supports the connection between pneumonia-associated inflammation and end organ lung dysfunction. A low CD4 cell count (<200 cells/µL) predicted inflammation and lung dysfunction. These results underscore the need for targeted clinical approaches to mitigate the adverse impacts of CAP on lung function in this population.

A new emerging zoonotic virus of concern: the 2019 novel Coronavirus (SARS CoV-2) / Un nuevo virus zoonótico emergente de preocupación: el Coronavirus novel 2019

We review here the origin, outbreak characteristics and main epidemiological features of the novel Coronavirus (2019nCoV) responsible of a new coronavirus disease (COVID-19). Rapid global health authorities' responses are now in course and international scientific collaboration is urgently need. Previous outbreaks experiences with similar viral agents have increased the capacity to containment and control of these recurrent health menaces.

Revisamos aquí el origen, características del brote y la epidemiología del nuevo Coronavirus (2019nCoV) responsable de una nueva enfermedad por coronavirus (COVID-19). Una rápida respuesta de las autoridades de salud mundiales está en marcha y se ha hecho un llamado urgente para colaboración científica internacional. Las lecciones aprendidas de brotes previos con agentes virales similares han aumentado las capacidades para contener y controlar estas amenazas recurrentes a la salud global.

Inflammatory Cell Differentiation and Chemotaxis and Extracellular Tissue Repair Markers Are Correlated with Pulmonary Dysfunction in HIV Infected Individuals Presenting with Community-Acquired Pneumonia.

Prior studies have shown that HIV patients develop permanent pulmonary dysfunction following an episode of community-acquired pneumonia (CAP). However, the mechanism causing pulmonary dysfunction remains an enigma. HIV patients experience chronic inflammation. We hypothesized that CAP exacerbates inflammation in HIV patients resulting in an accelerated decline in lung function. A prospective cohort pilot study enrolled HIV patients hospitalized in Medellin, Colombia, with a diagnosis of CAP. Sixteen patients were eligible for the study; they were split into 2 groups: HIV and HIV+CAP. Plasma, sputum, and pulmonary function test (PFT) measurements were retrieved within 48 h of hospital admission and at 1 month follow-up. The concentrations of 13 molecules and PFT values were compared between the 2 cohorts. The HIV+CAP group had lower lung function compared to the HIV group; forced vital capacity (FVC)% predicted and forced expiratory volume in 1 s (FEV1)% predicted decreased, while FEV1/FVC remained constant. APRIL, BAFF, CCL3, and TIMP-1 correlated negatively with FVC% predicted and FEV1% predicted; the relationships however were moderate in strength. Furthermore, the concentrations of BAFF, CCL3, and TIMP-1 were statistically significant between the 2 groups (P ≤ 0.05). Our results indicate that HIV patients with CAP have a different inflammatory pattern and lower lung function compared to HIV patients without CAP. BAFF, CCL3, and TIMP-1 were abnormally elevated in HIV patients with CAP. Future studies with larger cohorts are required to verify these results. In addition, further investigation is required to determine if BAFF, CCL3, and TIMP-1 play a role in the process causing pulmonary dysfunction.

Eficacia de la erradicación del Helicobacter pylori en la prevención del cáncer gástrico: Revisión sistemática y metanálisis / Efficacy of Eradicating Helicobacter Pylori for Prevention of Gastric Cancer: Systematic Review and Meta-Analysis

Esta revisión sistemática y metanálisis ha tenido como objetivo definir la eficacia de la erradicación de Helicobacter pylori sobre la prevención del cáncer gástrico. Realizamos una revisión de la literatura utilizando las principales bases de datos como PUBMED, EMBASE, CINAHL (EBSCO), Google académico, LILACS, Cochrane, ProQuest, disertaciones y tesis, obteniendo 3934 referencias, aplicando los criterios de inclusión y exclusión se seleccionaron 7 experimentos clínicos aleatorizados controlados. Utilizando la valoración de riesgo de sesgos de Cochrane, se evaluó la calidad de los estudios. El análisis estadístico se realizó con REVMAN 5.2. Con un total de 5.552 sujetos, se encontró desarrollo de cáncer gástrico en 55 (2,41%) de 2278 pacientes a quienes se erradicó el H. pylori y en 96 (4,22%) de 2.272 a quienes no se les erradicó, RR: 0,57 (IC= 0,42-0,79). El tiempo de seguimiento osciló entre 3 y 15 años. El análisis de heterogeneidad (Chi cuadrado) tuvo un valor de p no significativo (p= 0,48) confirmando la NO presencia heterogeneidad, permitiendo el metanálisis. Con el gráfico de embudo (Funnel Plot), se descartó el sesgo de publicación y el análisis de sensibilidad no mostró cambios significativos. En conclusión, este estudio sugiere que la erradicación del H. pylori disminuye el riesgo de cáncer gástrico, particularmente en poblaciones de alto riesgo, con una calidad de evidencia moderada. Recomendando en la práctica, la terapia de erradicación de H. pylori como medida de prevención.

The aim of this systematic review and meta-analysis is to determine the efficacy of eradicating Helicobacter pylori for prevention of gastric cancer. We conducted a literature review using major databases including PUBMED, EMBASE, CINAHL (EBSCO), Google Scholar, LILACS, Cochrane, ProQuest Dissertations and Theses. Seven experiments were selected out of the 3,934 references obtained by applying our inclusion and exclusion criteria. All seven were randomized controlled trials. The quality of the studies was assessed with the Cochrane assessment of risk of bias. Statistical analysis was performed with REVMAN 5.2. Out of a total of 5,552 subjects, 55 (2.41%) of the 2,278 patients who had had H. pylori eradicated developed gastric cancer, but 96 (4.22%) of the 2,272 patients who had not had the bacteria eradicated developed gastric cancer (RR: 0.57, CI = 0.42 to 0.79). Follow-up time ranged from 3 to 15 years. The analysis of heterogeneity (Chi square) had a non-significant p value (p = 0.48) confirming the absence of heterogeneity and allowing the meta-analysis. Funnel Plot analysis was used to discard publication bias, and the sensitivity analysis showed no significant changes. In conclusion, this study suggests that eradication of H. pylori reduces the risk of gastric cancer, particularly in high-risk populations with medium quality evidence. We recommend the practice of using eradicate of H. pylori as a preventive measure.