Parenteral drug use as the main barrier to hepatitis C treatment uptake in HIV-infected patients.

OBJECTIVES: Our objective was to identify patient factors associated with being untreated for hepatitis C virus (HCV) infection in HIV-coinfected patients. METHODS: A prospective longitudinal study was carried out. HIV-infected patients with active chronic HCV infection included in the HERACLES cohort (NCT02511496) constituted the study population. The main study outcome was receipt of HCV direct-acting antiviral (DAA) treatment from 1 May 2015 to 1 May 2017. The population was divided into patients who were receiving HCV treatment during follow-up and those who were not. RESULTS: Of the 15 556 HIV-infected patients in care, 3075 (19.7%) presented with chronic HCV infection and constituted the study population. At the end of the follow-up, 1957 patients initiated HCV therapy (63.6%). Age < 50 years, absence of or minimal liver fibrosis, being treatment-naïve, HCV genotype 3 infection, being in the category of people who inject drugs using opioid substitutive therapy (OST-PWID), and being in the category of recent PWID were identified as significant independent risk factors associated with low odds of DAA implementation. When a multivariate analysis was performed including only the PWID population, both OST-PWID [odds ratio (OR) 0.552; 95% confidence interval (CI) 0.409-0.746) and recent PWID (OR 0.019; 95% CI 0.004-0.087) were identified as independent factors associated with low odds of treatment implementation. CONCLUSIONS: We identified factors, which did not include prioritization of a DAA uptake strategy, that limited access to HCV therapy. The low treatment uptake in several populations seriously jeopardizes the elimination of HCV infection in the coming years.

Exudado uretral y afectación mucocutánea / Urethral discharge and mucocutaneous involvement

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[Sweet's syndrome and intestinal inflammatory disease. A case report and review of the literature]. / Síndrome de Sweet y enfermedad inflamatoria intestinal. Aportación de un nuevo caso y revisión de la literatura.

Sweet's syndrome, or febrile neutrophilic dermatosis, is a process characterized by fever, red tender plaques, neutrophilia and neutrophilic dermal infiltrate with papilar edema in the absence of vasculitis. The association with intestinal inflammatory disease is inusual, a new case associated with ulcerative colitis is reported, and we perform a literature review of Sweet's associated intestinal inflammatory disease.

Síndrome de Sweet y enfermedad inflamatoria intestinal. Aportación de un nuevo caso y revisión de la literatura / Sweet´s syndrome and intestinal inflammatory disease. A case report and review of the literature

El síndrome de Sweet o dermatosis neutrofílica aguda febril es un proceso caracterizado por fiebre, placas eritematosas dolorosas, neutrofilia y un infiltrado dérmico constituido por neutrófilos con edema papilar sin vasculitis. Su asociación con la enfermedad inflamatoria intestinal es inusual, presentamos un nuevo caso de síndrome de Sweet asociado a colitis ulcerosa, y realizamos una revisión de los casos descritos en la literatura asociados a enfermedad inflamatoria intestinal (AU)

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Tratamiento médico de la endocarditis por Coxiella burnetii / Medical treatment of Coxiella burnetii endocarditis

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