Factors influencing hepatitis C cure in the era of direct-acting antivirals. / Factores que influyen en la curación de la hepatitis C en la era de los antivirales de acción directa.

Direct-acting antiviral agents are highly potent drugs with a strong genetic barrier. Consequently, the factors influencing hepatitis C cure have been reduced and have progressively lost importance. Host factors, such as the presence of cirrhosis, race, and treatment adherence, influence sustained viral response. Adherence, together with treatment errors and drug interactions, are also important, especially in older patients. Viral factors, such as viral load, genotype, and the presence of baseline resistances affect the response rate but their influence can be minimised by using pan-genotypic regimens. Treatment simplification and the high efficacy of new antiviral treatments will allow treatment universalisation and will hopefully enable elimination of the infection in the next few decades. Supplement information: This article is part of a supplement entitled "The value of simplicity in hepatitis C treatment", which is sponsored by Gilead. © 2019 Elsevier España, S.L.U. All rights reserved.

[Endocarditis due to Bartonella spp. Three new clinical cases and Spanish literature review]. / Endocarditis por Bartonella spp. Aportación de tres nuevos casos y revisión de la literatura nacional.

INTRODUCTION: Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis. METHODS: Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain. RESULTS: Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement. CONCLUSION: Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp.

Meningitis por Cryptococcus gattii: descripción de un caso autóctono en España / No disponible

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Endocarditis por Bartonella spp. Aportación de tres nuevos casos y revisión de la literatura nacional / Endocarditis due to Bartonella spp. Three new clinical cases and Spanish literature review

Introducción. Las infecciones por Bartonella spp. incluyen un amplio espectro de enfermedades infecciosas (emergentes y reemergentes), entre las que figura la endocarditis con hemocultivo negativo. Métodos. Descripción de tres nuevos casos de endocarditis por Bartonella spp. y revisión de los casos publicados en España. Resultados. Con la aportación de estos tres nuevos casos de endocarditis por Bartonella spp., se describen en España un total de 6 casos. De forma global la media de edad fue de 51,6 años y el 83,3% eran varones. En el 66,7% de los pacientes existía el antecedente de contacto con gatos y en el 50% el de alcoholismo. Sólo un paciente presentó una valvulopatía previa. No existen manifestaciones clínicas propias de alguna de las especies de Bartonella. La válvula más afectada fue la aórtica. El agente responsable de todos los casos de endocarditis fue B. henselae. El diagnóstico se realizó mediante serología en 5 pacientes (83,3%). Todos los casos evolucionaron de forma favorable, si bien en 4 casos (66,7%) fue preciso el recambio valvular. Conclusión. La endocarditis por Bartonella spp. está presente en nuestro medio y sin duda subestimada. Esta entidad debe ser sospechada en pacientes con hemocultivos negativos y antecedentes epidemiológicos relacionados tales como alcoholismo crónico, ausencia de vivienda habitual, contacto con gatos y picaduras por pulgas o piojos, así como en aquellos pacientes con endocarditis y con serologías positivas frente a Chlamydia spp (AU)

Introduction. Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis. Methods. Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain. Results. Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement. Conclusion. Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp (AU)

Tenosinovitis por Criptococcus neoformans en paciente con sida / Tenosynovitis in a patient with AIDS

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