J. de la Torre

Ankle-branch index and HIV: the role of antiretrovirals.

To study the relationship between antiretroviral (ARV) treatment and abnormal ankle–branch index (ABI) and to compare the risk factors for altered ABI.

Simplicity and Efficacy of a Once-Daily Antiretroviral Regimen with Didanosine, Lamivudine, and Efavirenz in Naïve Patients: The VESD Study

Abstract Purpose: Our aim was to analyze the efficacy and safety of didanosine-lamivudine-efavirenz in a cohort of HIV patients starting antiretroviral therapy between January and September 2003. Method: We undertook a prospective, open-label, observational, multicenter study. Results: 163 patients were enrolled. Over a 48-week period, plasma HIV RNA levels declined sharply, with a median decrease at the end of the observation time of >4.62 log copies/mL. The proportion of patients achieving a plasma HIV RNA level below 50 copies/mL was 62.9% (intention-to-treat analysis) at the end of the study period. The mean CD4 cell count increased steadily over time by 199 cells/mL. Antiviral efficacy was similar in patients with a baseline HIV RNA level above or below 100,000 copies/mL. Overall, 57 (34.1%) patients interrupted therapy; 9 due to lack of treatment response, 18 due to adverse side-effects, and 30 patients lost to follow-up or who withdrew their consent. Adherence was very high (90%-95%) and quality of life was good or very good in 69%. Conclusion: The once-daily combination of didanosine-lamivudine-efavirenz resulted in sustained viral suppression and was well-accepted by patients under real-life conditions, even immunosuppressed patients and those with a high viral load. Associated adverse events and virological failures were few.

Very low prevalence and no clinical significance of occult hepatitis B in a cohort of HIV-infected patients with isolated anti-HBc seropositivity: the BHOI study.

Abstract Purpose: Data on occult HBV infection in HIV patients are conflicting. We aimed to analyse the prevalence and clinical significance of occult hepatitis B in HIV-infected subjects. Method: An open-label, cross-sectional, multicentre study including all subjects with isolated anti-HBc seropositivity from a cohort of 3,030 HIV-infected patients was undertaken. HBsAg and HBsAb were both negative in all cases, and those patients with acute or convalescent hepatitis B were excluded. HBV DNA was quantified by PCR with a detection limit of 20 IU/mL. Results: We found 5 cases (2.5%) of occult hepatitis B among 202 HIV-patients with isolated anti-HBc. The mean HBV DNA was 66 (15–112) IU/mL, none had symptomatic hepatitis, and their features, including aminotransferase levels, were similar to those without occult HBV infection. Conclusions: Occult hepatitis due to HBV is very unusual in HIV-positive patients with isolated anti-HBc. The use of standard regimens of HAART including drugs with activity against HBV might underestimate the prevalence of occult HBV infection. These patients had a very low viral load, no identifiable risk factors, and no greater risk of hypertransaminasaemia or the development of symptomatic hepatitis.

Severe Crohn's disease in a HIV-HCv Co-infected man.

We report the case of a man 47-year-old, with Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV) infection diagnosis since 1998. When he was twenty, he had been intravenous drug user. In November 2006 he had 608 lymphocytes CD4/μl and a viral load of 12.600 cop/ml of HIV, without antiretroviral treatment (ART), but a HCV viral load of 5.000.000 UI/ml, genotype 1 and portal hypertension in echography. He began treatment with pegylated interferon (p-IFN) and ribavirin at a dose of 180 μg/week and 1500 mg/ day respectively, for his first time, in January 2007. At week 12, the HCV viral load was 185 UI/ml.