Rosário Serrão

Acute hepatitis E complicated by Guillain-Barré syndrome in Portugal, December 2012 – a case report

Autochthonous hepatitis E virus (HEV) infection has been increasingly reported in Europe and the United States, mostly arising from genotype 3 and less frequently genotype 4. We report here on a patient with HEV genotype 3a infection complicated by Guillain-Barré syndrome in Portugal in December 2012. We draw attention to the diagnosis of autochthonous HEV infection and to its rare, but important, neurological complications.

HIV-2 infection with a long asymptomatic period

We give details of a patient infected with HIV-2 which had what we believe to be the longest asymptomatic period so far reported. The infection was probably acquired though a blood transfusion in Africa 27 years ago. At present the patient remains asymptomatic and her cellular defence mechanisms, evaluated by CD+4 lymphocyte counts and hypersensitivity skin tests, are not severely compromised. HIV-2 has come distinct epidemiological, clinical and biological features which are different from the related HIV-1 and deserve investigation in order for its natural history to be better understood.

Transmission of HIV-2: another perspective

Perpetua Gomes and colleagues’ article on transmission of HIV-2 in Portugal deserves some comments due to features that in our experience could explain the acquisition and dissemination of this virus in our country. The authors report their experience at the Hospital Egas Moniz Lisboa in the south of Portugal where Africans from west Africa were followed. They described 57% of the patients as natives of Guinea-Bissau or Cape Verde; thus 43% were presumably of Portuguese origin. At the Hospital S Joao and School of Medicine Porto located in the north of Portugal from 1985 to September 2003 we have observed 132 (4%) HIV-2-positive patients among 3251 HIV-infected patients. Diagnosis was based on US Centers for Disease Control and Prevention/WHO criteria and all the tests for identification of HIV and monitoring of infection were done at the Molecular Biology Centre in our institution a reference laboratory for Portugal. (excerpt)

Reasons for treatment discontinuation in the first year after beginning antiretroviral therapy in a cohort of Portuguese HIV-infected patients

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK

Primary drug resistance at diagnosis of HIV-1 infection: a Portuguese cohort.

Presence of viral mutations conferring resistance to antiretroviral drugs has potential impact on success of antiretroviral therapy (ART). The aim of this study was to describe the prevalence of resistance‐associated mutations in HIV‐infected patients without prior ART in a Portuguese cohort.

Prevention of mother-to-child transmission: experience of a Portuguese centre.

HIV infection during pregnancy still raises controversial issues. Combined antiretroviral therapy (cART) has been successful in reducing mother‐to‐child transmission (MTCT). Routine screening in pregnancy and in pre‐conception consultation proved to be one of the best methods able to get this treatment on time. We review our experience with pregnant patients with HIV infection.

Characterization of HIV-1 subtypes in a Portuguese cohort

Distribution of HIV‐1 subtypes is variable around the world, with the most common subtype in western Europe being subtype B. The aim our study was to describe the prevalence of different HIV‐1 subtypes in newly diagnosed patients and identify demographic and epidemiological characteristics related with different subtypes.

NON-AIDS-RELATED COMORBIDITIES IN PEOPLE LIVING WITH HIV-1 AGED 50 AND OLDER: THE AGING POSITIVE STUDY

OBJECTIVE To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1-infected population and to explore the factors associated with multiple NARC. METHODS This was a multicentre, cross-sectional study including HIV-1-infected patients aged ≥50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. RESULTS Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B=0.032, 95% confidence interval 0.015-0.049; p=0.0003) and between the duration of HIV-1 infection and NARC (B=0.039, 95% confidence interval 0.017-0.059; p=0.0005). CONCLUSIONS A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.

Ischaemic stroke in HIV-infected patients: a case-control study.

The aim of the study was to provide insights into the contributions of HIV infection stage, antiretroviral therapy (ART) and vascular risk factors to the occurrence of ischaemic stroke in HIV‐infected patients.

CO044. UM EM CADA 5 DOENTES COM INFECÇÃO VIH TÊM HIPOGONADISMO

e o tecido adiposo visceral (VAT) abdominal, que individualmente podem ter contributos diferentes para as alteracoes metabolicas. Os doentes com infeccao VIH sob terapeutica anti-retrovirica (TAR) podem ter alteracoes da composicao corporal, que se podem reflectir em diferente distribuicao do TA. Objetivo: Avaliar a SAT, VAT e razao VAT/SAT avaliada por TC a nivel abdominal: 1) em doentes infectados pelo VIH-1 sob TAR vs controlos nao infectados; 2) em doentes com e sem lipodistrofia definida pela clinica vs controlos; 3) em doentes com lipodistro-fia definida pela “razao massa gorda tronco/membros” (RMGTM) definida por DEXA vs controlos. Metodos: Avaliamos em 173 controlos e 211 doentes com infeccao VIH-1 sob TAR, parâmetros antropometricos e a massa gorda a nivel abdominal determinada por TC SAT, VAT e VAT/SAT, apos ajuste para a idade e IMC. Resultados: Independentemente do genero, a massa gorda total (MGT) e SAT era maior nos controlos do que nas doentes VIH e a razao VAT/SAT era maior nas doentes. Quando considerada a lipodistrofia clinica, nas mulheres, a SAT era maior nos controlos e naquelas sem lipodistrofia, sendo a razao VAT/SAT maior nas com infeccao (com ou sem LC). Nos homens, a MGT e SAT era maior nos controlos e naqueles sem LC; a razao VAT/SAT era maior nos que tinham infeccao (com ou sem LC). Se lipodistrofia definida por RMGTM, observou-se que nas mulheres, a SAT era maior nos controlos e nas sem lipodistrofia e a razao VAT/SAT era maior nas com infeccao (com ou sem lipodistrof ia). Nos homens, a MGT e SAT era maior nos controlos e naqueles sem lipodistrofia; a razao VAT/SAT era maior nos com infeccao (quer com ou sem lipodistrofia). Em ambos os generos observou-se maior VAT nos com lipodistrofia. Conclusao: Observou-se maior VAT/SAT nos doentes infectados, independentemente do genero e da definicao de lipodistrofia utilizada.