Publications by authors named "Ambrosioni J"

Article Synopsis
  • Study aimed to explore how common liver steatosis (LS) and liver fibrosis (LF) are among people with HIV, and what factors contribute to these liver conditions.
  • In a large cohort study involving over 4,600 people, it was found that 28% showed signs of LS, with this prevalence increasing to 55% in a group with higher cardiovascular risk factors; LF was less common, affecting only about 1-5% across different assessment methods.
  • Key factors linked to LS included current CD4 counts and conditions like diabetes and hypertension, while past use of certain HIV drugs was linked to LF; notably, current treatment with integrase strand transfer inhibitors appeared protective against LF.
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Article Synopsis
  • The study examined SARS-CoV-2 infection rates and risk factors among unvaccinated people living with HIV (PWH), finding an 18% prevalence of infection in this group.
  • It involved testing plasma samples from 4,400 PWH and revealed that a significant portion of those infected were asymptomatic or had mild symptoms.
  • The research concluded that common risk factors included younger age, female sex, MSM status, and syphilis history, while antiretrovirals, including tenofovir, did not protect against SARS-CoV-2 infection.
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Background: Drug-drug interactions between antiretroviral treatment (ART) and cytostatics may have a negative impact in the prognosis of people with HIV (PWH) and cancer.

Objective: The objective of this study is to evaluate the impact of the implementation of interdisciplinary management and the type of ART in PWH diagnosed with lymphoid neoplasms.

Methods: This is a multicentric, retrospective observational cohort study including PWH diagnosed with lymphoid neoplasm who started first-line chemotherapy between 2008 and 2020.

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Introduction: Rapid initiation of ART after HIV diagnosis is recommended for individual and public health benefits. However, certain clinical and ART-related considerations hinder immediate initiation of therapy.

Methods: An open-label, single-arm, single-centre 48-week prospective clinical trial involving ART-naïve HIV-diagnosed adults who started bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) within a week from the first hospital visit, before the availability of baseline laboratory and genotype results.

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Five long-acting (LA) antiretrovirals (ARVs) are currently available in a limited number of countries worldwide for HIV-1 prevention or treatment - cabotegravir, rilpivirine, lenacapavir, ibalizumab, and dapivirine. Implementing use of LA ARVs in routine clinical practice requires significant changes to the current framework of HIV-1 prevention, treatment, and service provision. Given the novelty, complexity, and interdisciplinary requirements of safe and optimal use of LA ARVs, consensus recommendations on the use of LA ARVs will assist clinicians in optimizing use of these agents.

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Five long-acting (LA) antiretrovirals (ARVs) are currently available in a limited number of countries worldwide for HIV-1 prevention or treatment-cabotegravir, rilpivirine, lenacapavir, ibalizumab, and dapivirine. Implementing use of LA ARVs into routine clinical practice requires significant changes to the current framework of HIV-1 prevention, treatment, and service provision. Given the novelty, complexity, and interdisciplinary requirements needed to safely and optimally utilize LA ARVs, consensus recommendations on the use of LA ARVs will assist clinicians in optimizing use of these agents.

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Background: The use of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) is based on the results of robust clinical trials.

Objectives: To assess the effectiveness and safety of BIC/FTC/TAF in treatment-naïve (TN) and treatment-experienced (TE) people with HIV using available real-world cohort studies.

Methods: Systematic review and meta-analysis of publications and communications identified via Boolean search in Medline, PubMed and Embase, and conference abstracts reporting retrospective real-world use of BIC/FTC/TAF, published until 31 January 2024.

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Background: A broadened clinical spectrum of concomitant complications emerges among the escalating incidence of substance use, particularly within the 'chemsex' context. This case exemplifies the profound neurotoxic repercussions and neurological risk of chemsex in a young HIV-positive male and addresses the multifaceted challenges of such evolving paradigms in substance utilization.

Clinical Finding: After consuming cannabis, poppers, methamphetamine, and cocaine, a 28-year-old HIV-positive male exhibited significant neurological and cognitive impairment.

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Background: Vaccination plays a critical role in mitigating the burden associated with yellow fever (YF). However, there is a lack of comprehensive evidence on the humoral response to primary vaccination in the paediatric population, with several questions debated, including the response when the vaccine is administered at early ages, the effect of co-administration with other vaccines, the duration of immunity and the use of fractional doses, among others. This study summarizes the existing evidence regarding the humoral response to primary YF vaccination in infants and children.

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In recent years, the epidemiology and prognosis of HIV infection have undergone significant changes thanks to the recommendation of antiretroviral therapy (ART) for all infected persons, the development of more effective and better tolerated drugs, and preventive measures such as pre-exposure prophylaxis (PrEP). The evolution of ART, now with simple oral and injectable options, has also contributed to improvements in comprehensive HIV treatment and care. With early diagnosis and early initiation of ART, the life expectancy of people with HIV has reached the same as the general population.

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Article Synopsis
  • The study aimed to analyze the effects of drug-drug interactions (DDIs) between antiretrovirals (ARVs) and other medications, including over-the-counter (OTC) drugs, on treatment outcomes in real-world settings.
  • Between March 2019 and May 2023, 139 clinical cases were reviewed, revealing that most interactions involved common ARV boosters and highlighted frequent DDI issues with CNS and cardiovascular drugs as well as OTC medications.
  • The findings emphasize the need for careful medication reconciliation, as OTC drugs often led to reduced efficacy of ARVs and toxicity in certain cases, making real-world case data a vital tool for understanding DDIs in clinical practice.
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Article Synopsis
  • * PWH had higher booster vaccination rates (68.5% vs. 63.1%) than PWoH, particularly among those with advanced HIV profiles, like low CD4 counts.
  • * The study identified factors such as prior SARS-CoV-2 diagnosis, migrant status, and socioeconomic challenges as barriers to primary vaccination for PWH, emphasizing the need for targeted interventions to enhance vaccine access and coverage.
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Background: Decreasing medication burden with raltegravir plus lamivudine in virologically suppressed persons with HIV (PWH) maintained efficacy and was well tolerated at 24 weeks, but more comprehensive data over longer follow-up are required.

Methods: Prospective 48 week extension phase of the raltegravir plus lamivudine arm from a previous 24 week pilot randomized clinical trial in which virologically suppressed PWH were randomized 2:1 to switch to fixed-dose combination 150 mg lamivudine/300 mg raltegravir twice daily or to continue therapy. In this 48 week extension phase, raltegravir was dosed at 1200 mg/day and lamivudine 300 mg/day.

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Background: While both the burden of therapy and the individual drugs in bictegravir/tenofovir alafenamide/emtricitabine (BIC/TAF/FTC) and dolutegravir/lamivudine differ, it is unclear whether their real-life tolerability may be also different.

Methods: Single-centre, clinical cohort analysis of all virologically suppressed persons with HIV (PWH) who were first prescribed bictegravir as BIC/TAF/FTC or dolutegravir as dolutegravir/lamivudine and had taken ≥1 dose of study medication. Major outcomes were discontinuations either for any reason or due to toxicity.

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Background: The European AIDS Clinical Society (EACS) guidelines were revised in 2023 for the 19th time, and all aspects of HIV care were updated.

Key Points Of The Guidelines Update: Version 12.0 of the guidelines recommend the same six first-line treatment options for antiretroviral treatment (ART)-naïve adults as versions 11.

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Background: New regimens may provide better tolerability, convenience, and safety for nonoccupational human immunodeficiency virus (HIV) postexposure prophylaxis (PEP). For this reason, we evaluated the single-tablet regimen of doravirine/lamivudine/tenofovir disoproxil fumarate (DOR/3TC/TDF) for 28 days.

Methods: This was a prospective, open-label, single-arm trial including individuals with potential HIV-1 exposure within 72 hours.

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Introduction: There are no data on community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in the context of the chemsex phenomenon. This study aimed to characterize CA-MRSA-related infections in a cohort of people living with HIV (PLWH) who engage in chemsex.

Methods: At the Hospital Clinic of Barcelona, from February 2018 to January 2022, we analyzed CA-MRSA infections diagnosed in a cohort of PLWH who engage in chemsex.

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Background: We aimed to describe infective endocarditis cases from noncardiac surgery centers, as current knowledge on infective endocarditis is derived mostly from cardiac surgery hospitals.

Methods: An observational retrospective study (2009-2018) was conducted in 9 noncardiac surgery hospitals in Central Catalonia. All adult patients diagnosed with definitive infective endocarditis were included.

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Background: The use of dolutegravir/lamivudine is based on solid clinical trials; however, real-world data remain limited.

Objectives: To provide data on the clinical use and effectiveness of dolutegravir/lamivudine in persons with HIV in a real-world scenario.

Patients And Methods: Retrospective, single-centre and observational study.

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Article Synopsis
  • The study focuses on assessing the effectiveness of [18F]FDG-PET/CT imaging in diagnosing infections related to cardiac implantable electronic devices (CIEDs), aiming to clarify its role compared to traditional methods like transesophageal echocardiography (TEE).
  • Results showed that [18F]FDG-PET/CT had a high specificity (100%) and a sensitivity of 85% for detecting infections, improving the diagnosis of systemic infections when used alongside TEE.
  • The findings suggest that [18F]FDG-PET/CT can help distinguish between local and systemic infections based on uptake in spleen and bone marrow, and it may assist in follow-up care for patients when device removal isn't possible
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Human immunodeficiency virus (HIV) infection is considered a chronic disease. Antiretroviral therapy has allowed persons with HIV (PLWHIV) to achieve the 90-90-90 objectives proposed by the World Health Organization for 2020; but an additional challenge is getting an adequate health-related quality of life. A determining factor in the health-related quality of life of PLWHIV is the health care they perceive to receive.

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Introduction: Infective endocarditis (IE) has undergone important changes in its epidemiology worldwide.

Methods: The study aimed to compare IE epidemiological features and outcomes according to predefined European regions and between two different time periods in the twenty-first century.

Results: IE cases from 13 European countries were included.

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BackgroundEpidemiological and immunovirological features of people living with HIV (PLWH) can vary by sex.AimTo investigate, particularly according to sex, characteristics of PLWH who consulted a tertiary hospital in Barcelona, Spain, in 1982-2020.MethodsPLWH, still in active follow-up in 2020 were retrospectively analysed by sex, age at diagnosis, age at data extraction (December 2020), birth place, CD4+ cell counts, and virological failure.

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