Publications by authors named "Francisco Fanjul"

Objective: With HIV now a chronic condition and an aging population, understanding the evolving profiles of older people with HIV (PWH) is crucial. In this longitudinal study, we examined changes in epidemiological and mortality trends among aging PWH aged 60 and above from 1998 to 2021.

Design: The study constructed four retrospective cohorts based on our calendar periods, reflecting the changing epidemiology of HIV - 1998-2003, 2004-2008, 2009-2014, and 2015-2021.

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  • A study was conducted to create a risk score to predict loss to follow-up (LTFU) in patients living with HIV (PLWH) in Catalonia and the Balearic Islands.
  • The study analyzed 6,661 PLWH and identified key factors contributing to LTFU, including age, nationality, drug use, viral load, and time since diagnosis.
  • The results indicated that a significant portion of PLWH (28.8%) was at medium risk and 3.4% at high risk for LTFU, highlighting the need for targeted interventions to retain patients in HIV care.
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  • The study focused on the impact of SARS-CoV-2 on people living with HIV in the Balearic Islands, specifically examining the incidence and factors contributing to infection and vaccination rates.
  • A total of 3,567 HIV patients were analyzed, revealing a 29% SARS-CoV-2 infection rate, with men who have sex with men being at higher risk, while factors like African origin and vaccination coverage were associated with lower risk.
  • The findings highlighted that vaccination is crucial for preventing SARS-CoV-2 infection, and revealed that older age and higher comorbidity scores led to increased vaccine uptake.
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Introduction: Lung cancer (LC) screening detects tumors early. The prospective GESIDA 8815 study was designed to assess the usefulness of this strategy in HIV + people (PLHIV) by performing a low-radiation computed tomography (CT) scan.

Patients And Methods: 371 heavy smokers patients were included (>20 packs/year), >45 years old and with a CD4+ <200 mm nadir.

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  • * The study analyzed cause of death using a modified protocol and found a significant decrease in all-cause mortality rates, dropping from 9.6 per 1000 person-years to 3.33. Major causes of death now include non-AIDS cancers, cardiovascular disease, and liver diseases.
  • * Key predictors for both AIDS and non-AIDS mortality included factors like age, comorbidities, and ART adherence,
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Objective: To assess neonatal SARS-CoV-2 anti-spike IgG antibody levels after maternal mRNA COVID-19 vaccination and/or infection during pregnancy and evaluate their protective effect.

Methods: Prospective observational study, conducted from January 2021 to December 2022. Infants were tested for anti-spike IgG antibodies at birth and then every 3 months until disappearance of titer.

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  • COVID-19 has a greater impact on migrants and ethnic minorities, including people with HIV, highlighting the need for detailed studies on their risks and outcomes.
  • A study in Catalonia analyzed data from over 10,000 people with HIV, comparing COVID-19 testing, vaccination rates, and clinical outcomes between migrants and Spanish natives.
  • Results showed migrants had lower testing and vaccination rates, faced higher hospitalization and ICU admission rates, but had similar COVID-19 diagnosis rates and mortality compared to non-migrants, indicating the necessity for targeted health policies.
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Background: Shorter duration of symptoms before remdesivir has been associated with better outcomes. Our goal was to evaluate variables associated with the need of ICU admission in a cohort of hospitalized patients for COVID-19 under remdesivir including the period from symptoms onset to remdesivir.

Methods: We conducted a retrospective multicentric study analysing all patients admitted with COVID-19 in 9 Spanish hospitals who received treatment with remdesivir in October 2020.

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Introduction: People living with HIV who are lost to follow-up have a greater risk of health deterioration, mortality, and community transmission.

Objective: Our aim was to analyse both how rates of loss to follow-up (LTFU) changed between 2006 and 2020 and how the COVID-19 pandemic affected these rates in the PISCIS cohort study of Catalonia and the Balearic Islands.

Methods: We analysed socio-demographic and clinical characteristics of LTFU yearly and with adjusted odds ratios to assess the impact of these determinants on LTFU in 2020 (the year of COVID-19).

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We performed a systematic sampling and analysis of airborne SARS-CoV-2 RNA in different hospital areas to assess viral spread. Systematic air filtration was performed in rooms with COVID-19 infected patients, in corridors adjacent to these rooms, to rooms of intensive care units, and to rooms with infected and uninfected patients, and in open spaces. RNA was extracted from the filters and real-time reverse transcription polymerase chain reaction was performed using the LightMix Modular SARS-CoV-2 E-gene.

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Background: Early identification of COVID-19 patients at risk of critical illness is a challenging endeavor for clinicians. We aimed to establish immunological, virological, and routine laboratory markers, which, in combination with clinical information, may allow identifying such patients.

Methods: Blood tests to measure neutrophil/lymphocyte ratio (NLR) and levels of ferritin, CRP, D-dimer, complement components (C3 and C4), cytokines, and lymphocyte subsets, as well as SARS-Cov-2 RT-PCR tests, were performed in COVID-19-confirmed cases within 48 hours of admission.

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Background: A low CD4/CD8 ratio during antiretroviral therapy (ART) identifies people with heightened immunosenescence and increased risk of mortality. We aimed to assess the effects of integrase strand transfer inhibitor (INSTI)-based, protease inhibitor-based, or non-nucleoside reverse transcriptase inhibitor (NNRTI)-based first-line ART on long-term CD4/CD8 ratio recovery.

Methods: This prospective cohort study included 13 026 individuals with HIV registered in the Spanish HIV Research Network (CoRIS) cohort recruited from 45 Spanish hospitals.

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Introduction: Previous studies have reported that the rate of FEV1 decline over time is increased in HIV patients but the mechanisms underlying this observation are unclear. Since current HIV treatment with Highly Active Antiretroviral Therapy (HAART) results in very good immune-viral control, we hypothesized that HAART should normalize the elevated rate of FEV1 decline previously reported in HIV patients if it was somehow related to the immune alterations caused by HIV, particularly in never smokers or quitters, since smoking is a well established risk factor for accelerated FEV1 decline in the general population.

Methods: We explored this hypothesis in a prospectively recruited cohort of 188 HIV (smoker and non-smoker) patients treated with HAART in Palma de Mallorca (Spain) and followed-up for 6 years.

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Background: Interatrial blocks are considered a new important risk factor for atrial fibrillation and cerebrovascular events. Their prevalence and clinical implications have been reported in general population and several subgroups of patients but no data from HIV-infected populations, with a non-negligible prevalence of atrial fibrillation, has been previously reported.

Methods: We conducted a cross-sectional study in a previously enrolled cohort of randomly selected middle-aged HIV-infected patients who attended our hospital and were clinically stable.

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A 30-year-old man, without previous medical record, was admitted to our centre due to persistent hacking cough for the previous 2 months, accompanied by nocturnal sweating, unquantified weight loss and low-grade fever. The patient was finally diagnosed of pulmonary tuberculosis (TB). During admission, a right forehead swelling was detected, painful to palpation, fluctuating and not attached to the skin, without cutaneous alterations or neurological impairment.

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