Publications by authors named "Hortensia Alvarez"

Article Synopsis
  • The study measured plasma cytokine levels in 30 elite controllers (EC) of HIV, comprising 15 transient controllers and 15 persistent controllers.
  • Results showed that PWH had higher cytokine levels compared to HIV-uninfected individuals, with EC exhibiting the highest levels.
  • Elevated levels of specific cytokines, IP-10 and MIG, were associated with transient controllers and could help predict the loss of viral control, offering potential biomarkers for future HIV management.
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Background: Interferon-inducible protein-10 (IP-10) and monokine induced by interferon-gamma (MIG) are chemokines recognized as inflammatory biomarkers during HIV-1 infection. We assessed their early and long-term dynamics after initiation of antiretroviral treatment (ART).

Methods: Persons with HIV-1 (PWH) aged>18 years starting their first ART in 2015-2021 in a prospective cohort (n=73) were included.

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Background: There are conflicting data regarding baseline determinants of virological nonsuppression outcomes in persons with human immunodeficiency virus (HIV) starting antiretroviral treatment (ART). We evaluated the impact of different baseline variables in the RESPOND cohort.

Methods: We included treatment-naive participants aged ≥18 who initiated 3-drug ART, in 2014-2020.

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Article Synopsis
  • The study measured cytokines in extracellular vesicles from people with HIV (PWH) who have different control statuses, specifically looking at elite controllers (EC) and their virological control (persistent vs. treated).
  • Results revealed that PWH had higher median levels of EV-associated cytokines compared to HIV-uninfected individuals, with EC showing the highest levels among PWH.
  • Certain cytokines, like IL-18 and IL-3, were identified as key indicators for distinguishing between PWH and uninfected individuals, as well as between different control statuses, suggesting a need for further research on their roles in HIV management.
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Background: Late HIV diagnosis (i.e CD4≤350 cells/µL) is associated with poorer outcomes. However, determinants of long-term mortality and factors influencing immune recovery within the first years after antiretroviral treatment (ART) initiation are poorly defined.

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BACKGROUND Varicella zoster virus (VZV) infection can increase the risk of cerebrovascular disease, involving small and large arteries, especially in immunosuppressed patients with ophthalmic division of the trigeminal nerve involvement. We present the case of a patient with intracerebral VZV vasculopathy without overt clinical manifestation but with abnormal imaging findings in the brain magnetic resonance (MR). CASE REPORT A 59-year-old woman with systemic lupus erythematosus (SLE), without other traditional cardiovascular risk factors, presented to the hospital due to headache, vertical diplopia, decreased of visual acuity of right eye, and disseminated varicella zoster virus (VZV) infection with predominant skin lesions distributed along the ophthalmic division of the right trigeminal nerve.

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Objectives: To pinpoint factors associated with low-level viraemia (LLV) and virological failure (VF) in people living with HIV in the era of high-efficacy antiretroviral treatment (ART) and widespread use of integrase strand transfer inhibitor (INSTIs)-based ART.

Methods: We included adults aged > 18 years starting their first ART between 2015 and 2018 in the Spanish HIV/AIDS Research Network National Cohort (CoRIS). Low-level viraemia was defined as plasma viral load (pVL) of 50-199 copies/mL at weeks 48 and 72 and VF was defined as pVL ≥ 50 copies/mL at week 48 and pVL ≥ 200 copies/mL at week 72.

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Article Synopsis
  • A severely immunosuppressed 28-year-old man with HIV-1 and COVID-19 had a prolonged SARS-CoV-2 infection lasting 15 weeks, marked by a unique Alpha variant with a specific mutation.
  • Despite a robust T-cell immune response against the virus, the individual exhibited signs of immunological exhaustion, which may have contributed to the sustained infection.
  • No significant intra-host evolution of the virus was observed during the prolonged infection, indicating that the virus remained relatively stable despite the prolonged presence in the host.
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Cerebral and spinal cord high-flow arteriovenous fistulae (HFAVF) are part of the spectrum of lesions found in Hereditary Hemorrhagic Telangiectasia (HHT). HFAVF consist of communications between large arteries and veins without interposed nidi or capillary transitions. The association between HHT and cerebral or spinal HFAVF in children has been reported and suggested as a potential marker for HHT.

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Background: The role of extracellular vesicles (EVs) in human immunodeficiency virus (HIV) pathogenesis is unknown. We examine the cellular origin of plasma microvesicles (MVs), a type of ectocytosis-derived EV, the presence of mitochondria in MVs, and their relationship to circulating cell-free mitochondrial deoxyribonucleic acid (ccf-mtDNA) in HIV-infected patients and controls.

Methods: Five participant groups were defined: 30 antiretroviral therapy (ART)-naive; 30 ART-treated with nondetectable viremia; 30 elite controllers; 30 viremic controllers; and 30 HIV-uninfected controls.

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There are no standardized criteria to characterize confirmed protocol-defined virological failure (PDVF) nor the inclusion criteria for the resistance analysis population (RAP) in Phase III randomized clinical trials (RCTs) of initial antiretroviral therapy (ART). We assessed the clinical impact of mismatching between virological non-response (HIV-1 RNA ≥50 copies/mL), confirmed PDVF (48 weeks), and RAP definition in studies with the newest first-line ART. A systematic review of all Phase III RCTs was performed, including preferred once-daily ART (EACS European AIDS guidelines) or recently approved by the US Food and Drug Administration.

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Curing hepatitis C virus (HCV) infection in patients harbouring multiple severe comorbidities is a medical challenge. Evidence-based data are lacking regarding HCV treatment with direct-acting antiviral regimens in particular populations of HCV/HIV-coinfected patients with cirrhosis and chronic kidney disease on haemodialysis. Here, we present the HCV treatment challenges facing a patient with HIV coinfection, prior failure of both HIV-1 and HCV therapy, cirrhosis, end-stage renal failure on haemodialysis, as well as management of drug-drug interactions, especially given the need to receive long-term amiodarone therapy.

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Article Synopsis
  • * Researchers found that the prevalence of significant NS5A RASs was low in the studied cohort, with only 5.5% in G1a patients and none in G3 patients, despite many having other factors that could complicate treatment.
  • * The findings suggest that testing for RASs could help tailor HCV treatment strategies to minimize side effects and shorten treatment duration, especially in patients with high-risk factors.
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Background: Vascular anomalies are a heterogeneous group of disorders seen in children and adults. A standard nomenclature for classification has been offered by the International Society for the Study of Vascular Anomalies. Its application is important for communication among the multiple specialties involved in the care of patients and for planning treatment, as well as for research and billing.

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Article Synopsis
  • The study focused on HCV infection in Northwest Spain and evaluated the effectiveness of the Spanish Strategic Plan for treating it.
  • A total of 387 patients were studied, with a significant number being co-infected with HIV and many having cirrhosis.
  • While 96.5% of treated patients achieved a sustained viral response, about 27.1% of priority patients still needed to start treatment, highlighting gaps in care.
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The immune reconstitution inflammatory syndrome (IRIS) remains a concern in severely immunosuppressed HIV-infected patients after starting antiretroviral therapy. We present an HIV-infected transgender woman with subcutaneous silicone fillers, who simultaneously developed tuberculosis-associated and silicone-related IRIS. We propose a possible connection between IRIS and the autoimmune/inflammatory syndrome induced by adjuvants (ASIA).

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HIV-1 RNAs are generated through a complex splicing mechanism, resulting in a great diversity of transcripts, which are classified in three major categories: unspliced, singly spliced (SS), and doubly spliced (DS). Knowledge on HIV-1 RNA splicing in vivo and by non-subtype B viruses is scarce. Here we analyze HIV-1 RNA splice site usage in CD4+CD25+ lymphocytes from HIV-1-infected individuals through pyrosequencing.

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The impact of mitochondrial DNA haplogroups on the outcome of liver fibrosis was evaluated in 362 hepatitis C virus infection (HCV)-monoinfected and HIV/HCV-coinfected patients (147 and 215, respectively) in clinical follow-up at 2 reference hospitals in the Northwest of Spain. The mitochondrial DNA haplogroup H was the most prevalent (50.3%) in this population.

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Background: Extensively pretreated subjects with virological failure (VF) may receive salvage regimens containing NRTIs with only residual or no activity. Once virological suppression is achieved, their contribution remains elusive.

Methods: This was a multicentre, randomized, prospective study.

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We recently reported the rapid expansion of an HIV-1 subtype F cluster among men who have sex with men (MSM) in the region of Galicia, Northwest Spain. Here we update this outbreak, analyze near full-length genomes, determine phylogenetic relationships, and estimate its origin. For this study, we used sequences of HIV-1 protease-reverse transcriptase and env V3 region, and for 17 samples, near full-length genome sequences were obtained.

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