Publications by authors named "Ignacio de Los Santos-Gil"

Objectives: Porphyria cutanea tarda (PCT) is common and usually associated with HCV chronic infection and HFE polymorphisms. Since DAA IFN-free regimens availability, SVR for HCV is nearly a constant and we wonder whether HCV SVR determine PCT evolution.

Methods: Retrospective observational study including patients with HCV associated PCT from the Gastroenterology and Infectious Diseases Departments at our Hospital, treated with DAA (Apr/2015-Apr/2017).

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Background: Cobicistat, dolutegravir and rilpivirine are all modest inhibitors of proximal tubular creatinine secretion (IPTCrS) and hence a moderate and early non-progressive creatinine estimated glomerular filtration rate (Cr-eGFR) reduction has been observed in clinical trials. Data regarding the impact of combination of those drugs on Cr-eGFR, in the clinical practice, are scarcely known.

Methods: Changes in Cr-eGFR after starting darunavir/cobicistat alone or in combination with dolutegravir and/or rilpivirine were studied in a nationwide retrospective cohort study of consecutive HIV-infected patients initiating darunavir/cobicistat.

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Background: There is a lack of consensus regarding the risk of hypertension in HIV-infected patients compared to the general population. Ambulatory blood pressure monitoring (ABPM) is the most accurate method for the hypertension diagnosis. Nevertheless, it is rarely used in HIV clinical care.

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Objectives: To compare the efficacy of sofosbuvir/ledipasvir (SOF/LDV) for 8 weeks (SL8) versus a 12-week course of SOF/LDV (SL12) among HIV/HCV-coinfected patients in clinical practice. In addition we compared sustained virological response (SVR) rates achieved with SL8 in HCV-monoinfected and HIV/HCV-coinfected patients in a real life setting.

Methods: HCV-infected patients were retrospectively selected from the HEPAVIR-DAA and GEHEP-MONO real-life prospective cohorts if they fulfilled the following criteria: 1) Infected with genotype 1; 2) Treatment with SL8 or SL12; 3) Treatment naïve prior to receiving SL8 or SL12; 4) Absence of cirrhosis; 5) Baseline HCV RNA<6 × 10 IU/mL; 6) Reached the scheduled time-point for SVR (SVR12) assessment.

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Objectives: To estimate the prevalence of undiagnosed human immunodeficiency virus (HIV) infection detected by routine testing of patients seeking care in an emergency department and to describe the characteristics associated with new HIV-infection diagnosis.

Material And Methods: Walk-in patients between the ages of 15 and 75 years who required a blood test were included. Routine fourth-generation enzyme-linked immunoassays were performed to detect HIV infection in all samples extracted.

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Objective: HIV/HCV-coinfected patients and hepatitis C virus (HCV) monoinfected subjects are thought to respond equally to direct-acting antiviral (DAA)-based therapy despite the lack of data derived from clinical trials. This study is aimed to evaluate the impact of HIV coinfection on the response to DAA-based treatment against HCV infection in the clinical practice.

Patients And Methods: In a prospective multicohort study, patients who initiated DAA-based therapy at the Infectious Disease Units of 33 hospitals throughout Spain were included.

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Background And Aims: Clinical trials of therapy against chronic hepatitis C virus (HCV) infection including boceprevir (BOC) or telaprevir (TVR) plus pegylated interferon and ribavirin (PR) have reported considerably higher response rates than those achieved with PR alone. This study sought to evaluate the efficacy and safety of triple therapy including BOC or TVR in combination with PR in HIV/HCV-coinfected patients under real-life conditions.

Methods: In a multicentre study conducted in 24 sites throughout five European countries, all HIV/HCV-coinfected patients who initiated a combination of BOC or TVR plus PR and who had at least 60 weeks of follow-up, were analyzed.

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Introduction: In Spain, HIV treatment guidelines are well known and generally followed. However, in some patients there are no plans to initiate ART despite having treatment indications. The current barriers to ART initiation are presented.

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Article Synopsis
  • IL28B genotype can influence how HIV-HCV-coinfected patients respond to treatment with telaprevir and pegylated interferon/ribavirin, but its impact varies.
  • In a study of 129 subjects, the majority were experienced in treatment, and while 73.8% demonstrated undetectable HCV RNA by week 4, the IL28B genotype did not significantly predict this outcome across all patients.
  • However, treatment-naive patients with the favorable IL28B-CC genotype showed better early response rates, indicating that genotype may play a role in initial viral response but not in overall treatment success.
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Rilpivirine (RPV) is a nonnucleoside reverse transcriptase inhibitor (NNRTI) that has been approved for use in treatment-naïve patients and which has potent antiviral activity. Its adverse effects profile differs from that of first-generation NNRTs. The pharmacological interactions produced by RPV are due to its effects on the CYP450 system; RPV is a substrate and mild inducer of CYP3A4.

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Background: The objective of this study was to determine the impact of sustained virologic response (SVR) to pegylated interferon (peg-IFN) plus ribavirin (RBV) on the incidence of liver-related complications and overall mortality in human immunodeficiency virus (HIV)-infected patients with compensated hepatitis C virus (HCV)-related cirrhosis.

Methods: We included in this prospective cohort study 166 coinfected patients with compensated cirrhosis, who received peg-IFN plus RBV, to assess the time from the starting date of HCV therapy to the first hepatic decompensation and death due to any cause.

Results: SVR was observed in 43 (25%) individuals.

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Article Synopsis
  • The study aimed to evaluate how effective pegylated interferon (peg-IFN) plus ribavirin (RBV) is in HIV patients with liver cirrhosis caused by hepatitis C virus (HCV) and identify factors influencing treatment success.
  • In a cohort of 629 HIV/HCV-coinfected patients, only 25% of those with cirrhosis achieved sustained virologic response (SVR) compared to 39% of patients without cirrhosis, suggesting treatment is less effective in cirrhotic patients.
  • Among those with cirrhosis, treatment success varied significantly by HCV genotype, with the highest SVR observed in genotype 3, while side effects led to more treatment discontinu
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Article Synopsis
  • The study evaluates the effectiveness of pegylated interferon combined with ribavirin in treating HIV and hepatitis C virus genotype 4 (HCV-4) coinfected patients.
  • A total of 31.5% of HCV-4 patients achieved a sustained virological response (SVR), which is statistically better compared to 22.7% in those with hepatitis C genotype 1.
  • The IL28B CC genotype is identified as a significant predictor for achieving SVR in HIV/HCV-4-coinfected patients.
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Objectives: To compare the frequency of grade 3 or 4 transaminase elevations (TEs) in HIV/hepatitis C virus (HCV) co-infected patients who started a three-antiretroviral drug regimen including efavirenz or a ritonavir-boosted protease inhibitor (PI/r) and the influence of pre-existing significant hepatic fibrosis or cirrhosis.

Patients And Methods: All pre-treated or treatment-naive HIV/HCV co-infected patients who started an antiretroviral regimen including two nucleos(t)ide reverse transcriptase inhibitors along with efavirenz or a PI/r in seven Spanish centres from January 2007 to December 2009 were included in this prospective study.

Results: Of 262 patients included in this study, 76 (29%) individuals began antiretroviral therapy (ART) including efavirenz and 186 (71%) a PI/r-based combination.

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[Etravirine in special populations].

Enferm Infecc Microbiol Clin

December 2009

The choice of antiretroviral treatment in comorbidities requires thorough knowledge of the interactions, pharmacokinetics and adverse effects of the drug to be used. Most drugs carry some risk in certain processes associated or not with HIV infection and drugs that can be used in these situations are of great interest. The development of etravirine, a new non-nucleoside reverse transcriptase inhibitor, will allow its use in these processes, with a lower risk of secondary effects and therefore of worsening the course of the disease and of treatment withdrawal.

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Background: The aim of this study was to assess the efficacy and safety of pegylated interferon (IFN) plus ribavirin (RBV) in human immunodeficiency virus (HIV) and hepatitis C virus (HCV)-coinfected patients with severe immunodeficiency in a clinical cohort. BACKGROUND. A total of 542 HIV-infected patients receiving treatment with pegylated IFN plus RBV from June 2001 through April 2007 were included in this study.

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Article Synopsis
  • The study aimed to assess the impact of baseline insulin resistance on the sustained virological response in HIV/HCV co-infected patients undergoing pegylated interferon and ribavirin therapy.
  • A total of 155 patients were analyzed, with 36% achieving sustained virological response, but insulin resistance (measured by HOMA) did not significantly influence these outcomes.
  • Key factors associated with better sustained virological response included genotype 3, lower baseline HCV viral load, and higher baseline LDL cholesterol, suggesting insulin resistance is not a crucial predictor in this context.
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Article Synopsis
  • Chronic kidney disease is a common comorbidity in HIV patients, prompting increased research and a need for vigilance in diagnosis.
  • Early investigations are crucial to detect renal issues and prevent further complications when patients first seek care.
  • Nephrotoxicity from certain drugs, particularly tenofovir, is noted, but overall renal toxicity is rare, highlighting the importance of proper patient management and understanding of potential risks.
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Objectives: To compare the response to hepatitis C virus (HCV) therapy among human immunodeficiency virus (HIV)/HCV co-infected patients receiving a nucleos(t)ide reverse transcriptase inhibitor [N(t)RTI] backbone consisting of abacavir plus lamivudine with that observed in subjects who receive tenofovir plus lamivudine or emtricitabine.

Methods: A total of 256 subjects, enrolled in a cohort of 948 HIV-infected patients who received pegylated interferon and ribavirin from October 2001 to January 2006, were included in this study. All patients were taking one protease inhibitor or one non-nucleoside reverse transcriptase inhibitor and abacavir plus lamivudine or tenofovir plus lamivudine or emtricitabine as N(t)RTI backbone during HCV therapy.

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Objectives: To investigate whether concomitant antiretroviral therapy (ART) is a predictor of sustained virological response (SVR) in human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients treated with pegylated interferon plus ribavirin.

Methods: Three hundred and ten HIV/HCV-coinfected patients on pegylated interferon plus ribavirin treatment, 258 of them with concurrent ART, were included in this retrospective multicentre study. The predictors of SVR were evaluated.

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Article Synopsis
  • The study focuses on the methodology and initial findings of the CoRIS project, which tracks naïve HIV-infected patients in Spain from January 2004 to October 2005.
  • Key demographics revealed that among 1,591 participants, a significant proportion were men who have sex with men (37%) and that many patients were diagnosed in 2004 or 2005, with a median age of 36.
  • The results highlight the predominant sexual transmission of HIV in Spain, a median CD4 count of 317 cells/mm³, and various AIDS-related illnesses, indicating the critical need for ongoing research in this area.
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