Publications by authors named "Jose A Perez Molina"

Background: Despite effective antiretroviral therapy, people with HIV (PWH) experience persistent systemic inflammation and increased morbidity and mortality. Modulating the gut microbiome through fecal microbiota transplantation (FMT) represents a novel therapeutic strategy. We aimed to evaluate proteomic changes in inflammatory pathways following repeated, low-dose FMT versus placebo.

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Untargeted metabolomic analysis is a powerful tool used for the discovery of novel biomarkers. Chagas disease (CD), caused by Trypanosoma cruzi, is a neglected tropical disease that affects 6-7 million people with approximately 30% developing cardiac manifestations. The most significant clinical challenge lies in its long latency period after acute infection, and the lack of surrogate markers to predict disease progression or cure.

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Background: In non-endemic countries, malaria can be transmitted through blood donations from imported cases. To ensure standards of quality and safety of human blood, the European Union and Spanish national law, requires a deferral period, or a screening by immunological or genomic test among those donors with potential risk of malaria. Scientific societies, European Committee on Blood Transfusion, and Spanish Society of Haematology and Haemotherapy, refer only to the result of the immunological test.

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Article Synopsis
  • - HIV is now viewed as a chronic disease with positive long-term outcomes, prompting the need for a new care model called the Optimal Care Model (OCM), which helps assess and classify patient complexity for better care.
  • - In a study of 94 adult patients living with HIV, the majority had low complexity and were predominantly cisgender men from Latin America and Africa, with most achieving an undetectable viral load.
  • - The OCM successfully classified many patients, but those with high or extreme complexity often fell into unclassifiable categories, suggesting the need for additional profiles focusing on mental health to enhance patient care.
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Article Synopsis
  • High-speed global travel, migration, and climate change have contributed to the rise of imported infections in Spain from 2012 to 2022, necessitating analysis of these trends.
  • The study used data from the +Redivi network, involving 25 health centres, to assess demographics and diagnostic outcomes related to these infections among various groups, including migrants and travelers.
  • Findings revealed stable rates for some infections like malaria, while others such as schistosomiasis and tuberculosis saw increased diagnoses, highlighting significant interactions based on time and participant demographics.
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Leprosy reactions often require prolonged high-dose steroids or immunosuppressive drugs, putting patients at risk of Pneumocystis jirovecii pneumonia (PJP). However, no PJP cases are reported, possibly due to dapsone treatment for leprosy. In patients with leprosy reactions not receiving dapsone because of toxicity or resistance and requiring long-term immunosuppression, PJP prophylaxis should be considered.

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Article Synopsis
  • Terminology inconsistencies in schistosomiasis cause confusion in data interpretation and clinical descriptions, prompting this study to establish consensus definitions for clinical aspects of the disease in migrants and travelers.
  • The Delphi method was utilized, involving a group of experts from GeoSentinel and TropNet who provided input on the definitions, which were revised and pilot-tested.
  • After several rounds of feedback and analysis, a high level of consensus (79-100% agreement) was achieved for all proposed definitions, which will enhance communication and support future research and guidelines for managing schistosomiasis.
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Article Synopsis
  • The study investigates the CD4/CD8 ratio as a possible marker for mortality risk in people living with HIV, highlighting its potential significance compared to CD4 counts alone.
  • A systematic review and meta-analysis were conducted, analyzing data from 20 studies, revealing that a low CD4/CD8 ratio (below 0.5) correlates with a significantly higher mortality risk.
  • While the analysis couldn't confirm a clear trend regarding CD8+ T-cell counts, it suggests that high counts may negatively affect long-term outcomes, emphasizing the need for standardized measurement protocols in future research.*
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Background: Treatment with benznidazole for chronic Chagas disease is associated with low cure rates and substantial toxicity. We aimed to compare the parasitological efficacy and safety of 3 different benznidazole regimens in adult patients with chronic Chagas disease.

Methods: The MULTIBENZ trial was an international, randomised, double-blind, phase 2b trial performed in Argentina, Brazil, Colombia, and Spain.

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Chagas disease affects approximately 7 million people worldwide in Latin America and is a neglected tropical disease. Twenty to thirty percent of chronically infected patients develop chronic Chagas cardiomyopathy decades after acute infection. Identifying biomarkers of Chagas disease progression is necessary to develop better therapeutic and preventive strategies.

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Chagas disease is currently present in many non-endemic countries and remains a neglected tropical disease globally. A review of the literature identified significant gaps and scarcity of updated information from European countries, with most studies reporting data from Spain and Italy. The index of underdiagnosis may be as high as 70%, affecting mainly females of child-bearing age.

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Purpose: Our aim was to describe non-AIDS-defining cancer (NADC) mortality among people living with HIV (PLWH), to compare it with that of the general population, and to assess potential risk factors.

Methods: We included antiretroviral-naive PLWH from the multicentre CoRIS cohort (2004-2021). We estimated mortality rates and standardised mortality ratios (SMRs).

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Hepatitis B is a major global health problem with high morbidity and mortality. Approximately 296 million people are living with chronic HBV, and 1.5 million new infections are detected each year, even though a highly effective vaccine has been available for decades and viral replication and transmission can be contained with the use of drugs.

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Background: People living with HIV have an increased risk of anal cancer.

Objective: To estimate anal cancer incidence and related risk factors in a national cohort of HIV-infected patients.

Design: Prospective multicenter cohort study.

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Article Synopsis
  • - The study explores how gut microbial communities might influence immune responses and treatment outcomes in patients with chronic Chagas disease, highlighting differences in clinical manifestations among various patient groups.
  • - Researchers analyzed stool samples from 80 participants, revealing that Chagas disease affected gut microbiota structure, with notable enrichment of certain bacteria in patients, while diet did not significantly differ between patients and controls.
  • - The findings suggest that specific microbiota changes could serve as potential biomarkers for Chagas disease, indicating that further investigation into gut bacteria diversity may enhance disease prognosis and management.
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Human papillomavirus can cause preinvasive, high-grade squamous intraepithelial lesions (HSILs) as precursors to cancer in the anogenital area, and the microbiome is suggested to be a contributing factor. Men who have sex with men (MSM) living with human immunodeficiency virus (HIV) have a high risk of anal cancer, but current screening strategies for HSIL detection lack specificity. Here, we investigated the anal microbiome to improve HSIL screening.

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Background: Rickettsioses are emerging zoonotic diseases with worldwide prevalence, recognized as a cause of imported fever in travellers and migrants. Our objective is to describe the microbiological, clinical and epidemiological characteristics of imported rickettsioses in travellers and migrants included in a Spanish collaborative network database.

Methods: This multicentre retrospective observational study was nested in +Redivi, the Cooperative Network for the Study of Infections Imported by Immigrants and Travellers.

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We assessed whether low CD4 count and high viral load (VL) affect the response to currently preferred ART. We performed a systematic review of randomized, controlled clinical trials that analyzed preferred first-line ART and a subgroup analysis by CD4 count (≤ or >200 CD4/μL) or VL (≤ or >100 000 copies/mL). We computed the odds ratio (OR) of treatment failure (TF) for each subgroup and individual treatment arm.

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Introduction: HIV continues to represent a problem of great relevance for public health in Spain. This study aims to carry out an analysis that will provide in-depth knowledge of the resources, clinical care, and management during the diagnosis, follow-up, and treatment phases of HIV infection in Spain.

Methods: In the first phase, a multidisciplinary Scientific Committee designed an information collection tool in the form of a survey.

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Background: Up to 40% of cases of imported malaria in Europe are diagnosed in recently arrived migrants, who generally exhibit asymptomatic or mild symptoms and show low parasitaemia (submicroscopic). The study describes the prevalence of malaria infection among asymptomatic Sub-Saharan African migrants (ASSAM) and compares asymptomatic malaria-infected (AMI) vs non-malaria infected patients.

Methods: An observational, comparative, retrospective study was carried out in ASSAM who underwent a medical examination, between 2010 and 2019 at the National Reference Unit for Tropical Diseases (NRU-Trop) in Madrid, Spain.

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