Publications by authors named "Knobel H"
Introduction: People with HIV (PWH) with poor immune response despite adequate antiretroviral treatment (ART) are susceptible to non-AIDS-related health issues. This study seeks to evaluate bone quality in Immunological Non-Responders (INRs) in comparison to those with proper immune response (IRs) using in vivo microindentation to quantify bone quality, in addition to conventional bone mineral density (BMD) evaluations.
Methods: A cross-sectional study was conducted at Hospital del Mar in Barcelona from January 2019 to June 2023.
Article Synopsis
- 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.
Background: People with HIV have a substantially higher risk of anal cancer than the general population. We aimed to identify risk factors associated with the development of anal cancer among people with HIV to implement more effective and targeted screening strategies.
Methods: We conducted a multicentre retrospective cohort study in 16 hospitals across Catalonia and the Balearic Islands, Spain, between Jan 1, 1998, and Dec 31, 2022.
Objectives: People living with HIV (PLWH) are common users of complementary and alternative medicine (CAM). The main objective of this study was to study the frequency and patterns of CAM natural products use in a large cohort of PLWH and to identify potential drug-drug interactions (DDIs) and the impact on their antiretroviral treatment (ART) adherence and efficacy.
Methods: This was a cross-sectional multicenter survey including 420 PLWH from different Spanish hospitals.
Article Synopsis
- * 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,
Article Synopsis
- The study assessed the safety and effectiveness of a two-pill HIV treatment regimen (BIC/FTC/TAF plus darunavir/cobicistat) for individuals with a history of treatment difficulties.
- The trial had 63 participants, mainly men, who were stable on a more complex regimen and showed high rates of maintaining low viral loads after 48 weeks.
- Results indicated the new regimen is well-tolerated, potentially enhancing adherence and long-term success in managing HIV for heavily treatment-experienced individuals.
Article Synopsis
- HIV infection causes chronic inflammation, leading to accelerated aging and comorbidities, even with effective antiretroviral treatments (ART).
- This study analyzed circulating microRNAs (miRNAs) in treatment-naïve HIV patients and found significant differences in miRNA levels compared to uninfected individuals, which persisted after one year on ART.
- Results showed elevated miR-21-5p and reduced levels of miR-6503-3p and miR-3135b in HIV patients, suggesting a connection between these miRNAs and inflammation/immune response, particularly with miR-21-5p indicating ongoing issues with inflammation and oxidative stress.
Background: This real-world study compared the safety and effectiveness of Dolutegravir/lamivudine (D/L) and Bictegravir/Emtricitabine/Tenefovir alafenamide (B/F/T) switch therapy regimens for people living with HIV (PLWH).
Methods: The retrospective study conducted from April 2019 to November 2022, included PLWH with < 50 copies/mL of HIV-RNA prior to recruitment who initiated either D/L or B/F/T switching therapy. The primary objective was to evaluate treatment discontinuation rates; safety and virologic outcomes were also evaluated.
Objectives: People with HIV (PWH) have a higher cardiovascular risk than the general population. It remains unclear, however, whether the risk of cardiovascular disease (CVD) is higher in late HIV presenters (LP; CD4 ≤ 350 cells/μL at HIV diagnosis) compared to PWH diagnosed early. We aimed to assess the rates of incident cardiovascular events (CVEs) following ART initiation among LP compared to non-LP.
View Article and Find Full Text PDFDevelopment and Validation of a Risk Score for Predicting Non-Adherence to Antiretroviral Therapy.
AIDS Res Hum Retroviruses
October 2023
Several patient-related factors that influence adherence to antiretroviral therapy (ART) have been described. However, studies that propose a practical and simple tool to predict nonadherence after ART initiation are still scarce. In this study, we develop and validate a score to predict the risk of nonadherence in people starting ART.
View Article and Find Full Text PDFBackground: The impact of tenofovir disoproxil fumarate (TDF) antiretroviral (ART) regimens on bone health has been characterized mostly by bone mineral density (BMD), but recently also by bone quality (BQ). The aim of this pilot study is to assess the changes in BMD and BQ after switch from TDF to tenofovir alafenamide (TAF) ART.
Methods: HIV individuals receiving TDF-based ART were randomized to switch to Bictegravir-TAF-Emtricitabine or to remain in the same regimen.
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).
Background: Early and accurate recognition of respiratory pathogens is crucial to prevent increased risk of mortality in critically ill patients. Microbial-derived volatile organic compounds (mVOCs) in exhaled breath could be used as noninvasive biomarkers of infection to support clinical diagnosis.
Methods: In this study, we investigated the diagnostic potential of in vitro-confirmed mVOCs in the exhaled breath of patients under mechanical ventilation from the BreathDx study.
Article Synopsis
- Long-term non-progressors (LTNPs) are HIV+ individuals whose viral replication is controlled but still face complications like bone remodeling impairment.
- A study measured bone strength components and inflammatory biomarkers among LTNPs, HIV+ progressors, and HIV-negative individuals, revealing that LTNPs had lower bone material strength (BMSi) and a distinct inflammatory profile.
- The findings indicate that LTNPs experience worse bone tissue quality compared to both HIV+ progressors and HIV-negative individuals, suggesting a broader impact of HIV infection on bone health.
Article Synopsis
- A study compared clinical characteristics and outcomes of patients with COVID-19 and seasonal influenza who needed supplemental oxygen, focusing on factors like age, comorbidities, and mortality rates.
- COVID-19 patients were generally younger but had more severe symptoms, including higher pneumonia rates and worse progression, leading to a significantly higher 30-day mortality rate of 15% compared to 5% for influenza patients.
- Additionally, COVID-19 patients experienced longer hospital stays and higher costs related to critical care and treatments compared to those with seasonal influenza.
Background: Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) is the reference for combination therapy based on protease inhibitors due to its efficacy, tolerability, and convenience. Head-to-head randomized comparisons between D/C/F/TAF and combination therapy based on integrase inhibitors in antiretroviral-naive patients are lacking.
Methods: Adult (>18 years old) human immunodeficiency virus-infected antiretroviral-naive patients (HLA-B∗5701 negative and hepatitis B virus negative), with viral load (VL) ≥500 c/mL, were centrally randomized to initiate D/C/F/TAF or dolutegravir/abacavir/lamivudine (DTG/3TC/ABC) after stratifying by VL and CD4 count.
Article Synopsis
- The study investigates neurocognitive impairment (NI) and frailty in older adults living with HIV, focusing on risk factors associated with these conditions.
- Conducted with 40 HIV-positive individuals aged over 65 in Barcelona, it used clinical assessments and blood testing to measure NI and frailty.
- Results revealed that low education level, a nadir CD4+ T-cell count below 350 cells/mm, and the presence of comorbidities (especially diabetes) significantly increased the risk of neurocognitive disorders in this population.
Objective: The health crisis due to the COVID-19 pandemic is a challenge in the dispensing of outpatient hospital medication (OHM). Models of Antiretroviral Therapy (ART) based on community pharmacy support (ARTCP) have proven to be successful. The aim was to evaluate the degree of satisfaction, acceptability and limitations of the implementation of ARTCP, in the context of a pandemic, in our environment.
View Article and Find Full Text PDFPatients suspected of ventilator-associated lower respiratory tract infections (VA-LRTIs) commonly receive broad-spectrum antimicrobial therapy unnecessarily. We tested whether exhaled breath analysis can discriminate between patients suspected of VA-LRTI with confirmed infection, from patients with negative cultures. Breath from 108 patients suspected of VA-LRTI was analysed by gas chromatography-mass spectrometry.
View Article and Find Full Text PDFBackground: Skeletal involvement of is infrequent and usually associated with disseminated cryptococcosis or underlying predisposing conditions. We present an atypical case of osteoarticular cryptococcosis in an immunocompetent patient.
Case Presentation: We herein report a case of bone and soft tissue cryptococcal infection in a 42-year-old male from Pakistan with well-controlled diabetes without other associated immunodeficiencies treated with antifungal therapy without surgical debridement.
Objective: Simultaneous PET/MRI combines soft-tissue contrast of MRI with high molecular sensitivity of PET in one session. The aim of this prospective study was to evaluate detection rates of recurrent prostate cancer by F-fluciclovine PET/MRI.
Methods: Patients with biochemical recurrence (BCR) or persistently detectable prostate specific antigen (PSA), were examined with simultaneous F-fluciclovine PET/MRI.
Introduction: Headspace gas chromatography-mass spectrometry (HS-GC-MS) is widely considered the gold standard of quantitative fecal VOC analysis. However, guidelines providing general recommendations for bioanalytical method application in research and clinical setting are lacking.
Objectives: To propose an evidence-based research protocol for fecal VOC analysis by HS-GC-MS, based on extensive testing of instrumental and sampling conditions on detection and quantification limits, linearity, accuracy and repeatability of VOC outcome.
Background & Aims: Analysis of volatile organic compounds (VOCs) in exhaled breath, 'volatomics', provides opportunities for non-invasive biomarker discovery and novel mechanistic insights into a variety of diseases. The purpose of this pilot study was to compare breath VOCs in an initial cohort of patients with non-alcoholic fatty liver disease (NAFLD) and healthy controls.
Methods: Breath samples were collected from 15 participants with Child-Pugh class A NAFLD cirrhosis, 14 with non-cirrhotic NAFLD, and 14 healthy volunteers.
Background: Bone mineral density (BMD) decreases with ART initiation with a tenofovir disoproxil fumarate-containing regimen, although bone tissue quality increases. The impact of dolutegravir (DTG)/abacavir (ABC)/lamivudine (3TC)-based ART initiation on bone health parameters is not clear.
Objectives: To study the impact of DTG/ABC/3TC-based therapy on bone health parameters in ART-naive individuals with HIV after 48 weeks of treatment.
Adherence to treatment in patients living with HIV remains the focus of attention of health professionals and researchers. However, patient profiles and the available therapeutic arsenal have changed greatly over the last decade. Inadequate adherence not only to antiretroviral therapy but also to other prescribed drugs remains the main cause of therapeutic failure.
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