ABSTRACT
OBJECTIVES: The aim of the study was to evaluate the long-term response to antiretroviral treatment (ART) based on atazanavir/ritonavir (ATZ/r)-, darunavir/ritonavir (DRV/r)-, and lopinavir/ritonavir (LPV/r)-containing regimens. METHODS: Data were analysed for 5678 EuroSIDA-enrolled patients starting a DRV/r-, ATZ/r- or LPV/r-containing regimen between 1 January 2000 and 30 June 2013. Separate analyses were performed for the following subgroups of patients: (1) ART-naïve subjects (8%) at ritonavir-boosted protease inhibitor (PI/r) initiation; (2) ART-experienced individuals (44%) initiating the new PI/r with a viral load (VL) ≤500 HIV-1 RNA copies/mL; and (3) ART-experienced patients (48%) initiating the new PI/r with a VL >500 copies/mL. Virological failure (VF) was defined as two consecutive VL measurements >200 copies/mL ≥24 weeks after PI/r initiation. Kaplan-Meier and multivariable Cox models were used to compare risks of failure by PI/r-based regimen. The main analysis was performed with intention-to-treat (ITT) ignoring treatment switches. RESULTS: The time to VF favoured DRV/r over ATZ/r, and both were superior to LPV/r (log-rank test; P < 0.02) in all analyses. Nevertheless, the risk of VF in ART-naïve patients was similar regardless of the PI/r initiated after controlling for potential confounders. The risk of VF in both treatment-experienced groups was lower for DRV/r than for ATZ/r, which, in turn, was lower than for LPV/r-based ART. CONCLUSIONS: Although confounding by indication and calendar year cannot be completely ruled out, in ART-experienced subjects the long-term effectiveness of DRV/r-containing regimens appears to be greater than that of ATZ/r and LPV/r.
Subject(s)
Anti-HIV Agents/therapeutic use , Antiretroviral Therapy, Highly Active/methods , HIV Infections/drug therapy , Adult , Europe , Female , Humans , Male , Middle Aged , Prospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: Prolidase deficiency is a complex disease characterized by various skin manifestations accompanied by mental retardation, facial dysmorphism and susceptibility to pyogenic infections. METHODS: We assessed a patient presenting a peculiar phenotype combining manifestations of prolidase deficiency with features typical of hyper-IgE syndrome. Mutation analysis was performed using direct PCR amplification and PCR restriction fragment length polymorphism analysis. RESULTS: We identified a novel homozygous recessive mutation in the PEPD gene, which was found to segregate in the family of the patient with the disease and was not found in a panel of DNA samples representative of all major Druze families living in northern Israel. DISCUSSION: Our results suggest that prolidase deficiency associated with hyper-IgE syndrome, a rare disorder, can be caused by mutations in PEPD.
Subject(s)
Dipeptidases/deficiency , Dipeptidases/genetics , Job Syndrome/enzymology , Mutation, Missense , Adult , Base Sequence , Consanguinity , DNA Mutational Analysis , Female , Homozygote , Humans , Male , Molecular Sequence Data , Pedigree , Polymorphism, Restriction Fragment LengthSubject(s)
Hygiene , Hypersensitivity/epidemiology , Inhalation , Olea/immunology , Pollen/immunology , Allergens/immunology , Antigens, Plant , Arabs , Child, Preschool , Christianity , Gene Frequency , Genome , Histocompatibility Antigens Class II/classification , Histocompatibility Antigens Class II/genetics , Humans , Hypersensitivity/ethnology , Hypersensitivity/genetics , Hypersensitivity/immunology , Immunoglobulin G/analysis , Islam , Israel/epidemiology , Jews , Plant Proteins/immunology , Prevalence , Skin TestsABSTRACT
BACKGROUND: Different studies reported a prevalence of latex allergy among health care workers ranging between 5-22%. The prevalence of an allergy to latex in public hospitals in Israel has been reported in selected, non-heavily exposed populations in Israeli hospitals. METHODS: Two hundred and three health care workers from the Rambam Medical Center volunteered to participate in this study. They completed a questionnaire including demographic data, personal, family allergic conditions and symptoms related to latex exposure. Blood samples were taken to determine the serum concentration of total IgE and latex-specific IgE antibodies. RESULTS: Thirty workers (14.8%) were found to have latex-specific IgE antibodies. The principal findings accompanying workers with latex-specific IgE antibodies are profession, positive personal and family history of allergic conditions and elevated total IgE. Approximately half of the health care workers allergic to latex were physicians, most of them from the departments of intensive care, surgery and internal medicine.
Subject(s)
Hypersensitivity, Immediate/epidemiology , Latex Hypersensitivity/epidemiology , Personnel, Hospital , Adult , Female , Hospitals, Public , Humans , Immunoglobulin E/blood , Israel/epidemiology , Male , Middle Aged , Prevalence , Surveys and QuestionnairesABSTRACT
We report a case of human gnathostomiasis presenting with bilateral pleural effusion and probable pericardial involvement. The diagnosis was made on the basis of the patient's country of origin (Nepal), the course of the disease, marked eosinophilia and the identification of Gnathostoma in a thoracic skin biopsy. The patient responded, presumably, to treatment with diethylcarbamazine (Hetrazan). This case is unique in its presentation and occurrence in Israel (although not necessarily acquired in Israel).
