ABSTRACT
OBJETIVES: The main objective was to compare the persistence between dolutegravir/lamivudine (DTG/3TC) and bictegravir/emtricitabine/tenofovir-alafenamide (BIC/FTC/TAF) and to analyze reasons for discontinuation. METHODS: We conducted a retrospective, non-interventional, descriptive, and longitudinal study. All human immunodeficiency virus (HIV) patients over 18â¯years treated with DTG/3TC or BIC/FTC/TAF in our center were included. Persistence after first year was compared using the χ2 test. Kaplan-Meier survival analysis was performed. RESULTS: Three hundred fifty-eight patients were included. 99.5% versus 90.99% of patients were persistent after the first year for DTG/3TC and BIC/FTC/TAF respectively (p=.001). Persistence with DGT/3TC was 1237â¯days (IC95% 1216-1258) and persistence with BIC/FTC/TAF was 986â¯days [(IC95% 950-1021); p<.001]. The difference was remained after adjusting for covariates with the cox regression model [HR=8.2 (IC95% 1.03-64.9), p=.047]. The main reasons for discontinuation for BIC/FTC/TAF were toxicity/tolerability. CONCLUSION: In our study, patients have a high persistence. Patients on DTG/3TC treatment are more persistent compared to BIC/FTC/TAF, although BIC/FTC/TAF have worse baseline characteristics. The main reason for discontinuation of BIC/FTC/TAF is tolerability/toxicity.
Subject(s)
Anti-HIV Agents , Emtricitabine , HIV Infections , Heterocyclic Compounds, 3-Ring , Lamivudine , Oxazines , Piperazines , Pyridones , Tenofovir , Humans , HIV Infections/drug therapy , Retrospective Studies , Male , Pyridones/therapeutic use , Female , Lamivudine/therapeutic use , Piperazines/therapeutic use , Oxazines/therapeutic use , Heterocyclic Compounds, 3-Ring/therapeutic use , Heterocyclic Compounds, 3-Ring/adverse effects , Adult , Middle Aged , Anti-HIV Agents/therapeutic use , Emtricitabine/therapeutic use , Tenofovir/therapeutic use , Alanine/therapeutic use , Alanine/analogs & derivatives , Longitudinal Studies , Drug Combinations , Amides/therapeutic use , Heterocyclic Compounds, 4 or More Rings/therapeutic use , Heterocyclic Compounds, 4 or More Rings/adverse effects , Adenine/analogs & derivatives , Adenine/therapeutic useABSTRACT
OBJETIVES: The main objective was to compare the persistence between dolutegravir/lamivudine (DTG/3TC) and bictegravir/emtricitabine/tenofovir-alafenamide (BIC/FTC/TAF) and to analyze reasons for discontinuation. METHODS: We conducted a retrospective, non-interventional, descriptive and longitudinal study. All human immunodeficiency virus (HIV) patients over 18 years treated with DTG/3TC or BIC/FTC/TAF in our center were included. Persistence after first year was compared using the χ2 test. Kaplan-Meier survival analysis was performed. RESULTS: Three hundred fifty-eight patients were included. 99.5% versus 90.99% of patients were persistent after the first year for DTG/3TC and BIC/FTC/TAF respectively (pâ¯=â¯0.001). Persistence with DGT/3TC was 1,237 days (IC95% 1,216-1,258) and persistence with BIC/FTC/TAF was 986 days ([IC95% 950-1,021]; pâ¯<â¯0.001). The difference was remained after adjusting for covariates with the cox regression model (HR= 8.2 [IC95% 1.03-64.9], pâ¯=â¯0.047). The main reasons for discontinuation for BIC/FTC/TAF were toxicity/tolerability. CONCLUSION: In our study patients had a high persistence. Patients on DTG/3TC treatment were more persistent compared to BIC/FTC/TAF, although BIC/FTC/TAF have worse baseline characteristics. The main reason for discontinuation of BIC/FTC/TAF was tolerability/toxicity.
Subject(s)
Anti-HIV Agents , HIV Infections , Heterocyclic Compounds, 3-Ring , Lamivudine , Oxazines , Piperazines , Pyridones , Humans , Retrospective Studies , HIV Infections/drug therapy , Male , Female , Pyridones/therapeutic use , Lamivudine/therapeutic use , Oxazines/therapeutic use , Adult , Heterocyclic Compounds, 3-Ring/therapeutic use , Heterocyclic Compounds, 3-Ring/adverse effects , Piperazines/therapeutic use , Middle Aged , Anti-HIV Agents/therapeutic use , Tenofovir/therapeutic use , Emtricitabine/therapeutic use , Longitudinal Studies , Alanine/therapeutic use , Alanine/analogs & derivatives , Amides/therapeutic use , Drug CombinationsABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Esophagitis/diagnostic imaging , Esophagitis/diet therapy , Gastritis/diagnostic imaging , Esophagitis/pathology , Gastritis/pathology , Esophagus/diagnostic imaging , Esophagus/pathology , Chest Pain/etiology , Tomography, X-Ray Computed , Parenteral Nutrition , Endoscopy, Digestive System/methodsABSTRACT
A 43-year-old male with an uneventful history presented with fever and ingestion-triggered retrosternal chest pain of a three-day duration, which was aggravated by deep breathing and the supine position. When asked regarding the possible ingestion of a foreign body he recalled having accidentally swallowed tiny glass shards from a broken bottle.
Subject(s)
Esophagitis , Foreign Bodies , Adult , Esophagitis/chemically induced , Esophagitis/diagnostic imaging , Foreign Bodies/complications , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Humans , MaleABSTRACT
Pneumocystis in humans is caused by a unicellular and eukaryotic organism called P. jirovecii. The overall incidence of P. jirovecii pneumonia (PCP) has decreased with the use of highly active antiretroviral therapy and the use of chemoprophylaxis with trimethroprim sulfametoxazole (TMP/SMX) in cases of immunosuppressed patients. However, approximately 85% of patients with advanced HIV infections continue to experience this disease with inadequate management. Pneumocystis infection can present with spontaneous pneumothorax in 2-6% of cases [8] which can be a potentially fatal complication. We report the case of a 32-year-old man presented with P. jirovecii pneumonia who developed cystic lesions and spontaneous bilateral pneumothorax in spite of TMP/SMX treatment. We consider it an interesting clinical case because few simultaneous bilateral pneumothorax cases have been described directly related to the PCP.
ABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Pleural Effusion/complications , Pleural Effusion/drug therapy , Pleural Effusion , Sarcoidosis, Pulmonary/complications , Sarcoidosis, Pulmonary , Chemoprevention , Diagnosis, Differential , Radiography, Thoracic/methods , AutoimmunityABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Coinfection/complications , Coinfection/drug therapy , Mycobacterium avium , Mycobacterium avium/isolation & purification , Mycobacterium avium/pathogenicity , Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination/therapeutic use , Lymphadenitis/complications , Lymphadenitis/drug therapy , Isoniazid/therapeutic use , Rifampin/therapeutic use , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/diagnosis , Coinfection/diagnosis , Anti-Retroviral Agents/therapeutic use , Ethambutol/therapeutic use , Clarithromycin/therapeutic use , Molecular Biology/methodsABSTRACT
Fundamento y objetivo: Describir un cuadro clínico poco habitual como la tuberculosis esplénica aislada. Paciente y método: Presentamos un caso de tuberculosis esplénica aislada, una forma rara de tuberculosis extrapulmonar, en un paciente inmunocompetente, y que, como peculiaridad, comienza en forma de hipercalcemia sintomática. Resultados: Se expone ampliamente el caso clínico y los procedimientos realizados para excluir las patologías que integraron el diagnóstico diferencial. Hacemos énfasis en la utilidad de la punción aspirativa con aguja fina del bazo para la obtención de muestras microbiológicas, y el uso de la reacción en cadena de la polimerasa específica para micobacterias para confirmar el diagnóstico de esta entidad. Igualmente, de acuerdo con otros autores, optamos por un tratamiento médico inicial con antituberculostáticos, reservando la cirugía para los casos refractarios o que se compliquen con rotura esplénica espontánea. Conclusión: La hipercalcemia puede ser una forma de presentación de las enfermedades granulomatosas. La afectación aislada del bazo por micobacterias es una forma poco frecuente de tuberculosis extrapulmonar y más aún en pacientes inmunocompetentes (AU)
Background and objective: To describe an unusual clinical presentation as isolated splenic tuberculosis. Patient and methods: We report a case of isolated splenic tuberculosis, a rare form of extrapulmonary tuberculosis in an immunocompetent patient, and, as a peculiarity, debuts in the form of symptomatic hypercalcemia. Results: We deeply report the clinical case and the procedures performed to exclude other diseases. We emphasize the usefulness of fine needle aspiration of the spleen to obtain microbiological samples, and the use of specific polymerase chain reaction for mycobacterias to establish the definitive diagnosis of this entity. In agreement with other authors, we chose initial medical treatment with antituberculous drugs, reserving surgery for refractory cases or in case of spontaneous splenic rupture. Conclusion: Hypercalcemia can be a presentation of granulomatous diseases. The isolated involvement of the spleen by mycobacterias is a rare form of extrapulmonary tuberculosis and more so in immunocompetent patients (AU)
Subject(s)
Humans , Male , Aged , Tuberculosis, Splenic/diagnosis , Hypercalcemia/etiology , Biopsy, Fine-Needle/methods , Polymerase Chain ReactionABSTRACT
BACKGROUND AND OBJECTIVE: To describe an unusual clinical presentation as isolated splenic tuberculosis. PATIENT AND METHODS: We report a case of isolated splenic tuberculosis, a rare form of extrapulmonary tuberculosis in an immunocompetent patient, and, as a peculiarity, debuts in the form of symptomatic hypercalcemia. RESULTS: We deeply report the clinical case and the procedures performed to exclude other diseases. We emphasize the usefulness of fine needle aspiration of the spleen to obtain microbiological samples, and the use of specific polymerase chain reaction for mycobacterias to establish the definitive diagnosis of this entity. In agreement with other authors, we chose initial medical treatment with antituberculous drugs, reserving surgery for refractory cases or in case of spontaneous splenic rupture. CONCLUSION: Hypercalcemia can be a presentation of granulomatous diseases. The isolated involvement of the spleen by mycobacterias is a rare form of extrapulmonary tuberculosis and more so in immunocompetent patients.
Subject(s)
Hypercalcemia/etiology , Tuberculosis, Splenic/diagnosis , Aged , Humans , Male , Tuberculosis, Splenic/complicationsSubject(s)
Acidosis/chemically induced , Anticonvulsants/adverse effects , Epilepsies, Partial/drug therapy , Fructose/analogs & derivatives , Acidosis, Renal Tubular/chemically induced , Aged , Anticonvulsants/therapeutic use , Cerebral Hemorrhage, Traumatic/complications , Comorbidity , Drug Substitution , Epilepsies, Partial/etiology , Fructose/adverse effects , Fructose/therapeutic use , Humans , Male , Phenytoin/therapeutic use , Polypharmacy , Schizophrenia, Paranoid/drug therapy , Schizophrenia, Paranoid/etiology , TopiramateSubject(s)
Contraceptives, Oral/adverse effects , Jugular Veins , Venous Thrombosis/chemically induced , Adult , Female , Humans , Middle AgedABSTRACT
No disponible
