ABSTRACT
OBJECTIVES: The aim of this study was to investigate the correlation between the HIV-1 reservoir and the levels of immune activation in chronic patients under fully suppressive cART. METHODS: We quantified the HIV proviral DNA and 2-LTR circles loads from PBMCs, the levels of CD38+ and Ki-67+ T-cells, and the levels of IL-7 in a cohort of patients with more than 5 years of ART at enrollment and after 1 year. RESULTS: In 29 participants with a median of 8 years (IQR, 6.9-9.4) under suppressive cART we found higher levels of CD8+ CD38+ T-cells after 1-year (P = .000). There was a non-statistically significant poor correlation between the levels of immune activation and the proviral DNA of CD4+ and CD8+ T-cells. Ki-67+ T-cells declined without significant differences, and there was no significant correlation with the proportion of CD38+. IL-7 decreased at the follow-up observation (P = .094), but there was no correlation with the levels of CD38+ and Ki-67+ T-cells. CONCLUSIONS: We found a weak but non-statistically significant correlation of the levels of T-cell activation with the proviral DNA and 2-LTR circles. This suggests the likely occurrence of further mechanisms driving chronic versus early immune activation other than viral replication by itself in chronic patients.
Subject(s)
Antiretroviral Therapy, Highly Active , DNA, Viral/genetics , HIV Infections/immunology , HIV-1/immunology , Lymphocyte Activation , Terminal Repeat Sequences/genetics , Adult , Anti-HIV Agents/therapeutic use , Cohort Studies , Female , HIV Infections/drug therapy , HIV Infections/virology , HIV-1/genetics , HIV-1/physiology , Humans , Interleukin-7/immunology , Male , Middle Aged , Prospective Studies , Viral Load , Virus ReplicationABSTRACT
OBJECTIVE: The objective of the study was to present the experience of the family planning service Hospital General de México, in locating and removing no palpable subdermal single-rod contraceptive implants. MATERIALS AND METHODS: A descriptive, prospective, and cross-sectional study was performed from January 2011 to April 2018. RESULTS: Hundred and sixty-four patients in whom the implant was not palpable were reviewed, the time between insertion and removal averaged 3.3 years (maximum 10 years and minimum 3 months). Three implants were inserted in the right arm, the rest on the left one. Forty-seven implants were found in fatty tissue (29%), 18 in fascia (11%), 94 in muscle (57%), 2 in the armpit (1.2%), and 3 were not found (1.8%). CONCLUSIONS: The no palpable implant is caused by an incorrect insertion technique. Migration should not be assumed as a cause of difficult location. Amount of non-palpable implants is not possible to determine due to a lack of records, but approximately 3% are considered non-palpable. Ultrasound has proven to be the study of choice to locate an incorrect inserted implant. In this case, the total number of implants was located, except in two patients.
OBJETIVO: Presentar la experiencia del servicio de planificación familiar del Hospital General de México Dr. Eduardo Liceaga en la localización y la extracción de implantes anticonceptivos subdérmicos no palpables. MATERIALS Y MÉTODOS: Estudio clínico descriptivo, prospectivo y transversal, realizado desde enero de 2011 hasta abril de 2018 en el servicio de planificación familiar del Hospital General de México Dr. Eduardo Liceaga. RESULTADOS: Se incluyeron 164 pacientes con implantes no palpables, de los cuales 161 se localizaron por ultrasonido. El promedio entre la inserción y el retiro fue de 3.3 años. Tres implantes fueron insertados en el brazo derecho y el resto en el izquierdo; tres no se encontraron. CONCLUSIÓN: Por su fácil acceso y simplicidad, el ultrasonido es el método de elección para localizar implantes profundos no palpables.
