RESUMEN
Background The international recommendations of antiretroviral treatment include resistance tests to guide the treatment regimen in each patient, which is not available on a regular basis in Ecuador. Aim To describe mutations that confer resistance to antiretrovirals in a population of Ecuadorian patients. Methods Plasma samples from 101 HIV-1 patients with failure to antiretroviral therapy, divided into 15 children and 86 adults, were studied with the GS Junior (Roche) and the sequences were analyzed with the DeepChek program. Results The most frequent mutations were M184V/I, K101E/P/H, K103N/S, D30N, M46L/I, I54L/M, V82T/F/A/S/L and L90M in adults and F77L, K103N/S, M46L/I, V82T/F/A/S/L and L90M in children. High resistance to non-nucleoside reverse transcriptase (RT) inhibitors in minority viral populations of adults and children (34.9% and 70%) was detected; in children both viral populations (majority and minority viral populations) (> 45%) were protease inhibitor resistant. Patients who had a greater number of therapeutic regimens had higher levels of resistance to antiretrovirals. Most of the samples were subtype B in the TR and protease region, and CRF25_cpx in integrase. Conclusions Mutations and resistance to antiretrovirals are shown in a population of Ecuadorian patients with HIV-1. These results will make it possible to issue a warning to health authorities about the need for resistance studies.
Asunto(s)
Antirretrovirales/farmacología , Farmacorresistencia Viral Múltiple/genética , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/genética , VIH-1/efectos de los fármacos , VIH-1/genética , Mutación/efectos de los fármacos , Adulto , Factores de Edad , Antirretrovirales/uso terapéutico , Terapia Antirretroviral Altamente Activa/métodos , Recuento de Linfocito CD4 , Niño , Preescolar , Estudios Transversales , Ecuador , Femenino , Infecciones por VIH/sangre , Transcriptasa Inversa del VIH/efectos de los fármacos , Humanos , Modelos Logísticos , Masculino , Reacción en Cadena de la Polimerasa , Carga ViralRESUMEN
Resumen Introducción Las recomendaciones internacionales de tratamiento anti-retroviral incluyen pruebas de resistencia para orientar el régimen de tratamiento en cada paciente, lo que no está disponible de forma estable en Ecuador. Objetivo Describir las mutaciones que confieren resistencia a anti-retrovirales en una población de pacientes ecuatorianos. Metodología A partir de muestras de plasma de 101 pacientes con VIH-1 con fallo a la terapia anti-retroviral, 15 niños y 86 adultos, se realizó pirosecuenciación con el GS Junior (Roche) y se analizaron las secuencias con el programa DeepChek. Resultados Las mutaciones más frecuentes fueron M184V/I, K101E/P/H, K103N/S, D30N, M46L/I, I54L/M, V82T/F/A/S/L y L90M en adultos, y F77L, K103N/S, M46L/I, V82T/F/A/S/L y L90M en niños. Se encontró una elevada resistencia a los inhibidores de la transcriptasa reversa (TR) no análogos de nucleósidos en poblaciones minoritarias virales de adultos y niños (34,9 y 70%, respectivamente), en los niños, tanto las poblaciones virales mayoritarias como minoritarias, fueron resistente a inhibidores de proteasa (> 45%). Los pacientes que tuvieron un mayor número de esquemas terapéuticos presentaron mayores niveles de resistencia a los anti-retrovirales. La mayoría de las muestras fueron del subtipo B en la región de la TR y proteasa, y CRF25_cpx en integrasa. Conclusiones Se muestran las mutaciones y la resistencia a antiretrovirales en una población de pacientes ecuatorianos con infección por VIH-1, que permitirán realizar un llamado de alerta a las autoridades de salud sobre la necesidad de realizar estudios de resistencia.
Background The international recommendations of antiretroviral treatment include resistance tests to guide the treatment regimen in each patient, which is not available on a regular basis in Ecuador. Aim To describe mutations that confer resistance to antiretrovirals in a population of Ecuadorian patients. Methods Plasma samples from 101 HIV-1 patients with failure to antiretroviral therapy, divided into 15 children and 86 adults, were studied with the GS Junior (Roche) and the sequences were analyzed with the DeepChek program. Results The most frequent mutations were M184V/I, K101E/P/H, K103N/S, D30N, M46L/I, I54L/M, V82T/F/A/S/L and L90M in adults and F77L, K103N/S, M46L/I, V82T/F/A/S/L and L90M in children. High resistance to non-nucleoside reverse transcriptase (RT) inhibitors in minority viral populations of adults and children (34.9% and 70%) was detected; in children both viral populations (majority and minority viral populations) (> 45%) were protease inhibitor resistant. Patients who had a greater number of therapeutic regimens had higher levels of resistance to antiretrovirals. Most of the samples were subtype B in the TR and protease region, and CRF25_cpx in integrase. Conclusions Mutations and resistance to antiretrovirals are shown in a population of Ecuadorian patients with HIV-1. These results will make it possible to issue a warning to health authorities about the need for resistance studies.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adulto , Infecciones por VIH/genética , Infecciones por VIH/tratamiento farmacológico , VIH-1/efectos de los fármacos , VIH-1/genética , Farmacorresistencia Viral Múltiple/genética , Antirretrovirales/farmacología , Mutación/efectos de los fármacos , Infecciones por VIH/sangre , Modelos Logísticos , Reacción en Cadena de la Polimerasa , Estudios Transversales , Factores de Edad , Recuento de Linfocito CD4 , Carga Viral , Terapia Antirretroviral Altamente Activa/métodos , Antirretrovirales/uso terapéutico , Ecuador , Transcriptasa Inversa del VIH/efectos de los fármacosRESUMEN
BACKGROUND: House dust mites constitute the major etiologic factor causing sensitization and asthma its geographical distribution map is quite well known, although it is not yet complete. Home environments world-wide show mites that mainly belong to the Piroglyphidae family, the D. pteronyssinus specie being the predominant one. However others have also been considered of interest. OBJECTIVE: The aim of this work was to study the species and to determine the levels of Der p I, Der f I and group II of allergens of Dermatophagoides. Present in houses from Tenerife, Canary Islands (Spain). METHODS: Dust samples were collected in 130 houses. RESULTS: D. pteronyssinus was found in 121 (95.3%) homes, being the predominant species in 113 (89%). In 69 (55%) homes, Dermatophagoides spp. were found together with other species from other generus. Mean values for Der p I were 13.7 +/- 13.88 (mean +/- SD), for Der f 1 1.05 +/- 1.83 and for the Group I of allergens 7 +/- 6.77. CONCLUSION: Although D. pteronyssinus is the predominant species in our area, there are others that may be off importance and should be taken into consideration in the diagnostic, home disallergenization and later treatment of patients.
Asunto(s)
Alérgenos/inmunología , Polvo , Glicoproteínas/inmunología , Ácaros/inmunología , Animales , Antígenos Dermatofagoides , Asma/epidemiología , Asma/etiología , Vivienda , Humanos , Ácaros/clasificación , Rinitis Alérgica Perenne/epidemiología , Rinitis Alérgica Perenne/etiología , Estaciones del Año , España/epidemiología , Especificidad de la EspecieRESUMEN
We present three cases of occupational allergy caused by the manipulation of food: cheese, chorizo (typical Spanish salami) and salty ham. A IgE-mediated sensitization is demonstrated by skin tests, RAST and positive challenge tests to Acarus siro and Blomia kulagini of the cheese rind, Euroglyphus maynei of the "chorizo" and Tyrophagus putrescentiae of the salty ham.
Asunto(s)
Queso , Conjuntivitis Alérgica/etiología , Contaminación de Alimentos , Manipulación de Alimentos , Productos de la Carne , Ácaros/inmunología , Enfermedades Profesionales/etiología , Rinitis Alérgica Perenne/etiología , Adulto , Animales , Queso/parasitología , Polvo , Femenino , Conservación de Alimentos , Humanos , Masculino , Productos de la Carne/parasitología , Enfermedades Profesionales/inmunología , Cloruro de Sodio , PorcinosAsunto(s)
Fluoruros/administración & dosificación , Alimentos Infantiles , Leche , Animales , Aditivos Alimentarios , Humanos , Lactante , Recién Nacido , EspañaRESUMEN
A study on the content of free fluoride in 39 milk formulae available in Spain. The selective ion electrode method has been selected. All formulae but one supply F amounts inadequate for cavities prophylaxis. Additional F should before be routinely administered per os in the form of sodium fluoride.