The incidence of HIV-2 infection in Spain is declining - a registry data analysis.

OBJECTIVES: HIV-2 infection is a neglected disease caused by a human retrovirus that causes AIDS more slowly than HIV-1. Infection with HIV-2 is endemic in West Africa. Given its differential features, guidelines recommend ruling out HIV-2 infection in all newly diagnosed HIV-seropositive individuals. METHODS: A national registry of HIV-2 cases was created in Spain in 1989, following the first report of three HIV-2+ individuals in Barcelona. The main demographics, clinical, and virological data are reported up to December 2023. RESULTS: A total of 424 individuals with HIV-2 infection were recorded in the Spanish registry. After a peak in 2009 when 31 cases were reported, new HIV-2 diagnoses steadily decreased. Less than 10 cases/year have been notified since the COVID-19 pandemic. In 2023, only eight cases were reported. Mean age at HIV-2 diagnosis was 44 years old, ranging from birth to 83 years. A total of 265 (62.5%) were male. Migrants predominated, being 322 (76%) Sub-Saharan Africans; however, 60 (14.2%) were native Spaniards. Heterosexual exposure was the most likely route of infection in at least 287 (67.7%) cases. A few cases could be traced to transfusions (n = 4), vertical infection (n = 2), or injection drug use (n = 7). In addition, 15 individuals (3.5%) were men who had sex with men. Coinfection with HIV-1 was recognized in 39 (9.2%) individuals. Molecular characterization of HIV-2 subtypes was performed in 139 individuals, 121 being infected with subtype A and 18 with subtype B. CONCLUSION: The annual incidence of HIV-2 infection in Spain has decreased after peaking 15 years ago, being the current number of cases below 10 per year. Three-quarters are African migrants, and two-thirds are male. Circulation of HIV-2 in Spain is limited and steadily decreasing.

Reversions of QuantiFERON-TB Gold Plus in tuberculosis contact investigation: A prospective multicentre cohort study.

BACKGROUND: Interferon-y Release Assays (IGRA) reversions have been reported in different clinical scenarios for the diagnosis of tuberculosis (TB) infection. This study aimed to determine the rate of QuantiFERON-TB Gold Plus (QFT-Plus) reversions during contact investigation as a potential strategy to reduce the number of preventive treatments. METHODS: Prospective, multicentre cohort study of immunocompetent adult contacts of patients with pulmonary TB tested with QFT-Plus. Contacts with an initial positive QFT-Plus (QFT-i) underwent a second test within 4 weeks (QFT-1), and if negative, underwent a repeat test 4 weeks later (QFT-2). Based on the QFT-2 result, we classified cases as sustained reversion if they remained negative and as temporary reversion if they turned positive. RESULTS: We included 415 contacts, of whom 96 (23.1%) had an initial positive test (QFT-i). Following this, 10 had negative QFT-1 results and 4 (4.2%) of these persisted with a negative result in the QFT-2 (sustained reversions). All four sustained reversions occurred in contacts with IFN-γ concentrations between ≥0.35 and ≤0.99 IU•mL-1 in one or both QFT-i tubes. CONCLUSION: In this study, TB contact investigations rarely reveal QFT-Plus reversion. These results do not support retesting cases with an initial positive result to reduce the number of preventive treatments.

[Results of pegylated interferon and ribavirin for the treatment of chronic hepatitis C in clinical practice: a 5-year experience]. / Resultados del tratamiento con interferón pegilado y ribavirina para la hepatitis crónica por el virus C en la práctica clínica. Experiencia de 5 años.

INTRODUCTION: Numerous clinical trials have demonstrated the efficacy of treatment with pegylated interferon and ribavirin but little is known about the results obtained in clinical practice. OBJECTIVE: To evaluate treatment response and factors influencing the treatment of chronic hepatitis C in clinical practice. MATERIAL AND METHODS: Between August 2001 and December 2005, we treated 219 patients with pegylated interferon (alpha 2a -fixed dose, or alpha 2b, according to weight) and ribavirin. Patients with genotype 1 or 4 received treatment with pegylated interferon alpha 2a (180 microg/week) and ribavirin (1000 mg/day if body weight was <75 kg or 1200 mg/day if body weight was >75 kg) or interferon alpha 2b (1.5 microg/kg/week) and ribavirin (10.6 mg/kg/day) for 48 weeks. Patients with genotype 2 or 3 were treated for 24 weeks with the same regimen of pegylated interferon alpha-2a or alpha-2b, but with 800 mg of ribavirin divided in two daily doses. Sustained viral response was defined as absence of HCV-RNA 6 months after the end of treatment. RESULTS: A total of 219 patients were included (69% men; mean age 44+/-10). As epidemiological antecedents, 22.4% of the treated patients had previously consumed drugs parenterally and 22.4% had received blood transfusions before 1992. Forty-seven percent of the patients with liver biopsy had fibrosis bridges or established liver cirrhosis. The genotype was distributed as follows: 69.8% genotype 1, 4.1% genotype 2, 17.8% genotype 3, and 8.2% genotype 4. Of the 219 patients, 76 (35%) were treated with pegylated interferon alpha 2a and 143 (65%) with interferon alpha 2b. Analysis of response by genotype revealed that sustained viral response was obtained in 46% genotype 1, 88.9% genotype 2, 78.9% genotype 3, and 33.3% genotype 4. Univariate analysis showed that the only variable influencing sustained viral response was genotype. CONCLUSION: Treatment with pegylated interferon and ribavirin in clinical practice shows a similar pattern of sustained viral response to that obtained in clinical research. The main variable correlated with sustained viral response continues to be viral genotype.

Resultados del tratamiento con interferón pegilado y ribavirina para la hepatitis crónica por el virus C en la práctica clínica. Experiencia de 5 años / Results of pegylated interferon and ribavirin for the treatment of chronic hepatitis C in clinical practice: A 5-year experience

INTRODUCCIÓN: Numerosos ensayos clínicos demuestran unaalta eficacia en el tratamiento con interferón pegilado y ribavirina;sin embargo, se conoce poco sobre los resultadosobtenidos en la práctica clínica.OBJETIVO: Evaluar en la práctica clínica la respuesta y losfactores que influyen en el tratamiento de la hepatitis crónicapor el virus C.MATERIAL Y MÉTODOS: Entre agosto de 2001 y diciembre de2005, se trató a 219 pacientes con interferón pegilado (alfa-2a en dosis fijas o alfa-2b según el peso) y ribavirina. Lospacientes que presentaban un genotipo 1 o 4 recibieron tratamientocon interferón pegilado alfa-2a (180 g/semana) yribavirina (1.000 mg/día si < 75 kg o 1.200 mg/día si > 75 kg)o interferón alfa-2b (1,5 g/kg/semana) y ribavirina (10,6mg/kg/día) durante 48 semanas. Los pacientes con genotipo2 y 3 fueron tratados durante 24 semanas con la misma pautade interferón pegilado alfa-2a o alfa-2b, pero con 800 mgde ribavirina al día repartida en dos dosis. La respuesta viralsostenida (RVS) se ha determinado como la negatividaddel ARN del virus de la hepatitis C a los 6 meses después definalizar el tratamiento.RESULTADOS: Se incluyeron 219 pacientes (un 69% varones,con una edad de 44 ± 10 años). Como antecedentes epidemiológicos,un 22,4% había consumido drogas por vía parenteraly un 22,4% había sido transfundido antes del año 1992.Un 47% de los pacientes con biopsia hepática tenía puentesde fibrosis o cirrosis hepática establecida. Los genotipos sedistribuyeron de la siguiente forma: 69,8% genotipo 1; 4,1%genotipo 2; 17,8% genotipo 3; 8,2% genotipo 4. Del total de219 pacientes, 76 (35%) fueron tratados con interferón pegiladoalfa-2a y 143 (65%) con interferón alfa-2b. Según el genotipo,la RVS se obtuvo en un 46% genotipo 1, un 88,9%genotipo 2, un 78,9% genotipo 3 y un 33,3% genotipo 4. Elanálisis univariado mostró que el genotipo es la única variableque influyó en la RVS. (..)(AU)

INTRODUCTION: Numerous clinical trials have demonstratedthe efficacy of treatment with pegylated interferon and ribavirinbut little is known about the results obtained in clinicalpractice.OBJECTIVE: To evaluate treatment response and factors influencingthe treatment of chronic hepatitis C in clinicalpractice.MATERIAL AND METHODS: Between August 2001 and December2005, we treated 219 patients with pegylated interferon(alpha 2a -fixed dose, or alpha 2b, according to weight) andribavirin. Patients with genotype 1 or 4 received treatmentwith pegylated interferon alpha 2a (180 g/week) and ribavirin(1000 mg/day if body weight was < 75 kg or 1200mg/day if body weight was > 75 kg) or interferon alpha 2b(1.5 g/kg/week) and ribavirin (10.6 mg/kg/day) for 48 weeks.Patients with genotype 2 or 3 were treated for 24 weekswith the same regimen of pegylated interferon alpha-2a oralpha-2b, but with 800 mg of ribavirin divided in two dailydoses. Sustained viral response was defined as absence ofHCV-RNA 6 months after the end of treatment (..) (AU)