Dimension of chronic hepatitis C virus in HIV-infected patients in the interferon-free era: an overview from south Spain.

The implementation of hepatitis C (HCV) direct-acting antiviral drugs is prioritized in several populations in which its application provides the most immediate and impactful benefit. In this scenario, a precise knowledge of the situation of human immunodeficiency virus (HIV)/HCV chronic co-infection is required to adequately address this disease. This cross-sectional study was performed in 21 hospitals in Andalusia (Spain). The study population consisted of HIV-infected patients with an active HCV chronic infection who were not receiving HCV treatment at the time of inclusion. A total of 13,506 HIV-infected patients were included in the study. Of them, 2561 (18.9 %) presented chronic HCV infection. The majority of the patients included were on highly active antiretroviral therapy (HAART; 96.2 %), showed plasma levels with an undetectable HIV viral load (92.5 %), and had a good immunological status (median CD4+ cell count of 486 cells/mL). The HCV genotype distribution was as follows: 58.1 % were genotype 1, 1.1 % were genotype 2, 16.1 % were genotype 3, and 22.1 % were genotype 4 (2.6 % were missing data). In total, 24.8 % of the patients showed liver fibrosis stage F0-F1, 27.9 % showed stage F2, 16.7 % showed stage F3, and 21 % showed stage F4 (9.6 % were missing data). With regards to previous HCV treatment experiences, 68.05 % of the patients were naïve and 31.95 % had failed to respond to a previous treatment. The burden of HCV/HIV co-infected patients in our population was reported as one in five HIV-infected patients requiring HCV treatment. The implementation of extra resources to face this important health challenge is mandatory.

[Aqueous humor and serum interleukin-6 in patients with uveitis]. / Interleucina-6 en humor acuoso y suero de pacientes con uveítis.

PURPOSE: A study on local and systemic behavior of interleukin-6 in patients with active uveitis. METHODS: IL-6 levels were measured in aqueous humor and peripheral blood samples using an enzyme-linked immunosorbent assay (ELISA) from 23 patients with uveitis and 16 control patients who had been operated for uncomplicated cataracts. RESULTS: Aqueous humor of patients with uveitis showed higher levels of interleukin-6 than those of controls (p<0.001). A comparison of cytokine levels between aqueous humor and serum from patients with uveitis showed significantly higher levels of interleukin-6 in aqueous than serum (p<0.001). Correlation studies using regression test for successive steps failed to demonstrate any association between interleukin-6 levels and the different clinical characteristics of uveitis patients (laterality, onset, patterns, visual damage, localization, inflammatory activity, etiology, and association with the B27 + histocompatibility antigen). CONCLUSIONS: IL-6 is a cytokine that actively participates in the pathogenesis of clinical uveitis. Our data emphasize the greater local than systemic participation of this cytokine.

Interleucina-6 en humor acuoso y suero de pacientes con uveítis / Aqueous humor and serum interleukin-6 in clinical uveitis

Objetivo: Estudiar el comportamiento local y sistémico de la interleucina-6 en pacientes con uveítis en actividad. Método: Se determinaron los niveles de interleucina-6 en humor acuoso y sangre periférica de 23 pacientes con uveítis en actividad y de 16 pacientes operados de catarata no complicada como grupo control, mediante la técnica inmunoenzimática ELISA. Resultados: Los pacientes con uveítis presentaron niveles superiores de interleucina-6 en humor acuoso respecto a controles (p<0,001). La comparación entre humor acuoso y suero de los pacientes con uveítis mostró unos niveles significativamente superiores de interleucina-6 en humor acuoso (p<0,001). El análisis mediante el test de regresión múltiple por pasos sucesivos no demostró ninguna asociación entre los niveles de interleucina-6 y las diferentes características clínicas de las uveítis (lateralidad, comienzo, patrón, daño visual, localización, actividad inflamatoria, etiología y asociación al antígeno HLAB27+).Conclusiones: La interleucina-6 es una citocina que participa activamente en la patogenia de la uveítis clínica. Nuestros datos demuestran una mayor participación local que sistémica de esta citocina (AU)