RESUMO
OBJECTIVES: The aim of the study was to establish a methodology for evaluating the hepatitis C continuum of care in HIV/hepatitis C virus (HCV)-coinfected individuals and to characterize the continuum in Europe on 1 January 2015, prior to widespread access to direct-acting antiviral (DAA) therapy. METHODS: Stages included in the continuum were as follows: anti-HCV antibody positive, HCV RNA tested, currently HCV RNA positive, ever HCV RNA positive, ever received HCV treatment, completed HCV treatment, follow-up HCV RNA test, and cure. Sustained virological response (SVR) could only be assessed for those with a follow-up HCV RNA test and was defined as a negative HCV RNA result measured > 12 or 24 weeks after stopping treatment. RESULTS: Numbers and percentages for the stages of the HCV continuum of care were as follows: anti-HCV positive (n = 5173), HCV RNA tested (4207 of 5173; 81.3%), currently HCV RNA positive (3179 of 5173; 61.5%), ever HCV RNA positive (n = 3876), initiated HCV treatment (1693 of 3876; 43.7%), completed HCV treatment (1598 of 3876; 41.2%), follow-up HCV RNA test to allow SVR assessment (1195 of 3876; 30.8%), and cure (629 of 3876; 16.2%). The proportion that achieved SVR was 52.6% (629 of 1195). There were significant differences between regions at each stage of the continuum (P < 0.0001). CONCLUSIONS: In the proposed HCV continuum of care for HIV/HCV-coinfected individuals, we found major gaps at all stages, with almost 20% of anti-HCV-positive individuals having no documented HCV RNA test and a low proportion achieving SVR, in the pre-DAA era.
Assuntos
Antivirais/uso terapêutico , Continuidade da Assistência ao Paciente/normas , Infecções por HIV/tratamento farmacológico , Hepatite C/tratamento farmacológico , Adulto , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Adequate antiretroviral therapy is essential for HIV-positive pregnant women to prevent mother-to-child transmission. We report a small case series of five women receiving raltegravir as part of their antiretroviral regimen during pregnancy.
Assuntos
Antirretrovirais/uso terapêutico , Quimioprevenção/métodos , Infecções por HIV/tratamento farmacológico , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/virologia , Pirrolidinonas/uso terapêutico , Adulto , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Humanos , Gravidez , Raltegravir Potássico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
A colourless affect, without neurological symptoms was for decades assumed to be a character attribute of the patient, until the age of 55 years when she developed an akinetic symptom-complex with tremor, but with no rigidity. In the light of the history, the investigations and the operation findings, the symptoms appeared to have a clear aetiological connection with a unilateral, mandarin-sized, fronto-medial meningioma on the inferior edge of the falx. It seemed likely that this had been growing since her youth. The reversible symptoms were judged to be the result of pressure on the mid-brain, with resultant ciuculatory disturbances.
