Assuntos
Infecção Hospitalar/epidemiologia , Endossonografia/estatística & dados numéricos , Soropositividade para HIV/epidemiologia , Hepatite C/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Desinfecção , Endossonografia/instrumentação , Esôfago/diagnóstico por imagem , Feminino , França/epidemiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Reto/diagnóstico por imagem , Medição de Risco , Vagina/diagnóstico por imagemAssuntos
Hepatite B Crônica/diagnóstico , Hospedeiro Imunocomprometido , Transplante de Rim , Doença Aguda , Substituição de Aminoácidos/genética , Vírus da Hepatite B/fisiologia , Hepatite B Crônica/etiologia , Humanos , Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Transplante de Rim/imunologia , Masculino , Pessoa de Meia-Idade , Recidiva , Imunologia de Transplantes , Ativação ViralRESUMO
The possible transmission of pathogens to 236 persons exposed to an endoscope processed in a flawed automated endoscope washer-disinfector in a gastrointestinal endoscopy unit was investigated. During 6 months, 197 patients (83.5%) were followed up, and no cases of acute human immunodeficiency virus, hepatitis C virus, or hepatitis B virus infection were observed. This event created the conditions for improvements in safety procedures.
Assuntos
Endoscópios Gastrointestinais/efeitos adversos , Endoscopia Gastrointestinal/efeitos adversos , Contaminação de Equipamentos , Controle de Infecções/métodos , Adulto , Idoso , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Falha de Equipamento , Feminino , Humanos , Controle de Infecções/instrumentação , Masculino , Pessoa de Meia-IdadeRESUMO
The genotypic inhibitory quotient (GIQ) has been proposed as a way to integrate drug exposure and genotypic resistance to protease inhibitors and can be useful to enhance the predictivity of virologic response for boosted protease inhibitors. The aim of this study was to evaluate the predictivity of the GIQ in 116 protease inhibitor-experienced patients treated with lopinavir-ritonavir. The overall decrease in human immunodeficiency virus type 1 (HIV-1) RNA from baseline to month 6 was a median of -1.50 log(10) copies/ml and 40% of patients had plasma HIV-1 RNA below 400 copies/ml at month 6. The overall median lopinavir study-state C(min) concentration was 5,856 ng/ml. Using univariate linear regression analyses, both lopinavir GIQ and the number of baseline lopinavir mutations were highly associated with virologic response through 6 months. In the multivariate analysis, only lopinavir GIQ, baseline HIV RNA, and the number of prior protease inhibitors were significantly associated with response. When the analysis was limited to patients with more highly mutant viruses (three or more lopinavir mutations), only lopinavir GIQ remained significantly associated with virologic response. This study suggests that GIQ could be a better predictor of the virologic response than virological (genotype) or pharmacological (minimal plasma concentration) approaches used separately, especially among patients with at least three protease inhibitor resistance mutations. Therapeutic drug monitoring for patients treated by lopinavir-ritonavir would likely be most useful in patients with substantially resistant viruses.
Assuntos
Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Inibidores da Protease de HIV/uso terapêutico , HIV-1/efeitos dos fármacos , Pirimidinonas/uso terapêutico , Ritonavir/uso terapêutico , Adulto , Idoso , Combinação de Medicamentos , Monitoramento de Medicamentos , Feminino , Genótipo , HIV-1/genética , Humanos , Modelos Lineares , Lopinavir , Masculino , Pessoa de Meia-Idade , Mutação/genética , Valor Preditivo dos Testes , RNA Viral/genéticaRESUMO
The effects of co-infection with hepatitis C virus (HCV) and GB virus C (GBV-C) on CD4 cell counts and plasma HIV-RNA levels has been investigated in HIV-infected patients treated with highly active antiretroviral therapy (HAART). Patients co-infected with HCV and GBV-C experienced a CD4 cell increase during 4 years of HAART, whereas the increase stopped after 2 years in the other groups.
