Hepatitis: Almeda J

Almeda J, Casabona J, Allepuz A, García-Alcaide F, del Romero J, Tural C, Colm J, Bolao F, Campins M, Domínguez A, Force L, Giménez A, Guerra-Romero L, Anonymous00243. · Centre de Estudis Espidemiològics sobre la Sida a Catalunya. Hospital Universitari Germans Trias i Pujol. Badalona. España. · Enferm Infecc Microbiol Clin. · Pubmed #12372236 links to  free full text

Abstract: Evidence is lacking on the possible efficacy and effectiveness of non-occupational postexposure prophylaxis (PEP). However, because of its biological plausibility, the use of antiretroviral (ARV) drugs to prevent the development of infection in certain cases of accidental or sporadic exposure has begun to be considered as common clinical practice. Previous studies performed in Spain have demonstrated both the demand and the prescription of ARV as PEP and especially the diversity and inconsistency in the criteria used. In this context, in April of 2000 the Centre for Epidemiological Studies on AIDS of Catalonia (CEESCAT) (Department of Health and Social Security of the Autonomous Government of Catalonia), in collaboration with the National AIDS Plan and the AIDS Study Group (GESIDA), promoted the creation of a working group for the drafting of recommendations for PEP against HIV outside the occupational health context. The recommendations have been made bearing in mind the exceptional character of the exposure, the time elapsed since exposure, as well as evaluation of the risk of infection according to the type of exposure and the information available on the source of infection. In addition, the recommendations include the immediate measures necessary, as well as the preventive measures and clinical follow-up required both for HIV and for other infectious agents. All PEP regimens should be started within 72 hours of exposure and appropriate daily doses of two nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor (PI), or two NRTIs and a non-nucleoside reverse transcriptase inhibitor (NNRTIs), should be administered for four weeks, bearing in mind the pharmacological and clinical situation of the source person. These recommendations should be updated periodically.

González-Tomé MI, Ramos Amador JT, Guillen S, Solís I, Fernández-Ibieta M, Muñoz E, Almeda J, Rojano X, Rojo P, Nieto O, Anonymous00103. · Department of Immunodeficiencies, Hospital 12 de Octubre, Madrid, Spain. · HIV Med. · Pubmed #18983478 No free full text.

Abstract: OBJECTIVES: We undertook a prospective study to estimate the prevalence of gestational diabetes mellitus (GDM) and associated risk factors in a cohort of 669 HIV-1 infected women. METHODS: The O'Sullivan and glucose tolerance tests were performed during regular visits of 609 mothers. RESULTS: The median age of the cohort was 30.7 years (range 16-44), with most women having had heterosexual contact (67%). The majority were in Centers for Disease Control (CDC) category A (71%) and 53% exhibited hepatitis C co-infection. Median viral load and CD4 count at third trimester were 545 cells/microL (range 139-1690 cells/microL) and 1.9 log (range 1.7-5.4), respectively. Seventy-four per cent of the patients were treated with highly active antiretroviral therapy (HAART), of whom 41% received a protease inhibitor (PI). An above-average prevalence of 7% [95% confidence interval (CI) 5.2-9.5] for positive GDM diagnosis was found. Risk factors associated with GDM in univariate analysis included older age, hepatitis C co-infection, stavudine and PI exposure. However, only older age [adjusted odds ratio (AOR) 1.09, 95% CI 1-1.1] and PI exposure (AOR 2.4, 95% CI 1-5.3) remained as independent risk factors for GDM development in multivariate analysis. CONCLUSIONS: In our cohort, the prevalence of GDM appears to be increased, with older age and PI exposure contributing as significant independent risk factors.