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  1. AU="Santos, José Ramón"
  2. AU="Kotp, Mohamed S"
  3. AU="Fu-Xin Wang"
  4. AU="Ehni, Hans-Jörg"
  5. AU="Kozminski, Barbara"
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  1. Article ; Online: Selective loss of CD107a TIGIT+ memory HIV-1-specific CD8+ T cells in PLWH over a decade of ART.

    Blanch-Lombarte, Oscar / Ouchi, Dan / Jimenez-Moyano, Esther / Carabelli, Julieta / Marin, Miguel Angel / Peña, Ruth / Pelletier, Adam / Talla, Aarthi / Sharma, Ashish / Dalmau, Judith / Santos, José Ramón / Sékaly, Rafick-Pierre / Clotet, Bonaventura / Prado, Julia G

    eLife

    2023  Volume 12

    Abstract: The co-expression of inhibitory receptors (IRs) is a hallmark of CD8+ T-cell exhaustion (Tex) in people living with HIV-1 (PLWH). Understanding alterations of IRs expression in PLWH on long-term antiretroviral treatment (ART) remains elusive but is ... ...

    Abstract The co-expression of inhibitory receptors (IRs) is a hallmark of CD8+ T-cell exhaustion (Tex) in people living with HIV-1 (PLWH). Understanding alterations of IRs expression in PLWH on long-term antiretroviral treatment (ART) remains elusive but is critical to overcoming CD8+ Tex and designing novel HIV-1 cure immunotherapies. To address this, we combine high-dimensional supervised and unsupervised analysis of IRs concomitant with functional markers across the CD8+ T-cell landscape on 24 PLWH over a decade on ART. We define irreversible alterations of IRs co-expression patterns in CD8+ T cells not mitigated by ART and identify negative associations between the frequency of TIGIT+ and TIGIT+ TIM-3+ and CD4+ T-cell levels. Moreover, changes in total, SEB-activated, and HIV-1-specific CD8+ T cells delineate a complex reshaping of memory and effector-like cellular clusters on ART. Indeed, we identify a selective reduction of HIV-1 specific-CD8+ T-cell memory-like clusters sharing TIGIT expression and low CD107a that can be recovered by mAb TIGIT blockade independently of IFNγ and IL-2. Collectively, these data characterize with unprecedented detail the patterns of IRs expression and functions across the CD8+ T-cell landscape and indicate the potential of TIGIT as a target for Tex precision immunotherapies in PLWH at all ART stages.
    MeSH term(s) Humans ; HIV-1 ; Anti-Retroviral Agents/therapeutic use ; CD4-Positive T-Lymphocytes ; CD8-Positive T-Lymphocytes ; Receptors, Immunologic
    Chemical Substances Anti-Retroviral Agents ; Receptors, Immunologic ; TIGIT protein, human
    Language English
    Publishing date 2023-09-19
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2687154-3
    ISSN 2050-084X ; 2050-084X
    ISSN (online) 2050-084X
    ISSN 2050-084X
    DOI 10.7554/eLife.83737
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Impact of Obefazimod on Viral Persistence, Inflammation, and Immune Activation in People With Human Immunodeficiency Virus on Suppressive Antiretroviral Therapy.

    Bernal, Silvia / Puertas, Maria C / Morón-López, Sara / Cranston, Ross D / Urrea, Víctor / Dalmau, Judith / Salgado, María / Gálvez, Cristina / Erkizia, Itziar / McGowan, Ian / Scherrer, Didier / Revollo, Boris / Sirera, Guillem / Santos, José Ramón / Clotet, Bonaventura / Paredes, Roger / Martinez-Picado, Javier

    The Journal of infectious diseases

    2023  Volume 228, Issue 9, Page(s) 1280–1291

    Abstract: Background: Persistence of viral reservoirs has been observed in people with human immunodeficiency virus (HIV), despite long-term antiretroviral therapy (ART), and likely contributes to chronic immune activation and inflammation. Obefazimod is a novel ... ...

    Abstract Background: Persistence of viral reservoirs has been observed in people with human immunodeficiency virus (HIV), despite long-term antiretroviral therapy (ART), and likely contributes to chronic immune activation and inflammation. Obefazimod is a novel drug that inhibits human immunodeficiency virus type 1 (HIV-1) replication and reduces inflammation. Here we assess whether obefazimod is safe and might impact HIV-1 persistence, chronic immune activation, and inflammation in ART-suppressed people with HIV.
    Methods: We evaluated obefazimod-related adverse events, changes in cell-associated HIV-1 DNA and RNA, residual viremia, immunophenotype, and inflammation biomarkers in blood and rectal tissue. We compared 24 ART-suppressed people with HIV who received daily doses of 50 mg obefazimod for 12 weeks (n = 13) or 150 mg for 4 weeks (n = 11) and 12 HIV-negative individuals who received 50 mg for 4 weeks.
    Results: The 50- and 150-mg doses of obefazimod were safe, although the 150-mg dose showed inferior tolerability. The 150-mg dose reduced HIV-1 DNA (P = .008, median fold change = 0.6) and residual viremia in all individuals with detectable viremia at baseline. Furthermore, obefazimod upregulated miR-124 in all participants and reduced the activation markers CD38, HLA-DR, and PD-1 and several inflammation biomarkers.
    Conclusions: The effect of obefazimod by reducing chronic immune activation and inflammation suggests a potential role for the drug in virus remission strategies involving other compounds that can activate immune cells, such as latency-reversing agents.
    MeSH term(s) Humans ; Viremia/drug therapy ; HIV Infections ; Inflammation/drug therapy ; HIV-1/genetics ; Biomarkers ; DNA/pharmacology ; Anti-Retroviral Agents/therapeutic use ; Viral Load ; CD4-Positive T-Lymphocytes
    Chemical Substances Biomarkers ; DNA (9007-49-2) ; Anti-Retroviral Agents
    Language English
    Publishing date 2023-07-24
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 3019-3
    ISSN 1537-6613 ; 0022-1899
    ISSN (online) 1537-6613
    ISSN 0022-1899
    DOI 10.1093/infdis/jiad251
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Virological efficacy of switch to DTG plus 3TC in a retrospective observational cohort of suppressed HIV-1 patients with or without past M184V: the LAMRES study.

    Santoro, Maria Mercedes / Armenia, Daniele / Teyssou, Elisa / Santos, José Ramón / Charpentier, Charlotte / Lambert-Niclot, Sidonie / Antinori, Andrea / Katlama, Christine / Descamps, Diane / Perno, Carlo Federico / Calvez, Vincent / Paredes, Roger / Ceccherini-Silberstein, Francesca / Marcelin, Anne Geneviève

    Journal of global antimicrobial resistance

    2022  Volume 31, Page(s) 52–62

    Abstract: Objectives: The aim of this study was to assess the efficacy of dolutegravir plus lamivudine (DTG+3TC) in a large set of virologically suppressed HIV-1 infected individuals with or without past M184V mutation.: Methods: This observational study ... ...

    Abstract Objectives: The aim of this study was to assess the efficacy of dolutegravir plus lamivudine (DTG+3TC) in a large set of virologically suppressed HIV-1 infected individuals with or without past M184V mutation.
    Methods: This observational study included individuals who switched to DTG+3TC with ≥1 genotype before switch. Survival analysis was used to evaluate the role of past M184V on virological rebound (VR) or blips after DTG+3TC switch.
    Results: A total of 712 individuals followed in several clinical centres in France, Italy and Spain were analysed. Past M184V was present in 60 (8.4%) individuals. By 3 years after switch, the overall probability of VR and blips was 6.7% and 6.9%, respectively, without any statistical significance according to the presence/absence of past M184V. A significantly higher probability of VR was found in individuals harbouring M184V before DTG+3TC with a duration of virological suppression (Ts) ≤.3.5 years compared to others (M184V+Ts ≤.3.5 years: 22.7%; M184M+Ts ≤.3.5 years: 9.0%; M184V+Ts >3.5 years: 7.8%; M184M+Ts >3.5 years: 4.9%; P = 0.007). This finding was not confirmed in multivariable models adjusting for behavioural and demographic variables. Genotypic resistance test after VR under DTG+3TC was available for 8/39 individuals; one poorly adherent individual developed M184V. No resistance to INIs was found.
    Conclusion: In this retrospective observational study, the probability of VR and blips in patients switching to DTG+3TC was very low after 3 years of treatment regardless M184V. The effect of a short duration of previous virological suppression in individuals with M184V remains troubling and needs ad hoc clinical trials to be confirmed.
    Language English
    Publishing date 2022-08-07
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2710046-7
    ISSN 2213-7173 ; 2213-7173
    ISSN (online) 2213-7173
    ISSN 2213-7173
    DOI 10.1016/j.jgar.2022.07.022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Ambrisentan use in a HIV-1 infected patient with end-stage renal disease and pulmonary hypertension: minimal removal by hemodialysis - a case report.

    Santos, José Ramón / Merino, Ana / Haefeli, Walter E / Miranda, Cristina / Prats, Marisol / Bancu, Ioana / Bailón, Lucía / Moltó, José

    BMC nephrology

    2020  Volume 21, Issue 1, Page(s) 24

    Abstract: Background: Ambrisentan is a selective endothelin receptor antagonist used for the treatment of pulmonary arterial hypertension (PAH). Little is known about ambrisentan removal by hemodialysis in patients with end-stage renal disease (ESRD).: Case ... ...

    Abstract Background: Ambrisentan is a selective endothelin receptor antagonist used for the treatment of pulmonary arterial hypertension (PAH). Little is known about ambrisentan removal by hemodialysis in patients with end-stage renal disease (ESRD).
    Case presentation: A 53-year-old woman with HIV/hepatitis C virus (HCV) co-infection, PAH and ESRD on regular hemodialyis was admitted in our hospital due to refractory heart failure while on treatment with bosentan (125 mg twice daily) and tadalafil (20 mg once daily) for PAH and antiretroviral treatment (cART) including darunavir/cobicistat (800/150 mg once daily). Excessive exposure to bosentan due to drug interactions between bosentan and darunavir/cobicistat was suspected. Bosentan was replaced by ambrisentan, with progressive improvement in her clinical condition. Pre- and postdialyzer cocentrations of ambrisentan in plasma were determined and hemodialysis extraction ratio for ambrisentan was 2%.
    Conclusions: Our results suggest that hemodialysis results in minimal ambrisentan removal, and therefore no specific ambrisentan dosage adjustment seems to be required in ESRD patients undergoing hemodialysis.
    MeSH term(s) Antihypertensive Agents/analysis ; Antihypertensive Agents/blood ; Antihypertensive Agents/therapeutic use ; Female ; HIV Infections/complications ; Hemodialysis Solutions/chemistry ; Hepatitis C, Chronic/complications ; Humans ; Hypertension, Pulmonary/complications ; Hypertension, Pulmonary/drug therapy ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Middle Aged ; Phenylpropionates/analysis ; Phenylpropionates/blood ; Phenylpropionates/therapeutic use ; Pyridazines/analysis ; Pyridazines/blood ; Pyridazines/therapeutic use ; Renal Dialysis
    Chemical Substances Antihypertensive Agents ; Hemodialysis Solutions ; Phenylpropionates ; Pyridazines ; ambrisentan (HW6NV07QEC)
    Language English
    Publishing date 2020-01-28
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-019-1659-5
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  5. Article ; Online: Effectiveness of Once/Day Dolutegravir Plus Boosted Darunavir as a Switch Strategy in Heavily Treated Patients with Human Immunodeficiency Virus.

    Navarro, Jordi / Santos, José Ramón / Silva, Ana / Burgos, Joaquin / Falcó, Vicenç / Ribera, Esteban / Imaz, Arkaitz / Curran, Adrian

    Pharmacotherapy

    2019  Volume 39, Issue 4, Page(s) 501–507

    Abstract: Study objective: Dual therapy with once/day dolutegravir (DTG) plus boosted darunavir (DRV/b) may be a suitable and effective strategy with a high genetic barrier to resistance in patients infected with human immunodeficiency virus (HIV). Our aim was to ...

    Abstract Study objective: Dual therapy with once/day dolutegravir (DTG) plus boosted darunavir (DRV/b) may be a suitable and effective strategy with a high genetic barrier to resistance in patients infected with human immunodeficiency virus (HIV). Our aim was to evaluate the effectiveness of DTG plus DRV/b (DTG+DRV/b) as a switch strategy in HIV-infected patients, irrespective of their history of virologic failure (VF).
    Design: Multicenter retrospective cohort study.
    Setting: Human immunodeficiency outpatient treatment clinics at three university hospitals in Spain.
    Patients: Fifty HIV-infected adults who had a stable antiretroviral treatment (ART) regimen and an undetectable viral load for at least 6 months, and whose ART was switched to once/day DTG+DRV/b between January 2015 and January 2018 were included in the analysis. Historical genotype at the time of VF was available in 44 patients.
    Measurements and main results: Patients were followed until VF or treatment discontinuation for any reason. The primary outcome was the percentage of patients with a viral load of 50 copies/mL or lower at the last follow-up visit. Secondary outcomes included changes in CD4
    Conclusion: In this cohort of heavily treated HIV-infected patients with virologic suppression, switching to the combination of DTG+DRV/b was a convenient regimen that was highly effective and had good tolerability.
    MeSH term(s) Anti-HIV Agents/administration & dosage ; Anti-HIV Agents/adverse effects ; Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active ; Darunavir/administration & dosage ; Darunavir/adverse effects ; Darunavir/therapeutic use ; Drug Resistance, Viral ; HIV Infections/drug therapy ; HIV Infections/virology ; Heterocyclic Compounds, 3-Ring/administration & dosage ; Heterocyclic Compounds, 3-Ring/adverse effects ; Heterocyclic Compounds, 3-Ring/therapeutic use ; Humans ; Multicenter Studies as Topic ; Retrospective Studies ; Spain ; Treatment Outcome ; Viral Load/drug effects
    Chemical Substances Anti-HIV Agents ; Heterocyclic Compounds, 3-Ring ; dolutegravir (DKO1W9H7M1) ; Darunavir (YO603Y8113)
    Language English
    Publishing date 2019-03-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 603158-4
    ISSN 1875-9114 ; 0277-0008
    ISSN (online) 1875-9114
    ISSN 0277-0008
    DOI 10.1002/phar.2227
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Effectiveness and safety of integrase strand transfer inhibitors in Spain: a prospective real-world study.

    Santos, José Ramón / Casadellà, Maria / Noguera-Julian, Marc / Micán-Rivera, Rafael / Domingo, Pere / Antela, Antonio / Portilla, Joaquin / Sanz, Jesús / Montero-Alonso, Marta / Navarro, Jordi / Masiá, Mar / Valcarce-Pardeiro, Nieves / Ocampo, Antonio / Pérez-Martínez, Laura / García-Vallecillos, Coral / Vivancos, María Jesús / Imaz, Arkaitz / Iribarren, José Antonio / Hernández-Quero, José /
    Villar-García, Judit / Barrufet, Pilar / Paredes, Roger

    Frontiers in cellular and infection microbiology

    2023  Volume 13, Page(s) 1187999

    Abstract: Introduction: Second-generation integrase strand transfer inhibitors (INSTIs) are preferred treatment options worldwide, and dolutegravir (DTG) is the treatment of choice in resource-limited settings. Nevertheless, in some resource-limited settings, ... ...

    Abstract Introduction: Second-generation integrase strand transfer inhibitors (INSTIs) are preferred treatment options worldwide, and dolutegravir (DTG) is the treatment of choice in resource-limited settings. Nevertheless, in some resource-limited settings, these drugs are not always available. An analysis of the experience with the use of INSTIs in unselected adults living with HIV may be of help to make therapeutic decisions when second-generation INSTIs are not available. This study aimed to evaluate the real-life effectiveness and safety of dolutegravir (DTG), elvitegravir/cobicistat (EVG/c), and raltegravir (RAL) in a large Spanish cohort of HIV-1-infected patients.
    Methods: Real-world study of adults living with HIV who initiated integrase INSTIs DTG, EVG/c, and RAL-based regimens in three settings (ART-naïve patients, ART-switching, and ART-salvage patients). The primary endpoint was the median time to treatment discontinuation after INSTI-based regimen initiation. Proportion of patients experiencing virological failure (VF) (defined as two consecutive viral loads (VL) ≥200 copies/mL at 24 weeks or as a single determination of VL ≥1,000 copies/mL while receiving DTG, EVG/c or RAL, and at least 3 months after INSTI initiation) and time to VF were also evaluated.
    Results: Virological effectiveness of EVG/c- and RAL-based regimens was similar to that of DTG when given as first-line and salvage therapy. Treatment switching for reasons other than virological failure was more frequent in subjects receiving EVG/c and, in particular, RAL. Naïve patients with CD4+ nadir <100 cells/μL were more likely to develop VF, particularly if they initiated RAL or EVG/c. In the ART switching population, initiation of RAL and EVG/c was associated with both VF and INSTI discontinuation. There were no differences in the time to VF and INSTI discontinuation between DTG, EVG/c and RAL. Immunological parameters improved in the three groups and for the three drugs assessed. Safety and tolerability were consistent with expected safety profiles.
    Discussion: Whereas second-generation INSTIs are preferred treatment options worldwide, and DTG is one of the treatment of choices in resource-limited settings, first-generation INSTIs may still provide high virological and immunological effectiveness when DTG is not available.
    MeSH term(s) Adult ; Humans ; Spain ; Prospective Studies ; Cobicistat ; Integrases ; HIV Infections/drug therapy
    Chemical Substances Cobicistat (LW2E03M5PG) ; Integrases (EC 2.7.7.-)
    Language English
    Publishing date 2023-06-26
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2619676-1
    ISSN 2235-2988 ; 2235-2988
    ISSN (online) 2235-2988
    ISSN 2235-2988
    DOI 10.3389/fcimb.2023.1187999
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  7. Article ; Online: Outcome of hospitalized patients with COVID-19 pneumonia treated with high-dose immunoglobulin therapy in a prospective case series.

    Reynaga, Esteban / Carrillo, Jorge / Santos, Jose Ramón / Roure, Silvia / Mateu, Lourdes / Paredes, Roger / Clotet, Bonaventura / Izquierdo-Useros, Nuria / Pedro-Botet, Maria Luisa

    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

    2020  Volume 27, Issue 4, Page(s) 651–652

    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; COVID-19/complications ; COVID-19/therapy ; Dose-Response Relationship, Drug ; Female ; Hospitalization ; Humans ; Immunization, Passive ; Immunoglobulins, Intravenous/administration & dosage ; Immunoglobulins, Intravenous/therapeutic use ; Inflammation/therapy ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome ; Young Adult
    Chemical Substances Immunoglobulins, Intravenous
    Keywords covid19
    Language English
    Publishing date 2020-10-13
    Publishing country England
    Document type Letter
    ZDB-ID 1328418-6
    ISSN 1469-0691 ; 1470-9465 ; 1198-743X
    ISSN (online) 1469-0691
    ISSN 1470-9465 ; 1198-743X
    DOI 10.1016/j.cmi.2020.10.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: High-dose intravenous immunoglobulins might modulate inflammation in COVID-19 patients.

    Rodríguez de la Concepción, María Luisa / Ainsua-Enrich, Erola / Reynaga, Esteban / Ávila-Nieto, Carlos / Santos, Jose Ramón / Roure, Silvia / Mateu, Lourdes / Paredes, Roger / Puig, Jordi / Jimenez, Juan Manuel / Izquierdo-Useros, Nuria / Clotet, Bonaventura / Pedro-Botet, María Luisa / Carrillo, Jorge

    Life science alliance

    2021  Volume 4, Issue 9

    Abstract: The use of high-dose of intravenous immunoglobulins (IVIGs) as immunomodulators for the treatment of COVID-19-affected individuals has shown promising results. IVIG reduced inflammation in these patients, who progressively restored respiratory function. ... ...

    Abstract The use of high-dose of intravenous immunoglobulins (IVIGs) as immunomodulators for the treatment of COVID-19-affected individuals has shown promising results. IVIG reduced inflammation in these patients, who progressively restored respiratory function. However, little is known about how they may modulate immune responses in COVID-19 individuals. Here, we have analyzed the levels of 41 inflammatory biomarkers in plasma samples obtained at day 0 (pretreatment initiation), 3, 7, and 14 from five hospitalized COVID-19 patients treated with a 5-d course of 400 mg/kg/d of IVIG. The plasmatic levels of several cytokines (Tumor Necrosis Factor, IL-10, IL-5, and IL-7), chemokines (macrophage inflammatory protein-1α), growth/tissue repairing factors (hepatic growth factor), complement activation (C5a), and intestinal damage such as Fatty acid-binding protein 2 and LPS-binding protein showed a progressive decreasing trend during the next 2 wk after treatment initiation. This trend was not observed in IVIG-untreated COVID-19 patients. Thus, the administration of high-dose IVIG to hospitalized COVID-19 patients may improve their clinical evolution by modulating their hyperinflammatory and immunosuppressive status.
    MeSH term(s) Administration, Intravenous ; Adult ; Aged ; Biomarkers/blood ; COVID-19/blood ; COVID-19/immunology ; COVID-19/therapy ; COVID-19/virology ; Chemokines/blood ; Cytokines/blood ; Female ; Humans ; Immunity/immunology ; Immunoglobulins/immunology ; Immunoglobulins/therapeutic use ; Immunoglobulins, Intravenous/immunology ; Immunoglobulins, Intravenous/therapeutic use ; Inflammation/blood ; Inflammation/therapy ; Inflammation/virology ; Male ; Middle Aged ; SARS-CoV-2/isolation & purification
    Chemical Substances Biomarkers ; Chemokines ; Cytokines ; Immunoglobulins ; Immunoglobulins, Intravenous
    Language English
    Publishing date 2021-07-28
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2575-1077
    ISSN (online) 2575-1077
    DOI 10.26508/lsa.202001009
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  9. Article ; Online: Determinants of the onset and prognosis of the post-COVID-19 condition: a 2-year prospective observational cohort study.

    Mateu, Lourdes / Tebe, Cristian / Loste, Cora / Santos, José Ramón / Lladós, Gemma / López, Cristina / España-Cueto, Sergio / Toledo, Ruth / Font, Marta / Chamorro, Anna / Muñoz-López, Francisco / Nevot, Maria / Vallejo, Nuria / Teis, Albert / Puig, Jordi / Fumaz, Carmina R / Muñoz-Moreno, José A / Prats, Anna / Estany-Quera, Carla /
    Coll-Fernández, Roser / Herrero, Cristina / Casares, Patricia / Garcia, Ana / Clotet, Bonaventura / Paredes, Roger / Massanella, Marta

    The Lancet regional health. Europe

    2023  Volume 33, Page(s) 100724

    Abstract: Background: At least 5-10% of subjects surviving COVID-19 develop the post-COVID-19 condition (PCC) or "Long COVID". The clinical presentation of PCC is heterogeneous, its pathogenesis is being deciphered, and objective, validated biomarkers are lacking. ...

    Abstract Background: At least 5-10% of subjects surviving COVID-19 develop the post-COVID-19 condition (PCC) or "Long COVID". The clinical presentation of PCC is heterogeneous, its pathogenesis is being deciphered, and objective, validated biomarkers are lacking. It is unknown if PCC is a single entity or a heterogeneous syndrome with overlapping pathophysiological basis. The large US RECOVER study identified four clusters of subjects with PCC according to their presenting symptoms. However, the long-term clinical implications of PCC remain unknown.
    Methods: We conducted a 2-year prospective cohort study of subjects surviving COVID-19, including individuals fulfilling the WHO PCC definition and subjects with full clinical recovery. We systematically collected post-COVID-19 symptoms using prespecified questionnaires and performed additional diagnostic imaging tests when needed. Factors associated with PCC were identified and modelled using logistic regression. Unsupervised clustering analysis was used to group subjects with PCC according to their presenting symptoms. Factors associated with PCC recovery were modelled using a direct acyclic graph approach.
    Findings: The study included 548 individuals, 341 with PCC, followed for a median of 23 months (IQR 16.5-23.5), and 207 subjects fully recovered. In the model with the best fit, subjects who were male and had tertiary studies were less likely to develop PCC, whereas a history of headache, or presence of tachycardia, fatigue, neurocognitive and neurosensitive complaints and dyspnea at COVID-19 diagnosis predicted the development of PCC. The cluster analysis revealed the presence of three symptom clusters with an additive number of symptoms. Only 26 subjects (7.6%) recovered from PCC during follow-up; almost all of them (n = 24) belonged to the less symptomatic cluster A, dominated mainly by fatigue. Recovery from PCC was more likely in subjects who were male, required ICU admission, or had cardiovascular comorbidities, hyporexia and/or smell/taste alterations during acute COVID-19. Subjects presenting with muscle pain, impaired attention, dyspnea, or tachycardia, conversely, were less likely to recover from PCC.
    Interpretation: Preexisting medical and socioeconomic factors, as well as acute COVID-19 symptoms, are associated with the development of and recovery from the PCC. Recovery is extremely rare during the first 2 years, posing a major challenge to healthcare systems.
    Funding: Fundació Lluita contra les Infeccions.
    Language English
    Publishing date 2023-09-05
    Publishing country England
    Document type Journal Article
    ISSN 2666-7762
    ISSN (online) 2666-7762
    DOI 10.1016/j.lanepe.2023.100724
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  10. Article ; Online: Development and Evaluation of an NTM-IGRA to Guide Pediatric Lymphadenitis Diagnosis.

    Villar-Hernández, Raquel / Latorre, Irene / Noguera-Julian, Antoni / Martínez-Planas, Aina / Minguell, Laura / Vallmanya, Teresa / Méndez, María / Soriano-Arandes, Antoni / Baquero-Artigao, Fernando / Rodríguez-Molino, Paula / Guillén-Martín, Sara / Toro-Rueda, Carlos / De Souza-Galvão, M Luiza / Jiménez-Fuentes, M Ángeles / Stojanovic, Zoran / Sabriá, Josefina / Santos, José Ramón / Puig, Jordi / Domínguez-Álvarez, Marisol /
    Millet, Joan-Pau / Altet, Neus / Galea, Yolanda / Muriel-Moreno, Beatriz / García-García, Esther / Bach-Griera, Marc / Prat-Aymerich, Cristina / Julián, Esther / Torrelles, Jordi B / Rodrigo, Carlos / Domínguez, José

    The Pediatric infectious disease journal

    2023  Volume 43, Issue 3, Page(s) 278–285

    Abstract: Background: Diagnosis of nontuberculous mycobacteria (NTM) infections remains a challenge. In this study, we describe the evaluation of an immunological NTM-interferon (IFN)-γ release assay (IGRA) that we developed using glycopeptidolipids (GPLs) as NTM- ...

    Abstract Background: Diagnosis of nontuberculous mycobacteria (NTM) infections remains a challenge. In this study, we describe the evaluation of an immunological NTM-interferon (IFN)-γ release assay (IGRA) that we developed using glycopeptidolipids (GPLs) as NTM-specific antigens.
    Methods: We tested the NTM-IGRA in 99 samples from pediatric patients. Seventy-five were patients with lymphadenitis: 25 were NTM confirmed, 45 were of unknown etiology but compatible with mycobacterial infection and 5 had lymphadenitis caused by an etiologic agent other than NTM. The remaining 24 samples were from control individuals without lymphadenitis (latently infected with M. tuberculosis , uninfected controls and active tuberculosis patients). Peripheral blood mononuclear cells were stimulated overnight with GPLs. Detection of IFN-γ producing cells was evaluated by enzyme-linked immunospot assay.
    Results: NTM culture-confirmed lymphadenitis patient samples had a significantly higher response to GPLs than the patients with lymphadenitis of unknown etiology but compatible with mycobacterial infection ( P < 0.001) and lymphadenitis not caused by NTM ( P < 0.01). We analyzed the response against GPLs in samples from unknown etiology lymphadenitis but compatible with mycobacterial infection cases according to the tuberculin skin test (TST) response, and although not statistically significant, those with a TST ≥5 mm had a higher response to GPLs when compared with the TST <5 mm group.
    Conclusions: Stimulation with GPLs yielded promising results in detecting NTM infection in pediatric patients with lymphadenitis. Our results indicate that the test could be useful to guide the diagnosis of pediatric lymphadenitis. This new NTM-IGRA could improve the clinical handling of NTM-infected patients and avoid unnecessary misdiagnosis and treatments.
    MeSH term(s) Humans ; Child ; Interferon-gamma Release Tests/methods ; Leukocytes, Mononuclear ; Tuberculosis/diagnosis ; Tuberculin Test ; Mycobacterium tuberculosis ; Mycobacterium Infections, Nontuberculous/diagnosis ; Lymphadenitis/diagnosis
    Language English
    Publishing date 2023-12-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392481-6
    ISSN 1532-0987 ; 0891-3668
    ISSN (online) 1532-0987
    ISSN 0891-3668
    DOI 10.1097/INF.0000000000004211
    Database MEDical Literature Analysis and Retrieval System OnLINE

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