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The role of women human rights defenders in Colombia is fundamental. The conditions of socioeconomic inequality, gender-based inequalities and discrimination, and the armed conflict have been complex scenarios in which women's leadership in the defence of human rights and peace have played a leading role. The creation of diverse collective processes and social networks at the local and national levels have been crucial strategies in the work of women defenders, their advocacy, and their forms of resistance. Their impact is undeniable. However, the work of women human rights defenders in Colombia has not been easy and has been frequently threatened. Hundreds of women human rights defenders have left the country as exiles over the past three decades or have been forcibly displaced within the country to protect their lives, many have suffered direct attacks, and some of them have been killed. The forms and impacts of violence against them have differential characteristics with respect to other defenders, which reveal the presence of gender stereotypes. In addition, indigenous, peasant, and lesbian, bisexual and trans women (LBT women) defenders face aggravated risks. Paradoxically, their visibility in the defence of peace has had very high costs for them after the signing of the Peace Accord between government and FARC-EP guerrillas in 2016. Women here are at a differential risk not only because they support the Peace Accord implementation in contexts where there are sectors that oppose it, but because they have gone beyond the low-key behaviour that is still expected for women in the political arena in many places of Colombia. Despite all this, they continue to lead the defence of human rights and their political advocacy has led to the creation of specific protection programmes for them by the Colombian state, the implementation of which is currently a challenge. [ABSTRACT FROM AUTHOR]

This study was designed to investigate the persistence of lipodystrophy (LD)-related social distress and isolation in HIV-infected patients in the current era, according to confirmatory dual energy X-ray absorptiometry (DEXA) measurements. Cross-sectional interview data were collected from 168 HIV-positive adult patients taking more than 2 years of antiretroviral therapy (133 cases with LD diagnosed a mean of 7.2 years before; 35 without LD, controls). Mean time of HIV infection was 16.2 years (2.1–27.3), and the mean time of exposure to highly active antiretroviral therapy of 11.7 years (2.1–21.1). The presence and severity of LD, confirmed by DEXA measurements, correlated with social isolation through a validated scale, including avoidance of social relationships, sex, work, or sport activities. In comparison with control patients, social distress was observed for patients having moderate body changes. The significant correlation between LD and social isolation was irrespective of age, CD4+ count, HIV RNA level, AIDS diagnosis, time of HIV infection, anxiety, or depressive symptoms. These results confirm that patient assessment of LD is correlated with whole-body DEXA scan, and they highlight the role of LD as an independent cause of social isolation even after years of the diagnosis. [ABSTRACT FROM PUBLISHER]

Purpose: Etravirine (ETR) has shown a good lipid profile in previous studies. The aim of this study was to determine the virologie, immunologic, and lipid outcome in HIV-infected patients switching to an ETR-based antiretroviral regimen due to intolerance or toxicity. Methods: Observational cohort study of 125 HIV-infected patients who switched therapy to an ETR-based regimen. The lipid profile, including total triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) was compared after 24 weeks. Results: Patients changed from efavirenz (n = 34; 28%) and ritonavir-boosted protease inhibitors (Pl/r; 67 cases: 21 atazanavir, 21 lopinavir, 11 fosamprenavir, 14 darunavir). Hyperlipidemia was the cause in only 22 patients (18%). At 24 weeks, a significant decrease was observed in mean TC level (-8%), LDL-C (-8%), TC:HDL ratio (-6%), and TG level (-20%). For patients receiving previously efavirenz, there was a significant reduction in TC (-23 mg/dL; -13%) and LDL-C (-25 mg/dL; -21 %) levels and a trend to a better TG level (-38 mg/dL; -21 %; P = .06). In the case of prior Pl/r therapy, there was also a significant reduction in TC (-14 mg/dL; -6%) and TG levels (-58 mg/dL; -16%), mostly in prior lopinavir- or fosamprenavir-based ther-apy (TC -15%; TG -53%). Median CD4+ count increased from 513 to 621 cells/uL (P = .03), and there were only 3 cases of virologie failure (2%). Conclusions: In patients switching to an ETR-containing regimen, there is a significant improvement of lipids and maintenance of immunologic and virologie response. This lipid-lowering effect was irrespective of the presence of previous hyperlipidemia and for patients receiving different antiretroviral drugs. [ABSTRACT FROM AUTHOR]

Purpose: There are few data about the safety and pharmacokinetics of lopinavir in HIV/HCV coinfected patients with very advanced liver disease.Method: Prospective study of 60 HIV/HCV coinfected patients who underwent a liver biopsy and received a lopinavir-based regimen. The rate of hepatotoxiciy and plasma trough levels were determined in absence/presence of cirrhosis (25 cases), especially in 11 patients with Child-Pugh stage B-C.Results: Overall, geometric mean level of lopi-navir was 7,109 ng/mL (interquartile range [IQR], 5,163-9,029), without differences according to cirrhosis (7,662; IQR, 5,165-10,442) or not (6,708; IQR, 5,524-8,526; P = .6). In 11 patients with Child-Pugh stage B-C, trough level was 9,640 ng/mL (IQR, 1,620-11,622 ng/mL), but there was a 99% interpatient variability (72 to 13,331 ng/mL). During a follow-up of 195.2 patient-years, there were 7 cases of hepatotox-icity, with an incidence of 3.39 episodes/100 patient-years (2.2 to 7.9). This incidence was higher in patients with Child-Pugh stage B-C (5.43 episodes/100 patient-years). There were no differences in lopinavir trough levels between patients with or without liver toxicity (7,100 vs 7,119 ng/mL; P = .9).Conclusion: The risk of lopinavir-associated hepatotoxicity in patients with very advanced liver disease is low. However, lopinavir plasma trough levels are increased, and there is a high interpatient variability. [ABSTRACT FROM AUTHOR]