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1. Effectiveness and tolerability of intravenous fosfomycin in treating complicated urinary tract infections caused by Escherichia coli: a prospective cohort study from the FOSFOMIC project

Author

Palomo, Virginia, Gutiérrez, David, de la Rosa, Sandra, Zeynep, Cansu Duran, Aller, Ana I., Arrabal, Emilio Guirao, Hernández-Torres, Alicia, García-Vázquez, Elisa, Hidalgo, Carmen, Pasquau, Juan, Guzmán-Puche, Julia, de Puerta, Lourdes Ruiz-Sánchez, Viale, Pierluigi, Ambretti, Simone, del Carmen Martínez-Jiménez, María, Garcinuño-Jiménez, María Ángeles, Moreno-Mellado, Elisa, Aslan, Abdullah Tarik, Akova, Murat, León, Eva, Merchante, Nicolás, Vinuesa, David, Moral-Escudero, Encarnación, Sadyrbaeva-Dolgova, Svetlana, López-Cárdenas, Salvador, Cano-Yuste, Ángela, Rinaldi, Matteo, Núñez-Núñez, María, Giannella, Maddalena, Sojo-Dorado, Jesús, Antolí-Royo, Ana Cristina, Chacón, Natalia, Merino-Bohórquez, Vicente, Portillo, Inés, Rodríguez-Baño, Jesús, Docobo-Pérez, Fernando, and Gutiérrez-Gutiérrez, Belén

Published
2025
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2. How can we optimize the diagnostic and therapeutic approach to pneumonia? Expert opinion-based recommendations

Author

Fernández-Ruiz, Mario, Castón, Juan José, del Pozo, José Luis, Carratalà, Jordi, Fortún, Jesús, Salavert, Miguel, Torre-Cisneros, Julián, Aguado, José María, Fernández Cruz, Ana, Ventura, Ana, Loeches, Belén, Dueñas, Carlos, Tomás, Cristina, Navarro, David, Oltra, Rosa, Resino-Foz, Elena, García Vázquez, Elisa, Míguez, Enrique, Merino, Esperanza, Braojos, Francisco, Martínez, Francisco Javier, López-Medrano Pérez, Francisco, Machuca, Isabel, Cobo, Javier, López Contreras, Joaquín, Reguera, José María, Ruiz Mesa, Juan Diego, Tiraboschi, Juan, Abella, Lucy, Masiá, Mar, del Toro López, María Dolores, Díaz López, María Dolores, Carrasco-Antón, Nerea, Merchante, Nicolás, Muñoz, Patricia, Torres, Rafael, Rodríguez, Regino, Mata-Forte, Tatiana, and Abril, Vicente

Published
2024
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4. Effects of first-line antiretroviral therapy on the CD4/CD8 ratio and CD8 cell counts in CoRIS: a prospective multicentre cohort study

Author

Jarrin, Inmaculada, Moreno, Santiago, Alejos, Belén, Muñoz-Fernández, MÁngeles, Consuegra, Irene, Merino, Esperanza, García, Gema, Lirola, Ana López, García, Dácil, Asensi, Víctor, Valle, Eulalia, Rubio, Rafael, Pulido, Federico, Iribarren, José Antonio, Arrizabalaga, Julio, Gutiérrez, Félix, Masiá, Mar, Muga, Roberto, Sanvisens, Arantza, Berenguer, Juan, Vidal, Francesc, Montero, Marta, Blanco, José Ramón, López Bernarlo de Quirós, Juan Carlos, González-Garcia, Juan, Peraire, Joaquín, Arazo, Piedad, López-Aldeguer, José, Dalmau, David, Arnalich, Francisco, Rivero, Maria, Oteo, José Antonio, Sampériz, Gloria, Amengual, María José, Jaén, Angels, de los Santos, Ignacio, Repáraz, Jesús, Navarro, Gemma, Bernal, Enrique, Sanz, Jesús, Viciana, Pompeyo, García, Federico, Casado, José Luis, Del Romero, Jorge, Cano, Alfredo, Antela, Antonio, Quero, José Hernández, Riera, Melchor, Raposo, Montserrat, Santos, Jesús, Losada, Elena, Daniel, Podzamczer, Peñaranda, María, Ayerbe, Cristina Gómez, Espinosa, Nuria, Olalla, Julián, Imaz, Arkaitz, Martínez, Onofre, Curran, Adrian, Castro, Ángeles, Pérez Stachowski, Javier, Muñoz, Josefa, Vera, Francisco Jesús, Galera, Carlos, Pernas, Berta, Amador, Concha, Zuriñe, Miren, Albendin, Helena, Suárez-García, Inés, Pasquau, Francisco, Omar, Mohamed, Malmierca, Eduardo, de Zarraga, Miguel Alberto, Gómez Vidal, María Amparo, Estrada, Vicente, Górgolas, Miguel, Sanz, José, Téllez, María Jesús, Galindo, María José, Cabello, Alfonso, Rivero, Antonio, Arranz, Alberto, Cervero, Miguel, Vilalta, Ramón, Pineda, Juan A, Rivero-Juárez, Antonio, Torres, Rafael, Poveda, Eva, Rincón, Pilar, Pérez, Alexandre, Moreno, Cristina, Portilla, Irene, Díaz-Flores, Felicitas, Rivas, María E, Bisbal, Otilia, Aramburu, María J, Padilla, Sergio, Fuster, Daniel, Gutiérrez, Isabel, Viladés, Consuelo, Blanes, Marino, Arribas, José Ramón, Ibarra, Valvanera, Sanmartí, Montse, de Alda, María Ruiz, Cervantes, Manel, Salas, Ana, Dronda, Fernando, Alcaraz, Antonia, Muñoz, Leopoldo, Rodríguez, Carmen, Ribas, María Angels, Viciana, Isabel, López-Cortés, Luis, Tiraboschi, Juan, del Arco, Alfonso, Martínez, Lorena, Mena, Álvaro, Mirena, Josu, Pérez, Aurora, Ena, Javier, González-Ruano, Patricia, Vergas, Jorge, Álvarez, Beatriz, Hernández, Cristina, Ferrer, Ana, López, Pedro, Macías, Juan, Crespo, Manuel, Navarro, Maria Luisa, Iniesta, Carlos, Agea, Iván, Gómez, Juan Luis, Suárez-Zarracina, Tomás, Hernando, Asunción, Camino, Xabier, Robledano, Catalina, Ramírez, Margarita, Veloso, Sergio, Tasias, María, Bernardino, Jose Ignacio, Metola, Luis, Cairó, Mireia, de León Cano, María Teresa, Calzado, Sonia, Sarria, Cristina, Moreno, Ana, Bravo, Joaquín, Alvarez, Marta, Puerta, Teresa, Campins, Antoni A, Palacios, Rosario, Silva, Ana, de la Torre, Javier, García, Josefina, Ibarra, Sofía, Iborra, Asunción, Benito, Concha, Martín, Dolores, Pérez-Somarriba, Juncal, Prieto, Laura, Novella, María, Machuca, Isabel, Merchante, Nicolás, Morano, Luis, González, Maria Isabel, García, Luis NM, Portilla, Joaquín, Alonso, María del Mar, Pérez, Laura, Domínguez, Lourdes, Rodríguez-Arrondo, Francisco, Colomé, Joan Gregori, Padilla, Belén, Vargas, Montserrat, Castro, Iván, Castro, Juan Miguel, Sanz, Mercedes, Martinez-Lacasa, Javier, Pierola, Beatriz, Navarro, Marta, Garcia-Fraile, Lucio, Pérez-Elias, Maria Jesús, Muñoz, Ángeles, Chueca, Natalia, Carrió, Juan Carlos, Vidal, Carmen, Pérez, Carmen, Saumoy, María, Prada, José Luis, Alcaraz, Begoña, Ferrero, Oscar, Moreno, Antonio, Fenoll, Vicenta, Ruiz, Mª Pilar, Frias, Mario, Real, Luis Miguel, Miralles, Celia, Garcia, Federico, Sanz, Nieves, Sánchez-Payá, José, Pelazas, Ricardo, Rial, David, von Wichman, Miguel Ángel, Adsuar, Araceli, Gijón, Paloma, Olona, Montserrat, Calabuig, Eva, Delgado, Ana, Pérez-Martínez, Laura, Velli, Pablo, Martín-Gayo, Enrique, Gutiérrez, Carolina, Alcaraz, Maria José, Vinuesa, David, Vera, Mar, Fanjul, Francisco, Gonzalez-Domenec, Carmen, Prieto, Paula, de las Lomas, José N García, Jimeno, Amaya, López, Josefina, Merlos, Maria, Gil, Concepción, Camacho, Angela, Corma, Anais, Ocampo, Antonio, Rava, Marta, Rodríguez, Juan Carlos, Hernández, Jehovana, Bermejo, Laura, Pascual, Lidia, Pascual, Rafael, Aldamiz-Echevarría, Teresa, Rull, Anna, Cuéllar, Sandra, Escosa, Luis, Font, Roser, Madrid, Nadia, del Carmen Villalba, Maria, Martinez-Montes, Clara, Ballesteros, Juan, Murillas, Javier, Cámara, María Mar, Vidal, Asunción, Algado, José Tomas, Fernández, Marta, Pousada, Guillermo, Iribarren, Jose Antonio, Gimeno, Lina, Alemán, María Remedios, Santacreu, Mireia, Goenaga, Miguel Ángel, Tejerina, Francisco, Rodríguez-Gallego, Esther, Salavert, Miguel, Herranz, Pedro, Martinez, Marina, del Campo, Santos, Guerrero, Carlos, Ayerdi, Oskar, Homar, Francisco, de la Peña, Mireia, Meca, Marisa, Díez, Marcos, Azkune, Harkaitz, Barber, Xavier, Balsalobre, Pascual, Castellanos, Alfonso Javier, García-Bujalance, Silvia, Vivancos, Maria Jesús, Fuentes, Ana, Martin, Maria Luisa, Lopez, Iñigo, Vilchez, Helem, Lopez, Miriam, Carreres, Melissa, Ibarguren, Maialen, Agullo, Vanessa, Diez, Cristina, López-Dupla, Miguel, García, Milagros, Umerez, Maitane, Martínez-Sanz, Javier, Payeras, Antoni, Reus, Sergio, Lizardi, Aitziber, Garcia, Javier, Pérez, Leire, González-Baeza, Alicia, Anxa, Usua, González, Juan, Boix, Vicente, Kortajarena, Xabier, Pascual, Reyes, Fanciulli, Chiara, Martín-Carbonero, Maria Luz, Mellado, Maria José, Micán, Rafael, Montejano, Rocio, Montes, María Luisa, Moreno, Victoria, Pérez-Valero, Ignacio, Rúa, Guadalupe, Rodés, Berta, Sainz, Talia, Sendagorta, Elena, Stella, Natalia, Valencia, Eulalia, Velasco, Tamara, Muñoz-Fernández, María Ángeles, Torrús, Diego, Carmona, María Pilar, Roca, María, Mayoral, Mario, Vallejo, Alejandro, Serrano-Villar, Sergio, Ron, Raquel, Talavera-Rodríguez, Alba, Fernández-Felix, Borja M, Herrera, Sabina, Muriel, Alfonso, de Zárraga, Miguel Alberto, and Vivancos, María J

Published
2020
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5. Executive summary: Consensus document of GEHEP of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), along with SOCIDROGALCOHOL, SEPD and SOMAPA on hepatitis C virus infection management in drug users

Author

Pineda, Juan A., Climent, Benjamín, García, Federico, García Deltoro, Miguel, Granados, Rafael, Gómez, Fernanda, Macías, Juan, Mena, Álvaro, Merchante, Nicolás, Ochoa, Enriqueta, Roncero, Carlos, Ruiz, Juan Jesús, Téllez, Francisco, and Morano, Luis

Published
2020
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6. Executive summary: Consensus document of the diagnosis, management and prevention of infection with the hepatitis E virus: Study Group for Viral Hepatitis (GEHEP) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC)

Author

Rivero-Juárez, Antonio, Aguilera, Antonio, Avellón, Ana, García-Deltoro, Miguel, García, Federico, Gortazar, Christian, Granados, Rafael, Macías, Juan, Merchante, Nicolás, Oteo, José Antonio, Pérez-Gracia, María Teresa, Pineda, Juan Antonio, Rivero, Antonio, Rodriguez-Lazaro, David, Téllez, Francisco, and Morano-Amado, Luis E.

Published
2020
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7. Quantitative study of ESBL and carbapenemase producers in wastewater treatment plants in Spain: a culture-based detection analysis of raw and treated waters [Dataset]

Author

Universidad de Sevilla. Departamento de Microbiología, Universidad de Sevilla. CTS 2010 Resistencia antimicrobianos, Junta de Andalucía. Consejería de Universidad, Investigación e Innovación, Fundación Francisco Soria Melguizo, López Cerero, Lorena, Monge Olivares, Laura, Peñalva Moreno, Germán, Pulido, Marina R., Garrudo Bárcena, Lara, Doval Aguirre, Miguel Ángel, Ballesta Mudarra, Sofía, Merchante, Nicolás, Rasero del Real, Pablo, Cuberos Gómez, Lucila, Carpes Hortal, Graciano, Universidad de Sevilla. Departamento de Microbiología, Universidad de Sevilla. CTS 2010 Resistencia antimicrobianos, Junta de Andalucía. Consejería de Universidad, Investigación e Innovación, Fundación Francisco Soria Melguizo, López Cerero, Lorena, Monge Olivares, Laura, Peñalva Moreno, Germán, Pulido, Marina R., Garrudo Bárcena, Lara, Doval Aguirre, Miguel Ángel, Ballesta Mudarra, Sofía, Merchante, Nicolás, Rasero del Real, Pablo, Cuberos Gómez, Lucila, and Carpes Hortal, Graciano

Abstract

Background Antibiotics could modify multidrug-resistant microorganisms (MDRO) populations in urban wastewater. Water treatment plays a major role in their control. This study aimed to explain the characteristics of multidrug-resistant Gram-negative bacteria in the wastewater of a city in southern Spain, the reduction achieved by treatment and the influence of human antibiotic prescriptions. Methods We collected 24-hour composite water samples from four wastewater treatment plants (WWTPs) over one year (2021-2022) and cultured them quantitatively. All acquired ESBL/carbapenemase isolates were sequenced and genomes were compared with those of clinical isolates. Linear mixed model regression analyses were performed to assess the WWTP effect and the association with human antibiotic prescriptions. Findings Aeromonas predominated among the MDROs and KPC-2 was the main carbapenemase detected in the influents. The 44% and 30% of E. coli and K. pneumoniae influent isolates, respectively, belonged to high-risk clones; 10·6% of Enterobacteriaceae could be matched to clinical isolates and a strain from a current hospital outbreak was found in raw samples. WWTPs reduced ESBL and carbapenemase producers by 1·4-log and 1·8-log, respectively. New MDROs and persistence of certain strains were detected in effluents. Quinolone and cephalosporin prescriptions, flow-rate and population density were associated with higher OXA-48 producer counts. Interpretation Despite the reduction, additional technologies should be implemented in WWTPs receiving hospital discharges. Due to the predominance of environmental species, culture and metagenomic approaches should be combined to differentiate human and sewages origin for antibiotic resistance monitoring. Antibiotic stewardship could be a strategy to reduce the release of MDROs.

Published
2024

10. Impact of HIV on the survival of hepatocellular carcinoma in hepatitis C virus-infected patients

Author

Merchante, Nicolás, Rodríguez-Fernández, Miguel, Figueruela, Blanca, Rodríguez-Arrondo, Francisco, Revollo, Boris, Ibarra, Sofía, Téllez, Francisco, Merino, Esperanza, Montero-Alonso, Marta, Galindo, María J., Rivero-Juárez, Antonio, Santos, Ignacio de Los, Delgado-Fernández, Marcial, García-Deltoro, Miguel, Vera-Méndez, Francisco J., García, María A., Aguirrebengoa, Koldo, Portu, Joseba, Ríos-Villegas, María J., Villalobos, Marina, Alemán-Valls, María R., Mínguez, Carlos, Galera, Carlos, Macías, Juan, and Pineda, Juan A.

Published
2020
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11. Impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection

Author

Instituto de Salud Carlos III, European Commission, Merck Sharp & Dohme, Merchante, Nicolás [0000-0003-1120-8942], Merchante, Nicolás, Chico, Pablo, Márquez Saavedra, Esther, Riera, Gerónima, Herrero, Rocío, González de la Aleja, Pilar, Aller-García, Ana Isabel, Rodríguez, Juan Carlos, Rodríguez-Fernández, Miguel, Ramos, José M., Trigo, Marta, Merino, Esperanza, Instituto de Salud Carlos III, European Commission, Merck Sharp & Dohme, Merchante, Nicolás [0000-0003-1120-8942], Merchante, Nicolás, Chico, Pablo, Márquez Saavedra, Esther, Riera, Gerónima, Herrero, Rocío, González de la Aleja, Pilar, Aller-García, Ana Isabel, Rodríguez, Juan Carlos, Rodríguez-Fernández, Miguel, Ramos, José M., Trigo, Marta, and Merino, Esperanza

Abstract

[Objective] To investigate the impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection (HA-CDI)., [Methods] Retrospective study conducted in the Hospital Universitario de Valme (HUV) and the Hospital General Universitario de Alicante (HGUA) in Spain between January 2019 and February 2021. The study period was divided into non-COVID19 period (2019 and months from 2020 to 2021 with ≤30 hospitalized COVID19 patients) and COVID19 period (months from 2020 to 2021 with >30 COVID19 patients). HA-CDI incidence rates (IR) were calculated as the number of new CDI cases per 10.000 occupied bed-days (OBD) and antimicrobial consumption by means of the defined daily dose (DDD) per 1000 OBD., Results] During the COVID19 period, HA-CDI IR in the HUV was 2.6 per 10.000 OBD, which was lower than what was observed during the non-COVID19 period (4.1 per 10.000 OBD; p = 0.1). In the HGUA, HA-CDI IR during COVID19 period was 3.9 per 10.000 OBD, which was not significantly different to the IR observed during the non-COVID19 period (3.7 per 10.000 OBD; p = 0.8). There was a slight increase in the total antibiotic consumption during COVID19 period in both hospitals, with significant increases of certain high-risk antibiotics as cephalosporins., [Conclusions] HA-CDI incidence has not increased during the COVID19 pandemic in two tertiary centers in Spain, in spite of a slightly higher antibiotic consumption during the COVID19 period in both hospitals. These findings suggest that, in the presence of strict infection control measures, hospital antibiotic consumption might have a lower impact than expected on HA-CDI.

Published
2022

12. High Incidence of Asymptomatic Phase I IgG Seroconversion After an Acute Q Fever Episode: Implications for Chronic Q Fever Diagnosis

Author

Merchante, Nicolás [0000-0003-1120-8942], Rodríguez-Fernández, Miguel, Espíndola-Gómez, Reinaldo, Trigo, Marta, Castro, Carmen, Martínez Pérez-Crespo, Pedro María, Herrero, Rocío, León Jiménez, Eva, Bernal, Samuel, Corzo, Juan E., Merchante, Nicolás, Merchante, Nicolás [0000-0003-1120-8942], Rodríguez-Fernández, Miguel, Espíndola-Gómez, Reinaldo, Trigo, Marta, Castro, Carmen, Martínez Pérez-Crespo, Pedro María, Herrero, Rocío, León Jiménez, Eva, Bernal, Samuel, Corzo, Juan E., and Merchante, Nicolás

Abstract

[Background] The aim of this study was to describe the natural history of acute Q fever, including its clinical and serological evolution and progression to chronic Q fever., [Methods] Observational cohort study (January 2011–September 2020) performed at Valme University Hospital (Seville, Spain). Inclusion criteria: (1) patients aged ≥18 years; (2) acute Q fever diagnosis, defined as suggestive symptoms in the presence of phase II immunoglobulin G (IgG) titer >1:256; (3) at least 6 months’ follow-up after the acute Q fever episode. The incidence of seroconversion to a chronic Q fever serological pattern, defined as phase I IgG titers ≥1:1024 6 months after acute Q fever diagnosis, was assessed., [Results] During the study period, 117 patients were included. Thirty-four (29%) patients showed phase I IgG titers ≥1:1024 6 months after acute Q fever diagnosis. All patients with classic serological criteria for chronic Q fever diagnosis remained asymptomatic despite no specific treatment, with a median (quartile 1–quartile 3 [Q1–Q3]) follow-up of 26.5 (14–44) months in this subgroup. No cases of Q fever endocarditis nor other persistent focalized infection forms were observed during the study period., [Conclusions] A significant proportion of acute Q fever patients develop classic serological criteria for chronic Q fever diagnosis in the absence of additional data of chronic Q fever. Consequently, phase I IgG cutoff titers >1:800 should not be used as a criterion to consider such a diagnosis. The incidence of persistent focalized infection forms after acute Q fever is extremely low and does not justify the use of prophylaxis strategies.

Published
2022

14. Role of IP-10 to Predict Clinical Progression and Response to IL-6 Blockade With Sarilumab in Early COVID-19 Pneumonia. A Subanalysis of the SARICOR Clinical Trial

Author

Junta de Andalucía, Red Española de Investigación en Patología Infecciosa, Ministerio de Ciencia e Innovación (España), European Commission, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (España), Trigo-Rodríguez, Marta, Cárcel, Sheila, Navas, Ana, Espíndola-Gómez, Reinaldo, Garrido-Gracia, José Carlos, Esteban-Moreno, M. Ángeles, León-López, Rafael, Martínez Pérez-Crespo, Pedro María, Aguilar Alonso, Eduardo, Vinuesa, David, Romero Palacios, Alberto, Pérez-Camacho, Inés, Gutiérrez-Gutiérrez, Belén, Martínez-Marcos, Francisco Javier, Fernández-Roldán, Concepción, León Jiménez, Eva, Aceituno Caño, Alexandra, Corzo, Juan E., Pérez-Nadales, Elena, Riazzo, Cristina, Fuente, Carmen de la, Jurado, Aurora, Torre-Cisneros, Julián, Merchante, Nicolás, Junta de Andalucía, Red Española de Investigación en Patología Infecciosa, Ministerio de Ciencia e Innovación (España), European Commission, Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (España), Trigo-Rodríguez, Marta, Cárcel, Sheila, Navas, Ana, Espíndola-Gómez, Reinaldo, Garrido-Gracia, José Carlos, Esteban-Moreno, M. Ángeles, León-López, Rafael, Martínez Pérez-Crespo, Pedro María, Aguilar Alonso, Eduardo, Vinuesa, David, Romero Palacios, Alberto, Pérez-Camacho, Inés, Gutiérrez-Gutiérrez, Belén, Martínez-Marcos, Francisco Javier, Fernández-Roldán, Concepción, León Jiménez, Eva, Aceituno Caño, Alexandra, Corzo, Juan E., Pérez-Nadales, Elena, Riazzo, Cristina, Fuente, Carmen de la, Jurado, Aurora, Torre-Cisneros, Julián, and Merchante, Nicolás

Abstract

[Background] The Clinical Trial of Sarilumab in Adults With COVID-19 (SARICOR) showed that patients with coronavirus disease 2019 (COVID-19) pneumonia and increased levels of interleukin (IL)-6 might benefit from blockade of the IL-6 pathway. However, the benefit from this intervention might not be uniform. In this subanalysis, we sought to determine if other immunoactivation markers, besides IL-6, could identify which subgroup of patients benefit most from this intervention., [Methods] The SARICOR trial was a phase II, open-label, multicenter, controlled trial (July 2020–March 2021) in which patients were randomized to receive usual care (UC; control group), UC plus a single dose of sarilumab 200 mg (sarilumab-200 group), or UC plus a single dose of sarilumab 400 mg (sarilumab-400 group). Patients who had baseline serum samples for cytokine determination (IL-8, IL-10, monocyte chemoattractant protein–1, interferon-inducible protein [IP]-10) were included in this secondary analysis. Progression to acute respiratory distress syndrome (ARDS) according to cytokine levels and treatment received was evaluated., [Results] One hundred one (88%) of 115 patients enrolled in the SARICOR trial had serum samples (control group: n = 33; sarilumab-200: n = 33; sarilumab-400: n = 35). Among all evaluated biomarkers, IP-10 showed the strongest association with treatment outcome. Patients with IP-10 ≥2500 pg/mL treated with sarilumab-400 had a lower probability of progression (13%) compared with the control group (58%; hazard ratio, 0.19; 95% CI, 0.04–0.90; P = .04). Conversely, patients with IP-10 <2500 pg/mL did not show these differences., [Conclusions] IP-10 may predict progression to ARDS in patients with COVID-19 pneumonia and IL-6 levels >40 pg/mL. Importantly, IP-10 value <2500 pg/mL might discriminate those individuals who might not benefit from sarilumab therapy among those with high IL-6 levels.

Published
2023

15. Role of previous systemic antibiotic therapy on the probability of recurrence after an initial episode of Clostridioides difficile infection treated with vancomycin

Author

Instituto de Salud Carlos III, European Commission, Merck Sharp & Dohme, Merchante, Nicolás, Herrero, Rocío, Valverde-Fredet, María Dolores, Rodríguez-Fernández, Miguel, Pinargote, Héctor, Martínez-Marcos, Francisco Javier, Gil-Anguita, Concepción, García-López, María, Tasias Pitarch, M., Abril López de Medrano, Vicente, Navarrete Lorite, Miguel Nicolás, Gómez-Ayerbe, Cristina, León Jiménez, Eva, González de la Aleja, Pilar, Ruiz-Castillo, Ana, Aller-García, Ana Isabel, Rodríguez, Juan Carlos, Ternero-Fonseca, Julia, Corzo, Juan E., Naranjo-Pérez, Alberto, Trigo-Rodríguez, Marta, Merino, Esperanza, Instituto de Salud Carlos III, European Commission, Merck Sharp & Dohme, Merchante, Nicolás, Herrero, Rocío, Valverde-Fredet, María Dolores, Rodríguez-Fernández, Miguel, Pinargote, Héctor, Martínez-Marcos, Francisco Javier, Gil-Anguita, Concepción, García-López, María, Tasias Pitarch, M., Abril López de Medrano, Vicente, Navarrete Lorite, Miguel Nicolás, Gómez-Ayerbe, Cristina, León Jiménez, Eva, González de la Aleja, Pilar, Ruiz-Castillo, Ana, Aller-García, Ana Isabel, Rodríguez, Juan Carlos, Ternero-Fonseca, Julia, Corzo, Juan E., Naranjo-Pérez, Alberto, Trigo-Rodríguez, Marta, and Merino, Esperanza

Abstract

[Objectives ] To investigate the role of previous antibiotic therapy in the risk of recurrence after a Clostridioides difficile infection (CDI) treated with vancomycin., [Methods] Multicentre observational study. Patients with a CDI episode achieving clinical cure with oral vancomycin and followed up 8 weeks were included. Previous antibiotic exposure up to 90 days was collected. Multivariate analysis of predictors of recurrence adjusted by the propensity score (PS) of being previously treated with each non-CDI antibiotic was performed., [Results] Two hundred and forty-one patients were included; 216 (90%) had received systemic antibiotics. Fifty-three patients (22%) had a CDI recurrence. Rates of recurrence were lower in those treated with piperacillin/tazobactam in the last month when compared with those not receiving piperacillin/tazobactam [3 (7%) versus 50 (25%); P = 0.01], whereas higher rates were seen in those treated with cephalosporins in the last month [26/87 (30%) versus 27/154 (17%); P = 0.03]. In multivariate analysis controlled by the inverse probability of treatment weighting by PS, receiving ≥5 days of piperacillin/tazobactam in the last month as the last antibiotic regimen prior to CDI was independently associated with a lower risk of recurrence [adjusted OR (AOR) 0.13; 95% CI: 0.06–0.29; P < 0.0001] whereas exposure for ≥5 days to cephalosporins (versus piperacillin/tazobactam) was associated with an increased risk (AOR 10.9; 95% CI: 4.4–27.1; P < 0.0001)., [Conclusions] Recent use of piperacillin/tazobactam might be associated with a lower risk of CDI recurrence, while recent use of cephalosporins might promote an increased risk. These findings should be considered when treating hospitalized patients.

Published
2023

16. Role of IP-10 to Predict Clinical Progression and Response to IL-6 Blockade With Sarilumab in Early COVID-19 Pneumonia. A Subanalysis of the SARICOR Clinical Trial

Author

Trigo-Rodríguez, Marta, primary, Cárcel, Sheila, additional, Navas, Ana, additional, Espíndola-Gómez, Reinaldo, additional, Garrido-Gracia, José Carlos, additional, Esteban Moreno, María Ángeles, additional, León-López, Rafael, additional, Pérez-Crespo, Pedro María Martínez, additional, Alonso, Eduardo Aguilar, additional, Vinuesa, David, additional, Romero-Palacios, Alberto, additional, Pérez-Camacho, Inés, additional, Gutiérrez-Gutiérrez, Belén, additional, Martínez-Marcos, Francisco Javier, additional, Fernández-Roldán, Concepción, additional, León, Eva, additional, Caño, Alexandra Aceituno, additional, Corzo-Delgado, Juan E, additional, Perez-Nadales, Elena, additional, Riazzo, Cristina, additional, de la Fuente, Carmen, additional, Jurado, Aurora, additional, Torre-Cisneros, Julián, additional, and Merchante, Nicolás, additional

Published
2023
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17. Role of previous systemic antibiotic therapy on the probability of recurrence after an initial episode of Clostridioides difficile infection treated with vancomycin

Author

Merchante, Nicolás, primary, Herrero, Rocío, additional, Valverde-Fredet, María Dolores, additional, Rodríguez-Fernández, Miguel, additional, Pinagorte, Héctor, additional, Martínez-Marcos, Francisco J, additional, Gil-Anguita, Concepción, additional, García-López, María, additional, Tasias Pitarch, María, additional, Abril López De Medrano, Vicente, additional, Navarrete Lorite, Miguel Nicolás, additional, Gómez-Ayerbe, Cristina, additional, León, Eva, additional, González-De La Aleja, Pilar, additional, Ruiz Castillo, Ana, additional, Aller, Ana I, additional, Rodríguez, Juan Carlos, additional, Ternero Fonseca, Julia, additional, Corzo, Juan E, additional, Naranjo Pérez, Alberto, additional, Trigo-Rodríguez, Marta, additional, and Merino, Esperanza, additional

Published
2023
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20. Community-acquired pneumonia – An EFIM guideline critical appraisal adaptation for internists

Author

Er, Ahmet Gorkem, primary, Alonso, Alberto Antonio Romero, additional, Marin-Leon, Ignacio, additional, Sayiner, Abdullah, additional, Bassetti, Stefano, additional, Demirkan, Kutay, additional, Lacor, Patrick, additional, Lode, Hartmut, additional, Lesniak, Wiktoria, additional, Tanriover, Mine Durusu, additional, Kalyoncu, Ali Fuat, additional, Merchante, Nicolás, additional, and Unal, Serhat, additional

Published
2022
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21. Hepatocellular carcinoma after sustained virological response with interferon-free regimens in HIV/hepatitis C virus-coinfected patients

Author

Merchante, Nicolás, Rodríguez-Arrondo, Francisco, Revollo, Boris, Merino, Esperanza, Ibarra, Sofía, Galindo, María J., Montero, Marta, García-Deltoro, Miguel, Rivero-Juárez, Antonio, Téllez, Francisco, Delgado-Fernández, Marcial, Ríos-Villegas, María J., García, María A., Vera-Méndez, Francisco J., Ojeda-Burgos, Guillermo, López-Ruz, Miguel A., Metola, Luis, Omar, Mohamed, Alemán-Valls, María Remedios, Aguirrebengoa, Koldo, Portu, Joseba, Raffo, Miguel, Macías, Juan, and Pineda, Juan A.

Published
2018
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22. Benefits From Sustained Virologic Response to Pegylated Interferon Plus Ribavirin in HIV/Hepatitis C Virus—Coinfected Patients With Compensated Cirrhosis

Author

for the Grupo Andaluz para el Estudio de las Hepatitis Víricas (HEPAVIR) de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI), Mira, José A., Rivero-Juárez, Antonio, López-Cortés, Luis F., Girón-González, José A., Téllez, Francisco, de Ios Santos-Gil, Ignacio, Macías, Juan, Merino, Dolores, Márquez, Manuel, Ríos-Villegas, María J., Gea, Isabel, Merchante, Nicolás, Rivero, Antonio, Torres-Cornejo, Almudena, and Pineda, Juan A.

Published
2013
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23. Increasing Incidence of Hepatocellular Carcinoma in HIV-Infected Patients in Spain

Author

Merchante, Nicolás, Merino, Esperanza, López-Aldeguer, José, Jover, Francisco, Delgado-Fernández, Marcial, Galindo, Maria José, Ortega, Enrique, Rivero, Antonio, Mínguez, Carlos, Romero-Palacios, Alberto, Padilla, Sergio, Márquez-Solero, Manuel, Amador, Concepción, Ríos-Villegas, Maria José, Téllez, Francisco, Portilla, Joaquín, and Pineda, Juan A.

Published
2013
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25. Early Use of Sarilumab in Patients Hospitalized with COVID-19 Pneumonia and Features of Systemic Inflammation: the SARICOR Randomized Clinical Trial

Author

Junta de Andalucía, European Commission, Ministerio de Ciencia e Innovación (España), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (España), Merchante, Nicolás, Cárcel Fernández, Sheila, Garrido-Gracia, José Carlos, Trigo, Marta, Esteban-Moreno, M. Ángeles, León, Rafael, Espíndola-Gómez, Reinaldo, Aguilar Alonso, Eduardo, Vinuesa García, David, Romero Palacios, Alberto, Pérez-Camacho, Inés, Gutiérrez-Gutiérrez, Belén, Martínez-Marcos, Francisco Javier, Fernández-Roldán, Concepción, Martínez Pérez-Crespo, Pedro María, Aceituno Caño, Alexandra, León Jiménez, Eva, Corzo, Juan E., Fuente, Carmen de la, Torre-Cisneros, Julián, Junta de Andalucía, European Commission, Ministerio de Ciencia e Innovación (España), Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (España), Merchante, Nicolás, Cárcel Fernández, Sheila, Garrido-Gracia, José Carlos, Trigo, Marta, Esteban-Moreno, M. Ángeles, León, Rafael, Espíndola-Gómez, Reinaldo, Aguilar Alonso, Eduardo, Vinuesa García, David, Romero Palacios, Alberto, Pérez-Camacho, Inés, Gutiérrez-Gutiérrez, Belén, Martínez-Marcos, Francisco Javier, Fernández-Roldán, Concepción, Martínez Pérez-Crespo, Pedro María, Aceituno Caño, Alexandra, León Jiménez, Eva, Corzo, Juan E., Fuente, Carmen de la, and Torre-Cisneros, Julián

Abstract

The objective of this study was to investigate the efficacy and safety of early treatment with sarilumab, added to standard of care (SOC), in hospitalized adults with COVID-19. Methods included phase II, open-label, randomized, controlled clinical trial of hospitalized patients with COVID-19 pneumonia and interleukin (IL)-6 levels ≥ 40 pg/mL and/or d-dimer > 1,500 ng/mL. Participants were randomized (1:1:1) to receive SOC (control group), SOC plus a single subcutaneous dose of sarilumab 200 mg (sarilumab-200 group), or SOC plus a single subcutaneous dose of sarilumab 400 mg (sarilumab-400 group). The primary outcome variable was the development of acute respiratory distress syndrome (ARDS) requiring high-flow nasal oxygenation (HFNO), non-invasive mechanical ventilation (NIMV) or invasive mechanical ventilation (IMV) at day 28. One-hundred and 15 participants (control group, n = 39; sarilumab-200, n = 37; sarilumab-400, n = 39) were included. At randomization, 104 (90%) patients had supplemental oxygen and 103 (90%) received corticosteroids. Eleven (28%) patients in the control group, 10 (27%) in sarilumab-200, and five (13%) in sarilumab-400 developed the primary outcome (hazard ratio [95% CI] of sarilumab-400 vs control group: 0.41 [0.14, 1.18]; P = 0.09). Seven (6%) patients died: three in the control group and four in sarilumab-200. There were no deaths in sarilumab-400 (P = 0.079, log-rank test for comparisons with the control group). In patients recently hospitalized with COVID-19 pneumonia and features of systemic inflammation, early IL-6 blockade with a single dose of sarilumab 400 mg was safe and associated with a trend for better outcomes. (This study has been registered at ClinicalTrials.gov under identifier NCT04357860.).

Published
2022

29. Early Use of Sarilumab in Patients Hospitalized with COVID-19 Pneumonia and Features of Systemic Inflammation: the SARICOR Randomized Clinical Trial

Author

Merchante, Nicolás, primary, Cárcel, Sheila, additional, Garrido-Gracia, José Carlos, additional, Trigo-Rodríguez, Marta, additional, Moreno, María Ángeles Esteban, additional, León-López, Rafael, additional, Espíndola-Gómez, Reinaldo, additional, Alonso, Eduardo Aguilar, additional, García, David Vinuesa, additional, Romero-Palacios, Alberto, additional, Pérez-Camacho, Inés, additional, Gutiérrez-Gutiérrez, Belén, additional, Martínez-Marcos, Francisco Javier, additional, Fernández-Roldán, Concepción, additional, Pérez-Crespo, Pedro María Martínez, additional, Caño, Alexandra Aceituno, additional, León, Eva, additional, Corzo, Juan E., additional, de la Fuente, Carmen, additional, and Torre-Cisneros, Julián, additional

Published
2022
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30. Impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection

Author

Merchante, Nicolás, primary, Chico, Pablo, additional, Márquez-Saavedra, Esther, additional, Riera, Gerónima, additional, Herrero, Rocío, additional, González-de-la-Aleja, Pilar, additional, Aller, Ana I., additional, Rodríguez, Juan Carlos, additional, Rodríguez-Fernández, Miguel, additional, Ramos, José Manuel, additional, Trigo-Rodríguez, Marta, additional, and Merino, Esperanza, additional

Published
2022
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31. IP-10 Predicts Clinical Progression and Response to IL-6 Blockade with Sarilumab in Early COVID-19 Pneumonia. The SARICOR Clinical Trial

Author

Trigo-Rodriguez, Marta, primary, Cárcel, Sheila, additional, Navas, Ana, additional, Espíndola-Gómez, Reinaldo, additional, Garrido-Gracia, José Carlos, additional, Moreno, María Ángeles Esteban, additional, León-López, Rafael, additional, Pérez-Crespo, Pedro María Martínez, additional, Aguilar Alonso, Eduardo, additional, Vinuesa, David, additional, Romero-Palacios, Alberto, additional, Pérez-Camacho, Inés, additional, Gutiérrez-Gutiérrez, Belén, additional, Martínez-Marcos, Francisco Javier, additional, Fernández-Roldán, Concepción, additional, León, Eva, additional, Caño, Alexandra Aceituno, additional, Corzo, Juan E., additional, de la Fuente, Carmen, additional, Jurado, Aurora, additional, Torre-Cisneros, Julián, additional, and Merchante, Nicolás, additional

Published
2022
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36. High Incidence of Asymptomatic Phase I IgG Seroconversion After an Acute Q Fever Episode: Implications for Chronic Q Fever Diagnosis

Author

Rodríguez-Fernández, Miguel, primary, Espíndola Gómez, Reinaldo, additional, Trigo-Rodríguez, Marta, additional, Castro, Carmen, additional, Martínez Pérez-Crespo, Pedro, additional, Herrero, Rocío, additional, León, Eva M, additional, Bernal, Samuel, additional, Corzo, Juan E, additional, and Merchante, Nicolás, additional

Published
2021
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38. Sustained virological response to direct-acting antiviral regimens reduces the risk of hepatocellular carcinoma in HIV/HCV-coinfected patients with cirrhosis

Author

Merchante, Nicolás, Rivero-Juárez, Antonio, Téllez, Francisco, Merino, Dolores, Ríos-Villegas, María J, Villalobos, Marina, Omar, Mohamed, Rincón, Pilar, Rivero, Antonio, Pérez-Pérez, Montserrat, Raffo, Miguel, López-Montesinos, Inmaculada, Palacios, Rosario, Gómez-Vidal, María A, Macías, Juan, Pineda, Juan A, Members of the HEPAVIR-Cirrhosis Study Group, Junta de Andalucía, Instituto de Salud Carlos III, Red Española de Investigación en Patología Infecciosa, and European Commission

Subjects
Adult, Liver Cirrhosis, Male, Microbiology (medical), medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Sustained Virologic Response, HIV Infections, Lower risk, Antiviral Agents, Risk Assessment, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Pharmacology, Antiinfective agent, Coinfection, business.industry, Incidence, virus diseases, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, digestive system diseases, Regimen, Infectious Diseases, Hepatocellular carcinoma, Cohort, Female, 030211 gastroenterology & hepatology, business, Follow-Up Studies
Abstract

HEPAVIR-Cirrhosis Study Group., [Objectives] To assess the impact of all-oral direct-acting antiviral agent (DAA) regimens on the risk of hepatocellular carcinoma (HCC) in HIV/HCV-coinfected patients with cirrhosis., [Methods] This was a multicentre prospective cohort study recruiting HIV/HCV-coinfected patients with a new diagnosis of compensated cirrhosis. Patients were followed up until HCC, death or the censoring date (March 2017). The primary endpoint was the emergence of HCC. The incidence rate (IR) (95% CI) of HCC in different groups was computed. Time-to-event analyses were performed to identify predictors of HCC emergence., [Results] The study included 495 HIV/HCV-coinfected patients with cirrhosis. After a median (IQR) follow-up of 59 (27–84) months, 22 (4.4%; 95% CI 2.6–6.3) patients developed an HCC. The IR (95% CI) of HCC was 0.93 (0.06–1.42) per 100 person-years (PY). Three hundred and three (61%) patients achieved sustained virological response (SVR) during follow-up, 79 after interferon (IFN)-based regimens and 224 after an all-oral DAA regimen. The IR (95% CI) of HCC after all-oral DAA was 0.35 (0.14–0.85) per 100 PY whereas it was 1.79 (1.11–2.88) per 100 PY in the remaining cohort (P = 0.0005). When only patients with SVR were considered, the IR (95% CI) of HCC after all-oral DAA was 0.32 (0.12–0.86) whereas it was 0 per 100 PY among those with SVR after IFN-based therapies (P = 0.27). Achieving SVR with an all-oral DAA regimen during follow-up was independently associated with a lower risk of HCC emergence (subhazard ratio 0.264; 95% CI 0.070–0.991; P = 0.049)., [Conclusions] SVR with all-oral DAA regimens reduces the risk of HCC in HIV/HCV-coinfected patients with compensated cirrhosis., This study was supported by grants from the Consejería de Salud de la Junta de Andalucía (PI-0014/2014), the Servicio Andaluz de Salud (grant number SAS/111239) and the Fondo de Investigaciones Sanitarias ISCIII (grant number PI13/01621 and PI16/01443). J. A. P. is the recipient of an intensification grant from the Instituto de Salud Carlos III (grant number Programa-I3SNS). In addition, this work has been partially funded by the Spanish AIDS Research Network RD16/0025/0010 as part of the Plan Nacional R + D+I and cofinanced by ISCIII Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER).

Published
2018
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41. High Incidence of Asymptomatic Phase I IgG Seroconversion After an Acute Q Fever Episode: Implications for Chronic Q Fever Diagnosis.

Author

Rodríguez-Fernández, Miguel, Gómez, Reinaldo Espíndola, Trigo-Rodríguez, Marta, Castro, Carmen, Pérez-Crespo, Pedro Martínez, Herrero, Rocío, León, Eva M, Bernal, Samuel, Corzo, Juan E, and Merchante, Nicolás

Subjects
CHRONIC disease diagnosis, Q fever, ACADEMIC medical centers, SCIENTIFIC observation, SEROCONVERSION, DISEASE incidence, LONGITUDINAL method, SYMPTOMS
Abstract

Background The aim of this study was to describe the natural history of acute Q fever, including its clinical and serological evolution and progression to chronic Q fever. Methods Observational cohort study (January 2011–September 2020) performed at Valme University Hospital (Seville, Spain). Inclusion criteria: (1) patients aged ≥18 years; (2) acute Q fever diagnosis, defined as suggestive symptoms in the presence of phase II immunoglobulin G (IgG) titer >1:256; (3) at least 6 months' follow-up after the acute Q fever episode. The incidence of seroconversion to a chronic Q fever serological pattern, defined as phase I IgG titers ≥1:1024 6 months after acute Q fever diagnosis, was assessed. Results During the study period, 117 patients were included. Thirty-four (29%) patients showed phase I IgG titers ≥1:1024 6 months after acute Q fever diagnosis. All patients with classic serological criteria for chronic Q fever diagnosis remained asymptomatic despite no specific treatment, with a median (quartile 1–quartile 3 [Q1–Q3]) follow-up of 26.5 (14–44) months in this subgroup. No cases of Q fever endocarditis nor other persistent focalized infection forms were observed during the study period. Conclusions A significant proportion of acute Q fever patients develop classic serological criteria for chronic Q fever diagnosis in the absence of additional data of chronic Q fever. Consequently, phase I IgG cutoff titers >1:800 should not be used as a criterion to consider such a diagnosis. The incidence of persistent focalized infection forms after acute Q fever is extremely low and does not justify the use of prophylaxis strategies. [ABSTRACT FROM AUTHOR]

Published
2022
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47. Efficacy and safety of early treatment with sarilumab in hospitalised adults with COVID-19 presenting cytokine release syndrome (SARICOR STUDY): protocol of a phase II, open-label, randomised, multicentre, controlled clinical trial

Author

León López, Rafael, primary, Fernández, Sheila Cárcel, additional, Limia Pérez, Laura, additional, Romero Palacios, Alberto, additional, Fernández-Roldán, María Concepción, additional, Aguilar Alonso, Eduardo, additional, Pérez Camacho, Inés, additional, Rodriguez-Baño, Jesús, additional, Merchante, Nicolás, additional, Olalla, Julián, additional, Esteban-Moreno, M Ángeles, additional, Santos, Marta, additional, Luque-Pineda, Antonio, additional, and Torre-Cisneros, Julian, additional

Published
2020
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49. Prediction of Esophageal Varices by Liver Stiffness and Platelets in Persons with HIV infection and Compensated Advanced Chronic Liver Disease

Author

Merchante, Nicolás, Saroli Palumbo, Chiara, Mazzola, Giovanni, Pineda, Juan A., Téllez, Francisco, Rivero-Juárez, Antonio, Ríos-Villegas, María José, Maurice, James B., Westbrook, Rachel H., Judge, Rebekah, Guaraldi, Giovanni, Schepis, Filippo, Perazzo, Hugo, Rockstroh, Juergen, Boesecke, Christoph, Klein, Marina B., Cervo, Adriana, Ghali, Peter, Wong, Philip, Petta, Salvatore, Ledinghen, Victor de, Macias, Juan, Sebastiani, Giada, McGill University, Fonds de la Recherche en Sante du Québec, German Center for Infection Research, Junta de Andalucía, Instituto de Salud Carlos III, Ministerio de Ciencia, Innovación y Universidades (España), Red Española de Investigación en SIDA, European Commission, Merchante, Nicola, Saroli Palumbo, Chiara, Mazzola, Giovanni, Pineda, Juan A, Téllez, Francisco, Rivero-Juárez, Antonio, Ríos-Villegas, Maria José, Maurice, James B, Westbrook, Rachel H, Judge, Rebekah, Guaraldi, Giovanni, Schepis, Filippo, Perazzo, Hugo, Rockstroh, Juergen, Boesecke, Christoph, Klein, Marina B, Cervo, Adriana, Ghali, Peter, Wong, Philip, Petta, Salvatore, De Ledinghen, Victor, Macías, Juan, and Sebastiani, Giada

Subjects
Variceal bleeding, Transient elastography, Baveno VI criteria, HCV coinfection, esophagogastroduodenoscopy, transient elastography, variceal bleeding, Esophagogastroduodenoscopy
Abstract

In Press., [Background] People living with human immunodeficiency virus (PLWH) are at increased risk of cirrhosis and esophageal varices. Baveno VI criteria, based on liver stiffness measurement (LSM) and platelet count, have been proposed to avoid unnecessary esophagogastroduodenoscopy (EGD) screening for esophageal varices needing treatment (EVNT). This approach has not been validated in PLWH. [Methods] PLWH from 8 prospective cohorts were included if they fulfilled the following criteria: (1) compensated advanced chronic liver disease (LSM >10 kPa); (2) availability of EGD within 6 months of reliable LSM. Baveno VI (LSM 150 000/μL), expanded Baveno VI (LSM 110 000/μL), and Estudio de las Hepatitis Víricas (HEPAVIR) criteria (LSM 110 000/μL and LSM, ViiV and Merck provided a grant to establish the diagnostic center for hepatic fibrosis and steatosis at McGill University Health Centre, which is in use for the LIVEr disease in HIV Cohort. G. S. is supported by a Junior 1 and 2 Salary Award from Fonds de Recherche Santé du Québec (award numbers 27127 and 267806) and research salary from the Department of Medicine of McGill University. C. B. received funding from Dt. Leberstiftung, German Center for Infection Research (DZIF), Hector Stiftung, The European treatment network for HIV, hepatitis and global infectious diseases. This study was supported by the Consejería de Salud de la Junta de Andalucía (grant number PI-0014/2014); the Servicio Andaluz de Salud (grant number SAS/111239); the Fondo de Investigaciones Sanitarias ISCIII (grant number PI13/01621); and Project PI16/01443, funded by Instituto de Salud Carlos III, integrated in the national I + D+i 2013–2016 and co-funded by the European Union (European Regional Development Fund/European Social Fund, “Investing in your future”). A. R.-J. is the recipient of a Miguel Servet Research Contract by the Ministerio de Ciencia, Promoción y Universidades of Spain (grant number CP18/00111). J. A. P. is the recipient of an intensification grant from the Instituto de Salud Carlos III (grant number Programa-I3SNS). This work has been partially funded by the Spanish AIDS Research Network RD16/0025/0010 as part of the Plan Nacional R + D + + I and cofinanced by the Instituto de Salud Carlos III Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional.

Published
2020

50. Liver stiffness at the time of sustained virological response predicts the clinical outcome in HIV/HCV-coinfected patients with advanced fibrosis treated with direct-acting antivirals

Author

Corma-Gómez, Anaïs, Macias, Juan, Téllez, Francisco, Freyre-Carrillo, C., Morano-Amado, Luis E., Rivero-Juárez, Antonio, Ríos-Villegas, María José, Alados, Juan Carlos, Vera-Méndez, Francisco Jesús, Merchante, Nicolás, Palacios, Rosario, Granados, Rafael, Merino, Dolores, De Los Santos, Ignacio, Pineda, Juan A., Instituto de Salud Carlos III, European Commission, Red Española de Investigación en SIDA, and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica

Subjects
Cirrhosis, Hepatocellular carcinoma, virus diseases, Response, Direct-acting antivirals, HIV/HCV coinfection, Sustained, Virological, digestive system diseases
Abstract

On behalf of RIS-HEP13 and GEHEP 011 study groups. In Press., [Background] Some people living with hepatitis C virus (HCV) with sustained virological response (SVR) develop hepatic complications. Liver stiffness (LS) predicts clinical outcome in people living with human immunodeficiency virus (HIV) with active HCV coinfection, but information after SVR is lacking. We aimed to analyze the predictive ability of LS at SVR for liver complications in people living with HIV/HCV with advanced fibrosis treated with direct-acting antivirals (DAA). [Methods] In sum, 640 people living with HIV/HCV fulfilling the following criteria were included: (i) Achieved SVR with DAA-including regimen; (ii) LS ≥ 9.5 kPa before therapy; and (iii) LS measurement available at SVR. The primary endpoint was the occurrence of a liver complication—hepatic decompensation or hepatocellular carcinoma (HCC)—or requiring liver transplant after SVR. [Results] During a median (Q1–Q3) follow-up of 31.6 (22.7–36.6) months, 19 (3%) patients reached the primary endpoint. In the multivariate analysis, variables (subhazard ratio [SHR] [95% confidence interval]) associated with developing clinical outcomes were: prior hepatic decompensations (3.42 [1.28–9.12]), pretreatment CPT class B or C (62.5 [3.08–1246.42]) and MELD scores (1.37 [1.03–1.82]), CPT class B or C at SVR (10.71 [1.32–87.01]), CD4 cell counts, This work was supported in part by the Instituto de Salud Carlos III (Project “P16/01443”), integrated in the national I+D+i 2013–2016 and co-funded by the European Union (European Regional Development Fund/European Social Fund, “Investing in your future”), by the Spanish Network for AIDS investigation (RIS) (www.red.es/redes/inicio) (RD16/0025/0040), as a part of the Nacional I+ D+I, ISCIII Subdirección General de Evaluación and the European Fund for Development of Regions (FEDER) and by GEHEP-Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (GEHEP-011 project). JAP has received a research extension grant from the Programa de Intensificación de la Actividad de Investigación del Servicio Nacional de Salud Carlos III (3SNS).

Published
2020

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