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Vicente Soriano

Publications and source records attributed to Vicente Soriano.

At least 19 recordsLinked to original sources
PubMed2006

Poor validity of self-reported HBV vaccination among young heroin users in Spain supports the policy "don't ask, draw a blood sample, vaccinate and try to schedule another visit".

OBJECTIVES: To assess the validity of self-reported hepatitis B virus vaccination status in young heroin users. STUDY DESIGN: Cross-sectional study among 949 street-recruited young injection heroin users (IHUs) and non-injection heroin users (NIHUs) in Madrid, Barcelona and Seville. Face-to-face interviews and dried blood spot tested for anti-HBc and anti-HBs. The validity of self-reported vaccination status was assessed comparing with the serological status. The percentage of agreement with the kappa (kappa) statistic and the positive predictive value were calculated. RESULTS: The percentage of agreement between self-reported and serologic vaccination status was 51.9% overall, with little difference by city (53.1% in Barcelona, 49.0% in Madrid and 51.5% in Seville) or between IHUs (51.3%) and NIHUs (53.0%). All the kappa scores were lower than 0.1. The positive predictive value of self-reports was less than 25% in all categories analysed, except in the city of Barcelona (37%). Among those who indicated that they had been vaccinated, 31% were actually susceptible. CONCLUSIONS: In areas with a high prevalence of infection and rising coverage of vaccination the policy "don't ask, take a blood sample, give a dose of vaccine and try to schedule another visit" should be recommended in clinical practice.

Adolescent↗
PubMed2006

[HIV entry into the cells--mechanisms and therapeutic possibilities].

Human immunodeficiency virus (HIV) entry into cells is the first step in the viral replication cycle, which has been explored as a new therapeutic target. A better knowledge of the mechanisms involved in the entry process has led to the development of agents, which may inhibit each of the different steps of the viral entry process: attachment of the gp120 to the CD4 cell receptor; binding of the gp120 to CCR5 or CXCR4 coreceptors; and the fusion of viral and cell membranes. Entry inhibitors are the latest family of antiretroviral compounds, being enfuvirtide, a fusion inhibitor, the first approved. Several other entry inhibitors are currently in clinical development and hopefully soon will be part of the therapeutic armamentarium against HIV.

Anti-HIV Agents↗
PubMed2006

Effectiveness and safety of abacavir, lamivudine, and zidovudine in antiretroviral therapy-naive HIV-infected patients: results from a large multicenter observational cohort.

OBJECTIVE: To analyze the safety and effectiveness of abacavir, lamivudine, and zidovudine (ABC/3TC/ZDV) in antiretroviral therapy (ART)-naive HIV-infected patients. DESIGN: Retrospective observational cohort study. METHODS: We analyzed all consecutive ART-naive HIV-infected patients who initiated ABC/3TC/ZDV in 71 centers throughout Spain and had a clinical visit and laboratory data at least 16 weeks after initiating this regimen. We assessed safety, mortality, new AIDS-defining conditions (ADCs) and treatment failure, the latter defined by any of the following: (1) reduction in plasma HIV-1 viral load (pVL) <1 log during the first 12 weeks of ART, unless it was less than the lower limit of quantification (LOQ); (2) failure to achieve a pVL or = LOQ after achieving a pVL <LOQ. RESULTS: A total of 730 patients were included, median patient age was 37 years, prior ADCs occurred in 20%, median pVL was 4.76 log, and median CD4 count was 255 cells/mm; 109 (14.9%) patients had <100 CD4 cells/mm. After a median follow-up of 50.5 weeks (interquartile ratio: 28-78), 104 (14.25%) patients discontinued therapy because of adverse events and 36 (4.93%) had a suspected hypersensitivity reaction to ABC. The frequency of treatment failure according to an intention-to-treat (ITT) analysis of observed data was 14.4%. In a more rigorous approach considering losses to follow-up and interruptions or switches of therapy as failures, however, the frequency of treatment failure was 22.92%. Factors independently associated with treatment failure by observed data ITT analysis were adherence <90% (hazard ratio [HR] = 4.248, 95% confidence interval [CI]: 2.640 to 6.833), methadone use (HR = 2.116, 95% CI: 1.180 to 3.797), baseline pVL (HR = 1.651, 95% CI: 1.190 to 2.292 per log), and prior ADC (HR = 1.639, 95% CI: 1.009 to 2.662). CONCLUSION: The triple-nucleoside regimen of ABC/3TC/ZDV is a reasonable option for ART-naive patients with a pVL <100,000 copies/mL in whom, for any reason, preferred regimens are not advisable, even in patients with a baseline CD4 cell count <100 cells/mm.

Adult↗
PubMed2006

Serum endostatin and bFGF as predictive factors in advanced breast cancer patients treated with letrozole.

INTRODUCTION: To investigate the value of baseline serum levels of VEGF, bFGF, endostatin and their ratio as predictive factors of response to endocrine therapy in patients with metastatic breast cancer (MBC) and positive ER treated with letrozole after tamoxifen failure. MATERIALS AND METHOD: The serum levels of endostatin, VEGF and bFGF were determined in postmenopausal patients with progressing MBC from serum samples obtained before initiation of letrozole. The relation between serum angiogenic factor levels and TTP was investigated. RESULTS: Seventy-six patients (45.2%) presented a high endostatin level (> 24.6 ng/ml), 40% low bFGF levels (0 pg/ml) and 50.4% low VEGF (=/< 187 ng/ml). With a median follow-up of 22 months, the median TTP was 12.3 months. Median TTP was worse in patients with high endostatin concentration as well as in the low bFGF group, but was not affected when VEGF was considered. When the two factors were combined, the median TTP of patients with endostatin > 24.6 ng/ml and bFGF equal 0 pg/ml was 9.5 months versus 19.5 months in patients with endostatin =/< 24.6 ng/ml and bFGF > 0 pg/ml. CONCLUSIONS: The baseline levels of bFGF and endostatin are predictive factors of efficacy in patients with MBC treated with letrozole and can select groups with different TTP.

Adult↗
PubMed2006

Injecting and HIV prevalence among young heroin users in three Spanish cities and their association with the delayed implementation of harm reduction programmes.

OBJECTIVES: To evaluate changes in the prevalence of HIV infection among young heroin users in three Spanish cities, and their association with harm reduction programmes (HRPs). METHODS: Two cross sectional studies. The 1995 study included 596 users; half were street recruited and half were recruited at drug treatment centres. The 2001-03 study included 981 street recruited users. Face to face interviews were conducted using a structured questionnaire. Samples for HIV testing (saliva in 1995 and dried blood spot in 2001-03) were collected. RESULTS: The proportion who had ever injected (IDUs) decreased in all three cities. HIV prevalence in IDUs decreased by half in Barcelona (44.1% to 20.8%) and Seville (44.2% to 22.2%), but remained constant in Madrid (36.8% and 34.9%). This difference was attributable to a decrease in HIV prevalence in long term IDUs in Barcelona and Seville, but not in Madrid. The crude odds ratio for HIV prevalence in Madrid compared with Barcelona in long term IDUs was 2.3 (95%CI 1.4 to 3.7), increasing to 3.1 (95%CI 1.5 to 6.2) after adjusting for sociodemographic and risk factors. HIV prevalence in short term IDUs was similar in all cities. In 1992 Barcelona already had 20 heroin users in methadone maintenance programmes (MMPs) per 10 000 population aged 15-49 years; Seville reached this rate in 1994, and Madrid, not until 1998. CONCLUSIONS: The prevalence of HIV infection did not decrease in long term injectors in Madrid. The delayed implementation of HRPs, especially MMPs, may be the most plausible hypothesis. This finding should shed light on decision making in countries in a similar epidemiological and sociological situation.

Adolescent↗
PubMed2006

[HIV and HCV coinfection].

Chronic hepatitis due to hepatitis C virus (HCV) infection is now one of the leading causes of morbidity and mortality among HIV-infected individuals. Coinfected patients present an accelerated course toward cirrhosis and an enhanced risk of liver toxicity associated with the use of antiretroviral agents. Treatment of chronic hepatitis C in HIV1 patients is less efficacious than in HCV-monoinfected individuals and requires particular expertise.

Anti-HIV Agents↗
PubMed2005

HTLV infection among young injection and non-injection heroin users in Spain: prevalence and correlates.

BACKGROUND: Although some studies have described the epidemiology of infection with HIV or hepatitis B and C in young users in Spain - one of the European countries with the highest prevalences - there are no studies of the prevalence of HTLV infection and the most important associated factors. OBJECTIVES: To evaluate the prevalence and main determinants of HTLV-1 and HTLV-2 infection in young heroin users (including both injection (IDUs) and non-injection drug users (NIDUs)) recruited outside health care services in three of Spain's principal cities. STUDY DESIGN: Cross-sectional cohort study. All participants (981) were street-recruited by chain referral procedures between April 2001 and December 2003. Face-to-face interviews were conducted using a structured questionnaire and dried blood spot samples were collected for serological testing. RESULTS: No sample was positive for HTLV-1 and 27 samples were positive for HTLV-2; all of these were found only in Spanish IDUs in the cities of Madrid (17, 6.2%) and Barcelona (10, 3.5%). The only two factors significantly associated with HTLV infection in the logistic regression analysis were HIV infection (OR 5.7; 95% CI 2.2-14.8) and having injected in the last 30 days (OR 6.5; 95% CI 1.4-29.8). Having been in prison (OR 2.4; 95% CI 0.9-6.4) and HCV infection (OR 3.8; 95% CI 0.5-30.7), which were strongly and significantly associated in the bivariate analysis, were no longer significant in the logistic analysis. Almost the same variables were selected in the tree analysis, in which subjects could be classified into three groups: high prevalence (28.5%, HIV+ and HBV+ who had injected in the last 30 days), medium prevalence (17.8%) and low (<3%) or zero prevalence (HIV-, HCV- and HBV-). CONCLUSIONS: HTLV-1 was not detected among young Spanish heroin users. HTLV-2 was not found in NIDUs (perhaps due to the low rate of sexual transmission); it was found only in IDUs from Madrid and Barcelona, but not in those from Seville. Its prevalence is very low and the main correlates of infection were HIV infection and injection as the usual route of heroin administration.

Adolescent↗
PubMed2005

[Regulation of transcription in different HIV-1 subtypes].

Transcriptional activation of HIV-1 gene expression is controlled in part by the interaction of viral and cellular transcription factors with the HIV-1 long terminal repeat (LTR) sequences. LTR variability among different HIV-1 subtypes could affect LTR binding of either cellular or viral elements, influencing the transcription level. This effect, in turn, may have consequences on the biology of the different HIV-1 clades and on disease progression. In some circumstances, a relationship between replication capacity in vitro and changes in binding sequences for transcription factors located at the LTR has been proven.

Cells, Cultured↗
PubMed2005

Therapeutic drug monitoring and the inhibitory quotient of antiretroviral drugs: can they be applied to the current situation?

Therapeutic drug monitoring is attracting growing interest as a means of increasing the effectiveness of antiretroviral therapy and of decreasing its toxicity, although data supporting this strategy are still scarce. Currently, nucleoside analog reverse-transcriptase inhibitors (NARTI) are not candidates because their effect depends on their active intracellular form and not on plasma concentration. Protease inhibitors (PI) and non-nucleoside analogue reverse-transcriptase inhibitors (NNARTI) meet the criteria for therapeutic drug monitoring. The main limitations are that the parameters to be monitored in order to measure exposure to the drug and the effective concentration of the drug have not been well defined. The few studies performed in treatment-naive patients have demonstrated that monitoring improves therapeutic efficacy. This strategy will be particularly useful when the risk of subtherapeutic or toxic concentrations is especially high (pharmacokinetic interactions, intestinal malabsorption, adverse effects, virological failure without obvious cause, pregnancy, children). Although it remains to be standardized, the inhibitory quotient integrates pharmacological and virological parameters and is useful in patients with prior virological failure. Any therapeutic drug monitoring program should be accompanied by measures to monitor and improve treatment adherence. There are good reasons to believe that therapeutic drug monitoring can be useful to improve treatment in specific circumstances. However, before its widespread use as a routine method can be recommended, the parameters to be used should be standardized and studies with appropriate methodology should be performed to define the role of therapeutic drug monitoring in distinct clinical situations.

Algorithms↗
PubMed2004

[Rate of infection by blood-borne viruses in active heroin users in 3 Spanish cities].

BACKGROUND AND OBJECTIVE: The objective of this paper was to determine the prevalence of human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) and human T lymphotropic virus (HTLV) infections in active heroin users in Spain. SUBJECTS AND METHOD: A cross-sectional study was carried out in 440 heroin users in three different urban areas of Spain: Barcelona, Madrid, and Seville. Specimens were analyzed for the presence of anti-HIV, anti-HCV, anti-HBc, and anti-HTLV antibodies. RESULTS: The rate of anti-HIV antibodies was 20% (CI 95%, 16.3-23.7%); anti-HBc: 21.4% (CI 95%, 17.5-25.2%); anti-HCV: 59.1% (CI 95%, 54.5-63.7%); and anti-HTLV (HTLV-II in all cases): 3.4% (CI 95%, 1.7-5.1%). Barcelona and Madrid had similar rates for each virus, yet these were lower in Seville especially with regard to HCV (Barcelona: 59.7% [CI 95%, 53.1-66.3%]; Madrid: 63.8% [CI 95%, 56.7-70.9%]; Seville: 41.8% [CI 95%, 28.8-54.9%]). CONCLUSIONS: HCV is the most prevalent infection among active heroin users in Spain. The rate of infection by blood-borne viruses is higher in Madrid and Barcelona than in Seville (notably for HCV), most likely due to a lower rate of intravenous users in this city.

Adult↗
PubMed2004

Failure to detect human immunodeficiency virus type 1 superinfection in 28 HIV-seroconcordant individuals with high risk of reexposure to the virus.

We have examined the occurrence of HIV-1 superinfection in 14 HIV-seroconcordant couples (i.e., partners were independently infected with different HIV-1 strains) with high risk of reexposure to the virus. Phylogenetic analyses based on pol and env global sequences obtained from more than 100 longitudinal plasma samples (corresponding to a period of 1-4 years) failed to detect HIV-1 superinfection in this cohort of patients. Our results suggest that despite recent reports of HIV-1 reinfection, chronic HIV infection seems to confer protection against superinfection with a second HIV-1 strain.

CD4 Lymphocyte Count↗
PubMed2004

[HIV-2 and HTLV-I/II infections in Spain].

Up to December 2002, a total of 56, 566 and 109 cases of human T-lymphotropic virus type 1 (HTLV-I), HTLV-II and human immunodeficiency virus type 2 (HIV-2) infection, respectively, were identified in Spain. Most HTLV-I- and HIV-2-infected subjects were immigrants from endemic areas or Spaniards who had traveled to, or had sexual contacts with natives from, these areas. In contrast, HTLV-II infection was mainly limited to Spanish intravenous drug users (IDU) who were frequently coinfected with HIV-1. Among HTLV-I-infected patients, 12 developed subacute myelopathy and 4 adult T-cell leukemia. As for the HIV-2-positive subjects, only 20 (18.3%) developed AIDS. There was no evidence of an increase in the incidence of HIV-2 and HTLV-I infections over time. In contrast, HTLV-II infection has spread in recent years among the HIV-1-positive IDU population in prisons, with a rate of 18% in some regions of Spain. Nevertheless, the prevalence of HTLV-II infection in HIV-1-positive IDU outpatients is still low (4.7%).

Adolescent↗
PubMed2004

[Advances in the diagnosis and treatment of the infection by the hepatitis B virus].

Infection by the hepatitis B virus (HBV) is a significant cause of morbidity and mortality, mainly due to evolvement to cirrhosis and hepatocellular carcinoma. The prevalence and genotypic distribution of HBV infection has marked geographic differences. HBV infection is a very dynamic process, with a phase of immune tolerance and high viral replication, followed by HBeAg clearance, not always accompanied by complete suppression of HBV replication. The latter situation corresponds to negative HBeAg hepatitis, which represents a group relatively resistant to therapy. The three approved drugs for the treatment of HBV infection (interferon alpha, lamivudine and adefovir) have limited efficacy. Relapses are more common with lamivudine and adefovir, requiring often long-term treatment. While the selection of lamivudine resistance mutations is frequent, adefovir has a high genetic barrier. HIV infection negatively impacts on HBV disease, requiring these coinfected patients strategies aimed to manage both viruses.

Antiviral Agents↗