Actualizaciones en Sida e Infectología
type: channel
description: ASEI es una revista científica de Fundación Huésped y la SADI que publica artículos sobre infectología, con foco en sida.
publisher: Fundación Huesped - Sociedad Argentina de Infectología
language: en
publication name: Actualizaciones en Sida e Infectología
issn: 2718-7845
items: C5 complement inhibitors: mechanisms of action, indications, risk of infections, and prevention strategies
items: ¡Thanks!
items: Syphilis in Argentina: beyond the numbers
items: The flu, ever the same and ever different, has once again shown us new paths
items: Inter-society document updating on dengue vaccination in Argentina
items: Dengue in the second trimester of pregnancy: a case of deciduitis, sub-amniotic hemorrhage, and fetal death
items: HIV-TB co-infection in Argentina: an unresolved public health issue
items: Antiretroviral treatment: what is coming
items: Beyond cardiopulmonary syndrome: Hantavirus-associated parainfectious encephalitis
items: Atypical mycobacterial infections of skin and soft tissue
items: Update on hepatitis A vaccination in Argentina
items: Antibiotic therapy adequacy to PROA flowchart in community-acquired pneumonia in moderate care patients
items: Infectious Endocarditis caused by Achromobacter xylosoxidans: Case report
items: Pneumococcal vaccination: an ongoing challenge
items: Use of aminoglycosides in patients with intra-abdominal infections in a secondary acute care hospital
items: Giant exophytic mass as a rare presentation of Kaposi's sarcoma in a person living with HIV
items: Lepromatous leprosy regarding a case diagnosed in Tierra del Fuego
items: Actinomycetoma: a purpose of a case
items: Detection of viral agents in cerebrospinal fluid in pediatrics: 7 years of experience
items: Tuberculosis preventive treatment in people living with HIV in Argentina
items: Bacillary angiomatosis and Kaposi's sarcoma in skin lesion of HIV positive patient
items: Bronchial mucormycosis, an unusual finding on bronchoscopy
items: Chromoblastomycosis: a combination therapy approach
items: Artificial intelligence in infectious diseases
items: Phagotherapy: an emerging alternative in the antibiotic multiresistance era
items: Analysis on the effects of the SARS-CoV-2 Pandemic in relation to voluntary HIV testing at a Public Hospital in Buenos Aires City
items: Carbapenem-resistant Enterobacterales: Epidemiological study of isolates in a public hospital in Santa Fe
items: Syphilis, HIV and hepatitis B in the Mother-Child binomial
items: Educational intervention to improve ceftriaxone prescription in an emergency department
items: ATV/r+RAL (DT) after failure with NNRTI

C5 complement inhibitors: mechanisms of action, indications, risk of infections, and prevention strategies
type: item
description: <pre id="tw-target-text" class="tw-data-text tw-text-large tw-ta" dir="ltr" style="text-align: left;" tabindex="-1" role="text" data-placeholder="Traducción" data-ved="2ahUKEwisgYyO69eUAxXajpUCHc6LLyUQ3ewLegQIDRAU" aria-label="Texto traducido: The C5 complement inhibitors eculizumab and ravulizumab are two monoclonal antibodies used to treat myasthenia gravis (MG), neuromyelitis optica spectrum disorder (NMOSD), atypical hemolytic uremic syndrome (aHUS), thrombotic microangiopathy (TMA), and paroxysmal nocturnal hemoglobinuria (PNH). These monoclonal antibodies target specific parts of the immune system and are therefore called targeted therapies. Their function is to block the C5 portion of complement, preventing its cleavage into C5a and C5b. The C5a portion has an inflammatory and prothrombotic effect; the C5b portion forms the terminal membrane attack complex (C5b-C9) (1, 2). In this way, inflammation that causes damage to the optic nerve, spinal cord and brainstem in NMOSD is stopped, destruction of the postsynaptic membrane is prevented in patients with MG, and hemolysis in PNH and thrombotic microangiopathy in HUS are controlled.">The C5 complement inhibitors eculizumab and ravulizumab are two monoclonal antibodies used to treat myasthenia gravis (MG), neuromyelitis optica spectrum disorder (NMOSD), atypical hemolytic uremic syndrome (aHUS), thrombotic microangiopathy (TMA), and paroxysmal nocturnal hemoglobinuria (PNH). These monoclonal antibodies target specific parts of the immune system and are therefore called targeted therapies. Their function is to block the C5 portion of complement, preventing its cleavage into C5a and C5b. The C5a portion has an inflammatory and prothrombotic effect; the C5b portion forms the terminal membrane attack complex (C5b-C9) (1, 2). In this way, inflammation that causes damage to the optic nerve, spinal cord and brainstem in NMOSD is stopped, destruction of the postsynaptic membrane is prevented in patients with MG, and hemo…
subject: Supplement
  topic: section
subject: C5
  topic: keywords
creator: Comisión de Infecciones en el Paciente Inmunocomprometido
rights: Copyright (c) 2026 Comisión de Infecciones en el Paciente Inmunocomprometido https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-05-26
publication date: 2026-05-26
doi: 10.52226/gx4cew08

¡Thanks!
type: item
description: The editorial team of Revista ASEI would like to express its sincere gratitude to the 51 reviewers who dedicated their time and expertise to the journal's meticulous editorial process over the past twelve months. During this period, 34 submissions were received and evaluated, of which 20 were accepted and published, 2 were rejected, and 12 were still under review at the end of 2025. Of the 20 published submissions, 7 were original articles, 4 were brief communications, 8 were case reports, and 1 was a review article. In addition, 6 editorials and 3 supplements were published.
subject: Communications from the Editorial Committee
  topic: section
subject: Thanks
  topic: keywords
creator: Editorial Committee
rights: Copyright (c) 2026 Comité Editorial https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-04-01
publication date: 2026-04-01
doi: 10.52226/8909fx06

Syphilis in Argentina: beyond the numbers
type: item
description: In recent years, syphilis has experienced a steady increase in Argentina, becoming one of the main challenges in the field of sexually transmitted infections (STIs). This upward trend, observed since the middle of the last decade, is reflected in the increase in notification rates, particularly among adolescents and young adults. According to data from Bulletin No. 42 on the Response to HIV and STIs in Argentina (1), the syphilis rate rose from 56.1 cases per 100,000 inhabitants in 2019 to 93 per 100,000 in 2024. The trend continued in 2025, with 46,613 confirmed cases, 71 % more than the median for the period 2020-2024 (2). It should be noted that the actual magnitude of the problem could be greater if underreporting of cases is taken into account. This scenario poses a specific health challenge. However, it is not enough to understand the phenomenon solely from the figures. Epidemiological data describe the magnitude of the problem, but do not fully explain its determinants. There is a less visible side to the STI epidemic, linked to biomedical, social, and cultural transformations that have changed sexual behaviors and perceptions of risk.
subject: Editorial
  topic: section
subject: syphilis
  topic: keywords
subject: sanitary challenge
  topic: keywords
subject: sexual behaviour
  topic: keywords
subject: risk
  topic: keywords
creator: Luciana Spadaccini
rights: Copyright (c) 2026 Luciana Spadaccini https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-04-01
publication date: 2026-04-01
doi: 10.52226/6xa30x64

The flu, ever the same and ever different, has once again shown us new paths
type: item
description: The influenza virus is a significant cause of morbidity and mortality worldwide. In addition to its well-known respiratory impact, multiple studies have shown that it can act as a trigger for major clinical events (AMI, stroke, diabetic decompensation, among others), which are equally preventable or mitigable by the available vaccine (1, 2). The emergence of a new variant (subclade) of the influenza A (H3N2) virus raised concerns among the medical community and the general population and prompted the publication of several documents by various scientific societies with the aim of providing clear information and practical tools, as well as including vaccination recommendations and specific considerations for both those who had not been vaccinated during the 2025 season and those who had received their vaccines in a timely manner (3). This editorial aims to contribute some reflections to the debate based on this scenario, improve understanding of the disease, learn about its global impact, and facilitate control strategies.
subject: Editorial
  topic: section
subject: flu
  topic: keywords
creator: Francisco Nacinovich
creator: Pablo Bonvehí
rights: Copyright (c) 2026 Francisco Nacinovich, Pablo Bonvehí https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-04-01
publication date: 2026-04-01
doi: 10.52226/bkrjtn08

Inter-society document updating on dengue vaccination in Argentina
type: item
description: Dengue fever has become a serious public health problem in Argentina, with a progressive geographic expansion and a sustained increase in the number of cases. During the 2023-2024 season, more than 580,000 cases and 419 deaths were recorded, underscoring the urgent need to implement preventive strategies that complement vector control. Vaccination with TAK-003 represents a fundamental advance in dengue prevention in Argentina within the framework of a comprehensive disease control strategy.
subject: Supplement
  topic: section
subject: dengue
  topic: keywords
subject: vaccine
  topic: keywords
subject: TAK-300
  topic: keywords
creator: Bertachini Bertachini
creator: Pablo Bonvehí
creator: Florencia Cahn
creator: María Marta Contrini
creator: Silvia González Ayala
creator: Susana Lloveras
creator: Alfonso Rodríguez Morales
creator: Hebe Vázquez
rights: Copyright (c) 2025 Octavia Bertachini, Pablo Bonvehí, Florencia Cahn, María Marta Contrini, Silvia González Ayala, Susana Lloveras, Alfonso Rodríguez Morales, Hebe Vázquez https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-16
publication date: 2025-12-16
doi: 10.52226/qswpfr05

Dengue in the second trimester of pregnancy: a case of deciduitis, sub-amniotic hemorrhage, and fetal death
type: item
description: Dengue virus infections during pregnancy are on the increase, in line with the rise in cases in general population of this arboviral disease, which has the highest global burden. The maternal-fetal implications that dengue causes during pregnancy show heterogeneous evidence, with studies primarily focused on the third trimester and peripartum period, and few assessing associated risk factors or leading to anatomo-pathological studies. We describe a case of a pregnant woman with risk factors who aquired the infection during the second trimester, resulting in a fatal outcome for the fetus, and in whom an anatomo-pathological study of the ovular remains revealed deciduitis and sub-amniotic hemorrhage.
subject: Case Report
  topic: section
subject: dengue, pregnancy, fetal death, placenta, hemorrhage
  topic: keywords
creator: Florencia Troglio
creator: Javier Mesa
creator: Gisela Wöhning
creator: Daniel Rivas
creator: Agustina Lacaze
rights: Copyright (c) 2026 Florencia Troglio, Javier Mesa, Gisela Wöhning, Daniel Rivas, Agustina Lacaze https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-04-01
publication date: 2026-04-01
doi: 10.52226/rrd9a810

HIV-TB co-infection in Argentina: an unresolved public health issue
type: item
description: Tuberculosis (TB) and HIV co-infection represents one of the most complex challenges for public health in Latin America and the Caribbean, and Argentina is no exception. In a regional context where both epidemics have shown sustained growth since 2015, the interaction between TB and HIV continues to have a disproportionate impact, particularly on the most vulnerable populations.
subject: Editorial
  topic: section
subject: tuberculosis
  topic: keywords
subject: public health
  topic: keywords
creator: Omar Sued
creator: Pedro Avedillo
rights: Copyright (c) 2025 Omar Sued, Pablo Avedillo https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/1xrd7040

Antiretroviral treatment: what is coming
type: item
description: Most people living with HIV who can access and take oral anti-retroviral therapy (ART) can enjoy a normal life expectancy. However, stigma (daily reminder of status and fear of disclosure), forgetting and the inconvenience of daily pills remain barriers to successful ART for some people (1). There is significant interest in longer-acting treatment modalities and the first ever complete long-acting (2-monthly) intramuscular injectable regimen for people who are virally suppressed was licensed for use in 2021. It consists of a novel integrase strand transfer inhibitor (INSTI) called cabotegravir, and rilpivirine, a non-nucleoside reverse transcriptase inhibitor (NNRTI). People who take it prefer it to daily oral therapy with high rates of treatment satisfaction and the discontinuation rates are low. The efficacy has been shown to be similar to that of daily oral ART in both clinical trials and clinical practice. However, the genetic barrier to resistance is lower and when virological failure occurs, single or dual class resistance is very common (2). Providing 2-monthly injections is labour-intensive for clinicians and uptake has not been as high as expected, mainly because it is not presented as an option universally. Data of off-license use in people who are not-virally suppressed are limited.
subject: Editorial
  topic: section
subject: HIV
  topic: keywords
subject: treatment
  topic: keywords
creator: Chloe Orkin
rights: Copyright (c) 2025 Chloe Orkin https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/vr0x0w90

Beyond cardiopulmonary syndrome: Hantavirus-associated parainfectious encephalitis
type: item
description: Hantavirus is a viral zoonosis transmitted primarily by rodents and classically associated with cardiopulmonary syndrome. Parainfectious neurological manifestations are rare and poorly documented in the literature. We present the case of a previously healthy 34-year-old man who developed hantavirus-associated parainfectious encephalitis as a complication of hantavirus infection. With intensive support, hemodialysis, and plasmapheresis, the patient achieved a favorable outcome. This case represents an important epidemiological and clinical contribution, highlighting the need to consider neurological manifestations in patients with hantavirus infection.
subject: Case Report
  topic: section
subject: Hantavirus, Encephalitis, Zoonoses, Plasmapheresis
  topic: keywords
creator: María Alejandrina Guerrera
creator: Micaela Nomdedeu
creator: María José Teruggi
creator: Juan Ignacio Irigoitia
creator: Anabella Erviti
creator: Guillermo Bertoni
creator: Alién Fernández
creator: Nadia Baldoni
creator: Florencia Otermin
creator: Juan Manuel Poggio
rights: Copyright (c) 2025 Maria Alejandrina Guerrera, Micaela Nomdedeu, María José Teruggi, Juan Ignacio Irigoitia, Anabella Erviti, Guillermo Bertoni, Ailén Fernández, Nadia Baldoni, Florencia Otermin, Juan Manuel Poggio https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/6zkxp194

Atypical mycobacterial infections of skin and soft tissue
type: item
description: Introduction: Nontuberculous mycobacteria (NTM) are environmental pathogens of increasing importance, responsible for skin and soft tissue infections (STIs), frequently associated with aesthetic or surgical procedures. Objectives: To describe the epidemiology, clinical characteristics, causative agents, diagnostic correlation and evolution of patients with STIs due to NTM in a High Complexity center. Materials and methods: A descriptive, observational, and retrospective study was conducted between January 2015 and December 2023, including adults with positive cultures for NTM in skin or soft tissue samples. Clinical, microbiological, and evolutionary data were collected through review of medical records. Results: Seventeen patients were identified (mean age 46 years, range 23–79; 65% female); three were immunocompromised (17.6%). The predominant clinical presentation was abscesses or nodules. Seven patients (41%) had a history of previous cosmetic procedures. The most frequently isolated species was M. abscessus (41%). The mean time to diagnosis was 40 days by culture and 5 days by PCR, the latter allowing for early initiation of treatment. Histological examination showed chronic inflammation in 10 patients, with granulomas in 4. Eight patients achieved complete resolution, two experienced relapses, and one died. Discussion: NTM infections are an emerging cause of skin and soft tissue infections, linked to the increase in cosmetic procedures. The implementation of molecular techniques allows for rapid diagnosis and timely treatment.
subject: Original article
  topic: section
subject: Nontuberculous mycobacteria, skin and soft tissue infections, aesthetic procedures.
  topic: keywords
creator: Jessica del Valle Molina
creator: Corina Nemirovsky
creator: Marisa del Lujan Sanchez
creator: Laura Barcan
creator: Luz Guadalupe Ibañez
rights: Copyright (c) 2026 Jessica del Valle Molina, Corina Nemirovsky, Marisa del Lujan Sanchez, Laura Barcan, Luz Guadalupe Ibañez https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-04-01
publication date: 2026-04-01
doi: 10.52226/cj9k3n07

Update on hepatitis A vaccination in Argentina
type: item
description: This issue of ASEI presents an update on the topic prepared by the Vaccine Commission of the Argentine Society of Infectious Diseases (SADI). This update constitutes a fundamental tool for guiding clinical and public health decisions. The document reviews current indications, vaccination schedules, outbreak control strategies, and specificities in immunocompromised hosts. The Editorial Committee of the ASEI Journal encourages all healthcare teams to read, apply, and disseminate this document. Prevention, ultimately, remains the most effective tool for preserving the health of the population.
subject: Supplement
  topic: section
subject: Hepatitis A
  topic: keywords
creator: Alejandra Gaiano
creator: Andrea Mónaco
creator: Ana De Prada
creator: Mariana Golikow
creator: Ana Ceballos
creator: Gisela Calderón Arévalo
creator: Gabriela Quintana
creator: Silvia González Ayala
rights: Copyright (c) 2025 Alejandra Gaiano, Andrea Mónaco, Martina De Prada, Mariana Golikow, Ana Ceballos, Gisela Calderón Arévalo, Gabriela Quintana , Silvia González Ayala https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/rkkqcr50

Antibiotic therapy adequacy to PROA flowchart in community-acquired pneumonia in moderate care patients
type: item
description: Introduction: Antimicrobial Stewardship Programs (ASP) use evidence-based flowcharts to standardize infection management. Their implementation is rarely evaluated, limiting the validation of their impact. Objective: To evaluate the adequacy of antibiotic treatment according to the ASP flowchart in patients with community-acquired pneumonia (CAP) hospitalized in a moderate care unit at a tertiary care center. Methods: Observational, retrospective study (April-December 2024) was conducted on 50 immunocompetent patients ≥18 years of age with CAP hospitalized in a moderate care unit. Six adequacy indicators were analyzed (empirical selection, dosage, time to first dose < 4 hours, therapeutic adjustment, sequential therapy, and treatment duration), classified as optimal (>90%), intermediate (60-90%), or low (<60%). Results were expressed using descriptive statistics. Results: The mean age was 74.8 years, and 56% were male. Adequacy was low for four indicators: empirical selection (48%), therapeutic adjustment (23%), sequential therapy (55%), and treatment duration (16%). The time to first dose < 4 hours was appropriate at an intermediate level (66%). Correct dosage (96%) was the only indicator that reached an optimal level. Discussion: There are critical gaps in the antibiotic treatment adequacy in NAC associated with low adequacy of empirical antibiotic treatment and adjustment, delay and underuse of sequential therapy, and excessively prolonged treatments. Immediate interventions from the ASP Team are needed, focusing on training in empirical selection and therapeutic adjustment, mandatory reassessment protocols to counteract therapeutic inertia, support systems for sequential therapy and duration, and prospective audits with real-time feedback.
subject: Original article
  topic: section
subject: Antimicrobial Stewardship
  topic: keywords
subject: Community Acquired Pneumonia
  topic: keywords
subject: Inpatients
  topic: keywords
subject: Guideline Adherence
  topic: keywords
creator: Joaquín Ferreira Bacciarini
creator: Angélica Benavente
creator: Mariela Seguezza
creator: Francisco Rodríguez De León
creator: Paulina Brasó
rights: Copyright (c) 2025 Joaquín Ferreira Bacciarini, Angélica Benavente, Mariela Seguezza, Francisco Rodríguez De León, Paulina Brasó https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/ncm3dt52

Infectious Endocarditis caused by Achromobacter xylosoxidans: Case report
type: item
description: Achromobacter xylosoxidans is a gram-negative, aerobic bacterium that causes invasive infections that are difficult to treat and have a high mortality rate. We present the case of a 75 years old man with a history of severe aortic stenosis admitted for acute pulmonary edema secondary to infective endocarditis, with positive blood and aortic valve cultures for said microorganism. Despite emergency clinical and surgical treatment, the patient died, highlighting the difficulty in managing endocarditis caused by rare microorganisms.
subject: Case Report
  topic: section
subject: Achromobacter xylosoxidans, Infective Endocarditis, heart valves
  topic: keywords
creator: Lucía Guadalupe Guzmán
creator: María Gabriela Peirotti
creator: Evelyn Garro
creator: Darío Conrado Quinodoz
rights: Copyright (c) 2026 Lucia Guadalupe Guzmán, María Gabriela Peirotti, Evelyn Garro, Darío Conrado Quinodoz https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-04-01
publication date: 2026-04-01
doi: 10.52226/ewa0ve09

Pneumococcal vaccination: an ongoing challenge
type: item
description: Pneumonia and invasive pneumococcal disease are associated with high morbidity and mortality, underscoring the importance of vaccination as a preventive strategy. In Argentina, since 2017, a sequential vaccination schedule with the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) has been recommended for adults aged 65 years and older, as well as for younger adults with comorbidities. The introduction of the 20-valent pneumococcal conjugate vaccine (PCV20) to replace the sequential scheme, has not only the purpose to simplify vaccination schedules but also improve adherence. The aim of this study was to describe the pneumococcal vaccination status among hospitalized adults in a Hospital in Buenos Aires, Argentina. An observational, descriptive, cross-sectional study was conducted among individuals aged 18 years and older with an indication for vaccination between November 2024 and February 2025. Patients were classified into three groups: complete vaccination (VC), incomplete vaccination (VI), and unvaccinated (NV). A total of 137 patients were analyzed; 56.9% were male, and the mean age was 74.3 years. Of them, 88.3% were older than 65 years; among younger patients, the predominant comorbidities were diabetes, smoking, HIV, and cancer. Overall, 46 patients (33.5%) had complete vaccination, 14 (10.2%) had an incomplete schedule, and 77 (56.2%) had not received any dose. None had received PCV20, as it was not available at our center during the study period. Our findings suggest that pneumococcal vaccination coverage remains suboptimal. It is essential to obtain data from local healthcare centers to develop targeted strategies to improve it.
subject: Brief communication
  topic: section
subject: Streptococcus pneumoniae
  topic: keywords
subject: vaccination
  topic: keywords
subject: adherence
  topic: keywords
creator: Marianela Paula López
creator: Paula Castro
creator: María Vanesa Durán
rights: Copyright (c) 2025 Marianela Paula López, Paula Castro, María Vanesa Durán https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/vekgxv39

Use of aminoglycosides in patients with intra-abdominal infections in a secondary acute care hospital
type: item
description: Aminoglycosides (AMG) are bactericidal, narrow-spectrum, and low-cost antibiotics, whose main limitation for clinical use is the risk of nephrotoxicity. The aim of this study was to characterize patients with intra-abdominal infections, describe the bacteriology and resistance profile, assess the frequency of acute kidney injury (AKI), and evaluate surgical outcomes. Materials and Methods: A prospective, observational study was conducted over one year, including hospitalized patients with intra-abdominal infections who received AMG therapy. AKI was defined as an increase in plasma creatinine of ≥0.3 mg/dL from baseline. Gentamicin serum levels and minimum inhibitory concentration (MIC) testing were performed. Results: A total of 126 patients were included, with a mean age of 51.6 years. The mean Karnofsky score was 89.8, and the mean Charlson comorbidity index was 1.8. The most frequent surgical diagnoses were appendicitis (38.9%), cholangitis (23%), and diverticulitis (13.5%). All patients received gentamicin, with a mean daily dose of 338.4 mg and a mean duration of 4.3 days. Escherichia coli was the most frequently isolated pathogen (68.8%), with 92.5% susceptibility to gentamicin. Clinical failure occurred in 15.1% of patients. AKI developed in 10.5% of cases, being mild in 91.7% and transient in 50%. Overall mortality was 3.2%. Patients who developed AKI were older and had higher Charlson and lower Karnofsky scores compared with controls (p<0.01). Conclusions: Aminoglycosides remain the antibiotic of choice in our setting, given their concordance with local antimicrobial susceptibility patterns. They showed a low rate of AKI and minimal therapeutic failure.
subject: Original article
  topic: section
subject: aminoglycosides, Gentamicin, Acute Kidney Injury, Anti-Bacterial Agents, Drug Resistance, Bacterial.
  topic: keywords
creator: Lucía Lamponi Tappatá
creator: Diego Maurizi
creator: Marisol Valle
creator: Analía Álvarez
creator: María Menichelli
creator: Alex Schell
creator: Matías Schulz
creator: Marlene Bustelo
creator: Naiara Paredes
creator: Dina Pedersen
creator: Celeste Martínez
creator: Alejandra Oriani
creator: Antonela Amusquibar
creator: Pamela Dietrich
creator: Mariano Echegorry
creator: Alejandra Corso
creator: Fernando Pasterán
rights: Copyright (c) 2026 Lucía Lamponi Tappatá, Diego Maurizi, Marisol Valle, Analía Álvarez, María Menichelli, Alex Schell, Matías Schulz, Marlene Bustelo, Naiara Paredes, Dina Pedersen, Celeste Martínez, Alejandra Oriani, Antonela Amusquibar, Pamela Dietrich, Mariano Echegorry, Alejandra Corso, Fernando Pasterán https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-04-01
publication date: 2026-04-01
doi: 10.52226/hp6xtd73

Giant exophytic mass as a rare presentation of Kaposi's sarcoma in a person living with HIV
type: item
description: Kaposi's sarcoma is the most common malignant tumor in people living with HIV. It typically affects the skin, mucous membranes, and lymph nodes, with the most frequent clinical presentation being erythematoviolaceous papules on the lower limbs, trunk, face, and oropharyngeal mucosa, with slow and centripetal dissemination. Visceral involvement may occur, with the gastrointestinal tract being the most frequent extracutaneous location. Evidence on atypical cutaneous presentations is limited in the literature. We present the case of a patient with a rare presentation of Kaposi's sarcoma, a giant exophytic mass resembling primary cutaneous lymphoma.
subject: Images in Infectology
  topic: section
subject: Kaposi, sarcoma. VIH. Skin neoplasm.
  topic: keywords
creator: Ana Clara Irassar
creator: Vanesa Dadon
creator: Joaquín Cabral
creator: Paola Staltari
creator: Leandro Danze
creator: Claudia G. Rodríguez
creator: Ezequiel Córdova
rights: Copyright (c) 2026 Ana clara Irassar, Vanesa Dadon, Joaquín Cabral, Paola Staltari, Leandro Danze, Claudia G. Rodríguez, Ezequiel Córdova https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-04-01
publication date: 2026-04-01
doi: 10.52226/z29c9254

Lepromatous leprosy regarding a case diagnosed in Tierra del Fuego
type: item
description: Leprosy is a chronic, endemic and ubiquitous infectious disease. In 2000, the World Health Organization declared the elimination of leprosy as a global public health problem. Although the prevalence has decreased drastically since the introduction of multidrug therapy, there are still a considerable number of cases appearing in central African countries, India, China and Brazil (1, 2, 3). In Argentina, there are 400 cases per year under treatment, and a geographic focus on provinces in the northeast, northwest and center of the country, which concentrate approximately 70% of the cases (4, 5). The importance of reporting this case in Tierra del Fuego is due to the fact that it is not an endemic area of leprosy and since it is not a public health problem, it is difficult to diagnose because physicians do not suspect it as a possible differential diagnosis within dermatoses (1).
subject: Case Report
  topic: section
subject: Leprosy, bacilloscopy multibacillary, Tierra del Fuego.
  topic: keywords
creator: Carla Cabrera
creator: Mariela Toledo
creator: Pablo Berenstein
creator: Juan Manuel Márquez
rights: Copyright (c) 2025 Carla Cabrera, Mariela Toledo, Pablo Berenstein, Juan Manuel Márquez https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/qp7z9d16

Actinomycetoma: a purpose of a case
type: item
description: We present the case of a 58-year-old male patient from Santiago del Estero, a rural worker, who consulted for an inflammatory tumor involving skin and deep tissues of the right foot, which has an estimated evolution of two years. Microbiological cultures showed dry and cerebriform colonies, which were identified as Streptomyces sp. by MALDI TOF mass spectrometry, BD Bruker ® and whole genome sequencing. The condition was diagnosed as actinomycetoma. Imaging studies showed bone involvement, so treatment with trimethoprim-sulfamethoxazole and minocycline was initiated. However, due to the development of pulmonary tuberculosis, treatment was adjusted to rifampin, ethambutol, pyrazinamide, isoniazid, and trimethoprim-sulfamethoxazole, with favorable clinical outcome.
subject: Case Report
  topic: section
subject: Streptomyces sp, actinomycetoma, micetoma
  topic: keywords
creator: Cinthya Indira Vargas Coello
creator: Carolina Ugarte
creator: Yamila Vallejos
creator: María Sol Haim
creator: Tomás Poklépovich
creator: Nadina Caraballo
creator: Noelia Costanzo
creator: Mariela Schijman
creator: María Emilia Villani
rights: Copyright (c) 2026 Cinthya Indira Vargas Coello, Carolina Ugarte, Yamila Vallejos, María Sol Haim, Tomás Poklépovich, Nadina Caraballo, Noelia Costanzo, Mariela Schijman, María Emilia Villani https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2026-04-01
publication date: 2026-04-01
doi: 10.52226/db71jt37

Detection of viral agents in cerebrospinal fluid in pediatrics: 7 years of experience
type: item
description: The diagnosis of viral meningoencephalitis and encephalitis is a frequent challenge in pediatrics and the establishment of viral etiology by polymerase chain reaction (PCR) is important because it allows guiding treatment and avoiding the unnecessary use of antibiotics. We designed a retrospective study with the aim of describing the frequency of distribution of viral agents detected in cerebrospinal fluid (CSF) of children with suspected meningoencephalitis/viral encephalitis, assessing the percentage of HSV1-2 detection in second lumbar puncture when the first result was negative and correlating with the cytophysicochemical study. CSF samples collected in the period April 2017 to February 2024 from 590 hospitalized patients were analyzed with mutiplex PCR Meningitis/Encephalitis Panel (FilmArray, Biofire Diagnostics) and commercial techniques for HSV1-2. At least one viral agent was detected in 17% of the samples, with the highest frequency of Enterovirus: 10.8%, Human Herpes-6: 3.9% and HSV1: 1.9%. Patients with detectable PCR presented meningoencephalitis: 53% and encephalitis 19%. In 22% of cases they were associated with other pathologies. All second samples (40/590) tested for HSV1-2 were negative. Cytophysicochemical tests showed no differences between cases of herpetic and non-herpetic encephalitis.
subject: Original article
  topic: section
subject: Viral meningoencephalitis, Herpetic encephalitis, Cerebrospinal fluid, Herpes simplex virus, Viral diagnosis.
  topic: keywords
creator: Maria Juliana Palau
creator: Natalia Treviño
creator: Maria Paula Eguiguren
creator: Lucía Zaccarello
creator: Sebastián Oderiz
creator: Cecilia Vescina
rights: Copyright (c) 2025 Maria Juliana Palau, Natalia Treviño, Maria Paula Eguiguren, Lucía Zaccarello, Sebastián Oderiz, Cecilia Vescina https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/2xan1a92

Tuberculosis preventive treatment in people living with HIV in Argentina
type: item
description: Tuberculosis (TB) remains a major threat to people living with HIV (PLHIV) in Argentina. Despite robust scientific evidence supporting the implementation of TB preventive therapy (TPT) in this group, its adoption in clinical practice within the country remains limited. This article discusses the need to detect and treat TB infection in PLHIV in Argentina and proposes an operational strategy for the implementation of TPT in this population. It concludes that establishing a comprehensive system for screening, treatment, and information recording in PLHIV is essential.
subject: Revision
  topic: section
subject: tuberculosis
  topic: keywords
subject: preventive treatment
  topic: keywords
subject: HIV
  topic: keywords
subject: Argentina
  topic: keywords
creator: Fernando Biasutti
rights: Copyright (c) 2025 Fernando Biasutti https://creativecommons.org/licenses/by-nc-sa/4.0/deed.es
date: 2025-12-11
publication date: 2025-12-11
doi: 10.52226/n4pn6078

Bacillary angiomatosis and Kaposi's sarcoma in skin lesion of HIV positive patient
type: item
description: Bacillary angiomatosis (BA) is a rare infectious disease, caused by bacteria of the genus Bartonella spp, transmitted by vectors such as fleas, lice and mosquitoes. It causes different clinical syndromes in humans. In patients with human immunodeficiency virus (HIV) infection with an LT CD4 + <100 cell/μL count, it is associated with the development of angiomatous lesions with neovascularization involving the skin and, with less frequency, mucous membranes, liver, spleen and bones. Kaposi's sarcoma (KS) is a neoplasm characterized by multifocal vascular hyperplasia of endothelial origin related to human herpes virus 8. It can also compromiso the skin, mucous membranes and viscera, with the epidemic variant being a marker disease of advanced HIV infection. The main clinical differential diagnosis for KS skin and mucosal lesions is the BA. Herein we present a patient with HIV/AIDS disease that developed BA and KS concomitantly in the same skin lesion.
subject: Case Report
  topic: section
subject: Bacillary angiomatosis, Kaposi’s sarcoma, HIV, AIDS
  topic: keywords
creator: Graciana Lucía Cárdenas
creator: Natalia Soledad Vittar
creator: Javier José Ricart
creator: Laura Gabriela Moreno Macías
creator: Jorge Velázquez
creator: Esteban Maronna
creator: Marcelo Corti
rights: Copyright (c) 2023 Graciana Lucía Cárdenas, Natalia Soledad Vittar, Javier José Ricart, Laura Gabriela Moreno Macías, Jorge Velázquez , Esteban Maronna, Marcelo Corti
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.179

Bronchial mucormycosis, an unusual finding on bronchoscopy
type: item
description: Mucormycosis is an infection caused by opportunistic fungi belonging to the order Mucorales. Since the SARS CoV 2 pandemic, warnings have been issued about the increase in the presentation of this infection. The presentation of tracheobronchial mucormycosis represents 37% of pulmonary involvement. We present the clinical case of a diabetic patient with severe pneumonia due to SARS VOC 2, with unfavorable evolution, who was taken to bronchoscopy and found whitish pseudomembranes obstructing the lumen of the left main bronchus, confirming histopathologically the presence of mucormycosis. A report of the present case is made to recognize the appearance of fungal infections in patients with poorly controlled diabetes and SARS COV 2 infection, who have a torpid evolution. The presence of white pseudomembranes should be an alarm sign to have this type of infections within the diagnostic possibilities.
subject: Case Report
  topic: section
subject: Diabetes mellitus
  topic: keywords
subject: mucormycosis
  topic: keywords
subject: SARS CoV 2
  topic: keywords
creator: Natalia Fernanda Calderón Lopez
creator: Diego Armando Oquendo Gahona
creator: Giovani Lastra González
creator: Jose Jovany Puentes
rights: Copyright (c) 2023 Natalia Fernanda Calderón Lopez, Diego Armando Oquendo Gahona, Giovani Lastra González, Jose Jovany Puentes
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.176

Chromoblastomycosis: a combination therapy approach
type: item
description: Chromoblastomycosis is a chronic and subcutaneous mycosis caused by various dematiaceous fungi, In Latin America, the most frequently found species are Fonsecaea pedrosoi and Cladophialophora carrionii. Treatment is a challenge because of the lack of response and recurrence in in some cases, especially in patients with extensive and chronic lesions. We report an individual with relapse of chromoblastomycosis (by Fonsecaea pedrosoi) in the right lower limb, who had undergone incomplete treatment with terbinafine and itraconazole. The patient responded favorably to retreatment with itraconazole and terbinafine combined with partial surgical resection of the lesion and skin grafting at the surgical site.
subject: Case Report
  topic: section
subject: chromoblastomycosis, terbinafine, itraconazole. tropical wart syndrome
  topic: keywords
creator: Viviana Leiro
creator: Patricia Fernández Pardal
creator: Mauro Coringrato
creator: Ornela Piñeiro
creator: Esteban Maronna
creator: Gabriela Santiso
rights: Copyright (c) 2023 Viviana Leiro, Patricia Fernández Pardal, Mauro Coringrato, Ornela Piñeiro, Esteban Maronna, Gabriela Santiso
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.164

Artificial intelligence in infectious diseases
type: item
description: We are in the midst of a true technological revolution in healthcare. Processes based upon artificial intelligence and machine learning are progressively touching all disciplinary areas, and its implementation in the field of infectious diseases is astonishing, accelerated by the COVID-19 pandemic. Today we have tools that can not only assist or carry on decision-making processes based upon guidelines or algorithms, but also modify its performance from the previously completed tasks. From optimization of the identification of resistant pathogens, selection of candidates for participating in clinical trials, the search of new antimicrobial therapeutic agents, the development of new vaccines, the prediction of future epidemics and pandemics, the clinical follow up of patients suffering infectious diseases up to the resource allocation in the management of an outbreak, are all current activities that can apply artificial intelligence in order to improve their final outcomes. This development has an exponential possibility of application, and is undoubtedly one of the main determinants that will shape medical activity in the future. Notwithstanding the maturation of this technology that is required for its definitive insertion in day-to-day healthcare activities, should be accompanied by definition of reference parameters, validation systems and regulatory guidelines that do not exist yet or are still in its initial stages.
subject: Revision
  topic: section
subject: artificial intelligence
  topic: keywords
subject: infectious diseases
  topic: keywords
subject: machine learning
  topic: keywords
subject: validation
  topic: keywords
subject: regulatory system
  topic: keywords
creator: Waldo Belloso
creator: Fernando Pasterán
creator: Valeria Burgos
creator: Sofía Díaz
creator: Vitas Ciabis
creator: Marcelo Risk
rights: Copyright (c) 2023 Waldo Belloso, Fernando Pasterán, Valeria Burgos, Sofía Díaz, Vitas Ciabis, Marcelo Risk
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.209

Phagotherapy: an emerging alternative in the antibiotic multiresistance era
type: item
description: The rising antimicrobial resistance associated with the crisis in new antibiotics production and the human and economic consequences of this phenomenon constitute a complex scenario that requires the urgent development of alternative antimicrobial strategies. Bacteriophages are viruses that infect and lyse bacteria. They have been known for over a century but in the last two decades, phage administration has gained popularity worldwide. There is an extensive body of preclinical and clinical evidence that positions phage therapy as one of the main tools for the treatment of difficult-to-treat infections. Although this is conceptually promising, its implementation is limited by the paucity of clinical data on safety and efficacy, obtained according to current scientific standards. This review describes the most relevant data on phage biology, pharmacokinetic and pharmacodynamic aspects known to date, regulatory issues, and the most relevant clinical results.
subject: Revision
  topic: section
subject: fagotherapy bacteriophage, phage, difficult-to-treat infections, antimicrobial resistance.
  topic: keywords
creator: Leda Guzzi
rights: Copyright (c) 2023 Leda Guzzi
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.123

Analysis on the effects of the SARS-CoV-2 Pandemic in relation to voluntary HIV testing at a Public Hospital in Buenos Aires City
type: item
description: The emergence of SARS-COV-2 at the end of 2019 caused difficulties for the public health system to achieve the goals set by the WHO (World’s Health Organization) focused on the eradication of HIV, mainly in developing countries. With the purpose of evaluating the impact in our field, a public hospital in Ciudad Autónoma de Buenos Aires provided the information about the volunteers tested in the time span of January 2017 up until June 2022 according to the records from the main laboratory. The number of tests conducted during the pre-pandemic were double in comparison of the ones made during the pandemic. There were significant statistical differences in the average of monthly tests conducted, with a reduction of up to 60%. Even in the course of 2022, they stayed below the numbers before 2019. Regarding the prevalence of reactive serologies, they were similar to the ones from 2019 (2.4%). Considering the lack of verified diagnosis of HIV implies the progression to AIDS, vulnerability to opportunistic infections, exposure of other people to the infection, risk of life and perpetuation of the virus in the population, it is necessary to actively retake the fight against HIV.
subject: Brief communication
  topic: section
subject: COVID-19 and HIV. Serological testing. HIV prevalence.
  topic: keywords
creator: María Teresa Gabriela Rocculi
rights: Copyright (c) 2023 María Teresa Gabriela Rocculi
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.158

Carbapenem-resistant Enterobacterales: Epidemiological study of isolates in a public hospital in Santa Fe
type: item
description: Introduction: The incidence of carbapenem-resistant Enterobacterales (CRE) rose in the last decade, and especially during the COVID-19 pandemic. Objective: To identify the antimicrobial resistance profile, as well as the frequency and type of carbapenems that were present in CRE isolations in a tertiary care hospital. Materials and methods: Epidemiological, observational and retrospective study. It included CRE isolated in clinical samples during 2021 in a tertiary care hospital in Argentina. Incidences (isolations/patients-day), confidence intervals of 95% (CI 95%) and statistical comparisons were made with OpenEpi. Results: 348 CRE were isolated (11.9 isolations/1,000 patients-day, IC95% 10.7-13.2). Incidence correlated to COVID-19 cases (rho=0.874, p<0.001). Most isolations were from the Intensive Care Unit (76.4%) and the from respiratory samples (27.6%, n=96) and blood cultures (24.4%, n=92). The main isolated CRE was Klebsiella pneumoniae (71.4%, n=260), with a general carbapenem resistance of 53.4%. KPC was the main resistance mechanism (61.2%). Two double carbapenemase-producing Enterobacterales were isolated. Klebsiella pneumoniae presented a higher overall resistance rate to non-betalactam antibiotics (60.6% vs 38.5%, p<0.001). Among CRE, a higher colistin resistance rate was found in KPC isolations (44.6% vs 23.9%, p=0.001) and lower resistance to amikacin (23.9% vs 72.6%, p<0.001). Conclusion: The difficulty in the selection of antibiotic regimens for CRE forces the treating physicians to put emphasis on the knowledge of resistance mechanisms to optimize them.
subject: Brief communication
  topic: section
subject: Carbapenem-resistant Enterobacteriaceae
  topic: keywords
subject: Carbapenems
  topic: keywords
subject: Antibiotic resistance
  topic: keywords
creator: Maximiliano Gabriel Castro
creator: Andrea Florencia Gómez Colussi2
creator: Gisela Romina Muñoz Cena2Sección de Microbiología, Hospital Dr. JB Iturraspe (Santa Fe, Argentina)
creator: Lucía Inés Ubriego
creator: Macarena Vicino
creator: Virginia Dotti
creator: María Fernanda Argarañá
rights: Copyright (c) 2023 Maximiliano Gabriel Castro, Andrea Florencia Gómez Colussi2, Gisela Romina Muñoz Cena, Lucía Inés Ubriego, Macarena Vicino, Virginia Dotti, María Fernanda Argarañá
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.151

Syphilis, HIV and hepatitis B in the Mother-Child binomial
type: item
description: INTRODUCTION Perinatal infections can be transmitted to the fetus and newborn. Syphilis, HIV and Hepatitis B must be screened during pregnancy. OBJECTIVE To know incidence, prevalence and management of syphilis, HIV and hepatitis B in the mother/child pairing. Compare results with official statistics. MATERIALS AND METHODS Retrospective, descriptive and analytical study, through review of medical records from the Sanatorio la Cañada and Hospital Pasteur in Villa Maria, Cordoba. Period 12/01/2020 to 03/31/2021. RESULTS 870 pregnancies studied, 5.3% reactive syphilis serology and 1% HIV. Maternal syphilis incidence 52.87 per 1000 pregnancies, percentage of positivity 5.3%. 76.1% under 30 years old. 41% late diagnoses. 37% incomplete treatments. Congenital syphilis incidence 18.3 per 1000 live newborns. Percentage of maternal HIV posivity 0.68%. 66.7% under 30 years old. 100% underwent correct treatment and 77.7% undetectable viral load at delivery. 100% exposed newborns studied, all undetectable viral load at birth. No cases of Hepatitis B. CONCLUSION 6.3% of pregnant women presented at least one reactive serology, prevailing age under 30 years. Percentage of maternal syphilis posivity lower than published by province of Cordoba. Congenital syphilis incidence exceeded the provincial and national (18.3 vs 1.18 vs 1.14). Percentage of maternal HIV posivity exceeded provincial ones. No detected vertical transmission of HIV at birth. Hepatitis B prevalence lower than official data. Pregnant women diagnosed with HIV have more follow-up from the health system than those diagnosed with syphilis.
subject: Original article
  topic: section
subject: Vertical Infection Transmission; HIV, Congenital Syphilis; Hepatitis B
  topic: keywords
creator: Lucia Guadalupe Guzmán
creator: Virginia Tavecchio
creator: Laureano Fraga
creator: María Soledad Frola
creator: Darío Quinodoz
rights: Copyright (c) 2023 Lucia Guadalupe Guzmán, Virginia Tavecchio, Laureano Fraga, María Soledad Frola, Darío Quinodoz
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.156

Educational intervention to improve ceftriaxone prescription in an emergency department
type: item
description: Objective: To evaluate the prevalence and appropriateness of ceftriaxone after an educational intervention in an emergency department. Methods: Quasi-experimental study, which included a consecutive sampling of unscheduled consultations of adult patients, during 2 months pre-intervention and post-intervention. The intervention consisted of training physicians to limit its indication only to specific clinical situations (meningitis, pelvic inflammatory disease, and acute abdomen). Retrospective data were used, with additional manual chart review, to validate appropriateness of antibiotic initiation and drug appropriateness. Descriptive and analytical statistics were used. Results: Among 28570 visits, 512 received ceftriaxone (1.79%; 95%CI 1.64-1.95), and only 60.54% were hospitalized. Regarding the before-after comparison, we observed a reduction in the rate of use (from 3.66% to 0.63%; p<0.001), the appropriateness in starting an antimicrobial was maintained (from 84.52% to 86.21%; p=0.778), and the appropriateness of ceftriaxone increased significantly (from 41.78% to 84.00% respectively; p<0.001). Additionally, hospital length of stay was reduced (median 6 to 5 days; p=0.014), with no difference in in-hospital mortality (19.44% vs 17.24%; p=0.691), nor in 30-day mortality (23.41% vs 18.96%; p=0.464). Conclusions: This intervention was effective. These findings represent a fundamental step in programs to optimize the use of hospital antimicrobials, aimed at reducing their overuse and consequent resistance.
subject: Original article
  topic: section
subject: Emergency Service, Hospital
  topic: keywords
subject: Practice Patterns, Physicians'
  topic: keywords
subject: Ceftriaxone
  topic: keywords
subject: Health Care Costs
  topic: keywords
subject: Drug Resistance, Bacterial
  topic: keywords
creator: Maria Florencia Grande Ratti
creator: Marisa Sanchez
creator: Naldo Genoud
creator: Facundo Arguello
creator: Maria Sol Burokas
creator: María Inés Staneloni
creator: Bernardo Julio Martínez
creator: Corina Nemirovsky
rights: Copyright (c) 2023 Maria Florencia Grande Ratti, Marisa Sanchez, Naldo Genoud, Facundo Arguello, Maria Sol Burokas, María Inés Staneloni, Corina Nemirovsky
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.196

ATV/r+RAL (DT) after failure with NNRTI
type: item
description: Background: Dual therapy has emerged as a novel concept for HIV treatment. Thisstudy was aimed at comparing a nucleoside-sparing dual regimen consisting of ATV/r + RAL (DT) vs standard therapy of ATV/r + TDF/FTC (TT) among individuals failing first NNRTI-containing treatment. Methods: Randomized multicenter open-label pilot study. Primary outcome: proportion of subjects with plasma HIV-1 RNA below the limit of detection (<50 copies/mL) at 48 weeks (W48). Secondary outcomes: proportion of discontinuation due to adverse events (AEs), time until viral suppression, time until loss of virological response, development of integrase resistance mutations, and absolute change in CD4 counts. The primary outcome was analyzed using the FDA snapshot analysis. Results: Out of 57 participants screened, 34 were randomized to receive: DT (n: 18) or TT (n: 16). At W48, virological response was achieved in 67% (n: 12/18) of participants receiving DT and 88% (n: 14/16) receiving TT by FDA snapshot analysis (p = NS) and 73% and 93% by per-protocol analysis (p = NS). CD4 cell count median change from baseline to W48 was +119 and + 52 cell/μL in DT and TT, respectively. Four participants receiving DT and one TT presented virological failure at W48, with low pVL. One participant developed an integrase resistance mutation (155H) and suppressed later on TT. Conclusion: ATV/r+RAL as second-line therapy showed a trend to more frequent virological failure, compared to TT, although the study was unpowered to prove this difference. No major differences were seen in tolerance or toxicity. This study is registered with ClinicalTrials.gov, Number: NCT01829802
subject: Original article
  topic: section
subject: Dual therapy
  topic: keywords
subject: Atazanavir
  topic: keywords
subject: Raltegravir
  topic: keywords
subject: Second-line therapy
  topic: keywords
subject: HIV experienced individuals
  topic: keywords
subject: integrase resistance
  topic: keywords
creator: Maria Ines Figueroa
creator: Omar Sued
creator: Carina Cesar
creator: Patricia Patterson
creator: Cleyton Yamamoto
creator: Valeria Fink
creator: Norma Luna
creator: Antonio Camiro-Zuñiga
creator: Ana Gun
creator: Pedro Cahn
rights: Copyright (c) 2023 María Inés Figueroa , Omar Sued, Carina Cesar, Patricia Patterson, Cleyton Yamamoto , Valeria Fink, Norma Luna, Antonio Camiro-Zúñiga, Ana Gun, Pedro Cahn
date: 2023-07-24
publication date: 2023-07-24
doi: 10.52226/revista.v31i112.193