Manifestaciones clínicas y marcadores biológicos en la historia natural de la infección por el VIH-1 en niños infectados verticalmente. Estudio longitudinal
Clinical manifestations and biological markers in the natural history of hiv-1 infection. Longitudinal study
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Barrueco, C.A. Jiménez, M.T. Vega, E. Garrido" "autores" => array:5 [ 0 => array:2 [ "nombre" => "M.A." "apellidos" => "Hernández-Mezquita" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Barrueco" ] 2 => array:2 [ "nombre" => "C.A." "apellidos" => "Jiménez" ] 3 => array:2 [ "nombre" => "M.T." "apellidos" => "Vega" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Garrido" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403300773073?idApp=UINPBA00005H" "url" => "/16954033/0000005200000002/v1_201307051448/S1695403300773073/v1_201307051448/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Manifestaciones clínicas y marcadores biológicos en la historia natural de la infección por el VIH-1 en niños infectados verticalmente. Estudio longitudinal" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "138" "paginaFinal" => "147" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Resino, J.M. Bellón, J.L. Jiménez, D. Gurbindo, M.A. Muñoz-Fernández" "autores" => array:5 [ 0 => array:3 [ "nombre" => "S." "apellidos" => "Resino" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "J.M." "apellidos" => "Bellón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.L." "apellidos" => "Jiménez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "D." "apellidos" => "Gurbindo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:4 [ "nombre" => "M.A." "apellidos" => "Muñoz-Fernández" "email" => array:1 [ 0 => "Mmunoz@cbm.uam.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Inmunología. Hospital Central Universitario Gregorio Marañón. Madrid." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Sección de Inmuno-Pediatría. Hospital Central Universitario Gregorio Marañón. Madrid." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dra. M.A. Muñoz-Fernández. Servicio de Inmunología. Hospital General Universitario Gregorio Marañón. Dr. Esquerdo, 46. 28007 Madrid." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical manifestations and biological markers in the natural history of hiv-1 infection. Longitudinal study" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-04-30" "fechaAceptado" => "1999-05-31" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186236" "palabras" => array:7 [ 0 => "VIH-1" 1 => "Niños" 2 => "Carga viral" 3 => "Fenotipo biológico" 4 => "Linfocitos T CD4+" 5 => "Supervivencia" 6 => "Marcadores pronósticos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Estudiar el valor predictivo de marcadores inmunológicos, virológicos y parámetros clínicos en la dinámica de progresión a muerte durante el seguimiento de una cohorte de 43 niños infectados por el VIH-1.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo en 43 niños infectados verticalmente por el VIH-1, menores de 12 meses de edad (rango, 0-11,80 meses) que no habían recibido tratamiento antiretroviral en el momento de su inclusión en el estudio. La cinética de replicación y el fenotipo de los aislados virales se determinó por cocultivo en CMSP y en MT-2, respectivamente. La carga viral se cuantificó en plasma utilizando el método estandarizado de RT-PCR de Roche. Las subpoblaciones linfocitarias se determinaron por citometría de flujo</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Realizamos un análisis multivariante de Cox, obteniendo un riesgo relativo de 6,42 (intervalo de confianza del 95%, 1,28-32,03); (p = 0,023) para los niños con una mediana de carga viral superior a 5 log10 copias/ml y de 6,84(intervalo de confianza del 95%, 1,52-30,69); (p = 0,012) para niños con cinética de replicación R/A. También estudiamos el valor predictivo de los síntomas clínicos y observamos que los síntomas con mayor valor predictivo de progresión a muerte fueron la encefalopatía progresiva (3,60 [IC 95%; 0,92-14,06; p = 0,065]) y la cardiopatía (6,29 [IC 95%: 1,59 - 24,85; p = 0,008]).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los marcadores inmunológicos y virológicos predictivos de progresión a muerte más importantes fueron la mediana de carga viral superior a 5 log10 y los aislados virales con cinética de replicación R/A a lo largo del estudio. Además, la encefalopatía progresiva y la cardiopatía se comportaron como marcadores independientes predictivos de progresión a muerte.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To study the relationship among clinical symptoms and biological markers as predictive value of progression to death in HIV-1 vertically infected infants</p> <span class="elsevierStyleSectionTitle">Patient and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We carry out a prospective study in 43 HIV-1 infants with a mean age of 4.27 (range: 0-11.8 months). None of the infant's mothers had received any antiviral treatment during pregnancy. None of the infants were breastfed. They were routinely assessed for clinical symptoms during follow-up</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Cox regression analysis was used to study the hazard ratio (HR) of progression to death. For the median viral load > 5 log10, the HR was 6.42 (95% CI, 1.28-32.03) (p = 0.023) and 6.84 (95% CI, 1.52-30,69) (p = 0.012) for biological phenotype of viral isolates with rapid replication and high titter (R/H-X4). We also study the predictive value of the clinical symptoms and we observe that the symptoms with more HR of progression to death were the progressive encephalopathy (3.60 [95% CI, 0.92-14.06; p = 0.065]) and the cardiopathy (6.29 [95% CI, 1.59-24.85; p = 0.008]).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Our data indicate that viral load > 5 log10 and biological phenotype R/H-X4 of virus isolates along the study are predictive markers of progression to death. In addition, the progressive encephalopathy and cardiopathy were also markers of progression death.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:51 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 6 | 12 | 18 |
| 2024 Octubre | 36 | 47 | 83 |
| 2024 Septiembre | 27 | 49 | 76 |
| 2024 Agosto | 52 | 95 | 147 |
| 2024 Julio | 37 | 44 | 81 |
| 2024 Junio | 48 | 36 | 84 |
| 2024 Mayo | 28 | 29 | 57 |
| 2024 Abril | 27 | 30 | 57 |
| 2024 Marzo | 23 | 33 | 56 |
| 2024 Febrero | 39 | 39 | 78 |
| 2024 Enero | 26 | 30 | 56 |
| 2023 Diciembre | 22 | 18 | 40 |
| 2023 Noviembre | 31 | 21 | 52 |
| 2023 Octubre | 25 | 24 | 49 |
| 2023 Septiembre | 17 | 25 | 42 |
| 2023 Agosto | 26 | 25 | 51 |
| 2023 Julio | 25 | 39 | 64 |
| 2023 Junio | 26 | 28 | 54 |
| 2023 Mayo | 32 | 23 | 55 |
| 2023 Abril | 22 | 19 | 41 |
| 2023 Marzo | 26 | 35 | 61 |
| 2023 Febrero | 12 | 14 | 26 |
| 2023 Enero | 13 | 25 | 38 |
| 2022 Diciembre | 33 | 23 | 56 |
| 2022 Noviembre | 37 | 41 | 78 |
| 2022 Octubre | 32 | 57 | 89 |
| 2022 Septiembre | 29 | 37 | 66 |
| 2022 Agosto | 34 | 56 | 90 |
| 2022 Julio | 22 | 45 | 67 |
| 2022 Junio | 26 | 43 | 69 |
| 2022 Mayo | 23 | 36 | 59 |
| 2022 Abril | 20 | 41 | 61 |
| 2022 Marzo | 26 | 54 | 80 |
| 2022 Febrero | 18 | 31 | 49 |
| 2022 Enero | 25 | 40 | 65 |
| 2021 Diciembre | 20 | 49 | 69 |
| 2021 Noviembre | 14 | 48 | 62 |
| 2021 Octubre | 32 | 49 | 81 |
| 2021 Septiembre | 20 | 55 | 75 |
| 2021 Agosto | 12 | 27 | 39 |
| 2021 Julio | 27 | 40 | 67 |
| 2021 Junio | 18 | 45 | 63 |
| 2021 Mayo | 9 | 27 | 36 |
| 2021 Abril | 38 | 58 | 96 |
| 2021 Marzo | 54 | 30 | 84 |
| 2021 Febrero | 60 | 18 | 78 |
| 2021 Enero | 49 | 26 | 75 |
| 2020 Diciembre | 34 | 18 | 52 |
| 2020 Noviembre | 20 | 29 | 49 |
| 2020 Octubre | 19 | 17 | 36 |
| 2020 Septiembre | 16 | 17 | 33 |
| 2020 Agosto | 25 | 9 | 34 |
| 2020 Julio | 20 | 17 | 37 |
| 2020 Junio | 17 | 4 | 21 |
| 2020 Mayo | 27 | 10 | 37 |
| 2020 Abril | 24 | 12 | 36 |
| 2020 Marzo | 21 | 10 | 31 |
| 2020 Febrero | 32 | 20 | 52 |
| 2020 Enero | 27 | 21 | 48 |
| 2019 Diciembre | 30 | 19 | 49 |
| 2019 Noviembre | 21 | 14 | 35 |
| 2019 Octubre | 13 | 13 | 26 |
| 2019 Septiembre | 13 | 17 | 30 |
| 2019 Agosto | 22 | 14 | 36 |
| 2019 Julio | 26 | 8 | 34 |
| 2019 Junio | 20 | 27 | 47 |
| 2019 Mayo | 44 | 59 | 103 |
| 2019 Abril | 23 | 32 | 55 |
| 2019 Marzo | 13 | 8 | 21 |
| 2019 Febrero | 21 | 12 | 33 |
| 2019 Enero | 9 | 9 | 18 |
| 2018 Diciembre | 21 | 10 | 31 |
| 2018 Noviembre | 18 | 11 | 29 |
| 2018 Octubre | 33 | 15 | 48 |
| 2018 Septiembre | 18 | 3 | 21 |
| 2018 Agosto | 1 | 0 | 1 |
| 2018 Julio | 2 | 0 | 2 |
| 2018 Mayo | 1 | 0 | 1 |
| 2018 Abril | 8 | 0 | 8 |
| 2018 Marzo | 5 | 0 | 5 |
| 2018 Febrero | 6 | 0 | 6 |
| 2018 Enero | 6 | 0 | 6 |
| 2017 Diciembre | 4 | 0 | 4 |
| 2017 Noviembre | 16 | 0 | 16 |
| 2017 Octubre | 16 | 0 | 16 |
| 2017 Septiembre | 8 | 0 | 8 |
| 2017 Agosto | 11 | 0 | 11 |
| 2017 Julio | 12 | 0 | 12 |
| 2017 Junio | 14 | 9 | 23 |
| 2017 Mayo | 18 | 7 | 25 |
| 2017 Abril | 15 | 3 | 18 |
| 2017 Marzo | 9 | 13 | 22 |
| 2017 Febrero | 8 | 3 | 11 |
| 2017 Enero | 5 | 2 | 7 |
| 2016 Diciembre | 18 | 3 | 21 |
| 2016 Noviembre | 29 | 8 | 37 |
| 2016 Octubre | 33 | 5 | 38 |
| 2016 Septiembre | 26 | 3 | 29 |
| 2016 Agosto | 17 | 4 | 21 |
| 2016 Julio | 12 | 3 | 15 |
| 2016 Junio | 2 | 0 | 2 |
| 2016 Mayo | 2 | 0 | 2 |
| 2016 Abril | 1 | 0 | 1 |
| 2016 Marzo | 1 | 0 | 1 |
| 2016 Febrero | 14 | 0 | 14 |
| 2016 Enero | 1 | 0 | 1 |
| 2015 Diciembre | 3 | 0 | 3 |
| 2015 Octubre | 1 | 0 | 1 |
| 2015 Agosto | 4 | 0 | 4 |
| 2015 Julio | 15 | 0 | 15 |
| 2015 Junio | 3 | 0 | 3 |
| 2015 Mayo | 12 | 0 | 12 |
| 2015 Abril | 10 | 0 | 10 |
| 2015 Marzo | 9 | 0 | 9 |
| 2015 Febrero | 2 | 0 | 2 |
| 2015 Enero | 11 | 0 | 11 |
| 2014 Diciembre | 10 | 0 | 10 |
| 2014 Noviembre | 11 | 0 | 11 |
| 2014 Octubre | 8 | 0 | 8 |
| 2014 Septiembre | 8 | 0 | 8 |
| 2014 Agosto | 8 | 0 | 8 |
| 2014 Julio | 5 | 0 | 5 |
| 2014 Junio | 19 | 0 | 19 |
| 2014 Mayo | 16 | 0 | 16 |
| 2014 Abril | 14 | 0 | 14 |
| 2014 Marzo | 12 | 0 | 12 |
| 2014 Febrero | 11 | 0 | 11 |
| 2014 Enero | 11 | 0 | 11 |
| 2013 Diciembre | 19 | 0 | 19 |
| 2013 Noviembre | 14 | 0 | 14 |
| 2013 Octubre | 12 | 0 | 12 |
| 2013 Septiembre | 11 | 0 | 11 |
| 2013 Agosto | 11 | 0 | 11 |
| 2013 Julio | 4 | 0 | 4 |
| 2013 Junio | 2 | 0 | 2 |
| 2013 Mayo | 5 | 0 | 5 |
| 2013 Abril | 4 | 0 | 4 |
| 2013 Marzo | 2 | 0 | 2 |
| 2013 Febrero | 15 | 0 | 15 |
| 2013 Enero | 11 | 0 | 11 |
| 2012 Diciembre | 9 | 0 | 9 |
| 2012 Noviembre | 10 | 0 | 10 |
| 2012 Octubre | 1 | 0 | 1 |
| 2012 Septiembre | 6 | 0 | 6 |
| 2012 Agosto | 1 | 0 | 1 |
| 2000 Febrero | 1179 | 0 | 1179 |
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