Browsing by Author "Lasso, Martin"

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    Characteristics of HIV-associated cryptococcal meningitis in a tertiary Chilean hospital: An observational retrospective study
    (2024) Elicer, Isabel; Eugenin, Laura; Acuna, Maria Paz; Uslar, Wilhelm; Fernandez, Ana; Lasso, Martin
    Background: Central nervous system opportunistic infections can be the first presentation of an HIV infection. Our aim is to describe clinical and laboratory characteristics of HIV-associated Cryptococcal Meningitis (CM), inhospital outcomes and analyze associations of these parameters with adverse outcomes. Methods: Observational study of local cohort of HIV-associated cryptococcal meningitis in a high complexity tertiary urban hospital in Santiago, Chile. Descriptive analysis through chart review of all episodes of HIV-associated CM in adults, from 1995 to 2019. Inclusion criteria were confirmed CM with cerebrospinal fluid culture or India ink in the appropriate clinical context and HIV diagnosis. We selected relevant variables that have been described as predictors of adverse outcomes in the literature and explore associations in our cohort. Results: There were 37 HIV associated CM cases, occurring from 2000 to 2019. Majority were men (86 %) with a median age of 35 years. CM was the first HIV manifestation in 32 %. Opening pressure was measured in 10 % of patients at admission. Most CSF parameters were mildly altered, and two patients presented with completely normal CSF findings. Most patients -94,4 %- suffered adverse events secondary to antifungal therapy. Despite of recommendations against their use, steroids were frequently prescribed. Mortality was 18,9 %, and was associated with older age, and more days of headache prior to admission. Conclusions: CM clinical presentation and CSF characteristics are variable at presentation, which can lead to delayed diagnosis. Inappropriate use of corticosteroids, antifungal toxicity and suboptimal management of elevated intracranial pressure are key aspects to improve.
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    Clinical characteristics and outcomes of people living with HIV hospitalized with COVID-19: a nationwide experience
    (2021) Ceballos, Maria Elena; Ross, Patricio; Lasso, Martin; Dominguez, Isabel; Puente, Marcela; Valenzuela, Pablo; Enberg, Margarita; Serri, Michel; Muñoz, Rodrigo; Pinos, Yazmin; Silva, Macarena; Noguera, Matías; Domínguez, Angélica; Zamora, Francisco; Chilean HIV/COVID-19 Study Group
    In this prospective, multicentric, observational study, we describe the clinical characteristics and outcomes of people living with HIV (PLHIV) requiring hospitalization due to COVID-19 in Chile and compare them with Chilean general population admitted with SARS-CoV-2. Consecutive PLHIV admitted with COVID-19 in 23 hospitals, between 16 April and 23 June 2020, were included. Data of a temporally matched-hospitalized general population were used to compare demography, comorbidities, COVID-19 symptoms, and major outcomes. In total, 36 PLHIV subjects were enrolled; 92% were male and mean age was 44 years. Most patients (83%) were on antiretroviral therapy; mean CD4 count was 557 cells/mm3. Suppressed HIV viremia was found in 68% and 56% had, at least, one comorbidity. Severe COVID-19 occurred in 44.4%, intensive care was required in 22.2%, and five patients died (13.9%). No differences were seen between recovered and deceased patients in CD4 count, HIV viral load, or time since HIV diagnosis. Hypertension and cardiovascular disease were associated with a higher risk of death ( p = 0.02 and 0.006, respectively). Compared with general population, the HIV cohort had significantly more men (OR 0.15; IC 95% 0.07–0.31) and younger age (OR 8.68; IC 95% 2.66–28.31). In PLHIV, we found more intensive care unit admission (OR 2.31; IC 95% 1.05–5.07) but no differences in the need for mechanical ventilation or death. In this cohort of PLHIV hospitalized with COVID-19, hypertension and cardiovascular comorbidities, but not current HIV viro-immunologic status, were the most important risk factors for mortality. No differences were found between PLHIV and general population in the need for mechanical ventilation and death.
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    Pandemic influenza A (H1N1) in HIV-1-infected patients
    (LIPPINCOTT WILLIAMS & WILKINS, 2010) Perez, Carlos M.; Dominguez, Maria I.; Ceballos, Maria E.; Moreno, Cristina; Labarca, Jaime A.; Rabagliati, Ricardo; Vasquez, Patricia; Lasso, Martin; Serri, Michel
    Objective: To characterize the clinical presentation, course and mortality of pandemic influenza in HIV-1-infected patients in Santiago, Chile.