María Luisa Montes-Ramírez

Hospital Universitario La Paz

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Trends

Author Order

Document Type

Co-Authors

José Ramón Arribas

Hospital Universitario La Paz

Ignacio Valero

University of Córdoba

Alicia González-Baeza

Universidad Autónoma de Madrid

Rafael Rubio

Research Institute Hospital 12 de Octubre

Francisco Zamora

Hospital Barros Luco-Trudeau

Federico Pulido

Hospital Universitario 12 De Octubre

Carmen Bayón

Hospital Universitario La Paz

José I. Bernardino

Hospital Universitario La Paz

María Lagarde

Hospital Universitario 12 De Octubre

Miriam Estébanez

Hospital Central de la Defensa Gómez Ulla

Cooperative Institutions

Instituto de Salud Carlos III

Centro de Investigación Biomédica en Red

Hospital Universitario La Paz

Hospital Universitario Ramón y Cajal

Hospital General Universitario Gregorio Marañón

Hospital Universitario de Valme

Fundación Seimc-Gesida

Universidad Autónoma de Madrid

Universitat Autònoma de Barcelona

Hospital Universitario 12 De Octubre

Author Statistics

Papers

Citation

H-Index

i-10 index

Research Field

Neurocognitive Impairment in Patients Treated with Protease Inhibitor Monotherapy or Triple Drug Antiretroviral Therapy

PLoS ONE (2013)

Ignacio Valero Alicia González-Baeza Miriam Estébanez María Luisa Montes-Ramírez Carmen Bayón

Background In patients who remain virologically suppressed in plasma with triple-drug ART a switch to protease inhibitor monotherapy maintains high rates of suppression; however it is unknown if protease inhibitor monotherapy is associated to a higher rate of neurocognitive impairment. Methods In this observational, cross-sectional study we included patients with plasma virological suppression (≥1 year) without concomitant major neurocognitive confounders, currently receiving for ≥1 year boosted lopinavir or darunavir as monotherapy or as triple ART. Neurocognitive impairment was defined as per the 2007 consensus of the American Association of Neurology. The association between neurocognitive impairment and protease inhibitor monotherapy, adjusted by significant confounders, was analysed. Results Of the 191 included patients - triple therapy: 96, 1–2 years of monotherapy: 40 and >2 years of monotherapy: 55 - proportions (95% CI) with neurocognitive impairment were: overall, 27.2% (20.9–33.6); triple therapy, 31.6% (22.1–41.0); short-term monotherapy, 25.0% (11.3–38.7); long-term monotherapy: 21.4% (10.5–32.3); p = 0.38. In all groups, neurocognitive impairment was mildly symptomatic or asymptomatic by self-report. There were not significant differences in Global Deficit Score by group. In the regression model confounding variables for neurocognitive impairment were years on ART, ethnicity, years of education, transmission category and the HOMA index. Adjusted by these variables the Odds Ratio (95% CI) for neurocognitive impairment of patients receiving short-term monotherapy was 0.85 (0.29–2.50) and for long-term monotherapy 0.40 (0.14–1.15). Conclusions Compared to triple drug antiretroviral therapy, monotherapy with lopinavir/ritonavir or darunavir/ritonavir in patients with adequate plasma suppression was not associated with a higher rate of asymptomatic neurocognitive impairment than triple drug ART.

Protease inhibitor (pharmacology)

Neurocognitive

Pharmacotherapy

10.1371/journal.pone.0069493

Cite

Citations (25)

Safety and efficacy of an induction dose of pegylated interferon alpha‐2a on early hepatitis C virus kinetics in HIV/HCV co‐infected patients: the CORAL‐1 multicentre pilot study

Journal of Viral Hepatitis (2007)

Cristina Tural R. Solà Rafael Rubio Miguel Santín Ramón Planas

To evaluate the safety and efficacy of an induction dose of pegylated interferon alpha 2a (IFN-alpha2a) on the 12-week hepatitis C virus (HCV) kinetics in human immunodeficiency virus (HIV) patients co-infected with HCV. One hundred sixteen HIV/HCV co-infected patients from nine hospitals in Spain were randomized to receive 270 microg/week of pegylated IFN-alpha2a for 4 weeks followed by 180 microg/week for 8 weeks or 180 microg/week for 12 weeks. Ribavirin was given at a daily dose of 1000 or 1200 mg. The main outcome measure was the percentage of patients achieving an HCV-RNA below 50 IU/mL or a decrease of 2 or more log(10) at week 12 (early virologic response, EVR). HCV-RNA was measured at baseline, weekly, for the first 4 weeks and monthly thereafter. We observed no difference in the percentage of patients achieving an EVR between arms (on-treatment, 74% in both arms; intention-to-treat, 70% in the induction arm and 67% in the control arm), nor were there differences in the percentage achieving an undetectable HCV qualitative polymerase chain reaction at any time points or in the decrease in HCV-RNA from baseline. No differences were found between arms in the percentage of dropouts (8% in the whole study population). Our study failed to find a benefit of an induction dose of 270 microg/week of pegylated IFN-alpha2a for 4 weeks on the EVR in co-infected patients who are treatment naive. Despite the lack of benefit with this regimen, induction therapy with this schedule was safe and well tolerated in co-infected patients.

Pegylated interferon

Hepatitis C

10.1111/j.1365-2893.2007.00860.x

Cite

Citations (10)

Facial Emotion Processing in Aviremic HIV-infected Adults

Archives of Clinical Neuropsychology (2016)

Alicia González-Baeza Fernando Carvajal Carmen Bayón Ignacio Valero María Luisa Montes-Ramírez

The emotional processing in human immunodeficiency virus-seropositive individuals (HIV+) has been scarcely studied. We included HIV+ individuals (n = 107) on antiretroviral therapy (≥2 years) who completed 6 facial processing tasks and neurocognitive testing. We compared HIV+ and healthy adult (HA) participants (n = 40) in overall performance of each facial processing task. Multiple logistic regressions were conducted to explore predictors of poorer accuracy in those measures in which HIV+ individuals performed poorer than HA participants. We separately explored the impact of neurocognitive status, antiretroviral regimen, and hepatitis C virus (HCV) coinfection on the tasks performance. We found similar performance in overall facial emotion discrimination, recognition, and recall between HIV+ and HA participants. The HIV+ group had poorer recognition of particular negative emotions. Lower WAIS-III Vocabulary scores and active HCV predicted poorer accuracy in recognition of particular emotions. Our results suggest that permanent damage of emotion-related brain systems might persist despite long-term effective antiretroviral therapy.

Neurocognitive

Regimen

10.1093/arclin/acw023

Cite

Citations (7)

BMJ Case Reports (2019)

Raquel Ron Ignacio Ruz‐Caracuel Eugenia García‐Fernández María Luisa Montes-Ramírez

A 47-year-old HIV-positive man with good immune and virological status presented with chronic multiple enlarged lymph nodes, lung disease and eosinophilia. Radiologic tests showed enlarged cervical, thoracic and axillary lymph nodes, with interstitial lung damage. After several non-specific histologic studies, an elevated serum IgG4 level led us to request immunohistochemistry of a lymph node sample. The test confirmed the diagnosis of IgG4-related disease.

Cervical lymph nodes

Axillary lymph nodes

10.1136/bcr-2018-226809

Cite

Citations (6)

Efficacy, Safety, and Durability of Long-Acting Cabotegravir and Rilpivirine in Adults With Human Immunodeficiency Virus Type 1 Infection: 5-Year Results From the LATTE-2 Study

Open Forum Infectious Diseases (2021)

Graham Smith W. Keith Henry Daniel Podzamczer Marı́a del Mar Masiá Christopher Bettacchi

In the Long-Acting Antiretroviral Treatment Enabling Trial 2 (LATTE-2) phase 2b study, long-acting (LA) injectable cabotegravir + rilpivirine dosed every 8 weeks (Q8W) or every 4 weeks (Q4W) demonstrated comparable efficacy with daily oral antiretroviral therapy (ART) through 96 weeks in ART-naive adults with human immunodeficiency virus type 1 (HIV-1). Here we report efficacy, tolerability, and safety of cabotegravir + rilpivirine LA over approximately 5 years.After 20 weeks of oral cabotegravir + abacavir/lamivudine, participants were randomized to cabotegravir + rilpivirine LA Q8W or Q4W or continue oral ART through the 96-week maintenance period. In the extension period through week 256, participants continued their current LA regimen (randomized Q8W/Q4W groups) or switched from oral ART to Q8W or Q4W LA therapy (extension-switch groups). Endpoints assessed included proportion of participants with HIV-1 RNA <50 copies/mL (Snapshot algorithm) and adverse events (AEs).At week 256, 186 of 230 (81%) participants in randomized Q8W/Q4W groups and 41 of 44 (93%) participants in extension-switch groups had HIV-1 RNA <50 copies/mL. No protocol-defined virologic failures occurred after week 48. Injection wsite reactions infrequently resulted in discontinuation (4 [2%] and 1 [2%] participants in randomized Q8W/Q4W and extension-switch groups, respectively). Three participants in randomized Q8W/Q4W groups experienced drug-related serious AEs, including 1 fatal serious AE (Q4W group); none occurred in extension-switch groups. Of 25 participants with AEs leading to withdrawal, 20 were in the randomized Q4W group; no AE leading to withdrawal occurred in >1 participant.Cabotegravir + rilpivirine LA exhibited long-term efficacy and tolerability, demonstrating its durability as maintenance therapy for HIV-1 infection.Clinical Trials Registration. NCT02120352.

Rilpivirine

Abacavir

Tolerability

Discontinuation

10.1093/ofid/ofab439

Cite

Citations (39)

Switching from tenofovir containing regimens to boosted protease inhibitor monotherapy: Impact on renal function

Enfermedades Infecciosas y Microbiología Clínica (2015)

Miriam Estébanez José I. Bernardino Lucía Serrano‐Luján Ignacio Valero Francisco Zamora

Regimen

Combination therapy

10.1016/j.eimc.2015.01.013

Cite

Citations (0)

Loneliness and social isolation in people with HIV aged ≥50 years. The No One Alone (NOA)‐GeSIDA study conducted by the GeSIDA 12021 study group

HIV Medicine (2024)

José Ramón Blanco Alicia González-Baeza Ana Martinez‐Vicente Helena Albendín-Iglesias Javier de la Torre

Abstract Introduction There is a growing number of people with HIV who are aged 50 years or older, and the prevalence of loneliness and social isolation remains unknown. Methods A multicentre study was conducted across 22 GeSIDA centres. A survey was carried out to assess loneliness [UCLA 3‐item Loneliness Scale‐3 (UCLA‐3)] and social isolation [Lubben Social Network Scale‐Revised (LSNS‐R)], along with sociodemographic aspects, HIV‐related factors, comorbidities, tobacco, alcohol and drug consumption, quality of life, anxiety and depression, and stigma. The prevalence of loneliness (UCLA‐3 ≥ 6) and evident social isolation (LSNS‐R ≤ 20) was calculated, and multivariable multinominal logistic regression models were used to identify associated factors. Results A total of 399 people with HIV were included; 77.4% were men, of average age 59.9 years (SD 6.5); 45.1% were aged ≥60 years; 86% were born in Spain; 86.7% in urban areas; 56.4% with secondary or higher education; 4.5% living alone against their wishes. A total of 66.9% were infected through sexual transmission, with a median of 22.9 years since diagnosis [interquartile range (IQR): 12.6–29.5] and a median nadir CD4 count of 245 cells/μL (IQR: 89–440). Overall, 90.7% had viral load <50 copies/mL, 93.5% had adherence >95%, and 26.3% had a prior AIDS diagnosis. In all, 29.1% and 21% reported significant symptoms of anxiety and depression, respectively, 24.3% had mobility issues, and 40.8% reported pain. Overall, 77.7% of participants reported neither loneliness nor social isolation, 10.0% loneliness only, 5.8% social isolation only and 6.5% both. Multivariable analyses identified that being aged 50–59, unemployed or retired, living alone unwillingly, single, poor quality of life, anxiety, and HIV‐related stigma were associated with loneliness. Meanwhile, lower education, living alone unwillingly, and depressive symptoms were associated with social isolation. Individuals living alone unwillingly, with depressive symptoms and experiencing HIV‐related stigma were at higher risk for both loneliness and social isolation. Conclusions There is a relatively high prevalence of loneliness and social isolation in our population. Living alone against one's wishes, being unmarried, and experiencing mobility issues could predispose individuals to feel lonely and socially isolated. Those with anxiety and stigma are more prone to loneliness, while individuals with depression are more predisposed to social isolation. It is necessary to develop strategies for the detection and management of loneliness and social isolation in people with HIV aged >50 years.

Interquartile range

Social Isolation

Depression

UCLA Loneliness Scale

10.1111/hiv.13743

Cite

Citations (0)

Efficacy, Safety, and Durability of Long-Acting Cabotegravir and Rilpivirine in Adults With HIV-1 Infection: ~5-Year Results From the LATTE-2 Study

Graham Smith W. Keith Henry Daniel Podzamczer Marı́a del Mar Masiá Christopher Bettacchi

Rilpivirine

Source

Cite

Citations (0)

Changes in Liver Steatosis After Switching From Efavirenz to Raltegravir Among Human Immunodeficiency Virus–Infected Patients With Nonalcoholic Fatty Liver Disease

Clinical Infectious Diseases (2017)

Juan Macı́as M.J. Mancebo Dolores Merino Francisco Téllez María Luisa Montes-Ramírez

Antiretroviral drugs with a lower potential to induce hepatic steatosis in human immunodeficiency virus (HIV) infection need to be identified. We compared the effect of switching efavirenz (EFV) to raltegravir (RAL) on hepatic steatosis among HIV-infected patients with nonalcoholic fatty liver disease (NAFLD) receiving EFV plus 2 nucleoside analogues. HIV-infected patients on EFV plus tenofovir/emtricitabine or abacavir/lamivudine with NAFLD were randomized 1:1 to switch from EFV to RAL (400 mg twice daily), maintaining nucleoside analogues unchanged, or to continue with EFV plus 2 nucleoside analogues. At baseline, eligible patients should show controlled attenuation parameter (CAP) values ≥238 dB/m. Changes in hepatic steatosis at 48 weeks of follow-up over baseline levels were measured by CAP. Overall, 39 patients were included, and 19 of them were randomized to switch to RAL. At week 48, median CAP for the RAL group was 250 (Q1–Q3, 221–277) dB/m and 286 (Q1–Q3, 269–314) dB/m for the EFV group (P = .035). The median decrease in CAP values was –20 (Q1–Q3, –67 to 15) dB/m for the RAL arm and 30 (Q1–Q3, –17 to 49) dB/m for the EFV group (P = .011). CAP values <238 dB/m at week 48 were observed in 9 (47%) patients on RAL and 3 (15%) individuals on EFV (P = .029). After 48 weeks, HIV-infected individuals switching EFV to RAL showed decreases in the degree of hepatic steatosis, as measured by CAP, compared with those continuing with EFV. In addition, the proportion of patients without significant hepatic steatosis after 48 weeks was greater for those who switched to RAL. NCT01900015.

Steatosis

Efavirenz

Raltegravir

Liver steatosis

10.1093/cid/cix467

Cite

Citations (49)

Comparison of transient elastography and liver biopsy for the assessment of liver fibrosis in HIV/hepatitis C virus-coinfected patients and correlation with noninvasive serum markers

Journal of Viral Hepatitis (2009)

Matilde Sánchez‐Conde María Luisa Montes-Ramírez Pilar Miralles Jaime Álvarez José M. Bellón

Transient elastography (FibroScan) is a novel, rapid and noninvasive technique to assess liver fibrosis. Our objective was to compare transient elastography (TE) and other noninvasive serum indexes as alternatives to liver biopsy in HIV/hepatitis C virus (HCV)-coinfected patients. The fibrosis stage (METAVIR Score), TE, the aspartate aminotransferase-to-platelet ratio index, the Forns fibrosis index, FIB-4 and HGM-2 indexes were assessed in 100 patients between January 2007 and January 2008. The diagnostic values were compared by calculating the area under the receiver operating characteristic curves (AUROCs). Using TE, the AUROC (95% CI) of liver stiffness was 0.80 (0.72-0.89) when discriminating between F 2, 0.93 (0.85-1.00) when discriminating between F 3 and 0.99 (0.97-1.00) when discriminating between F or= 3, the AUROCs of TE were significantly higher than those obtained with the other four noninvasive indexes. Based on receiver operating characteristic curves, three cutoff values were chosen to identify F or= 3 (>or=11 kPa) and F4 (>or=14 kPa). Using these best cutoff scores, the negative predictive value and positive predictive value were 81.1% and 70.2% for the diagnosis of F or= 3 and 100% and 57.1% for the diagnosis of F4. Thus, Transient elastography accurately predicted liver fibrosis and outperformed other simple noninvasive indexes in HIV/HCV-coinfected patients. Our data suggest that TE is a helpful tool for guiding therapeutic decisions in clinical practice.

Transient elastography

Cut-off

Hepatitis C

Hepatic fibrosis

10.1111/j.1365-2893.2009.01180.x

Cite

Citations (117)