El virus de la viruela símica es un orthopoxvirus de características zoonóticas endémico en las regiones de África Central y África Occidental, donde causa brotes desde 1970. En las últimas décadas se registró un aumento exponencial de casos, probablemente asociado a la disminución en la inmunidad conferida por la vacuna antivariólica, discontinuada luego de la erradicación de la viruela. En los últimos años se registraron casos esporádicos fuera del continente africano, siempre relacionados epidemiológicamente a la permanencia en áreas endémicas o contacto con animales infectados. Desde el 13 de mayo de 2022 se encuentra en curso el mayor brote de viruela símica registrado fuera de las áreas endémicas de África, con casos en los cinco continentes. La extensión, el impacto y la duración del brote permanecen aún inciertos.

Introducción: Para mejorar la retención en el sistema de salud de las personas que viven con VIH (PVVIH) con diagnóstico reciente y promover su adherencia se implementó el programa de acompañamiento de pares “Positivos para Positivos” (PPP). Material y métodos: Se entrenó a PVVIH con excelente adherencia y se les ofreció integrar PPP. Entre 06/2014 y 08/2018 cada individuo con diagnóstico reciente de infección VIH fue invitado a contactar con PPP. Se evaluó prospectivamente la evolución de los pacientes durante un año y se analizaron variables vinculadas a adherencia. Se compararon sus resultados con lo observado entre PVVIH con diagnóstico reciente sin apoyo de pares. Se analizó mediante tablas de 2x2 y la prueba exacta de Fisher (EpiInfo7.2.2.6). Resultados: Se incluyeron 158 PVVIH (40 grupo intervención y 118 grupo control). En el grupo intervención hubo más pacientes que iniciaron TARGA [100% vs 87,3%; RR 1,15 (IC95 1,07-1,23); p=0,024]. Tras excluir a los derivados y fallecidos tempranamente quedaron 37 y 112 pacientes respectivamente. En el grupo intervención se observó mejor control clínico [94,6% vs 75,9%; RR 4,2 (IC95 1,08-16,6); p=0,015] y menos abandono de seguimiento [8,1% vs 25,9%; RR 0,3 (IC95 0,11-0,98); p=0,02]. Entre quienes iniciaron TARGA y tuvieron al menos una consulta con el servicio de Infectología (37 grupo intervención y 97 grupo control) se registraron más pacientes con alta tasa de retiro de TARGA de farmacia [51,4% vs 18,6%; RR 2,77 (IC95 1,64–4,66); p=0,0003]; mayor alcance de CV <50 [100% vs 85,1%; RR 1,18 (IC95 1,06–1,30); p=0,06]; y menos interrupciones no estructuradas del TARGA [10,8% vs 36,1%; RR 0,3 (IC95 0,11–0,78); p=0,008]. Conclusión: El acompañamiento de pares impactó positivamente en la adherencia de las PVVIH con diagnóstico reciente en el primer año de seguimiento.

Background: Chagas-Mazza disease, usually considered a neglected tropical diseases, is an important cause of morbidity and mortality in Latin America. Treatment in adult chronic asymptomatic patients is still in debate. Main limitations of traditional drugs are the adverse drug reactions (ADRs). Nevertheless treatment of young adults and women of childbearing age is proposed to be useful in decreasing progression to cardiovascular disease and mother to child transmission Our objective is to evaluate tolerance and development of ADRs with benznidazol (BZN) in adult chronic asymptomatic patients with Chagas, in four public medical centers in CABA, a non-endemic area.Methods & Materials: We conducted a descriptiveobservational study of ADRs related to BZN treatment in four medical centers in CABA from 01/06/2012 to 01/10/2017. Patients between 18 and 65 years, without cardiovascular or digestive disease and Kushnir score of 0-1 were included. Pregnant or breastfeeding women, older than 65 years, or with Kushnir score 2-3 were excluded.Included patients signed an informed consent, were advised on risks-benefits of the medication and prescribed recommendations to improve tolerance. BZN was used at 5 mg/kg dose for 60 days. Daily self-monitoring records and weekly medical controls were performed. Telephone contacts were provided in case of eventualities.Results: Eighty-seven adult patients, 20 male and 67 female, median age 39 (18-60) treated with BZD were included. Sixty-six (75.86%) completed treatment and 40 (45%) developed 67 episodes of ADRs. Only 5 episodes were severe. Most frecuent reactions were gastrointestinal and cutaneous (80.6%) and only 1 was severe. Mild events represented 89.55% of the ADRs and could be managed with

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Background: Chagas-Mazza disease, usually considered a neglected tropical diseases, is an important cause of morbidity and mortality in Latin America. Treatment in adult chronic asymptomatic patients is still in debate. Main limitations of traditional drugs are the adverse drug reactions (ADRs). Nevertheless treatment of young adults and women of childbearing age is proposed to be useful in decreasing progression to cardiovascular disease and mother to child transmission.Our objective is to evaluate tolerance and development of ADRs with benznidazol (BZN) in adult chronic asymptomatic patients with Chagas, in four public medical centers in Ciudad Autónoma de Buenos Aires (CABA), a non-endemic area.Methods & Materials: We conducted a descriptiveobservational study of ADRs related to BZN treatment in four medical centers in CABA from 01/06/2012 to 31/12/2018. Patients between 18 and 65 years, without cardiovascular or digestive disease and Kushnir score of 0-1 were included. Pregnant or breastfeeding women, older than 65 years, or with Kushnir score 2-3 were excluded.Included patients signed an informed consent, were advised on risks-benefits of the medication and prescribed recommendations to improve tolerance. BZN was used at 5 mg/kg dose for 60 days. Daily self-monitoring records and weekly medical controls were performed. Telephone contacts were provided in case of eventualities Results: We included 106 patients (85 female and 21 male) with a median age of 36.7 years (18-60). The ADRs were observed in 56/106 (52.8%) of the patients. Of the total of patients; 80/106 (75.4%) completed the treatment and 26/106 (24.6%) did not complete it. Of those who did not complete, 21/26 presented ADRs, with only 6/21 (28.5%) being suspended at the request of the treating team. Of all the ADRs; 67/79 (84.8%) were mild and 6/106 (5.6%) severe. Only 1 patient (0.9%) required hospitalization and no deaths attributable to ADRs were observed. Conclusion:In our experience, BZD was safe in adults. Tolerance was acceptable and most of the adverse events were gastrointestinal and cutaneous, were mild and could be managed with symptomatic treatment with no mortality observed.