Treatment of VL with meglumine antimoniate or amphotericin B was shown to have similar efficacy and toxicity rates in Spanish HIV-infected patients. The differences in the toxicity patterns could be useful in choosing one of these agents as first-line treatment.

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BackgroundEmtricitabine/rilpivirine/tenofovir (FTC/RPV/TDF) was initially approved for the treatment of human immunodeficiency virus type 1 in treatment-naïve adult patients with a viral load ≤ 100,000 copies/mL.PurposeTo evaluate the effectiveness and safety of off-label use of FTC/RPV/TDF after this drug was included in our hospital’s formulary.Material and methodsThis retrospective observational study included all patients for whom FTC/RPV/TDFwasdispensed from our university hospital’s pharmacy department from October 2013 to March 2014. We collected the following information from medical records: age, sex, drug history, prior antiretroviral treatment, reasons for treatment change, viral load, CD4 count and atherogenic index at the start and end of the study period, adherence, side effects and reasons for discontinuing treatment.ResultsWe included 19 consecutive patients (14 men and 5 women; mean age, 44.7 years). All patients were treatment-experienced; 78% had previously been treated with efavirenz/emtricitabine/tenofovir. The most frequent reasons for changing antiretroviral treatment were hyperlipidaemia (38.8%) and interaction with methadone (22%). The viral load was <50 copies/mL in 10 patients. The mean CD4 count was 634.6/mm3 at baseline and 596.4/mm3 at study end (normal range: 450–1400/mm3). The mean atherogenic index, recorded in 16 patients, was 4.5 (normal range: 0–5) at both the beginning and end of the study. No side effects were documented. Two patients discontinued treatment for reasons unrelated to the antiretroviral (pregnancy and death). We detected no non-adherence to the treatment.ConclusionIn our centre, changing treatment to FTC/RPV/TDF is mostly due to side effects and interactions in the previous treatment. Although our preliminary data preclude definitive conclusions, FTC/RPV/TDF seems safe and effective.References and/or AcknowledgementsMolina JM, et al. Lancet 2011;378:238–46Nelson M, et al. Multicentre Open-Label Study of Switching from Atripla to Eviplera for Possible Efavirenz Associated CNS Toxicity. 2013Enferm Infecc Microbiol Clin 2013;31:604–13No conflict of interest.

Se estudió 51 pacientes procedentes de Lima y otros lugares del Perú con vitíligo, enfermedad idiopática adquirida, que resulta de la destrucción gradual de melanocitos y disturbios inmunológicos. Los objetivos fueron establecer el diagnóstico temprano de otras enfermedades autoinmunes asociadas y realizar la correlación clínico patológica, incluyendo los antecedentes familiares. Se estudió autoanticuerpos circulantes e inmunomicroscopía de la biopsia de piel. El vitíligo más frecuente fue el generalizado vulgaris. El 33,3 % del total de casos presentó otra enfermedad autoinmune asociada y el 37,2%, enfermedad por hipersensibilidad l. El 19,6% de familiares cercanos tuvieron vitíligo y 31,2%, otras enfermedades por autoinrnunidad.