Background: The increased life expectancy of people living with HIV (PLWHIV), due to the effectiveness of antiretroviral therapy, has been associated with a higher incidence of metabolic disorders such as dyslipidemia, insulin resistance, and adipose tissue redistribution. It has been demonstrated that the secretion of adipokines, particularly adiponectin, a key hormone in the regulation of inflammation and metabolism, is altered by these changes. This study it is intended to evaluate the HOMA-AD index and its correlations with metabolic, inflammatory, and obesity-related parameters.Methods: Eighty participants were divided into five groups (PLWHIV, PLWHIV+preT2D, PLWHIV+T2D, PWT2D, and Controls). Clinical history, anthropometric data, and blood samples were collected to assess biochemical parameters. Adiponectin, hs-CRP, IL-6, IL-18, and IL-8 levels were quantified by ELISA. HOMA2-IR, HOMA2-%B, HOMA2-%S, HOMA-AD, and surrogate IR indices (TyG, TyG-BMI, TyG-WHtR, METS-IR, QUICKI) were calculated. Adiposity indices (VAI, DAI) and inflammatory markers (TG/HDL-C, NEU/HDL-C, MON/HDL, PLT/HDL, NLR, PLR) were also evaluated. Analyses were performed using IBM SPSS, GraphPad Prism, and RStudio.Results: The discrimination of T2D in PLWHIV was effectively achieved by the indices HOMA-AD, TyG-WHtR, QUICKI, and METS-IR, with AUC values reaching up to 0.9. Moderate correlations were identified between HOMA-AD and METS-IR (R = 0.58), TyG-WHtR (R = 0.53), QUICKI (R = -0.90), DAI (R = 0.45), and VAI (R = 0.44), as well as inflammatory markers hs-CRP (R = 0.30), IL-6 (R = 0.25), and IL-18 (R = 0.27). A cutoff point of HOMA-AD >1 was associated with a significantly increased risk for T2D in PLWHIV (OR = 15.4; 95% CI: 2.79–79.5), x (OR = 1.97), and non-HIV T2D populations (OR = 9.53). These results highlight the importance of HOMA-AD and inflammatory markers in glycemic risk stratification.Conclusions: Our study demonstrates that the HOMA-AD index improves T2D detection in PLWHIV, likely due to its strong association with insulin resistance, systemic inflammation, and adiposity. It emerges as a promising tool to evaluate metabolic and inflammatory status in this population.

Sepsis is characterized by a dysregulated immune response, and hemogram-derived inflammatory indices have emerged as potential complementary biomarkers of disease severity and prognosis. However, their longitudinal behavior and clinical relevance during sepsis remain poorly characterized in people living with HIV (PLWH). This longitudinal retrospective study included PLWH with sepsis and three comparison groups: PLWH with comorbidities, PLWH without comorbidities, and HIV-negative controls. Hemogram-derived inflammatory indices and clinical severity scores were evaluated at sepsis diagnosis and on days 3 and 7. Longitudinal comparisons, correlations, ROC, Kaplan–Meier, and regression analyses were performed. Among the 22 patients with complete serial measurements through day 7, hemogram-derived inflammatory indices exhibited distinct temporal patterns, whereas cross-sectional analyses at days 0, 3, and 7 were influenced by progressively selected survivor subsets. Lower SII was associated with a shorter time from sepsis diagnosis to death. Component-level analyses showed that low SII predominantly reflected thrombocytopenia and reduced circulating neutrophils, with platelet count accounting for a substantial proportion of the time-to-death information captured by SII. Thus, the clinical meaning of SII depends not only on its absolute value but also on the hematological phenotype underlying it. As a low-cost and widely accessible index, SII warrants further evaluation as a complementary marker of hematological vulnerability in PLWH with sepsis.

Las sustancias químicas son causas importantes de lesiones del tracto gastrointestinal y suelen afectar a dos grupos de pacientes: los niños menores de 5 años y los adultos que intentan el suicidio. Sus efectos pueden variar, desde la necrosis hasta la perforación del tubo digestivo, que puede afectar la boca, faringe, esófago y estómago. La principal complicación de la ingesta accidental de cáusticos es la estenosis esofágica. La frecuencia con la que aparecen las estenosis esofágicas oscila entre el 15 y el 35% y se relaciona con el grado de lesión inducida por el agente ingerido. Pueden hacerse sintomáticas hacia la segunda o tercera semanas después de una fase latente de reparación o, en otros casos, meses o años después de la ingesta. Diferentes formas de tratamiento se han aplicado para tratar las estenosis esofágicas por cáusticos, y en primera línea está la dilatación endoscópica, con resultados exitosos en el 60 a 80% de los pacientes. Si estas no son efectivas se indica el tratamiento quirúrgico de reemplazo esofágico. se presenta el caso clínico de un paciente masculino de 48 años de edad sin antecedentes crónico-degenerativos, el cual inicia padecimiento tras la ingesta accidental de sustancia cáustica hacía 4 meses, con disfagia a líquidos y sólidos, por lo que es protocolizado en nuestra unidad para resolución quirúrgica definitiva mediante ascenso gástrico. aunque se asocia con tasas altas de estenosis anastomótica, la esofagectomía transhiatal y el ascenso gástrico con anastomosis cervical son procedimientos seguros para el tratamiento de estenosis esofágicas por sustancias cáusticas.

Background/Objectives: HIV infection has been associated with an increased incidence of non-communicable comorbidities, including metabolic disorders. This phenomenon has been linked to gut microbiota dysbiosis, which involves not only changes in bacterial composition but also functional alterations in metabolite production. The objective of this study was to describe the impact of intestinal microbial metabolomics on the development of type 2 diabetes in people living with HIV. Methods: This study provides a narrative synthesis of current evidence addressing the role of gut microbiota-derived metabolites in immunometabolic regulation and their implications in HIV-associated type 2 diabetes. Results: Microbial metabolites play a fundamental role in regulating key physiological processes such as intestinal permeability, systemic immune activation, and glucose metabolism. Compounds such as short-chain fatty acids, tryptophan catabolites, secondary bile acids, trimethylamine N-oxide, and imidazole propionate have been shown to significantly influence immunometabolic balance. In people living with HIV, these microbial products may exert diverse effects depending on their chemical nature and the molecular pathways they activate in peripheral tissues. The interaction between dysbiosis, chronic low-grade inflammation, and HIV-associated metabolic disturbances may contribute to the early onset of type 2 diabetes beyond traditional risk factors. Conclusions: Recognizing the role of microbial metabolites in the context of HIV infection is essential to broaden our pathophysiological understanding of associated metabolic comorbidities. It also opens opportunities to develop more comprehensive diagnostic and therapeutic strategies that include modulation of the gut microbiota and its metabolic activity for the prevention and management of type 2 diabetes in this population.

People Living with HIV (PLWHIV) present an increased risk of developing non-communicable diseases, such as type 2 diabetes (T2D), making it crucial to optimize glycemic control and assess metabolic markers. HbA1c is considered the gold standard for evaluating glycemic control, while fructosamine (FA) offers advantages in assessing non-glycemic determinants. Discrepancies between HbA1c and FA are common and may be influenced by temporal factors. The Glycation Gap (G-gap) emerges as a tool to clarify these discrepancies. A cross-sectional analytical study was conducted involving PLWHIV with various glycemic statuses, as well as patients with T2D and controls. Sociodemographic data were collected along with blood samples to measure biochemical profiles and FA. HbA1c predicted from FA (pHbA1c) was calculated using a linear regression equation, facilitating G-gap determination. A positive correlation was found between G-gap and levels of VLDL-C and triglycerides (TG). Additionally, a negative correlation was observed between HDL-C levels < 40 mg/dL and a positive G-gap. These associations suggest that the G-gap may be a useful tool for metabolic evaluation in PLWHIV and a preventive method for identifying individuals at risk of developing chronic complications related to T2D.