Background: Sexualized drug use (SDU) has become a public health concern in recent years. This study aimed to estimate the prevalence of SDU in gay, bisexual, and other men who have sex with men living with HIV (HIV + GBMSM) in Madrid during 2019/2020 and compare it with data from 2016/2017 in order to detect changes in patterns. Methods: We analyzed the frequency of SDU in a sample of HIV + GBMSM attending HIV clinics, who participated in an anonymous online survey regarding sexual behavior and recreational drug use. The association between SDU, sexual risk behaviors, and STIs was evaluated. Results: This study included 424 HIV + GBMSM, with a mean age of 40 (10.43) years. Overall, 94% (396) reported being sexually active. Additionally, 33% (140) had been diagnosed with an STI within the previous year. Moreover, 54% (229) had used drugs in the last year, 25% (107) engaged in SDU, and 16% (17) reported engagement in slamsex. After adjusting for confounding factors, SDU was associated with STIs, fisting, unprotected anal intercourse, and having >24 sexual partners in the last year. According to the DUDIT test scores, 80% (81) probably had problematic drug use (≥6 points), and 8% (8) probable drug dependence (≥25 points). When comparing the U-SEX-1 (2016/2017) data with the U-SEX-2 (2019/2020) data, no significant differences were found in the proportion of participants practicing SDU or slamming. Conclusions: The prevalence of SDU among HIV + GBMSM has remained high in recent years and without significant changes. The risk of problematic drug use among those who practice SDU is high. We observed a clear association between SDU, high-risk sexual behaviors, and STIs.

Purpose: To report a case of cancer-associated retinophaty (CAR) treated with intravenous immunoglobulin (IGIV) and review the use of IGIV in the treatment of CAR Methods: Case report: A 68-year-old woman, former smoker, presented with bilateral subacute decreased visual acuity with 1 month of evolution, without other symptoms. Clinical examination revealed retinal atrophy and a mild vitritis component. Treatment with corticosteroid and IGIV was initiated empirically with the stabilization of visual loss. Anti-recoverin antibodies tested positive and a small cell lung carcinoma was diagnosed. In a review of the literature, we found that only 12 cases of patients treated with intravenous immunoglobulins have been reported. Conclusions: the early use of IVIG could contribute to an improvement and/or stabilization of visual symptoms in this patient group due to its rapid effect and lower profile of adverse effects when administered with chemotherapy.

Background: We previously described the effectiveness of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) as a switch strategy in real life in people with HIV (PWH) at 48 weeks. We did not find that previous nucleoside reverse transcriptase inhibitor (NRTI) resistance-associated mutations (RAMs) had an impact on efficacy. Herein we report response rates after 3 years of follow-up. Methods: This retrospective review comprised PWH who were treatment experienced and switched to B/F/TAF in a single-center cohort. HIV RNA <50 copies/mL was analyzed at 96 and 144 weeks in an intention-to-treat analysis (missing = failure) and per-protocol analysis; patients with missing data or changes for reasons other than virologic failure were excluded. Results: An overall 506 PWH were included: 16.2% were women, the median age was 52.3 years, the median time of HIV infection was 18.9 years, and 13.6% had documented preexisting NRTI RAMs. At 96 weeks of follow-up in the intention-to-treat and per-protocol analyses, HIV RNA <50 copies/mL was seen in 73.1% and 95.4%, respectively. At 144 weeks, these figures were 68.2% and 94%. There were no statistically significant differences between patients with and without previous NRTI RAMs. A total of 140 patients were excluded for the per-protocol analysis at week 144: 46 were lost to follow-up, 32 discontinued treatment due to toxicity, 34 simplified to dual antiretroviral therapy, 7 switched for other reasons, and 20 patients died (no death was B/F/TAF related). Conclusions: Through 3 years of follow-up, switching to B/F/TAF maintained high rates of virologic suppression in long-term PWH. These results were seen even in patients with preexisting NRTI RAMs.

Background: Susac syndrome is a vasculopathy that affects the central nervous system, mainly the brain parenchyma, retina and inner ear. It affects mainly young women and. Management is based on expert consensus and in pregnant women the treatment is not well established. It is necessary to start treatment early because of its potential severity and sequelae. Method: We present two cases of Susac syndrome related to pregnancy/puerperium and performed a review of the literature. Conclusions: Susac syndrome is a disease that requires a high clinical suspicion, especially in pregnant women. Treatment in pregnancy or puerperium is not well established. Précis: Susac syndrome is a disease that requires a high clinical suspicion, especially in pregnant women. Treatment in pregnancy or puerperium is not well established.

Since the introduction of modern antiretroviral treatment for HIV and hepatitis C virus (HCV), the pattern of autoimmune diseases (ADs) in people living with HIV (PWH) might have changed. This is a retrospective study in a cohort of 5,665 PWH at the HIV Clinic of Hospital Universitario La Paz (Spain) to estimate the prevalence of ADs from January 1990 to June 2020. We divided the timeline into four periods: <1996, 1996–2006, 2006–2015, and 2015–2020. In total 369 participants were diagnosed with at least one AD, with a prevalence of 5.3% (95% confidence interval 4.7–5.9). In total, 302 (81%) participants were diagnosed simultaneously or after HIV diagnosis. Most prevalent diseases were immune thrombopenia (IT) ( n = 90), cutaneous psoriasis ( n = 52), autoimmune thyroid disorders ( n = 36), spondylarthritis ( n = 24), and inflammatory bowel disease (IBD) ( n = 21). There was a significant trend for more ADs in recent periods ( p = .037). In recent years, participants with ADs were older, had a long time since HIV diagnosis, and had higher CD4 ⁺ T cell count and higher CD4 ⁺ T cell nadir (temporal linear trend p < .001). There was a change in the pattern of ADs over time with a decrease in IT and an increase in spondylarthritis, arthritis, IBD, and thyroid disorders. One hundred thirty-nine participants (46%) were coinfected with HCV, with a steady decline throughout the study period. Only cryoglobulinemia was statistically associated with HCV infection. AD increases over time in PWH with reasonable immune virological control. We observed a higher frequency of spondylarthritis, arthritis, autoimmune thyroid disorders, and IBD in recent years.