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1.
Acta sci., Health sci ; 44: e56764, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367790

ABSTRACT

The aim of this study was to investigate possible factors related to antiretroviral therapy (ART) that contribute to the understanding of the highest rate of Aids detection on the coast of the state of Paraná, a port region identified administratively as the 1stRegional Health Division (1stHD) in the state of Paraná. Data on the sociodemographic profile of the population undergoing antiretroviral treatment (ART), medication changes, dropout of therapy, proportion of the population undergoing treatment and viral load were obtained through computerized systems. Between July 1, 2018 and June 31, 2019, 1,393 people were on ART in the 1stRS. Of these, 57.6% were male. During this period, 110 people started ART with a predominance of the age group between 30 and 39 years old. ART was switched for169 people and 211 patient dropouts were detected. The proportion of people diagnosed with HIV without treatment (gap) is still high, however 92.7% people on ART have suppressed viral load. It can be concluded that the lower educational level of the population undergoing treatment, the late diagnosis of those infected and the treatment gapprobably contribute to the highest rate of Aids detection in the 1stRS.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Acquired Immunodeficiency Syndrome/epidemiology , Pharmacoepidemiology/methods , Anti-Retroviral Agents/therapeutic use , Sociodemographic Factors , Brazil/epidemiology , Incidence , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/drug therapy , Health Strategies , Viral Load
2.
Acta sci., Health sci ; 44: e53630, Jan. 14, 2022.
Article in English | LILACS | ID: biblio-1367783

ABSTRACT

The aim of this study was to investigate adverse reactions to Dolutegravir, a drug recently made available by the Unified Health System (SUS) for treating HIV infections. The frequency, severity and sex distribution of adverse reactions to Dolutegravir were identified over the first 18 months of its availability in users in the state of Paraná. Information was obtained through the pharmacovigilance questionnaire prepared by the Ministry of Health, accessed through the Logistics Control System for Medicines(SICLOM). During the study period, dolutegravirwas dispensed to 9,865 patients in the state. However, 9,207 users (93.3%) answered the pharmacovigilance questionnaire. Among them, 1.75% reported 279 adverse reactions. This population was composed mainly of male people (69.57%), in the ratio of 2.29 men for each woman, white (67.08%), aged between 20 and 29 years (26.71%), single (45.34%) and with education between 8 and 11 years of study (41.61%). Gastrointestinal (36.92%) and nervous system (14.34%) disorders were the most prevalent. 77.78% adverse reactions were considered non-serious by users. It can be concluded that dolutegravirhad a low prevalence of adverse reactions in users in the state of Paraná, demonstrating to be safe for use by the population in therapy against HIV, in accordance with clinical trials.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , HIV Infections/drug therapy , HIV Integrase Inhibitors/adverse effects , Anti-Retroviral Agents/adverse effects , Anti-Retroviral Agents/pharmacology , Pharmacovigilance , Unified Health System , Severity of Illness Index , Sex Distribution , HIV Integrase Inhibitors/therapeutic use , Anti-Retroviral Agents/therapeutic use
3.
Rev. bras. promoç. saúde (Impr.) ; 34(1): 1-10, 17/02/2021.
Article in English, Portuguese | LILACS | ID: biblio-1343983

ABSTRACT

Objetivo: Identificar o perfil da população que buscou a Profilaxia Pré-Exposição ao HIV (PrEP) no Paraná e, entre os usuários da PrEP, avaliar modificações nos comportamentos de risco de adquirir infecções sexualmente transmissíveis (IST's), além de alterações nos exames laboratoriais de monitoramento. Métodos: Coorte retrospectiva com dados secundários obtidos do Sistema de Controle Logístico de Medicamentos acessados em 2018 e 2019. Investigou-se o perfil sociodemográfico da população que buscou a PrEP, de forma a correlacioná-lo aos segmentos prioritários para o uso do medicamento profilático. Entre os usuários, avaliaram-se dados comportamentais, testes diagnósticos para IST's, funções renal e hepática referentes a diferentes momentos no decorrer do uso. Os resultados comparados deram-se por meio dos testes Wilcoxon e Exato de Fisher. Resultados: 255 pessoas buscaram a PrEP. Predominaram-se o sexo masculino (92,28%), homossexuais (78,04%), de 20 a 39 anos (83,53%), brancos (71,76%), com 12 ou mais anos de estudo (74,90%). Para uso da PrEP elegeram-se 188 pessoas. Entre estas, durante o uso, observou-se aumento de práticas sexuais sem preservativo (p=0,012), diminuição no número de parceiros e do consumo de álcool (p=0,001), aumento da atividade de enzimas hepáticas ALT/AST (p=0,018), sem diferença no diagnóstico do HIV e outras IST's. Conclusão: Homens que fazem sexo com homens predominaram na busca pela profilaxia. Entre os usuários da PrEP, apesar do aumento de práticas sexuais desprotegidas, não houve aumento do diagnóstico de IST's no período do estudo. O medicamento da PrEP demonstrou bom perfil de segurança nos exames laboratoriais de seguimento.


Objective: To identify the profile of the population that sought HIV Pre-Exposure Prophylaxis (PrEP) in Paraná; and assess, among PrEP users, changes in risk behaviors for acquiring sexually transmitted infections (STIs) as well as changes in monitoring laboratory tests. Methods: Retrospective cohort with secondary data obtained from the Drug Logistics Control System accessed in 2018 and 2019. The sociodemographic profile of the population that sought PrEP was investigated to correlate it with priority segments for the use of prophylactic medication. Among users, behavioral data, diagnostic tests for STIs, kidney, and liver functions were evaluated at different times during use. The results were compared using the Wilcoxon and Fisher's Exact tests. Results: 255 people sought PrEP. Males predominated (92.28%), homosexuals (78.04%), from 20 to 39 years old (83.53%),white people (71.76%), with 12 or more years of schooling (74.90%). For the use of PrEP, 188 people were elected. Among them, during the usage, was noticed an increase in sexual practices without a condom (p=0.012), a decrease in the number of partners and alcohol consumption (p=0.001), an increase in the activity of liver enzymes ALT/AST (p=0.018), with no difference in the diagnosis of HIV and other STI's. Conclusion: Men who have sex with men predominated in the search for prophylaxis. Among PrEP users, despite the increase in unprotected sexual practices, there was no increase in the diagnosis of STIs during the study period; PrEP drugs showed a good safety profile in follow-up laboratory tests.


Objetivo: Identificar el perfil de la población que fue en busca de la Profilaxis pre-exposición al VIH (PrEP) en Paraná y, de entre los usuarios de la PrEP, evaluar los cambios de conducta de riesgo para tener infecciones de transmisión sexual (ITS) además de las alteraciones de las pruebas de laboratorios para el monitoreo. Métodos: Cohorte retrospectiva con datos secundarios del Sistema de Control Logístico de Medicamentos con acceso en 2018 y 2019. Se investigó el perfil sociodemográfico de la población que fue en busca de la PrEP, para correlacionarlo con los segmentos prioritarios para el uso del medicamento profiláctico. De los usuarios se ha evaluado los datos comportamentales, las pruebas de diagnósticos para las ITS, las funciones renales y hepática referente a distintos momentos durante el uso. Los resultados comparados se han dado a través de las pruebas de Wilcoxon y el Exacta de Fisher. Resultados: 255 personas han buscado la PrEP. Hubo el predominio para el sexo masculino (92,28%), homosexuales (78,04%), entre los 20 y 39 años (83,53%), blancos (71,76%), con 12 o más años de estudio (74,90%). Se há elegido 188 personas para el uso de la PrEP. De entre ellas, durante el uso, se observó el aumento de las prácticas sexuales sin condón (p=0,012), la disminución del número de compañeros y del consumo del alcohol (p=0,001), el aumento de la actividad de enzimas hepáticas ALT/AST (p=0,018), sin diferencia en el diagnóstico del VIH y de otras ITS. Conclusión: Los hombres que tienen sexo con hombres prevalecieron para la búsqueda de la profilaxis. De entre los usuarios de la PrEP, a pesar del aumento de las prácticas sexuales sin protección no hubo el aumento del diagnóstico de ITS en el período del estudio. El medicamento de la PrEP demostró un perfil bueno de seguridad en las pruebas de laboratorios de seguimiento.


Subject(s)
HIV , Pre-Exposure Prophylaxis , Population Health , Synthetic Drugs
4.
Einstein (Säo Paulo) ; 19: eAO5800, 2021. tab, graf
Article in English | LILACS | ID: biblio-1350699

ABSTRACT

ABSTRACT Objective: To characterize the sociodemographic profile of the population undergoing antiretroviral treatment in the state of Paraná, Brazil, to investigate the proportion of people undergoing treatment among all those diagnosed, and to analyze the proportion of patients with suppressed viral load in different regions of the state. Methods: Observational descriptive and analytical study carried out with information referring to the period from January 2018 to January 2019. Data were obtained from the Sistema Informatizado de Monitoramento Clínico das Pessoas Vivendo com HIV/AIDS [Computerized System for Clinical Monitoring of People Living with HIV/AIDS] and Sistema de Controle Logístico de Medicamentos[Drug Supply Control System]. The proportion of people on antiretroviral treatment in the state and the proportion of patients with viral load ≤1,000 copies/mL and ≤50 copies/mL were calculated. The results were compared with the corresponding parameters of the World Health Organization goal 90-90-90. Results: The state of Paraná managed to reach the second and third parameters of the 90-90-90 goal of the World Health Organization. Among those diagnosed, 93.12% were on antiretroviral treatment, and 90.0% of them had a viral load below 50 copies of viral RNA/mL of blood, indicating virologic success. Conclusion: The health policy aimed at the population living with HIV/AIDS, and the health services available in Paraná have been successful in parameters relevant to the control of the epidemic. However, it is necessary to ensure the diagnosis of people infected with HIV in the population.


RESUMO Objetivo: Caracterizar o perfil sociodemográfico da população em tratamento antirretroviral no estado do Paraná, investigar a proporção de pessoas em tratamento entre todos os diagnosticados e analisar a proporção de pacientes com carga viral suprimida nas diferentes regiões do estado. Métodos: Estudo observacional descritivo e analítico realizado com informações referentes ao período de janeiro de 2018 a janeiro de 2019. Os dados foram obtidos do Sistema Informatizado de Monitoramento Clínico das Pessoas Vivendo com HIV/AIDS e do Sistema de Controle Logístico de Medicamentos. Foram calculadas as proporções de pessoas em tratamento antirretroviral no estado e de pacientes com carga viral ≤1.000 cópias/mL e ≤50 cópias/mL. Os resultados foram comparados com os parâmetros correspondentes da meta 90-90-90 da Organização Mundial da Saúde. Resultados: O estado do Paraná alcançou o segundo e o terceiro parâmetros da meta 90-90-90 da Organização Mundial da Saúde. Entre os diagnosticados, 93,12% encontravam-se em tratamento antirretroviral, e 90,0% destes apresentavam carga viral abaixo 50 cópias do RNA viral/mL de sangue, indicando sucesso virológico. Conclusão: A política de saúde voltada à população vivendo com HIV/AIDS e os serviços de saúde disponibilizados no Paraná têm obtido êxito em parâmetros relevantes para o controle da epidemia. Entretanto, é necessário assegurar o diagnóstico das pessoas infectadas por HIV na população.


Subject(s)
Humans , HIV Infections/drug therapy , Anti-HIV Agents/therapeutic use , Brazil , RNA, Viral , Viral Load , Antiretroviral Therapy, Highly Active , Anti-Retroviral Agents/therapeutic use
5.
Einstein (Säo Paulo) ; 18: eAO4995, 2020. tab, graf
Article in English | LILACS | ID: biblio-1090037

ABSTRACT

ABSTRACT Objective To describe antiretroviral treatment regimens prescribed and their compliance with the Clinical Protocol and Therapy Guidelines of the Ministry of Health for the management of HIV infection. Methods Observational and descriptive study. Secondary data of the state of Paraná (Brazil) on drugs, treatment regimens, lines of treatment and number of individuals on treatment, from January to June 2018, were accessed at the Antiretroviral Agents Logistic Control System. Combinations of antiretroviral drugs (treatment regimens) were compared according to the current Clinical Protocol and Therapy Guidelines and non-compliances were classified and quantified. Results In Paraná, 35,127 individuals with HIV were treated with 253 different treatment regimens. Of the prescribed regimens, 19.1% were first-line, 27.4% second-line and 48.5% third-line. Among non-compliances, the most prevalent were absence of association of protease inhibitors and ritonavir (42.8%), low efficacy triple therapy (36.9%), double therapy (26.1%), monotherapy (20.3%), and triple therapy of nucleoside analog reverse transcriptase inhibitors (17.1%). Conclusion Most individuals receiving HIV treatment in the state of Paraná are on treatment regimens established in the current Clinical Protocol and Therapy Guidelines, which contributes to successful therapy. However, associations not provided by the current Clinical Protocol and Therapy Guidelines were identified in the initial treatment lines, which could lead to ineffectiveness, virologic failure and viral resistance.


RESUMO Objetivo Descrever esquemas terapêuticos de antirretrovirais prescritos e sua conformidade com o Protocolo Clínico e Diretrizes Terapêuticas, do Ministério da Saúde, para manejo da infecção pelo HIV. Métodos Estudo observacional e descritivo. Os dados do estado do Paraná sobre medicamentos que compõem os esquemas terapêuticos, linhas de tratamento e número de pessoas em uso destes foram acessados no Sistema de Controle Logístico de Medicamentos Antirretrovirais no período de janeiro a junho de 2018. As combinações de antirretrovirais (esquemas terapêuticos) foram comparadas conforme o Protocolo Clínico e Diretrizes Terapêuticas vigente, e as inconformidades foram categorizadas e quantificadas. Resultados No Paraná, 35.127 pessoas com HIV foram tratadas com 253 esquemas terapêuticos distintos. Dentre os esquemas prescritos, 19,1% eram de primeira linha, 27,4% de segunda linha e 48,5% de terceira linha. Nas inconformidades, predominaram a não associação entre inibidores da protease e ritonavir (42,8%), terapia tripla de baixa eficiência (36,9%), terapia dupla (26,1%), monoterapia (20,3%) e terapia tripla de inibidores da transcriptase reversa análogos de nucleosídeos (17,1%). Conclusão Maior parte das pessoas em tratamento do HIV no Paraná utilizam esquemas terapêuticos previstos no Protocolo Clínico e Diretrizes Terapêuticas vigente, o que contribui para o sucesso terapêutico. Entretanto, associações não previstas foram identificadas nas linhas de tratamento iniciais, podendo ocasionar inefetividade, falha virológica e resistência viral.


Subject(s)
Humans , Clinical Protocols/standards , Guideline Adherence/standards , Anti-Retroviral Agents/administration & dosage , Brazil , HIV Infections/drug therapy , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/therapeutic use , Guideline Adherence/statistics & numerical data , Anti-Retroviral Agents/therapeutic use , Drug Therapy, Combination/standards , Drug Therapy, Combination/statistics & numerical data , Medication Adherence/statistics & numerical data
6.
ABCS health sci ; 43(3): 136-140, 20 dez. 2018. graf
Article in Portuguese | LILACS | ID: biblio-967911

ABSTRACT

INTRODUÇÃO: Com o propósito de estimular a adesão aos antirretrovirais e minimizar os riscos de resistência a estes medicamentos, o Ministério da Saúde (MS) passou a disponibilizar o medicamento 3 em 1, uma coformulação de tenofovir (300 mg), lamivudina (300 mg) e efavirenz (600 mg), o qual inova com uso de um único comprimido diário. OBJETIVO: Estimar a adesão aos medicamentos antirretrovirais da primeira linha de tratamento contra o HIV. MÉTODOS: Verificação da frequência dos retornos mensais de pacientes a um dispensário dos medicamentos antirretrovirais fornecidos pelo MS. RESULTADOS: Os pacientes em tratamento com o medicamento 3 em 1 foram mais assíduos e retornaram com frequência 65% maior ao dispensário. CONCLUSÃO: Com a introdução do 3 em 1 confirma-se que a simplificação de esquemas terapêuticos é uma medida que facilita a adesão ao tratamento. Isso gera a expectativa de manter por mais tempo os indivíduos em uso da primeira linha de tratamento, retardando a necessidade de recorrer a outras linhas terapêuticas mais onerosas, com maior número de medicamentos e riscos associados.


INTRODUCTION: In order to stimulate adherence to antiretrovirals and minimize the risks of viral mutations and resistance to these drugs, the Ministry of Health (MS) started providing the 3-in-1 drug, a co-formulation of tenofovir (300 mg), lamivudine (300 mg) and efavirenz (600 mg), which innovates by the use of a single daily tablet. OBJECTIVE: Estimating the adherence to antiretroviral drugs in the first line of HIV treatment. METHODS: Verification of the frequency of monthly patient returns to a dispensary of antiretroviral drugs provided by MS. RESULTS: Patients treated with the 3-in-1 medication were more assiduous and returned 65% higher at the dispensary. CONCLUSION: The introduction of 3-in-1 confirms that the simplification of therapeutic schemes is a measure that facilitates adherence to treatment. This generates the expectation of keeping individuals in the first line of treatment longer, delaying the need to resort to other more expensive therapeutic lines, with a higher number of drugs and associated risks.


Subject(s)
Humans , HIV/drug effects , Anti-Retroviral Agents/administration & dosage , Anti-Retroviral Agents/pharmacology , Medication Adherence , Medication Adherence/statistics & numerical data , Treatment Adherence and Compliance/statistics & numerical data
7.
Espaç. saúde (Online) ; 18(1): 204-214, jul. 2017. Graficos
Article in Portuguese | LILACS | ID: biblio-859249

ABSTRACT

O presente trabalho trata-se de um relato de experiência sobre o desenvolvimento de um Plano Operativo (PO) através das estratégias do Planejamento Estratégico Situacional (PES) durante o Curso de Especialização de Gestão da Assistência Farmacêutica da Universidade Federal de Santa Catarina, no ano de 2014. Foi desenvolvida uma análise descritiva e explicativa do referido plano, refletindo sobre sua execução, potencialidades e fragilidades. Este relato teve como objetivo principal descrever a execução do referido PO, relacionando o problema trabalhado com sua importância para a assistência farmacêutica e a experiência vivida durante a sua construção para os atores envolvidos. Como objetivos específicos buscou-se identificar a relevância do PES para a execução de planejamentos de rotina e verificar a implantação do que foi proposto no PO. A partir dos resultados obtidos, foi possível verificar que as ferramentas dinâmicas do PES podem auxiliar todos os profissionais de saúde no planejamento de suas ações no dia a dia de trabalho e na resolução de conflitos ou situações-problema frequentemente encontrados na assistência farmacêutica de estados e municípios (AU).


This work is an experience report about the development of an Operating Plan (OP) through the Strategic Situational Planning tools (SSP) during the Specialization Course of Pharmaceutical Care Management, Federal University of Santa Catarina in 2014. A descriptive and explanatory analysis of the plan was developed, reflecting on its implementation, strengths and weaknesses. This report aimed to describe the performance of the OP, relating the prioritized problem with its importance to the pharmaceutical care and the experience during the construction of this work for the actors involved. As specific goals, it sought to identify the relevance of SSP for the performance of routine planning, and to observe the implementation of what has been proposed in the OP. Based on the results obtained, it was possible to observe that the SSP dynamic tools can greatly assist all health professionals in planning their actions on daily work, especially in the resolution of conflicts or problem-situations that are often found in pharmaceutical care in the states and cities (AU).


Subject(s)
Acquired Immunodeficiency Syndrome , Anti-Retroviral Agents , Pharmaceutical Services
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