ABSTRACT
INTRODUCCIÓN: el debut de sida es una forma de presentación de la enfermedad causada por VIH que se caracteriza por alteración del estado general del paciente, síndrome de desgaste, aparición de graves infecciones oportunistas, neoplasias y alteraciones neurológicas. MÉTODOS: se estudió el comportamiento de los niveles de linfocitos T CD4+ y de carga viral en pacientes con debut de sida y terapia antirretroviral, al inicio y un año después del tratamiento. Se estudiaron 55 pacientes los cuales tuvieron al inicio del tratamiento conteos de linfocitos TCD4+ inferiores a 200cel/µL y carga viral elevada. RESULTADOS: después de un año de terapia, los valores de linfocitos T CD4+ aumentaron por encima de 200 cel/µL y la carga viral disminuyó a niveles no detectables en los pacientes estudiados. CONCLUSIONES: los resultados de esta investigación confirman los beneficios del tratamiento antirretroviral particularmente para los pacientes con debut de sida.
INTRODUCTION: the AIDS premiere is a form of presentation of the illness caused by HIV that is characterized by alteration of the patient's general state, waste syndrome, appearance of serious opportunists infections, neoplasia and neurological alterations. METHODS: the behavior of the CD4+ T lymphocytes levels were studied and of viral load in patient with AIDS premiere and antiretroviral therapy, to the beginning and one year after the treatment. 55 patients those were studied which had to the beginning of the treatment CD4+ T lymphocytes counts less to 200cel/µL and high viral load. RESULTS: after a year of therapy, the values of CD4+ T cells recovered and the viral load diminished at non detecting levels in the evaluated patients. CONCLUSIONS: the results of this study confirm the benefits of antiretroviral therapy, particularly for patient with AIDS premiere.
Subject(s)
Humans , Male , CD4-Positive T-Lymphocytes/drug effects , Acquired Immunodeficiency Syndrome , Viral Load/drug effects , Anti-Retroviral Agents/therapeutic use , Cross-Sectional Studies/methods , Prospective Studies , Observational StudyABSTRACT
O vírus linfotrópico das células T humanas do tipo 1 (HTLV-1) é o agente etiológico da mielopatia associada ao HTLV / paraparesia espástica tropical (HAM / TSP ), que ocorre em menos de 5 % dos indivíduos infectados. A resposta imune controla parcialmente a infecção, porém pode estar ligada a patogênese da doença. O objetivo deste estudo foi caracterizar fenotipicamente as subpopulações de linfócitos T, em pacientes assintomáticos e com diagnóstico de HAM/TSP. Foram avaliados 103 pacientes acompanhados no Centro de HTLV da Escola Bahiana de Medicina e Saúde Pública (EBMSP) e 19 controles não infectados. Os pacientes foram categorizados de acordo com o grau de certeza do diagnóstico de HAM/TSP: possível (Ps), provável (Pb) e definido (D), além de pacientes assintomáticos (ASS). O perfil fenotípico (CD25, CD45RA, CD45RO, HLA-DR, CD25, CCR-7, CD62L)...
The human T-cell lymphotropic vírus type 1(HTLV-1) is the etiological agent of HTLV- associated myelopathy/ Tropical spastic paraparesis(HAM/TSP), wich occurs in less then 5% of the infected individuals. The immune response partially controls the infection, but may be linked to the pathogenesis of disease. The aim of this study was to characterize phenotipically T lymphocyte subpopulations in asymptomatic and in patients diagnosed with HAM/TSP. We evaluated 103 patients treated at the center for HTLV of Bahia School of Medicine and Public Health (EBMSP) and 19 uninfected controls. Patients were categorized as asymptomatic and according to the degree of certainty of the diagnosis of HAM/TSP: Possible(Ps), Probable(Pb) and Definite(D). The phenotypic profile (CD25, CD45RA, CD45RO, HLA-DR, CCR-7, CD62L)...
Subject(s)
Humans , Spinal Cord Diseases/diagnosis , Spinal Cord Diseases/immunology , Spinal Cord Diseases/pathology , Spinal Cord Diseases/prevention & control , Spinal Cord Diseases/virology , Receptors, Antigen, T-Cell , Receptors, Antigen, T-Cell/administration & dosage , Receptors, Antigen, T-Cell/analysis , Receptors, Antigen, T-Cell/immunology , Human T-lymphotropic virus 1/pathogenicityABSTRACT
La infección por virus de inmunodeficiencia humana (VIH) es uno de los mayores problemas de salud actuales, se estima que más de 40 millones de personas están infectadas en el mundo. Se realizó un estudio descriptivo de corte transversal en 40 pacientes VIH/SIDA pertenecientes al servicio de Medicina del IPK con el propósito de caracterizar las causas del cambio de tratamiento antirretroviral y los tipos de reacciones adversas presentadas con este tratamiento en un grupo de pacientes VIH/SIDA..Los pacientes recibieron diferentes esquemas de antirretrovirales entre los que predominaron los siguientes: 3TC, d4T e Indinavir (57,5 por ciento), seguido de 3TC, AZT e Indinavir (22,5 por ciento). Las causas más frecuentes de cambio de tratamiento fueron las reacciones adversas y la mala adherencia al tratamiento. Entre las personas que están recibiendo terapia contra el VIH, existe una tendencia cada vez más frecuente de abandonar o cambiar la terapia. Las causas de estos cambios y del abandono de las terapias suelen estar relacionadas con los efectos secundarios, la fatiga del tratamiento, la fase de la infección por VIH en que se encuentra el paciente, y factores relativos a su estilo de vida. Las causas más frecuentes de cambio de tratamiento fueron las reacciones adversas, seguidas de la mala adherencia al tratamiento antirretroviral. Las reacciones adversas más frecuentes en el grupo de estudio fueron los vómitos y los trastornos digestivos respectivamente
The HIV virus infection is one of the major current problems of health estimating that more than 40 millions of persons are infected at world level. A cross-sectional and descriptive study was conducted in 40 HIV/AIDS patients from the Tropical Medicine Institute service to characterize the causes of the change in antiretroviruses treatment and the types of adverse reactions related to this treatment in a group of HIV/AIDS patients. Patients received different antiretroviruses schemes with predominance of 3TC, d4T and Indinarir (57,5 percent), followed by 3TC, AZT and Indinavir (22,5 percent). The more frequent causes of change of this treatment were the adverse reactions and a poor adherence to it. Among the persons with therapy HIV there is a more and more frequent trend to give up or to change of therapy. The causes of these changes and the leaving the therapy are related to side effects, treatment fatigue, and the HIV infection phase in patient and relative factors related to the lifestyle. The more frequent causes of the change of treatment were the adverse reactions followed by a poor adherence to antiretroviruses treatment. The more frequent adverse reactions were vomiting and digestive disorders, respectively
Subject(s)
Anti-Retroviral Agents/therapeutic use , Aztreonam/therapeutic use , Indinavir/therapeutic use , Lamivudine/therapeutic use , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/drug therapy , Cross-Sectional Studies , Epidemiology, DescriptiveABSTRACT
From the beginning of the AIDS epidemic, pneumocystis pneumonia (PCP) has been distinguished as one of the most frequent opportunistic diseases with high morbid-mortality. As from 1996, the advent of the highly active antiretroviral therapy (HAART) has changed the characteristics of such epidemic by reducing its related diseases and, as a result, AIDS-related mortality. With the purpose to estimate PCP occurrence and HAART interference, 376 HIV-infected or AIDS patients were studied from January 1992 to December 2002. Among them, 58 (15.5 percent) PCP cases were found. There was a higher occurrence of PCP in the group of patients in which HAART was not used, with 40 (69.0 percent) of the episodes. As regards the studied period, a tendency to a linear reduction in annual PCP incidence was observed. The mean of T CD4+ lymphocytes in the patients with PCP (117 cells/mm³) was significantly lower when compared to that of the other individuals (325 cells/mm³). Therefore, this study suggests a temporal reduction in PCP occurrence related to HAART use with higher T CD4+ lymphocyte counts. Nevertheless, this opportunistic infection still shows significant incidence in AIDS patients. (NCT00516581).