Epidemiological profile of Adolescents living with HIV/AIDS in Espirito Santo, Brazil: A cross-sectional study / Perfil epidemiológico de adolescentes vivendo com HIV/AIDS no Espírito Santo, Brasil: um estudo transversal

Introduction: The AIDS epidemic has undergone several transformations, and, in recent years, there has been an increase in cases of HIV/AIDS among adolescents and young people. Thus, it is essential to know this population to base health actions scientifically.Objective: This study aims to analyze the epidemiological profile of adolescents living with HIV/AIDS in Espírito Santo, Brazil.Methods: A descriptive, sectional study in which notifications of HIV/AIDS among adolescents aged 13 to 19 between 2010 and 2020 were analyzed.Results: 523 adolescents with HIV/AIDS were found in the analyzed period (an average of 47 cases/year). There was a predominance of male adolescents (68.8%), older than 16 years (mean=18.0 years), of mixed race/colour (54.6%), living in the metropolitan region near the capital. It was observed that the schooling of females is lower, with 47.2% of them in elementary school, while 45.0% of the boys are in high school. In most cases, the infection occurred via sexual intercourse, among men, through homosexual relations (55.0%), and among women, through heterosexual relations (82.2%). The HIV viral load was detectable in almost all (84.8%) cases, and 11 (6.8%) of these adolescents died.Conclusion: The epidemiological profile of HIV and AIDS cases among adolescents in Espírito Santo shows a higher frequency of cases in males aged 16 to 19 years, with incomplete high school education, who acquired HIV through unprotected sex in homosexual relationships. We highlight the high percentage of young people with detectable viral loads and deaths due to complications of AIDS

Introdução: A epidemia da AIDS passou por diversas transformações e, nos últimos anos, observa-se aumento de casos de HIV/AIDS entre adolescentes e jovens. Assim, é fundamental conhecer essa população para embasar cientificamente as ações em saúde. Objetivo: analisar o perfil epidemiológico de adolescentes que vivem com HIV/AIDS no Estado do Espírito Santo, Brasil. Método: estudo descritivo, seccional, no qual foram analisadas notificações de HIV/AIDS entre adolescentes de 13 a 19 anos, entre 2010 e 2020.Resultados: foram encontrados 523 adolescentes vivendo com HIV/AIDS no período analisado (média de 47 casos/ano). Prevaleceu os adolescentes do sexo masculino (68,8%), com mais de 16 anos (média=18,0 anos), de raça/cor parda (54,6%), residentes na região metropolitana, próxima a capital. Foi observado que a escolaridade do sexo feminino é menor, estando 47,2% delas no ensino fundamental, enquanto 45,0% dos rapazes já estão no ensino médio. Em grande parte dos casos a infecção ocorreu via sexual, sendo, entre os homens, através de relações homossexuais (55,0%) e entre as mulheres por meio de relações heterossexuais (82,2%). A carga viral de HIV foi detectável em quase totalidade (84,8%) dos casos e 11 (6,8%) destes adolescentes evoluíram para óbito. Conclusão: O perfil epidemiológico dos casos de HIV e AIDS, entre os adolescentes, no Estado do Espírito Santo, demonstra maior frequência de casos no sexo masculino, na faixa etária de 16 a 19 anos, com ensino médio incompleto, que adquiriram HIV por via sexual desprotegida, em relações homossexuais. Destaca-se a alta porcentagem de jovens com carga viral detectável e os óbitos em decorrência de complicações da AIDS.

Linfadenitis por Mycobacterium en pacientes inmunocompetentes y viviendo con VIH/sida / Lymphodenitis by Mycobacterium in immunocompetent and living with HIV/AIDS patients

Introducción: La coinfección del virus de inmunodeficiencia humana (VIH) y la tuberculosis ha alterado su presentación histológica, esto es particularmente frecuente en las linfadenitis. Objetivos: Realizar la caracterización etiológica de linfadenopatías producidas por el género Mycobacterium, destacar la importancia del diagnóstico precoz de esta enfermedad para evitar diseminación de la infección, tanto en pacientes inmunocompetentes como inmunodeficientes, específicamente con VIH/sida. Método: Se realizó estudio descriptivo-prospectivo entre enero de 2017 y enero de 2019. Durante este período se recibieron 5640 muestras, de estas 81 obtenidas a partir de tejido ganglionar; la toma de muestra mayoritariamente fue quirúrgica 74 (91,35 por ciento) y 7 (8,64 por ciento) por biopsia aspirativa (BAAF). Del total de muestras, 60 (74,07 por ciento) procedían de pacientes con VIH/sida, las muestras se descontaminaron por el método de ácido sulfúrico al 4 por ciento, se cultivaron en medio sólido Löwenstein-Jensen e incubaron a 37°C. Se realizaron lecturas semanalmente. Para identificar Mycobacterium tuberculosis se realizó la prueba rápida comercial inmunocromatográfica SD TB AgMPT64. Resultados: De 81 muestras analizadas se obtuvieron 22 (27,16 por ciento) aislamientos, 16 (72,72 por ciento) de Mycobacterium tuberculosis, y 6 (27,27 por ciento) de especies no tuberculosas. De estas, 18 (81,81 por ciento) procedían de pacientes con VIH/sida. Conclusión: Por todo lo antes expuesto es importante la vigilancia diagnóstica en este tipo de infección extrapulmonar, tanto para M. tuberculosis como para otras especies no tuberculosas y poder comenzar tempranamente el tratamiento específico evitando la diseminación de la infección, pues esta puede tener consecuencias fatales, sobre todo en pacientes con algún tipo de inmunosupresión, como aquellos con VHI/sida. Si un paciente mantiene fiebre prolongada, con linfadenopatías, sin síntomas respiratorios y no responde a los tratamientos con antibióticos, es necesario pensar en este tipo de infección(AU)

Introduction: The coinfection of human immunodeficiency virus (HIV) and tuberculosis has altered its histological presentation; this is particularly frequent in lymphadenitis. Objective: To carry out the etiological characterization of lymphadenopathies produced by the genus Mycobacterium, highlighting the importance of early diagnosis of this disease to avoid dissemination of the infection, both in immunocompetent and immunodeficient patients, specifically HIV / AIDS. Methods: A descriptive-prospective study was carried out between January 2017 - January 2019. During this period, 5640 samples were received, of these 81 obtained from lymph node tissue, the sample collection was mostly surgical 74 (91.35 percent) and 7 (8.64 percent) by aspiration biopsy (BAAF). Of the total samples, 60 (74.07 percent) were from HIV / AIDS patients, the samples were decontaminated by the 4 percent sulfuric acid method and cultured in solid Löwenstein-Jensen medium and incubated at 370C, the readings were made weekly. For the identification of Mycobacterium tuberculosis, the commercial SD TB AgMPT64 immunochromatographic rapid test was performed. Results: Of 81 samples analyzed, 22 (27.16 percent) isolates were obtained, 16 (72.72 percent) of Mycobacterium tuberculosis (MTB), and 6 (27.27 percent) of non-tuberculous species, of these 18 (81.81%) were from HIV / AIDS patients. Conclusion: For all the above, diagnostic surveillance is important in this type of extrapulmonary infection, both for M tuberculosis and for other non-tuberculous species and to be able to start specific treatment early, avoiding the spread of the infection, since it can have fatal consequences on all in patients with some type of immunosuppression, such as HIV/AIDS. If a patient maintains a prolonged fever, with lymphadenopathy, without respiratory symptoms and does not respond to antibiotic treatment, it is necessary to consider this type of infection(AU)

Conocimientos y actitudes de voluntarios de la Cruz Roja Colombiana sobre VIH y sus portadores / Knowledge and attitudes of volunteers of the Colombian Red Cross on VIH and its carriers

RESUMEN Objetivo Determinar el conocimiento y las actitudes de un grupo de 53 jóvenes de la Cruz Roja de la Juventud en la Seccional Valle del Cauca sobre el fenómeno social del VIH/SIDA y sus portadores. Método El diseño de la investigación se basó en la línea de desarrollo humano y construcción de ciudadanía, bajo el método cuantitativo de orden descriptivo. Para la recolección de la información, se empleó un formato de encuesta de tipo descriptivo con preguntas cerradas o de alternativa fija, compuesto por un cuestionario de 39 preguntas. Resultados Entre el 69% y 72% de los jóvenes refieren conocimiento sobre sus derechos sexuales y reproductivos; sin embargo, un porcentaje bajo, entre 26% y 39%, afirma haber recibido asesoría sobre la realización de la prueba del VIH, un porcentaje menor se la ha realizado. Conclusiones Es claro el bajo nivel de reconocimiento que tienen las instituciones y los medios de comunicación como difusores de temas relacionados con la salud sexual y reproductiva y el VIH/SIDA. Por otro lado, a pesar del reconocimiento de sus derechos, perviven en los jóvenes mitos sobre la forma de contagio, la actitud de distanciamiento con los portadores y las conductas de riesgo en las prácticas sexuales.

ABSTRACT Objective Determine the knowledge and attitudes of a group of 53 young people of the Red Cross of Youth in the Valle del Cauca Sectional about the social phenomenon of HIV/AIDS and its bearers. Method The design of the research was based on the line of human development and construction of citizenship, under the quantitative method of descriptive order. For the collection of information, a descriptive survey format with closed questions or a fixed alternative was used, consisting of a questionnaire of 39 questions. Results Between 69% and 72% of young people report knowledge about their sexual and reproductive rights, however, a low percentage between 26% and 39% say they have received counseling about the HIV test and a smaller percentage have accomplished. Conclusions It is clear the low levels that institutions and media have in the dissemination of the topic of sexual and reproductive health and HIV/AIDS. Despite the recognition of their rights, myths persist about the form of contagion, the attitude of distancing with carriers and risk behaviors in sexual practices.

Influencing factors of unprotected anal intercourse among Tianjin male homosexuals who used recreational drugs / 上海预防医学

Objective:To explore the demographic characteristics and sexual behavior of men who have sex with men （MSM） in Tianjin， and to compare these aspects between recreational drug users and non-users. Methods:This research was conducted by Tianjin Centers for Disease Control and Prevention. From July to September 2015， various methods such as simple random sampling and snowball sampling were used to recruit MSM. Information was collected through on-site questionnaire surveys， and laboratory tests were conducted to detect human immunodeficiency virus （HIV） infection status in the research subjects. Statistical description and frequency distribution tests on demographic information and behavioral variables were performed. Results:A total of 410 qualified participants， ranged from 17 to 70 years old， were included. A total of 297 （72.4%） MSM were unmarried， 194 （47.3%） had monthly income over 3 000 yuan， 182 （44.4%） MSM had high school education， and 366 （89.3%） were working full-time. Among all 410 participants， 208 MSM self-reported using recreational drugs. Among them， 140 MSM had used Rush Popper. Influencing factors of unprotected anal intercourse （UAI） among Rush Popper users include： more than 30 years old， average monthly income less than 5 000 yuan， and sex with temporary partners （all P<0.05）. Conclusion:Among MSM in Tianjin， the use of recreational drugs is quite common， and Rush Popper is the most commonly used recreational drug. Therefore， it is necessary to establish and strengthen the relevant laws and regulations for the reduction of Rush Popper circulation among the MSM population.

Factores que influyen en la adherencia al tratamiento farmacológico en pacientes infectados con VIH / Factors influencing adherence to pharmacological treatment in patients infected with HIV

La adherencia al tratamiento constituye actualmente una de las principales preocupaciones en relación al control del VIH/sida, asociándose fuertemente al éxito o fracaso terapéutico. Este estudio muestra la adherencia al tratamiento antirretroviral identificando diversos factores que podrían ser facilitadores u obstáculos por medio de la aplicación de los instrumentos cuantitativo y cualitativo. Objetivo: Validación los instrumentos cuantitativo y cualitativo para determinar los factores que influyen en la adherencia al tratamiento antirretroviral y analizar la percepción del paciente sobre el seguimiento que recibe en el Servicio de Farmacia Integral. Métodos: La investigación es mixta, de corte transversal y de tipo exploratorio, descriptivo. El diseño es no experimental. La validación de los instrumentos se realizará mediante juicio de expertos, se utilizó una prueba piloto para el cuantitativo con 15 pacientes, seleccionados de forma no aleatoria, no probabilística. Para el instrumento cualitativo se utiliza un paciente. Resultados: 98.8% de confiabilidad de los instrumentos cualitativos y 85% cuantitativo. De las conductas o comportamiento individual de los pacientes depende exclusivamente la adherencia terapéutica. La percepción del usuario es buena sobre el desempeño profesional al realizar el seguimiento terapéutico, pero todavía se demuestra que deben incrementarse las acciones para que se logre una verdadera descentralización de la atención. Conclusiones: El instrumento es apto para aplicar a los usuarios, los factores sociodemográficos, comportamiento individual y conductas frente al tratamiento influyen en la adherencia terapéutica(AU)

Adherence to treatment is currently one of the main concerns in relation to the control of HIV / AIDS, strongly associated with therapeutic success or failure. This study shows adherence to antiretroviral treatment by identifying various factors that could be facilitators or obstacles through the application of quantitative and qualitative instruments. Objective: Validation of the quantitative and qualitative instruments to determine the factors that influence adherence to antiretroviral treatment and analyze the patient's perception of the follow-up they receive at the Comprehensive Pharmacy Service. Methods: The research is mixed, cross-sectional and exploratory, descriptive. The design is non-experimental. The validation of the instruments was carried out through expert judgment; a pilot test was used for the quantitative with 15 patients, selected in a non-random, non-probabilistic way. One patient selected for the qualitative instrument. Results: 98.8% reliability of the qualitative instruments and 85% quantitative. The conduct or individual behavior of the patients depends exclusively on therapeutic adherence. The user's perception is good on the professional performance when carrying out the therapeutic follow-up, but it is showing yet, that the actions must be increase so that achieve a true decentralization of care. Conclusions: The instrument is suitable to apply to users, sociodemographic factors, individual behavior and behaviors towards treatment influence therapeutic adherence(AU)

Percepción de pacientes con VIH/Sida sobre consulta odontológica en IPS de Santa Marta - Colombia / Perception of patients with HIV / AIDS on dental consultation in Santa Marta - Colombia

Introducción: La atención odontológica oportuna e inclusiva tiene un papel importante en las personas con VIH/SIDA, por cuanto permite prevenir y dar tratamiento a las múltiples lesiones orales que acompañan a esta patología, mejorando la calidad de vida de esta población. Objetivo: Determinar la percepción y experiencia de pacientes con VIH/SIDA sobre la consulta odontológica en una Institución Prestadora de Salud (IPS) de Santa Marta, Colombia. Materiales y métodos: Se realizó un estudio descriptivo cuantitativo donde participaron 64 pacientes con VIH/SIDA de una IPS de la ciudad de Santa Marta, quienes se les aplicó un instrumento de recolección de datos. Resultados: El 65,6% expresó nunca percibir rechazo por parte del odontólogo, el 25% refiere haber experimentado algún rechazo por lo menos una vez y un 9,4% siempre se siente rechazado. Conclusiones: Existe la necesidad de abordar esta enfermedad no sólo desde el aspecto clínico, sino también desde lo social, para educar tanto al profesional de la salud como a la comunidad, sobre avances científicos, el estudio de esta patología y los riesgos reales de contraerla, para desmitificar esta afección y erradicar la discriminación hacia los pacientes.

Introduction: Timely and comprehensive dental care is important for HIV/AIDS patients as it facilitates prevention and treatment of the multiple oral lesions that accompany this pathology, and consequently, improves their quality of life. Objective: To determine the perception and experience of the dental care service provided by a Health Provider Institution (HPI) to HIV/AIDS patients from the city of Santa Marta (Colombia). Materials and methods: A descriptive quantitative study was carried out with 64 HIV/AIDS patients treated in the HPI, to whom a data collection instrument was applied. Results: 65.6% of the HIV/AIDS patients did not perceive any rejection from the dentist, whereas 25% and 9.4% of these patients reported being discriminated at least once and always, respectively. Conclusions: There is a need to approach this disease not only from a clinical standpoint but also from a social perspective in order to educate both health professionals and communities about: scientific advances; how to study this pathology; and the risks of contracting HIV/AIDS. It is also necessary to demystify some misconceptions and eradicate discrimination against these patients.

Características sociodemográficas y clínicas de pacientes con diagnóstico nuevo de VIH / Sociodemographic and clinical characteristics of patients with new HIV diagnosis

Objetivo: Caracterizar de forma sociodemográfica y clínica pacientes con diagnóstico nuevo de VIH, que fueron hospitalizados en una Clínica Universitaria de alta complejidad entre el año 2010 - 2016. Materiales y métodos: Se realizó un estudio observacional, descriptico, de corte transversal por medio de revisión de historias clínicas, que incluyo pacientes ≥14 años, a quienes se les diagnosticó VIH durante la hospitalización y tuvieran al menos un conteo de linfocitos CD4. Resultados: La mediana para la edad fue 41 años (RIC 31 - 51), el 85,1% eran hombres. Los principales síntomas al ingreso fueron generales/sistémicos (70,2%). 99 pacientes (61,5%) tenían infecciones oportunistas siendo tuberculosis la más frecuente (34,3%). La mediana para el conteo de CD4 fue 88 células/mm3 RIC (27 - 327) y el 77% se clasificó como SIDA. 29 pacientes murieron (18%) encontrando como posible factor de riesgo tener conteo de CD4 fue 88 células/mm3 RIC (27 - 327) y el 77% se clasificó como SIDA. 29 pacientes murieron (18%) encontrando como posible factor de riesgo tener conteo de CD4<200 células/mm3 , no pertenecer al régimen contributivo, ingresar con síntomas respiratorios, tener diagnóstico de neumonía, criterios de falla multiorgánica o necesidad de UCI/UCE. Conclusión: Para nuestro caso la mayoría de pacientes con diagnóstico nuevo de VIH se encontraban en estados avanzados de inmunosupresión con alta carga de enfermedades definitorias de SIDA. Es importante fortalecer las políticas de salud pública para diagnosticar más temprano la infección por VIH.

Purposes: To characterize sociodemographic and clinical aspects in newly diagnosed HIV patients that were hospitalized at a university health center between 2010 - 2016. Methods: We made an observational descriptive cross - sectional study reviewing clinical records, including patients older than 14 years old, who were diagnosed with HIV infection during hospitalization and at least a CD4 count. Results: Median age at diagnosis was 41 years old (IQR 31 - 51), 85% were men. The main symptoms were general/systemic (70.2%). 99 patients (61.5%) had opportunist infections, being tuberculosis the most frequent (34.3%). The median CD4 were 88 cells/mm3 (IQR 27 - 327) and 77% were classified as AIDS. 29 patients died (18%), finding as a risk factor for mortality don't having a good health care insurance, low CD4 count, having respiratory symptoms, pneumonia diagnosis, multiple organic failure's criteria and ICU admission. Conclusion: In our case, the majority of patients with a new diagnosis of HIV were in advanced stages of immunosuppression with a high burden of AIDS defining diseases. It is important to strengthen public health policies to diagnose HIV infection earlier.

Significados del trabajo en personas que viven con vih / The meaning of work for people living with HIV / Significados do trabalho nas pessoas que vivem com VIH

Resumen Introducción: De los 36 millones de personas que viven con vih en el mundo, el 63 %, aproximadamente, son activas a nivel laboral, pero poco se sabe de los significados que el trabajo representa para ellas. Objetivo: Comprender los significados que el trabajo tiene para un grupo de trabajadores con vih y que viven en la ciudad de Bogotá. Metodología: Estudio de tipo cualitativo, hermenéutico e interpretativo, en el que participaron voluntariamente once trabajadores (seis mujeres y cinco hombres), seleccionados según criterios de pertinencia y adecuación. La muestra se definió por saturación teórica, y la recolección de datos se dio mediante una entrevista semiestructurada. El análisis siguió la técnica hermenéutica propuesta por Diekelman, Allen y Tanner. Resultados: Para los participantes del estudio, el significado del trabajo, cuando se vive con vih, se encuentra sustentado bajo tres categorías: 1) "Empleabilidad, tipo de empleo y manejo de horarios", 2) "Salud, trabajo y vih" y 3) "Entorno social y laboral del vih". Conclusiones: El vih significa una disminución en las posibilidades laborales, que afecta las condiciones extra- e intralaborales del trabajador, principalmente debido al estigma que se impone a la infección, lo cual lleva a acciones de discriminación e influye en las opciones de empleo. Trabajar es un determinante fundamental en el acceso a la salud y, por ende, en su mantenimiento.

Abstract Introduction: Out of the 36 million of people living with hi vworldwide, approximately 63 % are actively working, yet very little is known about the meaning work has for them. Ob jective: To understand the meaning that work has for a group of workers with hiv living in the city of Bogota. Methodolo gy: A qualitative, hermeneutic, interpretive study in which 11 workers (six Women and five men) voluntarily participated, chosen based on relevance and adequacy criteria. The sample was defined by theoretical saturation, and data was collected using a semi-structured interview. This analysis followed the hermeneutic techniques proposed by Diekelman, Allen and Tanner. Results: For the people participating in the study, the meaning of work, when you live with hiv, is supported under three categories: 1) "employability, type of job and schedu les", 2) "health, work and hiv" y 3) "the social and work envi ronment of hiv". Conclusions: Living with hiv means having less work opportunities, and it affects the worker's conditions both in and out of work, mainly because of the stigma surroun ding the infection, which leads to discriminatory actions and influences job opportunities. Working is a fundamental deter minant to have access to healthcare and thus, maintaining it.

Resumo Introdução: Dos 36 milhões de pessoas que vivem com vih neste mundo, o 63 %, aproximadamente, são ativas no nível laboral, porém pouco se sabe dos significados que o trabalho representa para aquelas. Objetivo: Compreender os significa dos que o trabalho tem para o time de trabalhadores com vih e que moram na cidade de Bogotá. Metodologia: Estudo de for mato qualitativo, hermenêutico e interpretativo, no qual par ticiparam voluntariamente onze trabalhadores (seis mulheres e cinco homens), escolhidos segundo critérios de pertinência e adequação. A amostra se definiu por saturação teórica, e a coleta de dados se deu mediante uma entrevista semiestrutu rada. A análise seguiu a técnica hermenêutica proposta pelos Diekelman, Allen e Tanner. Resultantes: Para os participantes do estudo, o significado do trabalho, quando se vive com vih, se encontra suportado sob três categorias: 1) "Empregabilida de, jeito de emprego e uso de horários", 2) "Saúde, trabalho e vih" e 3) "Redor social e laboral do vih". Conclusões: O vih significa uma diminuição nas possibilidades laborais, que afeta as condiciones extra- e intra laborais do laborista, primordial mente devido ao estigma que se impõe contra a infeção, o qual leva a ações de segregação e influem nas opções de emprego. Trabalhar é um determinante fundamental no acesso na saúde e, decorrerá, no seu mantimento.

Estratégias e barreiras na aderência à terapia antirretroviral / Strategies and barriers to adherence to antiretroviral therapy

o principal objetivo do monitoramento de adesão a terapia antirretroviral (TARV) é manter os portadores do Vírus da Imunodeficiência Humana (HIV) com carga viral indetectável. A adesão do paciente à TArV é um processo dinâmico, multifatorial que requer decisões compartilhadas e corresponsabilizadas entre o usuário do serviço, a equipe de saúde e a rede social de apoio, visando atender às singularidades socioculturais, melhorando a qualidade de vida dos pacientes com HIV. Existem vários nos métodos de avaliação da aderência disponíveis, com diferentes implicações para as práticas clínicas e de pesquisa, porém não está definido um método padrão-ouro. Tendo em vista que a efetividade da terapia depende diretamente do engajamento dos pacientes, o estudo visa expor, mediante revisão de literatura, as principais barreiras encontradas nesse contexto e as diversas estratégias utilizadas na prática clínica para promover a adesão integral dos indivíduos portadores de HIV ao tratamento.

The main objective of adherence monitoring is to keep HIV patients with undetected viral load. Patient adherence to ArT is a dynamic, multifactorial process that requires shared and shared decision-making between the service user, the health team and the network social support, aiming to attend sociocultural singularities, improving the quality of life of patients with HIV. There is great variability in the extent of adhesion available with different implications for clinical and research practices. However, a standardized method for assessing adherence is not established. Considering that the effectiveness of the therapy depends directly on the engagement of the patients, the study aims to expose, through a literature review, the main barriers encountered in this contex and the various strategies used in medical practice to promote the integral adherence of individuals with HIV to treatment.

HIV/aids no cárcere: desafios relacionados à regularidade no uso da terapia antirretroviral / HIV/aids in prison: challenges related to the regularity in the use of antiretroviral therapy

Considerando a infecção pelo HIV uma condição crônica e de alta prevalência no ambiente carcerário, este estudo objetivou analisar os desafios relacionados à regularidade no uso da terapia antirretroviral (TARV) pelas pessoas vivendo com HIV em unidades prisionais (UP) da região de Ribeirão Preto (RP), São Paulo. Tratase de um estudo descritivo, do tipo inquérito. Foram incluídos indivíduos reclusos há mais de seis meses, com diagnóstico de HIV e em uso de TARV. Utilizou-se um banco de dados contendo variáveis sociodemográficas, clínicas e de acompanhamento dos casos; adesão à TARV e ações desenvolvidas pelas equipes de saúde das UP para o monitoramento da ingestão medicamentosa. Os dados foram analisados por meio de técnicas descritivas e testes de associação (Quiquadrado e Exato de Fisher). Identificou-se 67 indivíduos em uso de TARV, dos quais, 80,6% cumpriam pena em regime fechado e 38,8% possuíam de dois a cinco anos de clausura. Houve o predomínio de homens (79,1%); 25 a 39 anos (52,2%); não brancos (64,2%); solteiros (47,8%); ensino fundamental I e II (67,1%); possuíam profissão (88,1%) e ganhavam de um a três salários mínimos (50,7%) antes da reclusão. Quanto ao perfil clínico e de acompanhamento: 44,8% diagnosticaram HIV na prisão; 86,6% faziam acompanhamento em serviço de assistência especializada em HIV (SAE); 41,7% interromperam o tratamento em algum momento; 31,3% possuíam TCD4+ acima de 500 cópias e em 62,7% a carga viral era indetectável. Identificou-se o uso de drogas ilícitas (71,6%) e lícitas (80%) prévias ao encarceramento. Em relação ao atraso na entrega da TARV, 70,3% referiram nunca ou quase nunca ocorrer tal situação; 42,2% referiram nunca ou quase nunca perderem consultas nos SAE; 79,1% informaram que nunca ou quase nunca recebem os resultados dos exames laboratoriais processados fora das UP. Sobre o questionamento acerca do uso da TARV nos últimos sete dias: 76,1% tomaram medicamentos fora do horário; 80,6% deixaram de tomar medicamentos; 91% tomaram menos ou mais compridos. Em 58,2% dos casos houve retirada regular da TARV junto às unidades dispensadoras de medicamentos situadas na rede pública de saúde de Ribeirão Preto. Quanto às ações desenvolvidas dentro das UP voltadas ao monitoramento da TARV, considerou-se regular apenas o questionamento sobre o uso contínuo dos medicamentos, sendo que as demais foram insatisfatórias. A adesão à TARV apresentou associação estatisticamente significante com o sexo feminino (p=0,028); o uso de drogas lícitas (p=0,006) e a interrupção do acompanhamento médico (p=0,014) estiveram associadas à não adesão. Os achados deste estudo permitem refletir sobre a complexidade da assistência prestada às pessoas que vivem com HIV/aids no ambiente prisional, principalmente no que tange o monitoramento do uso da TARV, sinalizando a necessidade de desenvolvimento e incorporação de estratégias de intervenção que qualifiquem a produção do cuidado em saúde na perspectiva integral e resolutiva, capaz de produzir impactos condizentes com os desafios que perpassam a prevenção e o manejo do HIV

Considering that the HIV/aids infection constitutes a chronic condition with high prevalence in prisons, this study aimed to analyze the challenges related to regularity in the use of antiretroviral therapy (ART) by people living with HIV in prisons (UP) in the region of Ribeirão Preto (PR), São Paulo. This is a descriptive, inquiry-type study. We included individuals who had been incarcerated for more than six months, diagnosed with HIV/aids and using ART. We used a database containing sociodemographic and clinical information and variables on the case follow-up, ART adherence and actions developed by PU health teams to monitor drug intake. Data were analyzed using descriptive techniques and association tests (Chi-square and Fisher's Exact). A total of 67 individuals using ART were identified, of whom 80.6% were in closed regime and 38.8% had two to five years of incarceration. There was a predominance of men (79.1%); 25 to 39 years old (52.2%); non-white (64.2%); single (47.8%); elementary education I and II (67.1%); having a profession (88.1%) and earning one to three minimum wages (50.7%) before incarceration. In regard of the clinical and follow-up profile: 44.8% had HIV diagnosed in prison; 86.6% were attending a specialized HIV care service (SAE); 41.7% discontinued treatment at some point of time; 31.3% had TCD4+ over 500 copies and in 62.7% of participants the viral load was undetectable. The use of illicit drugs (71.6%) and licit drugs (80%) prior to incarceration was also identified. Regarding delays in ART delivery, 70.3% reported that a delayed delivery never or almost never occurred; 42.2% reported that they never or almost never miss appointments in SAE; 79.1% reported that they never or almost never receive the results of laboratory tests processed outside the PU. Regarding the use of ART in the last seven days: 76.1% took medicines outside medication time; 80.6% stopped taking medicines; 91% took a higher or a lower dosage. In 58.2% of the cases, the withdrawal of ART from the drug dispensing units located in the public health network of RP was regular. Regarding the actions developed within the PUs aimed at ART monitoring, the questioning about the continuous use of the drugs was assessed as regular and the others were unsatisfactory. Adherence to ART had a statistically significant association with woman (p = 0.028). The use of licit drugs (p = 0.006) and interruption of medical follow-up (p = 0.014) were associated with non-adherence. The findings of this study allow us to reflect on the complexity of care provided to people living with HIV/aids in prisons, especially regarding the monitoring of ART, suggesting the need for development and incorporation of strategies that qualify the health care delivery towards an integral and resolutive perspective, capable of producing impacts that are consistent with the challenges of HIV prevention and management

HIV/aids no cárcere: desafios relacionados à regularidade no uso da terapia antirretroviral / HIV/aids in prison: challenges related to the regularity in the use of antiretroviral therapy

Considerando a infecção pelo HIV uma condição crônica e de alta prevalência no ambiente carcerário, este estudo objetivou analisar os desafios relacionados à regularidade no uso da terapia antirretroviral (TARV) pelas pessoas vivendo com HIV em unidades prisionais (UP) da região de Ribeirão Preto (RP), São Paulo. Tratase de um estudo descritivo, do tipo inquérito. Foram incluídos indivíduos reclusos há mais de seis meses, com diagnóstico de HIV e em uso de TARV. Utilizou-se um banco de dados contendo variáveis sociodemográficas, clínicas e de acompanhamento dos casos; adesão à TARV e ações desenvolvidas pelas equipes de saúde das UP para o monitoramento da ingestão medicamentosa. Os dados foram analisados por meio de técnicas descritivas e testes de associação (Quiquadrado e Exato de Fisher). Identificou-se 67 indivíduos em uso de TARV, dos quais, 80,6% cumpriam pena em regime fechado e 38,8% possuíam de dois a cinco anos de clausura. Houve o predomínio de homens (79,1%); 25 a 39 anos (52,2%); não brancos (64,2%); solteiros (47,8%); ensino fundamental I e II (67,1%); possuíam profissão (88,1%) e ganhavam de um a três salários mínimos (50,7%) antes da reclusão. Quanto ao perfil clínico e de acompanhamento: 44,8% diagnosticaram HIV na prisão; 86,6% faziam acompanhamento em serviço de assistência especializada em HIV (SAE); 41,7% interromperam o tratamento em algum momento; 31,3% possuíam TCD4+ acima de 500 cópias e em 62,7% a carga viral era indetectável. Identificou-se o uso de drogas ilícitas (71,6%) e lícitas (80%) prévias ao encarceramento. Em relação ao atraso na entrega da TARV, 70,3% referiram nunca ou quase nunca ocorrer tal situação; 42,2% referiram nunca ou quase nunca perderem consultas nos SAE; 79,1% informaram que nunca ou quase nunca recebem os resultados dos exames laboratoriais processados fora das UP. Sobre o questionamento acerca do uso da TARV nos últimos sete dias: 76,1% tomaram medicamentos fora do horário; 80,6% deixaram de tomar medicamentos; 91% tomaram menos ou mais compridos. Em 58,2% dos casos houve retirada regular da TARV junto às unidades dispensadoras de medicamentos situadas na rede pública de saúde de Ribeirão Preto. Quanto às ações desenvolvidas dentro das UP voltadas ao monitoramento da TARV, considerou-se regular apenas o questionamento sobre o uso contínuo dos medicamentos, sendo que as demais foram insatisfatórias. A adesão à TARV apresentou associação estatisticamente significante com o sexo feminino (p=0,028); o uso de drogas lícitas (p=0,006) e a interrupção do acompanhamento médico (p=0,014) estiveram associadas à não adesão. Os achados deste estudo permitem refletir sobre a complexidade da assistência prestada às pessoas que vivem com HIV/aids no ambiente prisional, principalmente no que tange o monitoramento do uso da TARV, sinalizando a necessidade de desenvolvimento e incorporação de estratégias de intervenção que qualifiquem a produção do cuidado em saúde na perspectiva integral e resolutiva, capaz de produzir impactos condizentes com os desafios que perpassam a prevenção e o manejo do HIV

Considering that the HIV/aids infection constitutes a chronic condition with high prevalence in prisons, this study aimed to analyze the challenges related to regularity in the use of antiretroviral therapy (ART) by people living with HIV in prisons (UP) in the region of Ribeirão Preto (PR), São Paulo. This is a descriptive, inquiry-type study. We included individuals who had been incarcerated for more than six months, diagnosed with HIV/aids and using ART. We used a database containing sociodemographic and clinical information and variables on the case follow-up, ART adherence and actions developed by PU health teams to monitor drug intake. Data were analyzed using descriptive techniques and association tests (Chi-square and Fisher's Exact). A total of 67 individuals using ART were identified, of whom 80.6% were in closed regime and 38.8% had two to five years of incarceration. There was a predominance of men (79.1%); 25 to 39 years old (52.2%); non-white (64.2%); single (47.8%); elementary education I and II (67.1%); having a profession (88.1%) and earning one to three minimum wages (50.7%) before incarceration. In regard of the clinical and follow-up profile: 44.8% had HIV diagnosed in prison; 86.6% were attending a specialized HIV care service (SAE); 41.7% discontinued treatment at some point of time; 31.3% had TCD4+ over 500 copies and in 62.7% of participants the viral load was undetectable. The use of illicit drugs (71.6%) and licit drugs (80%) prior to incarceration was also identified. Regarding delays in ART delivery, 70.3% reported that a delayed delivery never or almost never occurred; 42.2% reported that they never or almost never miss appointments in SAE; 79.1% reported that they never or almost never receive the results of laboratory tests processed outside the PU. Regarding the use of ART in the last seven days: 76.1% took medicines outside medication time; 80.6% stopped taking medicines; 91% took a higher or a lower dosage. In 58.2% of the cases, the withdrawal of ART from the drug dispensing units located in the public health network of RP was regular. Regarding the actions developed within the PUs aimed at ART monitoring, the questioning about the continuous use of the drugs was assessed as regular and the others were unsatisfactory. Adherence to ART had a statistically significant association with woman (p = 0.028). The use of licit drugs (p = 0.006) and interruption of medical follow-up (p = 0.014) were associated with non-adherence. The findings of this study allow us to reflect on the complexity of care provided to people living with HIV/aids in prisons, especially regarding the monitoring of ART, suggesting the need for development and incorporation of strategies that qualify the health care delivery towards an integral and resolutive perspective, capable of producing impacts that are consistent with the challenges of HIV prevention and management

Intractable Pruritus: A Presenting Sign of HIV Infection / 대한피부과학회지

To achieve early detection of HIV infection, physicians must be aware of symptoms related to HIV infection. Dermatologists, in particular, can play an important role, because more than 90% of patients infected with HIV will develop at least one type of dermatologic disorder, which may be the first indicator of the existence of infection. A 26-year-old male presented with a one-year history of intractable pruritus associated with multiple excoriations and small ulcers. Initially, his condition clinically resembled adult atopic dermatitis. However, no improvement was observed despite treatment including narrowband ultraviolet B (UVB), antihistamine, and topical and systemic corticosteroid. After a week, the patient developed seizures and was diagnosed with diffuse large B-cell lymphoma of the brain. HIV testing was performed, and the patient was revealed to be HIV-positive. He began highly active antiretroviral therapy (HAART), and the pruritus and skin condition improved dramatically. Herein, we report a case of HIV infection for which the presenting sign was intractable pruritus.

O sofrimento e o prazer dos trabalhadores de enfermagem no cuidado ao cliente com HIV/AIDS / The suffering and pleasure of nursng staff resulting from care to HIV/AIDS patients

O objeto deste artigo são o sofrimento e o prazer dos trabalhadores de enfermagem decorrentes da assistência a clientes com HIV/AIDS na Unidade de Doença Infectocontagiosa. Como objetivo, deseja-se descrever e analisar os sentimentos dos trabalhadores de enfermagem decorrentes da assistência ao cliente com HIV/AIDS. A metodologia empregada é a abordagem qualitativa, de caráter descritivo e exploratório. Os dados foram obtidos entre maio e agosto de 2010, utilizando a entrevista semiestruturada, são analisados através da técnica de Análise Temática de Conteúdo. Constatou-se que o sofrimento psíquico advindo da vivência do processo demorte/morrer dos pacientes, do estigma da doença, da discriminação aos pacientes e aos profissionais e do medo que os profissionais têm da contaminação ocupacional. O prazer estava atrelado ao sentimento de utilidade e ao reconhecimento dos pacientes acerca da qualidade do cuidado. A vivência do sofrimento apareceu de forma mais contundente que o sentimento de prazer. Recomendam-se, entre outras, as seguintes estratégias para minimizar o sofrimento psíquico deste coletivo profissional: grupos de reflexão, ginástica laboral, terapias alternativas, ambiente laboral mais humanizado e capacitação permanente dos profissionais

The objective of this article is the suffering and pleasure of nurses assisting patients with HIV/AIDS in the Unit for Infectious Diseases. The main objective is to describe and analyze the feelings of these nursing workers deriving from the assistance to patients with HIV/AIDS. The methodology applied consists of a qualitative approach, of descriptive and exploratory character. The data were obtained between May and August 2010, through semi-structure interview, and also analyzed by the Thematic Content Analysis techniques. It was found out that the psychic pain was due to the patients' process of death/dying, the stigma of the disease, the prejudice that both patients and professionals suffer as well as the fear those professionals feel of the occupational contamination. Their joy was connected to the feeling of being useful and the patients' acknowledgement to the quality of the given care. The experience of pain appeared in a stronger way than the feeling of pleasure. The following strategies are recommended, among others, to minimize the psych pain of the professional people: focus groups, laboral gymnastics, alternative therapies, more humanized laboral environment and permanent education of the professionals.

Criptococose mucocutânea nasal: um relato de caso / Nasal mucocutaneous cryptococcosis: a case report

Paciente feminina, 47 anos, hipertensa e tabagista, em uso crônico de corticoide, apresentou lesões em pele e mucosa nasal, com dor local; tratado empiricamente como sinusite. Houve piora das lesões, com ulceração. Após nove meses do início dos sintomas, foi realizada biópsia da lesão, revelando o anatomopatológico uma micose cutânea sugestiva de criptococose. A paciente foi diagnosticada com infecção pelo vírus da imunodeficiência humana (HIV) e, então, internada em hospital de referência, tendo recebido tratamento com fluconazol 800mg/dia endovenoso, a seguir, fluconazol 800mg/dia oral até completar 12 semanas de tratamento. Houve resolução da lesão ulcerada e posterior fibrose da narina esquerda

A 47-year-old woman, carrier systemic hypertension, tobacco user, and chronic user of corticosteroids, showed skin and nasal mucosa lesions, with local pain; treated empirically as sinusitis. The lesions evolved with increased ulceration. After nine months of symptoms onset, the lesion was biopsied, revealing fungal skin pathology suggestive of cryptococcosis. The patient was diagnosed with an HIV infection. The patient was then hospitalized in a specialized hospital and treated with intravenous fluconazole 800mg/day, followed by fluconazole 800mg daily orally up to 12 weeks of treatment. There was resolution of the ulcerated lesion and subsequent fibrosis of the left nostril

El papel de las bifidobacterias en el funcionamiento del organismo humano / Role of bifidobacteria in the function of the human body

Bifidobacterium animalis ssp lactis Bb12 is a probiotic strain that has received considerable attention from the scientific community. It has tolerance to higher temperatures and lower, acidic pH than other bacteria. When administered for 12 months to infants and children together with S. thermophilus this was associated with lower incidences of acute diarrhea. Studies in different countries and with different experimental designs confirmed these results. It was also shown that its administration did not interfere the growth or the normal weight gain of the children. Bifidobacterium animalis ssp lactis Bb12 was associated with decreases of the fecal excretion of rotavirus during episodes of diarrhea, a fact that represents an epidemiological benefit. Bifidobacterium animalis ssp lactis Bb12 exerts positive effects on manifestations of atopy/eczema, with decreases of the parameters of inflammation such as CD4 in blood serum and eosinophil protein X in urine. This was associated with changes in the extension and severity of the skin lesions. No modifications of the normal growth parameters were observed when Bifidobacterium animalis ssp lactis CNCM I-3446 was given. Administration of Bifidobacterium animalis ssp lactis Bb12 is associated with higher levels of fecal sIgA and calprotectin, which are considered parameters of immune responses and ofthe capacity to launch inflammatory responses. The statements made by some groups that infants under 4 months of age who are not breastfed should not receive probiotics have weak support if it is considered that maternal milk contains a large number and variety of strains of bacteria which may be considered as probiotics. These may not only protect from acute diarrhea but also from upper respiratory infections. Although cases of septicemia due to probiotic have been reported these represent an infinitely small proportion of the total numbers of consumers. No outbreaks have been reported that would point to invasive properties in a strain. It is not advisable to administer any living bacteria to individuals in shock or with innate or severe defects of immunity. However, carriers of HIV or patients with AIDS benefit from probiotic agents. A study carried out in Chile showed that although without evident clinical benefits L. rhamnosus HN001, significantly increased fecal sIgA as a manifestation of improved mucosal defense in the digestive tract.

Bifidobacterium animalis ssp lactis Bb12 es una de las cepaBifidobacterium animalis ssp lactis Bb12 es una de las cepas probióticas más estudiadas. Posee ventajas que la hacen útil para el uso industrial: tolerancia a ambientes ácidos y a temperaturas superiores a las de los demás probióticos. En un estudio de 12 meses Bifidobacterium animalis ssp lactis Bb12 fue administrada por un año asociada con S. thermophilus y se observó que los niños experimentaron menos episodios de diarrea aguda. Estudios con seguimientos de distinta duración y diseño refrendaron estos resultados y su administración no ejercía influencias negativas en el crecimiento. Esta bifido-bacteria inducía disminuciones de la excreción de rotavirus durante episodios de diarrea, lo que disminuye la posibilidad de contagios. Bifidobacterium animalis ssp lactis Bb12 ejerce efectos positivos sobre las manifestaciones de atopia como el eccema con el descenso de marcadores de inflamación tales como CD4 en el suero y de la proteína X de los eosinófilos en la orina; y mejorías de las alteraciones de la permeabilidad. Estudios con Bifidobacterium animalis ssp lactis CNCM I-3446 administrada con ARA y DHA mostraron alteraciones de los parámetros de crecimiento y bioquímicos en lactantes y preescolares en seguimientos entre 14 y 119 días. La administración de Bifidobacterium animalis ssp lactis Bb12 junto con inmunizaciones se asociaba con niveles más elevados de sIgA específica anti-poliovirus y de calprotectina, cuyos niveles estarían asociados con los de esta inmunoglobulina. Se ha sostenido que no existe justificación para administrar probióticos a menores de 4-6 meses no amamantados, el hecho que la leche materna los proporciona en cantidad y variedad apoya las posibles ventajas de su administración. Los probióticos protegerían no sólo de infecciones del tracto gastrointestinal sino también de las respiratorias altas. Hay casos aislados de sepsis en individuos con diversas afecciones, pero la proporción de afectados es mínima. No se han comunicado brotes epidémicos que indicarían cepas probióticas con capacidades invasoras. Probablemente no es aconsejable administrarlos a sujetos en shock o con defectos de la función de barrera intestinal. Los portadores de VIH y los pacientes con SIDA experimentan mejorías al recibir probióticos. En un estudio en Chile se demostró que aunque sin efectos clínicamente evidentes, administrar L. rhamnosus HN001 produjo aumentos del la IgA secretoria fecal, que representa un aumento de las defensas del tubo digestivo.

Progressive multifocal leucoencephalopathy in HIV/AIDS: Observational study from a tertiary care centre in northern India.

Background & objectives: Progressive multifocal leucoencephalopathy (PML) is seen mostly in advanced human immunodeficiency virus (HIV) infection. Little is known about the epidemiology and disease course of these patients from India. This study was aimed to determine the frequency of PML in patients with HIV/AIDS, and the clinical features and survival of these patients. Methods: The charts of HIV/AIDS patients with PML seen over a period of five years (2006-2011) at the Antiretroviral treatment (ART) centre at a tertiary care centre in New Delhi, India, were retrospectively reviewed. Results: Of 1465 patients with HIV/AIDS, 18 (1.2%) were diagnosed with PML; four were laboratory confirmed and 14 had consistent clinical and radiological features. PML was the initial presentation of HIV infection in 10 (56%) patients, and 16 (89%) patients had CD4 count less than 200/μl. Insidious onset focal limb weakness (78%) and visual disturbance (28%) were common symptoms. Magnetic resonance imaging (MRI) of the brain revealed characteristic white matter lesions in all the patients. The estimated median survival was 7.6 months (95% CI, 0-20 months). Interpretation & conclusions: Our results show that the patients present late to access treatment with advanced immunosuppression at presentation. PML is associated with high morbidity and mortality despite institution of highly active antiretroviral therapy (HAART). There is a need to address the lacuna in diagnostic and management services for these patients in India.

Análise dos dados epidemiológicos da aids em idosos no estado de Rondônia, Amazônia ocidental / Epidemiological analysis of aids in elderly in the state of Rondonia, western Amazon

O preconceito e os paradigmas da sociedade e do próprio idoso quanto a sua sexualidade acabam fazendo com que o mesmo não use métodos preventivos, sendo um fator agravante na infecção pelo vírus HIV nessa população. Atualmente, o perfil epidemiológico da doença vem mudando como aumento de casos em indivíduos acima de 49 anos. Objetivo: quantificar e analisar os dados da infecção por HIV na população acima de 49 anos no estado de Rondônia. Métodos: os dados foram coletados na AGEVISA/RO, através de dados epidemiológicos dos Sistemas de Informação de Agravode Notificação - SINAN NET e SINAN W. Os casos estudados foram entre o período de janeiro de 2000 a agosto de 2011; as variáveis analisadas emnosso estudo foram: faixa etária, gênero, modo de transmissão, ano de diagnóstico e evolução do caso. Resultados: no período de tempo analisado foram registrados 2.252 casos da doença na população de Rondônia de 14 a 81 anos, desse total, 323 (14,3%) são indivíduos com idade acima de 49 anos, sendoque 67,2% são homens e 32,8%, mulheres. O modo mais comum de transmissão do vírus encontrado nesse estudo foi por via sexual e entre heterossexuais.Na evolução dos casos, 256 pacientes encontram-se em tratamento e 69 foram a óbito. Conclusão: nos últimos 10 anos houve um aumento de 440% do número de casos de HIV soropositivos na população idosa no estado de Rondônia.

The prejudice of society and even the elderly about its sexuality, makes this group do not use basic methods of preventing, revealing anaggravating factor of HIV infection in this population. Currently, the epidemiology of the disease has been changing with this apparent increase in the burden of the disease in the elderly. Objective: to quantify and analyze HIV infections among persons over aged 49 years in the state of Rondonia.Methods: data were collected in AGEVISA/RO, through epidemiological data source SINAN NET and SINAN W. The data set obtained refers to theperiod from January 2000 to August 2011, using as variables: age bracket, gender, mode of transmission, year of diagnosis and progress of the disease.Results: 2,252 cases were recorded with individuals between 14 and 81 years old, of which 323 (14.3%) are people over 49 years of age, and 67.2% are menand 32.8% women. The most common mode of transmission found in this study was through sex and among heterosexual. Concerning the progress of thedisease, 256 patients are under treatment and 69 died. Conclusion: over the past 10 years there was a 440% increase in reported cases of HIV seropositive cases among elderly population in the state of Rondonia, changing the epidemiology of the disease.

AIDS-related Gastrointestinal Kaposi Sarcoma in Korea: A Case Report and Review of the Literature / 대한소화기학회지

Kaposi sarcoma (KS) is a vascular neoplasm, which is fairly prevalent in acquired immunodeficiency syndrome (AIDS) patients. Mucocutaneous and lymph node involvements are characteristic features of KS in AIDS patients. The involvement of gastrointestinal tract occurs in 40% of KS patients and leads to significant morbidity and mortality. In the highly active antiretroviral therapy (HAART) era, the rate of AIDS related KS has fallen with control of human immunodeficiency virus (HIV) viremia. However, it is still recognized as the primary AIDS-defining illness, and the proportion of AIDS diagnoses made due to KS ranged from 4.1% to 7.5%. In Korea, AIDS-related KS has been report in low rate incidence. Its gastrointestinal involvements are rarely reported. To date, five cases have been recorded in Korea. Herein, we present an additional case of gastrointestinal KS as the AIDS-defining illness and review of the Korean medical literature.

Actitudes frente al VIH/SIDA en estudiantes de la escuela Simón Rodríguez, Estado Bolívar, Venezuela / Attitudes towards HIV/AIDS in students from the "Simón Rodríguez" school, Bolivar State, Venezuela

En Venezuela, la tasa de incidencia anual de la infección por VHI/SIDA es de 2 por cada millón de habitantes en adolescentes. Los estados con tasa superior al promedio nacional son Distrito Federal, Bolívar y Mérida; la incidencia es más temprana en varones de 15 a 19 años y de 20 a 24 años, con el 3,03 por ciento y 11,24 por ciento, respectivamente. En julio de 2007 se realizó un estudio descriptivo, de corte transversal, con la finalidad de identificar actitudes frente al VHS/SIDA en estudiantes de la Escuela Técnica Industrial "Simón Rodríguez". La recopilación de los datos estuvo a cargo de los investigadores mediante un cuestionario realizado al efecto. Los resultados reflejaron que el 84 por ciento comenzó las relaciones sexuales antes de los 15 años de edad, el 64,1 por ciento mantuvieron inestabilidad con su pareja sexual y utilizaron poco el condón como medio de protección en las relaciones sexuales. Se puede concluir que las actitudes que más atención demandan son la inestabilidad de la pareja sexual y el poco uso del condón, lo que pudiera estar indicando que es necesario crear programas educativos que aborden estas temáticas en el centro educacional.

In Venezuela, the annual rate of HIV/AIDS infection is of two by each million of inhabitants in adolescents. The states with the higher rate to national average are the following: Federal District, Bolivar and Merida, the incidence is earlier in males aged 15-19 and 20-24 is of 3,03 percent and 12,24 percent, respectively. In July, 2007 a descriptive and cross-sectional study was conducted to identify the attitudes towards HIV/AIDS in students of the "Simón Rodríguez"Industrial Technique School. Researchers performed the data collection by a questionnaire applied to that end. The results showed that the 84 percent started the sexual intercourses before the 15 years old, the 64,1 percent maintained instability with its partner and not much use of condom as a protection mean in sexual intercourses. It is possible to conclude that the attitudes with more attention are the instability of sexual partner and the not much use of condom being necessary to create educational programs approaching these subject matters in the educational institution.

Perfil dos pacientes com hipertensão arterial incluídos em uma coorte com HIV/AIDS em Pernambuco, Brasil / Profile of patients with hypertension included in a cohort with HIV/AIDS in the state of Pernambuco, Brazil

FUNDAMENTO: Hipertensão arterial sistêmica (HAS) é fator de risco modificável, cujo controle pode reduzir doença cardiovascular nos pacientes com vírus da imunodeficiência adquirida (HIV). OBJETIVO: Estimar a prevalência de HAS e descrever as características dos pacientes com HAS e pré-hipertensão infectados pelo HIV/AIDS. MÉTODOS: Estudo seccional alinhado a uma coorte de pacientes com HIV/AIDS. Considerou-se hipertensão em níveis > 140/90 mmHg ou uso de anti-hipertensivos e pré-hipertensão em níveis > 120/80 mmHg. RESULTADOS: Dos 958 pacientes, 388 (40,5 por cento) eram normotensos, 325 (33,9 por cento) pré-hipertensos e 245 (25,6 por cento) hipertensos. Desses 245 pacientes, 172 (70,2 por cento) sabiam ser hipertensos e 36 (14,8 por cento) apresentavam pressão arterial controlada. Tiveram diagnóstico de HAS após o diagnóstico do HIV 62 pacientes (54,4 por cento). Lipodistrofia ocorreu em 95 (46,1 por cento) dos pacientes, já sobrepeso/obesidade em 129 (52,7 por cento). Utilização de antirretrovirais ocorreu em 184 (85,9 por cento), 89 (41,6 por cento) com inibidores de protease (IP) e 95 (44,4 por cento) sem IP. Utilizavam antivirais > 24 meses 74,7 por cento. Idade, antecedentes familiares de hipertensão, circunferência abdominal, índice de massa corporal e triglicerídeos foram maiores entre pacientes hipertensos. Tempo de infecção pelo HIV, contagem de linfócitos CD4, carga viral, tempo e tipo de esquema antirretroviral foram semelhantes nos hipertensos e pré-hipertensos. CONCLUSÃO: A elevada frequência de hipertensos não controlados e de riscos cardiovasculares nos infectados pelo HIV apontam a necessidade de medidas preventivas e terapêuticas contra HAS nesse grupo.

BACKGROUND: Hypertension (HBP) is modifiable risk factor, whose control may reduce cardiovascular disease in patients with human immunodeficiency virus (HIV). OBJECTIVE: To estimate the prevalence of hypertension and describe the characteristics of patients with hypertension infected by HIV/AIDS. METHODS: A cross-sectional study aligned to a cohort of patients with HIV/AIDS. The study considered hypertension at levels > 140/90 mmHg or use of antihypertensive drugs and pre-hypertension at levels > 120/80 mmHg. RESULTS: Out of 958 patients, 388 (40.5 percent) were normotensive, 325 (33.9 percent) were pre-hypertensive, and 245 (25.6 percent) were hypertensive. Out of these 245 patients, 172 (70.2 percent) were aware of the fact there they were hypertensive, and 36 (14.8 percent) had blood pressure controlled. Sixty-two (62) patients (54.4 percent) were diagnosed with hypertension after HIV diagnosis. Lipodystrophy occurred in 95 (46.1 percent) patients; overweight/obesity in 129 (52.7 percent). Use of antiretrovirals occurred in 184 (85.9 percent), 89 (41.6 percent) with protease inhibitors (PI) and 95 (44.4 percent) without PI. Out of these patients, 74.7 used antivirals > 24 months. Age, family history of hypertension, waist circumference, body mass index and triglyceride levels were higher among hypertensive patients. Time of HIV infection, CD4 count, viral load, time and type of antiretroviral regimen were similar in hypertensive and prehypertensive patients. CONCLUSION: The high frequency of uncontrolled hypertensive patients and cardiovascular risks in HIV-infected patients point out to the need for preventive and therapeutic measures against hypertension in this group.