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1.
Esc. Anna Nery Rev. Enferm ; 27: e20220082, 2023. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1404751

ABSTRACT

Resumo Objetivo desenvolver e avaliar um inquérito de Conhecimento, Atitude e Prática sobre estilo de vida saudável em pessoas com vírus da imunodeficiência humana. Método estudo de desenvolvimento, com elaboração do inquérito por meio de revisão integrativa e análise das diretrizes; análise de conteúdo e aparência por 22 juízes especialistas; e análise semântica por 22 pacientes em acompanhamento ambulatorial. Mensurada a proporção de avaliações positivas dos itens, considerando-se percentual igual ou maior a 85%. Resultados o inquérito teve três domínios e sete eixos: doenças crônicas em pessoas com vírus da imunodeficiência humana; controle do peso corporal; alimentação saudável; prática de exercício físico; evitar fumo, álcool e drogas ilícitas; controle/redução do estresse; adesão aos antirretrovirais e outros medicamentos. Domínios conhecimento e atitude tiveram 10 perguntas, e o de prática, 11. Na avaliação pelos juízes especialistas, participaram enfermeiros, médicos e nutricionista, com concordância positiva dos itens acima de 85%. Os pacientes fizeram a análise semântica, com concordância positiva nos domínios de 100%. Conclusão e implicações para a prática o inquérito teve evidência de validade adequada, para ser utilizado por enfermeiros e outros profissionais de saúde, para subsidiar a assistência, estratégias educativas e pesquisas com pessoas vivendo com o vírus da imunodeficiência humana.


Resumen Objetivo elaborar y evaluar una encuesta de conocimientos, actitudes y prácticas sobre estilo de vida saludable en personas con virus de inmunodeficiencia humana. Método estudio de desarrollo, con la elaboración de la encuesta a través de una revisión y análisis integrador de las directrices; análisis de contenido y apariencia por 22 jueces expertos; y análisis semántico por 22 pacientes ambulatorios. Se midió la proporción de valoraciones positivas de los ítems, considerando un porcentaje igual o superior al 85%. Resultados la encuesta tuvo tres dominios y siete ejes: enfermedades crónicas en personas portadoras del virus de la inmunodeficiencia humana; control del peso corporal; alimentación saludable; ejercicio físico; evitación del tabaquismo, alcohol y drogas ilícitas; control/reducción del estrés; adherencia a los antirretrovirales y otros medicamentos. Los dominios conocimientos y actitudes tenían 10 preguntas y los dominios práctica tenían 11. En la evaluación de los jueces expertos, participaron enfermeros, médicos y nutricionistas, con concordancia positiva de los ítems superior al 85%. Los pacientes fueron sometidos a análisis semántico, con 100% de concordancia positiva en los dominios. Conclusión e implicaciones para la práctica la encuesta tuvo pruebas adecuadas de validez, para ser utilizada por enfermeros y otros profesionales de la salud, para apoyar la asistencia, las estrategias educativas y la investigación con personas que viven con el virus de la inmunodeficiencia humana.


Abstract Objective to develop and assess a Knowledge, Attitude and Practice survey on healthy lifestyle in people with human immunodeficiency virus. Method a development study, with the elaboration of survey through of an integrative review and analysis of the guidelines; content and appearance analysis by 22 expert judges; and semantic analysis by 22 outpatients. The proportion of positive assessments of the items was measured, considering a percentage equal to or greater than 85%. Results the survey had three domains and seven axes: chronic diseases in people with human immunodeficiency virus; body weight control; healthy eating; physical exercise; avoiding smoking, alcohol and illicit drugs; stress control/reduction; antiretroviral and other medication compliance. Knowledge and attitude domains had 10 questions, and practice domains had 11. In the assessment by expert judges, nurses, doctors and nutritionists participated, with positive agreement of items above 85%. Patients underwent semantic analysis, with 100% positive agreement in the domains. Conclusion and implications for practice the survey had adequate evidence of validity, to be used by nurses and other health professionals, to support care, educational strategies and research with people living with the human immunodeficiency virus.


Subject(s)
Humans , Male , Female , HIV Infections/therapy , Health Knowledge, Attitudes, Practice , Surveys and Questionnaires , HIV , Healthy Lifestyle , Chronic Disease/therapy , Anti-Retroviral Agents/therapeutic use , Medication Adherence , Health Literacy
2.
Esc. Anna Nery Rev. Enferm ; 27: e20210507, 2023.
Article in Portuguese | LILACS, BDENF | ID: biblio-1404752

ABSTRACT

RESUMO Objetivo compreender as perspectivas e desafios no cotidiano de pessoas após a descoberta do viver com VIH em Bissau, Guiné-Bissau, tendo em vista diferentes contextos de vulnerabilidade. Método estudo exploratório-descritivo, que utilizou entrevista semiestruturada com 16 pessoas vivendo com VIH, acompanhadas em um hospital de Bissau. Empregou-se técnica de análise de conteúdo temática. Os relatos dos participantes foram analisados a partir de duas categorias empíricas: A descoberta, os impactos e os desafios de viver com VIH; e Experiência com o antirretroviral: recomeço e perspectivas. Resultados sinalizaram que os desafios iniciam com a revelação do diagnóstico que, geralmente, desperta uma diversidade de sentimentos e comportamentos. O estigma e a discriminação estimulam a adoção do sigilo sobre o status sorológico, resultando na fragilidade de suporte emocional no enfrentamento à soropositividade. A terapia antirretroviral foi vislumbrada como esperança para o enfrentamento da doença. A vulnerabilidade social foi a dimensão que mais se destacou, e violações dos direitos humanos foram constatadas. Conclusão e implicações para a prática o estudo permite compreender as perspectivas, desafios e vulnerabilidades de pessoas que vivem com VIH. O viver com VIH merece atenção especial por parte dos profissionais de saúde que atuam no cuidado dessas pessoas, destacando-se como contribuição a relevância de um cuidado de saúde integral, em que a ética e a subjetividade estejam presentes.


RESUMEN Objetivo este estudio cualitativo tuvo como objetivo comprender perspectivas y desafíos en la vida cotidiana de las personas que viven con VIH en Bissau, Guinea-Bissau, considerando diferentes contextos de vulnerabilidad. Método estudio exploratorio-descriptivo, que utilizó una entrevista semiestructurada con 16 personas que viven con el VIH, seguido en un hospital de Bissau. Se utilizó la técnica de análisis de contenido temático. Los informes de los participantes se analizaron a partir de dos categorías empíricas: El descubrimiento, los impactos y los desafíos de vivir con el VIH; y La experiencia antirretroviral: un nuevo comienzo y perspectivas. Resultados los resultados indicaron que los desafíos comienzan con la divulgación del diagnóstico, que generalmente suscita una diversidad de sentimientos y conductas. El estigma y la discriminación fomentan la adopción del secreto sobre el estado serológico, lo que resulta en un apoyo emocional débil para hacer frente a la seropositividad. La terapia antirretroviral es una esperanza para hacer frente a la enfermedad. La vulnerabilidad social fue la dimensión que más se destacó y se encontraron violaciones a sus derechos humanos. Conclusión e implicaciones para la práctica el estudio permite comprender las perspectivas, los desafíos y las vulnerabilidades de las personas que viven con el VIH. Vivir con VIH merece especial atención por parte de los profesionales de la salud que actúan en el cuidado de estas personas, destacando como aporte la relevancia de la atención integral en salud, en la que la ética y la subjetividad están presentes.


ABSTRACT Objective to understand perspectives and challenges in the daily lives of people after the discovery of living with HIV in Bissau, Guinea-Bissau, considering different contexts of vulnerability. Method an exploratory-descriptive study conducted through semi-structured interviews with sixteen people living with HIV attending a hospital in the city of Bissau. We used the thematic content analysis technique. Participants' reports were analyzed following two empirical categories: Discovery, impacts and challenges of living with HIV; and Experience with antiretroviral therapy: new beginning and perspectives. Results the results indicate that the challenges start with the disclosure of diagnosis, which arouses a diversity of feelings and behaviors. Stigma and discrimination encourage the adoption of confidentiality about serological status, which increases the fragility of emotional support in coping with seropositivity. Antiretroviral therapy was seen as a hope for coping with the disease. Social vulnerability was the dimension that stood out the most, and human rights violations involving people living with HIV were verified. Conclusion and implications for practice the study makes it possible to understand the perspectives, challenges and vulnerabilities of people living with HIV. Living with HIV deserves special attention from health professionals who work in the care of these people, highlighting as a contribution the relevance of comprehensive health care, in which ethics and subjectivity are present.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Public Health , HIV Seropositivity/therapy , Anti-Retroviral Agents/therapeutic use , Health Vulnerability , Social Support , Adaptation, Psychological , HIV Infections/diagnosis , Qualitative Research , Medication Adherence , Social Stigma , Treatment Adherence and Compliance , Guinea-Bissau
3.
Rev. Univ. Ind. Santander, Salud ; 54: e336, Dec. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1407035

ABSTRACT

Resumen Introducción: En la última década, millones de venezolanos han emigrado de su país; Colombia ha sido su principal destino. Es importante evaluar las repercusiones de la migración sobre eventos de interés en salud pública como la infección por el VIH, a fin de adoptar políticas pertinentes para atender la epidemia. Sin embargo, la información del estado de salud de la población migrante y su impacto sobre la salud pública en Colombia es escasa. Objetivos: Evaluar el papel de los casos de VIH importados desde Venezuela en el comportamiento del evento VIH/SIDA/ mortalidad por VIH en Colombia. Metodología: Mediante cálculo integral se compara el área bajo las curvas de casos de VIH totales e importados notificados al Sistema Nacional de Vigilancia en Salud Pública de Colombia. Resultados: La curva de casos de VIH importados desde Venezuela tiene una contribución menor (2,26 %) en el incremento de casos notificados en Colombia. Conclusiones: La migración venezolana no es el principal factor responsable del incremento de casos de VIH en Colombia, deben evaluarse otros factores involucrados en la difusión de la pandemia a nivel local.


Abstract Introduction: Millions of Venezuelans have emigrated due to their country's socio-economic crisis in the last decade; Colombia has been their main destination. To adopt relevant policies to address the problem, it is important to assess the impact of migration on public health interest events such as HIV infection. However, information on the health status of immigrants and its repercussions on public health in Colombia is scarce. Objective: Outline how the Venezuelan migration phenomenon has impacted HIV notification within Colombia. Methodology: Through an integral calculation, the area under the curves of total and imported HIV cases reported to the National Public Health Surveillance System of Colombia are compared. Incidence measures are carried out among the migrant population and the Colombian regions with the highest concentration of migrants are analyzed in greater depth. Results: The curve of HIV cases imported from Venezuela has a smaller contribution (2.26%) in the increase of cases notified in Colombia. Conclusions: The migratory crisis is not the main cause responsible for the increase in cases in Colombia. Other factors involved in the spread of the pandemic at the local level must be evaluated.

4.
Rev. latinoam. psicol ; 54: 43-50, ene.-dic. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1409658

ABSTRACT

Abstract Introduction/objective: Sexually transmitted infections (STIs) -HIV included- are a major problem in Latin America, mainly in Colombia. In 2021, 17647 cases were reported, which compared to the previous year showed an increase of 29.7%. The main aim of this study was to assess the knowledge regarding HIV and other STIs among the adolescent population in Colombia. Method: A total of 2012 Colombian adolescents between 12-19 years of age participated in this study. The HIV and Other Sexually Transmitted Infections Knowledge Scale (KSI), a self-report measure, was administered. Results: The results showed moderate to low general knowledge (M = 9.90, SD = 4.64) regarding HIV and other STIs. Adolescents did not know if a tongue-kiss led to an HIV infection (75%), or whether both the vaginal ring and the IUD were effective methods for preventing HIV/AIDS (82%). Results showed better scores in knowledge regarding HIV transmission (84%), HIV testing (66%), and condom use to prevent HIV infection (71%). Conclusions: Significant differences were observed in HIV/STIs knowledge between both sexes, but the effect magnitudes were small. Thus, these differences were neglected. This study contributes to understanding the state of knowledge and strengthening prevention strategies of professionals linked to the field of quality of life, education, and sexual healthcare in Colombia.


Resumen Introducción/objetivo: Las infecciones de transmisión sexual (ITS) y el VIH son un gran desafío en América Latina, principalmente en Colombia. Para el 2021 se reportaron 17 647 casos, que comparados con el 2019 muestran un incremento del 29.7 %. El objetivo principal de este artículo fue evaluar el conocimiento sobre el VIH y otras ITS en la población adolescente de Colombia. Método: En este estudio participaron un total de 2012 adolescentes colombianos con edades entre los 12 y los 19 años. Se administró la Escala de Conocimientos sobre el VIH y otras infecciones de transmisión sexual (KSI) y una medida de autoinforme. Resultados: Los resultados mostraron un conocimiento general de moderado a bajo (M = 9.90, SD = 4.64) sobre el VIH y otras ITS. Las adolescentes no sabían si un beso con lengua conducía a una infección por el VIH (75 %) o si tanto el anillo vaginal como el DIU eran métodos efectivos para prevenir el VIH/SIDA (82 %). Los resultados mostraron mejores puntuaciones en conocimientos sobre la transmisión del VIH (84 %), pruebas de detección del VIH (66 %) y uso de preservativos para prevenir la infección por el VIH (71 %). Conclusiones: Se observaron diferencias significativas en el conocimiento del VIH/ ITS entre ambos sexos, pero los tamaños del efecto fueron pequeños. Por tanto, estas diferencias fueron despreciadas. Este estudio contribuye a comprender el estado del conocimiento y a fortalecer las estrategias de prevención que realizan los profesionales vinculados al campo de la calidad de vida, la educación y la salud sexual en Colombia.

5.
Nursing (Säo Paulo) ; 25(294): 8940-8953, nov.2022.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1402599

ABSTRACT

Objetivo: Analisar as evidências científicas de como a Teoria do Autocuidado pode ser utilizada na assistência de enfermagem ao paciente comHIV/AIDS. Método: Revisão integrativa da literatura realizada entre agosto e setembro de 2022mediante a Biblioteca Virtual em Saúde (BVS) /Biblioteca Regional de Medicina (BIREME) e MEDLINE/PUBMED por meio dos descritores: Autocuidado (Self Care); HIV (HIV) e Teoria de Enfermagem (Nursing Theory).Foram selecionados para a revisão 10 artigos, através de buscas realizadas em intervalo atemporal.Resultados:A teoria do autocuidadopossibilita uma análise da construção ou mudança de uma realidade ao paciente com HIV/AIDS, cujo propósito é a apreensão de atitudes de práticas que proporcionem a autonomia e, promova uma saudável relação com o outro, social e com o meio. Conclusão: A teoria do autocuidado viabiliza subsídios teóricos proporcionandoao enfermeiro a realização de um atendimento qualificado e que atende as necessidades individuais dos pacientes com HIV/AIDS(AU)


Objective: To analyze the scientificevidence of how the Self-Care Theorycanbeused in nursing care for patientswith HIV/AIDS. Method:Integrativeliterature review carried out between August and September 2022 using the Virtual Health Library (VHL) / Regional Library of Medicine (BIREME) and MEDLINE/PUBMED using the descriptors: Self-Care; HIV (HIV) and Nursing Theory. Tenarticleswereselected for the review, throughsearchescarried out in a timelessinterval. Results: The theory of self-care enablesan analysis of the constructionorchange of a reality for the patientwith HIV/AIDS, whosepurpose is to apprehendattitudes of practicesthatprovideautonomy and promote a healthyrelationshipwith the other, social and with the quite. Conclusion: The theory of self-care providestheoreticalsupport, providing nurses withqualified care thatmeets the individual needs of patientswith HIV/AIDS.(AU)


Objetivo:Analizarlas evidencias científicas de cómolaTeoríadel Autocuidado puede ser utilizada enel cuidado de enfermería a pacientes con VIH/SIDA. Método:Revisión integrativa de la literatura realizada entre agosto y septiembre de 2022 através de la Biblioteca Virtual enSalud (BVS) / Biblioteca Regional de Medicina (BIREME) y MEDLINE/PUBMED utilizando losdescriptores: Autocuidado; VIH (VIH) y Teoría de Enfermería. Diez artículos fueronseleccionados para larevisión, a través de búsquedas realizadas enun intervalo atemporal. Resultados: La teoríadel autocuidado posibilitaunanálisis de laconstrucción o cambio de una realidad para el paciente con VIH/SIDA, cuyo propósito es aprehenderactitudes de prácticas que brindenautonomía y promuevan una sana relaciónconelotro, social y conel bastante.Conclusión: La teoríadel autocuidado proporciona sustento teórico, proporcionando a losenfermeros cuidados calificados que atiendanlasnecesidadesindividuales de los pacientes con VIH/SIDA.(AU)


Subject(s)
Self Care , Nursing Theory , HIV
6.
An. bras. dermatol ; 97(5): 641-643, Sept.-Oct. 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1403148

ABSTRACT

Abstract Malignant syphilis is an uncommon variant of syphilis, most often (but not always) found in immunosuppressed individuals. This report describes the case of a 57-year-old man, infected with the acquired human immunodeficiency virus (HIV), with a generalized picture of erythematous-squamous papules that rapidly progressed to painful and ulcerated plaques and nodules, some covered with a black rupioid crust. The analytical study performed revealed positive VDRL (Venereal Disease Research Laboratory) and RPR (Rapid Plasma Reagin). The skin biopsy was nonspecific; however, the immunohistochemical analysis disclosed the presence of spirochetes. The patient was then treated with benzathine penicillin G 2.4 MU once a week IM for three weeks, with progressive resolution of the lesions. Considering its rarity, this atypical form of syphilis that needs to be known to better recognize its clinical presentation and provide more prompt treatment to patients.

7.
Ciênc. Saúde Colet. (Impr.) ; 27(10): 3923-3937, out. 2022. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1404128

ABSTRACT

Resumo A Profilaxia Pré-Exposição ao HIV (PrEP) tem renovado o otimismo no controle da epidemia de HIV, não obstante seu contínuo crescimento entre os homens que fazem sexo com homens (HSH). A popularidade dos aplicativos de encontro afetivo-sexual e plataformas de mídias digitais na troca de informações e experiências sobre PrEP nas redes sociais de pares é reconhecida, embora sejam escassos estudos sobre contextos, motivações e alcance em termos da prevenção ao HIV. O artigo objetiva compreender a dinâmica das redes de pares virtuais e presenciais entre HSH para a decisão de usar PrEP, sua revelação e publicização. Estudo qualitativo com uso de entrevistas semiestruturadas com 48 usuários de PrEP de cinco cidades brasileiras. A maioria dos entrevistados compartilha informações e experiências sobre PrEP nas redes sociais de pares, contudo sua publicização revela tensões decorrentes da permanência de estigmas associados à homossexualidade e ao HIV. O protagonismo na revelação do uso da PrEP expressa engajamento em conquistar novos usuários. A relevância das redes sociais de pares no compartilhamento de experiências e informações sobre a PrEP tem potencial para a diversificação do público-alvo, ampliação e democratização da cobertura de PrEP no país.


Abstract HIV Pre-Exposure Prophylaxis (PrEP) has renewed optimism in controlling the HIV epidemic, despite its continued growth among men who have sex with men (MSM). The popularity of dating-sexual dating apps and digital media platforms in exchanging information and experiences about PrEP on peer social networks is recognized. However, studies on contexts, motivations, and scope in HIV prevention are scarce. The article aims to understand the dynamics of virtual and face-to-face peer networks among MSM for the decision to use PrEP, its disclosure, and publicity. Qualitative study using semi-structured interviews with 48 PrEP users from five Brazilian cities. Most interviewees share information and experiences about PrEP in peer social networks. However, its publication reveals tensions arising from the permanence of stigmas associated with homosexuality and HIV. The protagonism in exposing the use of PrEP expresses commitment to attracting new users. The relevance of peer social networks in sharing experiences and information about PrEP has the potential to diversify the target audience and expand and democratize PrEP coverage in the country.

8.
Ciênc. Saúde Colet. (Impr.) ; 27(10): 3913-3922, out. 2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1404135

ABSTRACT

Resumo Este ensaio explora a relação entre diversidade e saúde pública ao abordar tensões que envolvem classificações e reconhecimento no campo das políticas de HIV e Aids. Objetiva refletir sobre como se articulam categorias classificatórias e operativas no âmbito das respostas programáticas em relação à produção social de diferenças e desigualdades. Para tanto, parte do referencial teórico dos estudos sobre vulnerabilidade e reconhecimento e de metodologia que inclui revisão crítica da literatura sobre a categoria HSH e material etnográfico oriundo de pesquisas das autoras e de revisão de literatura, relativo ao movimento social, pesquisas e políticas com foco em lésbicas, gays, bissexuais, travestis e transexuais (LGBT). Recupera o processo de construção da categoria HSH no campo das políticas de prevenção de HIV e Aids em âmbito internacional, situando atores políticos e tensões. Problematiza essas tensões ao analisar processos de produção de sujeitos políticos e mudanças nas relações socioestatais que envolvem LGBT. Enfatiza a importância de considerar como diferenças e desigualdades emergem nos processos sociopolíticos e de destinar estudos para aprimorar políticas, assegurando um cuidado efetivamente mais respeitoso.


Abstract This essay explores the relationship between diversity and public health by addressing tensions related to classifications and recognition in the field of HIV and AIDS policy. The objective is to reflect on how classificatory and operative categories are articulated within the scope of programmatic responses towards the social production of differences and inequalities. To do so it draws from the theoretical framework of studies on vulnerability and recognition and from a methodology that includes a critical review of the literature on the category men who have sex with men (MSM) and ethnographic material, derived from the authors' research and a literature review related to social movements, and research and policies focused on lesbians, gays, bisexuals, transvestites and transsexuals (LGBT). It reviews how the MSM category was constructed in the field of HIV and AIDS prevention policies at an international level, situating political actors and tensions. It problematizes these tensions by analyzing processes of production of political subjects as well as changes in socio-state relations that involve LGBT. It emphasizes the importance of considering how differences and inequalities emerge in socio-political processes and of dedicating studies to improve policies, ensuring an effectively more respectful care.

9.
Säo Paulo med. j ; 140(5): 682-690, Sept.-Oct. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1410210

ABSTRACT

ABSTRACT BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

10.
Rev. peru. med. exp. salud publica ; 39(3): 352-356, jul.-sep. 2022. tab
Article in Spanish | LILACS | ID: biblio-1410012

ABSTRACT

RESUMEN El sarcoma de Kaposi (SK) es el cáncer más frecuente en las personas que viven con VIH. Las investigaciones sobre esta condición son escasas en la región, por lo que, el objetivo de este artículo fue describir las características demográficas, clínicas y terapéuticas de los pacientes con VIH que desarrollaron SK en el Hospital Cayetano Heredia entre el 2000 y 2018. Se identificaron 129 casos de SK, con una mediana de edad de 33 años, con predominio en varones con el 92% (119/129), y en su mayoría hombres que tienen sexo con hombres (HSH). La mediana de tiempo desde el diagnóstico de VIH hasta el del SK fue de cinco meses, asociado con un recuento de linfocitos CD4 de 64 células/µL (RIC: 33-185) al momento del diagnóstico de SK. El compromiso cutáneo fue el más común; sin embargo, al menos la mitad de ellos también tuvo la forma visceral.


ABSTRACT Kaposi's sarcoma (KS) is the most frequent cancer in people living with HIV. Research on this condition is scarce in the region, therefore, this article aimed to describe the demographic, clinical and therapeutic characteristics of patients with HIV who developed KS at the Cayetano Heredia Hospital between 2000 and 2018. A total of 129 KS cases were identified, with a median age of 33 years, predominantly males with 92% (119/129), and mostly men who have sex with men (MSM). The median time from HIV diagnosis to KS diagnosis was five months, associated with a CD4 lymphocyte count of 64 cells/μL (IQR: 33-185) at KS diagnosis. Cutaneous involvement was the most common presentation; however, at least half also had the visceral form.


Subject(s)
Humans , Male , Female , Adult , Sarcoma, Kaposi , Acquired Immunodeficiency Syndrome , HIV , CD4 Antigens , Latin America
11.
Ciênc. Saúde Colet. (Impr.) ; 27(9): 3461-3474, set. 2022. graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1394233

ABSTRACT

Resumo Este artigo examina as continuidades, rupturas e temporalidades na produção de bioidentidades no contexto da epidemia de HIV-Aids. Problematiza, a partir de um estudo multissituado na confluência de áreas e subáreas biomédicas que despontavam em popularidade nas décadas de 1980 e 1990, as agendas comuns de pesquisa sob a moldagem dos termos e categorizações popularizadas durante o pânico sexual provocado pelo aumento das taxas de contágio e morte. O desenho metodológico é caracterizado como de métodos mistos e envolveu, prioritariamente, pesquisa documental e revisão temática sobre a produção acadêmica nas áreas e disciplinas inseridas no eixo das biociências, com a finalidade de buscar e selecionar os estudos primários sobre homossexualidade e HIV/Aids, por meio da produção global. As conclusões atestam que a administração da Aids em sua condição crônica tratável produziu afinidades eletivas e de correspondência entre categorias epidemiológicas e sociais (MSM/HSH, PWA, GMLA) com noções de gênero e sexualidade definidas.


Abstract This article examines the continuities, ruptures and temporalities in the production of bioidentities in the context of the HIV-AIDS epidemic. Based on a multi-site study at the confluence of biomedical areas and sub-areas that rose in popularity in the 1980s and 1990s, it questions the common research agendas under the influence of terms and categorizations popularized during the sexual panic of AIDS caused by the increase in contagion rates and death. The methodological design is characterized as mixed methods and primarily involved documental research and thematic review on academic production in the areas and disciplines included under the aegis of the biosciences, in order to search for and select primary studies on homosexuality and HIV/AIDS, through global production. The conclusions attest that the management of AIDS in its treatable chronic condition produced elective and correspondence affinities between epidemiological and social categories (MSM/PWA, GMLA) with defined notions of gender and sexuality.

12.
Arq. gastroenterol ; 59(3): 390-393, July-Sept. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1403502

ABSTRACT

ABSTRACT Background: The emergence of potent combined highly active antiretroviral therapy (ART) in 1996 changed the natural history of HIV infection, with a significant reduction in mortality due to opportunistic infections but increased morbidity due to chronic cardiovascular, hepatic, and renal diseases. In May 2016, a reference center for liver transplantation in the Northeast of Brazil performed the first liver transplantations (LT) in HIV patients, with five others until 2021. Methods: The criteria for selection of LT were good adherence and absence of resistance to ART, HIV viral load maximum suppression, T-CD4+ lymphocyte count of more than 100 cells/mm3, and absence of opportunistic infections in the last 6 months. Results: Six liver transplants were performed between May 2016 and May 2021, five men, with a mean age of 53.2 years, and one was a diabetic patient. All patients had access to grafts with short cold ischemia with a mean time of 5 hours and 39 minutes. The 4-month survival rate was 100%, with a range time of follow-up of 4-63 months (mean time of 31 months). The mean pre-transplant T-CD4+ lymphocyte count was 436 cells/mm3. The mean length of hospital stay after transplantation was 16.8 days. One patient presented precocious vena cava thrombosis; another had stenosis of cavocaval anastomosis leading to refractory ascites, renal failure and post-transplant graft dysfunction, and another presented stenosis of choledochal anastomosis. Immunosuppression and prophylaxis were used according to standard protocols, and there were no differences in the profile of infections or rejection after liver transplantation. Conclusion: This case series documents good survival and usual transplant procedures for confirmed HIV cases.


RESUMO Contexto: A emergência da terapia antirretroviral de alta potência, em 1996, mudou a história natural da infecção por HIV, com redução significativa de mortalidade por infecções oportunistas, mas com aumento de morbidade por doenças crônicas cardiovasculares, hepáticas e renais. Em maio de 2016, um centro de referência em transplante hepático no Nordeste do Brasil realizou o primeiro transplante hepático em portadores de HIV, com cinco outros até 2021. Métodos: Os critérios de seleção para o transplante hepático foram: boa aderência e ausência de resistência à terapia antirretroviral, carga viral indetectável, contagem de linfócitos T-CD4+ acima de 100/ mm3 e ausência de infecções oportunistas nos últimos 6 meses. Resultados: Seis transplantes hepáticos foram feitos em portadores de HIV entre maio de 2016 e maio de 2021, cinco homens, com idade média de 53,2 anos, um paciente diabético. Todos os pacientes tiveram acesso a enxertos com tempo de isquemia fria curto com média de 5 horas e 39 minutos. A sobrevida em 4 meses foi de 100%, com tempo de acompanhamento de 4-63 meses (média de 31 meses). A contagem média de linfócitos T-CD4+ pré-transplante foi de 436 células/ mm3. A média de tempo de internação foi de 16,8 dias. Um paciente teve trombose de veia cava proximal; outro teve estenose de anastomose cavo-caval, levando à ascite refratária, falência renal e disfunção de enxerto pós-transplante; e outro teve estenose de anastomose do colédoco. A imunossupressão e a profilaxia foram usadas de acordo com protocolos padrão e não houve diferenças no perfil de infecções ou de rejeição pós-transplante. Conclusão: Esta casuística ilustra que o transplante de fígado em portadores do HIV apresenta complicações usuais e sobrevida satisfatória.

13.
Hematol., Transfus. Cell Ther. (Impr.) ; 44(3): 307-313, July-Sept. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1404986

ABSTRACT

ABSTRACT Introduction: Hematologic abnormalities are common in HIV and involve all blood cell lineages. A study on cytopenias, as correlated with disease progression, can be valuable in resource-limited settings. This study aimed to determine the hematologic profile of HIV patients and its association with CD4 count and antiretroviral (ARV) treatment. Methods: This is a retrospective cohort study involving adult Filipino HIV patients with complete blood count (CBC) and CD4 count determinations prior to the initiation of ARV treatment and after ≥6 months of ARV treatment. Logistic regression was performed to determine the association between cytopenias and a CD4 count <200 cells/μL. Results: The study included 302 patients. Anemia was the most common cytopenia. Anemia and leukopenia were associated with an increased likelihood of having a CD4 count <200 cells/μL in ARV-naïve patients. In ARV-treated patients, leukopenia was associated with an increased probability of having a CD4 count <200 cells/μL. An increase in hemoglobin, white blood cell (WBC) and platelet counts was observed after ≥6 months of ARV treatment. Conclusion: Anemia and leukopenia can be used as markers of immune status in HIV-infected individuals and improvement in the CBC parameters can be used to assess response to ARV treatment. Routine monitoring of hematologic parameters is recommended.

14.
Rev. bioét. (Impr.) ; 30(3): 652-661, jul.-set. 2022. tab, graf
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1407264

ABSTRACT

Resumo Neste trabalho, pretendeu-se analisar aspectos éticos no seguimento terapêutico de pacientes com HIV mediante revisão sistemática de literatura, realizada por meio de pesquisas nas bases PubMed, LILACS e MEDLINE, usando descritores em inglês e português, com 169 publicações de 2011 a 2021. Para evitar viés, foi utilizado o método Prisma e consideradas as recomendações estabelecidas pelo sistema Grading of Recommendations Assessment, Development and Evaluation para classificação do nível de evidência. O bem-estar de pacientes com HIV está associado ao nível de relações interpessoais, qualidade do tratamento e crenças pessoais. A estigmatização e o medo da divulgação da doença nos grupos em que convivem são os principais motivos de aflição. Com isso, é fundamental um maior apoio aos pacientes durante o diagnóstico e tratamento da doença, para que possam elaborar melhor suas estratégias de enfrentamento.


Abstract This study analyzed ethical aspects in the therapeutic follow-up of patients with HIV via a systematic literature review conducted by searching the PubMed, LILACS and MEDLINE databases, using descriptors in English and Portuguese language, with 169 publications from 2011 to 2021. To avoid bias, the Prisma guidelines were used and the recommendations established by the Grading of Recommendations Assessment, Development and Evaluation system were considered to classify the level of evidence. The well-being of HIV patients is associated with the level of interpersonal relationships, quality of treatment and personal beliefs. Stigmatization and fear of the dissemination of the disease in the groups in which they live are the main reasons for distress. Support to patients during the diagnosis and treatment of the disease are fundamental, so that they can better apply their coping strategies.


Resumen Este trabajo propone analizar los aspectos éticos en el seguimiento terapéutico de pacientes con VIH a través de una revisión sistemática de la literatura en las bases de datos PubMed, LILACS y MEDLINE, utilizando descriptores en inglés y portugués, lo que resultó en 169 publicaciones entre 2011 y 2021. Para evitar sesgos se utilizó el método Prisma y, para clasificar el nivel de evidencia, se consideraron las recomendaciones establecidas por el sistema Grading of Recommendations Assessment, Development and Evaluation. El bienestar de los pacientes con VIH estuvo asociado al nivel de relaciones interpersonales, calidad del tratamiento y creencias personales. El estigma y el miedo a propagar la enfermedad en los grupos con los cuales conviven fueron los principales motivos de preocupación. Por lo tanto, es fundamental brindar un mayor apoyo a los pacientes durante el diagnóstico y tratamiento de la enfermedad para que puedan desarrollar mejor sus estrategias de afrontamiento.

15.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1410058

ABSTRACT

RESUMEN Introducción: las micosis diseminadas siguen aumentando su incidencia en pacientes inmunodeprimidos originando elevadas tasas de morbimortalidad. Los factores de riesgo más importantes asociados al desarrollo de infecciones oportunistas en pacientes infectados con el VIH son recuentos bajos de linfocitos T CD4+ y falta de adherencia al tratamiento con antirretrovirales. Objetivo: describir las características clínicas de las micosis diseminadas en pacientes con SIDA internados en el Departamento de Medicina Interna del Hospital Nacional, Itauguá, Paraguay, desde 2016 al 2018. Materiales y métodos: estudio observacional descriptivo prospectivo y retrospectivo de corte transverso. Se incluyeron a todos los varones y mujeres mayores de 18 años con SIDA diagnosticados con micosis diseminada. La investigación fue aprobada por el Comité de Ética de la Facultad de Medicina de la Universidad Nacional de Itapúa, Paraguay. Resultados: Se incluyeron 80 pacientes de los cuales 52 fueron varones con una edad media de 40 años ±10 años. La micosis más frecuente fue la candidiasis diseminada en 39 pacientes (49,5%), seguida por la criptococosis en 19 pacientes (23%). Del total de los pacientes, 69 (87%) tenían recuentos de CD4+ 100.000 copias y 41 sujetos (51%) habían abandonado el tratamiento antirretroviral. Los órganos más afectados fueron el tubo digestivo y aparato respiratorio. La mortalidad se observó en 17 casos (21%). Entre éstos, 11 (63%) sujetos presentaron falla renal y 9 (55%) estaban caquécticos. Conclusión: se encontró predominio de sexo masculino con una edad media de 40 años. La mayoría de los pacientes tenían carga viral elevada y recuento de CD4+ bajos. La micosis más frecuente fue la candidiasis. Uno de cada cuatro pacientes presentó criptococosis, con mayor frecuencia a nivel meníngeo. La mortalidad por micosis diseminada fue 21%.


ABSTRACT Introduction: Disseminated mycoses continue to increase their incidence in immunosuppressed patients, causing high rates of morbidity and mortality. The most important risk factors associated with the development of opportunistic infections in HIV-infected patients are low CD4+ T lymphocyte counts and lack of adherence to antiretroviral treatment. Objective: To describe the clinical characteristics of disseminated mycoses in patients with AIDS admitted to the Department of Internal Medicine of the Hospital Nacional of Itauguá, Paraguay from 2016 to 2018. Materials and methods: Prospective and retrospective descriptive cross-sectional observational study. All men and women older than 18 years with AIDS and diagnosed with disseminated mycosis were included. The research was approved by the Ethics Committee of the Faculty of Medicine of the National University of Itapúa, Paraguay. Results: Eighty patients were included, of which 52 were men with a mean age of 40 years ±10 years. The most frequent mycosis was disseminated candidiasis in 39 patients (49.5%), followed by cryptococcosis in 19 patients (23%). Of the total number of patients, 69 (87%) had CD4+ counts 100,000 copies, and 41 subjects (51%) had discontinued antiretroviral treatment. The most affected organs were the digestive tract and the respiratory system. Mortality was observed in 17 cases (21%) and among these, 11 (63%) subjects had renal failure and 9 (55%) were cachectic. Conclusion: Male predominance was found with a mean age of 40 years. Most of the patients had high viral load and low CD4+ counts. The most frequent mycosis was candidiasis. One in four patients presented cryptococcosis, most frequently at meningeal level. Mortality due to disseminated mycosis was 21%.

16.
RECIIS (Online) ; 16(3): 606-623, jul.-set. 2022.
Article in Portuguese | LILACS | ID: biblio-1398917

ABSTRACT

Neste artigo são delineadas reflexões teórico-etnográficas a partir de pesquisa de campo realizada em três grupos do WhatsApp formados por pessoas que vivem com HIV/aids (PVHA). Tem como objetivo compreender as experiências afetivo-sexuais dessas pessoas, construídas por meio de diálogos, interações e socialidades vividas nesses grupos pesquisados. A partir da descrição das socialidades nos grupos e dos modos como, por meio da biscoitagem, as pessoas fazem circular afetos e desejos sem, necessariamente, constituírem relacionamentos afetivo-sexuais, argumenta-se que, em suas interações sociais, os interlocutores conectavam pessoas, artefatos sociotécnicos, lugares, situações, emoções, relações, projetos de vida etc., de tal maneira que produziam mais que simplesmente apoio, suporte, ajuda ou comunicação sobre o HIV, visto que teciam seus próprios mundos sociais. Estes achados ganham relevância especial ao se considerar a experiência de PVHA que mantêm algum grau de segredo sobre sua sorologia positiva para o HIV


This article outlines theoretical-ethnographic reflection based on a field research about three WhatsApp groups formed by people living with HIV/AIDS (PLWHA). It aims to understand the affective-sexual experiences of these people constructed through dialogues, interactions and socialities on these WhatsApp groups. From the description of sociality in these groups and the ways in which, through biscoitagem, people circulated affections and desires without necessarily constituting affective-sexual relationships, it is argued that, in their social interactions, the interlocutors connected people, socio-technical artefacts, places, situations, emotions, relationships, life projects etc., in a way that produced more than support, mutual help or communication about HIV, insofar as they were weaving their own social worlds. These findings gain special relevance when we consider the experience of the PLWHA who maintain some degree of secrecy about their positive HIV serology


Este artículo esboza reflexiones teórico-etnográficas a partir de una investigación de campo en tres grupos en WhatsApp formados por personas viviendo con VIH/SIDA (PVVS). El objetivo es comprender las experiencias afectivo-sexuales de estas personas construidas a través de diálogos, interacciones y socialidades vividas en estos grupos. A partir de la descripción de la sociabilidad en los grupos investigados y de las formas en que, a través de la biscoitagem, las personas circulaban afectos y deseos sin constituir necesariamente relaciones afectivo-sexuales, se argumenta que, en sus interacciones sociales, los interlocutores conectaron personas, artefactos sociotécnicos, lugares, situaciones, emociones, relaciones, proyectos de vida etc., de manera que produjeron más que solamente apoyo, soporte, ayuda o comunicación sobre VIH, ya que tejian sus propios mundos sociales. Estos hallazgos adquieren especial relevancia cuando se considera la experiencia de las PVVS que mantienen cierto grado de secreto sobre su serología positiva para el VIH


Subject(s)
Humans , HIV , Privacy , Social Networking , Social Interaction , Acquired Immunodeficiency Syndrome , Interpersonal Relations , Life Change Events , Anthropology, Cultural
17.
Rev. cientif. cienc. med ; 25(1): 73-78, sept. 2022.
Article in Spanish | LILACS | ID: biblio-1399932

ABSTRACT

El Virus de la Inmunodeficiencia Humana (V.I.H.) en etapas avanzadas confiere al portador la susceptibilidad para desarrollar infecciones oportunistas. Se sabe poco sobre el COVID-19 en pacientes con infección por el VIH, y a pesar de que la mayoría estos pacientes coinciden con los factores de riesgo de mal pronóstico cuando hay una coinfección con el COVID-19, se han informado muy pocos casos referentes al tema. En este artículo se presentamos un caso clínico de una paciente pediátrica, sin antecedentes patológicos de importancia, con diagnósticos iniciales de pénfigo y neumonía que, después de posteriores estudios pasó a diagnóstico de VIH-SIDA/ COVID 19.


The Human Immunodeficiency Virus (H.I.V.) in advanced stages confers the carrier susceptibility to develop opportunistic infections. Little is known about COVID 19 in patients with HIV infection, and although the majority of patients in this group coincide with risk factors for poor prognosis when coinfected with COVID 19, very few cases have been reported referring to the subject. In this article we present a clinical case of a pediatric patient, with no significant pathological history, which after further studies went on to a diagnosis of HIV-AIDS/COVID 19.


Subject(s)
COVID-19 , Pneumonia , HIV
18.
Rev. cuba. med. trop ; 74(2): e768, May.-Aug. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1408905

ABSTRACT

RESUMEN 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 %) y 7 (8,64 %) por biopsia aspirativa (BAAF). Del total de muestras, 60 (74,07 %) procedían de pacientes con VIH/sida, las muestras se descontaminaron por el método de ácido sulfúrico al 4 %, 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 %) aislamientos, 16 (72,72 %) de Mycobacterium tuberculosis, y 6 (27,27 %) de especies no tuberculosas. De estas, 18 (81,81 %) 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.


ABSTRACT 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%) and 7 (8.64%) by aspiration biopsy (BAAF). Of the total samples, 60 (74.07%) were from HIV / AIDS patients, the samples were decontaminated by the 4% 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%) isolates were obtained, 16 (72.72%) of Mycobacterium tuberculosis (MTB), and 6 (27.27%) 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.

19.
Rev. cuba. med. trop ; 74(2): e493, May.-Aug. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1408912

ABSTRACT

RESUMEN Introducción: Cryptosporidium spp. son parásitos que causan infecciones respiratorias principalmente en pacientes inmunocomprometidos. Objetivo: Detectar Cryptosporidium spp. en el lavado broncoalveolar (BAL) de pacientes VIH positivos y con síndrome respiratorio. Métodos: Se seleccionaron 60 muestras de BAL y se analizaron mediante microscopía óptica con tinción de Ziehl-Neelsen y PCR de punto final; esta última es una técnica eficiente para el diagnóstico de patógenos oportunistas. Se recolectaron datos clínicos y epidemiológicos de cada paciente. Resultados: La prevalencia hallada en este estudio mediante PCR de punto final fue del 5 %. Los signos y síntomas que se presentaron con mayor frecuencia, sobre todo en el grupo etario de 31 a 40 años, fueron fiebre, tos y disnea; sin embargo, no se obtuvieron asociaciones estadísticamente significativas a ninguna de las variables y no se pudo visualizar parásitos mediante la tinción de Ziehl-Neelsen. Conclusión: Cryptosporidium spp. puede causar infecciones pulmonares de difícil reconocimiento clínico, pues se confunde con otras infecciones oportunistas. En el presente estudio no puede establecerse si la detección del ADN parasitario correspondió a una verdadera infección o solamente a colonización, lo que es importante para implementar técnicas con mayor sensibilidad para el diagnóstico. Se debe considerar relevante la prevalencia encontrada en Ecuador, al ser inusualmente alta en comparación con países cercanos como Brasil.


ABSTRACT Introduction: Cryptosporidium spp. are parasites that cause respiratory infections mainly in immunocompromised patients. Objective: To detect Cryptosporidium spp. in bronchoalveolar lavage (BAL) of HIV-positive patients with respiratory syndrome. Methods: Sixty samples of BAL were selected and analyzed by optical microscopy with Ziehl-Neelsen staining and end-point PCR. The latter is an efficient technique for the diagnosis of opportunistic pathogens. Clinical and epidemiological data were collected from every patient. Results: In this study, the prevalence by end-point PCR was 5%. The most frequent signs and symptoms, mainly in the age group 31-40 years old, were fever, cough, and dyspnea. However, no significant statistical associations to any variable were obtained, and no parasites were observed with the Ziehl-Neelsen staining technique. Conclusions: Cryptosporidium spp. can cause pulmonary infections that are difficult to identify clinically, since they are confused with other opportunistic diseases. The current study could not establish whether the detection of parasitic DNA corresponded to a real infection or only to colonization, which is important to implement diagnostic techniques with greater sensitivity. The prevalence found in Ecuador should be considered relevant, as it is unusually high in comparison with nearby countries such as Brazil.

20.
Rev. cuba. med. trop ; 74(2): e813, May.-Aug. 2022. graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1408913

ABSTRACT

RESUMEN Introducción: La lipodistrofia asociada al virus de la inmunodeficiencia humana es un importante factor de riesgo cardiovascular, que se presenta entre el 10 y el 80 % de los casos, atenta contra la calidad de vida y disminuye la adherencia terapéutica. Resulta de gran interés su prevención y tratamiento. Objetivo: Describir los factores de riesgo que contribuyen a su desarrollo, sus aspectos fisiopatológicos y el tratamiento. Métodos: Se realizó una búsqueda bibliográfica en inglés y español. Se consultaron las bases de datos Pubmed, SciELO, Lilacs, Cochrane Library y Web of Science. La estrategia de búsqueda que se empleó fue: VIH OR sida AND lipodistrofia AND tejido adiposo AND terapia antirretroviral. Información, análisis y síntesis: La lipodistrofia se caracteriza por lipoatrofia de las extremidades, cara y glúteos, lipohipertrofia del área visceral, cervical y dorsocervical, o una combinación de estos. Las proteínas del virus de inmunodeficiencia humana realizan modificaciones en la regulación de genes que provocan inhibición de la diferenciación de los adipocitos y aumento de la apoptosis, a lo que contribuye el estado basal inflamatorio sistémico producido por el mismo virus. Los antirretrovirales desempeñan un papel importante en la génesis de dicha lipodistrofia. Conclusiones: El sexo femenino, la malnutrición y la edad avanzada son algunos de los factores de riesgo más relevantes asociados a la lipodistrofia del virus de inmunodeficiencia humana en la cual influyen los efectos propios del virus y la terapia antirretroviral. No existe un tratamiento farmacológico eficaz, solo se contemplan medidas higiénico-dietéticas y la cirugía estética.


ABSTRACT Introduction: Human immunodeficiency virus associated-lipodystrophy is an important cardiovascular risk factor that develops in 10% to 80% of the cases, impairs quality of life, and reduces adherence to treatment. Its prevention and treatment is of great interest. Objective: To describe the risk factors that contribute to the development, pathophysiological aspects and treatment of human immunodeficiency virus associated-lipodystrophy. Methods: A bibliographic search in English and Spanish was conducted. Pubmed, SciELO, Lilacs, Cochrane Library and Web of Science databases were consulted. The search strategy used was: HIV OR AIDS AND lipodystrophy AND adipose tissue AND antiretroviral treatment. Information, Analysis and Synthesis: Lipodystrophy is characterized by lipoatrophy of the upper and lower limbs, face and buttocks; lipohypertrophy of the visceral, cervical and dorsocervical areas, or a combination of them. Human immunodeficiency virus proteins make modifications in the gene regulation that inhibits the adipocyte differentiation and increases apoptosis, favored by the systemic inflammatory basal state caused by the virus itself. Antiretrovirals play an important role in the genesis of lipodystrophy. Conclusions: Female sex, malnutrition, and older ages are some of the main risk factors of the human immunodeficiency virus associated-lipodystrophy, which is influenced by the effects of the virus itself and the antiretroviral therapy. An effective drug treatment is not available, only hygienic-dietary measures and aesthetic surgery are considered.

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