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1.
Rev. Assoc. Med. Bras. (1992) ; 68(2): 202-205, Feb. 2022.
Article in English | LILACS | ID: biblio-1365344

ABSTRACT

SUMMARY OBJECTIVE: The objective of this study was to emphasize the importance of legal and bioethical knowledge in maintaining medical confidentiality, especially in situations when there is a diagnosis of HIV infection. METHODS: A literature review of studies published in the Scientific Electronic Library Online and National Library of Medicine databases was performed. Sixteen studies available in full, online, and free, published between 2010 and 2020, were selected. RESULTS: The studies highlighted that, despite the ethical duty to breach confidentiality for the protection of third parties, many doctors are reluctant to reveal this secret due to the power of stigmatization and social discrimination related to the diagnosis of HIV infection, which affects integrity, counseling, and capability to treat patients. CONCLUSION: HIV diagnosis implies bioethical and legal questions. Respect for medical confidentiality is a matter to be discussed, as there is a need to protect the privacy of the patient, at the same time the responsibility to preserve the health of others.


Subject(s)
Humans , HIV Infections/diagnosis , Disclosure , Confidentiality
2.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(1): 271-280, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1250686

ABSTRACT

Abstract Objectives: to describe life quality of women with HPV and analyze the accuracy of anal visual inspection with acetic acid and lugol compared to high-resolution anoscopy in the detection of anal intraepithelial lesions. Methods: diagnostic evaluation study conducted with adult solid-organ transplant recipients and/or diagnosed with HIV and/or with a history of anogenital neoplasia, attended at the High Resolution Anoscopy outpatient clinic between April and December 2018. To calculate the accuracy parameters, 87 women participated: 44 with lesions and 43 without them. The 44 women with lesions were also subjected to a descriptive study to assess their life quality using the SF-36 questionnaire. Results: it was observed that almost half of the women in the study practiced vaginal, anal and oral intercourse without condom. History of HPV infection and anogenital neoplasia were the most prevailing with percentages of 81% and 72.7%, respectively. In five out of the eight domains of SF-36 they did not perform well in regard to life quality. Visual inspection with acetic acid and lugol presented sensitivity of 22.7% and specificity of 100%. Conclusion: unsatisfactory life quality was evidenced. Direct visual inspection with acetic acid and lugol should not be used in trials to spot intraepithelial HPV lesions, for it presents low sensitivity.


Resumo Objetivos: descrever a qualidade de vida das mulheres com HPVe analisar aacurácia da inspeção visual anal com ácido acético e lugol comparada à anuscopia de alta resolução para detecção de lesão intraepitelial anal. Métodos: estudo de avaliação diagnostica realizado com mulheres adultas transplantadas de órgãos sólidos e/ou diagnosticadas com HIV e/ou com antecedente de neoplasia anogenital, atendidas no ambulatório de AAR entre abril e dezembro de 2018. Para cálculo dos parâmetros de acurácia, participaram 87 mulheres: 44 com lesões e 43 sem lesões. Das 44 mulheres com lesão, também foi realizado um estudo descritivo para a avaliar a qualidade de vida utilizando-seo questionário SF-36. Resultados: Observou-se que quase metade das mulheres do estudo são adeptas ao intercurso vaginal, anal e oralesem preservativo. Os antecedentes de infecção pelo HPV e neoplasia anogenital foram os mais prevalentes com valores de 81% e 72, 7% respectivamente. Cinco, dos oito domínios do SF-36, não apresentaram boa performance em relação à qualidade de vida. A inspeção visual com ácido acético e lugol apresentou sensibilidade de 22,7%o e especificidade de 100,0%o. Conclusão: evidenciou-se qualidade de vida insatisfatória. A inspeção visual anal direta com ácido acético e lugol não deve ser usada na triagem de lesões intraepiteliais por HPV, pois apresenta baixa sensibilidade.


Subject(s)
Humans , Female , Anus Neoplasms/diagnosis , Quality of Life , HIV Infections/diagnosis , Triage , Sickness Impact Profile , Squamous Intraepithelial Lesions/diagnostic imaging , Acetic Acid
3.
Ciênc. Saúde Colet ; 26(1): 297-307, jan. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1153768

ABSTRACT

Resumo O estudo teve por objetivo analisar a tendência temporal dos coeficientes de incidência da infecção por HIV-aids por meio de estudo ecológico retrospectivo e regressão segmentada em maiores de 13 anos notificados no SINAN entre os anos de 1980 e 2016. Dos 14.204 casos notificados, 70,9% eram do sexo masculino e 39,5% brancos. Nota-se aumento da incidência do critério aids de 1986 a 1996 com variação anual percentual (APC) de 108,5% ao ano entre 1983 a 1989 (IC: 90,3 - 128,4), entre os anos de 1989 e 1998 a APC foi de 13,2% (IC: 8,2 - 18,3) e redução da APC no período de 1998 a 2016, -6,2% (IC: -7,4 - -4,9). Altos coeficientes do critério óbito entre os anos 1988 a 2002 (4,7/100.00 hab.) com queda acentuada após 1995. Observa-se crescimento do critério HIV+ a partir do ano 2000, chegando a 30,2 por 100 mil habitantes em 2016. Embora as taxas de incidência ainda permaneçam altas no município, estas tendências são compatíveis com o impacto positivo das políticas de detecção precoce e acesso ao seguimento clínico e terapêutico dos indivíduos com HIV e aids na cidade.


Abstract The objective of this study was to analyze the temporal trend of the incidence coefficients of HIV-AIDS infection via a retrospective ecological study and segmented regression in individuals older than 13 year reported at SINAN between 1980 and 2016. Of the 14,204 reported cases, 70.9% were male and 39.5% were white. The AIDS criterion presented growing incidence from 1986 to 1996 with Annual Percentual Change (APC) of 108.5% per year between 1983 and 1989 (CI: 90.3 - 128.4), between 1989 and 1998 the APC was 13.2% (CI: 8.2 - 18.3) and APC reduction in the period from 1998 to 2016, -6.2% (CI: -7.4 - -4.9). High coefficients of the death criteria between 1988 and 2002 (4.7/100,000 inhabitants), with a noticeable decrease after 1995. The growth of the HIV+ criteria from 2000 onward was observed, reaching 30.2 cases per 100,000 inhabitants in 2016. Although incidence rates still remain high in the municipality, these trends are consistent with the positive impact of early detection policies and access to clinical and therapeutic follow-up of individuals with HIV and AIDS in Campinas.


Subject(s)
Humans , Male , Female , HIV Infections/diagnosis , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/epidemiology , Brazil/epidemiology , Incidence , Retrospective Studies , Cities
4.
Cad. Saúde Pública (Online) ; 37(12): e00062920, 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1355954

ABSTRACT

A distribuição da epidemia de aids no Brasil está associada a uma ampla gama de fatores que definem maior ou menor vulnerabilidade de grupos populacionais. O estudo teve como objetivo analisar as características clínicas e laboratoriais dos casos de infecção pelo HIV/aids em indivíduos com 13 anos de idade ou mais, e sua evolução para o óbito na população indígena assistida pelo Distrito Sanitário Especial Indígena de Mato Grosso do Sul. Realizou-se um estudo descritivo e retrospectivo sobre a condição clínica e evolução da doença entre 2001 e 2014, a partir de três bases de dados secundários. Foram avaliados o tempo de evolução para a aids, o tempo de evolução ao óbito, a carga viral, a contagem de linfócitos T-CD4+ e o tempo de sobrevida. Foram identificados 103 casos de infecção pelo HIV, dos quais 48,5% evoluíram para aids, sendo 60% em menos de um ano desde o diagnóstico. Foram registrados 40 óbitos, sendo 77,5% em decorrência da infecção pelo HIV. Desses que morreram, apenas 30% tiveram sobrevida maior do que um ano. Este estudo sugere que o diagnóstico da infecção pelo HIV se deu nas fases avançadas da doença, revelando-se tardio e apontando uma cobertura diagnóstica deficiente. A rápida evolução ao óbito e curto período de sobrevida também podem indicar fragilidade no acesso aos serviços de saúde de referência, assim como desarticulação e pactuações insuficientes entre Distrito, municípios e estado.


Distribution of the AIDS epidemic in Brazil is associated with a wide range of factors that determine different population groups' greater or lesser vulnerability. The study's objective was to analyze clinical and laboratory characteristics of HIV/AIDS in individuals 13 years or older and the evolution to death in the indigenous population assisted by the Special Indigenous Health District of the State of Mato Grosso do Sul, Brazil. A descriptive and retrospective study was performed on the clinical conditions and evolution of the disease from 2001 to 2014, based on three secondary databases. The study assessed time in progression to AIDS, time in progression to death, viral load, CD4+ T-lymphocyte count, and survival time. A total of 103 cases of HIV infection were identified, of which 48.5% progressed to AIDS, 60% in less than a year since diagnosis. Forty deaths were recorded, 77.5% of which due to HIV infection. Of those who died, only 30% had survived for more than a year. The study suggests that diagnosis of HIV infection occurred in advanced stages of the disease (i.e., late), and points to deficient diagnostic coverage. Rapid progression to death and short survival time are indicative of insufficient access to specialized health services, as well as disconnection and deficient collaboration between the Indigenous Health District, municipalities, and the state.


La distribución de la epidemia de sida en Brasil está asociada a una amplia gama de factores que definen mayor o menor vulnerabilidad de grupos poblacionales. El objetivo del estudio fue analizar las características clínicas y de laboratorio de los casos de infección por el VIH/sida en individuos con 13 años de edad o más, y su evolución hacia el óbito en la población indígena, asistida por el Distrito Sanitario Especial Indígena de Mato Grosso do Sul. Se realizó un estudio descriptivo y retrospectivo sobre la condición clínica y la evolución de la enfermedad entre 2001 y 2014, a partir de tres bases de datos secundarios. Se evaluó el tiempo de evolución para el sida, el tiempo de evolución para el óbito, la carga viral, el cálculo de linfocitos T-CD4+ y el tiempo de supervivencia. Se identificaron 103 casos de infección por VIH, de los cuales un 48,5% evolucionaron hacia sida, siendo 60% en menos de un año desde el diagnóstico. Se registraron 40 óbitos, siendo un 77,5% derivados de la infección por VIH. De esos que murieron, solamente un 30% tuvieron una supervivencia mayor que un año. Este estudio sugiere que el diagnóstico de la infección por VIH se produjo en fases avanzadas de la enfermedad, revelándose tardío y apuntando una cobertura diagnóstica deficiente. La rápida evolución al óbito y corto período de supervivencia, también pueden indicar fragilidad en el acceso a los servicios de salud de referencia, así como la descoordinación y acuerdos insuficientes entre distrito, municipios y estado.


Subject(s)
Humans , HIV Infections/diagnosis , HIV Infections/epidemiology , Indigenous Peoples , Brazil/epidemiology , Indians, South American , Retrospective Studies
5.
Esc. Anna Nery Rev. Enferm ; 25(1): e20190386, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1124796

ABSTRACT

RESUMO Objetivo Analisar o discurso dos gerentes saúde relacionado à organização da oferta do teste rápido anti-HIV, na perspectiva do atributo integralidade. Método Pesquisa exploratória de natureza qualitativa realizada em um distrito sanitário do município de João Pessoa/PB. A coleta de dados foi realizada em setembro de 2017, utilizando-se um roteiro de entrevista semiestruturado, o qual foi aplicado a treze gerentes de saúde de serviços de Atenção Primária à Saúde. O material empírico foi analisado à luz do dispositivo teórico-metodológico de Análise de Discurso, identificando-se o bloco discursivo: Organização dos serviços para a realização do teste rápido anti-HIV. Resultados Os discursos apontam a filiação ideológica que compreende a fragmentação da assistência, normatização da demanda com enfoque em agendamentos, estigmatização e desresponsabilização do cuidado, dificultando a realização da integralidade na perspectiva da descentralização da oferta do teste rápido anti-HIV. Conclusão e implicações para a prática O discurso dos gerentes de saúde aponta fragilidades na qualidade do serviço e organização da oferta do teste rápido anti-HIV. Executar as políticas para reverter a situação atual e a educação permanente dos profissionais podem potencializar a integralidade do serviço.


RESUMEN Objetivo Analizar el discurso de los gerentes de la salud relacionados con la organización de la oferta de pruebas rápidas anti-VIH, desde la perspectiva del atributo de integralidad. Método Investigación exploratoria de naturaleza cualitativa, realizada en un distrito sanitario del municipio de João Pessoa/PB. La recogida de datos se llevó a cabo en septiembre de 2017, utilizando un plan de entrevista semiestructurada, que se aplicó a trece gerentes de la salud de servicios de Atención Primaria de la Salud. El material empírico se analizó a la luz del dispositivo metodológico teórico del Análisis del Discurso, identificando el bloqueo discursivo: Organización de servicios para realizar la prueba rápida anti-VIH. Resultados Los discursos señalan la afiliación ideológica que incluye la fragmentación de la asistencia, la normatización de la demanda con enfoque en los horarios, la estigmatización y la irresponsabilidad de la atención, lo que dificulta alcanzar la integralidad desde la perspectiva de la descentralización la oferta de prueba rápida anti-VIH. Conclusión e implicaciones para la práctica El discurso de los gerentes de la salud señala las deficiencias en la calidad del servicio y la organización de la oferta de pruebas rápidas anti -VIH. La implementación de políticas para revertir la situación actual y la educación permanente de los profesionales puede potenciar la integralidad del servicio.


ABSTRACT Objective Analyze health managers discourse related to the organization of the rapid anti-HIV test provision, from the perspective of the integrality attribute. Method Exploratory research of qualitative nature, undertaken in a health district of the municipality of João Pessoa, Paraíba. Data collection was carried out in September 2017, using a semi-structured interview script for a semi-structured interview, which was applied to thirteen health care service managers from Primary Health Care services. The empirical material was analyzed in the light of the theoretical-methodological Discourse Analysis device, identifying the discursive block: Organization of services for conducting the rapid anti-HIV test. Results The speeches point out to the ideological affiliation that comprises the fragmentation of the assistance, standardization of the demand with focus on schedules, stigmatization and unaccountability of the care, making it difficult to achieve comprehensiveness in the perspective of the decentralization of the offer of rapid anti-HIV test. Conclusion and implications for practice The discourse of health managers points out weaknesses in the quality of service and organization of the rapid anti- HIV test provision. Implementing policies to reverse the current situation and continuing education for professionals can enhance the integrality of the service.


Subject(s)
Humans , Male , Female , Primary Health Care/organization & administration , AIDS Serodiagnosis , Integrality in Health , Stereotyping , HIV Infections/diagnosis , Qualitative Research , Early Diagnosis , Health Manager
6.
Article in English | LILACS | ID: biblio-1283958

ABSTRACT

Introduction: There is a need for studies to know the real situation and outline measures to guarantee a reduction in the rates of pregnant women diagnosed with HIV, Syphilis and Toxoplasmosis. Objective: To determine the prevalence of Syphilis, HIV and toxoplasmosis in puerperal women assisted at the largest public maternity hospital in Campos dos Goytacazes in 2016. Methods: Cross-sectional study, using secondary data from the puerperal women assisted at the largest maternity hospital in the northern region of the State of Rio de Janeiro, in the year 2016. Results: There were 970 puerperal women, with a prevalence of HIV, Syphilis and Toxoplasmosis in pregnancy of 1.6, 2.7 and 2%, respectively. Most pregnant women were diagnosed at delivery due to low serological coverage during pregnancy. Conclusion: The high prevalence of Syphilis, HIV and Toxoplasmosis in pregnancy requires efficient prenatal care for its identification and approach.


Introdução: São necessários estudos para conhecer a real situação e delinear medidas que garantam a redução dos índices de gestantes com diagnóstico de vírus da imunodeficiência humana, sífilis e toxoplasmose. Objetivo: Determinar a prevalência de sífilis, vírus da imunodeficiência humana e toxoplasmose em puérperas atendidas na maior maternidade pública de Campos dos Goytacazes (RJ) no ano de 2016. Métodos: Estudo transversal, utilizando dados secundários das puérperas atendidas na maior maternidade do Norte Fluminense no ano de 2016. Resultados: Foram 970 puérperas, com prevalência de vírus da imunodeficiência humana, sífilis e toxoplasmose na gestação de 1,6, 2,7 e 2%, respectivamente. A maioria das gestantes foi diagnosticada no momento do parto em razão da baixa cobertura sorológica durante a gestação. Conclusão: A alta prevalência de sífilis, vírus da imunodeficiência humana e toxoplasmose na gravidez requer um pré-natal eficiente para sua identificação e abordagem.


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Syphilis/diagnosis , HIV Infections/diagnosis , Toxoplasmosis/diagnosis , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Prenatal Diagnosis , Socioeconomic Factors , Syphilis/epidemiology , HIV Infections/epidemiology , Toxoplasmosis/epidemiology , Prevalence , Cross-Sectional Studies
7.
Article in English | WPRIM | ID: wpr-878357

ABSTRACT

Objective@#The aim of the present study was to evaluate the performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one dried blood spot (DBS) as an alternative sample to plasma.@*Method@#A total of 571 paired DBS/plasma samples were collected from men who have sex with men (MSM) and injection drug users (IDUs), and serological and molecular assays were performed. Using plasma results as the reference standard, the performance of DBS tests for HIV-1 RNA, HIV-1 DNA, and HCV RNA was evaluated. Pearson's correlation coefficients and Bland-Altman analysis were performed to assess the correlation and concordance between DBS and plasma.@*Results@#Among paired plasma/DBS samples with detectable HIV-1 RNA and HCV RNA, five samples (5/32) were not detectable in DBS, while measurable HIV-1 RNA levels were present in plasma (1.44 to 3.99 log @*Conclusion@#The performance of the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA using one DBS was acceptable. DBS, as an alternative sample to plasma, may be a viable option for the simultaneous detection of HIV-1 RNA, HIV-1 DNA, and HCV RNA in resource-limited settings or for individuals living in areas that are difficult to access.


Subject(s)
DNA, Viral/analysis , Diagnostic Tests, Routine/methods , Dried Blood Spot Testing/methods , HIV Infections/diagnosis , HIV-1/isolation & purification , Hepacivirus/isolation & purification , Hepatitis C/diagnosis , RNA, Viral/analysis , Sensitivity and Specificity , Specimen Handling/methods , Syphilis/diagnosis , Treponema pallidum/isolation & purification
8.
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1292642

ABSTRACT

Objetivo: Descrever o perfil epidemiológico dos casos de Vírus da Imunodeficiência Humana (HIV) notificados no estado de Goiás, por meio de dados do Sistema de Informação de Agravos e Notificação (SINAN). Metodologia: Foi realizado um estudo observacional, descritivo, de corte transversal, com dados secundários. A população alvo foi constituída de indivíduos diagnosticados com HIV notificados pelo SINAN no estado de Goiás, no período de 2015 a 2019. Resultados: Foram registradas 7.575 notificações para HIV; destas, 79,2% eram homens, 71,1% tinham entre 20 e 39 anos de idade e 42% eram naturais da grande Goiânia. Este estudo demonstrou que entre os anos de 2015 e 2019 ocorreu aumento nas taxas de incidência de HIV. A modalidade de transmissão mais prevalente foi a homossexual. Dos casos analisados, 34% (n=2.598) apresentaram algum sintoma ou doença definidora da Síndrome da Imunodeficiência Humana (AIDS). Cerca de 60 pessoas (0,9%) foram registradas com o status de teste não realizado, inferindo que esses indivíduos foram casos descartados, ou seja, não se tratava de uma infecção por HIV. Considerações finais: É preciso que se desenvolvam políticas públicas de saúde voltadas para essa população, sendo considerados seus fatores sociodemográficos e determinantes sociais, para que medidas apropriadas e efetivas de promoção, prevenção e recuperação da saúde sejam implementadas


Objective: To describe the epidemiological profile of Human immunodeficiency vírus (HIV) cases, notified in the State of Goiás using data from the Diseases Information and Notification System (SINAN). Methodology: An observational, descriptive, cross-sectional study was carried out with secondary data. The target population consisted of individuals diagnosed with HIV notified by SINAN in the State of Goiás, in the period from 2015 to 2019. Results: Were registered 7.575 notifications for HIV, were registered, of these 79.2% were men, 71.1% were between 20 and 39 years old and 42% born in Greater Goiânia. This study demonstrated that between the years 2015 to 2019 there was an increase in HIV incidence rates. The most prevalent mode of transmission was homosexual. Of the cases, 34% (n = 2.598) of the symptoms, some symptom or disease defining AIDS (Human Immunodeficiency Syndrome). About 60 people (0.9%) were registered with the status of a test not performed, inferring that these individuals were discarded cases, that is, it was not an HIV infection. Final considerations: It is necessary to develop public health policies aimed at this population, considering their sociodemographic factors and social determinants, in order to implement appropriate and effective measures for the promotion, prevention and recovery of health


Subject(s)
Humans , Male , Female , Adolescent , Adult , HIV Infections/epidemiology , Acquired Immunodeficiency Syndrome , Health Information Systems , Health Profile , HIV Infections/diagnosis , HIV Infections/mortality , AIDS-Related Opportunistic Infections , Disease Notification
9.
Medicina (B.Aires) ; 80(6): 714-717, dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1250300

ABSTRACT

Resumen La sífilis maligna asociada al virus de la inmunodeficiencia humana (HIV). Se presenta con lesiones nodulares cutáneas con tendencia a la ulceración. Entre sus hallazgos histopatológicos se destaca la presencia de granulomas no caseificantes, lo cual obliga al diagnóstico diferencial con otras patologías granulomatosas infecciosas y no infecciosas. La evolución de la enfermedad es favorable con el tratamiento con penicilina en la mayoría de los casos. Presentamos el caso de una paciente con infección por HIV que cumple criterios diagnósticos de sífilis maligna y alertamos sobre esta entidad granulomatosa poco frecuente.


Abstract Malignant syphilis occurs frequently in patients infected with human immunodeficiency virus (HIV) and presents with cutaneous nodular lesions that tend to ulcerate. Non caseating granulomas are among the most conspicuous histopathological findings and require differential diagnosis with other infectious and non-infectious granulomatous conditions. The evolution of the disease is usually favourable with penicillin treatment. We present the case of an HIV-positive patient who meets diagnostic criteria for malignant syphilis and alert on this infrequent granulomatous entity.


Subject(s)
Humans , Syphilis/complications , Syphilis/diagnosis , Syphilis/drug therapy , HIV Infections/complications , HIV Infections/diagnosis , Administration, Cutaneous , Diagnosis, Differential , Granuloma
10.
Rev. cient. Esc. Univ. Cienc. Salud ; 7(2): 42-47, jun.-dic. 2020.
Article in Spanish | LILACS, BIMENA | ID: biblio-1343962

ABSTRACT

Honduras reportó dos primeros casos de enfermedad por coronavirus (COVID19) el 11 de marzo del 2020, actualmente reporta un total de 46,365 casos confirmados con 1,465 fallecidos que estiman una tasa letalidad de 3.16%, es por esto que se ha cuestionado si la infección por virus de inmunodeficien- cia humana (VIH) incrementa el riesgo de contagio y severidad de la COVID-19 debido a su riesgo de inmunosupresión. En el presente estudio de casos se incluyeron 6 pacientes con VIH coinfectados con COVID-19 tratados en el Hospital Nacional Dr. Mario Catarino Rivas (HNMCR) desde el inicio de la pandemia en marzo hasta julio del 2020. Se codificaron como P1 a P6, todos los pacientes recibían tratamiento antirretroviral, 4 de ellos en estado crítico con hipoxia severa que ameritó soporte venti- latorio y fallecieron (P2, P3, P5, P6). Un paciente (P1) en estado estable fue dado de alta tras 7 días de estancia hospitalaria. Un paciente (P4) fue asintomático. La evidencia científica aún sigue siendo escasa sobre el riesgo de contagio con el SARS-CoV-2 en pacientes con VIH. Las personas infectadas por el VIH no están protegidas de la infección por SARS-CoV-2 ni tienen un riesgo menor de padecer una enfermedad grave y por lo general, deben recibir el mismo enfoque de tratamiento aplicado a la población general. El presente trabajo se limita a la descripción de una serie de casos por lo que no se puede generalizar en todos los pacientes con VIH, sin embargo, se pretende contribuir a conocer la coinfección...(AU)


Subject(s)
Humans , Male , Female , Middle Aged , HIV Infections/diagnosis , COVID-19 , Anti-Retroviral Agents/therapeutic use
11.
Rev. cuba. enferm ; 36(4): e3460, graf
Article in Spanish | LILACS, BDENF, CUMED | ID: biblio-1280292

ABSTRACT

Introducción: El virus de la inmunodeficiencia humana destruye las células del sistema inmunológico, genera alteraciones en la condición de salud de quien lo contrae a nivel físico, emocional, espiritual y social. Constituye un acontecimiento que cambia la vida y debe ser analizado integralmente para desarrollar un acompañamiento terapéutico efectivo. Objetivo: Comprender las transiciones experimentadas por una persona que vive con el virus de inmunodeficiencia humana, la naturaleza de la transición, las condiciones facilitadoras e inhibidoras y los patrones de respuesta desde la teoría de las transiciones. Métodos: Investigación cualitativa con diseño de historia de vida, realizada en Armenia, Colombia durante el 2018. Se realizó entrevista a profundidad a una persona, desde los postulados de Afaf Meleis, los datos fueron categorizados y analizados mediante el software ATLAS TI versión 7. Resultados: Se logró evidenciar una transición de salud-enfermedad, con patrón múltiple simultánea y secuencial, al recibir el diagnóstico suyo y de su hijo, requiriendo ajustes en el desempeño de su rol (transición situacional- organizativa). Se identificaron conocimientos previos acerca del virus y el compromiso con el tratamiento farmacológico. Además, se evidenció el amor y la fe hacia Dios, a quien le atribuye gran parte de su recuperación junto con el acompañamiento familiar y de su grupo de apoyo. Conclusiones: Resulta importante crear un perfil individual del paciente, que conlleve a un óptimo acompañamiento desde estrategias educativas, motivacionales, participativas y colectivas para abordar la dimensión física, emocional, espiritual y social de las personas que viven con el virus de inmunodeficiencia humana(AU)


Introduction: The human immunodeficiency virus destroys the cells of the immune system, generates changes in the health condition of those who contract it on a physical, emotional, spiritual and social level; It constitutes a life-changing event and must be comprehensively analyzed to develop effective therapeutic support. Objective: Understand the transitions experienced by a person living with the human immunodeficiency virus, the nature of the transition, the facilitating and inhibiting conditions and the response patterns from the theory of transitions. Methods: Qualitative research with life history design, carried out in Armenia, Colombia during 2018. An in-depth interview was conducted to a person, from the postulates of Afaf Meleis, the data was categorized and analyzed using the ATLAS TI version 7 software. Results: It was possible to demonstrate a health-disease transition, with a simultaneous and sequential multiple pattern, upon receiving the diagnosis from her and her son, requiring adjustments in the performance of his role (situational-organizational transition); Previous knowledge about the virus and commitment to pharmacological treatment were identified. In addition, love and faith towards God was evident, to whom he attributes a large part of his recovery along with family accompaniment and his support group. Conclusions: It is important to create an individual profile of the patient, which leads to optimal support from educational, motivational, participatory and collective strategies to address the physical, emotional, spiritual and social dimension of people living with the human immunodeficiency virus(AU)


Subject(s)
Humans , HIV Infections/diagnosis , Life Change Events , Nursing Theory
12.
Ciênc. Saúde Colet ; 25(12): 5003-5016, Dec. 2020. tab
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1142701

ABSTRACT

Resumo A infecção pelo HIV é preditora de diversas alterações metabólicas e de composição corporal, além de quadro de desnutrição, anemia e hipovitaminoses. Existem assim, especificidades de diagnóstico e tratamento conforme o estágio da doença e o ambiente ambulatorial ou hospitalar. O objetivo desse trabalho é apresentar arcabouço teórico e conceitual sobre a realização do diagnóstico nutricional em pessoas que vivem com HIV/AIDS. Buscou-se evidências científicas atuais nacionais e internacionais publicadas em artigos científicos, livros recentes, protocolos, consensos e diretrizes. O diagnóstico nutricional engloba vários aspectos e habilidades clínicas e conhecimentos específicos sobre essa morbidade. Assim, devido sua complexidade e abrangência, compreende: história clínica e situação clínica atual, consumo alimentar, dados antropométricos, composição corporal, bioquímicos, pressão arterial e exame físico. Foi demonstrado o processo de diagnóstico nutricional de forma a fornecer subsídios para as equipes de saúde na identificação de parâmetros que possibilitem instituir um plano de cuidado nutricional que promova, previna e recupere as alterações detectadas nas pessoas que vivem com HIV/AIDS.


Abstract HIV infection is a predictor of several metabolic and body composition alterations, in addition to malnutrition, anemia, and hypovitaminosis. There are thus specificities of diagnosis and treatment depending on the stage of the disease and the outpatient or hospital environment. The scope of this narrative review was to update the conceptual and theoretical framework regarding the nutritional diagnosis of people living with HIV/AIDS. Current national and international scientific evidence published in scientific articles, recent books, protocols, consensuses, and guidelines were analyzed. The nutritional diagnosis encompasses several clinical aspects and abilities and specific knowledge about HIV/AIDS, such as: clinical history and current clinical situation, food consumption, anthropometric data, body composition, and biochemistry, blood pressure and physical examination. The nutritional diagnosis process was demonstrated in order to provide subsidies for the health teams in the identification of parameters that make it possible to establish a plan for nutritional care to promote, prevent and recuperate the alterations detected in people living with HIV/AIDS.


Subject(s)
Humans , HIV Infections/diagnosis , Acquired Immunodeficiency Syndrome/diagnosis , Malnutrition/diagnosis , Malnutrition/etiology , Malnutrition/epidemiology , Body Composition , Review Literature as Topic
13.
Rev. chil. pediatr ; 91(5): 672-683, oct. 2020. tab
Article in Spanish | LILACS | ID: biblio-1144265

ABSTRACT

La prevención de la transmisión vertical de VIH es un desafío para todos los países del mundo. Esto se ve complejizado por la construcción permanente de sociedades globales, con grado variable de población migrante internacional. Las políticas, programas y acciones sanitarias para la prevención de transmisión vertical de VIH en gestantes migrantes demandan una perspectiva intercultural, en donde se aborden todas las dimensiones sociales, culturales y de género asociadas a la infección. El entender la realidad local en cuanto a la prevención de transmisión vertical de VIH en población migrante internacional en Chile es esencial para llevar acciones concretas que favorezcan la prevención de transmisión madre-hijo de VIH. En este artículo se presentan algunos conceptos esenciales relacionados a esta temática. También se expone información internacional y nacional sobre riesgos de transmisión vertical de VIH en migrantes gestantes, la importancia del plan nacional de preven ción de transmisión vertical de VIH en nuestro país, y algunos esfuerzos que se están realizando para adaptar dicho plan a la realidad de diversidad social y cultural que migrantes gestantes presentan hoy en Chile, como un valioso insumo de salud pública con perspectiva intercultural.


Preventing vertical transmission of HIV is a challenge for all countries worldwide. The permanent construction of global societies with a variable degree of international migrant population has made it more complex. Health policies, programs, and actions for preventing vertical transmission of HIV in pregnant migrants demand an intercultural perspective, where social, cultural, and gender dimen sions associated with the infection are addressed. Understanding the local reality regarding the pre vention of vertical transmission in the international migrant population in Chile is essential to carry out concrete actions that favor the prevention of mother-to-child transmission of HIV. This article presents some essential concepts related to this topic. It also presents international and national in formation on risks of vertical transmission in pregnant migrants, the importance of the national plan for preventing vertical transmission of HIV in our country, and some ongoing efforts to adapt such plan to the reality of social and cultural diversity that pregnant migrants currently present in Chile, as a useful public health instrument with an intercultural perspective.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/ethnology , Pregnancy Complications, Infectious/therapy , Prenatal Care/methods , Transients and Migrants , HIV Infections/transmission , Infectious Disease Transmission, Vertical/prevention & control , Emigrants and Immigrants , Culturally Competent Care/methods , HIV Infections/diagnosis , HIV Infections/ethnology , HIV Infections/therapy , Chile/epidemiology , Social Determinants of Health , Health Policy
14.
An. bras. dermatol ; 95(5): 655-657, Sept.-Oct. 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130939

ABSTRACT

Abstract We present the case of an HIV-negative man with asymptomatic penile erythematoviolaceous papules associated with similar slightly verrucous papules in the interdigital space of the right foot. A biopsy of the penile lesion confirmed Kaposi's sarcoma. No other causes of immunosuppression were observed. Penile lesions of KS are rare in HIV-negative individuals but it should also be considered in the differential diagnosis. Careful follow-up is recommended.


Subject(s)
Humans , Male , Penile Neoplasms , Sarcoma, Kaposi/diagnosis , Skin Neoplasms/diagnosis , HIV Infections/complications , HIV Infections/diagnosis , Herpesvirus 8, Human , Diagnosis, Differential
15.
Medicina (B.Aires) ; 80(5): 554-556, ago. 2020. graf
Article in Spanish | LILACS | ID: biblio-1287209

ABSTRACT

Resumen El SARS-CoV-2 es el virus causante de la enfermedad COVID-19, desconocida antes del brote que ocurrió en diciembre de 2019 en Wuhan, China, y desencadenó la actual pandemia. Las manifestaciones de la infección por SARS-CoV-2 son muy variables entre los pacientes. Los peores desenlaces se suelen asociar a edad avanzada y factores de riesgo reconocidos. Entre estos sería razonable considerar los distintos tipos de inmunodeficiencia, en particular la producida por HIV. Sin embargo, no existen hasta el momento, estudios que demuestren que la infección HIV empeore la evolución y el pronóstico de COVID-19. La neumonía por el hongo Pneumocystis jirovecii (antes denominado P. carinii) afecta con mayor frecuencia a inmunodeprimidos y puede tener desenlace fatal. Exponemos el caso de una mujer de mediana edad con síndrome de Raynaud que ingresó con neumonía y durante la internación se le diagnosticó infección simultánea por HIV, SARS-CoV-2 y P. jirovecci. Evolucionó de forma favorable con tratamiento empírico sin requerir maniobras invasivas ni soporte ventilatorio, logrando el alta y seguimiento de forma ambulatoria.


Abstract SARS-CoV-2 causes the disease named COVID-19, which emerged in Wuhan, China, in December 2019 and developed into the current pandemic. The manifestations of SARS-CoV-2 infection are highly variable. The worst outcomes are usually associated with advanced age and known risk factors. Among these, it would be reasonable to consider conditions compromising the immune system, particularly the immunodeficiency associated to HIV. To date, however, there is no evidence of HIV infection worsening the evolution and prognosis of COVID-19. Pneumocystis jirovecii (previously-P. carinii) pneumonia, is a fungal disease that most commonly affects immunocompromised persons and can be life-threatening. Typically, patients at risk are those with any underlying condition altering host immunity. We present the case of a middle-aged woman with Raynaud's syndrome who was admitted with pneumonia. During hospitalization she was simultaneously diagnosed with infection by HIV, COVID-19 and P. jirovecci. The patient evolved favorably upon empirical treatment without requiring invasive maneuvers or ventilatory support. Outpatient follow-up after hospital discharge was uneventful.


Subject(s)
Humans , Female , Middle Aged , Pneumonia, Pneumocystis/diagnosis , Pneumonia, Viral , HIV Infections/diagnosis , Coronavirus Infections/diagnosis , Pneumocystis carinii/isolation & purification , Pandemics , Coronavirus , Clinical Laboratory Techniques , Severe Acute Respiratory Syndrome , Betacoronavirus , COVID-19 Testing , SARS-CoV-2 , COVID-19
16.
Rev. méd. Chile ; 148(6): 818-821, jun. 2020.
Article in Spanish | LILACS | ID: biblio-1139376

ABSTRACT

The Chilean Academy of Medicine convened a commission to evaluate the status of HIV epidemic and the national response to it, regarding its achievements, gaps and challenges, aiming to recommend actions to optimize assessment quality and national response. This publication summarizes the agreed upon opinion of its members. The epidemic is overwhelmingly sexually transmitted, predominant in homo/bisexual men. Vertical transmission is very low. An increasing number of new diagnoses is occurring, with relative over representation of foreign people lately. There is a legal guarantee of confidentiality, nondiscrimination and treatment for those affected, both in the private and public sector. All public health services have active HIV care units. Modern antiviral drugs and monitoring tests are also available. Despite these clear achievements, insufficient, occasionally inadequate public policies and certain rigid regulations thwart optimal effectivity and efficiency of the programs, contributing to the slow and incomplete compliance with international commitments. Shortcomings worth highlighting are: suboptimal educational and preventive programs directed to youngsters, vulnerable and general population; persistent underdiagnosis of infected population; cumbersome requirements to request and inform diagnostic tests, thus discouraging testing; excessive centralization and long latency of diagnosis confirmation and monitoring tests; incomplete epidemiologic analysis and public reporting of findings; non flexibility and slow updating of therapeutic guidelines; insufficient adaptation of care and drug delivery modalities to patients' needs; excessive administrative requirements at care centers and restrictive legislation for outcome and interventional clinical research. Recommendations to deal with these issues were proposed.


Subject(s)
Humans , Male , HIV Infections/diagnosis , HIV Infections/prevention & control , HIV Infections/epidemiology , Epidemics/prevention & control , Medicine , Pharmaceutical Preparations , Chile/epidemiology
17.
Guatemala; Universidad del Valle de Guatemala. Programa Regional Centroamericano de VIH, MSPAS, CDC, PEPFAR, The University Norht Caroline; mar 2020. 99 p. ilus.
Monography in English | LILACS, LIGCSA | ID: biblio-1147330

ABSTRACT

In a qualitative study with both MSM and TW living with HIV in Guatemala City, Barrington et al (2016) again found that intersecting stigma and discrimination created fear of HIV testing and linkage to HIV care and barriers to knowledge about HIV. Retention-specific determinants included HIV clinic dynamics and limited employment opportunities, which affected economic stability. These multiple levels of factors driving linkage and retention in care and treatment require multi-level, integrated responses (AU)


Subject(s)
Humans , Male , Female , Adult , HIV Infections/diagnosis , HIV , Anti-HIV Agents/therapeutic use , Sexual Health , Social Support , Medical Informatics Applications , Prospective Studies , Fear/psychology , Social Stigma , Guatemala/epidemiology
18.
Cad. Saúde Pública (Online) ; 36(6): e00170118, 2020.
Article in Portuguese | LILACS | ID: biblio-1100978

ABSTRACT

Resumo: Os homens são o principal grupo afetado pela infecção do HIV no Brasil, com tendência de crescimento nos últimos dez anos. Nos dados oficiais, os homens heterossexuais representam 49% dos casos, os homossexuais 38% e os bissexuais 9,1%. Os homens heterossexuais ficaram subsumidos na categoria de "população geral", não recebendo destaque em políticas ou ações de prevenção. O presente artigo se propõe a analisar as circunstâncias e estratégias por meio das quais os homens heterossexuais descobrem o diagnóstico do HIV. Busca-se, assim, compreender os caminhos percorridos, bem como os atores sociais envolvidos no diagnóstico de HIV/aids. Os dados analisados resultam de uma pesquisa qualitativa na qual foram entrevistados 36 homens vivendo com HIV/aids que não se identificam como homossexuais e/ou bissexuais. Esses homens foram contatados em três serviços especializados em aids de Porto Alegre, Rio Grande do Sul, Brasil. Os resultados indicam que eles se consideram imunes ao HIV, sendo o diagnóstico um evento inesperado. As mulheres (parceiras afetivo-sexuais e/ou ex-parceiras) são peças fundamentais para o diagnóstico masculino, pois revelam, seja pelo pré-natal, seja pelo adoecimento, a presença do HIV. Uma parcela importante dos homens se descobre soropositivo por ocasião de alguma doença, como a tuberculose, ou após várias idas e vindas dos serviços de saúde. A busca pela testagem de forma espontânea só acontece mediante a identificação de situações e sinais associados a uma possível contaminação. Os homens heterossexuais possuem poucas oportunidades de diagnóstico do HIV e, para além do gênero, são sujeitos à vulnerabilidade programática.


Abstract: Men are the main group affected by HIV infection in Brazil, with an upward trend in the last 10 years. According to official data, heterosexual men represent 49% of cases, followed by homosexuals with 38% and bisexuals with 9.1%. Heterosexual men have been subsumed in the category "overall population" and have failed to receive specific attention in preventive policies or activities. The article proposes to analyze the circumstances and strategies by which heterosexual men learn of their HIV diagnosis. The study thus seeks to understand the paths and social actors involved in their HIV/AIDS diagnosis. The data are from a qualitative study interviewing 36 men living with HIV/AIDS that did not self-identify as homosexuals and/or bisexuals. The men were contacted in three specialized AIDS services in Porto Alegre, Rio Grande do Sul State, Brazil. The results indicate that men consider themselves immune to HIV, and that the diagnosis is an unexpected event. Women (affective-sexual partners and/or former partners) are fundamental components in the men's diagnosis, since they reveal the presence of HIV through either prenatal care or their own illness. An important share of these men discover that they are HIV-positive through some illness such as tuberculosis or after several visits to health services. Spontaneous search for HIV testing only occurs through situations and signs associated with possible infection. Heterosexual men have few opportunities for HIV diagnosis, and beyond gender issues, they are subject to programmatic vulnerability.


Resumen: Los hombres son el principal grupo afectado por la infección del VIH en Brasil, con una tendencia de crecimiento en los últimos 10 años. En los datos oficiales, los hombres heterosexuales representan un 49% de los casos, los homosexuales un 38% y los bisexuales un 9,1%. Los hombres heterosexuales quedaron encajados en la categoría de "población general", no siendo relevantes en políticas o acciones de prevención. Este artículo se propone analizar las circunstancias y estrategias a través de las cuales los hombres heterosexuales descubren el diagnóstico del VIH. Se busca, de esta forma, comprender los caminos recorridos, así como los actores sociales implicados en el diagnóstico del VIH/SIDA. Los datos analizados son resultado de una investigación cualitativa en la que se entrevistaron a 36 hombres, viviendo con VIH/SIDA, que no se identifican como homosexuales y/o bisexuales. Se contactó con estos hombres a través de tres servicios especializados en sida de Porto Alegre, Rio Grande do Sul, Brasil. Los resultados indican que los hombres se consideran inmunes al VIH, siendo el diagnóstico un evento inesperado. Las mujeres (parejas afectivo-sexuales y/o ex-parejas) son piezas fundamentales para el diagnóstico masculino, puesto que revelan, sea a través del cuidado prenatal, sea a través de la enfermedad, la presencia del VIH. Una parte importante de los hombres se descubre seropositiva, debido a alguna enfermedad, como la tuberculosis, o tras varias idas y venidas a los servicios de salud. La búsqueda de un test espontáneo solamente se produce mediante la identificación de situaciones y señales asociadas a una posible infección. Los hombres heterosexuales poseen pocas oportunidades de diagnóstico del VIH y, más allá del género, están sujetos a vulnerabilidad programática.


Subject(s)
Humans , Male , Female , Pregnancy , HIV Infections/diagnosis , HIV Infections/epidemiology , Feline Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/epidemiology , Epidemics , Sexual Behavior , Brazil , HIV , Heterosexuality , Men
19.
Clin. biomed. res ; 40(2)2020. ilus
Article in English | LILACS | ID: biblio-1148189

ABSTRACT

Introduction: Human immunodeficiency virus (HIV), which causes Acquired Immunodeficiency Syndrome, still affects millions of people worldwide. Despite recent advances in the understanding of biological mechanisms of viral replication, there are relevant gaps regarding the virus-host relationship. Unraveling these complexities may lead to the development of new therapeutic strategies and the establishment of new biomarkers useful for the diagnosis and prognosis of infection and its comorbidities. Therefore, in this study we discuss the main biological characteristics of microRNAs and the potential use of these nucleic acids in their free circulating form as indicators of risk or protection against HIV infection. Methods: A narrative review of the literature was carried out in the following databases through keyword and/or health descriptor searches: i) Google Scholar; ii) CAPES periodicals portal; iii) United States National Library of Medicine (PubMed) and iv) Elsevier's Science Direct library. The keywords "microRNA; HIV infection; circulating microRNA; biomarkers" were used to search the databases as mentioned above.Results: Circulating microRNAs (ci-miRNA) are closely related to numerous processes in the HIV infection pathophysiology. They are involved in viral latency, increased viremia, hepatic injury, heart dysfunction, pulmonary hypertension, immune response impairment, and participate in Kaposi's sarcoma pathology. Additionally, these molecules may indicate protection in elite controllers, reduce viral replication and load, and be useful markers of the infection's eclipse phase. Conclusion: Ci-miRNA levels are altered levels in individuals with HIV, playing a dual role in infection. Advances in research have shown that ci-miRNAs could differentiate stages of HIV infection and diseases associated with a viral infection and serve as biomarkers for antiretroviral therapy's effectiveness through changes in their expression. (AU)


Subject(s)
Humans , HIV Infections/diagnosis , MicroRNAs , Virus Replication/immunology , Biomarkers
20.
Rev. Soc. Bras. Med. Trop ; 53: e20190117, 2020. tab, graf
Article in English | LILACS | ID: biblio-1057297

ABSTRACT

Abstract INTRODUCTION: This study intends to describe a HIV intake screening strategy in recently incarcerated adults in Distrito Federal, Brasilia, Brazil. METHODS: We tested 455 recently incarcerated adults in Distrito Federal in 2016 using rapid tests (RT) applied to oral samples (OS). RESULTS: The estimated frequency of positive tests was 0.88% (95% confidence interval [CI] 0.34% to 2.24%). CONCLUSIONS: The present findings reveal the potential significance of detecting new HIV infection cases in a vulnerable population using point-of-care rapid diagnostic tests.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Prisoners/statistics & numerical data , HIV Infections/diagnosis , Reagent Kits, Diagnostic , Brazil/epidemiology , HIV Infections/epidemiology , Prevalence , Kaplan-Meier Estimate , Middle Aged
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