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S. Afr. j. child health (Online) ; 16(1): 1-5, 2022. figures, tables
Article in English | AIM, AIM | ID: biblio-1359340


Background. Mother-to-child transmissions (MTCT) accounts for 90% of the 370 000 new HIV-positive children, globally. Despite progress in the prevention of mother-to-child transmission (PMTCT) of HIV, children still acquire HIV infection. Objective. To identify and describe the prevalence of maternal, infant and/or health system-related risk factors gleaned from the literature for HIV transmission in HIV-positive children admitted to the paediatric intensive care unit (PICU) at Inkosi Albert Luthuli Central Hospital (IALCH), Durban, South Africa. Method. A retrospective electronic chart review identifying all HIV-positive children under 2 years admitted to the PICU at IALCH between January 2017 and December 2019 was undertaken. Individual patient records were analysed using a standardised template. Results. Of the 80 mothers and children with HIV enrolled in the present study, 38.8% (n=31/80) of mothers were diagnosed prior to pregnancy, 42.5% (n=34/80) were diagnosed during pregnancy (unsure when exactly transmission occurred), and 18.8% (n=15/80) of mothers were diagnosed after delivery. The median (range) time of antiretroviral treatment (ART) was 225 (30 - 365) days for mothers. More than half of mothers (56.3%, n=45/80) whose babies became HIV-positive had poor adherence to antiretroviral drugs (HIV viral load >1 000 copies/mL). An HIV-positive diagnosis in the children of these mothers occurred throughout infancy and early childhood, especially in the first 6 months (87.5%, n=70/80). A third of mothers practised mixed feeding. Health system deficiency, mainly via cancellation of tests without notifying healthcare workers, was typical in infants (33%; n=26/80) and mothers (68.8%, n=55/80). All others (100%) were not counselled about the importance of PMTCT and 93.8% of mothers were not counselled about the importance of follow-up. Almost all HIV-positive infants (95%, n=76) presented with severe respiratory illness, mainly severe acute respiratory distress syndrome (62.5%, n=50/80) and pneumonia with hypoxic respiratory failure (32.5%, n=26/80). The overall mortality of the cohort was 22.5% (n=18/80), and most deaths were associated with cytomegalovirus (CMV), Pneumocystis jirovecii pneumonia (PJP) or both (61.1%, n=11/18). Conclusion. This present study confirmed that a new diagnosis of HIV positivity occurs throughout pregnancy and early childhood in infants. Poor adherence to ART in mothers and their infants, poor counselling, failure to attend antenatal and postnatal care, mixed feeding, and challenged laboratory services were common modifiable factors that need addressing.

Humans , Male , Female , Child, Preschool , HIV Infections , Child, Hospitalized , HIV Seropositivity , Infectious Disease Transmission, Vertical , Intensive Care Units , Postpartum Period
S. Afr. med. j ; 112(2): 96-101, 2022.
Article in English | AIM, AIM | ID: biblio-1358378


Background. Better integration of HIV and sexually transmitted infection (STI) prevention and treatment services is needed to accelerate progress towards the goal of zero new HIV infections. Objectives. To describe HIV positivity, antiretroviral therapy (ART) use, viral suppression and recency of HIV infection among symptomatic STI service attendees at two primary care clinics in South Africa. Methods. In a cross-sectional study, male and female STI service attendees presenting with symptoms consistent with STI syndromes were enrolled following informed consent. An interviewer-administered questionnaire was completed and appropriate genital and blood specimens were collected for STI testing and HIV biomarker measurements including recency of infection and antiretroviral (ARV) drug levels. Descriptive statistics were used to describe enrolled attendees, and to determine the proportion of attendees who were HIV-positive, recently infected, taking ART and virally suppressed. HIV-positive attendees with detectable ARVs were considered to be on ART, while those with viral loads (VLs) ≤200 copies/mL were considered virally suppressed. Results. Of 451 symptomatic attendees whose data were analysed, 93 (20.6%) were HIV-positive, with 15/93 (16.1%) being recently infected. Recent infection was independently associated with genital ulcer disease at presentation, especially ulcers with no detectable STI pathogens. Among the 78 (83.9%) with long-term infection, only 30 (38.5%) were on ART, with 23/30 (76.7%) virally suppressed. Conclusions. In a population at risk of HIV transmission, there was a high burden of recent infection and unsuppressed VLs. Incorporating pre-exposure prophylaxis, ART initiation and adherence support into STI services will be necessary for progress towards eliminating HIV transmission

HIV Infections , Viral Load , Sexually Transmitted Diseases , HIV Seropositivity
Rev. medica electron ; 43(1): 2977-2985, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156789


RESUMEN Se presentó el caso clínico de un paciente seropositivo, en fase sintomática avanzada. Fue atendido en el Servicio de Medicina Interna del Hospital Clínico Quirúrgico Docente "León Cuervo Rubio", de la ciudad de Pinar del Río, por presentar disnea, astenia, anorexia y pérdida de peso. Al examen oral se constató lesión tumoral de la lengua que dificultaba la masticación y deglución. La biopsia mostró sarcoma de Kaposi asociado al VIH/sida. La evolución tórpida y el estadio tan avanzado de la enfermedad, propiciaron el deceso del paciente (AU).

ABSTRACT The authors presented the clinical case of a seropositive patient, in advanced symptomatic phase. The patient attended the Internal Medicine Service of the Teaching Clinical Surgical Hospital Leon Cuervo Rubio of Pinar del Rio, presenting dyspnea, asthenia, anorexia and weight loss. On the oral examination, a tumor lesion was found making difficult to chew and swallow. A biopsy showed Kaposi sarcoma associated to HIV/AIDS. The torpid evolution and disease's advanced stage propitiated the patient's death (AU).

Humans , Male , Middle Aged , Sarcoma, Kaposi/complications , HIV Seropositivity/complications , Sarcoma, Kaposi/etiology , Sarcoma, Kaposi/mortality , Sarcoma, Kaposi/drug therapy , Sarcoma, Kaposi/epidemiology , Condylomata Acuminata/diagnosis , HIV Seropositivity/mortality , Intensive Care Units
Rev. argent. salud publica ; 13: 1-9, 5/02/2021.
Article in Spanish | LILACS, BINACIS, ARGMSAL | ID: biblio-1352386


INTRODUCCIÓN: El consumo de tabaco en las personas que viven con VIH (PVV) en Argentina está entre un 40 y un 60%. El consumo de tabaco se relaciona con la aparición de cáncer en la población general y con una disminución de la respuesta al tratamiento antirretroviral en las PVV. Los médicos que atienden a las PVV pueden tener un papel fundamental en ayudar a sus pacientes a dejar de fumar. Este estudio examinó los factores relacionados con la utilización de las prácticas clínicas de cesación tabáquica en una muestra de médicos infectólogos que atienden a PVV en Argentina. MÉTODOS: Se administró una encuesta en línea a miembros de la Sociedad Argentina de Infectología, quienes referían atender a PVV. Se realizaron análisis descriptivos y modelos lineales generalizados. RESULTADOS: Participaron 138 profesionales (20,4% de los convocados). La implementación de métodos para la cesación tabáquica por los infectólogos fue significativamente mayor en aquellos profesionales que habían recibido educación al respecto (RPa: 1,22; IC 95%: 1,10-1,35), y disminuía significativamente en quienes no habían recibido entrenamiento formal (RPa: 0,64; IC 95%: 0,44-0,94). DISCUSIÓN: Hay necesidad de incorporar el entrenamiento en cesación tabáquica en la capacitación profesional de médicos que atienden a PVV para aumentar sus destrezas en estas prácticas clínicas y disminuir el consumo de tabaco en esta población

HIV Seropositivity , Tobacco Use Cessation , Professional Training
Article in English | LILACS | ID: biblio-1359846


Introduction: Urinary tract infections (UTI) are common in women and can cause systemic repercussions. In pregnant women, for example, the occurrence of UTI or asymptomatic bacteriuria (AB) can lead to premature birth and fetal death. The generalized immune depletion caused by HIV is related to the exacerbation of infections, and may be related to UTI. Objective: The objective of this review was to evaluate the characteristics of UTI in pregnant and non-pregnant HIV-positive women as well as the factors that interfere in its occurrence. Methods: By searching the databases PubMed, Web of Science, Scielo and Lilacs, we selected eleven articles that correlated UTI and HIV infection in women. Results: Our analysis showed that HIV-positive pregnant women have a higher predisposition to UTI than HIV-negative ones. The Viral Load (VL) is directly related to UTI and AB in HIV-positive nonpregnant women. TCD4 lymphocyte levels (TCD4) lower than 200 cells/mL and VL over 10,000 copies/mL are correlated with higher UTI and AB rates in HIV-positive pregnant women. There is a tendency for greater variability of pathogens in HIV-positive women and a predisposition to higher rates of antibiotic resistance in HIV-positive pregnant women. Conclusion: HIV-positive pregnant women have higher predisposition to urinary tract infection and its incidence is correlated with a high viral load and a low TCD4 count.

Introdução: As infecções do trato urinário (ITU) são comuns em mulheres e podem causar repercussões sistêmicas. Em mulheres grávidas, por exemplo, a ocorrência de ITU ou bacteriúria assintomática (BA) pode levar ao nascimento prematuro e à morte fetal. A depleção imunológica generalizada causada pelo HIV está relacionada à exacerbação de infecções e pode estar relacionada à ITU. Objetivo: O objetivo desta revisão foi avaliar as características da ITU em gestantes e não gestantes HIV-positivas, bem como os fatores que interferem na sua ocorrência. Métodos: Por meio de busca nas bases de dados PubMed, Web of Science, SciELO e LILACS, foram selecionados 11 artigos que correlacionavam ITU a infecção pelo HIV em mulheres. Resultados: Nossa análise mostrou que gestantes soropositivas têm maior predisposição à ITU do que gestantes soronegativas. A carga viral está diretamente relacionada a ITU e BA em mulheres não grávidas HIV-positivas. Os níveis de linfócitos TCD4 (TCD4) abaixo de 200 células/mL e a carga viral acima de 10.000 cópias/mL estão correlacionados a maiores taxas de ITU e BA em mulheres grávidas HIV-positivas. Há uma tendência para maior variabilidade de patógenos em mulheres HIV-positivas e uma predisposição para maiores taxas de resistência a antibióticos em mulheres grávidas HIV-positivas. Conclusão: Gestantes HIVpositivas apresentam maior predisposição à infecção do trato urinário e sua incidência está correlacionada com alta carga viral e baixa contagem de TCD4.

Humans , Urinary Tract Infections , Women , Pregnant Women , Urinary Tract , HIV , HIV Seropositivity
Sex., salud soc. (Rio J.) ; (36): 74-94, dez. 2020. tab
Article in Spanish | LILACS | ID: biblio-1156947


Resumen A partir de seis entrevistas a hombres con VIH (HV) con identidades no heteronormativas, este artículo explora los cambios y continuidades, después del diagnóstico, en sus sexualidades y expresiones de género. Se focalizó la atención en los condicionamientos estructurales a estas experiencias. Para el análisis, se retomaron elementos de la construcción de género de y la teoría de la estructuración. Se recurre al método de comparación constante, para formar categorías con los patrones encontrados. Los resultados destacan que la opresión estructural a las prácticas sexuales y expresiones de género, se incrementa con la agudización de necesidades materiales y de apoyo, espiritual y psicológico.

Resumo Com base em seis entrevistas com homens com HIV (HH), com identidades não-heteronromativas, este estudo explora as mudanças e continuidades em sua sexualidade e expressões de gênero após o diagnóstico, focalizando as condições estruturais dessas experiências. Elementos de construção de gênero e a teoria de estruturação foram usados na análise. Usando o método de comparação constante para formar categorias com os padrões encontrados. Os resultados mostram que a opressão estrutural das práticas sexuais e expressões de gênero aumentam com o agravamento das necessidades materiais e de apoio espiritual e psicológico.

Abstract Based on six interviews with men with HIV (MH) that have non-heteronormative identities, this study explores transformations and continuities in their sexuality and gender expressions after the diagnosis. The focus was on the structural conditioning of this experience. For the analysis, elements of the construction of gender and the theory of structuring were used. The constant comparison method is used to form categories within patterns found. The results highlight that the structural oppression of sexual practices and gender expressions increases with the exacerbation of material needs and for spiritual and psychological support.

Humans , Male , Female , HIV Infections , HIV Seropositivity , Sexuality , Sexual and Gender Minorities , Gender Identity , Life Change Events , Interviews as Topic , Qualitative Research , Social Stigma , Transgender Persons , Personal Narrative , Gender Norms , Mexico
Gerais (Univ. Fed. Juiz Fora) ; 13(2): 1-15, maio-ago. 2020. ilus
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1133965


A presente pesquisa buscou identificar as concepções acerca do estigma social entre pessoas vivendo com o HIV/AIDS. Participaram 44 soropositivos, com idade entre 23 e 67 anos (M = 41,00; DP = 10,60), que estavam em acompanhamento no centro de testagem e aconselhamento (CTA) da Secretária da Saúde da Prefeitura Municipal de Parnaíba/PI. Utilizou-se entrevista semiestruturada e questionário sociodemográfico para caracterização da amostra. Constatou-se que, apesar de quase três décadas passadas da epidemia e da sua mudança epidemiológica, as pessoas que convivem com HIV/AIDS ainda sofrem e internalizam estigmas, que são construções históricas, culturais e sociais, que giram em torno da doença, assim demonstrando medo do julgamento moral da sociedade. Espera-se que esses dados possam subsidiar futuras intervenções em saúde coletiva que possam contribuir para atenuar as vivências de estigma social no contexto da soropositividade para o HIV/AIDS.

The current research sought to identify the conceptions about the social stigma among people living with HIV/AIDS. Participated 44 HIV-positive individuals, aged between 23 and 67 years (M = 41,00, SD = 10,60), who were being monitored at the testing and counseling center (CTA) of the Secretary of Health of the Municipality of Parnaíba/PI, Brazil. Semi-structured interview and sociodemographic questionnaire were used to characterize the sample. It was found that, despite almost three decades after the epidemic and its epidemiological change, people living with HIV/AIDS still suffer and internalize stigmas, which are historical, cultural and social constructions, revolving around the disease, as well showing fear of the moral judgment of society. It is expected that these data may support future public health interventions that can contribute to alleviate the experiences of social stigma in the context of HIV/AIDS seropositivity.

Prejudice , Social Stigma , Psychology, Social , Stereotyping , Acquired Immunodeficiency Syndrome , HIV , HIV Seropositivity
Sex., salud soc. (Rio J.) ; (34): 25-45, jan.-abr. 2020.
Article in Portuguese | LILACS | ID: biblio-1139628


Resumo Neste artigo, discutimos narrativas sobre as relações afetivo-sexuais de homens jovens vivendo com HIV/aids, com carga viral indetectável e possibilidade de não transmis-sibilidade do HIV. Realizamos dez entrevistas semiestruturadas com homens que fazem sexo com homens, entre 18 e 30 anos, acompanhados em um SAE - Serviço de Assistência Es-pecializada de Salvador-BA, em 2017. Nas narrativas em foco, a condição de indetectável aparece como uma mudança [bio]identitária importante, e sua manutenção como uma res-ponsabilidade contínua consigo e com o outro. Apesar de avanços biomédicos e das novas possibilidades interativas abertas nesse cenário, os efeitos estigmatizantes do HIV persistem, sustentados pelos discursos de medo e culpa por uma possível transmissão do vírus. Uma noção de corpos perigosos, de risco, em detrimento dos avanços alcançados com os estudos que indicam que indetectável=intransmissível.

Resumen En este artículo, discutimos narrativas sobre las relaciones afectivo-sexuales de hombres jóvenes que viven con VIH/sida, con carga viral indetectable y posibilidades de no transmisibilidad del VIH. Hicimos diez entrevistas semi-estructuradas con hombres que tienen sexo con hombres, entre 18 y 30 años, en seguimiento en el servicio especializado de salud, en Salvador de Bahía, 2017. En las narrativas en foco, la condición de indetectable expresa un cambio bio-identitario importante, y su mantenimiento una responsabilidad con-tinua consigo y con el otro. A pesar de los avances biomédicos y de las nuevas posibilidades interactivas abiertas en ese escenario, los efectos estigmatizantes del VIH persisten, respal-dados en discursos de miedo y culpa por la posible transmisión del virus. Una noción de cuerpos peligrosos y riesgosos, a pesar de los avances logrados en los estudios que afirman indetectable=intransmisible.

Abstract In this article, we discuss narratives on affective-sexual relationships of young men living with HIV/AIDS, with undetectable viral load and possibility of not transmit-ting HIV. We conducted ten semi-structured interviews with men who have sex with men, aged between 18 and 30 years old, followed at a specialized health service in Salvador, Ba-hia, Brazil, in 2017. In these narratives, the undetectable condition appears as an impor-tant [bio]identity change, and its maintenance as an ongoing responsibility to themselves and others. Despite biomedical advances, the 'undetectable equals Untransmittable' (U=U) campaign and new interactive possibilities open up in this scenario, the stigma of HIV as well as a notion of dangerous/risky bodies persist, supported by discourses of fear and guilt for a possible virus transmission.

Humans , Male , Adult , HIV Infections/transmission , Acquired Immunodeficiency Syndrome/transmission , Homosexuality, Male , Viral Load , Sexuality , Sexual and Gender Minorities , Self Care , Brazil , HIV Infections/prevention & control , Interviews as Topic , Acquired Immunodeficiency Syndrome/prevention & control , HIV Seropositivity/transmission , Biomedical Technology , Social Stigma , Personal Narrative , Psychological Distress , Interpersonal Relations
Medisan ; 24(1)ene.-feb. 2020. imag
Article in Spanish | LILACS, CUMED | ID: biblio-1091168


Se describe el caso clínico de un paciente de 18 años de edad, seropositivo al VIH, quien fue atendido en el Hospital Provincial de Luena, provincia angolana de Moxico, por presentar dolor lumbar. Se le realizó tomografía axial computarizada, la cual mostró gran destrucción vertebral y colecciones paravertebrales bilaterales. El paciente mantuvo una evolución desfavorable y falleció 20 días después de realizado el diagnóstico.

The case report of an 18 years patient, HIV seropositive is described. He was assisted at Luena Provincial Hospital, angolan province of Moxico due to a lumbar pain. A computerized axial tomography was carried out, which showed great vertebral destruction and bilateral paravertebral collections. The patient maintained an unfavorable clinical course and died 20 days after the diagnosis.

Tuberculosis, Spinal , Adolescent , Mycobacterium tuberculosis , HIV Seropositivity
Rev. bras. promoç. saúde (Impr.) ; 33: 1-10, 03/01/2020.
Article in English, Portuguese | LILACS | ID: biblio-1104259


Objetivo: Analisar a influência da situação socioeconômica e do estágio do vírus da imunodeficiência humana na qualidade de vida de pessoas soropositivas. Métodos: Trata-se de um estudo quantitativo e transversal, realizado entre 2016 e 2017, desenvolvido em um centro de referência no tratamento de pessoas com o vírus da imunodeficiência humana em São Luís (Maranhão, Brasil). A amostra compôs-se de 122 pessoas soropositivas que realizavam tratamento e acompanhamento nesse centro de referência. Utilizou-se um instrumento para coleta de dados socioeconômicos e o questionário de qualidade de vida WHOQol-HIV-bref. A análise dos dados ocorreu por meio da modelagem com equações estruturais. Construíram-se duas variáveis latentes, situação socioeconômica e qualidade de vida, utilizando análise fatorial confirmatória e, em seguida, a análise de caminhos. Resultados: Todas as cargas fatoriais das variáveis latentes apresentaram-se convergentes. Em relação à parte estrutural do modelo, para cada variação de um desvio padrão na situação socioeconômica, há um aumento de 0,601 desvio padrão na qualidade de vida dos participantes. Não houve efeito direto significante do estágio clínico do vírus na qualidade de vida (p=0,165), nem da situação socioeconômica no estágio clínico (p=0,610), bem como não houve efeito indireto da situação socioeconômica na qualidade de vida quando mediado pelo estágio clínico (p=0,654). Conclusão: O estágio clínico não se associou à qualidade de vida e não apresentou efeito mediador entre a situação socioeconômica e a qualidade de vida. A situação socioeconômica influenciou diretamente a qualidade de vida dos participantes.

Objective: To analyze the influence of socioeconomic status and human immunodeficiency virus stage on the quality of life of HIV-positive people. Methods: This quantitative cross-sectional study was conducted between 2016 and 2017 at a reference center for the treatment of people with human immunodeficiency virus in São Luís (Maranhão, Brazil). The sample comprised 122 HIV-positive people undergoing treatment and follow-up at the reference center. We used an instrument to collect socioeconomic data and the WHOQol-HIV-bref. Data analysis was performed using structural equation modeling. Two latent variables were constructed ­ socioeconomic status and quality of life ­ using confirmatory factor analysis followed by path analysis. Results: All factor loadings of the latent variables described converge. With regard to the structural part of the model, for each variation of one standard deviation in the socioeconomic status there was an increase of 0.601 standard deviation in the quality of life of the participants. The clinical stage of the virus had no significant direct effect on quality of life (p=0.165). Also, socioeconomic status had no significant effect on the clinical stage of the virus (p=0.610). Additionally, socioeconomic situation did not have any indirect effect on quality of life mediated by clinical stage (p=0.654). Conclusion: The clinical stage was not associated with quality of life and did not have a mediating effect on socioeconomic status and quality of life. The socioeconomic status directly influenced the participants' quality of life.

Objetivo: Analizar la influencia de la situación socioeconómica y del estado del virus de la inmunodeficiencia humana en la calidad de vida de personas seropositivas. Métodos: Se trata de un estudio cuantitativo y transversal realizado entre 2016 y 2017 desarrollado en un centro de referencia para el tratamiento de personas con el virus de la inmunodeficiencia humana de São Luís (Maranhão, Brasil). La muestra ha sido de 122 personas seropositivas que realizaban el tratamiento y el seguimiento en ese centro de referencia. Se utilizó un instrumento para la recogida de datos socioeconómicos y el cuestionario de calidad de vida WHOQol-VIH-bref. El análisis de los datos se dio a través de ecuaciones estructurales. Se ha construido dos variables latentes, la situación socioeconómica y la calidad de vida, utilizándose el análisis factorial confirmatorio y después el análisis de caminos. Resultados: Todas las cargas factoriales de las variables latentes se presentaron convergentes. Respecto la parte estructural del modelo para cada variación de una desviación típica de la condición socioeconómica hay un aumento de 0,601 desviación típica de la calidad de vida de los participantes. No hubo el efecto directo significativo del estado clínico del virus para la calidad de vida (p=0,165) ni de la situación socioeconómica del estado clínico (p=0,610) así como no hubo el efecto indirecto de la situación socioeconómica en la calidad de vida cuando mediado por el estado clínico (p=0,654). Conclusión: El estado clínico no se asoció con la calidad de vida y no presentó el efecto mediador entre la situación socioeconómica y la calidad de vida. La situación socioeconómica ha influenciado directamente en la calidad de vida de los participantes.

Quality of Life , Social Class , Statistical Analysis , Acquired Immunodeficiency Syndrome , HIV Seropositivity
In. Verga, Federico; Burghi, Gastón. Encares de paciente crítico. Montevideo, Oficina del Libro FEFMUR, 2020. p.329-341.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1342661
S. Afr. j. bioeth. law ; 13(2): 1-6, 2020.
Article in English | AIM, AIM | ID: biblio-1270216


COVID-19 has significantly changed the lives of people worldwide. After one of the most stringent lockdowns in the world, South Africa (SA) prepared to allow increasing numbers of workers to return to their workplaces. Employees received several requests to disclose health conditions to their employers that might put them at higher risk for COVID-19, as some of the regulations issued under the state of disaster by the SA government oblige employers to make special provisions for 'vulnerable employees'. Despite their benevolent intention, such requests constitute a massive infringement of employees' rights, and some of the medical, legal and ethical considerations relevant in this context are discussed. Given the relative scarcity of medical evidence, the constitutional protection of employees' rights and the ethical concerns, a cautious and well-administrated approach within the legally permissible space is necessary

COVID-19 , Coronavirus Infections , HIV Seropositivity , South Africa , Vulnerable Populations
S. Afr. j. child health (Online) ; 14(2): 62-65, 2020. tab
Article in English | AIM, AIM | ID: biblio-1270384


Background. HIV infection can lead to the development of HIV-associated nephropathy (HIVAN) with the majority of patients progressing to end-stage kidney disease. Previous studies have recognised basic fibroblast growth factor (bFGF) as a biomarker for HIVAN, since significant levels of bFGF low-affinity receptors have been found in the kidneys of HIV-infected children.Objective. To assess the association between bFGF and kidney disease in the development of focal segmental glomerulosclerosis (FSGS) in HIV-positive and negative children.Methods. The study group consisted of 31 children; HIVAN (n=11) and idiopathic FSGS (n=20). The control group consisted of both HIV-positive (n=20) and HIV-negative (n=20) children with no kidney disease. Serum samples from all patients in both the study and control groups were analysed for bFGF.Results. The concentration of bFGF was higher, in comparison with idiopathic FSGS children, in HIVAN children (p=0.0167). There was also a significant elevation of serum bFGF levels in children with HIVAN when compared with HIV-positive (p=0.0288) and HIV-negative (p=0.0043) control groups.Conclusion. This study demonstrated statistically significant differences between bFGF levels in children with HIVAN and a control group, although it failed to distinguish significant differences in bFGF levels between HIVAN and idiopathic FSGS children

AIDS-Associated Nephropathy , Biomarkers , Child , Glomerulosclerosis, Focal Segmental , HIV Infections , HIV Seropositivity , South Africa
ABCD arq. bras. cir. dig ; 33(2): e1521, 2020. tab
Article in English | LILACS | ID: biblio-1130539


ABSTRACT Background: Non-Hodgkin's lymphomas (NHL) are primary neoplasms derived from lymphocytes, and Kaposi's sarcoma (SK) is a multicentric disease of viral etiology and is associated with HIV. Aim: To study the etiopathogenesis and clinical characteristics of NHL and KS, describing their mutual factors. Methods: This retrospective investigation was performed on 101 medical charts. The patients were studied according to their age, gender, and HIV-positivity, following the PRISMA guidelines. The characteristics of the tumors and comorbidities were analyzed according to their age and lymphatic metastasis. Results: The mean age of the patients ranged between 15-87 years for NHL and between 25-54 for KS, but the age of patients with NHL associated with HIV did not surpass 34 years. The ratio male: female was 1,8:1 for NHL, but only men presented KS. HIV-positivity was found in five patients with NHL and in 14 with KS. The stages of NHL were: I (21%), II (18,4%), III (26,3%), and IV (34,2%), but KS were found only at III (40%) and IV (60%) stages. The lymphatic metastases were positive in 62 patients NHL and in four with KS. HIV-positivity occurred in 60% of patients with NHL and in 50% with KS. Conclusion: The HIV seropositivity was revealed for most of patients during the NHL and SK propaedeutic and none of them present clinical manifestations of AIDS. NHL associated with HIV was found only in young patients. NHL and KS patients have similar epidemiological, clinical, and therapeutic characteristics.

RESUMO Racional: Os linfomas não Hodgkin (LNH) são neoplasias primárias derivadas de linfócitos e o sarcoma de Kaposi (SK) é doença multicêntrica de etiologia viral, ambas associadas ao HIV. Objetivo: Avaliar características clínicas dos LNH e SK, relacionando fatores etiopatogênicos mútuos. Métodos: Foram avaliados retrospectivamente 101 prontuários. Os doentes foram analisados quanto a idade, sexo e soropositividade para o HIV, de acordo com o PRISMA guidelines. Os tumores foram classificados por estadiamento, presença de linfonodos regionais invadidos e tipo celular. Resultados: A idade variou entre 15 e 87 anos para o LNH e 25 a 54 anos para o SK, mas a idade dos pacientes com LNH associado com o HIV não ultrapassou 34 anos. A proporção homem: mulher foi de 1,8:1 para o LNH, enquanto SK foi registrado apenas em homens. A soropositividade para o HIV ocorreu em cinco pacientes com LNH e 14 com SK. A invasão de linfonodos regionais foi positiva em 62 com LNH e quatro com SK. Os linfomas foram 27,9% de baixo grau, 17,4% de grau intermediário e 12,8% de alto grau. A soropositividade para HIV, foi diagnosticada durante a propedêutica do tumor em 60% dos pacientes com LNH e 50% dos com SK. Conclusão: A maioria dos pacientes portadores de HIV descobriram a soropositividade durante propedêutica para LNH e SK, sem manifestações clínicas de AIDS. Todos os pacientes com LNH associado com o HIV eram jovens. Pacientes com LNH e com SK apresentam características epidemiológicas, clínicas e terapêuticas semelhantes entre si.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Sarcoma, Kaposi/etiology , Sarcoma, Kaposi/epidemiology , Lymphoma, Non-Hodgkin/etiology , Lymphoma, Non-Hodgkin/epidemiology , HIV Infections/complications , Retrospective Studies , HIV Seropositivity
Rev. enferm. UFSM ; 10: 59, 2020.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1123675


Objetivo: conhecer as percepções da equipe de saúde sobre o protocolo de atenção materno infantil implantado em um serviço escola de referência regional para HIV. Método: estudo descritivo com abordagem qualitativa, realizado em 2017, no interior de Minas Gerais, Brasil, com a participação dos 10 membros da equipe do serviço escola. O grupo focal foi utilizado para a coleta de dados, e as informações coletadas foram analisadas mediante análise temática indutiva. Resultados: os relatos foram organizados em temas que retratam aspectos das mudanças realizadas no serviço, contribuições do protocolo para a organização dos processos de trabalho e a integralidade da atenção a clientela materno infantil, bem como destacam fatores imbricados na implantação que agiram como facilitadores ou dificultadores deste processo. Conclusão: as percepções da equipe apontaram para o reconhecimento das potencialidades do protocolo implantado para o cuidado à mulher e à criança, no cenário do HIV.

Objective: to understand the health staff's perceptions of the protocol of maternal-child care implanted in a teaching service of regional reference for HIV. Method: descriptive study with a qualitative approach, carried out in 2017, in the countryside of Minas Gerais, Brazil, with the participation of 10 staff members at the teaching service. The focus group was used for data collection, and the information collected was analyzed using inductive thematic analysis. Results: the reports were organized in themes that portray aspects of changes performed in the service, contributions of the protocol to the organization of work processes and the integrality of the maternal-child clientele, in addition to highlighting factors intertwined in deployment that acted as facilitating or hindering factors in this process. Conclusion: the staff's perceptions pointed to the recognition of the potential of the protocol deployed for the care with women and children in the scenario of HIV.

Objetivo: conocer las percepciones del equipo de salud sobre el protocolo de atención materno-infantil implantado en un servicio escuela de referencia regional para el VIH. Método: se realizó un estudio descriptivo con abordaje cualitativo, realizado en 2017, en el interior de Minas Gerais, Brasil, con la participación de 10 miembros del equipo de servicio escuela. El grupo de enfoque fue utilizado para la recolección de datos, y la información recogida fue analizada utilizando análisis temático inductivo. Resultados: los informes fueron organizados en temas que retratan aspectos de cambios realizados en el servicio, las contribuciones del protocolo para la organización de los procesos de trabajo y la integralidad de la clientela materno-infantil, así como destacan los factores interrelacionados en la implementación que actuaron como facilitadores o dificultadores en este proceso. Conclusión: la percepción del equipo señaló el reconocimiento del potencial del protocolo implementado para la atención a mujeres y niños, en el escenario del VIH.

Humans , Child Health , Maternal-Child Nursing , Women's Health , HIV Seropositivity , Protocols
Borno Med. J. (Online) ; 17(1): 1-8, 2020. tab
Article in English | AIM, AIM | ID: biblio-1259676


Background: Appropriate infant feeding is still a challenge to HIV-positive mothers especially in the developing world despite their desire to breast feeding beyond the WHO recommended 12 months' duration. Objective: To determine the duration of breast feeding and correlate with outcome of HIV-exposed infants in UDUTH, Sokoto. Methods: This descriptive observational study was conducted among HIV-exposed infants attending Paediatric ART(PMTCT) clinic, UDUTH, Sokoto. The demographics, infant post-exposure prophylaxis, duration of breast feeding and results of early infant diagnosis (EID) of the infants using HIV-DNA PCR machine; and maternal highly active antiretroviral therapy (HAART) history were documented. The data were analyzed using SPSS version 24.0. A p-value of ≤0.05 was taken as significant. Results: One hundred and sixty-three HIV-positive mother-infant pairs were studied, 103(61.7%) of the HIV-positive mothers were aged 25-34 years, 105(62.9%) were of lower socio-economic class and 94(56.3%) had informal education. One hundred and fifteen (62.5%) were on TDF/3TC/EFV and 143 (85.6%) were on HAARTs prior to the index pregnancy. One hundred and sixty-three of the HIV-exposed infants studied were breast-fed and 165 (98.8%) had nevirapine as infant PEP. The mean duration of breast feeding among HIV-exposed infants was 13.2(±3.5) months with a range 6 ­ 20 months. Ninety-eight (60.1%) infants were breastfed beyond 12months. All the HIV-exposed infants were not infected at the end of breastfeeding for 12 months or more. Conclusion: Majority of the HIV-positive mother's breastfed beyond WHO recommended 12 months and their infants were uninfected. This may support the upward review of the duration of breast feeding of HIV-exposed infants in our community

Breast Feeding , Duration of Therapy , HIV Seropositivity , Infant , Nigeria , Patient Outcome Assessment
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(4): 999-1010, Sept.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1057119


Abstract Objectives: to evaluate the association between the sociodemographic and clinical aspects of the caregiver and the child, the family's ability to prepare and administer milk and complementary feeding of children exposed to HIV. Methods: cross-sectional study performed with 72 caregivers, in Brazil, through the tool of sociodemographic and clinical characterization of the caregiver and the Capability to Care for HIV-Exposed Children Assessment Scale. Results: there was a high capability to feed (76.6%), both for milk (85.0%) and comple-mentary (65%) feeding. For the milk feeding, accessing the health unit in any situation (p=0.003), having other child exposed to HIV (p=0.013), maintaining the follow-up in the health service (p=0.048) and not consuming alcohol (p=0.045) influenced on the higher probability of the caregiver to present high capability, while residing in the peri-urban area (p=0.002) indicated moderate capability. For the complementary feeding, the higher the schooling (p=0.025), the number of appointments scheduled for the child (p=0.045) and the child being followed up in the health service (p=0.035), the higher the probability of obtaining high capability. Conclusions: the exposure of social and clinical factors of caregivers influences the ability to feed. To ensure adequate nutrition, it is necessary for the health services to be able to consider the geo-socio-cultural characteristics of families in the elaboration of guidelines.

Resumo Objetivos: avaliar a associação entre os aspectos sociodemográficos e clínicos do cuidador e da criança, a capacidade familiar para preparar e administrar a alimentação láctea e complementar de crianças expostas ao HIV. Métodos: estudo transversal realizado com 72 cuidadores, entre fevereiro de 2016 a março de 2017, por meio de instrumento de caracterização sociodemográfica e clínica do cuidador e Escala de Avaliação da Capacidade para Cuidar de Crianças Expostas ao HIV. Resultados: evidenciou-se alta capacidade para alimentar (76,6%), tanto para alimen-tação láctea (85,0%) quanto complementar (65%). Para a láctea, acessar a unidade básica em qualquer situação (p=0,003), ter outros filhos expostos ao HIV (p=0,013), manter o acompanhamento no serviço de saúde (p=0,048) e não consumir álcool (p=0,045) influen-ciou na maior probabilidade de o cuidador apresentar alta capacidade, enquanto que residir em zona periurbana (p=0,002) indicou capacidade moderada. Para a alimentação comple-mentar, quanto maior a escolaridade (p=0,025), o número de consultas da criança (p=0,045) e a criança estar em acompanhamento no serviço de saúde (p=0,035), maior a probabilidade de obter capacidade alta. Conclusões: a exposição dos fatores sociais e clínicos das cuidadoras influencia na capacidade para alimentar. Para garantir a alimentação adequada, é necessário que os serviços de saúde estejam aptos a considerar as características geo-sócio-culturais das famílias na elaboração das orientações.

Humans , Male , Female , Infant, Newborn , Infant , Child Care , Parenting , Caregivers , Infant Formula , Breast-Milk Substitutes , Infant Nutrition , Socioeconomic Factors , Bottle Feeding , Brazil , Cross-Sectional Studies , HIV Seropositivity , HIV Seropositivity/transmission , Infectious Disease Transmission, Vertical , Maternal Behavior
Rev. enferm. UERJ ; 27: e37461, jan.-dez. 2019. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1000343


Objetivo: descrever o perfil e avaliar a qualidade de vida de pessoas vivendo com HIV atendidas em serviços públicos de saúde. Métodos: estudo transversal, quantitativo com 281 pessoas vivendo com HIV atendidas em serviços públicos de saúde nos municípios do Rio de Janeiro e Niterói. Os dados foram coletados por meio de instrumento de dados socioeconômicos e clínicos e do WHOQOL-HIV bref, analisados por estatística descritiva, após aprovação do Comitê de Ética em Pesquisa. Resultados: a amostra foi composta majoritariamente por homens, renda de até dois salários mínimos e percepção positiva da saúde. A qualidade de vida foi positivamente avaliada na maioria das facetas, as maiores médias foram nos domínios: psicológico, relações sociais, espiritualidade, religião e crenças pessoais e a menor no domínio meio ambiente. Conclusão: o perfil das pessoas vivendo com HIV corrobora, os dados nacionais e a avaliação da qualidade de vida foi mais positiva do que em outros estudos.

Objective: to describe the profile and evaluate the quality of life of people living with HIV treated in public health services. Methods: in this cross-sectional, quantitative study of 281 people living with HIV treated in public health services in the municipalities of Rio de Janeiro and Niteroi, data were collected using a socioeconomic and clinical instrument and the WHOQOL-HIV brief questionnaire, and analyzed by descriptive statistics, with research ethics committee approval. Results: the sample comprised mainly men, with income of up to two minimum wages and a positive perception of their health. Most facets of quality of life were positively assessed, with the highest averages in the psychological, social relations, spirituality, religion and personal beliefs domains, and the lowest, in the environmental domain. Conclusion: the profile of people living with HIV corroborates national data, and the assessment of quality of life was more positive than in other studies.

Objetivo: describir el perfil y evaluar la calidad de vida de personas viviendo con VIH atendidas en servicios públicos de salud. Métodos: estudio transversal, cuantitativo, junto a 281 personas viviendo con VIH, atendidas en servicios públicos de salud en los municipios de Río de Janeiro y Niterói. Se han recolectado los datos mediante un instrumento de datos socioeconómicos y clínicos y del WHOQOL-HIV bref, analizados por estadística descriptiva, después de la aprobación del Comité de Ética en Investigación. Resultados: la muestra se compuso mayoritariamente de hombres, con ingresos de hasta dos salarios mínimos y percepción positiva de la salud. Se evaluó positivamente la calidad de vida en la mayoría de las facetas, los promedios más altos en los dominios: psicológico, relaciones sociales, espiritualidad, religión y creencias personales y el más bajo en el dominio medio ambiente. Conclusión: el perfil de las personas que viven con VIH corrobora con los datos nacionales y la evaluación de la calidad de vida fue más positiva que en otros estudios

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Quality of Life , HIV , HIV Seropositivity/psychology , Nursing , Quality of Life/psychology , Cross-Sectional Studies , Spirituality
Rev. bioét. (Impr.) ; 27(4): 756-763, out.-dez. 2019.
Article in Portuguese | LILACS | ID: biblio-1057443


Resumo Tecnologias reprodutivas permitem que casais soroconcordantes homoafetivos tenham filhos biológicos saudáveis, já que, se aplicadas adequadamente, impedem a transmissão vertical do vírus da imunodeficiência humana. Diante do avanço das ciências naturais e das consequências sociais que o acompanham, a ciência jurídica deve progredir para lidar com essas novas realidades. Com base nisso, a pesquisa propõe-se a investigar a obrigação estatal de regulamentar políticas públicas que contemplem técnicas de reprodução assistida, visto que a integralidade do direito à saúde e ao planejamento familiar deve abarcar o grupo-objeto deste estudo. Utilizou-se método dedutivo e técnicas de revisão literária, com enfoque na legislação brasileira vigente, em monografias do biodireito e resoluções do Conselho Federal de Medicina sobre o tema.

Abstract Reproductive technologies allow HIV positive seroconcordant homosexual couples to have healthy biological children, since, if executed properly, they prevent the vertical transmission of the human immunodeficiency virus. Given the advance in natural sciences and the accompanying social consequences, law must progress to deal with these new realities. Based on that, the present study proposes to investigate the state obligation on the regulation of public policies that contemplate assisted reproduction techniques, since the right to health and family planning should encompass the object group of this research. We used the deductive method and literary review techniques focusing on the Brazilian legislation in force, biolaw dissertations and the resolutions of the Brazilian Federal Council of Medicine on the subject.

Resumen Las tecnologías reproductivas permiten que las parejas seroconcordantes homoafectivas tengan hijos biológicos saludables, ya que, si se aplican adecuadamente, impiden la transmisión vertical del virus de la inmunodeficiencia humana. Frente al avance de las ciencias naturales y de las consecuencias sociales que lo acompañan, la ciencia jurídica debe progresar para lidiar con estas nuevas realidades. En base a ello, el presente estudio se propone investigar la obligación estatal de reglamentar políticas públicas que contemplen técnicas de reproducción asistida, puesto que la integralidad del derecho a la salud y a la planificación familiar debe abarcar al grupo-objeto de esta investigación. Se utilizaron el método deductivo y técnicas de revisión de la literatura, enfocándose en la legislación brasileña vigente, en monografías de bioderecho y en resoluciones del Consejo Federal de Medicina acerca del tema.

Public Policy , Reproductive Techniques , HIV Seropositivity
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(5): 1383-1388, out.-dez. 2019.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1022100


Objective: The study's main purpose has been to assess the life transformations that occurred in seropositive women regarding their sexuality. Methods: This is an integrative literature review with descriptive characteristics and a qualitative approach, which has analyzed 7 articles published between 2008 and 2017, in the following databases SciELO, LILACS, MEDLINE, BDENF and CUIDEN. Results: The presence of seropositivity in women has influenced their sexuality by revealing the following attitude changes: they were more likely to avoid relationships; they felt lonely or uncomfortable talking about HIV with their partners; they were afraid to spread the virus; they have addressed increasing their responsibility towards condom use, as well as negotiating with their partners to do the same. Conclusion: It was found that the HIV-positive diagnosis interferes directly with women's sexuality, then affecting loving relationships and modifying their quality of life

Objetivo: Investigar as transformações ocorridas em mulheres soropositivas frente à sua sexualidade. Métodos: Trata-se de um estudo descritivo com abordagem qualitativa do tipo revisão integrativa, do qual foram analisados 7 artigos publicados entre os anos de 2008 e 2017, nas bases de dados Scielo, Lilacs, Medline, Bdenf e Cuiden. Resultados: A soropositividade em mulheres influenciou na sua sexualidade ao revelar as seguintes mudanças de atitudes: se fecharam para relacionamentos; se sentiram solitárias ou desconfortáveis para conversar sobre o HIV com o parceiro; apresentaram medo de contaminar; revelou aumento da responsabilidade do uso de preservativo e da negociação com o parceiro para uso do mesmo. Conclusão: Constatou-se que o diagnóstico de HIV positivo interfere diretamente na sexualidade feminina, afetando os relacionamentos afetivos e modificando sua qualidade de vida

Objetivo: Investigar las transformaciones ocurridas en mujeres seropositivas frente a su sexualidad. Métodos: Se trata de un estudio descriptivo con abordaje cualitativo del tipo revisión integrativa, del cual se analizaron 7 artículos publicados entre los años 2008 y 2017, en las bases de datos Scielo, Lilacs, Medline, Bdenf y Cuiden. Resultados: La seropositividad en mujeres influenció en su sexualidad al revelar los siguientes cambios de actitudes: se cerraron para relaciones; se sintieron solitarias o incómodas para conversar sobre el VIH con el compañero; presentaron miedo de contaminar; reveló un aumento de la responsabilidad del uso del preservativo y de la negociación con el socio para su uso. Conclusión: Se constató que el diagnóstico de VIH positivo interfiere directamente en la sexualidad femenina, afectando las relaciones afectivas y modificando su calidad de vida

Humans , Female , HIV Seropositivity/psychology , Sexuality/psychology , Sexual Health