Prevalencia de patología ano-rectal en pacientes portadores de VIH/SIDA / Prevalence of ano-rectal pathology in HIV/AIDS patients

Introduction: The ano-rectal pathology (ARP) is the most common surgical condition in patients with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). Our aim was to determine the current prevalence and clinical characteristics of the ARP in patients with HIV/AIDS in clinical control in the infectious diseases unit of the Hernán Henríquez Aravena Hospital in Temuco. Patients and Method: Study design: Cross section. Location and period: Infectious Diseases Unit of the hospital during the month of June 2010. Inclusion criteria: Patients with HIV/AIDS under control in the unit, medical records were analyzed and complete physical examination was performed. Results: In the period of study 384 patients were in control in the unit. Fifty had ARP which is a prevalence of 13%. Anal condyloma disease and hemorrhoidal disease were the most common diseases. Most patients (76%) were on antiretroviral therapy with good clinical response. Conclusion: The prevalence of ARP in HIV/AIDS patient has increased in recent years. This study shows a change in the pattern of presentation, being anal condyloma the most common ARP.

Introducción: La patología ano-rectal (PAR) es la afección quirúrgica más frecuente en pacientes portadores del virus de la inmunodeficiencia adquirida (VIH) y del síndrome de la inmunodeficiencia adquirida (SIDA). Nuestro objetivo fue determinar la prevalencia actual y las características clínicas de la PAR en pacientes portadores de VIH/SIDA en control clínico en la unidad de infectología del Hospital Doctor Hernán Henríquez Aravena de Temuco. Materiales y Método: Diseño de estudio: Corte transversal. Lugar y período: Unidad de Infectología del Hospital Doctor Hernán Henríquez Aravena de Temuco durante el mes de junio de 2010. Criterios de inclusión: Pacientes portadores de VIH-SIDA en control en la unidad, se analizó su historial clínico y se realizó un examen físico completo. Resultados: Durante el período 384 pacientes se encontraban en control en la unidad. Cincuenta presentaron PAR lo que constituye una prevalencia del 13%. La condilomatosis anal y la enfermedad hemorroidal fueron las patologías más frecuentes. La mayoría de los pacientes (76%) se encontraban en terapia anti-retroviral y con buena respuesta clínica. Conclusión: La prevalencia de patología ano-rectal en pacientes portadores de VIH/ SIDA se ha incrementado en los últimos años. Se aprecia un cambio en las características clínicas de presentación, siendo la condilomatosis anal la PAR más frecuente.

Neurosífilis en pacientes portadores y no portadores de VIH: descripción y comparación de dos cohortes históricas / Neurosyphilis in the patients with and without HIV infection: description and comparison of two historical cohorts

Neurosyphilis follows a more aggressive and different clinical course in HIV-infected patients compared to patients with normal immunity. Two historical series of patients with a diagnosis of neurosyphilis between 1995 and 2008 were compared: they included a group of 15 patients with y and 28 patients without HIV infection. Probability of neurosyphilis in patients with positive serum VDRL was increased in patients infected with HIV comparedto HIV negative patients (OR: 62.37 IC:95 percent (32.1-119.1) p value:< 0,001). Predominant clinical manifestations in neurosyphilis in the HIV negative group were ocular abnormality, vascular encephalic and spinal cord lesions. In the HIV positive group, they were fever, ocular abnormalities and headache. There were no differences in cerebrospinal fluid characteristics between both groups. Neurosyphilis was diagnosed even in patients with blood VDRL of < 1:32, that happened in 17.8 percent of the HIV positive patients with blood and in 60 percent of t he HIV negative patients. Penicillin sodium given at dose ¡Ý than 18.000.000 IU/day IV during 14 days was the most common treatment. In patients with clinical neurosyphilis, 93 percent of HIV negative group, and 54.2 percent of HIV positive group had persistent neurological after-effects. Three HIV positive patients died due to causes not related to neurosyphilis.