Your browser doesn't support javascript.
loading
Montrer: 20 | 50 | 100
Résultats 1 - 7 de 7
Filtre
1.
An. acad. bras. ciênc ; 76(4): 727-741, Dec. 2004. tab, graf
Article Dans Anglais | LILACS | ID: lil-388264

Résumé

Embora os protocolos de prevenção da transmissão materno-infantil do HIV tenham diminuído a infecção pediátrica pelo HIV nos países desenvolvidos, um grande número de crianças ainda se infectam nas nações em desenvolvimento. Dados disponíveis de infecção pediátrica são entretanto ainda escassos. Neste trabalho, nós conduzimos um levantamento clínico, laboratorial e genotípico de um grande coorte de crianças infectadas pelo HIV em acompanhamento em dois grandes centros de atendimento de HIV/AIDS pediátrica do Rio de Janeiro. Crianças em tratamento anti-retroviral, bem como crianças recentemente diagnosticadas e ainda virgens de tratamento foram analisadas. A prevalência de mutações de resistência às drogas, beem como as respostas imunológicas e virológicas ao tratamento foram avaliadas. Além disso, as frequências dos subtipos do HIV-1 e a sua distrbuição ao longo da epidemia de HIV/AIDS no Brasil foram estudadas. Nós observamos uma alta prevalência de mutações de resistência em vírus de crianças em tratamento, ao passo que o grupo virgem de tratamento não possuía mutações. Apesar dos altos níveis de mutações nas crianças tratadas, uma significativa melhora de sua condição imunológica foi observada. A distribuição de subtipos do HIV-1 seguiu as tendências da população adulta, com o aparecimento de subtipos não-B e de formas recombinantes após 1990. Dentro do nosso conhecimento, este é o maior coorte pediátrico de HIV/AIDS já analisado no Brasil, e os resultados obtidos são de suma importância para um melhor entendimento da evolução do HIV/AIDS em um contexto pediátrico.


Sujets)
Humains , Nourrisson , Enfant d'âge préscolaire , Enfant , Adolescent , Agents antiVIH , Résistance virale aux médicaments , Infections à VIH , VIH-1 (Virus de l'Immunodéficience Humaine de type 1) , Mutation , ARN viral , Brésil , Études de cohortes , Études transversales , Génotype , Prévalence
2.
Indian J Pediatr ; 2003 Aug; 70(8): 615-20
Article Dans Anglais | IMSEAR | ID: sea-80425

Résumé

OBJECTIVE: Heterosexual contact is the predominant mode of transmission among adults in India with an increasing number of women of childbearing age becoming infected with HIV. Consequently, children in India increasingly getting infected, primarily from vertical transmission. A retrospective review of the profile of HIV infected children attending an HIV clinic in South India is reported. METHODS: All HIV-infected children under 15 years of age at the time of first presentation and managed at this center between June 1996 and June 2000 are included in this report. Socio-demographic characteristics and clinical manifestation were collected in a precoded proforme. A complete physical examination and baseline laboratory investigations were performed at entry into the clinic and at subsequent follow-up. RESULTS: Fifty-eight HIV-infected children were included: thirty-nine (67.2%) were male with mean age 4 years. Perinatal transmission was the predominant mode of HIV acquisition (67%). Common clinical manifestations in these children at presentation included oral candidiasis (43%), pulmonary tuberculosis (35%), recurrent respiratory infections (26%), bacterial skin infection (21%), papulo-pruritic dermatitis (19%), hepatosplenomegaly and lymphadenopathy (14%) each and chronic diarrhea (7%). CONCLUSION: An understanding of the epidemiology of pediatric HIV infection may reveal opportunities to reduce and perhaps eliminate perinatal transmission. Knowledge of clinical manifestations in this setting will help physicians meet the management challenges presented by HIV infected children.


Sujets)
Infections opportunistes liées au SIDA/épidémiologie , Adolescent , Adulte , Répartition par âge , Thérapie antirétrovirale hautement active/statistiques et données numériques , Transfusion sanguine/statistiques et données numériques , Allaitement naturel/statistiques et données numériques , Numération des lymphocytes CD4/statistiques et données numériques , Enfant , Enfant d'âge préscolaire , Femelle , Études de suivi , Infections à VIH/traitement médicamenteux , Séroprévalence du VIH , Humains , Inde/épidémiologie , Nourrisson , Transmission verticale de maladie infectieuse/statistiques et données numériques , Mâle , Parents , Études rétrospectives , Facteurs de risque , Répartition par sexe , Facteurs socioéconomiques
3.
Braz. j. infect. dis ; 6(4): 201-205, aug. 2002.
Article Dans Anglais | LILACS | ID: lil-331030

Résumé

This report describes a case of Toxoplasma encephalitis during pregnancy of an HIV infected woman who was severely immunosuppressed (CD(4): 17 cells/mm3), had a high viral load (RNA PCR:230,000 copies/ml), was treated with sulfadiazine, pyrimethamine and folinic acid for toxoplasmosis and was being treated with highly potent antiretroviral drugs (AZT, 3TC and nelfinavir) for HIV infection. The newborn was born through an elective C-section, received six weeks of AZT according to the 076 protocol and was clinically normal at birth. Subsequently he had two RNA PCR negatives for HIV, seroreverted and had no clinical or laboratory evidence of congenital toxoplasmosis. Despite the concerns of the use of these combined therapies on the foetus during pregnancy, their efficacy illustrates that keeping the mother alive and in good health is an important strategy to protect the unborn child from acquiring these two infections.


Sujets)
Adulte , Animaux , Femelle , Humains , Nouveau-né , Grossesse , Infections opportunistes liées au SIDA/traitement médicamenteux , Infections opportunistes liées au SIDA/parasitologie , Infections à VIH/complications , Infections à VIH/transmission , Transmission verticale de maladie infectieuse , Toxoplasmose cérébrale , Agents antiVIH , Thérapie antirétrovirale hautement active , Complications infectieuses de la grossesse/traitement médicamenteux , Complications infectieuses de la grossesse/parasitologie , Complications infectieuses de la grossesse/virologie , Maladies néonatales/traitement médicamenteux , Maladies néonatales/parasitologie , Maladies néonatales/virologie , VIH (Virus de l'Immunodéficience Humaine) , Infections opportunistes liées au SIDA/transmission , Infections à VIH/traitement médicamenteux , Infections à VIH/virologie , Transmission verticale de maladie infectieuse , Toxoplasma , Toxoplasmose cérébrale , Résultat thérapeutique , Charge virale
4.
Braz. j. infect. dis ; 5(2): 78-86, Apr. 2001. tab
Article Dans Anglais | LILACS | ID: lil-301188

Résumé

Objectives: To determine the HIV vertical transmission rate (VTR) and associated risk factors by use of zidovudine and infant care education in Brazil. Methods: Since 1995, a prospective cohort of HIV infected pregnant womwn has been followed at the Federal University of Rio de Janeiro. A multidisciplinary team was established to implement the best available strategy to prevent maternal-infant HIV transmission. Patients with AIDS or low CD4 and high viral load received anti-retroviral drugs in addition to zidovudine. Children were considered infected if they had 2 positive PCR-RNA test between 1 and 4 months of age, or were HIV antibody positive after 18 months. Education regarding infant treatment and use of formula insteadof breast feeding was provided. Results: Between 199 and August, 2000. HIV status was determined for 145 infants. Compliance with intra-partum treatment, infant treatment and use of formula was 88.2 percent. Intra-partum zidovudine treatment was completed in 134/145 (92.6 percent) of patients; 88.1 percent had rupture of membranes < 4 hours; 85.4 percent of mothers were asymptomatic. The mean CD4 count was 428,4 cells and mean viral load 39,050 copies. HIV vertical transmission rate was 4/145 (2.75 percent; CI: 0.1 percent - 5.4 percent). The only risk factor significantly associated with transmission was a failure to use zidovudine intra-partum in 2 of the 4 mothers (50 percent versus 6.4 percent in non-transmitting mothers). A trend toward low CD4 and high viral load at entry, and rupture of membranes > 4 hours were associated with increased HIV transmission. Conclusion: HIV vertical transmission in Brazil was reduced to a level similar to other countries with the most effective prevention programs using a multidisciplinary team approach. A high levelof compliance for use of anti-retroviral drugs, the provision of health education to mothers, and use of formula for all exposed infants.


Sujets)
Humains , Femelle , Nouveau-né , Grossesse , VIH-1 (Virus de l'Immunodéficience Humaine de type 1) , Transmission verticale de maladie infectieuse , Équipe soignante , Syndrome d'immunodéficience acquise/prévention et contrôle , Syndrome d'immunodéficience acquise/thérapie , Syndrome d'immunodéficience acquise/transmission , Zidovudine , Éducation pour la santé , Santé Maternoinfantile , Facteurs de risque , Charge virale
5.
Rev. Inst. Med. Trop. Säo Paulo ; 43(1): 01-06, Jan.-Feb. 2001. ilus, tab
Article Dans Anglais | LILACS | ID: lil-285674

Résumé

The aim of this case series was to describe the clinical, laboratory and epidemiological characteristics and the presentation of bacillary angiomatosis cases (and/or parenchymal bacillary peliosis) that were identified in five public hospitals of Rio de Janeiro state between 1990 and 1997; these cases were compared with those previously described in the medical literature. Thirteen case-patients were enrolled in the study; the median age was 39 years and all patients were male. All patients were human immunodeficiency virus type 1 (HIV-1) infected and they had previous or concomitant HIV-associated opportunistic infections or malignancies diagnosed at the time bacillary angiomatosis was diagnosed. Median T4 helper lymphocyte counts of patients was 96 cells per mmÝ. Cutaneous involvement was the most common clinical manifestation of bacillary angiomatosis in this study. Clinical remission following appropriate treatment was more common in our case series than that reported in the medical literature, while the incidence of relapse was similar. The frequency of bacillary angiomatosis in HIV patients calculated from two of the hospitals included in our study was 1.42 cases per 1000 patients, similar to the frequencies reported in the medical literature. Bacillary angiomatosis is an unusual opportunistic pathogen in our setting


Sujets)
Humains , Adulte , Mâle , Infections opportunistes liées au SIDA/complications , Angiomatose bacillaire/complications , Infections opportunistes liées au SIDA/anatomopathologie , Angiomatose bacillaire/anatomopathologie , Angiomatose bacillaire/thérapie , Récidive , Études rétrospectives
7.
Rio de Janeiro; s.n; 1996. 68 p.
Monographie Dans Portugais | LILACS | ID: lil-181286

Résumé

Trata especificamente dos problemas obstétricos de mulheres infectadas pelo HIV. Reflete a urgência de enfrentar a atual realidade mundial da epidemiologia e clínica da infecçäo pelo HIV


Sujets)
Programme clinique , Obstétrique , Complications infectieuses de la grossesse , Syndrome d'immunodéficience acquise/embryologie , Santé des femmes , Précis
SÉLECTION CITATIONS
Détails de la recherche