ABSTRACT
Introduction: HIV disease was transformed from a fatal condition to one with metabolic complications. In Mexico City, the associated factors for prediabetes in this population are unknown; investigating it is relevant to improve their quality of life. Objective: To determine the risk association factors for prediabetes in people living with HIV. Material and methods: Cross-analytical, retrospective study. Records of patients living with HIV were reviewed, exposure factors and fasting glucose concentration were recorded. Patients from 18 to 65 years of age were included, on co-formulated antiretroviral treatment, without adjustment of antiretroviral treatment in the last two years, with a BMI of 18.5-40 kg/m2. Results: 148 patients were included, 68 presented prediabetes. The factors with risk association that were identified are: age over 60 years (OR 9.48, 95% CI 1.68-40.13), treatment with Efavirenz/Tenofovir/Emtricitabine (OR 9.28, 95% CI 2.55-33.74) and treatment time antiretroviral older than 12 months (OR 2.53, 95% CI .912-7.041). Conclusion: The prevalence of prediabetes in people living with HIV is 46%. The main associated factor was the consumption of Atripla. This study has clinical relevance since it will allow the implementation of prevention, diagnosis and treatment strategies for prediabetes in order to reduce associated morbidity and mortality.
Introducción: la enfermedad por VIH ha pasado de ser un padecimiento mortal a uno con complicaciones metabólicas. En la Ciudad de México se desconocen los factores asociados para prediabetes en esta población, investigarlo es relevante para mejorar su calidad de vida. Objetivo: determinar los factores con asociación de riesgo para prediabetes en personas que viven con VIH. Material y métodos: estudio transversal-analítico, retrospectivo. Se revisaron expedientes de pacientes que viven con VIH, registrándose los factores de exposición y la concentración de glucosa en ayuno. Se incluyeron pacientes de 18 a 65 años, en tratamiento antirretroviral coformulado, sin ajuste de tratamiento antirretroviral en los últimos dos años, con IMC de 18.5-40 kg/m2. Resultados: se incluyeron 148 pacientes, 68 presentaron prediabetes. Los factores con asociación de riesgo que se identificaron son: edad mayor de 60 años (OR: 9.48, IC95%: 1.68-40.13), tratamiento con Efavirenz/Tenofovir/Emtricitabina (OR: 9.28, IC95%: 2.55-33.74) y tiempo de tratamiento antirretroviral mayor de 12 meses (OR: 2.53, IC95%: 0.912-7.041). Conclusión: la prevalencia de prediabetes en personas que viven con VIH es del 46%. El principal factor asociado fue el consumo de Atripla. Este estudio tiene relevancia clínica ya que permitirá implementar estrategias de prevención, diagnóstico y tratamiento de prediabetes con la finalidad de reducir la morbimortalidad asociada.
Subject(s)
HIV Infections , Prediabetic State , Humans , Child, Preschool , Middle Aged , Prediabetic State/diagnosis , Prediabetic State/epidemiology , Prediabetic State/etiology , HIV , Quality of Life , Retrospective Studies , HIV Infections/complications , HIV Infections/drug therapy , HIV Infections/epidemiologyABSTRACT
The care of elderly patients requires an evaluation that deserves a host of special considerations, such as biological aspects of aging, those related to activities of daily living and functionality, neuro-psychological conceptions, family dynamics and economic conditions. The growth of the aging population in our country is accompanied by an increase in chronic diseases and more individuals have greater vulnerability, requiring a more consumption of resources because of the high demand for services. This requires the incorporation of specialized care in the institutional system, which has caused serious consequences in the current health system, benefiting specialization and technology, but with a loss of an integrated and horizontal view of the patient. Therefore it is necessary to develop a practical tool that allows the family physician to identify and differentiate the geriatric population that requires specialized care from who does not, identifying problems that may improve and allow the design of strategies to improve health status and maintain functional autonomy of the elderly. Comprehensive Geriatric Assessment (CGA) is a fundamental tool for clinical practice of any medical care to the elderly.
