Evaluation of late presentation for HIV treatment in a reference center in Belo Horizonte, Southeastern Brazil, from 2008 to 2010

Introduction: Since 1996 Brazil has provided universal access to free antiretroviral therapy, and as a consequence, HIV/AIDS patients' survival rate has improved dramatically. However, according to scientific reports, a significant number of patients are still late presenting for HIV treatment, which leads to consequences both for the individual and society. Clinical and immunological characteristics of HIV patients newly diagnosed were accessed and factors associated with late presentation for treatment were evaluated. Methods: A cross-sectional study was carried out in an HIV/AIDS reference center in Belo Horizonte, Minas Gerais, in Southeastern Brazil from 2008 to 2010. Operationally, patients with late presentation (LP) for treatment were those whose first CD4 cell count was less than 350 cells/mm3 or presented an AIDS defining opportunistic infection. Patients with late presentation with advanced disease (LPAD) were those whose first CD4 cell count was less than 200 cells/mm3 or presented an AIDS defining opportunistic infection. LP and LPAD associated risk factors were evaluated using logistic regression methods. Results: Five hundred and twenty patients were included in the analysis. The median CD4 cell count was 336 cells/mm3 (IQR: 130-531). Two hundred and seventy-nine patients (53.7%) were classified as LP and 193 (37.1%) as LPAD. On average, 75% of the patients presented with a viral load (VL) >10,000 copies/ml. In multivariate logistic regression analysis the factors associated with LP and LPAD were age, being symptomatic at first visit and VL. Race was a factor associated with LP but not with LPAD. Conclusion: The proportion of patients who were late attending a clinic for HIV treatment is still high, and effective strategies to improve early HIV detection with a special focus on the vulnerable population are urgently needed. .

Evaluation of late presentation for HIV treatment in a reference center in Belo Horizonte, Southeastern Brazil, from 2008 to 2010.

INTRODUCTION: Since 1996 Brazil has provided universal access to free antiretroviral therapy, and as a consequence, HIV/AIDS patients' survival rate has improved dramatically. However, according to scientific reports, a significant number of patients are still late presenting for HIV treatment, which leads to consequences both for the individual and society. Clinical and immunological characteristics of HIV patients newly diagnosed were accessed and factors associated with late presentation for treatment were evaluated. METHODS: A cross-sectional study was carried out in an HIV/AIDS reference center in Belo Horizonte, Minas Gerais, in Southeastern Brazil from 2008 to 2010. Operationally, patients with late presentation (LP) for treatment were those whose first CD4 cell count was less than 350 cells/mm(3) or presented an AIDS defining opportunistic infection. Patients with late presentation with advanced disease (LPAD) were those whose first CD4 cell count was less than 200 cells/mm(3) or presented an AIDS defining opportunistic infection. LP and LPAD associated risk factors were evaluated using logistic regression methods. RESULTS: Five hundred and twenty patients were included in the analysis. The median CD4 cell count was 336 cells/mm(3) (IQR: 130-531). Two hundred and seventy-nine patients (53.7%) were classified as LP and 193 (37.1%) as LPAD. On average, 75% of the patients presented with a viral load (VL) >10,000 copies/ml. In multivariate logistic regression analysis the factors associated with LP and LPAD were age, being symptomatic at first visit and VL. Race was a factor associated with LP but not with LPAD. CONCLUSION: The proportion of patients who were late attending a clinic for HIV treatment is still high, and effective strategies to improve early HIV detection with a special focus on the vulnerable population are urgently needed.

Atributos químicos de um Latossolo espacialmente relacionados com aprodutividade e componentes de produção do feijão em Selvíria (MS) / Chemical attributes at Oxisol spatialy related to common been productivity and yield features in Selvíria (MS)

O feijão-comum (Phaeseolus vulgaris L.) destaca-se nos hábitos alimentares dos países latino-americanos por possuir grande importância na dieta nutricional no provimento de proteínas, ferro e carboidratos, sendo o Brasil o maior produtor mundial deste legume. Na safra agrícola 2006/2007, no município de Selvíria, MS, localizado no Cerrado Brasileiro, foi avaliada a variabilidade espacial do feijoeiro, em função dos atributos químicos de um Latossolo Vermelho distroférrico pelo sistema de cultivo mínimo, irrigado com pivô central. Objetivou-se selecionar, entre os atributos do solo pesquisado, aquele com a melhor correlação, linear e espacial, para explicar a variabilidade da produtividade do feijoeiro. Foi instalada uma malha geoestatística para a coleta de dados do solo e das plantas, com 117 pontos amostrais, em uma área de 2025 m2 com declive homogêneo de 0,055 m m-1. A produtividade de grãos de feijão (PRG), número de vagens por planta (NVP), número de grãos por vagem (NGV), número de grãos por planta (NGP) e massa de cem grãos (MCG), representaram os atributos da planta, enquanto que P, MO e pH, representaram os atributos químicos solo coletados em três profundidades (0,00-0,10 m, 0,10-0,20 m e 0,20-0,30 m). A média produtividade de grãos do feijoeiro foi consequência de uma menor população de plantas que esse sistema proporcionou, o que pode ter sido causado pela diminuição do conteúdo de matéria orgânica.(AU)

The common bean (Phaseolus vulgaris L.) stands out in the eating habits of Latin Americans for having great importance in providing the nutritional diet of protein, iron and carbohydrates, with Brazil being the largest producer of the vegetable. In the season 2006/2007, in Selvíria, MS , located in the Brazilian Cerrado, we evaluated the spatial variability of bean, depending on the chemical properties of Oxisol using a minimum tillage system, irrigated with center pivot. The objective of this work was to select the soil attributes that have the best spatial and linear correlation, to explain the variability of common bean grain yield. A geostatistical grid, with 117 sampling points, was installed to collect the soil and plant data in an area of 2.025 m2 with homogeneous slope of 0.05 5m m-1. The common bean grain yield (GY), number of haricot per plant (NHP), number of grains per haricot (NGH), number of grains per plant (NGP) and weight of one hundred grains (DHG), represented the attributes of the plants, while P, OM, pH, were the soil chemical attributes collected at three depths (0.00-0.10 m, 0.10-0,20 m e 0.20-0.30 m). The average common bean grain yield was a consequence of lower plant population provided by that the system, this may have been caused by a decrease in organic matter content.(AU)

Atributos químicos de um Latossolo espacialmente relacionados com aprodutividade e componentes de produção do feijão em Selvíria (MS) / Chemical attributes at Oxisol spatialy related to common been productivity and yield features in Selvíria (MS)

O feijão-comum (Phaeseolus vulgaris L.) destaca-se nos hábitos alimentares dos países latino-americanos por possuir grande importância na dieta nutricional no provimento de proteínas, ferro e carboidratos, sendo o Brasil o maior produtor mundial deste legume. Na safra agrícola 2006/2007, no município de Selvíria, MS, localizado no Cerrado Brasileiro, foi avaliada a variabilidade espacial do feijoeiro, em função dos atributos químicos de um Latossolo Vermelho distroférrico pelo sistema de cultivo mínimo, irrigado com pivô central. Objetivou-se selecionar, entre os atributos do solo pesquisado, aquele com a melhor correlação, linear e espacial, para explicar a variabilidade da produtividade do feijoeiro. Foi instalada uma malha geoestatística para a coleta de dados do solo e das plantas, com 117 pontos amostrais, em uma área de 2025 m2 com declive homogêneo de 0,055 m m-1. A produtividade de grãos de feijão (PRG), número de vagens por planta (NVP), número de grãos por vagem (NGV), número de grãos por planta (NGP) e massa de cem grãos (MCG), representaram os atributos da planta, enquanto que P, MO e pH, representaram os atributos químicos solo coletados em três profundidades (0,00-0,10 m, 0,10-0,20 m e 0,20-0,30 m). A média produtividade de grãos do feijoeiro foi consequência de uma menor população de plantas que esse sistema proporcionou, o que pode ter sido causado pela diminuição do conteúdo de matéria orgânica.

The common bean (Phaseolus vulgaris L.) stands out in the eating habits of Latin Americans for having great importance in providing the nutritional diet of protein, iron and carbohydrates, with Brazil being the largest producer of the vegetable. In the season 2006/2007, in Selvíria, MS , located in the Brazilian Cerrado, we evaluated the spatial variability of bean, depending on the chemical properties of Oxisol using a minimum tillage system, irrigated with center pivot. The objective of this work was to select the soil attributes that have the best spatial and linear correlation, to explain the variability of common bean grain yield. A geostatistical grid, with 117 sampling points, was installed to collect the soil and plant data in an area of 2.025 m2 with homogeneous slope of 0.05 5m m-1. The common bean grain yield (GY), number of haricot per plant (NHP), number of grains per haricot (NGH), number of grains per plant (NGP) and weight of one hundred grains (DHG), represented the attributes of the plants, while P, OM, pH, were the soil chemical attributes collected at three depths (0.00-0.10 m, 0.10-0,20 m e 0.20-0.30 m). The average common bean grain yield was a consequence of lower plant population provided by that the system, this may have been caused by a decrease in organic matter content.