ABSTRACT
No disponible
Subject(s)
Humans , Time Factors , Patient Compliance , Anti-Retroviral Agents , Antiretroviral Therapy, Highly Active , HIV Infections , HIV-1ABSTRACT
No disponible
Subject(s)
Humans , HIV-1 , Patient Compliance , HIV Infections , Anti-HIV Agents , Antiretroviral Therapy, Highly Active , Pharmaceutical PreparationsSubject(s)
Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/drug therapy , Antiretroviral Therapy, Highly Active/methods , Lipodystrophy , Acidosis/prevention & control , Antioxidants/therapeutic use , Humans , Hypercholesterolemia/epidemiology , Lipodystrophy/drug therapy , Lipodystrophy/etiology , Lipodystrophy/physiopathologyABSTRACT
No disponible
Subject(s)
Humans , Lipodystrophy , Antiretroviral Therapy, Highly Active , Antioxidants , Acquired Immunodeficiency Syndrome , Acidosis , HypercholesterolemiaABSTRACT
No disponible
Subject(s)
Humans , Risk Factors , Syndrome , HIV-1 , HIV Infections , Anti-HIV Agents , LipodystrophySubject(s)
Drug Resistance, Viral , HIV Infections/drug therapy , Female , HIV Infections/immunology , HIV Infections/prevention & control , HIV Infections/virology , HIV Seropositivity/drug therapy , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications/drug therapy , Treatment Failure , Viral LoadABSTRACT
OBJECTIVE: To analyze the influence of anti-retroviral therapy (ART) and prophylaxis against opportunist disease on survival of patients with AIDS. PATIENTS AND METHODS: Study of AIDS patients diagnosed from January 1996 to October 1997 in a Madrid hospital. An analysis was made of demographic, clinical, and immunological data, as well as ART and prophylaxis against Pneumocystis carinii pneumonia (PCP) and tuberculosis (TB). Both univariate and multivariate analyses were performed, as well as Kaplan-Meier curves. RESULTS: A total of 205 patients were included in the study (83% male) with a median age of 34 years. ART, PCP prophylaxis, and TB prophylaxis were received by 147 (72%), 141 (69%) and 22 (11%) patients, respectively. Among individuals on ART, the likelihood of survival at 12 and 22 months since diagnosis of AIDS was made was 79% and 76%, respectively, and among non treated individuals 54% and 54%, respectively (p < 0.05). ART was associated with a 57% decrease in death risk, and regarding PCP prophylaxis, no benefit on survival was found. CONCLUSIONS: ART was significantly associated with a lower risk of death among AIDS patients. The survival rate was not increased with PCP prophylaxis.
Subject(s)
AIDS-Related Opportunistic Infections/mortality , AIDS-Related Opportunistic Infections/prevention & control , Anti-HIV Agents/therapeutic use , Pneumonia, Pneumocystis/mortality , Pneumonia, Pneumocystis/prevention & control , Tuberculosis/mortality , Tuberculosis/prevention & control , AIDS-Related Opportunistic Infections/immunology , Adult , CD4 Lymphocyte Count , Female , Follow-Up Studies , Humans , Male , Retrospective Studies , Risk , Survival RateABSTRACT
Objetivo. Analizar la influencia del tratamiento antirretrovírico (ARV) y de la profilaxis para enfermedades oportunistas en la supervivencia de pacientes con síndrome de la inmunodeficiencia adquirida (SIDA).Pacientes y métodos. Estudio de seguimiento de los casos de SIDA diagnosticados entre enero de 1996 y octubre de 1997 en un hospital de Madrid. Se analizaron datos demográficos, clínicos, inmunológicos, tratamiento ARV y profilaxis para neumonía por Pneumocystis carinii (NPC) y tuberculosis (TB). Se realizó un estudio univariado, multivariado y curvas de Kaplan-Meier. Resultados. Se incluyeron 205 pacientes (83 por ciento varones); mediana de edad: 34 años. Recibieron tratamiento ARV 147 (72 por ciento), profilaxis para NPC 141 (69 por ciento) y profilaxis para TB 22 (11 por ciento). En los pacientes con tratamiento ARV la probabilidad de supervivencia a los 12 y 22 meses del diagnóstico de SIDA fue de 79 por ciento y 76 por ciento, y en los no tratados de 54 por ciento y 54 por ciento, respectivamente (p < 0,05). El tratamiento ARV se asoció con una reducción del riesgo de muerte del 57 por ciento, sin encontrarse beneficio independiente en la supervivencia en relación con la profilaxis para NPC. Conclusiones. El tratamiento ARV se asocia significativamente con un menor riesgo de muerte en los pacientes con SIDA. La profilaxis para NPC no incrementó la supervivencia (AU)
Subject(s)
Adult , Male , Female , Humans , Risk , Tuberculosis , Survival Rate , AIDS-Related Opportunistic Infections , Anti-HIV Agents , CD4 Lymphocyte Count , Pneumonia, Pneumocystis , Retrospective Studies , Follow-Up StudiesABSTRACT
BACKGROUND: Primary cavity-based lymphomas (PCBL) represent and uncommon group on non-Hodgkin lymphomas associated with AIDS. They present as malignant effusions with no bone marrow or lymph node involvement, although some cases with bone marrow infiltration at advanced stages have been reported. Tumoral cells are monoclonal and are occasionally infected with human herpesvirus type-8 (HHV-8). PATIENTS AND METHODS: The clinical and evolutive characteristics of six HIV-positive patients with PCBL were analysed. In three of them the presence of genetic sequences of HHV-8 in peripheral blood lymphocytes and lymphomatous effusions was investigated by PCR. RESULTS: The mean age of patients was 37 years and 5 were males. The only female patient had been drug abuser, four males were homosexuals and the other promiscuous heterosexual. The mean CD4+ lymphocyte count was 84 x 10(6)/l (range: 20-180) and all of them had been diagnosed of AIDS. The presentation forms were as pericardial effusion in one case, pleural effusion in three and tumoral ascites in two. Two of the male patients had also Kaposi sarcoma (KS). At diagnosis none of them had infiltration of the bone marrow nor lymphadenopathy. Most malignant cells had immunoblastic traits. The effusions had the characteristics of an exudate and the mean value of lactate dehydrogenase (LDH) was 5,255 IU/l (range: 1,500-11,483). In the three cases investigated there was HHV-8 DNA in the lymphocytes present in the lymphomatous effusion and in peripheral blood. The mean survival after diagnosis was 89 days (7-240). The female patient died without therapy seven days after admission and the five male patients were treated with chemotherapy with a poor response. CONCLUSIONS: HIV-related PCBL associated or not with KA appear in severely immunodepressed patients, their behaviour is very aggressive and its clinical course fatal in a short period of time. The are often associated with KS and HHV-8 seems to be the involved causative agent.
Subject(s)
HIV Infections/complications , Lymphoma, Non-Hodgkin/complications , AIDS-Related Opportunistic Infections/complications , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/diagnosis , Adult , Female , HIV Infections/diagnosis , Herpesviridae/isolation & purification , Herpesviridae Infections/complications , Herpesviridae Infections/diagnosis , Humans , Immunophenotyping , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, Non-Hodgkin/mortality , Male , Middle Aged , Prognosis , Sarcoma, Kaposi/complications , Time FactorsABSTRACT
A cross-sectional study was conducted at diagnosis of HIV infection in 42 patients aged > or = 60 years attended in two hospitals in the Madrid Community. Clinical and epidemiologic characteristics were retrospectively analyzed. Mean age was 64 years, 38 patients (90.4%) were males, and 24 (57.1%) met the AIDS criteria at diagnosis. Risk behaviour: 14 (33.3%) heterosexuals, 13 (30.9%) homosexuals, 3 (7.1%) bisexuals, 3 (7.1%) had received blood derivatives, 2 (4.7%) transfused patients, 1 (2.3%) parenteral drug abuser, 1 (2.3%) others and 5 (11.9%), unknown. In 18 (42.8%) patients there was a delay of diagnosis of 7.5 +/- 1.2 months (range: 1.5-24 months). These patients had lymphocyte counts lower than those diagnosed without delay (102 +/- 20 vs 262 +/- 67.10(9)/l, p < 0.01). Patients without AIDS criteria had a likelihood of 15.4% of progression towards AIDS at one year. The survival rate of patients with AIDS at one year was 50.1%. Patients with AIDS and diagnostic delay had a survival rate at one year lower than that in patients without diagnostic delay (30.7% vs 77.8%, p = 0.03). In summary, a predominant sexual transmission was found in our series. Delay of diagnosis entails a greater clinical and immunologic deterioration and a lower survival at one year. Early diagnosis and therapy with anti-retroviral agents might induce a longer survival in these patients.
