Factores de riesgo asociados a la transmisión madre-hijo del VIH en los pacientes del CAPACITS de Veracruz / Risk factors associated with mother-to-child transmission of HIV in the patients of CAPACITS in Veracruz, Mexico

La infección por el virus de la inmunodeficiencia humana (VIH) puede adquirirse por transmisión perinatal, y el riesgo de adquirirla ha aumentado porque en los últimos años la epidemia ha tomado un patrón heterosexual, lo que aumenta el número de mujeres infectadas, un riesgo potencial para la transmisión perinatal. Objetivo: Determinar los factores de riesgo asociados a la transmisión vertical en recién nacidos hijos de madres con VIH atendidas en el Centro de Atención a Pacientes con Infecciones de Transmisión Sexual y SIDA (CAPACITS) de Veracruz. Material y métodos: Se realizó un estudio de cohorte retrospectivo de una población de madres VIH+ e hijos que acudieron al CAPACITS de Veracruz en el periodo comprendido entre 2007-2012. Se revisaron los expedientes de mujeres embarazadas y sus recién nacidos atendidos en el CAPACITS, y los resultados se analizaron con estadística descriptiva y mediante la prueba de χ² y regresión logística. Resultados: Se estudiaron 50 mujeres que solicitaron control prenatal. Las variables estudiadas fueron factores asociados en la madre y factores relacionados con el recién nacido. En relación al tratamiento antirretroviral en la muestra, nueve embarazadas (18%) no tomaron ningún tratamiento; dos de sus hijos se infectaron. De los casos de madres con tratamiento, ninguno de sus hijos se infectó. Considerando las variables relacionadas con infección en el producto, una madre sin esquema de tratamiento fue el factor principal para el contagio del niño, en segundo lugar fue el conteo de CD4 < 200 células/mm³ y en tercer lugar la carga viral materna. Conclusión: El resultado de nuestro estudio predice que la positividad de los recién nacidos depende del tratamiento antirretroviral de la madre.

HIV infection can be acquired through perinatal transmission. The risk of acquiring this infection has been increased in recent years because the epidemic has taken a heterosexual pattern, which has caused a growth in the number of infected women and a potential risk for perinatal transmission. Objective: To determine the risk factors associated with vertical transmission in newborns to HIV-positive mothers at the Care Center for Patients with Sexually Transmitted Infections and AIDS (CAPACITS) in Veracruz, Mexico. Material and methods: We conducted a retrospective cohort study of a population of HIV-positive mothers and their newborns, who sought care at the CAPACITS of Veracruz between 2007 and 2012. The records of controlled mothers and their children were analyzed using descriptive and inferential statistics. Results: The study was performed in 50 women. The variables studied were: associated factors in mothers and associated factors in newborns. Concerning the antiretroviral treatment in the sample of mothers, nine (18%) did not take any treatment; two of their children became infected. In the case of treated mothers, none of their children became infected. Considering the infection-related variables in the product, the main factor for the spread of the infection to the children was a mother without treatment schedule and, in second place, a CD4 count < 200 cells/mm³. Conclusions: The results of our study predict that the positivity of the newborn depends on the maternal antiretroviral treatment.

[Abdominal and gastrointestinal symptoms of Dengue fever. Analysis of a cohort of 8559 patients]. / Síntomas abdominales y gastrointestinales del dengue. Análisis de una cohorte de 8.559 pacientes.

INTRODUCTION/AIM: Dengue fever is a common disease in tropical and subtropical regions and is characterized by fever, headache, and joint and muscle pain. Occasionally, patients develop abdominal and gastrointestinal symptoms but information about the real frequency of these manifestations is lacking. The aim of this study was to determine the frequency of abdominal and gastrointestinal symptoms in a cohort of patients with Dengue fever. PATIENTS AND METHODS: We performed a retrospective review of 8559 patients with a diagnosis of Dengue fever during the 2006 epidemic to determine the frequency of abdominal and gastrointestinal symptoms. RESULTS: Abdominal and gastrointestinal symptoms were present in 67% of patients. The most frequent symptom was nausea (n=4453, 52%), followed by abdominal pain (n=3058, 36%), vomiting (n=2477, 29%), diarrhea (n=1471, 17%), hepatomegaly, (n=144, 2%), gastrointestinal bleeding (n=34, 0.3%) and ascites (n=8, 0.1%). Hospitalization was required in 1640 patients (19%), of which 1210 (74%, p=0.0001) had some abdominal and gastrointestinal symptoms. In this group, the most frequent symptoms were nausea (n=972, 59%), abdominal pain (n=692, 42%), vomiting (n=668, 41%) and diarrhea (n=393, 24%). Among patients admitted to our hospital for Dengue, 70% showed alterations in liver function tests. CONCLUSIONS: Our findings suggest that close to 67% of patients with Dengue fever have abdominal and gastrointestinal symptoms or abnormalities in liver function tests. Abdominal and gastrointestinal symptoms were significantly more frequent in patients who were hospitalized. The differential diagnosis of an acute febrile syndrome with abdominal pain or gastrointestinal symptoms in patients living in endemic areas or who have recently travelled to certain regions should include Dengue fever.

Síntomas abdominales y gastrointestinales del dengue. Análisis de una cohorte de 8.559 pacientes / Abdominal and gastrointestinal symptoms of Dengue fever. Analysis of a cohort

Introducción/objetivo: El dengue es una enfermedad común en áreas tropicales y subtropicalesque se caracteriza por fiebre, cefalea, artralgia y mialgia. Ocasionalmente, los pacientesdesarrollan síntomas abdominales y gastrointestinales (SAGI), sin embargo, existe poca informaciónrespecto a la frecuencia real de estas manifestaciones. El objetivo de este estudio fuedeterminar la frecuencia de SAGI en una cohorte de pacientes con dengue.Pacientes y métodos: Se realizó una revisión retrospectiva de 8.559 pacientes con diagnósticode dengue durante la epidemia del a˜no 2006 para determinar la frecuencia de los SAGI.Resultados: El 67% de los pacientes presentaron SAGI. La náusea fue el síntoma más frecuente(n = 4.453, 52%) seguida del dolor abdominal (n = 3.058, 36%), vómito (n = 2.477, 29%), diarrea(n = 1.471, 17%), hepatomegalia (n = 144, 2%), esplenomegalia (n = 43, 0,5%), sangrado digestivo(n = 34, 0,3%) y ascitis (n = 8, 0,1%). Se hospitalizaron a 1.640 pacientes (19%) de los cuales1.210 (74%, p = 0,0001) presentaban algún SAGI. En este grupo los síntomas más frecuentesfueron náusea (n = 972, 59%), dolor abdominal (n = 692, 42%), vómito (n = 668, 41%) y diarrea(n = 393, 24%). En el grupo de los pacientes hospitalizados con dengue en el HRAEV el 70%presentó alteraciones en las pruebas de función hepática.Conclusión: Nuestros hallazgos indican que cerca del 67% de los pacientes con dengue presentanSAGI o alteraciones de pruebas de función hepática. La frecuencia de SAGI fue significativamentemayor en pacientes hospitalizados. El diagnóstico diferencial de un síndrome febrilagudo con síntomas gastrointestinales en pacientes en áreas endémicas o con historia de viajea ciertas regiones con antecedentes epidémicos debe incluir al dengue (AU)

Introduction/aim: Dengue fever is a common disease in tropical and subtropical regions andis characterized by fever, headache, and joint and muscle pain. Occasionally, patients developabdominal and gastrointestinal symptoms but information about the real frequency of thesemanifestations is lacking. The aim of this study was to determine the frequency of abdominaland gastrointestinal symptoms in a cohort of patients with Dengue fever.Patients and methods: We performed a retrospective review of 8559 patients with a diagnosisof Dengue fever during the 2006 epidemic to determine the frequency of abdominal andgastrointestinal symptoms.Results: Abdominal and gastrointestinal symptoms were present in 67% of patients. The mostfrequent symptom was nausea (n = 4453, 52%), followed by abdominal pain (n = 3058, 36%),vomiting (n = 2477, 29%), diarrhea (n = 1471, 17%), hepatomegaly, (n = 144, 2%), gastrointestinalbleeding (n = 34, 0.3%) and ascites (n = 8, 0.1%). Hospitalization was required in 1640 patients(19%), of which 1210 (74%, p = 0.0001) had some abdominal and gastrointestinal symptoms. Inthis group, the most frequent symptoms were nausea (n = 972, 59%), abdominal pain (n = 692,42%), vomiting (n = 668, 41%) and diarrhea (n = 393, 24%). Among patients admitted to ourhospital for Dengue, 70% showed alterations in liver function tests.Conclusions: Our findings suggest that close to 67% of patients with Dengue fever have abdominaland gastrointestinal symptoms or abnormalities in liver function tests. Abdominal andgastrointestinal symptoms were significantly more frequent in patients who were hospitalized.The differential diagnosis of an acute febrile syndrome with abdominal pain or gastrointestinalsymptoms in patients living in endemic areas or who have recently travelled to certain regionsshould include Dengue fever (AU)