RESUMO
BACKGROUND: Highly active antiretroviral therapy for HIV-infected patients is associated with metabolic side effects, which could cause an increased cardiovascular risk in these patients. Non-invasive study of endothelial function by brachial artery ultrasound can detect subclinical atherosclerosis. Several studies have assessed endothelial function in HIV-infected patients with associated cardiovascular risk factors. OBJECTIVES: The aim of this study is to determine endothelial function in HIV-infected patients under antiretroviral therapy with low or mild coronary risk and lipid levels within the normal range. METHODS: Transversal study including 28 HIV-infected adults (15 receiving antiretroviral therapy and 13 naive) with low or mild cardiovascular risk and 12 healthy controls. Subjects with diabetes mellitus, hypertension, cardiovascular disease, obesity, high cholesterol or high triglyceride levels were excluded. Endothelial function was determined with flow-mediated dilation (FMD) of the brachial artery by ultrasound study. RESULTS: Treated HIV-infected patients had significantly lower FMD (5.93 +/- 3.56) than healthy controls (10.64 +/- 3.08, P = 0.008). Naive patients had an intermediate FMD, but this was not statistically significant. CONCLUSIONS: HIV-infected patients receiving antiretroviral therapy who have low or mild cardiovascular risk and lipid levels within the normal range have endothelial dysfunction compared with healthy controls.
Assuntos
Fármacos Anti-HIV/efeitos adversos , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/fisiopatologia , Endotélio Vascular/fisiopatologia , Infecções por HIV/complicações , Adulto , Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Doenças Cardiovasculares/induzido quimicamente , Estudos Transversais , Endotélio Vascular/efeitos dos fármacos , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Vasodilatação/efeitos dos fármacosRESUMO
Multicentric reticulohistiocytosis is a rare systemic disease. The patients usually develop an erosive polyarthritis in a few years. The most effective treatment is still unclear due to the few reports published of this disease. We report a case of multicentric reticulohistiocytosis with clinical, histopathologic and immunohistochemical study. The patient was treated with cyclophosphamide and nonsteroidal antiinflammatory drugs with an infrequent long-term survival.
