RESUMO
In order to discriminate general from aetiology-specific risk factors for immune reconstitution inflammatory syndrome (IRIS), we followed up, during six months, 99 patients with advanced HIV infection commencing antiretroviral therapy (ART) without active opportunistic infections or evident inflammation. IRIS predictors were determined by univariate analysis using clinical data from 76 ART-responding patients either completing follow-up or developing IRIS, and by multivariate analysis of inflammation, disease progression and nutrition status variables. We identified 23 primary IRIS events (30.3%). Univariate predictors for all IRIS events were higher platelet counts and lower CD4/CD8 ratio, whereas subclinical inflammation was the multivariate predictor. Platelets, alkaline phosphatase levels and %CD8 T-cells in univariate analysis also predicted mycobacteria-associated IRIS independently, remaining elevated during follow-up. Herpesvirus IRIS was predicted by platelets and inflammation. Indicators of advanced HIV disease and subclinical inflammation jointly predict IRIS, and some are specific of the underlying microbial aetiology, possibly explaining previous reports.
Assuntos
Antirretrovirais/uso terapêutico , Terapia Antirretroviral de Alta Atividade/métodos , Infecções por HIV/tratamento farmacológico , Síndrome Inflamatória da Reconstituição Imune/epidemiologia , Síndrome Inflamatória da Reconstituição Imune/etiologia , Adulto , Relação CD4-CD8 , Feminino , Herpesviridae/imunologia , Herpesviridae/patogenicidade , Infecções por Herpesviridae/imunologia , Infecções por Herpesviridae/patologia , Humanos , Síndrome Inflamatória da Reconstituição Imune/microbiologia , Síndrome Inflamatória da Reconstituição Imune/virologia , Masculino , Mycobacterium/imunologia , Mycobacterium/patogenicidade , Contagem de Plaquetas , Fatores de Risco , Tuberculose/imunologia , Tuberculose/patologiaAssuntos
Humanos , Masculino , Adolescente , Adulto , Pessoa de Meia-Idade , Etanol , Contração Miocárdica , Ventrículos do Coração , Fonocardiografia , EcocardiografiaRESUMO
The use of a reduced solution of phosphomolybdic acid for the precipitation of phenothiazine derivatives offers excellent conditions for the assay of these compounds. The quantitative assay range for each of the phenothiazine derivatives was determined by the precipitation, proportionality, in accordance with the procedure used for chlorpromazine. The conditions offered by the new method make it possible to assay 12 phenothiazine derivatives.
