RESUMO
BACKGROUND: Anemia, neutropenia, and thrombocytopenia are commonly observed in HIV-infected patients. This study was undertaken to evaluate the prevalence of cytopenias and their association with CD4 count. Furthermore, the association of hemoglobin concentration with mortality was also investigated. METHODS: We reviewed the data of 701 HIV-infected patients followed at our institution. Blood cell counts, hemoglobin concentration, CD4 count, and viral load were recorded. We also recorded the mortality rate after 1 year in the groups with CD4 <200/µl and ≥ 200/µl according to hemoglobin concentration. RESULTS: Of the total patients, 37.5% had anemia; 61.1% (110/180) were in the low CD4 group and 29.4% (153/521) were in the high CD4 group (p<0.01). Mean neutrophil counts were 2.610 × 10(9)/l and 3.204 × 10(9)/l in the low CD4 and high CD4 groups, respectively (p<0.01); mean platelet counts were 218.639 × 10(9)/l and 234.807 × 10(9)/l for the low CD4 and the high CD4 groups, respectively (p=0.03). Patients whose hemoglobin concentration was below the median value had a higher death rate in both the low CD4 (14 vs. 4 deaths, p=0.013) and high CD4 (8 vs. 1 death, p=0.0158) groups. CONCLUSIONS: We found an association between CD4 count and hemoglobin level, neutrophil count, and platelet count, and that anemia was independently associated with a higher mortality.
Assuntos
Infecções por HIV/sangue , HIV-1/isolamento & purificação , Doenças Hematológicas/epidemiologia , Adolescente , Adulto , Idoso , Anemia/complicações , Anemia/epidemiologia , Fármacos Anti-HIV/farmacologia , Contagem de Células Sanguíneas , Brasil/epidemiologia , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , HIV-1/genética , Doenças Hematológicas/complicações , Hemoglobinas/análise , Hemoglobinas/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Neutropenia/complicações , Neutropenia/epidemiologia , RNA Viral/sangue , Estudos Retrospectivos , Trombocitopenia/complicações , Trombocitopenia/epidemiologia , Carga Viral , Adulto Jovem , Zidovudina/farmacologiaRESUMO
Acute Chagas' disease corresponds to the initial period of a Trypanosoma cruzi infection. Levosimendan is a positive inotropic drug with vasodilatory properties that is indicated for acute heart failure. We describe two cases of myocarditis due to acute Chagas' disease, resulting from oral intake of sugar cane juice infected with T. cruzi and resulting complications. Both developed acute decompensated heart failure refractory to Dobutamine. We describe for the first time in the medical literature the use of Levosimendan for myocarditis due to acute Chagas' disease, with excellent clinical and hemodynamic results.
