Doença arterial coronariana: Um novo paradigma na AIDS

The HIV-infected individuals have been identified as a peculiar group whose propensity to the development of abnormalities in lipids metabolism supports the hypothesis that AIDS itself can be considered as an independent risk factor for the occlusive diseases development. The AIDS progression, as well as the therapy against HIV has been capable to show an array of metabolic disturbances that HIV-infected patients are prone to. These metabolic alterations affect the fate of plasmatic lipids and homocysteine as a result of three factor mainly: (i) the viral infection per se which triggers the development of hypertriglyceridemia and hipocholesterolemia; (ii) multiple vitamins and micronutrients deficiencies, that favors an onset of hyperhomocysteinemia; (iii) the state-of-the-art therapy for HIV infection, which is accompanied to idiosyncratic effects encompassing the lipid metabolism. In this context, a variety of risk factors to atherosclerosis can be identified in the HIV-infected individual. Of note, it must be considered that once life expectancy of these patients has been expanded due to the effective therapy, on the other hand they can accelerate atherosclerotic disease or its pathological appearance in the same extent.

Impact of Epstein-Barr virus load, virus genotype, and frequency of the 30bp deletion in the viral BNLF-1 gene in patients harboring the human immunodeficiency virus

Patients infected with the human immunodeficiency virus (HIV) are at higher risk of developing Epstein-Barr Virus (EBV)-associated lymphomas. The usefulness of monitoring EBV in peripheral blood mononuclear cells (PBMCs) of patients infected with HIV has not been established. The aim of this study was to evaluate the EBV viral load in PBMCs, the frequency of viral genotypes, and the presence of the 30-bp deletion in the BNLF-1 gene. DNA samples from 156 patients attending the HIV/AIDS Day Clinic at Botucatu School of Medicine, Sao Paulo State University were evaluated. The EBV viral load was detectable by real time PCR in 123/156 (78.8%) cases and was higher in patients not receiving antiretroviral treatment or under therapeutic failure than in patients under successful highly active antiretroviral therapy (HAART) (P=0.0076). Overall, the profile of patients with high EBV viral load included elevated HIV viremia (P=0.0005), longer time of HIV diagnosis (P=0.0026), and increased levels of T CD8 + lymphocytes (P=0.0159). The successful amplification of the EBNA-2 gene by nested-PCR was achieved in 95 of 123 (77.2%) cases, of which 75.8% were EBV-1, 9.5% EBV-2, and 14.7% were co-infected with both EBV-1 and -2. The analysis of the BNLF-1 gene was possible in 99 of 123 (80.5%) cases, of which 50.5% had the 30-bp deletion. EBV-1 was more common than EBV-2, which may reflect the fact that the cohort was predominantly Caucasian and heterosexual. J. Med. Virol. 85:2110-2118, 2013. © 2013 Wiley Periodicals, Inc.

Prevalência e fatores associados á verrugas anogenitais em homens portadores de HIV/AIDS atendidos em serviço especializado

Pós-graduação em Doenças Tropicais - FMB

Atividade física e lipodistrofia em portadores de HIV/AIDS submetidos à terapia anti-retroviral

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Utilização so ácido graxo ômega-3 na hipertrigliceridemia de indivíduos com HIV/Aids: relação com níveis de citocinas

Pós-graduação em Doenças Tropicais - FMB

Impacto do tratamento anti-retroviral na ocorrência de macrocitose em pacientes com HIV/Aids do município de Maringá - Paraná

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Caracterização do atendimento multiprofissional a pessoas vivendo com HIV/AIDS em Três Lagoas (MS), com ênfase na adesão à terapia antirretroviral potente combinada

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estudo da ocorrência de atitudes discriminatórias na assistência à saúde de pessoas com HIV/AIDS

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Na companhia do vírus: concepções e vivências de adolescentes portadores do HIV/Aids

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Aplicação do instrumento HAT-QoL para análise da qualidade de vida de mulheres com infecção pelo HIV, ou com AIDS e sua correlação com variáveis sócio-demográficas, epidemiológicas e clínicas

Pós-graduação em Doenças Tropicais - FMB

Prevalence of Oral Lesions in Hospitalized Patients with Infectious Diseases in Northern Brazil

The aim of this study was to assess the prevalence of oral lesions in infectious-contagious diseases patients being treated in the University Hospital of the Federal University of Para, northern Brazil. One hundred seven patients with infectious diseases were clinically investigated for oral lesions at the University Hospital of Para, northern Brazil. From total sample, most patients were men (65.7%) with a mean age of 45.4 years. About prevalence of systemic diseases, tuberculosis was the most frequent illness, followed by AIDS, hepatitis types B and C, leishmaniasis, and meningitis. Analyzing oral manifestations, periodontal diseases and candidiasis were the most prevalent diseases in both genders, followed by recurrent aphthous ulcers, saburral tongue, simplex herpes, and squamous cell carcinoma. Of all 107 patients, only 10 males and 6 females did not present any oral manifestation. There was no statistical difference between genders with any systemic condition (P > 0.05). The great prevalence of oral manifestations in hospitalized patients with systemic disorder emphasizes the need of integral dental care in this context, aiming at a multidisciplinary approach of patients. Therefore, presence of some oral conditions, such as candidiasis, should be an alert to different systemic conditions, once in assistance with physicians; dentists can influence the early diagnosis and treatment.

Prevalência da excreção e caracterização molecular do poliomavírus humano JC em amostras de urina de pacientes com aids sem leucoencefalopatia multifocal pro-gressiva

The human poliomavirus is the etiologic agente of Progressive multifocal leukoencephalopathy (PML), a disease characterized by focal lesions not expansives of the central nervous system that develops in imunocompromissed patients, specially people with aids. The main aim of the study was to evalute the prevalence of the JCV excretion in urine samples of patients with aids, without PML, to compare two JCV DNA detection techniques through of two diferents genomic regions and to evaluate the genotypic characterization of the positive samples. A total of 75 samples were colected in the Instituto de Infectologia Emílio Ribas, in Sao Paulo, Brazil, between may and november, 2009. To detect the JC virus it was made the DNA extraction and then the polimerase chain reaction (PCR). Firstly a fragment of 215 bp was amplified, which corresponds to the codifying gene of the strutural protein of de JC vírus capsid VP1. All the samples were later submitted to another PCR that uses a pair of primers complementaries to the early region of the JCV (T antigen) amplifying a fragment of 173 bp. Followed by the digestion of the amplified product with the restriction enzime BamH1, resulting in two smaller fragments (120 bp and 53 bp). The JC vírus was detected in 53 samples, for both techniques (70,7% for VP1 PCR, and the restriction enzime BamH1), 34/46 were men (73,9%) and 19/29 were women (65,5%). The JCV excretion was higher in individuals that were over 46 years old. Regarding the seven genotypes described in the literature, the ones that were more prevalent among the JC positive patients were 3B and 3A with 10 samples each (21,0%), the 2B with 9 samples (19,0%) and genotype 6, with six samples (13,0%). As in the brown patients as the white ones, the most prevalent genotype was 3B. In the present study it was observed a high prevalence of JCV DNA (70,7%) and the genotype 3 (43,0%)... (Complete abstract click electronic access below)

Prevalence of anogenital warts in Men with HIV/AIDS and associated factors

Infection with human papilloma virus (HPV) is the most common sexually transmitted disease in the world. Among the 630 million new cases of HPV that occur each year, 30 million develop anogenital warts. Although subclinical infection with HPV is the most common cause, genital warts are also associated with immunosuppression caused by HIV. In view of the high prevalence of HPV/HIV co-infection particularly among men who have sex with men, the objectives of this study were to determine the prevalence of anogenital warts in men with HIV/AIDS and to identify associated factors. A cross-sectional study was conducted on 159 men with HIV/AIDS consecutively selected at a referral service in Botucatu, São Paulo, Brazil, in which the association between sociodemographic, behavioral and clinical variables and the presence of anogenital warts was evaluated. After hierarchical analysis of the data, variables presenting a p value ≤ 0.2 were entered into an unconditional multivariate logistic regression model. Forty-nine (31%) of the HIV-positive patients had anogenital warts. The mean age was 44.6 ± 9.6 years. The main factors associated with the presence of anogenital warts were irregular antiretroviral treatment and genital herpes(HSV). The present study demonstrate that anogenital warts occur in almost one-third of the male population infected with HIV and factors associated with a higher risk of being diagnosed with anogenital warts were irregular cART use and co-infection with HSV, other variables could not be associated.

Oral health status of people living with HIV/AIDS attending a specialized service in Brazil

Verify factors that influence the oral health status of people living with HIV/AIDS (PLWHA) in Brazil. The study was cross-sectional and includes 177 HIV-positive individuals, who answered questionnaire on the sociodemographic conditions, HIV aspects, habits, and satisfaction with the service. The oral health data were collected by means of the decayed, missing, and filled teeth (DMFT) index, use and need of dentures, and the Community Periodontal Index. Average number of the DMFT was 17.64. Most HIV-positive patients presented good periodontal status, 35.0% used dentures, 41.5% needed denture in the maxilla, and 62.0% in the mandible. In the multivariate analysis, older age and dissatisfaction with health care were associated with nonuse of dentures. The abandonment of the use of antiretroviral therapy increased the risk of PLWHA presenting more than three decayed teeth. Poor oral health of the PLWHA was mainly influenced by sociodemographic factors and use and satisfaction with service.

Vivendo com HIV/AIDS: estudos da ocorrência de discrimição nos serviços de saúde

Introduction: The discrimination experienced by people with HIV / AIDS, not only by society but also by health professionals is one of the major problems observed relative the epidemic. Objective: To verify and to analyze the occurrence of discriminatory attitudes in the assistance to the health of people living with HIV/AIDS. Methods: It was a quantitative research was carried out with the participation of sixty-eight HIV-positive individuals from four Brazilian cities. The participants answered auto-administrate questionnaires that contained open and closed questions including the considered subject. Results: 41.2% of the total participants, HIV + people, said they had been discriminated against by health professionals. Among the discriminatory situations experienced by HIV patients, 34.2% nursing professionals were involved, in 34.2% dentists and in 31.6% doctors were involved. Those who have suffered discrimination, 78.6% said they had been discriminated against in public health service. Conclusion: The occurrence of discrimination in the assistance to the health of HIV-positive patients was high. The majority of discrimination situations occurred in the public health service. It is necessary the institution of strategies aiming at human attendance to these patients.