Navegando por Assunto "HIV (Vírus)"

Agora exibindo 1 - 20 de 36

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Abandono do tratamento de tuberculose em co-infectados TB/HIV
(2010-06) RODRIGUES, Ivaneide Leal Ataíde; MONTEIRO, Larissa Lima; PACHECO, Régia Hevelline Barros; SILVA, Sílvio Éder Dias da
This study aimed at analyzing the reasons that patients co-infected with tuberculosis and HIV leave the treatment of tuberculosis and to know the conduct of the health team toward that abandonment. The study, using a qualitative approach, performed semi-structured interviews on 45 professionals working at a referral health center in Pará state. Two units emerged based on the thematic analysis: patient-associated factors that make TB treatment adherence difficult; and service-associated factors that contribute to treatment abandonment. It was found that, in terms of the patients, that their low socioeconomic condition was the most common factor that led to abandonment. Other factors that led to this outcome included the adverse drug effects, the use of illegal drugs, and poor personal motivation. Regarding the service, issues related to the physical structure, working process organization and accessibility were also relevant to their non-adherence. Results show there is a need to change the practices performed at the health care services.
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Adesão ao tratamento anti-retroviral por cuidadores de crianças e adolescentes soropositivos de uma Unidade de Saúde do Estado do Pará
(Universidade Federal do Pará, 2007-02) BRANCO, Caroline Mota; FERREIRA, Eleonora Arnaud Pereira; http://lattes.cnpq.br/6600933695027723
The adhesion to treatment has been receiving a lot of attention in Health´s Psychology these years. Studies in this area reveal that the patients who don't take part in the treatment cannot receive benefits of therapeutical intervention. The literature about adhesion in the anti-retroviral´s treatment reveals that is the caretaker who usually has the responsibility for managing soropositive children and teenager´s treatment. This study aims to describe the standard adhesion of caretakers treatment who live in the State of Pará, identifying the variables that interfere in their participation. It still reveals the types of cope strategies used to deal with the adverse conditions of soropositivity. For that, it was carried out a descriptive study, of transverse cut, with 30 caretakers, enrolled in the “Unidade de Referência Materno-infantil e Adolescente do Estado do Pará” (UREMIA), using, as instruments of data collection, an interview with caretakers - which investigated socialdemografic, clinical and psicosocial children and teenager's aspects - and the “Escala Modos of Enfrentamento de Problemas” (EMEP). Concerning to caretakers participation, it was observed that some conditions facilitated the treatment´s adhesion. Those conditions were related to varied of family organization (such as the number of people that lived in a house), to the history of treatment interruption and the self-report of caretakers about the fulfilment standard which should be emitted about the success (or failure) of the adhesion. The influence of those varied demonstrated the influence of behavior control made by rules, because the caretakers emitted the fulfillment standard classified as "adhesion" in order to avoid being in contact with the aversive consequences of the non-continuation of the treatment. Concerning to the cope strategies, it was showed a major grade for Factor 3, emphasizing the use of strategies focused on religious practices and/or imaginative thoughts. This research verified that the caretakers of the sample avoided thinking about the soropositivity problem as it is really constituted, using religious thoughts or "magic" to continue working with the daily routine of the subject coping, which involved the condition of children and teenager’s soropositivity. Based on all this data, this research suggests that more studies should be carried out in order to investigate themes related to the function of social contigences about the behavior of children and teenager’s caretakers from Pará, and also investigate aspects concerned to the diagnosis revealing.
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Adesão ao tratamento por cuidadores de crianças e adolescentes soropositivos para o HIV
(2011-12) SALLES, Caroline Mota Branco; FERREIRA, Eleonora Arnaud Pereira; SEIDL, Eliane Maria Fleury
This study aimed to investigate the pattern of adherence of caregivers of HIV seropositive children and adolescents and to identify the coping strategies against the stressors of seropositivity. The 30 caregivers that participated in the study responded to a semi-structured interview and a scale of how to cope with problems. A clinical record was used as a secondary data source. The caregivers were classified in an adhesion group (n=25) and non-adhesion group (n=5), based on their behavior related to the use of antiretroviral medicaments and other criteria. No significant differences were found in coping strategies between the groups, except in the strategy based on religiosity/fantasy thinking. The results provide a basis for interventions aimed at reducing psychosocial impacts of HIV.
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Análise do dano neural em pacientes hansenianos e na coinfecção HIV/ Hanseníase através de duas coortes clínicas
(Universidade Federal do Pará, 2013) BATISTA, Keila de Nazaré Madureira; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
In Brazil where leprosy is endemic and where HIV infection continues to expand and internalizing, if expected to find an increased prevalence of individuals living with both leprosy and HIV / AIDS, but there are few reports on the neurological damage that can cause overlapping. The aim of this study was to investigate nerve damage in leprosy leprosy patients coinfected with human immunodeficiency virus, compared with leprosy coinfected not at the beginning of treatment and at discharge, through two clinical cohorts. The sample consisted of 99 patients of whom 46 had coinfection MH / HIV and only 53 leprosy, these patients were seen at the outpatient clinic of the Center for Tropical Medicine and evaluated by the Simplified Technique. As a result there was a predominance of males, aged between 15 and 45 and the origin of the Metropolitan Region of Belém In group coinfection MH / HIV were prevalent in these paucibacillary patients and the presence of neuritis , abnormal sensitivity , motor abnormalities, presence of disability and neural damage was higher in this group than in the MH. In group predominated MH multibacillary patients and the presence of these neuritis, abnormal sensitivity, motor abnormalities, presence of disability and nerve damage was higher in this group than in coinfected MH / HIV. Monitoring of patients coinfected MH / HIV there was a small reduction in the presence of failure and nerve damage while in the MH group monitoring the presence of disability remained increased and nerve damage. In the Kaplan-Meier survival analysis was found that in patients MH was maintaining the chance of the patient remains without nerve damage, while in the coinfected patients group, was observed a reduction in the chance of the patient to keep without nerve damage the end of treatment. Thus it is concluded that the neural damage behaves differently in the two groups manner, predominantly in the paucibacillary group coinfected patients coinfected and not in multibacillary patients, but with the same gravity, which is troubling since diagnosing this damage at the beginning of the appearance of leprosy is still a problem for public health.
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Atenção em saúde aos casos de coinfecção hiv/hanseníase em uma área hiperendêmica para hanseníase na Amazônia
(Universidade Federal do Pará, 2016-07-01) ALBUQUERQUE, Nahima Castelo de; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
This study aimed to evaluate the primary health care to patients co-infected patients with HIV/leprosy in hyperendemic area for leprosy in the Amazon. This is a descriptive, exploratory study, evaluation of health services, with quantitative and qualitative approaches. They were interviewed twenty people diagnosed with HIV and leprosy who were followed up at the clinic of Center Tropical Medicine. It was used an adaptation of the assessment instrument of primary health care performance, containing sociodemographic and clinical informations, gateway, health services used, integration of care actions, Free Association of Words Test and stories of feelings related to the diagnosis of co-infection. The quantitative evaluation was conducted by the description of frequencies. Qualitative evaluation was categorized by the free association of data words according to the stimuli to HIV, leprosy and quality of health care. The results of the subjective questions of the interviews were analyzed based on thematic content. The study was approved by the Research Ethics Committee of the Center Tropical Medicine of Pará State University, under the CAEE Nº 49477115.1.0000.5172. It was identified a predominance of males, aged 40 to 59 years old, brown race, low socioeconomic level and derived from the city of Belem-Para. There was a predominance of patients diagnosed with Aids and antiretroviral therapy. In relation to leprosy there was parity between the clinical forms and, consequently, of paucibacillary and multibacillary cases. Regarding the health services used, coinfected patients were attend essentially by specialized services and have no link with the PHC. Unfamiliarity has been observed about the health services available in the network. In interpreting evocations and discourses prevail speeches related to feelings of death, fear, sadness, concern and questions related to diagnosis of HIV and leprosy. About the changes in daily life, stand out the inability to work and the largest health care. The results shows the need for strengthening PHC in the context of public policies for HIV/Aids and leprosy control, to make it the main gateway for patients, regardless of cases of co-infection, ensuring access on a expanded health perspective. We conclude that despite the satisfaction of users and the services provided in secondary care, the current health care model does not consider the singularities co-infection users of HIV/leprosy.
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Avaliação da efetividade da farinha da casca do maracujá sobre as alterações metabólicas secundárias à terapia antirretroviral em pacientes portadores de síndrome Lipodistrófica
(Universidade Federal do Pará, 2010-09-01) MARQUES, Simone do Socorro Fernandes; SABAA-SRUR, Armando Ubirajara Oliveira; http://lattes.cnpq.br/9777905758332275; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
Anatomical and metabolic changes are common in individuals with HIV who use high-Retroviral Therapy (HAART). We conducted a clinical trial to evaluate the effectiveness of using flour of passion fruit peel (FCM) associated with the Dietary Guideline on the metabolic changes secondary to HAART in patients with lipodystrophy in lipodystrophy clinic of the Hospital Universitário João de Barros Barreto. We evaluated 36 adult patients of both sexes, people with HIV with lipodystrophy syndrome in use of HAART. These individuals were divided into two groups (n = 18 each), group 1 received 30 grams daily FCM for 90 days associated with dietotherapeutic counseling, group 2 received only dietotherapeutic counseling. The metabolic changes were analyzed before and after intervention. The results were analyzed by BioEstat 5.0 and Diet Pro and significance level p <0.05. There was greater prevalence of males, age 40-49 years, singles and family income 1-3 times the minimum wage. The majority had 10-15 years time of HIV diagnosis and the same time the use of HAART. The scheme was first prescribed HAART 1 or 2 NRTIs + 2 IP. Lipoatrophy syndrome was more prevalent and the metabolic syndrome was detected in 19.4% of the sample. Most patients presented diagnostic nutritional Eutrophic. There was no significant difference between the two groups mentioned in any of these variables, demonstrating the homogeneity of the groups. The use of FCM was effective in reducing plasma levels of total cholesterol after 30 days of use, without, however, changing its classification, there was improvement in the plasma levels of LDL - c after the use of FCM for 90 days and improvement category (increased LDL - c rating - great) there was an increase in HDL - c after 90 days of consumption of FCM without improvement in the classification of lipoproteins, there was a decrease of plasma levels of triglycerides after 30 days of FCM and improvement category. There were no changes in blood glucose after the use of FCM. Individuals who used the FCM showed a lower risk of developing coronary artery disease after 90 days of use. There was no difference between the two groups regarding the consumption of the main components of food. The use of 30 grams of FCM for 90 days associated with the Dietary Guideline is effective in improving plasma levels of total cholesterol, LDL - c, HDL – c, Triglycerides without interfering with blood glucose values.
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Avaliação da marcha e do equilíbrio em pacientes portadores de síndrome lipodistrófica secundária à terapia antirretroviral
(Universidade Federal do Pará, 2013-09-25) LIMA, Ramon Costa de; CALLEGARI, Bianca; http://lattes.cnpq.br/0881363487176703; SILVA FILHO, Manoel da; http://lattes.cnpq.br/2032152778116209
The Acquired Immune Deficiency Syndrome (AIDS ) is a disease that devastates the world's population decades and hear this diagnosis was like a " death sentence " . With the advent of new drug therapies, characteristic of the acute disease has become a chronic condition . However , the drugs used in antiretroviral therapy (ART ) have adverse reactions , especially when the patient is subjected to long-term use of so-called "cocktail " . One of the side effects of ART is lipodystrophy , which causes the molecular scale adpócitos apoptosis and mitochondrial alterations in the muscle fibers . Thus, the objective of this study was to investigate the effects of muscle Lipodystrophy and changing patterns of gait and balance of patients in this clinical contexto. Were evaluated 38 subjects of both sexes, divided into two groups: HIV positive with lipodystrophy (HIVL) and HIV positive without lipodystrophy (HIV). The balance test was used a force platform (EMGSystem of Brazil), which evaluates the displacement of the pressure Center (Cop) in the anteroposterior directions (AP) and mediolateral (ML) of the individual generating the variables the total linear displacement, total area of displacement and displacement velocity amplitude of the displacement at a time of sixty seconds for each collection. For the gait test we used the 8-channel Electromyograph (EMGSystem of Brazil) to capture the electrical signals of the muscles Rectus Femoral (RF), biceps femoral (BF), gastrocnemius Lateral (GL), anterior tibialis (TA) and Gluteus Médius (GMD) during ambulation and processing of electromyographic signal was made through the mathematical model Root Mean Square (RMS), and normalized by maximum voluntary contraction (MVC). The results of each group were expressed as mean and standard deviation and compared using the Student t test for parametric samples and the Mann-Whitney test for nonparametric samples. Analysis of the results in the two phases of the gait cycle showed significant differences. In the phase of support and swing phase electromyographic signals of GMD and TA muscle were higher in HIVL group for HIV group. As for the balance variables with statistical significance when comparing the groups were the total displacement and displacement area, both higher in HIVL group for HIV group. Thus we conclude that patients with lipodystrophy syndrome showed changing patterns of gait and balance.
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Avaliação do polimorfismo genético das apolipoproteínas A1 e A5 em pacientes HIV positivos com síndrome lipodistrófica no estado do Pará
(Universidade Federal do Pará, 2012-06-13) DUTRA, Claudia Daniele Tavares; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
Introducion: Dyslipidemia is one of the metabolic changes caused by using antiretroviral therapy (ART) in HIV patients with lipodystrophy syndrome. Objective: To evaluate the genetic polymorphisms of apolipoproteins A1 and A5 in HIV patients with lipodystrophy in use of antiretroviral therapy and its association with dyslipidemia. Methods: It´s a cross-sectional and analytical study. We used a research protocol which studied conditions sociodemographic, clinical risk factors (physical activity, smoking, drinking, food frequency) for dyslipidemia, and biochemical assessment of the apolipoproteins A1 and A5 polymorphisms. Results: Of the 105 HIV-positive patients studied, 63.8% were men, mean age of 44.5 (± 9.4) years, 70.5% reported being single and having a family income of up to three minimum wages (77,1%). The risk factors were: smoking (21%), alcohol use (43.8%), physical inactivity (69.5%), diabetes mellitus (16.2%), overweight (22.9%) and cardiovascular risk (39.1%). The most prevalent form of lipodystrophy syndrome was mixed (51.4%). Food frequency intake observed of fruits (60.8%) and vegetables (36.3%), milk and dairy products (75%) were daily. While candy and sweets (31.4%), sausages (11.7%) and fatty snacks (26.4%) were more than twice a week. And the habit of eating meat with fat apparent was common (56.9%). The observed dyslipidemia classification revealed most patients with isolated hypertriglyceridemia (30.5%) and mixed hyperlipidemia (32.4%). It was observed that the isolated hypertriglyceridemia associated with the apolipoprotein A5 gene (rs3135506, rs619054 and rs662799), and not being influenced by clinical forms of lipoatrophy. There was no presence of the apolipoprotein A1 polymorphism (Lys107-0must2) in the patients studied. Conclusion: The main factors for hypertriglyceridemia were being man and had apolipoprotein A5 gene polymorphisms (rs3135506, rs619054 and rs662799).
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Avaliação do programa de HIV/Aids na concepção dos usuários: o caso em um hospital de referência em Belém-PA
(Universidade Federal do Pará, 2010) MENDES, Marcelo Monteiro; SOUSA, Maria do Socorro Batista de; http://lattes.cnpq.br/7985347783921988; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
Study regarding the evaluation of the HIV / AIDS in a referral hospital in the design of the users. The purpose of this study was to describe the design of the users in the inpatient unit and outpatient program on HIV / AIDS in a university hospital in Belém-PA. For the study were plotted as specific objectives: to present the suggestions of users of the program to improve the development of program activities and provide minimal tools for building an evaluation model for the program. Reference was used in the landscape of HIV / AIDS, health policies in Brazil and AIDS, and evaluation of programs and services in health. The method and approach were qualitative, descriptive case study. We used a structured semi-structured interviews on the topic. The research was conducted in the dependency HUJBB, more specifically in the services of the HIV / AIDS, in which respondents were users of the NCS and hospitalized at the clinic of infectious and parasitic diseases. By analyzing the data, the lines were divided into four categories: characterization of the user as to access the service, the motivation of the user quality of service; difficulties facing the service and guidance activities, expectations for improving the program. The search result clarifies the restrictions and qualities of the program, the dissatisfaction of the user in accessing the service, the high degree of motivation and the lack of it; the main difficulties of adhering to the guidelines and program activities, such as fear to facing death, lack of resource to get the service, the prejudice faced by people with HIV / AIDS and sexual promiscuity, and user expectations for the program: fast service, better infrastructure. It concludes with the improvements that can contribute to the quality of life of users, support is enough demand for professionals to attend the program and provide comprehensive treatment to people living with HIV / AIDS seen at HUJBB program.
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Comparação do perfil nutricional de crianças soropositivas e soronegativas para o HIV
(Universidade Federal do Pará, 2011-07-07) DIAS, Rosa Maria; VIEIRA, José Luiz Fernandes; http://lattes.cnpq.br/2739079559531098
Background: Children affected by the HIV virus through vertical transmission commonly present energetic-protein malnutrition (EPM), or wasting syndrome that precedes other manifestations of the disease, compromising their normal development. Objective: to investigate the nutritional profile of serum positive to HIV virus children, comparing them to healthy children and to the reference patterns. Methods: cross-sectional descriptive study of 90 children aged 5 to 9 years, divided into two groups, matched by sex and age: one consisting of 30 seropositive children and another of 60 healthy children. The nutritional evaluation was made by anthropometry, according to the indexes of height to age (HA), weight to age (WA) and Body Mass Index to Age (BMIA), analyzed by the new curves proposed by the World Health Organization (WHO, 2007). Additional data were obtained through a semi structured interview form answered by parents or guardians of the child. In the statistical analysis, Chi-square and Exact of Fischer tests were used, with significance level of 5%. Results: Most children were masculine (60%). All HIV-positive children were using ART. The mothers of both groups, HIV positive (73.4%) and seronegative (65.0%), had education up to 8 years and lived with up to 3 minimum wages, and only 3.3% took ART during pregnancy and childbirth. The evaluation of nutritional status showed a high percentage of low weight to age (13.3%) in seropositive children, and low height to age or growth retard in both groups, mainly among HIV-positive (23.3%). In all ages and in both groups, height deficits in centimeters were observed, in relation to the corresponding reference values, although they do not present in a regular and crescent way with increasing of age. The IMCI indicated adequacy of weight to height and overweight in both groups. Conclusion: Despite serum positive children have lost speed of growth and reached lower stature, they adjusted their weight, presenting favorable nutritional status.
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Comparison between histopathologic features of leprosy in reaction lesions in HIV coinfected and non-coinfected patients
(2015-02) PIRES, Carla Andréa Avelar; MIRANDA, Mario Fernando Ribeiro de; BITTENCOURT, Maraya de Jesus Semblano; BRITO, Arival Cardoso de; XAVIER, Marília Brasil
BACKGROUND: Leprosy and HIV are diseases that have a major impact on public health in Brazil. Patients coinfected with both diseases, appear to be at higher risk to develop leprosy reactions. OBJECTIVE: The aim of this study is to describe the histopathological aspects of cutaneous lesions during reactional states in a group of patients with HIV-leprosy coinfection, compared to patients with leprosy, without coinfection. METHODS: Two groups were established: group 1 comprised of 40 patients coinfected with HIV-leprosy; group 2, comprised of 107 patients with leprosy only. Patients presenting reactional states of leprosy had their lesions biopsied and comparatively evaluated. RESULTS: Reversal reaction was the most frequent feature in both groups, with dermis edema as the most common histopathological finding. Giant cells were seen in all group 1 histopathological examinations. Dermis edema was the most common finding in patients with erythema nodosum leprosum. CONCLUSION: Few histopathological differences were found in both groups, with reversal reaction as the most significant one, although this fact should be analyzed considering the predominant BT clinical form in the coinfected group and BB form in the group without HIV. Larger prospective studies in patients with HIV-leprosy coinfection are needed to confirm and broaden these results.
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Entre crianças em Belém – Pará: o dito na convivência com a AIDS
(Universidade Federal do Pará, 2006-02-15) PARENTE, Francilene de Aguiar; ANTONAZ, Diana; http://lattes.cnpq.br/7547028254641362
The purpose of this dissertation is to study if, and by which means, children living with HIV/aids perceive their condition mainly, but not only, by means of bodily evidences causing changes in daily life. The comparison with the life of other children, added to bodily experience, allows the construction of a meaningful world, which functions as a counterpoint to silence. Mother-son relationship is to be emphasised as the main focus of this research, in which, both verbal and non-verbal categories are considered, as means of apprehending reality. The use of qualitative methods reveals silence as a meaningful code.
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Epidemiologia espacial e sorológica da hanseníase no estado do Pará
(Universidade Federal do Pará, 2013) BARRETO, Josafá Gonçalves; KITRON, Uriel; http://lattes.cnpq.br/4693583802608442; SALGADO, Claudio Guedes; http://lattes.cnpq.br/2310734509396125
Leprosy remains a severe public health problem in the State of Pará, Brazil. Over 80,000 cases were detected during the last 20 years in Pará, and currently, the annual case detection rate (50/100,000 inhabitants) is three-fold higher than the Brazilian average. The main objective of this study was to develop a method combining anti-PGL-I serology and spatial epidemiology as a tool for reducing the leprosy disease burden in Pará. An initial cross-sectional survey was conducted in eight municipalities of Pará at the residences of people reported to be affected by leprosy during the last five to six years. A group of researchers with experience treating leprosy patients, including dermatologists, nurses, physical therapists and lab technicians, performed a dermatoneurologic clinical examination and collected blood samples to test for anti-PGL-I IgM in 1,945 household contacts (HHC) of the 531 reported cases. Additionally, 1,592 school children (SC), aged 6-20 years, from 37 randomly selected elementary and secondary public schools underwent the same clinical and serologic evaluation. The residential addresses of reported leprosy cases and the residences of the examined SC were georeferenced to determine the spatial distribution pattern of leprosy. Two years later, based on the previous serological data, we returned to two cities to re-examine the same subjects. To evaluate the significance of geographic information in detecting new cases, we also selected two new public schools located in high-risk areas for leprosy. High-risk areas were determined by the spatial analysis of the distribution of cases in one municipality. During the initial survey, 156 (8%) HHC and 63 (4%) SC were diagnosed as new leprosy cases; 806 (41.4%) HHC and 777 (48.8%) SC tested positive for anti-PGL-I. Spatial analysis of one selected municipality demonstrated heterogeneity in the distribution of leprosy cases, with spatial clusters of high and low detection rates in specific regions of the city (p<0.01). Additionally, 94.7% of the initially examined SC lived within less than 200 meters of a leprosy case registered during the six years prior to this study. During follow-up, the incidence of leprosy was significantly higher among seropositive individuals (22.3%) when compared to seronegative individuals (9.4%) (OR = 2.7; 95%CI = 1.29 – 5.87; p = 0.01); leprosy rates were also significantly higher among dwellers of residences with at least one seropositive subject (17.4%), compared with dwellers of residences with no seropositive subjects (7.4%) (OR = 2.6; 95%CI = 1.18 – 5.91; p = 0.02). Selecting schools located in areas of the city at high-risk of leprosy increased the efficiency of detecting new cases among SC (8.2%) when compared to randomly selected schools (4%) (p = 0.04). The data indicate a high rate of undiagnosed leprosy cases and of subclinical infection with M. leprae in the State of Pará. Anti-PGL-I serology and spatial epidemiology are effective tools to increase the early detection of new cases, and these methods should be used by the municipalities of Pará to help reach leprosy control targets.
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Epidemiological and oral manifestations of HIV-positive patients in a specialized service in Brazil
(2008-12) PEDREIRA, Erick Nelo; CARDOSO, Camila Lopes; BARROSO, Éder do Carmo; SANTOS, Jorge André de Souza; FONSECA, Felipe Paiva; TAVEIRA, Luís Antônio de Assis
The purpose of this study was to evaluate the prevalence of oral lesions in HIV-positive patients attending the Specialized Service for Infectious-contagious Diseases and Parasitoses of the Health Secretariat of the State of Pará (URE-DIPE/SESPA), in the city of Belém, PA, Brazil. A total of 79 HIV-positive patients (53 males and 26 females) were examined. Clinical and epidemiological evaluations were done by correlating the lesions with gender, race, chronological age, risk behavior and prevailing immune status (CD4+ cells count). Lesion location and the presence of associated factors, such as alcohol use, smoking and denture wearing, were quantified individually for each type of lesion using a diagnostic pattern based on the clinical aspects. Approximately 47% of the patients (n=37) presented some type of oral lesion. Candidiasis (28%) and periodontal disease (28%) were the most common, followed by cervical-facial lymphadenopathy (17.5%). Other lesions observed were hairy leukoplakia, melanin hyperpigmentation, ulcerative stomatitis (aphthous), herpes simplex, frictional keratosis and pyogenic granuloma. This analysis presented some relevance as to the statistical data. Concerning CD4+ cells, most lesions manifested with the reduction of the CD count. There were a larger number of HIV-positive female heterosexual patients. Alcohol and/or smoking were strongly associated with the occurrence of hairy leukoplakia in these patients. Candidiasis and periodontal disease were the most common oro-regional clinical manifestations in the patients.
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Epidemiological aspects of retrovirus (HTLV) infection among Indian populations in the Amazon Region of Brazil
(2003-08) ISHAK, Ricardo; VALLINOTO, Antonio Carlos Rosário; AZEVEDO, Vânia Nakauth; ISHAK, Marluísa de Oliveira Guimarães
HTLV was initially described in association with a form of leukemia in Japan and a neurological disease in the Caribbean. It was soon shown that HTLV-II was endemic among Amerindians and particularly among Brazilian Indians. The Amazon Region of Brazil is presently the largest endemic area for this virus and has allowed several studies concerning virus biology, the search for overt disease, epidemiological data including detailed demographic data on infected individuals, clear-cut geographic distribution, definition of modes of transmission and maintenance within small, epidemiologically-closed groups, and advances in laboratory diagnosis of the infection. A new molecular subtype named HTLV-IIc was further described on the basis of genome sequencing and phylogenetic analysis. This subtype is present in other areas of Brazil, indicating that the virus is additionally both a valuable marker for tracing past human migration routes in the Americas and a probable marker for social habits of the present human population. HIV, the other human retrovirus, is still not prevalent among indigenous communities in the Brazilian Amazon, but these groups are also easy targets for the virus.
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Estudo da frequência das neoplasias intra-epiteliais cervicais em mulheres portadoras do vírus da imunodeficiência humana
(Universidade Federal do Pará, 2003) AZEVEDO, Valéria Nascimento da Gama; FRAIHA NETO, Habib; http://lattes.cnpq.br/9202245658963683; LIMA, Fábio André Souto; http://lattes.cnpq.br/1304485376972715
Cervical cancer and its prescursor lesions are the most important gynecologic manifestations of human immunodeficiency virus infection. Thirty six women infected with human immunodeficiency vírus (HIV) and fifty four uninfected were studied to evaluate the frequency by cervical squamous intraepithelial lesions (SILs), the precursors to invasive cervical cancer. All pacients were interviewed and had a gynecologic examination including Papanicolaou (Pap) test and colposcopy. Biopsies were done on colpocopic abnormalities. The CD4 cell levels were assessed in HIV infected women and we asked about use of antiretrovíral therapy on incidence of SILs, and almost all them used the drugs. The results showed that the frequency of SILs was similar in the two groups. The most of infected women had CD4 levels over than 200 cells/mm3. They were considered immunocompetent. And thirty three women trom thirty six used antiretroviral therapy. In our study the women infected with human immunodeficiency virus, using antiretroviral therapy, with immunocompetent status, had the same frequency of SILs observed on uninfected women.
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Fatores clínicos e laboratoriais da doença pelo HIV na composição corporal, força muscular, nível de atividade física, lipodistrofia e sua repercussão na qualidade de vida
(Universidade Federal do Pará, 2014-11-28) SILVA, Luiz Fernando Gouvêa e; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
The aim of this study was to analyze the association between clinical and laboratory factors of HIV disease on body composition, muscle strength, physical activity levels, the lipodystrophy syndrome and the influence of these factors on the quality of life of patients. The sample consisted of 219 HIV-infected patients, outpatients of the municipality of Santarem - PA. Sociodemographic information, clinical and laboratory profiles of the patients were collected as well as evaluations according to body composition, grip strength, physical activity levels, lipodystrophy and quality of life. Data were analyzed descriptively and inferentially, through the facilities of the software Graphpad Prism 3.0 and BioEstat 5.0, adopting a significance level of p <0.05. Sociodemographic results showed a higher frequency in males (59%), aged 28-37 years (35.2%), eight years of schooling or more (67.6%), parda ethnicity (73%), civil singleness (50.2%), income equal to or less than 2 minimum wages (76.8%), unemployed (17.1%). Clinically, most patients were on ART (89%) had a diagnosis of Aids (51.1%), diabetes was most frequent among the comorbidities (40%), tuberculosis between the co-infections (32.56%) and toxoplasmosis among other infections (51.43%), the most commonly used regimen was AZT/3TC/EFV (43.2%) and mixed lipodystrophy predominated (44.6%). It was observed that regimen AZT/3TC/LPV-r decreases muscle mass, arm muscle area (AMA) and dominant force in relation to the scheme consisting of AZT/3TC/EFV. Regarding associations, note that BMI was associated with the time of HIV infection, the percentage of fat related to gender and income, lipodystrophy with age, use of ART, time of infection and ART, the circumference of the abdomen (CAb) with gender, age, education, duration of infection and ART, the waist-hip ratio (WHR) with age, education and time to ART. For biochemical, immunological and hemoglobin markers was no association between BMI and glucose and triglyceride, percentage fat with total cholesterol and triglycerides, lipodystrophy with viral load, triglyceride and total cholesterol, the CAb with viral load, triglyceride and hemoglobin, WHR with glucose, triglyceride and total cholesterol. The AMA was higher in patients without IP in the ART regimen, with time of infection above 50 months and in males. The strength of the dominant and non-dominant handgrip were higher for males, not brown, not using IP in ART and normal concentration of hemoglobin. In addition, patients aged 60-68 years showed values of dominant and non-dominant force lower than other age groups. According to quality of life was observed lower scores for concern related to confidentiality and financial, were the largest ever with professional confidence and concern about medication. We can concluded that the presence of lipodystrophy, inadequate CAB and WHR caused changes in total cholesterol and triglyceride. Time of HIV and high ART positively associated with lipodystrophy, changed CAB and WHR. The active patients showed better scores for the overall function, life satisfaction, concerns about confidentiality and the overall average scores compared to inactive.
Acesso aberto (Open Access)
Fatores de risco para hanseníase em portadores de HIV e AIDS em áreas de alta endemicidade na Amazônia
(Universidade Federal do Pará, 2008-07-15) MONTEIRO, Ronaldo Costa; XAVIER, Marília Brasil; http://lattes.cnpq.br/0548879430701901
In a country where leprosy is endemic and where HIV infection is still expanding and interiorizando is expected to find an increase in the prevalence of individuals living with both leprosy and HIV / AIDS. Aiming to identify risk factors for leprosy in people with HIV / AIDS and describe clinical and epidemiological aspects, there was a case control study involving 33 patients co-infected (HIV / leprosy) and 90 controls (HIV / AIDS without leprosy). In the sample studied the male was more frequent in both the co-infected as in controls, prevailed youth and young adults in both groups, Belém was the most frequent area of origin between co-infected and controls, there was no difference between family income of co-infected and controls, the co-infected patients presented with their majority in the AIDS stage with great oscillation of peripheral CD4 cells. The clinical forms most often found among those co-infected, were the paucibacillary, with the average of CD4+ cells in peripheral blood significantly higher in the group of co-infected. The probable risk factors for leprosy related to HIV infection (clinical situation, state of immunodeficiency laboratory and co-morbidity with other mycobacteriosis) were not statistically significant. Risk factors for leprosy already described in the literature, such as contacts intradomiciliares and family history of leprosy, have been shown to be significantly the risk factors for leprosy in individuals with HIV / AIDS, increasing by 45 times and 21 times respectively, the chance of becoming ill from evil of Hansen. Most co-infected showed signs and symptoms of leprosy 6 months after the start of HAART, confirming previous studies that suggest leprosy to be a disease associated with immune reconstitution in patient with HIV / AIDS. Subsequent studies are needed to complement to this and previous on this so intriguing and challenging co-infection.
Acesso aberto (Open Access)
Genotipagem do HIV-1 no Pará em pacientes experimentando falha terapêutica antirretroviral
(Universidade Federal do Pará, 2011) LOPES, Carmen Andréa Freitas; MONTEIRO, Maria Rita de Cassia Costa; http://lattes.cnpq.br/5536136455627983
Suppressive antiretroviral therapy significantly reduces morbidity and mortality related to HIV, but the emergence of resistant virus may limit the success of treatment. The objective of this study describe, in HIV / AIDS experiencing failure with antiretroviral therapy, in state of Pará, the prevalence of mutations in reverse transcriptase and protease enzymes of HIV-1 and correlate them to resistance to antiretrovirals. A descriptive, retrospective crosssectional data obtained in the Reference Unit Specialized in Special Infectious and Parasitic Diseases from Belem-Pará, profile of patients with laboratory evidence of treatment failure. This sample was represented by genotyping of fifty patients from January 2004 to December 2005. Inclusion criteria were: adherence to therapy prior to genotype, treatment failure, viral resistance profile to antiretroviral therapy and be patient of public health. We described the demographic population profile of antiretroviral therapy prior to genotyping, long known HIV infection, quantitative profile of CD4 + and viral load, in addition to genotype testing performed. The predominant resistance found in patients living in Belém (72%), males (90%) and aged 30 to 49 years old. The highest rates of mutations in reverse transcriptase of HIV-1 were: 214F (86%), 184V (76%), 215FY (56%), 211K (48%), 219QEN, 67N and 103N (42% each), 41L (32%), 70R (28%) and 210W (20%). In 46IL protease (38%), 90M (32%) and 82AFT (20%) were most prevalent among the major replacements and, among the secondary, 63P (74%), 93LM (52%), 10FIV (48%), and 35D (46%) predominated. Was attributed to selective pressures these mutations most commonly used antiretrovirals: 3TC, AZT, D4T, DDI, EFV, IDV, NFV, RTV and SQV. The use of multiple antiretroviral regimens, boosted the prevalence of these mutations, with an impact within the classes in which there was 32% complete resistance to one class, 22% two classes and 4% to three classes of antiretrovirals. We conclude that patients exposed to HAART only prior to genotyping compared to those exposed to more than one HAART had a lower prevalence of resistance to antiretrovirals, with the possibility of rescue therapy with antiretrovirals assets available at the time that was the minority however.
Acesso aberto (Open Access)
Hepatite C: prevalência e fatores de risco entre portadores do VIH/SIDA em Belém, Pará, na Amazônia brasileira
(Universidade Federal do Pará, 2004) MONTEIRO, Maria Rita de Cássia Costa; NASCIMENTO, Margarida Maria Passeri do; PASSOS, Afonso Dinis Costa; FIGUEIREDO, José Fernando de Castro
The objective of this investigation was to study the prevalence of hepatitis C virus infection and to identify possible risk factors for its transmission, in 406 adult patients with HIV/Aids who attended at public health services, in Belém city, Pará, Brazil. The anti-HCV was performed by third generation immunoenzymatic technique, and the HCV RNA by polymerase chain reaction. The overall prevalence of hepatitis C virus was 16% (CI: 12.4 - 19.6). Multivariate analysis showed association between virus C infection and age, with significant risk in the group about fifty years old or more (OR=9.75), blood transfusion (OR=4.74) and use of injecting drugs (OR=149.28). The hepatitis C virus infection was detected in 83.7% of intravenous drug users and 22.1% of transfused patients. These data indicate the efficient transmission of the virus through the percutaneous exposition and reaffirm the high risk to hepatitis C among injectable illicit drug user.