Navegando por Assunto "Terapia antirretroviral"

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Alterações endócrinas e metabólicas em pacientes HIV positivos com lipodistrofia
(Universidade Federal do Pará, 2007-11-30) YAMANO, Ernesto Yoshihiro Seki; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
Lipodystrophy is one of the complications of highly active antiretroviral therapies (HAART). This study evaluates the metabolic and endocrine changing in patients with lipodystrophy. Forty patients were evaluated and classified as lipoatrophy, lipohypertrophy and mixed syndrome. We analyzed insulin resistance for HOMA-IR (Homeostasis Model Assesment Insulin Resistance), fasten glucose and OGTT, urea, creatinine, TSH, Free T4, cortisol, DHEA, ratio cortisol/DHEA, prolactin, testosterone (in male), FSH, LH and estradiol (in female), total cholesterol, LDL-c, HDL-c, uric acid. Anthropometrics measures (Weight, height, body mass index, waist, hip and skin folds thickness), ultrasonographic exams for evaluate hepatic steatosis and measure of bone density. The isolated lipohipertrophy occurred only in female (p<0,05). The mean of age was similar in the groups, without changing in the distribution by age group. Dyslipidemia occurred in all groups after HAART (lipodystrophy mixed, 100%, lipohypertrophy, 80% and lipoatrophy, 70%). Antropometric data showed waist increased in the female with lipohypertrophy (98+ 13,4) and decreased in female with lipoatrophy (76,8 + 6,1). Patients with lipoatrophy have been eutrophic (82,4%) and patients with lipohypertrophy have overweight or obesity (60%). Male was associated with osteoporosis (p < 0,05). We found elevated prevalence of the dyslipidemia (85%) and metabolic syndrome (37,5%) in all groups. The metabolic syndrome was associated with lipohypertrophy. No significant changes were found in the thyroid, cortisol, cortisol/DHEA ratio, testosterone, FSH, LH and prolactina. Conclusions: Female is associated with isolated lipohypertrophy, metabolic syndrome and insulin resistance. Male is related with Osteopenia and osteoporosis. Hepatic steatosis were common, but is not influenced for a type of lipodystrophy. Hormonal changing were unusual events in lipodystrophy.
Acesso aberto (Open Access)
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.
Acesso aberto (Open Access)
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).
Acesso aberto (Open Access)
Avaliação do risco cardiovascular em pacientes com lipodistrofia secundária a terapia antirretroviral: critérios de framingham, índice tornozelo-braço e medida da espessura da camada medio-intimal da carótida
(Universidade Federal do Pará, 2011-12-16) KOURY JUNIOR, Adib; LIBONATI, Rosana Maria Feio; http://lattes.cnpq.br/3818175484709618
The use of combination antiretroviral therapy has significantly reduced mortality and morbidity in patients infected by HIV virus. However, this treatment may cause metabolic alterations such as dyslipidemia, glucose intolerance, insulin resistance and lipodystrophy. The clinical and laboratorial consequences that follow these alterations may raise the risk for cardiovascular diseases. This research aimed to investigate the epidemiological, clinical and laboratorial aspects of patients with lipodystrophy associated to raise cardiovascular risk, ankle-brachial index (ABI) and measurement of the carotid intima-media thickness (cIMT). For so, it was performed a Transversal analytical study with 62 patients with lipodystrophy using highly active antiretroviral therapy (HAART) with ages varying from 29 to 68, followed up in the outpatient unit of lipodystrophy of João de Barros Barreto University Hospital. The patients were submitted to anamnesis with clinical examination, blood collection for laboratorial tests with glycemia dosage, total cholesterol and its fractions, triglycerides and ultrasensitive PCR, measurement of the ankle-brachial index and measurement of the carotid intima-media thickness through mode B ultrasonography. The patients were classified according to their cardiovascular risks through the criteria of the Framingham Score. The variables were analyzed by the study of the measurements of central trend and the hypotheses were analyzed by the chi-square Test and/or the Fisher exact Test. The prevalence of alteration of the ABI in the studied sample was 21% and of the patients with a increase of the cIMT was 48.4%. According to the Framingham score, 53.2% of the patients presented low risk to a cardiovascular event in a 10 year range, 16.1% of moderate risk and 30.7% of high risk. A patient with a increase of the cIMT presented a larger cardiovascular risk through the Framingham score. Male, age, increase of the abdominal circumference have presented a significant association with the carotid intima-media thickness cIMT.
Acesso aberto (Open Access)
Representações sociais sobre a Aids e a Terapia Anti-Retroviral: influências no tratamento de pessoas vivendo com HIV/Aids
(Universidade Federal do Pará, 2010) CUNHA, Janaina Barbosa Gomes; BARRETTO, André Maurício Lima; http://lattes.cnpq.br/3046718437592588; CHAVES, Ernani Pinheiro; http://lattes.cnpq.br/5741253213910825
As Antiretroviral therapy evolves, AIDS has acquired chronic disease characteristics especially in those countries in which access to medication is actually guaranteed. Brazil has become a model country since it has a health care program that has presented good results towards epidemic control. In November 1996, the Brazilian National Health Care System announced a law which established the mandatory nature of free access to antiretroviral medicat ion for all those who needed it. The obtained results with treatment – that is, progressive reduction of viral load and maintenance and/or reestablishment of immune system functioning – have been associated to outstanding benefits on physical health of HIV-positive patients which allow these people to resume and materialize their life projects. However, universal access to medication that enables free-of-cost treatment for HIV carriers still faces adherence issues. Considering a more restricted understanding, adherence may be defined as a person’s behavior – such as taking medicine, following guidelines of a diet or adopting changes in life style – that relates to recommendations established by the health care team. In this context, this study proposes to analyzing HIV-positive subjects´ social representations of antiretroviral treatment and its implications on their adherence process to it, therefore featuring images and meanings these HIV-positive individuals who have adhered or not adhered to antiretroviral therapy have about this kind of treatment and its consequences on their lives as well as standing out the objectifications and anchorages that form their social representations. Methodology was based on theoretical formulations about qualitative research, prioritizing interviews focused on Explicitness Method of Underlying Speech. These interviews were held at Parasite and Infectious Diseases Special Reference Unit – this unit belongs to the network of Pará State Health Secretariat health care units – and at João de Barros Barreto University Hospital, more specifically at Parasite and Infectious Diseases Clinical Unit.