Doenças Infecciosas

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Programa de Pós-Graduação em Doenças Infecciosas

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Navegando Doenças Infecciosas por Assunto "Acquired Immunodeficiency Syndrome"

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    Análise da retenção à terapia antirretroviral de pessoas vivendo com HIV e fatores associados no Brasil de 2014 a 2022
    (Universidade Federal do Espírito Santo, 2025-03-26) Freitas, Marcelo Araújo de; Pascom, Ana Roberta Pati ; https://orcid.org/0000-0002-2646-3383; http://lattes.cnpq.br/1066727701162204; Miranda, Angelica Espinosa Barbosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; https://orcid.org/0000-0002-0763-233X; http://lattes.cnpq.br/9275784580459018; Mesquita, Fábio Caldas de; https://orcid.org/0000-0002-8297-0224; http://lattes.cnpq.br/5238492147032062; Oliveira, Maria Cristina Pimenta de ; https://orcid.org/0000-0002-4205-9786; http://lattes.cnpq.br/4908168036177095; Teixeira, Carlos Graeff ; https://orcid.org/0000-0003-2725-0061; http://lattes.cnpq.br/0464152494769261; Cerutti Junior, Crispim ; https://orcid.org/0000-0002-9485-4191; http://lattes.cnpq.br/4257067087979999
    INTRODUCTION: Retention in antiretroviral therapy (ART) is essential for controlling HIV/AIDS and reducing mortality rates worldwide. In Brazil, although ART is widely accessible, challenges remain in maintaining individuals in treatment over time. This study aimed to analyze trends in ART retention from 2014 to 2022 in the country. METHODS: This population-based study used national antiretroviral dispensing databases from the Ministry of Health to assess retention at 6, 12, 24, 36, 48, and 60 months after treatment initiation. The analysis included individuals aged 15 years or older, defining retention as a delay in medication dispensing of no more than 28 days. Additionally, a multivariate analysis was conducted for 60-month retention in the year 2022. RESULTS: The study observed over 3.4 million ART dispensations, revealing that retention steadily declined over time, with the lowest proportions observed at 60 months (71% in 2022). Men had consistently higher retention compared to women (79% vs 73% in 2022). Lower retention was found among younger age groups (74% in 2022), indigenous populations (67% in 2022), individuals with lower education levels (72% in 2022), and those residing in northern (74% in 2022) regions of Brazil. The multivariate analysis of 60-month retention in 2022 found a higher likelihood of retention among individuals without tuberculosis coinfection (OR: 1,26; IC95% 1,17 – 1,36; p=0,000). CONCLUSIONS: The study highlights significant challenges in retention, especially after prolonged ART use, with notable disparities across demographic and regional groups. The findings suggest the need for targeted interventions to improve ART retention, particularly among vulnerable populations, and may support public health policies to strengthen continuous HIV care in Brazil
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    Perfil clínico e epidemiológico de pacientes em tratamento antirretroviral atendidos na unidade dispensadora de medicamentos do Hospital Universitário Cassiano Antônio de Moraes - UDM/HUCAM antes e depois da introdução do Dolutegravir
    (Universidade Federal do Espírito Santo, 2020-08-31) Silva, Givago Gomes da; Junior, Crispim Cerutti; https://orcid.org/0000-0002-9485-4191; http://lattes.cnpq.br/4257067087979999; https://orcid.org/0000-0001-9940-7211; http://lattes.cnpq.br/9401860598358055; Miranda, Angelica Espinosa Barbosa; https://orcid.org/0000-0002-5556-8379; http://lattes.cnpq.br/5842271060162462; Silva, Sandra Fagundes Moreira da; https://orcid.org/0000-0002-5338-9270; http://lattes.cnpq.br/6703252431611986
    Introduction: The description of acquired immunodeficiency syndrome (AIDS) occurred in the early 1980s by the Center for Disease Control and Prevention in the United States of America. The classic characteristic of the infection is the depletion of CD4 + T lymphocytes, with the consequent manifestation of AIDS-defining diseases, such as extrapulmonary tuberculosis and toxoplasmosis. Objective: To evaluate the clinical and epidemiological profile of patients undergoing antiretroviral therapy at the medication dispensing unit of Hospital Universitário Cassiano Antônio de Moraes - UDM / HUCAM before and after the institution of dolutegravir (DTG) as the first line of treatment. Methods: Retrospective cohort study based on secondary data obtained from Logistic Control System for Therapeutic Drugs (SICLOM) OPERACIONAL and Control System for Laboratory Tests of the National Network of Lymphocytes CD4+/CD8+ Count and HIV Viral Load (SISCEL) of patients beginning antiretroviral therapy treated at the UDM / HUCAM. The study included patients aged 18 years or older and who were being followed up on an outpatient basis at HUCAM. The variables studied were: age, gender, marital status, education, CD4 count and viral load. The statistical program used was SPSS version 20 (IBM). In the step of bivariate analysis, tests applied for comparison of categorical variables were Chi-square and Fisher Exact. The comparison of continuous variables involved tests for comparison of means or non-parametric tests. The step of multivariate analysis verified the association between the intervening variables and two different outcomes, namely viral load and discordant immunological response, using binomial logistic regression. The measure of association was represented by the odds ratio (OR) and its respective 95% confidence interval. In the binary logistic regression step, the enter method was used for all variables with a p-value <0.2 in the bivariate analysis. The statistical significance was set at the 5% level. Results: In the group prior to the DTG, there was a predominance of males (67.5%), non-white color / race (60.3%), to have born in the state of Espírito Santo (74.2%) and a marital status in the category of unmarried (85.2%). Regarding education, 59.3% had a high level of education. The mean age presented by this group was 44.2 ± 11.8 years (mean ± standard deviation) (95% CI: 42.5-45.9). Regarding the DTG group, there was also a predominance of males (69.8%), non-white color / race (77.4%), to have born in the state of Espírito Santo (73.6%) and an unmarried marital status (88.7%). Regarding education, 50.9% had a high level of education. The mean age of this group was 40.7 ± 14 (95% CI: 37.2-44.5). The study revealed that individuals treated with DTG were almost ten times more likely to have an undetectable final viral load have been treated before the introduction of DTG. Those undergoing treatment prior to DTG were less likely to have a discordant immune response. Conclusion: The present study identified a profile of male individuals, young adults, with a non-white declared race, of unmarried marital status, with a high level of education and born in Espírito Santo. There was a higher probability of undetectable final viral load and discordant immunological response among those treated with DTG