Mestrado em Doenças Infecciosas
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Navegando Mestrado em Doenças Infecciosas por Assunto "AIDS"
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- ItemAnálise dos óbitos por AIDS no Brasil e sua relação com o uso de terapia antirretroviral no período de 2009 a 2013(Universidade Federal do Espírito Santo, 2016-04-06) Freitas, Marcelo Araújo de; Pascom, Ana Roberta Pati; Miranda, Angélica Espinosa Barbosa; Mesquita, Fábio Caldas de; Cerutti Junior, CrispimINTRODUCTION: Despite the introduction of universal access to antiretroviral therapy (ART) in Brazil 20 years ago, around 12,000 people still die of AIDSrelated causes every year. The aim of this study was to describe antiretroviral treatment of people living with HIV (PLHIV) who died of AIDS-related causes between 2009 and 2013. METHODS: We conducted a cross-sectional, populationbased study to establish the distribution of AIDS-related deaths among PLHIV between 2009 and 2013 in Brazil according to antiretroviral therapy status. Data were generated from a linkage process between Mortality Information System (SIM) and National ART dispensing database (SICLOM). Trends were modeled using linear regression analysis. RESULTS: A total of 61,425 AIDS-related deaths were registered in Brazil between 2009 and 2013. Median age at death was 41 years (IQR: 33-49) and 65.7% (40,337) of deaths were among men; 47.2% (29,004) of PLHIV who died during the study period never started treatment, 7.0% (4,274) had discontinued treatment, 15.9% (9,775) were on ART for six months or less and 29.9% (18,372) were on ART for more than six months. Only 1.3% of the PLHIV were on third-line ARV regimens at the time of death. CONCLUSIONS: Almost all of those who died of AIDS-related causes in Brazil did not get the full benefit of antiretroviral therapy. Even in a context of universal access to antiretroviral treatment for many years, robust health policies targeting gaps in HIV continuum of care are crucial to further reduce the impact of AIDS-related mortality in Brazil.
- ItemAnálise espacial de coinfecção TB/HIV em microrregiões do Brasil de 2007 a 2011(Universidade Federal do Espírito Santo, 2017-05-16) Loriato, Karina Covre; Miranda, Angélica Espinosa Barbosa; Cerutti Junior, Crispim; Zandonade, ElianaIntroduction: Human immunodeficiency virus (HIV) infection is an important risk factor for tuberculosis (TB). Knowledge of the spatial distribution and dependence of tuberculosis and HIV/AIDS cases in Brazil will allow the visualization of its geographical distribution and the frequency of occurrence of coinfection in space/time. Objectives: To characterize the demographic and clinical aspects of the cases of TB/HIV/AIDS coinfection and to analyze the spatial dependence of epidemiological data on these cases in the micro-regions of Brazil with the use of geoprocessing tools. Methods: The study comprises 558 micro regions of the Brazilian territory. It is an ecological study in which the SINAN tuberculosis notification database was used. Demographic and clinical epidemiological profile was performed. For the spatial analysis, the Moran index, local empirical bayesian estimator (LEbayes), the global empirical Bayesian estimator (GEbayes) and the Poisson model were used. Results: The final sample of the study was 33,773 notifications of new cases of tuberculosis in HIV/AIDS patients. In the profile, 23,621 individuals (69.94%) were male; 15,882 (54.46%) were declared black or brown; 19,216 (56.9%) were aged 15 to 39 years; and 10,484 (41.09%) had between one and three years of study. Regarding clinical aspects, 24,654 (84.71%) had suspected X-ray of TB and sputum smear microscopy was positive in 12,194 (51.11%) collected samples. The most common form of tuberculosis was pulmonary tuberculosis, in 21,100 (62.5%). Cure was reported in 17,288 (53.93%) cases, abandonment occurred in 4,575 cases (14.27%) and 5,340 (16.65%) died. The Moran index showed a weak and significant spatial correlation, being the index value 0.265481 and p-value of 0.01. Conclusions: The results showed that TB/HIV/AIDS coinfection occurs mainly in men aged 15-39, browns and blacks with up to six years of study, and does present an weak overall pattern of dependence in space.
- ItemPerfil 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/6703252431611986Introduction: 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