Mestrado em Doenças Infecciosas

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http://repositorio.ufes.br/handle/10/17579

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Navegando Mestrado em Doenças Infecciosas por Assunto "AIDS"

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    Análise 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, Crispim
    INTRODUCTION: 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.
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    Análise 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, Eliana
    Introduction: 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.
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    Fatores associados à transmissão vertical da infecção pelo HIV e manifestações clínicas em crianças notificadas no Hospital Infantil Nossa Senhora da Glória, 2005-2008
    (Universidade Federal do Espírito Santo, 2011-06-28) Dias, Carolina Frizzera; Moreira-Silva, Sandra Fagundes; Miranda, Angelica Espinosa Barbosa; Silva, Rita Elizabeth Checon de Freitas; Abreu, Thalita Fernandes de
    Introduction: The main indicator of monitoring the reduction on HIV infection in children is the incidence rate of AIDS incidence in children under five years ols. Objectives: Describe the profile of children exposed to HIV attending the reference center for AIDS in chldren at The Hospital Infantil Nossa Senhora da Glória (HINSG) and determine the vertical transmission rate and clinical signs and simptoms among the infected ones. Methods: Descriptive study in children exposed to HIV infection by vertical transmission attending a pediatric public hospital in Vitoria (ES) from January 2005 to December 2008. A questionnaire including epidemiological and clinical data of mother and child was applyed. Associations between HIV positive and negative cases were tested using chi-square test. Odds Ratio and confidence intervals were calculated and multivariate logistic regression was used. Results: Two hundred and twenty-one children (97.8%) were exposed to HIV during pregnancy or childbirth. A total of 47 (21.3%) children were diagnosed with AIDS; 25 (53.2%) have already entered service with the diagnosis and 22 (44.8%) became positive during follow-up. A frequencia de infecção de HIV foi de 21,3% (IC 95% 15,9%-26,7%). One hundred and ninety-three (87.3%) children were admitted in the hospital in their first year of life, 51.1% vs. 97.1% (p <0.001), when comparing AIDS cases with those with negative serology. The frequency of HIV infection was 21.3% (IC 95% 15.9%-26.7%). Regarding children s mothers included in the study, diagnosis of HIV infection was performed before pregnancy in 97 (43.3%) cases, in 56 (25.0%) during the prenatal period, and in 59 (26,4%) at birth or after delivery. In 12 cases (5.4%), mode of maternal diagnosis was unknown. Among factors independently associated with vertical transmission of HIV: having entered the service before the first year of life [OR = 0.08 (0.17 to 0.37)], be alive [OR = 0.12 (0, 31 to 0.47)] and have received complet prophylaxis [OR = 0.29 (0.09 to 0.97)] were protective factors while being born by vaginal delivery [OR = 4.45 (1.47 - 13.47)] was a risk factor for HIV infection. Regarding clinical symptms in children, the most common was anemia for more than 30 days (65.9%), followed by wasting syndrome (59.6%) and bacterial meningitis, pneumonia or sepsis (57.4%). Sixteen children (32% of cases) were classified in category C3, the most serious of all. Conclusions: The results showed high frequency of HIV in children. Received the omplet prophylaxis and joining the service less than one year of life were protectors factors. Being born through vaginal delivery was risk factor for transmission. Most children had moderate to severe manifestations of AIDS, demonstrating importance of constant monitoring of prophylactic measures for mother and child for controling HIV among children.