Oriented display of HIV-1 Env trimers by a novel coupling strategy enhances B cell activation and phagocytosis.

Introduction: Conformationally stabilized Env trimers have been developed as antigens for the induction of neutralizing antibodies against HIV-1. However, the non-glycosylated immunodominant base of these soluble antigens may compete with the neutralizing antibody response. This has prompted attempts to couple Env trimers to organic or inorganic nanoparticles with the base facing towards the carrier. Such a site-directed coupling could not only occlude the base of the trimer, but also enhance B cell activation by repetitive display. Methods: To explore the effect of an ordered display of HIV-1 Env on microspheres on the activation of Env-specific B cells we used Bind&Bite, a novel covalent coupling approach for conformationally sensitive antigens based on heterodimeric coiled-coil peptides. By engineering a trimeric HIV-1 Env protein with a basic 21-aa peptide (Peptide K) extension at the C-terminus, we were able to covalently biotinylate the antigen in a site-directed fashion using an acidic complementary peptide (Peptide E) bearing a reactive site and a biotin molecule. This allowed us to load our antigen onto streptavidin beads in an oriented manner. Results: Microspheres coated with HIV-1 Env through our Bind&Bite system showed i) enhanced binding by conformational anti-HIV Env broadly neutralizing antibodies (bNAbs), ii) reduced binding activity by antibodies directed towards the base of Env, iii) higher Env-specific B cell activation, and iv) were taken-up more efficiently after opsonization compared to beads presenting HIV-1 Env in an undirected orientation. Discussion: In comparison to site-directed biotinylation via the Avi-tag, Bind&Bite, offers greater flexibility with regard to alternative covalent protein modifications, allowing selective modification of multiple proteins via orthogonal coiled-coil peptide pairs. Thus, the Bind&Bite coupling approach via peptide K and peptide E described in this study offers a valuable tool for nanoparticle vaccine design where surface conjugation of correctly folded antigens is required.

Nutritional outcomes of therapeutic feeding program and its predictors among undernourished adult HIV positive patients at healthcare facilities of West Guji Zone, Southern Ethiopia: A retrospective cohort study.

BACKGROUND: For those living with HIV/AIDS, malnutrition is a significant issue everywhere, but it is particularly prevalent in Sub-Saharan Africa. A nutritional support program is becoming a more and more common strategy to prevent malnutrition in HIV-positive persons. Thus, this study aimed to assess nutritional treatment outcomes and their predictors among adult HIV-positive undernourished individuals in West Guji Zone healthcare facilities. METHOD: A facility-based retrospective cohort study was conducted among 348 randomly selected adult HIV- positive patients in the West Guji Zone healthcare facilities between January 2018 and December 2022. Data were collected using the data extraction tool. Entered into Epi Data version 3.1 and exported to SPSS version 26 for analysis. The Kaplan-Meier survival curve and log-rank test were used to predict the time to recovery and to compare survival curves across categorical variables. A Cox proportional hazard regression model was fitted to identify an independent predictor of the recovery rate. Statistical significance was declared at a p-value of < 0.05. RESULTS: In the final analysis 348 undernourished HIV-positive persons were included. Based on preset exit criteria, approximately 198, 56.9% of patients enrolled in the RUTF program were able to recovered, with an incidence of 9.83 (95% CI: 3.12, 13.44) per 100 person-month observations. Being divorced (AHR = 0.21; 95% CI: 0.06, 0.69) and being in the WHO advanced stage (AHR = 0.42; 95% CI: 0.23, 0.79) was a negative predictor. Being in the age range of 18-29 and 30-39 and having a working functional status (AHR = 2; 95% CI: 1.25, 3.23) were positive predictors. CONCLUSION: Nutritional recovery in this study lower than WHO Sphere requirements. Age between 18 and 39 and working functional status were good indicators of nutritional recovery, whereas advanced WHO clinical stage and divorced marital status were negative predictors.

Midwives' perceptions of and attitudes towards prevention of mother-to-child-transmission of HIV

Background: Prevention of mother-to-child transmission (PMTCT) of HIV services has become an integral part of antenatal services. Prevention of mother-to-child transmission was introduced in all the regions of Ghana, but mother-to-child transmission (MTCT) continued to increase. Objectives: To explore and describe midwives' perceptions and attitudes towards PMTCT of HIV services. Method: Quantitative research approach and descriptive cross-sectional design were used. The population includes all midwives between the ages of 21 and 60 years who work in antenatal care (ANC) clinics in 11 district hospitals in the Central Region of Ghana where the study was conducted. Forty-eight midwives were interviewed using a census sample process. Data were analysed using the Statistical Package for the Social Sciences version 21. Correlation analysis was performed to find the relationships between the attitudes and the perceptions of the midwives on PMTCT of HIV services. Results: Seventy percent of midwives had positive perceptions of PMTCT of HIV services and 85% had positive attitudes towards the provision of PMTCT of HIV services. Midwives were screening all pregnant women who visited the ANCs and referring those who tested positive to other institutions where they can be monitored. Some of the concerns considered were views on retesting HIV-infected pregnant women throughout their pregnancy. There was a positive correlation between attitudes and perceptions of midwives on PMTCT of HIV services. Conclusion: Midwives had positive perceptions and positive attitudes towards the PMTCT of HIV services that they were providing to antenatal attendees. Also, as the attitudes of the midwives towards PMTCT of HIV services improved, their perceptions of PMTCT services also improved. Contribution: Decentralisation of PMTCT of HIV services to community-based health facilities is appropriate to enable sub-district health facilities to test for HIV and provide counselling services to pregnant women.

Bitter kola and kola nut use and their effect on treatment outcome on People Living with HIV at a Military Hospital in Benue state Nigeria: Bitter kola (Garcinia) and Cola nut (Cola nitida among PLWHIV

Introduction Bitter Kola (Garcinia Kola) and kola nut, contains substances attributed to numerous effects on humans including anti-inflammatory, anti-allergic properties, anti-infective and caffeinism. This study explores Bitter kola and kola nut use and its impact on treatment outcome on People Living with HIV (PLWHIV). Methods: The study was conducted at a Military Hospital in Nigeria. An analytical cross-sectional study was done using questionnaire among 700 HIV-positive clients selected using simple random sampling. Data were collected by researcher and three trained assistants. Chi-square test and binary logistic regression were used for identifying associations and predictors, respectively. The level of significance was set at p < 0.05. Results: Findings show that 260 (63.6%) and 179 (25.6%) have ever and currently used Bitter kola/Kola nut, respectively. Also, 14 (7.8%) used Bitter kola/Kola nut alone while 165 (92.2%) used it in addition to other substances, especially with alcohol 123 (68.7%). Bitter kola use was associated with age (p = 0.037), gender (p < 0.001), occupation (p = 0.001), and number of children (p < 0.011). Identified predictors were being a female (AOR 0.79; 95% CI 0.08-0.92) and earning <18,000 Naira (AOR 2.91; 95% CI 2.03-21.54). There was no association of Bitter kola/kola nut use with CD4 count and viral load suppression. Conclusion: Though Kola nut and Bitter kola use was high as in the general population we have not found any effect on treatment outcome among PLWHIV. This calls for more research to ascertain if there are other possible beneficial effects on PLWHIV.

Qualidade de vida de pessoas vivendo com HIV atendidas em serviços públicos de saúde / Quality of life of people living with HIV treated in public health services / Calidad de vida de personas viviendo con VIH atendidas en servicios públicos de salud

Objetivo: descrever o perfil e avaliar a qualidade de vida de pessoas vivendo com HIV atendidas em serviços públicos de saúde. Métodos: estudo transversal, quantitativo com 281 pessoas vivendo com HIV atendidas em serviços públicos de saúde nos municípios do Rio de Janeiro e Niterói. Os dados foram coletados por meio de instrumento de dados socioeconômicos e clínicos e do WHOQOL-HIV bref, analisados por estatística descritiva, após aprovação do Comitê de Ética em Pesquisa. Resultados: a amostra foi composta majoritariamente por homens, renda de até dois salários mínimos e percepção positiva da saúde. A qualidade de vida foi positivamente avaliada na maioria das facetas, as maiores médias foram nos domínios: psicológico, relações sociais, espiritualidade, religião e crenças pessoais e a menor no domínio meio ambiente. Conclusão: o perfil das pessoas vivendo com HIV corrobora, os dados nacionais e a avaliação da qualidade de vida foi mais positiva do que em outros estudos.

Objective: to describe the profile and evaluate the quality of life of people living with HIV treated in public health services. Methods: in this cross-sectional, quantitative study of 281 people living with HIV treated in public health services in the municipalities of Rio de Janeiro and Niteroi, data were collected using a socioeconomic and clinical instrument and the WHOQOL-HIV brief questionnaire, and analyzed by descriptive statistics, with research ethics committee approval. Results: the sample comprised mainly men, with income of up to two minimum wages and a positive perception of their health. Most facets of quality of life were positively assessed, with the highest averages in the psychological, social relations, spirituality, religion and personal beliefs domains, and the lowest, in the environmental domain. Conclusion: the profile of people living with HIV corroborates national data, and the assessment of quality of life was more positive than in other studies.

Objetivo: describir el perfil y evaluar la calidad de vida de personas viviendo con VIH atendidas en servicios públicos de salud. Métodos: estudio transversal, cuantitativo, junto a 281 personas viviendo con VIH, atendidas en servicios públicos de salud en los municipios de Río de Janeiro y Niterói. Se han recolectado los datos mediante un instrumento de datos socioeconómicos y clínicos y del WHOQOL-HIV bref, analizados por estadística descriptiva, después de la aprobación del Comité de Ética en Investigación. Resultados: la muestra se compuso mayoritariamente de hombres, con ingresos de hasta dos salarios mínimos y percepción positiva de la salud. Se evaluó positivamente la calidad de vida en la mayoría de las facetas, los promedios más altos en los dominios: psicológico, relaciones sociales, espiritualidad, religión y creencias personales y el más bajo en el dominio medio ambiente. Conclusión: el perfil de las personas que viven con VIH corrobora con los datos nacionales y la evaluación de la calidad de vida fue más positiva que en otros estudios

Aleitamento materno: a visão de puérperas soropositivas para hiv e htlv quanto a não amamentação / Breastfeeding: the vision of soropositive puerperos for hiv and htlv regarding non-breastfeeding

Introdução: O aleitamento materno é o mais simples método de vínculo, proteção e nutrição para a criança. Entretanto, o aleitamento pode ser contraindicado nos casos em que a puérpera possuir soropositividade para o HIV e HTLV. Objetivo: Conhecer a visão da puérpera soropositiva para HIV e HTLV quanto a não amamentação. Método: Descritivo com abordagem qualitativa, pois propicia conhecer a natureza e processo que constitui o objeto de estudo, descrevendo-os e interpretando-os. Enquanto que a abordagem qualitativa possibilitará compreender a realidade estudada. Realizado em um hospital materno-infantil referência em gestação de alto risco. Participaram oito puérperas soropositivas para HIV/HTLV no período de março-abril de 2017. Resultado: Três categorias: entendimento relacionado ao não aleitamento materno; sentimento da puérpera quanto a não amamentação e conhecimento sobre o funcionamento e importância do banco de leite humano. Considerações finais: Pode-se compreender a visão da puérpera sobre o aleitamento materno, falta de conhecimento das participantes advindas do interior e falta de informações quanto ao HTLV, salientando a importância da interação entre a enfermagem e a puérpera a fim de melhor orientá-la.(AU)

Índice de conhecimento das gestantes portadoras do Vírus da Imunodeficiência Humana (HIV) acerca de sua patologia / Index of knowledge of pregnant women carriers of the Immunodeficiency Virus (HIV) about its pathology

O presente estudo trata-se de pesquisa quantitativa realizada com Gestantes Portadoras do Vírus da ImunodeficiênciaHumana (HIV) acerca de sua Patologia, realizada no Instituto de Medicina Integrada Professor Fernando Figueira-IMIP, com afinalidade de verificar o índice de conhecimento das gestantes portadoras do Vírus da Imunodeficiência Humana (HIV) a cercade sua patologia. Os dados foram coletados através de um questionário semi-estruturado. Na análise dos dados verificou-seque grande parte das gestantes passando de 50% das entrevistadas, tem conhecimento sobre o seu tratamento, autocuidado,prevenção, conhecimento da medicação, tipo de parto, importância da realização do pré-natal, exames, entre outros. Opresente estudo permitiu conhecer melhor a realidade de cada gestante a respeito do seu conhecimento diante de todo otratamento e a importância de um acompanhamento integrado para si e para o seu filho.

The Present Study this is quantitative research conducted with pregnant women with human immunodeficiency virus(HIV) to their About Pathology, held at the Institute of Integrated Medicine Professor Fernando Figueira–IMIP, with the purpose ofverifying the content knowledge of pregnant women with human immunodeficiency virus (HIV) about its pathology. Data werecollected through a semi-structured questionnaire. In analyzing the data it was found that most pregnant women from 50% ofrespondents, is knowledgeable about your treatment, care, prevention, knowledge of medication, type of delivery, the importanceof performing prenatal examinations, among other . This study allowed us to know better the reality of every pregnant womanabout her knowledge before any treatment and the importance of an integrated monitoring for you and your son.

Este estudio trata de un estudio cuantitativo de las mujeres embarazadas con el virus de inmunodeficienciahumana (VIH) sobre su patología, que se celebró en el Instituto de Medicina Integrada Profesor Fernando Figueira, IMIP, conel fin de verificar el índice de conocimiento de las mujeres embarazadas con virus de la inmunodeficiencia humana (VIH) acerca de su condición. Los datos fueron recolectados a través de un cuestionario semi-estructurado. En el análisis de datosse encontró que las mujeres más embarazadas aumentó del 50% de los encuestados, es conocedor de su tratamiento,el cuidado, la prevención, el conocimiento de la medicación, tipo de parto, la importancia de la realización de exámenesprenatales, entre otros . Este estudio nos permitió comprender mejor la realidad de cada mujer acerca de su conocimientoantes de que todo el tratamiento y la importancia de un seguimiento integrado para ti y tu hijo.

Relaciones familiares y sociales de las personas con VIH / Familly and social relations of people with hiv

El presente artículo es un estudio preliminar en el marco de la tesis doctoral de la primera autora; elobjetivo: describir las relaciones familiares y sociales de las personas con VIH, se realizó en unadependencia de la Región Central de Salud, Ministerio de Salud, República de El Salvador.Metodología: cualitativo, fenomenológico, en el cual se analizó el contenido de entrevistas enprofundidad, en seis personas con VIH, quienes participaron voluntariamente, recibiendo atenciónambulatoria, y con un tiempo de ocurrencia menor a dos años. La muestra estuvo constituida por lasaturación teórica de la información obtenida, alcanzada con doce participantes.Resultado: se basó en los discursos que evidencian experiencias vividas, interpretándose según elfilosófico Martin Heidegger; se identificaron dos categorías: la primera relaciones familiares con cuatro sucategorías: relaciones de pareja, relaciones deficientes, relaciones negativas y relaciones positivas; lasegunda categoría: relaciones sociales conformadas por seis su categorías: relaciones de amistad,relaciones laborales, relaciones en iglesia, relaciones enfermera paciente y relaciones con otro equipo desalud. Estando implícito la comunicación permitiendo entender cómo se dan las relaciones en una partede su mundo.Conclusión: que aunque los participantes reconocen una mejoría en las relaciones con algunos miembrosde su familia no ocurre igual en las relaciones sociales y de acuerdo con Baker las y los profesionales deenfermería deben atender a las personas con VIH, considerando la capacidad de escucha y comprensión,tomándolo como un ser holístico considerando que tiene dificultades en la comunicación y deterioro en lasrelaciones familiares y sociales.

This paper is a preliminary study in the framework of the doctoral thesis of the first author; The goal: todescribe the family and social relationships of people with HIV was held in a unit of the Eastern Region,Ministry of Health, Republic of El Salvador.Methodology: qualitative, phenomenological, in which the content is analyzed in-depth interviews in sixpeople with HIV, who participated voluntarily, receiving outpatient care, and with a time of less than twoyears occurrence. The sample consisted of theoretical saturation of the information obtained, achieved withtwelve participants.Analysis: It was based on the speeches that show experiences, interpreted according to Martin Heidegger'sphilosophical; the first family relationships with four subcategories: two categories identified relationships,poor relationships, negative relationships and positive relationships; the second category: socialrelationships formed six subcategories: friendly relations, labor relations, church relations, nurse-patientrelationships and relationships with other health team. While allowing communication implicitunderstanding how relationships are given a part of their world. We conclude that although participantsrecognized an improvement in relations with some members of his family does not happen just in socialrelations and according to Baker's and nurses must care for people with HIV, considering the ability tolisten and understanding, taking it as a holistic being considering it has communication difficulties anddeterioration in family and social relationships.

O presente artigo é um estudo preliminar no marco da tese doctoral de la primera autora; O objetivo:descrever as relações familiares e sociais das pessoas com HIV, é realizado em uma dependência da RegiãoCentral de saúde, Ministério de Saúde, República de El Salvador.Metodologia: qualitativo, fenomenológico, qual é o conteúdo do conteúdo de entrevistas em profundidade,em seis pessoas com o VIH, quem participa voluntariamente, recebe atenção ambulatória, e tem um tempode ocurrência menor a dois anos. La muestra estuvo constituida por la saturación teórica de la informaciónobtenida, alcanzada con doce participantes.Análise: se basou nos discursos que evidenciam experiências vividas, interpretándose según o filosóficoMartin Heidegger; Se identificaron das categorias: as primeiras relações familiares com quatro categorias:relaciones de pareja, relações deficientes, relações negativas e relações positivas; A segunda categoria:relações sociais conformadas por seis categorias: relações de amizade, relações laborais, relações emigreja, relações enfermagem paciente e relações com outro equipamento de saúde. Estando implícito acomunicação permitindo entender como se as relações em uma parte de seu mundo.Conclusão: que aunque los participantes reconocen una mejoría en las relaciones con algunos miembros de su familia no ocurre igual en las relaciones sociales y de acuerdo con Baker las y los profesionales de enfermería Y comprensión, tomándolo como um ser holístico considerando que tem dificuldades na comunicação e deterioro nas relações familiares e sociais.

Relatório Semestral 2016 Relatório Semestral das Actividades Relacionadas ao HIV/SIDA / Semestral Report 2016 Mid-Year Report on Activities Related to HIV/AIDS

O Programa Nacional de Controlo (PNC) de ITS-HIV/SIDA é a entidade do Serviço Nacional de Saúde responsável pela gestão dos serviços de saúde relacionados ao HIV. A sua missão é de coordenar, regulamentar e prestar cuidados e tratamento às pessoas vivendo com HIV. Para responder de forma estratégica aos desafios desta missão, o PNC ITS-HIV/SIDA conta com as seguintes componentes sendo: 1) Cuidados Clínicos e TARV Adulto; 2) Cuidados Clínicos e TARV Pediátrico; 3) TB/HIV; 4) APSS/PP; 5) ITS; 6) ATS; 7) Monitoria e Avaliação e 8) Melhoria de Qualidade. No primeiro semestre de 2016, o Programa de ITS-HIV/SIDA deu continuidade as actividades anteriormente traçadas nos planos vigentes e comprometeu-se a alcançar as ambiciosas metas, apesar dos desafios encontrados ao longo da implementação. Referir que estas actividades concorrem para uma melhoria na qualidade de vida dos Moçambicanos...

The National Control Program (NCP) for STI-HIV/AIDS is the National Health Service entity responsible for managing HIV-related health services. Its mission is to coordinate, regulate, and provide care and treatment for people living with HIV. To respond in a strategic strategic response to the challenges of this mission, the NHP STI-HIV/AIDS has the following components being: 1) Adult Clinical Care and ART; 2) Pediatric Clinical Care and ART; 3) TB/HIV; 4) APSS/PP; 5) ITS; 6) ATS; 7) Monitoring and Evaluation and 8) Quality Improvement. In the first half of 2016, the STI-HIV/AIDS Program continued the activities previously outlined in the current plans and committed to achieving the ambitious targets, despite the challenges encountered throughout implementation. It should be noted that these activities contribute to an improvement in the quality of life of Mozambicans...

Práticas alimentares para crianças expostas ao HIV: revisão integrativa da literatura / Food practice for children exposed to HIV: integrative review of literature

Objetivou-se analisar as evidências a respeito das práticas alimentares para crianças expostas ao Vírus da Imunodeficiência Humana (HIV). Trata-se de um estudo de revisão integrativa desenvolvido nas bases de dados LILACS, PUBMED e SCOPUS. O levantamento dos estudos ocorreu em janeiro de 2014. As produções demonstraram a existência de três tipos de alimentação predominante em crianças expostas ao HIV: aleitamento materno, aleitamento artificial e alimentação básica da família. As práticas alimentares de crianças expostas ao HIV não correspondem às práticas preconizadas nacionalmente. É necessário instituir um aconselhamento alimentar pela equipe de saúde, como também um planejamento alimentar adequado, inclusão das crianças nas consultas de puericultura e acesso às fórmulas infantis.

The objective was the analysis of the evidence regarding feeding practices for children exposed to the Human Immunodeficiency Virus (HIV). It is an integrative review study, developed on the LILACS, PUBMED, and SCOPUS databases. The study took place on January 2014 and highlighted three predominant practices used on children that have been exposed to the HIV: breastfeeding, formula milk, and a basic family diet. The current feeding practices for children exposed to the HIV do not correspond to the country's recommended practices. The nutritional advice given by a health staff must be implemented, as well as an adequate feeding practice, the inclusion of the children on childcare medical consultations and easy access to child feeding formulas.

Evaluation of Selected Aspects of the Nutrition Therapeutic Programme offered to HIV-Positive Women of Child-Bearing Age in Western Cape Province; South Africa

Background: The Nutrition Therapeutic Programme (NTP) involves the provision of food supplements at primary health clinics (PHCs) to correct nutritional deficiencies in vulnerable groups. Although previous studies have identified problems with implementing the programme at PHCs; assessments of its efficiency have been scarce.Objective: To evaluate implementation of the NTP at PHCs that provide antiretroviral therapy.Methods: A cross-sectional; descriptive study was conducted at 17 PHCs located within 3 districts of Western Cape Province. Two target groups were chosen: 32 staff members working at the sites and 21 women of child-bearing age enrolled in the NTP. Questionnaires were used to obtain data.Results: Only 2 women (10%) lived in food-secure households; the rest were either at risk of hunger (29%) or classified as hungry (61%). Most of the women knew they had to take the supplements to improve their nutritional status; but the majority only recalled receiving basic nutritional advice; and the information was mainly given verbally. Ten of the women had shared their supplements with others; mostly with their children. The study identified lack of clearly defined NTP responsibilities at the PHCs; causing confusion amongst the staff. Although many staff members expressed problems with the NTP; only 38% of them reported having routine evaluations regarding the programme.Conclusion: Several aspects compromised the effectiveness of the NTP; including socio- economic factors leading to clients' non-compliance. The strategic organisation and implementation of the NTP varied between different PHCs offering antiretroviral therapy; and staff experienced difficulties with the logistics of the programme

Evidências científicas de enfermagem acerca do HIV/Aids entre idosos: uma revisão integrativa de literatura / Scientific nursing evidences about HIV/Aids among elderly: a literature review / Evidencia científica de enfermería acerca del HIV/Aids entre ancianos: una revisión de la literatura

A Síndrome da Imunodeficiência Adquirida tem registrado mudanças no perfil da epidemia nas últimas décadas. Este estudo teve por objetivo levantar as produções científicas de enfermagem sobre HIV/AIDS na população idosa nos últimos dez anos e discutir as evidências que perpassam as produções científicas encontradas. Realizou-se uma revisão integrativa de literatura por intermédio das bases de dados LILACS, SciELO e BDENF, com seleção final de 21 artigos. Com base nesses artigos, foram criadas três categorias: implicações do diagnóstico precoce, dificuldades e facilidades a adesão à terapia antirretroviral e ações de Enfermagem. São necessárias habilidades para lidar com as questões relacionadas ao envelhecimento, complexidade do tratamento antirretroviral e eventos adversos, que são as principais causas de abandono da terapêutica. Concluiu-se que o papel da Enfermeira é fundamental no acolhimento e na avaliação integral do idoso.

In recent decades, changes in the profile of the Acquired Immunodeficiency Syndrome epidemic have occurred. This study aimed to raise the scientific productions of nursing about HIV/AIDS in the elderly population over the last ten years and discuss the evidence throughout the scientific research obtained. An integrative literature review through the LILACS, SciELO and BDENF was performed, resulting in the final selection of 21 articles. Based on these articles, three categories were created: early diagnosis implications, difficulties and facilities of adherence to antiretroviral therapy and Nursing actions. Skills are necessary to deal with issues related to aging, complexity of antirretroviral treatment and adverse events, which are the main causes of abandonment to therapy. It was concluded that the role of nursing is essential for admission and full evaluation of elderly people.

En las últimas décadas, se han producido cambios en el perfil de la epidemia del síndrome de inmunodeficiencia adquirida. Este estudio evalúa la producción científica de enfermería sobre el virus HIV/AIDS en la población de ancianos en los últimos diez años, discutiendo la evidencia de que atraviesan las producciones científicas encontradas. Se realizó una revisión integradora de la literatura a través de las bases LILACS, SciELO y BDENF, con selección final de 21 artículos. Se crearon tres categorías: implicaciones del diagnóstico precoz, dificultades y facilidades de la adherencia a la terapia antirretroviral y acciones de enfermería. Habilidades son necesarias para tratar con las cuestiones relacionadas al envejecimiento, complejidad del tratamiento antirretroviral y eventos adversos, principales causas de abandono de la terapia. El rol de la enfermera es fundamental en la acogida y en la evaluación integral de los ancianos.

Integralidade do cuidado na testagem anti-HIV: o olhar das mulheres / Care integrality in HIV testing: the look of women / Atención integral en las pruebas del VIH: la mirada de las mujeres

A detecção da positividade para o HIV, durante o trabalho de parto, por meio dos testes rápidos, fragiliza as mulheres e gera demandas específicas de cuidados. Este estudo objetivou analisar o cuidado profissional a mulheres com teste rápido positivo para HIV a partir do olhar de mulheres que tomaram conhecimento da positividade durante o trabalho de parto ou puerpério. Trata-se de estudo do tipo exploratório, com abordagem qualitativa. Os dados foram coletados por meio de entrevista semiestruturada e analisados por meio da técnica de análise de discurso. Observou-se que as relações de cuidado às mulheres com teste rápido positivo para HIV se distanciam da integralidade, uma vez que se mantêm distantes e superficiais, sendo norteadas pelo modelo biomédico. A incorporação da perspectiva da integralidade nas ações de saúde exige reflexão por parte do(a)s profissionais, do(a)s gestore(a)s do sistema público de saúde, bem como a capacitação desse(a)s profissionais.

The positive detection during partum labor makes women weak and generates specific care demands. The aim of this research was to analyze professional care to women with positive result from fast HIV test based on the point of view of women who knew the positive result during partum labor or postpartum. This is an exploratory study with a qualitative approach. Data were collected through semi-structured interviews and analyzed using the discourse analysis technique. It was observed that the relations of care for women with positive rapid HIV test are far away from integrality, since they remain distant and superficial, being guided by the biomedical model. The mainstreaming of integrality in health care requires consideration by the professional, public health system managers, as well as training of those professionals.

La detección de seropositividad durante el trabajo de parto debilita las mujeres y genera demandas específicas de atención. El estudio objetivó analizar la atención profesional a las mujeres con resultado positivo para el VIH, desde la mirada de las mujeres que se enteraron de la seropositividad durante el trabajo de parto o el puerperio. El estudio es de carácter exploratorio con un abordaje cualitativo. Los datos fueron recolectados a través de entrevistas semi-estructuradas y analizadas con la técnica del análisis del discurso. Fue observado que las relaciones de atención a las mujeres seropositivas para el VIH se distancian de la integralidad, ya que se mantienen alejadas y superficiales, siendo guiado por el modelo biomédico. La incorporación de la perspectiva de la integralidad en las acciones de salud requiere una reflexión por parte de los profesionales, de los administradores del sistema de salud pública, además de la capacitación de estos profesionales.

Factores asociados a la seropositividad para virus linfotrópico de células T humanas tipo I y II (HTLV I y II) y otros marcadores serológicos en donantes de sangre de un hemocentro en Cartagena-Colombia / Factors associated with seropositivity for human T-cell lymphotropic virus type I and II (HTLV I and II) and other serological markers in blood donors from a blood center in Cartagena-Colombia

Con el fin de poner a prueba la asociación, entre la prevalencia de transfusiones sanguíneas, la práctica de tatuajes o acupuntura, la presencia de otros marcadores (Chagas, HIV, Anti HCV, HBsAg, AntiHBc, Syphilis) y algunas conductas sexuales, con la seropositividad al Virus Linfotrópico de Células T Humanas tipo I y II se desarrolló este estudio epidemiológico analítico de corte transversal, cuya muestra escogida corresponde a la población de Donantes de sangre del Hemocentro Caribe, un total de 3867, los cuales fueron analizados a partir de los datos obtenidos de una Encuesta e historia clínica del donante, logrando los siguientes resultados: Seroprevalencia del (HTLV I y II) (3,1%), (HIV) (1,9%), (Chagas) (4,1), (Anti HCV) (5,4%), (HBsAg) (1,6%), (Anti HBc II) (12,7%), y (Syphilis TP) (3,7%). Se encontró que la mayoría de los marcadores tienen asociación con la presencia de otro marcador especialmente el anticuerpo del núcleo de la Hepatitis B, (HBc II), Así mismo estos muestran asociación marcada con la procedencia de otras regiones diferentes a la Caribe y las relaciones sexuales riesgosas Se concluye que los hallazgos evidencian una seroprevalencia significativa no solo del (HTLV I y II) en la población estudiada, también de los otros marcadores, que merece mucha atención.

To test the association between prevalence of blood transfusions, the practice of tattooing or acupuncture, the presence of other markers (hepatitis B and C, Chagas, Syphilis, HIV, antibody of the Hepatitis B) and some sexual behaviors, with the seropositive for T-cell lymphotropic virus type I and II Human developed analytical epidemiological study of cross sectional, which corresponds to the selected sample population of blood donors at the Blood Center of the Caribbean, a total of 3867 donor, which were analyzed from data obtained from a survey of donor and medical history, achieving the following results: seroprevalence (HTLV I and II) (3.1%), (HIV) (1.9 %), (Chagas) (4.1), (Anti HCV) (5.4%), (HBsAg) (1.6%) (Anti HBc II) (12.7%), and (Syphilis TP) (3.7%). We found that most markers are associated with the presence of another marker especially antibody of the Hepatitis B (HBc II) Also they show strong association with the origin of different regions of the Caribbean and risky sex. We conclude that the findings show a significant seroprevalence of not only (HTLV I and II) in the study population, also of the other markers, which deserves much attention.

Fluconazole and amphotericin B susceptibility testing of Cryptococcus neoformans: Results of minimal inhibitory concentrations against 265 isolates from HIV-positive patients before and after two or more months of antifungal therapy

La frecuencia de la criptococosis en los pacientes con sida sigue siendo alta en Argentina, a pesar de contar con terapia antirretroviral de alta eficacia. Sin tratamiento, esta micosis es habitualmente fatal.En la última década, el esquema terapéutico empleado para la criptococosis en el Hospital de Infecciosas “F. J. Muñiz” ha consistido en la administración de anfotericina B (AMB) seguida por fluconazol (FCZ), ya que la 5-fluorocitosina no se comercializa en Argentina. En un número considerable de pacientes no se negativizan los cultivos en 2–3 semanas de iniciada la terapia antifúngica, tal como sería deseable, y es posible aislar Cryptococcus neoformans en diferentes muestras clínicas aún después de dos ó más meses de tratamiento, inclusive en casos que mejoran clínicamente.El objetivo de este estudio fue evaluar el perfil de sensibilidad de aislamientos de C. neoformans obtenidos de 116 pacientes a las dos drogas mencionadas y compararlos con los de 149 aislamientos de los mismos enfermos después de, al menos, dos meses de tratamiento.Pudimos comprobar que la concentración inhibitoria mínima (CIM) de AMB fue⩽1μg/ml para los 265 aislamientos antes y después del tratamiento.La CIM de FCZ antes de iniciada la terapia fue ⩽8μg/ml en todos los casos. Solamente un aislamiento de un enfermo que presentó una recidiva mostró resistencia in vitro a esta droga (CIM⩾64μg/ml), y otros cuatro mostraron sensibilidad dosis dependiente (CIM 16–32μg/ml): tres de ellos de pacientes con recidivas y el cuarto de un enfermo que continuó con cultivos positivos durante largo tiempo. Estos valores no tuvieron correlación con la evolución de la micosis, como ya ha sido señalado en otras publicaciones(AU9

Cryptococcosis, a fatal disease without appropriate treatment, is still one of the major opportunistic mycoses in AIDS patients in Argentina despite the availability of high active anti-retroviral therapy (HAART).Over the last decade, drugs employed in the treatment of disseminated cryptococcosis at Infectious Diseases Hospital “F.J. Muñiz” included amphotericin B (AMB) followed by fluconazole (FCZ), due to the fact that flucytosine was not available in Argentina during this period. A considerable number of patients did not negativize cultures after 2–3 weeks of treatment as it was expected, and in some of them the isolation of Cryptococcus neoformans in different samples was still possible after 2 or more months of adequate therapy and even in cases with clinical improvement.The aim of this study was to establish the susceptibility profile of C. neoformans clinical isolates to those antifungals and to investigate whether there were any changes after at least 2 months of treatment. A total of 265 strains were studied (116 obtained from patients at diagnosis and 149 corresponding to the same individuals 2 months or more after receiving therapy). Susceptibility patterns before treatment to AMB showed MICs ≤1μg/ml for all the strains, and no increase was seen after treatment.All the strains were susceptible to FCZ (MIC≤8μg/ml) at diagnosis; but in a group with relapses or those who did not negativize cultures, one isolate became resistant after therapy (MIC≥64μg/ml) and other four showed dose-dependent susceptibility (MIC 16–32μg/ml). There was no relation between these results and clinical outcome as it was pointed out in other publications(AU)

Psoriasis e infección por el virus de la inmunodeficiencia humana / Psoriasis and HIV infection

La coexistencia de psoriasis con la infección por el virus de la inmunodeficiencia humana (VIH) implica dificultades diagnósticas y terapéuticas para el especialista en Dermatología. En este artículo se revisan las peculiaridades de dicha coexistencia desde el punto de vista epidemiológico, patogénico, anatomopatológico, clínico y pronóstico. Se describen las principales dermatosis que se incluyen en el diagnóstico diferencial. También se analizan las diferentes posibilidades terapéuticas en estos pacientes, dependiendo del grado de inmunosupresión. Se incluyen como opción de tratamiento la terapia antirretroviral, el tratamiento tópico, los retinoides, los fármacos inmunosupresores clásicos y se revisa la literatura actual sobre el uso de las nuevas terapias biológicas en pacientes con infección por el VIH. Finalmente, se describe el riesgo de interacciones farmacológicas que tienen lugar en el tratamiento de la psoriasis en estos pacientes, que reciben múltiples fármacos (AU)

Dermatologists face diagnostic and therapeutic difficulties when psoriasis coexists with human immunodeficiency virus (HIV) infection. This article will review some of the aspects of this coexistence from the epidemiologic, pathogenic, histopathologic, clinical, and prognostic point of view. The main skin diseases that should be included in the differential diagnosis are described. Also analyzed are the different therapeutic options in these patients according to the degree of immunodeficiency. Possibilities include antiretroviral treatment, topical treatment, retinoids, and classic immunosuppressants. The review will also cover current literature on the use of new biologic therapies in patients with HIV infection. Finally, we will discuss the risk of drug interactions during psoriasis treatment in these patients, who receive multiple pharmacologic therapies (AU)

HIV-positive and HIV-negative consumers accept an instant soy maize porridge

The objective of this study was to assess consumer acceptability; preference and consumption intent of an instant soy maize porridge; compared to an instant plain maize porri- dge; in order to determine the successful inclusion of the soy maize porridge as a food supplement for HIV subjects in a subsequent nutrition intervention trial; to improve their nutritional status. A 5-point hedonic and food action rating scale was used for this purpose. HIV-positive (n=57) and HIV-negative (n=47) subjects were recruited on a basis of availability and willingness to participate. Long-term acceptability and compliance of HIV-positive consumers (n=9) was assessed after three and five months. Analysis of variance (ANOVA); Tukey's multiple comparison test and T-tests (p=0.05) were performed. Overall; consumers found the soy maize porridge significantly more acceptable; preferred it to; and also intended to consume it more often than the plain maize porridge. There were no significant differences between the HIV-positive and HIV-negative group regarding acceptability; preference and consumption intent. After three and five months; the HIV-positive consumers (n=9) did not find acceptability of the soy maize porridge significantly different from the first evaluation. It therefore had the potential to be included successfully in the nutrition intervention trial. The current study emphasises the need for sensory evaluation of food products prior to including them in intervention studies; to assess consumers' acceptance of them

Uma prática de cuidado investigativa à gestante HIV-soropositivo orientada pela teoria de Parse / Investigative care practice of HIV-positive pregnant women according Parse's theory

Trata-se de um estudo de natureza qualitativa que teve como objetivo desenvolver uma prática de cuidado investigativa direcionada à gestante HIV-soropositivo orientada pela teoria de Rosemarie Parse. O estudo foi desenvolvido numa Maternidade de Florianópolis, SC, Brasil, e teve como população alvo quatro gestantes HIVsoropositivo em acompanhamento pré-natal. O referencial teórico foi operacionalizado através do processo de enfermagem focalizando três dimensões: esclarecendo significado, sincronizando ritmo e mobilizando a transcendência. A obtenção dos dados deu-se através de entrevista e observação. Os resultados revelam um modo inovador de cuidar, propiciando vislumbrar as gestantes HIV-soropositivo de forma holística, promovendo sua evolução como ser humano.

Fitoterapia y SIDA / Phytotherapy and AIDS

El uso de tratamientos complementarios derivados de hierbas medicinales es bastante común entre las personas infectadas por VIH. Diversos estudios señalan que, en USA, hasta el 80% de la población seropositiva ha recurrido alguna vez a la medicina complementaria. Los objetivos que se buscan en este tipo de terapias son reforzar el sistema inmunológico, evitar las neoplasias, tratar problemas asociados al SIDA, como las infecciones, las alteraciones de la piel, la depresión o paliar los efectos adversos de los antirretrovirales, como las náuseas, la diarrea o la pérdida de peso. La falta de eficacia de estos tratamientos y, sobre todo las potenciales interacciones de los remedios herbales utilizados en estos casos con los fármacos antirretrovirales hacen necesaria su revisión

The use of complementary treatments derived from medicinal herbs is quite common among HIV-infected individuals. Several studies show that up to 80% of the seropositive population in the USA has resorted at one time or another to the use of complementary medicine. The objective that these types of therapies seek is to reinforce the immunological system, to avoid neoplasias, to treat AIDS-associated problems, infections, skin disorders, depression, and to palliate the side effects of antiretroviral agents, such as nausea, diarrhoea, or weight loss. The lack of efficacy of these treatments and, mainly, the potential interactions of herbal remedies with antiretroviral agents used in these cases, call for their urgent review