Assessment of the Cavidi ExaVir Load Assay for Monitoring Plasma Viral Load in HIV-2-Infected Patients.

HIV plasma viral load is an established marker of disease progression and of response to antiretroviral therapy, but currently there is no commercial assay validated for the quantification of viral load in HIV-2-infected individuals. We sought to make the first clinical evaluation of Cavidi ExaVir Load (version 3) in HIV-2-infected patients. Samples were collected from a total of 102 individuals living in Cape Verde, and the HIV-2 viral load was quantified by both ExaVir Load and a reference in-house real-time quantitative PCR (qPCR) used in Portugal in 91 samples. The associations between viral load and clinical prognostic variables (CD4+ T cell counts and antiretroviral therapy status) were similar for measurements obtained using ExaVir Load and qPCR. There was no difference between the two methods in the capacity to discriminate between nonquantifiable and quantifiable HIV-2 in the plasma. In samples with an HIV-2 viral load quantifiable by both methods (n = 27), the measurements were highly correlated (Pearson r = 0.908), but the ExaVir Load values were systematically higher relative to those determined by qPCR (median difference, 0.942 log10 copies/ml). A regression model was derived that enables the conversion of ExaVir Load results to those that would have been obtained by the reference qPCR. In conclusion, ExaVir Load version 3 is a reliable commercial assay to measure viral load in HIV-2-infected patients and therefore a valuable alternative to the in-house assays in current use.

[Evaluation of the quality of primary health care from the perspective of the elderly]. / Avaliação da qualidade da atenção primária à saúde sob a perspectiva do idoso.

The scope of this study was to assess the quality of Primary Health Care (PHC) provided to the elderly from their viewpoint. The study design was cross-sectional and observational in a stratified random sample of elderly individuals, enrolled in 10 of the 20 Basic Health Units (BHU) in the city of Macaiba, State of Rio Grande do Norte, Brazil. After an interview conducted using the adult version of the primary care assessment tool (PCATool-Brazil), the quality level was estimated (0-10, based on desirable attributes) and the association between demographic and socioeconomic factors was analyzed. The participants (n = 100) assigned a score of fair (5.7) to Quality; Longitudinality of care was awarded a high score (7.3), however Integrality (4.7), Family Orientation (4.1) and Accessibility (3.8) were considered weak. Socio-demographic factors linked to vulnerability (low income, rural area and older age) were positively associated with different PHC attributes. A margin for improvement in PHC attributes was observed, especially with respect to increasing the focus on the family, extending working hours in BHUs and enhancing prevention of diseases and ensuing complications.

Avaliação da qualidade da atenção primária à saúde sob a perspectiva do idoso / Evaluation of the quality of primary health care from the perspective of the elderly

O objetivo foi avaliar a qualidade do cuidado na Atenção Primária à Saúde (APS) ofertado à pessoa idosa segundo a sua perspectiva. O desenho foi observacional transversal em amostra aleatória estratificada de idosos (> 60 anos) cadastrados em 10 das 20 Unidades Básicas de Saúde (UBS) do município de Macaíba (RN), Brasil. Após entrevista com o instrumento PCATool-Brasil versão Adulto, estimou-se o nível de qualidade (0 a 10, baseado em atributos desejáveis) e analisou-se a associação de fatores sociodemográficos. Os participantes (n = 100) atribuíram à qualidade nota regular (5,7). A Longitudinalidade do cuidado foi um ponto forte (7,3), mas a Integralidade (4,7), a Orientação Familiar (4,1) e a Acessibilidade (3,8) são fragilidades na perspectiva do idoso. Fatores sociodemográficos ligados à vulnerabilidade (menor renda, área rural e maior idade) associaram-se positivamente a diferentes atributos da APS. Evidenciou-se margem para melhoria do cuidado ao idoso, sendo prioritário ampliar o foco na família, o horário de funcionamento das UBS e a diversidade na prevenção de doenças e agravos.

The scope of this study was to assess the quality of Primary Health Care (PHC) provided to the elderly from their viewpoint. The study design was cross-sectional and observational in a stratified random sample of elderly individuals, enrolled in 10 of the 20 Basic Health Units (BHU) in the city of Macaiba, State of Rio Grande do Norte, Brazil. After an interview conducted using the adult version of the primary care assessment tool (PCATool-Brazil), the quality level was estimated (0-10, based on desirable attributes) and the association between demographic and socioeconomic factors was analyzed. The participants (n = 100) assigned a score of fair (5.7) to Quality; Longitudinality of care was awarded a high score (7.3), however Integrality (4.7), Family Orientation (4.1) and Accessibility (3.8) were considered weak. Socio-demographic factors linked to vulnerability (low income, rural area and older age) were positively associated with different PHC attributes. A margin for improvement in PHC attributes was observed, especially with respect to increasing the focus on the family, extending working hours in BHUs and enhancing prevention of diseases and ensuing complications.