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5.
Braz. j. infect. dis ; 17(4): 444-449, July-Aug. 2013. tab
Artículo en Inglés | LILACS | ID: lil-683132

RESUMEN

OBJECTIVE: To study whether patients with HIV-1 associated lipodystrophy (LD) on highly active antiretroviral treatment (HAART) have more psychopathology and worse psychosocial adjustment than a similar group without this syndrome. METHODS: In a cross-sectional, observational study we compared 47 HIV-1 infected patients with LD (LD group) with 39 HIV-1 infected patients without LD (non-LD group). All participants were on HAART. The Beck Depression Inventory (BDI), the State and Trait Anxiety Inventory (STAI) and the Goldberg Health Questionnaire (GHQ-60) were administered. Levels of familial, work and social adjustment and adjustment to stressful events were evaluated in a semi-structured interview. Clinical information was extracted from the clinical records. RESULTS: In the univariate analysis patients with LD showed higher state anxiety scores (p = 0.009) and worse work adjustment (p = 0.019) than those without LD. A total of 45.3% of LD patients scored above the cut-off point on the trait anxiety scale, and over 33.3% scored above the cut-off point on the BDI, GHQ and state anxiety scales. However, in multivariate analyses LD was not independently associated with psychopathology or with worse adjustment in the studied areas. CONCLUSIONS: The finding that LD was not a predictor of greater psychopathology or worse psychosocial adjustment in HIV-1 infected patients, despite the high scores found, suggests that factors not taken into account in this study, such as LD severity and self-perception should have been included in the analysis. Further studies including a greater number of variables and a larger sample size will advance our understanding of this complex condition.


Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Terapia Antirretroviral Altamente Activa/psicología , Síndrome de Lipodistrofia Asociada a VIH/psicología , Ajuste Social , Estudios de Casos y Controles , Estudios Transversales , Síndrome de Lipodistrofia Asociada a VIH/tratamiento farmacológico , Acontecimientos que Cambian la Vida , Factores Socioeconómicos , Encuestas y Cuestionarios
6.
Braz J Infect Dis ; 17(4): 444-9, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23742804

RESUMEN

OBJECTIVE: To study whether patients with HIV-1 associated lipodystrophy (LD) on highly active antiretroviral treatment (HAART) have more psychopathology and worse psychosocial adjustment than a similar group without this syndrome. METHODS: In a cross-sectional, observational study we compared 47 HIV-1 infected patients with LD (LD group) with 39 HIV-1 infected patients without LD (non-LD group). All participants were on HAART. The Beck Depression Inventory (BDI), the State and Trait Anxiety Inventory (STAI) and the Goldberg Health Questionnaire (GHQ-60) were administered. Levels of familial, work and social adjustment and adjustment to stressful events were evaluated in a semi-structured interview. Clinical information was extracted from the clinical records. RESULTS: In the univariate analysis patients with LD showed higher state anxiety scores (p=0.009) and worse work adjustment (p=0.019) than those without LD. A total of 45.3% of LD patients scored above the cut-off point on the trait anxiety scale, and over 33.3% scored above the cut-off point on the BDI, GHQ and state anxiety scales. However, in multivariate analyses LD was not independently associated with psychopathology or with worse adjustment in the studied areas. CONCLUSIONS: The finding that LD was not a predictor of greater psychopathology or worse psychosocial adjustment in HIV-1 infected patients, despite the high scores found, suggests that factors not taken into account in this study, such as LD severity and self-perception should have been included in the analysis. Further studies including a greater number of variables and a larger sample size will advance our understanding of this complex condition.


Asunto(s)
Terapia Antirretroviral Altamente Activa/psicología , Síndrome de Lipodistrofia Asociada a VIH/psicología , Ajuste Social , Adulto , Estudios de Casos y Controles , Estudios Transversales , Femenino , Síndrome de Lipodistrofia Asociada a VIH/tratamiento farmacológico , Humanos , Acontecimientos que Cambian la Vida , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
7.
Med Clin (Barc) ; 127(2): 47-50, 2006 Jun 10.
Artículo en Español | MEDLINE | ID: mdl-16801002

RESUMEN

BACKGROUND AND OBJECTIVE: Patients on methadone maintenance therapy who are administered nelfinavir show a decrease in methadone plasma levels. However, the clinical relevance of this fact is seldom significant because it does not correlate with the appearance of opioid withdrawal symptoms (OWS). The objective of this study was to assess the clinical and pharmacokinetic interactions between methadone and nelfinavir. PATIENTS AND METHOD: A prospective multicenter study of human immunodeficiency virus (HIV) positive patients on stable methadone therapy who initiated nelfinavir was performed. To determine the presence of OWS, 2 questionnaires, objective and subjective, were administered at weeks 1, 2, 3 and 4. A pharmacokinetic study measuring the minimal plasmatic concentration of methadone was done at baseline and at week 4. RESULTS: 29 patient were included. In 7 patients who underwent pharmacokinetic studies, the minimal plasmatic concentration of methadone decreased after 4 weeks of nelfinavir treatment from 6.889 ng/ml to 4.354 ng/ml (37%; p = 0.046). However the results of the questionnaires did not show the significant OWS, which precluded an increase in the dose of methadone. CONCLUSIONS: In patients under stable methadone treatment, antiretroviral therapy including nelfinavir does not require any significant modification of methadone dose. The decrease in methadone plasmatic levels does not correlate with OWS.


Asunto(s)
Inhibidores de la Proteasa del VIH/farmacocinética , Metadona/farmacocinética , Narcóticos/farmacocinética , Nelfinavir/farmacocinética , Adulto , Interacciones Farmacológicas , Femenino , Humanos , Masculino , Estudios Prospectivos
8.
Med. clín (Ed. impr.) ; 127(2): 47-50, jun. 2006. graf
Artículo en Es | IBECS | ID: ibc-046360

RESUMEN

Fundamento y objetivo: En los pacientes tratados con nelfinavir y metadona disminuyen los valores plasmáticos de ésta, lo que clínicamente no suele ser importante, ya que no aparecen síntomas de abstinencia a opiáceos (SAO). Nuestro objetivo ha sido evaluar las interacciones clínicas y farmacocinéticas entre la metadona y el nelfinavir. Pacientes y método: Estudio prospectivo y multicéntrico con pacientes infectados por el virus de la inmunodeficiencia humana en tratamiento estable con metadona que iniciaban nelfinavir. La presencia de SAO se averiguó mediante sendos cuestionarios, objetivo y subjetivo, en las semanas 1, 2, 3 y 4. En un subgrupo de pacientes se midió la concentración mínima plasmática de metadona basalmente y a la cuarta semana de tratamiento. Resultados: Se incluyó a 29 pacientes y en 7 se realizó estudio farmacocinético. La concentración mínima plasmática de metadona disminuía a la cuarta semana de recibir nelfinavir desde 6,889 hasta 4,354 ng/ml (37%; p = 0,046). Los cuestionarios no detectaron SAO de forma significativa, por lo que no fue necesario cambiar significativamente las dosis de metadona. Conclusiones: La administración de nelfinavir en pacientes en tratamiento estable con metadona no precisa de modificaciones significativas de la dosis de ésta, ya que el descenso producido en sus valores plasmáticos no provoca la aparición de SAO


Background and objective: Patients on methadone maintenance therapy who are administered nelfinavir show a decrease in methadone plasma levels. However, the clinical relevance of this fact is seldom significant because it does not correlate with the appearance of opiod withdrawal symptoms (OWS). The objective of this study was to assess the clinical and pharmacokinetic interactions between methadone and nelfinavir. Patients and method: A prospective multicenter study of human immunodeficiency virus (HIV) positive patients on stable methadone therapy who initiated nelfinavir was performed. To determine the presence of OWS, 2 questionnaires, objective and subjective, were administered at weeks 1, 2, 3 and 4. A pharmacokinetic study measuring the minimal plasmatic concentration of methadone was done at baseline and at week 4. Results: 29 patient were included. In 7 patients who underwent pharmacokinetic studies, the minimal plasmatic concentration of methadone decreased after 4 weeks of nelfinavir treatment from 6.889 ng/ml to 4.354 ng/ml (37%; p = 0.046). However the results of the questionnaires did not show the significant OWS, which precluded an increase in the dose of methadone. Conclusions: In patients under stable methadone treatment, antiretroviral therapy including nelfinavir does not require any significant modification of methadone dose. The decrease in methadone plasmatic levels does not correlate with OWS


Asunto(s)
Masculino , Femenino , Humanos , Metadona/farmacocinética , Nelfinavir/farmacocinética , Infecciones por VIH/tratamiento farmacológico , Interacciones Farmacológicas , Síndrome de Abstinencia a Sustancias/diagnóstico , Encuestas y Cuestionarios , Estudios Prospectivos
9.
J Acquir Immune Defic Syndr ; 41(1): 17-22, 2006 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-16340468

RESUMEN

To examine whether polymorphisms of the RANTES chemokine gene promoter are associated with long-term nonprogressive HIV-1 infection in white Spanish subjects, we performed a cross-sectional genetic association case-control study. Two-hundred sixty-seven white Spaniards were studied: 58 were HIV-1-infected long-term nonprogressors (LTNPs) of more than 16 years, 109 were HIV-1-infected usual progressors (UPs), and 100 were control subjects. Three RANTES single nucleotide polymorphisms (SNPs) at positions -28C>G, -109T>C, and -403G>A were assessed. The prevalence of the CCR5Delta 32 allele was also examined. Genotyping was performed using polymerase chain reaction and automatic sequencing analysis methods. Genotype and allele frequencies between the 3 groups were compared by the chi2 test and the Fisher exact test. The distribution of allelic variants of RANTES in controls, UPs, and LTNPs, respectively, was 3%, 2%, and 5% for -28G; 4%, 2%, and 2% for -109C; and 18%, 18%, and 18% for -403A (P = not significant). The differences were still nonsignificant when we exclusively analyzed individuals not carrying the CCR5Delta32 allele. We conclude that LTNP of more than 16 years is not associated with SNPs in the RANTES gene promoter in white Spanish HIV-1-infected subjects.


Asunto(s)
Quimiocina CCL5/genética , Infecciones por VIH/genética , Polimorfismo Genético , Polimorfismo de Nucleótido Simple , Adulto , Estudios de Casos y Controles , Quimiocinas/genética , Estudios Transversales , Progresión de la Enfermedad , Femenino , Infecciones por VIH/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Mutación Missense , Regiones Promotoras Genéticas , Eliminación de Secuencia , España , Factores de Tiempo
10.
Am J Clin Nutr ; 77(2): 420-4, 2003 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-12540403

RESUMEN

BACKGROUND: Before the advent of highly active antiretroviral therapy (HAART), 20% and 10% of HIV-infected patients had low vitamin B-12 and red blood cell folate (RBCF) concentrations, respectively. However, few patients had real vitamin B-12 deficiency. OBJECTIVE: We evaluated the prevalence of low vitamin B-12 and RBCF concentrations in HIV-infected patients receiving HAART and the usefulness of serum homocysteine (sHcy) for differentiating patients with deficiency from those with harmlessly low vitamin B-12. DESIGN: The prevalence of low vitamin B-12 and RBCF was evaluated in 126 HIV-infected patients receiving HAART. Moreover, sHcy concentrations were evaluated in 40 HIV-infected patients with low vitamin B-12 and in 37 HIV-infected patients with low RBCF and were compared with those in 128 HIV-infected patients with normal vitamin B-12 and RBCF. sHcy was used to monitor treatment with vitamin B-12 and folic acid in 28 patients (24 with low vitamin B-12 and RBCF and 4 with hyperhomocysteinemia but normal vitamin B-12 and RBCF). RESULTS: The prevalence of low vitamin B-12 was significantly lower in patients receiving HAART than in previously studied patients who did not receive HAART (8.7% compared with 27%). Nine of the 40 patients (22.5%) with low vitamin B-12 (< or = 200 pmol/L) had hyperhomocysteinemia (> 17.5 micromol homocysteine/L). Nineteen (51.4%) of the 37 patients with low RBCF (< or = 580 nmol/L, percentile 10) had hyperhomocysteinemia. Among the 9 patients with an RBCF concentration < or = 450 nmol/L (percentile 2.5), all had hyperhomocysteinemia. The treatment with vitamin B-12 and folic acid normalized sHcy concentrations. CONCLUSIONS: The prevalence of low vitamin B-12 decreased after the introduction of HAART. The study of sHcy is useful for detecting HIV-infected patients with low vitamin B-12 and real deficiency.


Asunto(s)
Terapia Antirretroviral Altamente Activa , Ácido Fólico/administración & dosificación , Infecciones por VIH/sangre , Homocisteína/sangre , Deficiencia de Vitamina B 12/diagnóstico , Vitamina B 12/sangre , Adulto , Diagnóstico Diferencial , Eritrocitos/química , Femenino , Ácido Fólico/sangre , Deficiencia de Ácido Fólico/sangre , Deficiencia de Ácido Fólico/diagnóstico , Deficiencia de Ácido Fólico/epidemiología , Infecciones por VIH/tratamiento farmacológico , Homocisteína/fisiología , Humanos , Hiperhomocisteinemia/sangre , Hiperhomocisteinemia/epidemiología , Masculino , Evaluación Nutricional , Estado Nutricional , Vitamina B 12/administración & dosificación , Deficiencia de Vitamina B 12/sangre , Deficiencia de Vitamina B 12/epidemiología
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