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INTRODUCTION: The incidence of syphilis has increased since the 1970s. METHODS: This was a descriptive and analytical cross-sectional study with a non-probabilistic sample. RESULTS: Of 973 patients with human immunodeficiency virus, 179 (18.4%) tested positive for both human immunodeficiency virus and syphilis, 84.8% were men, 50.9% were aged between 36 and 50 years, 47.8% with syphilis were diagnosed with human immunodeficiency virus for 10-20 years, and 40.3% received antiretroviral therapy for 10-20 years. CONCLUSIONS: The prevalence of syphilis in patients with human immunodeficiency virus is higher than expected, making it urgent to adopt efficient public health measures.
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Infecciones por VIH/epidemiología , Sífilis/epidemiología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Recuento de Linfocito CD4 , Coinfección , Estudios Transversales , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Sífilis/diagnóstico , Carga Viral , Adulto JovenRESUMEN
Abstract INTRODUCTION The incidence of syphilis has increased since the 1970s. METHODS This was a descriptive and analytical cross-sectional study with a non-probabilistic sample. RESULTS: Of 973 patients with human immunodeficiency virus, 179 (18.4%) tested positive for both human immunodeficiency virus and syphilis, 84.8% were men, 50.9% were aged between 36 and 50 years, 47.8% with syphilis were diagnosed with human immunodeficiency virus for 10-20 years, and 40.3% received antiretroviral therapy for 10-20 years. CONCLUSIONS The prevalence of syphilis in patients with human immunodeficiency virus is higher than expected, making it urgent to adopt efficient public health measures.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Anciano , Adulto Joven , Sífilis/epidemiología , Infecciones por VIH/epidemiología , Brasil/epidemiología , Sífilis/diagnóstico , Prevalencia , Estudios Transversales , Factores de Riesgo , Recuento de Linfocito CD4 , Carga Viral , Coinfección , Hospitales Universitarios , Persona de Mediana EdadRESUMEN
OBJECTIVE: Describe the coding process of death causes for people living with HIV/AIDS, and classify deaths as related or unrelated to immunodeficiency by applying the Coding Causes of Death in HIV (CoDe) system. METHODS: A cross-sectional study that codifies and classifies the causes of deaths occurring in a cohort of 2,372 people living with HIV/AIDS, monitored between 2007 and 2012, in two specialized HIV care services in Pernambuco. The causes of death already codified according to the International Classification of Diseases were recoded and classified as deaths related and unrelated to immunodeficiency by the CoDe system. We calculated the frequencies of the CoDe codes for the causes of death in each classification category. RESULTS: There were 315 (13%) deaths during the study period; 93 (30%) were caused by an AIDS-defining illness on the Centers for Disease Control and Prevention list. A total of 232 deaths (74%) were related to immunodeficiency after application of the CoDe. Infections were the most common cause, both related (76%) and unrelated (47%) to immunodeficiency, followed by malignancies (5%) in the first group and external causes (16%), malignancies (12 %) and cardiovascular diseases (11%) in the second group. Tuberculosis comprised 70% of the immunodeficiency-defining infections. CONCLUSIONS: Opportunistic infections and aging diseases were the most frequent causes of death, adding multiple disease burdens on health services. The CoDe system increases the probability of classifying deaths more accurately in people living with HIV/AIDS. OBJETIVO: Descrever o processo de codificação das causas de morte em pessoas vivendo com HIV/Aids, e classificar os óbitos como relacionados ou não relacionados à imunodeficiência aplicando o sistema Coding Causes of Death in HIV (CoDe). MÉTODOS: Estudo transversal, que codifica e classifica as causas dos óbitos ocorridos em uma coorte de 2.372 pessoas vivendo com HIV/Aids acompanhadas entre 2007 e 2012 em dois serviços de atendimento especializado em HIV em Pernambuco. As causas de óbito já codificadas a partir da Classificação Internacional de Doenças foram recodificadas e classificadas como óbitos relacionados e não relacionados à imunodeficiência pelo sistema CoDe. Foram calculadas as frequências dos códigos CoDe das causas do óbito em cada categoria de classificação. RESULTADOS: Ocorreram 315 (13%) óbitos no período do estudo; 93 (30%) tinham como causa uma doença definidora de Aids da lista do Centers for Disease Control and Prevention. No total 232 óbitos (74%) foram relacionados à imunodeficiência após aplicar o CoDe. As infecções foram as causas mais comuns, tanto nos óbitos relacionados (76%) como não relacionados (47%) à imunodeficiência, seguindo-se de malignidades (5%) no primeiro grupo e de causas externas (16%), malignidades (12%) e doenças cardiovasculares (11%) no segundo. A tuberculose compreendeu 70% das infecções definidoras de imunodeficiência. CONCLUSÕES: Infecções oportunistas e doenças do envelhecimento foram as causas mais frequentes de óbito, imprimindo carga múltipla de doenças aos serviços de saúde. O sistema CoDe aumenta a probabilidade de classificar os óbitos com maior precisão em pessoas vivendo com HIV/Aids.
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Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Causas de Muerte , Codificación Clínica , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Algoritmos , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Clasificación Internacional de Enfermedades , MasculinoRESUMEN
ABSTRACT OBJECTIVE Describe the coding process of death causes for people living with HIV/AIDS, and classify deaths as related or unrelated to immunodeficiency by applying the Coding Causes of Death in HIV (CoDe) system. METHODS A cross-sectional study that codifies and classifies the causes of deaths occurring in a cohort of 2,372 people living with HIV/AIDS, monitored between 2007 and 2012, in two specialized HIV care services in Pernambuco. The causes of death already codified according to the International Classification of Diseases were recoded and classified as deaths related and unrelated to immunodeficiency by the CoDe system. We calculated the frequencies of the CoDe codes for the causes of death in each classification category. RESULTS There were 315 (13%) deaths during the study period; 93 (30%) were caused by an AIDS-defining illness on the Centers for Disease Control and Prevention list. A total of 232 deaths (74%) were related to immunodeficiency after application of the CoDe. Infections were the most common cause, both related (76%) and unrelated (47%) to immunodeficiency, followed by malignancies (5%) in the first group and external causes (16%), malignancies (12 %) and cardiovascular diseases (11%) in the second group. Tuberculosis comprised 70% of the immunodeficiency-defining infections. CONCLUSIONS Opportunistic infections and aging diseases were the most frequent causes of death, adding multiple disease burdens on health services. The CoDe system increases the probability of classifying deaths more accurately in people living with HIV/AIDS.
RESUMO OBJETIVO Descrever o processo de codificação das causas de morte em pessoas vivendo com HIV/Aids, e classificar os óbitos como relacionados ou não relacionados à imunodeficiência aplicando o sistema Coding Causes of Death in HIV (CoDe). MÉTODOS Estudo transversal, que codifica e classifica as causas dos óbitos ocorridos em uma coorte de 2.372 pessoas vivendo com HIV/Aids acompanhadas entre 2007 e 2012 em dois serviços de atendimento especializado em HIV em Pernambuco. As causas de óbito já codificadas a partir da Classificação Internacional de Doenças foram recodificadas e classificadas como óbitos relacionados e não relacionados à imunodeficiência pelo sistema CoDe. Foram calculadas as frequências dos códigos CoDe das causas do óbito em cada categoria de classificação. RESULTADOS Ocorreram 315 (13%) óbitos no período do estudo; 93 (30%) tinham como causa uma doença definidora de Aids da lista do Centers for Disease Control and Prevention. No total 232 óbitos (74%) foram relacionados à imunodeficiência após aplicar o CoDe. As infecções foram as causas mais comuns, tanto nos óbitos relacionados (76%) como não relacionados (47%) à imunodeficiência, seguindo-se de malignidades (5%) no primeiro grupo e de causas externas (16%), malignidades (12%) e doenças cardiovasculares (11%) no segundo. A tuberculose compreendeu 70% das infecções definidoras de imunodeficiência. CONCLUSÕES Infecções oportunistas e doenças do envelhecimento foram as causas mais frequentes de óbito, imprimindo carga múltipla de doenças aos serviços de saúde. O sistema CoDe aumenta a probabilidade de classificar os óbitos com maior precisão em pessoas vivendo com HIV/Aids.
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Humanos , Masculino , Femenino , Causas de Muerte , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Codificación Clínica , Algoritmos , Brasil/epidemiología , Clasificación Internacional de Enfermedades , Estudios Transversales , Síndrome de Inmunodeficiencia Adquirida/complicacionesRESUMEN
Kaposi's sarcoma is a multifocal vascular lesion of low-grade potential that is most often present in mucocutaneous sites and usually also affects lymph nodes and visceral organs. The condition may manifest through purplish lesions, flat or raised with an irregular shape, gastrointestinal bleeding due to lesions located in the digestive system, and dyspnea and hemoptysis associated with pulmonary lesions. In the early 1980s, the appearance of several cases of Kaposi's sarcoma in homosexual men was the first alarm about a newly identified epidemic, acquired immunodeficiency syndrome. In 1994, it was finally demonstrated that the presence of a herpes virus associated with Kaposi's sarcoma called HHV-8 or Kaposi's sarcoma herpes virus and its genetic sequence was rapidly deciphered. The prevalence of this virus is very high (about 50%) in some African populations, but stands between 2% and 8% for the entire world population. Kaposi's sarcoma only develops when the immune system is depressed, as in acquired immunodeficiency syndrome, which appears to be associated with a specific variant of the Kaposi's sarcoma herpes virus. There are no treatment guidelines for Kaposi's sarcoma established in Brazil, and thus the Brazilian Society of Clinical Oncology and the Brazilian Society of Infectious Diseases developed the treatment consensus presented here.
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Femenino , Humanos , Masculino , Sarcoma de Kaposi , Brasil , Estadificación de Neoplasias , Pronóstico , Factores de Riesgo , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/epidemiología , Sarcoma de Kaposi/terapia , Sociedades MédicasRESUMEN
Kaposi's sarcoma is a multifocal vascular lesion of low-grade potential that is most often present in mucocutaneous sites and usually also affects lymph nodes and visceral organs. The condition may manifest through purplish lesions, flat or raised with an irregular shape, gastrointestinal bleeding due to lesions located in the digestive system, and dyspnea and hemoptysis associated with pulmonary lesions. In the early 1980s, the appearance of several cases of Kaposi's sarcoma in homosexual men was the first alarm about a newly identified epidemic, acquired immunodeficiency syndrome. In 1994, it was finally demonstrated that the presence of a herpes virus associated with Kaposi's sarcoma called HHV-8 or Kaposi's sarcoma herpes virus and its genetic sequence was rapidly deciphered. The prevalence of this virus is very high (about 50%) in some African populations, but stands between 2% and 8% for the entire world population. Kaposi's sarcoma only develops when the immune system is depressed, as in acquired immunodeficiency syndrome, which appears to be associated with a specific variant of the Kaposi's sarcoma herpes virus. There are no treatment guidelines for Kaposi's sarcoma established in Brazil, and thus the Brazilian Society of Clinical Oncology and the Brazilian Society of Infectious Diseases developed the treatment consensus presented here.
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Sarcoma de Kaposi , Brasil , Femenino , Humanos , Masculino , Estadificación de Neoplasias , Pronóstico , Factores de Riesgo , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/epidemiología , Sarcoma de Kaposi/terapia , Sociedades MédicasRESUMEN
Lithiasic cholecystitis is classically associated with the presence of enterobacteria, such as Escherichia coli, Enterococcus, Klebsiella, and Enterobacter, in the gallbladder. Cholecystitis associated with fungal infections is a rare event related to underlying conditions such as diabetes mellitus, steroid use, and broad-spectrum antibiotic use for prolonged periods, as well as pancreatitis and surgery of the digestive tract. Here, we present the first reported case of a gallbladder infection caused by Candida famata.
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Anciano , Femenino , Humanos , Candidiasis/microbiología , Colecistitis/microbiología , Candida/clasificación , Candida/aislamiento & purificación , Candidiasis/diagnóstico , Resultado FatalRESUMEN
Objective To compare automatic and manual measurements of intima-media complex (IMC) in common carotid, common femoral and right subclavian arteries of HIV-infected patients in relation to a control group, taking into consideration the classical risk factors for atherosclerosis. Materials and Methods The study sample comprised 70 HIV-infected patients and 70 non-HIV-infected controls paired according sex and age. Automatic (gold standard) and manual measurements of IMC were performed in the carotid arteries. Manual measurements were also performed in common femoral and right subclavian arteries. Bland-Altman graphs were utilized in the comparison and the adopted level significance was 5%. Results Intima-media complex alterations were not observed in any of the individuals as the mean automatic measurement in the right common carotid (RCC) artery was considered as the gold standard. As the gold standard was compared with the manual measurements (mean, maximum and minimum), no clinically significant alteration was observed. As the gold standard was compared with other sites, the difference was statistically and clinically significant at the origin of right subclavian artery (RCC: 0.51 mm vs. 0.91 mm) (p < 0.001). Conclusion HIV-infected individuals are not at higher risk for atherosclerosis than the control population. .
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Introduction: Smoking is the leading cause of preventable death in the world. The prevalence of smoking is higher in people infected with HIV than in the general population. Although it is biologically plausible that smoking increases the morbidity and mortality of people living with HIV/AIDS, few studies in developing countries have analyzed the determinants and consequences of smoking in HIV infected people. Objective: To estimate the prevalence of smoking and identify the socioeconomic factors associated with smoking and smoking cessation in patients with HIV by sex. Methods: A cross-sectional study was conducted with baseline data, obtained from an ongoing prospective cohort study of patients with HIV attending two referral centers in Recife, Northeast Region of Brazil, between July 2007 and October 2009. Results: The prevalence of current smoking was 28.9%. For both sexes, smoking was independently associated with heavy alcohol drinking and marijuana use. Among women, smoking was associated with living alone, not being married and illiteracy; and among men, being 40 years or older, low income and using crack. Compared with ex-smokers, current smokers were younger and more likely to be unmarried, heavy drinkers and marijuana users. Conclusions: It is important to incorporate smoking cessation interventions for the treatment of heavy alcohol drinkers and marijuana users with HIV/AIDS, which may increase life expectancy and quality of life, as smoking is related to risk of death, relapse of tuberculosis, and non communicable diseases. .
Resumo Introdução: Tabagismo é a principal causa de morte evitável no mundo e a sua prevalência é maior em pessoas infectadas pelo HIV. Embora haja plausibilidade biológica no fato de o tabagismo aumentar a morbimortalidade de pessoas que vivem com HIV, poucos estudos em países em desenvolvimento têm analisado os determinantes e as conseqüências desse hábito nessa população. Objetivos: Estimar a prevalência de tabagismo e identificar os fatores associados com o tabagismo e com a cessação do tabagismo em infectados pelo HIV, por sexo. Métodos: Estudo seccional utilizando os dados de base de uma coorte prospectiva de pacientes com HIV atendidos em dois centros de referência em Recife, nordeste do Brasil, entre julho de 2007 e outubro de 2009. Resultados: A prevalência de tabagismo foi de 28,9%. Para ambos os sexos, o tabagismo esteve associado com alcoolismo e uso de maconha. Entre as mulheres, o tabagismo esteve associado com não ser casada, morar só, e não saber ler e escrever; e entre os homens esteve associado com idade ≥ 40 anos, baixa renda mensal e uso de crack. Comparado com os ex-fumantes, os fumantes eram mais jovens, não casados, bebiam mais e fumavam maconha. Conclusão: É importante incorporar intervenções para cessação do tabagismo no tratamento de usuários de maconha e alcoolistas com HIV/AIDS, o que pode aumentar a qualidade e expectativa de vida desses pacientes, uma vez que o tabagismo está relacionado com maior risco de morte, recidiva da tuberculose e também com doenças crônicas não infecciosas. .
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Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven , Infecciones por VIH , Fumar/epidemiología , Brasil/epidemiología , Estudios Transversales , Prevalencia , Distribución por Sexo , Cese del Hábito de Fumar , Factores SocioeconómicosRESUMEN
Lithiasic cholecystitis is classically associated with the presence of enterobacteria, such as Escherichia coli, Enterococcus, Klebsiella, and Enterobacter, in the gallbladder. Cholecystitis associated with fungal infections is a rare event related to underlying conditions such as diabetes mellitus, steroid use, and broad-spectrum antibiotic use for prolonged periods, as well as pancreatitis and surgery of the digestive tract. Here, we present the first reported case of a gallbladder infection caused by Candida famata.
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Candidiasis/microbiología , Colecistitis/microbiología , Anciano , Candida/clasificación , Candida/aislamiento & purificación , Candidiasis/diagnóstico , Resultado Fatal , Femenino , HumanosRESUMEN
Hepatotoxicity due to antituberculosis drugs limits treatment in patients coinfected with HIV and tuberculosis. We conducted a case-control study to identify risk factors for hepatotoxicity among patients coinfected with tuberculosis and HIV in two hospitals in Recife, Pernambuco State, Brazil. The sample consisted of 57 patients (36.5% of the total) who developed hepatotoxicity and a control group of 99 patients (63.5% of the total), who did not present this effect. Hepatotoxicity consisted of jaundice or a high concentration of AST/ALT or total bilirubinemia. Multivariate logistic regression showed that a T CD4+ count of < 200 cells/mm(3) increased the risk of hepatotoxicity by a factor of 1.233 (p < 0.001) and that coinfection with hepatitis B or C virus increased this risk by a factor of 18.187 (p = 0.029). Discharge occurred among 66.1% of the case group (p = 0.026). The absence of hepatotoxicity was a protective factor against death (OR = 0.42; 95%CI: 0.20-0.91). Coinfection with the B and C hepatitis virus and a T CD4+ cell count below 200 cells/mm(3) were independent risk factors for hepatotoxicity in these patients.
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Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Antituberculosos/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Tuberculosis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores de Tiempo , Tuberculosis Pulmonar/tratamiento farmacológico , Adulto JovenRESUMEN
Hepatotoxicity due to antituberculosis drugs limits treatment in patients coinfected with HIV and tuberculosis. We conducted a case-control study to identify risk factors for hepatotoxicity among patients coinfected with tuberculosis and HIV in two hospitals in Recife, Pernambuco State, Brazil. The sample consisted of 57 patients (36.5% of the total) who developed hepatotoxicity and a control group of 99 patients (63.5% of the total), who did not present this effect. Hepatotoxicity consisted of jaundice or a high concentration of AST/ALT or total bilirubinemia. Multivariate logistic regression showed that a T CD4+ count of < 200cells/mm³ increased the risk of hepatotoxicity by a factor of 1.233 (p < 0.001) and that coinfection with hepatitis B or C virus increased this risk by a factor of 18.187 (p = 0.029). Discharge occurred among 66.1% of the case group (p = 0.026). The absence of hepatotoxicity was a protective factor against death (OR = 0.42; 95%CI: 0.20-0.91). Coinfection with the B and C hepatitis virus and a T CD4+ cell count below 200cells/mm³ were independent risk factors for hepatotoxicity in these patients.
Hepatotoxicidade secundária às drogas antituberculose limita o tratamento em pacientes coinfectados com HIV e tuberculose. Conduzimos estudo caso-controle para identificar fatores de risco para hepatotoxicidade entre pacientes com tuberculose e infecção pelo HIV em dois hospitais de Recife, Pernambuco, Brasil. O grupo caso consistiu de 57 (36,5%) pacientes com hepatotoxicidade e o grupo controle, 99 (63,5%) pacientes que não a apresentaram. Hepatotoxicidade foi definida como icterícia ou alta concentração de ALT/AST ou de bilirrubinemia total. Regressão logística multivariada mostrou que a contagem de linfócitos T CD4+ < 200 células/mm³ aumentou o risco de hepatotoxicidade em 1,233 vezes (p < 0,001), e coinfecção com vírus de hepatite B ou C aumentou o risco em 18,187 (p = 0,029). Alta hospitalar ocorreu em 66,1% dos pacientes do grupo caso (p = 0,026). Ausência de hepatotoxicidade foi fator de proteção para óbito (OR = 0,42; IC: 0,20-0,91). Coinfecção pelos vírus das hepatites B e C e linfócitos T CD4+ abaixo de 200 células/mm³ foram fatores de risco independentes para a hepatotoxicidade nesses pacientes.
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Antituberculosos/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Tuberculosis/tratamiento farmacológico , Estudios de Casos y Controles , Factores de Riesgo , Factores de Tiempo , Tuberculosis Pulmonar/tratamiento farmacológicoRESUMEN
A cross-sectional study was conducted using body mass index (BMI) to estimate the prevalence of thinness and overweight/obesity and associated factors in 2,018 individuals with HIV/AIDS attending health services referral centers. The dependent variable was classified as thinness, overweight/obesity and eutrophy. Multinomial logistic regression analyses were performed considering eutrophy as the reference level. The prevalence of thinness was 8.8% and of overweight/obesity, 32.1%. The variables associated with thinness were anemia and CD4 cell count < 200mm³. The variables associated with risk of overweight/obesity were age > 40 years and diabetes, and the variables identified as decreasing likelihood of overweight/obesity were having no long-term partner, smoking, presence of an opportunistic disease, anemia, and albumin levels < 3.5mg/dL. The main nutritional problem observed in this population was overweight and obesity, which were much more prevalent than thinness. Older individuals with diabetes should be targeted for nutritional interventions and lifestyle changes.
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Infecciones por VIH/complicaciones , Obesidad/complicaciones , Delgadez/complicaciones , Adolescente , Adulto , Índice de Masa Corporal , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Estado Nutricional , Obesidad/epidemiología , Sobrepeso/complicaciones , Sobrepeso/epidemiología , Prevalencia , Factores de Riesgo , Factores Socioeconómicos , Delgadez/epidemiologíaRESUMEN
A cross-sectional study was conducted using body mass index (BMI) to estimate the prevalence of thinness and overweight/obesity and associated factors in 2,018 individuals with HIV/AIDS attending health services referral centers. The dependent variable was classified as thinness, overweight/obesity and eutrophy. Multinomial logistic regression analyses were performed considering eutrophy as the reference level. The prevalence of thinness was 8.8 percent and of overweight/obesity, 32.1 percent. The variables associated with thinness were anemia and CD4 cell count < 200mm³. The variables associated with risk of overweight/obesity were age > 40 years and diabetes, and the variables identified as decreasing likelihood of overweight/obesity were having no long-term partner, smoking, presence of an opportunistic disease, anemia, and albumin levels < 3.5mg/dL. The main nutritional problem observed in this population was overweight and obesity, which were much more prevalent than thinness. Older individuals with diabetes should be targeted for nutritional interventions and lifestyle changes.
Estudo seccional para estimar a prevalência de magreza e sobrepeso/obesidade e fatores associados em 2.018 indivíduos com HIV/AIDS, atendidos em serviços de referência em Recife, Pernambuco, Brasil, utilizando o índice de massa corporal. A variável dependente foi classificada como magreza, sobrepeso/obesidade e eutrofia. Realizou-se análise de regressão logística multinomial considerando-se como referência os eutróficos. A prevalência de magreza foi de 8,8 por cento e a de sobrepeso/obesidade de 32,1 por cento. Permaneceram associados à magreza ter anemia e contagem de células TCD4 < 200mm³. Os fatores associados à maior chance de sobrepeso/obesidade foram: idade > 40 anos e presença de diabetes, e aqueles inversamente associados com sobrepeso/obesidade: não ter companheiro fixo, tabagismo, história recente de doença oportunista, anemia e níveis de albumina < 3,5mg/dL. O principal desvio nutricional observado foi o sobrepeso/obesidade, superando a magreza. Os indivíduos mais velhos com diabetes devem ser alvos de intervenções nutricionais e de estilo de vida.
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Adolescente , Adulto , Femenino , Humanos , Masculino , Infecciones por VIH , Obesidad , Delgadez , Índice de Masa Corporal , Brasil , Estudios Transversales , Estado Nutricional , Obesidad , Sobrepeso , Sobrepeso , Prevalencia , Factores de Riesgo , Factores Socioeconómicos , DelgadezRESUMEN
Este estudo teve como objetivo analisar características clínicas, epidemiológicas e bacteriológicas de 60 pacientes com tuberculose pulmonar infectados pelo HIV(+) comparando-as às de 120 pacientes com TB pulmonar/HIV(-). Analisou-se as características em relaçäo ao sexo, idade, hábitos de vida, antecedentes de contato ou tratamento anterior para tuberculose, características clínicas e bacteriológicas e resultado do tratamento. Os doentes co-infectados foram predominantemente do sexo masculino (p=0,001), referiram com maior freqüência perda >10 quilos (p<0,001), apresentaram maior freqüência de teste tuberculínico näo reatores (p<0,001), baciloscopia negativa (p=0,001) e cultura de escarro negativa (p<0,001). O insucesso do tratamento foi mais significante naqueles HIV(+) (p<0,001). Näo se encontrou uma maior freqüência de resistência aos tuberculostáticos associada à co-infecçäo (p=0,407). A tuberculose extrapulmonar associada à tuberculose pulmonar foi mais freqüente nos soropositivos que nos HIV (-), 30 por cento e 1,6 por cento respectivamente. Estes achados evidenciam predominância de características clínico-laboratoriais atípicas nos pacientes com co-infecçäo, alertando para a possibilidade deste diagnóstico.