Impact of Metabolic Syndrome and Cardiovascular Risk on the Quality of Life of People Living with HIV.

BACKGROUND: The time elapsed since HIV infection diagnosis (TdiagHIV) affects the quality of life (QoL) and can get worse when chronic illnesses start. OBJECTIVE: The aim of this study was to analyze the impact of metabolic syndrome (MetS) and cardiovascular risk (CVR) on the QoL of people living with HIV (PLHIV). METHODS: Cross-sectional study, with 60 PLHIV followed at a Reference Center in the city of Jataí, Goiás, Brazil. Data collection involved sociodemographic, clinical, CVR, MetS, and QoL information. The data were analyzed using descriptive and inferential statistics, with the BioEstat 5.3 program adopting p0.05. RESULTS: There was a predominance of men (61.7%), aged ≥38 years (53.3%), with a TdiagHIV of 97.88Añ85.65 months and use of antiretroviral therapy (ART) of 80.13Añ69.37 months. The worst domain of QoL was concern about confidentiality (40 points), and the best was medication concerns (95 points). MetS predominated at 18.3% and a moderate CVR at 11.7%. MetS was positively associated with age 38 years, the female sex, with the lowest score in QoL for general function, and the highest for TdiagHIV and the use of ART (p0.05). A moderate CRV was positively related to higher TdiagHIV and ART use, and low HDL-c, and the lowest score for QoL was found for trust in a professional (p0.05). CONCLUSION: PLHIV who are older, have a higher TdiagHIV, and use ART are more likely to develop MetS and moderate CVR. The presence of these diseases in PLHIV causes impairment in areas of QoL.

Survival analysis over a 20-year period of a Brazilian cohort of blood donors coinfected HIV-HCV

ABSTRACT Among individuals coinfected with HCV and HIV, studies of mortality from non-hepatic causes have shown inconsistent results. The aim of this study was to investigate the contribution of HCV and HIV co-infection to mortality from hepatic and non-hepatic causes in Brazil. This retrospective cohort study included blood donors from Fundação Pró-Sangue de São Paulo (FPS) who were followed from 1994 to 2016 to compare mortality and its causes between HIV-HCV coinfected individuals versus those seronegative for all tested infections. Records from the FPS database and the Mortality Information System were linked through a probabilistic record Relationship (RL). The Hazard Ratio (HR) was estimated using Cox multiple regression models. HCV-HIV coinfected individuals compared to seronegative individuals had a higher risk of death from all causes (HR = 14.54), non-liver neoplasms (HR = 2.55), infections (HR = 10.37) and liver disease (HR = 7.0). In addition, HCV mono-infected individuals compared to seronegative individuals had a higher risk of death from all causes (HR = 2.23), liver cancer (HR = 32.21), liver disease (HR = 14.92), infection (HR = 3.22), and trauma (HR = 1.68). Individuals coinfected with HCV and HIV have increased overall mortality and death due to infections, liver diseases and non-liver neoplasms as compared to those uninfected with HCV and HIV.

SARS-CoV-2 and acute pancreatitis: a new etiological agent?

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Opportunistic and non-opportunistic intestinal parasites in HIV/ AIDS patients in relation to their clinical and epidemiological status in a specialized medical service in Goiás, Brazil.

Patients infected with the Human Immunodeficiency Virus (HIV) often have opportunistic infections, among which strongyloidiasis and coccidiosis are the most common parasitic infections that aggravate their health status. This study examined the prevalence of intestinal parasites, particularly of Strongyloides stercoralis and intestinal coccidia in patients with the Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) who were treated at the Specialized Assistance Service (SAE) of Jataí, State of Goiás, Brazil, and analyzed its correlation with clinical, laboratory, and socio-epidemiological parameters. A total of 270 stool samples were analyzed by the Lutz technique, Rugai's method, Agar Plate Culture, Ritchie's method and specific staining, Ziehl-Neelsen modified technique, Kinyoun's method and the rapid safranin method. The prevalence of intestinal parasites was 28.88% including 3.8% of S. stercoralis, Cryptosporidium sp. and Cystoisospora belli. There was a significant positive correlation between intestinal parasites and the clinical status and the use of antiretroviral therapy (ART), smoking, CD4+ lymphocyte counts and sexual orientation. In conclusion, the widespread use of antiretroviral therapy and health assistance contributed to the low prevalence of S. stercoralis and coccidiosis in patients with HIV/ AIDS who were followed up at the SAE.

Estudo transversal da letalidade da hantavirose no estado de Goiás, 2007-2013 / Estudio transversal de la letalidad de la infección por hantavirus en el estado de Goiás, Brasil, 2007-2013 / Cross-sectional study on case fatality rate due to hantavirus infection in Goiás State, Brazil, 2007-2013

OBJETIVO: descrever o perfil epidemiológico e clínico da hantavirose e analisar fatores associados à letalidade em Goiás, Brasil. MÉTODOS: foi conduzido um estudo transversal com dados do Sistema de Informação de Agravos de Notificação (Sinan), referentes ao período de 2007 a 2013, no estado de Goiás. Regressão logística foi empregada para estimar razões de chances (OR) com intervalos de confiança de 95% (IC95%). RESULTADOS: foram notificados 1.171 casos suspeitos de hantavirose e 73 (6,2%) confirmados. Entre os confirmados, observou-se maior frequência entre homens (n=50), febre como sintoma mais frequente (n=70) e elevada proporção de hospitalizações (n=68). A taxa de letalidade foi de 57,5%. Foram fatores associados ao óbito: insuficiência respiratória aguda (IRpA) (OR=3,6; IC95%1,2;10,6), hemoconcentração (OR=3,3; IC95%1,1;7,9) e não uso do respirador mecânico (OR=3,4; IC95%1,3;9,1). Após ajuste, a IRpA permaneceu associada ao óbito (OR=3,4; IC95%1,0;11,6). CONCLUSÃO: foi identificada alta taxa de letalidade, associada principalmente com insuficiência respiratória.

OBJETIVO: evaluar el perfil clínico y epidemiológico del hantavirus y los factores asociados con su letalidad en Goiás, Brasil. MÉTODOS: estudio transversal usando datos del Sistema de Información de Enfermedades de Declaración Obligatoria (Sinan), referentes al periodo 2007-2013, en el estado de Goias. Usamos regresión logística para calcular odds ratio (OR) con intervalos de confianza al 95%. RESULTADOS: fueron reportados 1.171 casos sospechosos de hantavirus 73 fueron confirmados (6,2%). Entre los confirmados la frecuencia fue mayor entre hombres (n=50), fiebre fue síntoma más común (n=70), 68 fueron hospitalizados, la tasa de letalidad fue 57,5%. Variables asociadas con letalidad: insuficiencia respiratoria aguda (IRpA) (OR=3,6 IC95% 1,2; 10,6), hemoconcentración (OR=3.3 IC95% 1,1; 7,9) y no usar respirador mecánico (OR=3,4 IC95% 1,3; 9,1). Sólo IRpA se mantuvo asociado en modelos multivariados (OR=3,4 IC95% 1,0; 11,6). CONCLUSIÓN: identificamos una alta tasa de letalidad asociada principalmente con insuficiencia respiratoria.

OBJECTIVE: to describe the epidemiological and clinical profile of hantavirus infection and to analyze factors associated with case-fatality in Goiás, Brazil. METHODS: this was a cross-sectional study on case fatality due to hantavirus infection from 2007 to 2013 using data from the Notifiable Diseases Information System (SINAN) for Goiás State. Logistic regression analysis was performed to estimate odds ratios (OR) with 95% confidence intervals (95%CI). RESULTS: 1,171 suspected cases were reported, of which 73 (6.2%) were confirmed. Among the confirmed cases, greater frequency was found among males (n=50), fever was the most common symptom (n=70), and there was a high proportion of hospitalization (n=68). The case-fatality rate was 57.5% . The following factors were associated with death: acute respiratory failure (ARF) (OR=3.6; 95%CI 1.2;10.6), hemoconcentration (OR=3.3; 95%CI 1.1;7.9) and not using a mechanical ventilator (OR=3.4; 95%CI 1.3;9.1). After adjustment, the ARF was still associated with death (OR=3.4; 95%CI 1.0;11.6). CONCLUSION: the case-fatality rate was high, primarily associated with respiratory failure.