Different factors are associated with changing body composition in people living with HIV.

INTRODUCTION: Antiretroviral Therapy (ART) gives people living with HIV/AIDS (PLWHA) a new perspective of life, although some develop changes in impaired body composition. This study aimed to assess the factors associated with changes in body composition in PLWHA using ART, depending food consumption. MATERIAL AND METHODS: It was a cross-sectional study and took place through interviews with patients treated at an University Hospital. Secondary data: CD4+ T cells, ART time and age. The level of physical activity and smoking were self-reported. For the assessment of body composition, electrical bioimpedance and measurements of weight, height and waist circumference were used. RESULTS: The highest percentages of fat mass and fat-free mass, in treatment for more than 5 years, were in the female group (p <0.01), aged> 50 years (p = 0.02) and in the male group (p <0.01), young adult (p <0.01), respectively. The final linear regression model for both free fat mass and fat mass had sex, age, smoking and nutritional diagnosis as relevant factors. The frequency of food consumption was inadequate for calories, carbohydrates, proteins and lipids was high, however it did not significantly influence body composition. CONCLUSIONS: Gender, age, smoking and nutritional diagnosis by BMI significantly influence body composition.

Neutralizing antibodies against SARS-CoV-2 in Brazilian pregnant women vaccinated with one or two doses of BNT162b2 mRNA vaccine (Pfizer/WyethTM).

Pregnant women have an increased risk of developing severe coronavirus disease. In Brazil, the number of hospitalizations and adverse outcomes, including death caused by COVID-19, in women during the pregnancy-puerperal cycle was high in the first pandemic year. Doubts regarding vaccines' efficacy and safety for the mother and fetus delayed vaccination. This study evaluated the generation of IgG titers and neutralizing antibodies to the BNT162b2 mRNA vaccine in 209 healthy pregnant women. For this, were used the QuantiVac ELISA (IgG) and SARS-CoV-2 NeutraLISA kits (EUROIMMUN, Lübeck, SH) following the manufacturer's recommendations. One dose vaccine produced anti-SARS-CoV-2 IgG in 85% (81/95), and two produced in 95% (76/80) women. Among unvaccinated women, four of 34 (12%) showed protection. The first dose of the BNT162b2 vaccine protected 69% of the women with neutralizing antibodies (median of %IH = 97). In the second dose, protection occurred in 94% of the pregnant women (median of IH% = 97). This study showed no differences in IgG antibody titers between one- and two-dose of the BNT162b2 mRNA vaccine groups, boosting with the second dose increased the number of women who produced specific IgG and neutralizing antibodies, raising by 114-folds the chance of producing the SARS-CoV-2 neutralizing antibodies compared to the unvaccinated pregnant woman, which may contribute to reduce the chance of severe COVID-19.

Adherence to antiretroviral therapy and changes in body composition in people living with HIV and AIDS / Adesão a terapia antirretroviral e alterações da composição corporal em pessoas vivendo com HIV/AIDS

Introduction: The successful treatment of human immunodeficiency virus (HIV) infection depends on adherence to antiretroviral therapy. Since the development of ART, there has been a significant increase in the survival of people living with HIV/AIDS. However, in the same way that it works in a positive way, the antiretroviral therapy has side effects that ultimately influence the rate of adherence to drug treatment. Objective: Evaluate adherence to antiretroviral therapy (ART) and changes in the body composition of adults diagnosed with HIV/AIDSon ART for at least 12 months. Methods: A cross-sectional study was conducted at an outpatient clinic for infectious-parasitic diseases at a teaching hospital that is a reference in the treatment of people living with HIV/ AIDS. Socio-demographic and clinical data were collected from medical records. Weight, height, body mass index (BMI) and abdominal circumference (AC) were recorded. Bioelectrical impedance analysis was performed using the tetrapolar protocol to assess body composition. The "Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral" was used to investigate adherence to ART. Results: Sixty-one patients (27 women and 33 men) participated in the study. Most were more than 40 years of age and were classified as overweight based on BMI. Most patients (86.8%) had been using ART for more than five years and 78.6% were classified as sedentary. Among the patients with an adequate AC, 82.3% were men. Among the 11 patients with low adherence to ART, 90.9% were men. Among the 33 with strict adherence, 69.6% were women. Mean percentage of fat mass was 28.63% among the men, and 40.82% among the women. Conclusion: Strict adherence to ART was seen in more than half of the study population. Women had more side effects from ART, as this group hadgreater adherence to treatment. The findings underscore the relationship between high rates of adherence to ART and changes in body composition, such as increased fat deposition and risk of associated diseases.

Introdução: O sucesso do tratamento da infecção pelo vírus da imunodeficiência humana (HIV) depende da adesão à terapia antirretroviral (TARV). Desde o desenvolvimento da TARV, houve aumento significativo da sobrevida das pessoas que vivem com HIV/Síndrome da Imunodeficiência Adquirida (AIDS). Porém, da mesma forma que atua de modo positivo, a terapia antirretroviral possui efeitos colaterais que acabam influenciando a taxa de adesão terapêutica ao tratamento medicamentoso. Esses efeitos incluem significativas alterações na composição corporal, resistência à insulina e dislipidemias. Objetivo: Avaliar a adesão à terapia antirretroviral e descrever alterações na composição corporal de adultos com diagnóstico de HIV/AIDS que usaram terapia antirretroviral por no mínimo 12 meses. Métodos: Estudo transversal realizado em um ambulatório de doenças infectoparasitárias em Hospital Universitário, referência no tratamento de pessoas que vivem com HIV/AIDS. Verificou-se dados sociodemográficos e clínicos nos prontuários. Foram registrados peso, altura, índice de massa corporal (IMC) e circunferência abdominal (CA). Realizou-se a bioimpedância segundo o protocolo da técnica tetrapolar para avaliação da composição corporal. Para avaliar a adesão terapêutica foi usado o Cuestionario para la Evaluación de la Adhesión al Tratamiento Antiretroviral. Resultados: Foram estudados 61 pacientes, 27 mulheres e 34 homens; a maior parte tinha acima de 40 anos e IMC classificado como sobrepeso. A maioria dos pacientes (86,8%) usavam TARV há mais de cinco anos e 78,6% se autodeclararam sedentários. Do total de pacientes que apresentaram circunferência abdominal adequada, 82,3% eram homens. Dos 11 pacientes que se classificaram como baixa adesão à TARV, 90,9% eram homens, e dos 33 que se classificaram como estritamente aderentes, 69,6% eram mulheres. Os homens apresentaram 28,63% de média de porcentual de massa gorda (%MG), enquanto as mulheres apresentaram 40,82%. Conclusão: A adesão estrita à TARV foi vista em mais da metade da população estudada. As mulheres apresentaram mais efeitos colaterais oriundos da TARV, visto que este grupo mostrou uma adesão maior ao tratamento. Isso reforça a relação entre altas taxas de adesão à terapia medicamentosa e alterações na composição corporal, como o aumento da deposição de gordura e riscos de doenças associadas.