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1.
Texto & contexto enferm ; 29: e20180471, Jan.-Dec. 2020. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1059140

RESUMEN

ABSTRACT Objective: to analyze the knowledge of the elderly assisted by the Unified Health System (Sistema Único de Saúde, SUS) about HIV/AIDS infection in a health unit, before and after an educational intervention. Method: a quasi-experimental study analyzing the changes related to the knowledge about HIV/AIDS of 60 elderly individuals divided into two groups, who participated in an educational intervention, in an outpatient clinic of a SUS rehabilitation center in the second half of 2016. To evaluate the effectiveness of the teaching/learning process, a semi-structured questionnaire called QHIV3I was applied before and after the intervention. For data analysis, the generalized version of McNemar's chi-square test was used. Results: comparing the knowledge of the elderly before and after the educational intervention showed a higher number of correct answers, with a minimum percentage of 3.34% and a maximum of 75%. Significant statistical differences were found in one of the questions in the concept, transmission and treatment domains; and in the two vulnerability questions. Conclusion: it was found that the educational intervention contributed to the improvement of knowledge about HIV/AIDS in the elderly population. Thus, it is reasserted that the health promotion policy finds its essential foundation in health education strategies.


RESUMEN Objetivo: analizar el conocimiento de los ancianos atendidos por el Sistema Único de Salud (SUS) acerca de la infección por VIH/SIDA en una unidad de salud, tanto antes como después de una intervención educativa. Método: estudio cuasi-experimental en el que se analizaron los cambios relacionados con el conocimiento sobre VIH/SIDA de 60 ancianos subdivididos en dos grupos y que participaron de una intervención educativa en el área de atención ambulatoria de un centro especializado en rehabilitación del SUS, durante el segundo semestre de 2016. Para evaluar la eficacia del proceso de enseñanza/aprendizaje se aplicó un cuestionario semiestructurado denominado QHIV3I, antes y después de la intervención. En el análisis de los datos se utilizó la versión generalizada de la prueba de chi-cuadrado de McNemar. Resultados: en la comparación de los conocimientos de los ancianos antes y después de la intervención educativa se evidenció una mayor cantidad de respuestas correctas, con un porcentaje mínimo de 3,34% y uno máximo de 75%. Se encontraron diferencias significativas en una de las preguntas de los dominios de concepto y de transmisión y tratamiento, además de en las dos preguntas sobre vulnerabilidad. Conclusión: se constató que la intervención educativa contribuyó a mejorar los conocimientos sobre VIH/SIDA en la población de la tercera edad. Esto reafirma que la política de promoción de la salud encuentra sus fundamentos esenciales en las estrategias de educación en salud.


RESUMO Objetivo: analisar o conhecimento dos idosos atendidos pelo Sistema Único de Saúde (SUS) acerca da infecção do HIV/aids numa unidade de saúde, antes e após intervenção educativa. Método: estudo quase-experimental, em que se analisou as mudanças relativas ao conhecimento sobre HIV/aids de 60 idosos subdivididos em dois grupos, que participaram de intervenção educativa, num ambulatório de um centro especializado em reabilitação do SUS no segundo semestre de 2016. Para avaliar a eficácia do processo de ensino/aprendizagem, aplicou-se questionário semiestruturado denominado QHIV3I, antes e após a intervenção. Na análise dos dados, utilizou-se a versão generalizada do teste qui-quadrado de McNemar. Resultados: a comparação dos conhecimentos dos idosos antes e depois da intervenção educativa evidenciaram maior número de acertos, com percentual mínimo de 3,34% e máximo de 75%. Diferenças estatísticas significativas foram encontradas em uma das questões nos domínios conceito, transmissão e tratamento; e nas duas questões sobre vulnerabilidade. Conclusão: constatou-se que a intervenção educativa contribuiu para o aprimoramento de conhecimentos sobre HIV/aids na população idosa. Com isso, reafirma-se que a política de promoção da saúde encontra nas estratégias de educação em saúde seu alicerce essencial.


Asunto(s)
Humanos , Anciano , Salud del Anciano , Educación en Salud , Síndrome de Inmunodeficiencia Adquirida , VIH , Sistema Único de Salud , Salud , Transmisión de Enfermedad Infecciosa , Promoción de la Salud , Aprendizaje
3.
Rev Lat Am Enfermagem ; 28: e3365, 2020.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-33027403

RESUMEN

OBJECTIVE: to evaluate the cost-effectiveness ratio and the budget impact of sending text messages associated with medical consultations in order to reduce the viral load of patients infected with the Human Immunodeficiency Virus. METHOD: a randomized clinical trial, basis for the development of a dynamic cohort model with Markov states in order to compare medical appointments for adults infected with the Human Immunodeficiency Virus versus the alternative strategy that associated medical consultations to sending text messages through telephone. RESULTS: 156 adults participated in the study. As for the viral load, it was verified that in the control group there was an increase, in the intervention group A (weekly messages) there was a reduction (p = 0.002) and in group B (biweekly messages) there was no statistically significant difference. Sending text messages would prevent 286,538 new infections by the Human Immunodeficiency Virus and 282 deaths in the 20-year period, compared to the standard treatment. The alternative strategy would result in saving R$ 14 billion in treatment costs. CONCLUSION: weekly sending messages in association with the standard treatment can reduce the circulating viral load due to its effect in decreasing new infections, in addition to reducing health costs.


Asunto(s)
Infecciones por VIH , Envío de Mensajes de Texto , Adulto , Análisis Costo-Beneficio , VIH , Infecciones por VIH/epidemiología , Infecciones por VIH/terapia , Humanos , Aceptación de la Atención de Salud
4.
Washington, D.C.; OPS; 2020-10-08.
No convencional en Español | PAHO-IRIS | ID: phr-52815

RESUMEN

La tuberculosis es una de las diez causas principales de muerte en el mundo y representa todavía un importante problema de salud pública en la Región de las Américas. La Región ha avanzado en la prevención y el control de la enfermedad; sin embargo, al ritmo actual de descenso del número de muertes y de la incidencia no se alcanzarán las metas ni los hitos propuestos para poner fin a la epidemia. Por ello, es necesario acelerar los esfuerzos de los países para cumplirlas. Este informe sobre la Tuberculosis en las Américas presenta la situación de la tuberculosis en la Región, así como los avances logrados por los países en la prevención, el diagnóstico, el tratamiento y hacia la eliminación de la enfermedad en el marco de la Estrategia Fin de la TB, de los Objetivos de Desarrollo Sostenible y de los compromisos asumidos en la reunión de alto nivel sobre la tuberculosis celebrada por las Naciones Unidas en el 2018. El documento muestra y analiza datos epidemiológicos y programáticos de la situación de la tuberculosis en la Región, y en él se destacan la detección de casos, el tratamiento preventivo, los resultados del tratamiento, la tuberculosis farmacorresistente, la coinfección por la TB y el VIH, y los grupos en situación de vulnerabilidad, entre otros aspectos. Además, incluye un análisis sobre el financiamiento de la tuberculosis en la Región. Los autores esperan que este informe facilite la comprensión de la situación de la tuberculosis en la Región y sirva de ejemplo para realizar análisis similares en cada uno de los países, con miras a impulsar una mejor toma de decisiones hacia el fin de la tuberculosis.


Asunto(s)
Tuberculosis , Américas , Salud Pública , VIH , Objetivos de Desarrollo del Milenio , Desarrollo Sostenible , Mortalidad
5.
Washington, D.C.; OPS; 2020-10-01. (OPS-W/CDE/HT/20-0036).
en Español | PAHO-IRIS | ID: phr-52783

RESUMEN

[Extracto]. La carga de morbilidad y mortalidad asociada con la infección por el VIH ha disminuido a lo largo de los últimos diez años a medida que ha aumentado el acceso al tratamiento antirretroviral. A pesar de este progreso, casi la mitad de las personas con infección por el VIH inician su atención con un cuadro avanzado y muchas siguen muriendo por infecciones oportunistas relacionadas con el VIH. La meningitis criptocócica es una infección oportunista grave que constituye una causa primordial de morbilidad y mortalidad en las personas con infección avanzada por el VIH, y representa cerca del 15% de todas las muertes relacionadas con el sida a nivel mundial. Se estima que, cada año, unos 223.100 casos de meningitis criptocócica causan 181.000 defunciones de personas con infección por el VIH. La criptococosis es poco común en los niños con infección por el VIH, incluso en zonas geográficas con una elevada morbilidad en adultos. [...]


Asunto(s)
VIH , Tuberculosis , Enfermedades de Transmisión Sexual , Enfermedades Transmisibles , Criptococosis
6.
Medicine (Baltimore) ; 99(40): e22639, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33019487

RESUMEN

INTRODUCTION: Tuberculous meningitis (TBM) is the most fatal type of tuberculosis in which corticosteroids are added with antitubercular therapy to prevent permanent brain damage. However, this treatment may produce paradoxical reactions. In such cases, thalidomide use might reduce central nervous system inflammation and improve the outcome. We present the case of a human immunodeficiency virus-negative patient with TBM who developed paradoxical reactions manifesting as multiple intracranial tuberculomas that were resistant to standard care (antitubercular drugs and corticosteroids) but responded well to thalidomide. PATIENT'S MAIN CONCERN AND CLINICAL FINDINGS: The patient was a 40-year-old Chinese female, who was admitted with a 10-day history of headaches, night sweats, and cough. She was healthy before contracting the infection and had no history of contact with tuberculosis patients. DIAGNOSES, INTERVENTION, AND OUTCOME: We diagnosed the patient with TBM complicated by the occurrence of pulmonary tuberculosis. Positive results were obtained from Gram and Ziehl-Neelsen staining of the sputum and acid-fast bacilli sputum culture. Standard treatment was initiated with antitubercular drugs (daily isoniazid, rifampicin, ethionamide, and pyrazinamide) and corticosteroids (dexamethasone). However, 3 months later the magnetic resonance imaging of the head revealed some new tuberculoma lesion. Thus, a specific therapy of antitubercular drugs and thalidomide was introduced. On completion of a 12-month course of antitubercular drugs with 2 months of thalidomide, the patient showed favorable outcomes without neurologic sequelae. Moreover, thalidomide appeared safe and well tolerated in the patient. CONCLUSION: In addition to the specific anti-tubercular and adjuvant corticosteroid therapies for TBM, thalidomide can be used as a "salvage" antitubercular drug in cases that are unresponsive to corticosteroids.


Asunto(s)
VIH/inmunología , Inmunosupresores/uso terapéutico , Talidomida/uso terapéutico , Tuberculosis Meníngea/tratamiento farmacológico , Tuberculosis Pulmonar/complicaciones , Corticoesteroides/uso terapéutico , Adulto , Antituberculosos/uso terapéutico , Grupo de Ascendencia Continental Asiática/etnología , Encéfalo/patología , Quimioterapia Combinada , Femenino , Hospitalización , Humanos , Imagen por Resonancia Magnética/métodos , Terapia Recuperativa , Resultado del Tratamiento , Tuberculoma/diagnóstico por imagen , Tuberculosis Meníngea/diagnóstico , Tuberculosis Pulmonar/tratamiento farmacológico
7.
BMC Infect Dis ; 20(1): 655, 2020 Sep 07.
Artículo en Inglés | MEDLINE | ID: mdl-32894072

RESUMEN

BACKGROUND: People who use drugs including people who inject drugs (PWUD/ID), sex workers (SWs) and men who have sex with men (MSM) are at increased risk of HIV and viral hepatitis infection. Limited epidemiological data on the infections exists in key populations (KPs) in South Africa. We investigated the prevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV and selected risk factors among these KPs to inform effective responses. METHODS: We used convenience sampling to recruit a targeted 3500 KPs accessing HIV-related health services across Cape Town (SWs, MSM, PWUD/ID), Durban (SWs, PWUD/ID), Pietermaritzburg (SWs), Mthatha (SWs), Port Elizabeth (SWs), Johannesburg (MSM) and Pretoria (MSM and PWUD/ID) into a cross-sectional survey. An interviewer questionnaire to assess socio-demographic characteristics, drug use and sexual risk practices, was administered. HBV surface antigen (HBsAg); HCV antibody, viral load and genotype, and HIV antibody, was tested. RESULTS: Among the 3439 people included in the study (1528 SWs, 746 MSM, 1165 PWUD/ID) the median age was 29 years, most participants were black African (60%), and 24% reported homelessness. 82% reported substance use in the last month, including alcohol (46%) and heroin (33%). 75% were sexually active in the previous month, with condom use at last sex at 74%. HIV prevalence was 37% (highest among SWs at 47%), HBsAg prevalence 4% (similar across KPs) and HCV prevalence was 16% (highest among PWUD/ID at 46%). CONCLUSIONS: HBV, HCV and HIV pose a health burden for KPs in South Africa. While HIV is key for all included KPs, HCV is of particular importance to PWUD/ID. For KPs, HBV vaccination and behavioural change interventions that support consistent condom and lubricant access and use are needed. Coverage of opioid substitution therapy and needle and syringe services, and access to HCV treatment for PWUD/ID need to be expanded.


Asunto(s)
Infecciones por VIH/epidemiología , VIH/inmunología , Hepacivirus/genética , Hepacivirus/inmunología , Virus de la Hepatitis B/inmunología , Hepatitis B/epidemiología , Hepatitis C/epidemiología , Adulto , Estudios Transversales , Femenino , Genotipo , Anticuerpos Anti-VIH/sangre , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/etiología , Infecciones por VIH/prevención & control , Hepatitis B/etiología , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis C/etiología , Anticuerpos contra la Hepatitis C/sangre , Homosexualidad Masculina , Humanos , Masculino , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Trabajadores Sexuales , Minorías Sexuales y de Género , Sudáfrica/epidemiología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Carga Viral , Adulto Joven
9.
Medicine (Baltimore) ; 99(37): e21661, 2020 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-32925712

RESUMEN

To support optimal third-line antiretroviral therapy (ART) selection in Namibia, we investigated the prevalence of HIV drug resistance (HIVDR) at time of failure of second-line ART. A cross-sectional study was conducted between August 2016 and February 2017. HIV-infected people ≥15 years of age with confirmed virological failure while receiving ritonavir-boosted protease inhibitor (PI/r)-based second-line ART were identified at 15 high-volume ART clinics representing over >70% of the total population receiving second-line ART. HIVDR genotyping of dried blood spots obtained from these individuals was performed using standard population sequencing methods. The Stanford HIVDR algorithm was used to identify sequences with predicted resistance; genotypic susceptibility scores for potential third-line regimens were calculated. Two hundred thirty-eight individuals were enrolled; 57.6% were female. The median age and duration on PI/r-based ART at time of enrolment were 37 years and 3.46 years, respectively. 97.5% received lopinavir/ritonavir-based regimens. The prevalence of nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI), and PI/r resistance was 50.6%, 63.1%, and 13.1%, respectively. No significant association was observed between HIVDR prevalence and age or sex. This study demonstrates high levels of NRTI and NNRTI resistance and moderate levels of PI resistance in people receiving PI/r-based second-line ART in Namibia. Findings underscore the need for objective and inexpensive measures of adherence to identify those in need of intensive adherence counselling, routine viral load monitoring to promptly detect virological failure, and HIVDR genotyping to optimize selection of third-line drugs in Namibia.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Farmacorresistencia Viral , Infecciones por VIH/tratamiento farmacológico , Adolescente , Adulto , Estudios Transversales , Femenino , VIH/efectos de los fármacos , Humanos , Lopinavir/uso terapéutico , Masculino , Persona de Mediana Edad , Namibia/epidemiología , Prevalencia , Inhibidores de la Transcriptasa Inversa/uso terapéutico , Ritonavir/uso terapéutico , Insuficiencia del Tratamiento , Adulto Joven
10.
Mem Inst Oswaldo Cruz ; 115: e200082, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32935750

RESUMEN

Respiratory failure (RF) is the main cause of hospital admission in HIV/AIDS patients. This study assessed comorbidities and laboratory parameters in HIV/AIDS inpatients with RF (N = 58) in relation to those without RF (N = 36). Tuberculosis showed a huge relative risk and platelet counts were slightly higher in HIV/AIDS inpatients with RF. A flow cytometry assay for reactive oxygen species (ROS) showed lower levels in platelets of these patients in relation to the healthy subjects. However, when stimulated with adrenaline, ROS levels increased in platelets and platelet-derived microparticles of HIV/AIDS inpatients, which may increase the risk of RF during HIV and tuberculosis (HIV-TB) coinfection.


Asunto(s)
Micropartículas Derivadas de Células/metabolismo , Infecciones por VIH/sangre , VIH/inmunología , Especies Reactivas de Oxígeno/sangre , Insuficiencia Respiratoria/complicaciones , Fármacos Anti-VIH/uso terapéutico , Biomarcadores/sangre , Plaquetas , Citometría de Flujo , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Humanos , Insuficiencia Respiratoria/sangre
11.
Molecules ; 25(17)2020 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-32899354

RESUMEN

Peptidyl fluoromethyl ketones occupy a pivotal role in the current scenario of synthetic chemistry, thanks to their numerous applications as inhibitors of hydrolytic enzymes. The insertion of one or more fluorine atoms adjacent to a C-terminal ketone moiety greatly modifies the physicochemical properties of the overall substrate, especially by increasing the reactivity of this functionalized carbonyl group toward nucleophiles. The main application of these peptidyl α-fluorinated ketones in medicinal chemistry relies in their ability to strongly and selectively inhibit serine and cysteine proteases. These compounds can be used as probes to study the proteolytic activity of the aforementioned proteases and to elucidate their role in the insurgence and progress on several diseases. Likewise, if the fluorinated methyl ketone moiety is suitably connected to a peptidic backbone, it may confer to the resulting structure an excellent substrate peculiarity and the possibility of being recognized by a specific subclass of human or pathogenic proteases. Therefore, peptidyl fluoromethyl ketones are also currently highly exploited for the target-based design of compounds for the treatment of topical diseases such as various types of cancer and viral infections.


Asunto(s)
Clorometilcetonas de Aminoácidos/síntesis química , Fenilalanina/análogos & derivados , Virus del SRAS/efectos de los fármacos , Inhibidores de Serina Proteinasa/síntesis química , Proteínas no Estructurales Virales/antagonistas & inhibidores , Clorometilcetonas de Aminoácidos/farmacología , Química Farmacéutica/métodos , Cisteína Endopeptidasas/química , Cisteína Endopeptidasas/metabolismo , VIH/efectos de los fármacos , VIH/enzimología , Proteasa del VIH/química , Proteasa del VIH/metabolismo , Humanos , Cinética , Fenilalanina/síntesis química , Fenilalanina/farmacología , Virus del SRAS/enzimología , Inhibidores de Serina Proteinasa/farmacología , Relación Estructura-Actividad , Proteínas no Estructurales Virales/química , Proteínas no Estructurales Virales/metabolismo
12.
Rev Assoc Med Bras (1992) ; 66(8): 1139-1145, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32935811

RESUMEN

OBJECTIVE: To analyze the scientific evidence on the disclosure of the diagnostic of adolescents infected by HIV/AIDS in the South American context. DATABASE: Systematic literature review using the PubMed, Cinahal, Embase, Cochrane, BVS, and Global Health databases and the descriptors: adolescent and HIV and family and Argentina or Bolivia or Brasil or Chile or Colombia or Ecuador or French Guiana or Paraguay or Peru or Uruguay or Venezuela. DATA SYNTHESIS: Brasil was the country highlighted. It was verified that parents have a direct and indirect influence over the adolescents' life, especially regarding behaviors and health care. Dialog among family members can reduce adolescents' vulnerability to HIV and encourage diagnostic disclosure. CONCLUSION: It is necessary to amplify research involving adolescents with HIV/AIDS and their parents/caregivers and family members to improve care and reduce the cases of the disease. It is suggested that policies of prevention and treatment should involve families, caregivers, partners, and the community.


Asunto(s)
Revelación , Infecciones por VIH , Adolescente , Argentina , Brasil , Chile , VIH , Humanos , Perú , Venezuela
13.
BMC Infect Dis ; 20(1): 663, 2020 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-32907539

RESUMEN

BACKGROUND: Studies have demonstrated that health care students and practitioners are not immune to stigma towards people living with HIV (PLHIV). This attitude could lead to poor quality of care if it remains uncorrected. However, little is known about dietetic students' acceptance of PLHIV despite their substantial role in treatment. This study aimed to measure the extent of knowledge and stigma towards PLHIV among dietetic students and to determine the associated factors using the attribution theory. METHODS: Students from three dietetics schools in Indonesia (n = 516) were recruited to participate in this cross-sectional study. Survey questions covered demographic information, interaction with PLHIV, access to information sources, cultural values, and beliefs as predictor variables. The outcome variables were comprehensive knowledge of HIV, HIV and nutrition-specific knowledge, and attitudes. Analyses with linear regression and the stepwise selection were performed to determine factors related to the outcome. RESULTS: The levels of HIV comprehensive knowledge and HIV-nutrition specific knowledge among dietetic students were low, as indicated by the average score of 19.9 ± 0.19 (maximum score = 35) and 8.0 ± 0.11 (maximum score = 15), respectively. The level of negative attitudes towards PLHIV was high, with 99.6% of participants reported having a high stigma score. Types of university affiliation (public or private), beliefs and values, exposure to HIV discourse, access to printed media, and years of study were significantly related to HIV comprehensive knowledge (p < 0.05). Nutrition-specific knowledge was also correlated with university affiliation, beliefs and values, participation in HIV discussion, and years of study (p < 0.05). HIV comprehensive knowledge, university affiliation, discussion participation, and ethnicities were associated with attitudes (p < 0.05). CONCLUSIONS: Awareness and acceptance of PLHIV must be further improved throughout dietetic training to ensure patients' quality of care since students represent future dietary care providers. Considering the consistent findings that affiliation to education institution correlates with HIV knowledge and attitude, some examinations concerning the curriculum and teaching conduct might be necessary.


Asunto(s)
Dietética/educación , Infecciones por VIH/psicología , VIH , Conocimientos, Actitudes y Práctica en Salud , Estigma Social , Estudiantes/psicología , Estudios Transversales , Femenino , Infecciones por VIH/virología , Educación en Salud/métodos , Humanos , Indonesia , Modelos Lineales , Masculino , Encuestas y Cuestionarios , Universidades , Adulto Joven
14.
BMC Infect Dis ; 20(1): 704, 2020 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-32977745

RESUMEN

INTRODUCTION: In sub-Saharan Africa, considerable HIV-burden exists among women. Anti-retroviral (ARV) based prevention products could decrease this burden, and their uptake could be increased if they also protect against pregnancy and sexually transmitted infections (STI). METHODS: A discrete choice experiment (DCE) was undertaken in South Africa (2015) through a household survey of adult females (n = 158) and adolescent girls (n = 204) who self-reported HIV-negative status. The DCE was used to project the uptake (percentage using product) of oral pre-exposure prophylaxis (PrEP), vaginal rings, and injectable long-lasting ARV agents among these women, and how uptake could depend on whether these products protect against pregnancy or STI acquisition. Uptake estimates were used to model how each product could decrease a women's HIV acquisition risk. RESULTS: In adolescent women, there will be limited uptake (< 6% for any product) and impact (< 4% decrease in HIV acquisition risk) of new products unless they provide pregnancy protection, which could quadruple use and impact. Adult women have weaker preference for pregnancy protection, with moderate use (< 17% for each) and impact (< 14 percentage point decrease) if they only provide HIV protection. All women had highest preference for injectable ARVs, with oral PrEP having high preference if injectable ARVs are not available. Adult women will use the ring, but adolescent women will not. Importantly, even with three additional prevention products, all providing pregnancy and STI protection, > 14% of women will remain unprotected and > 31% of the baseline acquisition risk will remain. CONCLUSIONS: Incorporating multiple prevention components into new ARV-based prevention products may increase their uptake and impact among women.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Dispositivos Anticonceptivos Femeninos , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , VIH , Profilaxis Pre-Exposición/métodos , Adolescente , Adulto , Femenino , Infecciones por VIH/virología , Humanos , Embarazo , Autoinforme , Sudáfrica/epidemiología , Adulto Joven
15.
Univ. salud ; 22(2): 120-126, mayo-ago. 2020. tab
Artículo en Español | LILACS, COLNAL | ID: biblio-1115961

RESUMEN

Introducción: La atención odontológica oportuna e inclusiva tiene un papel importante en las personas con VIH/SIDA, por cuanto permite prevenir y dar tratamiento a las múltiples lesiones orales que acompañan a esta patología, mejorando la calidad de vida de esta población. Objetivo: Determinar la percepción y experiencia de pacientes con VIH/SIDA sobre la consulta odontológica en una Institución Prestadora de Salud (IPS) de Santa Marta, Colombia. Materiales y métodos: Se realizó un estudio descriptivo cuantitativo donde participaron 64 pacientes con VIH/SIDA de una IPS de la ciudad de Santa Marta, quienes se les aplicó un instrumento de recolección de datos. Resultados: El 65,6% expresó nunca percibir rechazo por parte del odontólogo, el 25% refiere haber experimentado algún rechazo por lo menos una vez y un 9,4% siempre se siente rechazado. Conclusiones: Existe la necesidad de abordar esta enfermedad no sólo desde el aspecto clínico, sino también desde lo social, para educar tanto al profesional de la salud como a la comunidad, sobre avances científicos, el estudio de esta patología y los riesgos reales de contraerla, para desmitificar esta afección y erradicar la discriminación hacia los pacientes.


Introduction: Timely and comprehensive dental care is important for HIV/AIDS patients as it facilitates prevention and treatment of the multiple oral lesions that accompany this pathology, and consequently, improves their quality of life. Objective: To determine the perception and experience of the dental care service provided by a Health Provider Institution (HPI) to HIV/AIDS patients from the city of Santa Marta (Colombia). Materials and methods: A descriptive quantitative study was carried out with 64 HIV/AIDS patients treated in the HPI, to whom a data collection instrument was applied. Results: 65.6% of the HIV/AIDS patients did not perceive any rejection from the dentist, whereas 25% and 9.4% of these patients reported being discriminated at least once and always, respectively. Conclusions: There is a need to approach this disease not only from a clinical standpoint but also from a social perspective in order to educate both health professionals and communities about: scientific advances; how to study this pathology; and the risks of contracting HIV/AIDS. It is also necessary to demystify some misconceptions and eradicate discrimination against these patients.


Asunto(s)
Humanos , Atención Odontológica , VIH , Percepción , Síndrome de Inmunodeficiencia Adquirida
16.
Washington; Organización Panamericana de la Salud; Aug. 24, 2020.
No convencional en Inglés, Español | LILACS | ID: biblio-1118287

RESUMEN

The Pan American Health Organization (PAHO), in collaboration with the Regional Inter-Agency Group of UNAIDS and co-sponsors, developed this information note. The note consolidates the most recent recommendations from WHO and UNAIDS and relevant references and available resources for HIV programs and other stakeholders of the HIV response.


La comunidad y la respuesta al VIH tienen mucho que ofrecer a la preparación y la resiliencia a la enfermedad por coronavirus del 2019 (COVID-19). Contar con organizaciones dirigidas por la comunidad, como las redes de personas que viven con el VIH, para que participen en las mesas de planificación y respuesta desde el principio es fundamental para fomentar la confianza, asegurar un intercambio productivo de información y sentar las bases para la adopción de medidas conjuntas de solución de problemas. Los gobiernos, las organizaciones y redes de la sociedad civil y las personas que viven con el VIH deberían adoptar las siguientes medidas clave para abordar las cuestiones que puedan surgir en la respuesta al VIH en medio del brote de COVID-19, a fin de garantizar que la respuesta se ajuste a los principios de los derechos humanos.


Asunto(s)
Neumonía Viral/prevención & control , Neumonía Viral/epidemiología , VIH , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/epidemiología , Pandemias/prevención & control , Betacoronavirus , Control de Infecciones/organización & administración , Planificación
17.
J Assoc Physicians India ; 68(9): 23-26, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32798341

RESUMEN

Introduction: HIV/AIDS is a chronic multisystem disease and about 70% develop neurologic complications (including distal symmetric polyneuropathy (DSPN) any time during their life. DSPN is also a very common toxicity of drugs used to treat HIV infection. Little is known about the impact of HIV per se or other factors (apart from drugs) on the occurrence of DSPN in these patients. Methods: It was a cross sectional, observational study, done at the department of Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India. Ninety consecutive 18-40 years old HIV infected but treatment naïve (ART naïve) cases and 30 age and sex matched healthy controls were recruited for this study. Results: Out of 90 cases, 12 (13.4%) had DSPN (8 males and 4 females). The mean CD4 counts of these cases with and without DSPN was 294.73/µl and 370.84/µl respectively. Only 3 out of these 12 cases were symptomatic on presentation and rest nine were diagnosed on NCV study. No control had abnormal NCV. Presence of DSPN was found to be directly associated with infection with HIV per se (p<0.001) along with duration of HIV infection (p<0.01) and level of immunodeficiency (p<0.001). Conclusion: This study demonstrates that DSPN is already present in 13.4% of treatment naive patients with HIV/AIDS and even with milder immunodeficiency and at early stages of disease. Not only HAART but HIV by itself is a major causative risk factor for DSPN in these patients.


Asunto(s)
Infecciones por VIH , Polineuropatías , Adolescente , Adulto , Terapia Antirretroviral Altamente Activa , Recuento de Linfocito CD4 , Estudios Transversales , Femenino , VIH , Infecciones por VIH/terapia , Humanos , India , Masculino , Prevalencia , Adulto Joven
18.
Med Sci (Paris) ; 36(8-9): 783-796, 2020.
Artículo en Francés | MEDLINE | ID: mdl-32773024

RESUMEN

SARS-CoV-2 is a new human coronavirus (CoV), which emerged in People's Republic of China at the end of 2019 and is responsible for the global Covid-19 pandemic that caused more than 540 000 deaths in six months. Understanding the origin of this virus is an important issue and it is necessary to determine the mechanisms of its dissemination in order to be able to contain new epidemics. Based on phylogenetic inferences, sequence analysis and structure-function relationships of coronavirus proteins, informed by the knowledge currently available, we discuss the different scenarios evoked to account for the origin - natural or synthetic - of the virus. On the basis of currently available data, it is impossible to determine whether SARS-CoV-2 is the result of a natural zoonotic emergence or an accidental escape from experimental strains. Regardless of its origin, the study of the evolution of the molecular mechanisms involved in the emergence of this pandemic virus is essential to develop therapeutic and vaccine strategies.


Asunto(s)
Betacoronavirus/genética , Enfermedades Transmisibles Emergentes/virología , Infecciones por Coronavirus/virología , Coronavirus/clasificación , Evolución Molecular , Pandemias , Filogenia , Neumonía Viral/virología , ARN Viral/genética , Secuencia de Aminoácidos , Animales , Betacoronavirus/clasificación , Betacoronavirus/aislamiento & purificación , Derrame de Material Biológico , China/epidemiología , Infecciones por Coronaviridae/transmisión , Infecciones por Coronaviridae/veterinaria , Infecciones por Coronaviridae/virología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Reservorios de Enfermedades , Mutación con Ganancia de Función , Genoma Viral , VIH/genética , Especificidad del Huésped , Humanos , Mamíferos/virología , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Virus Reordenados/genética , Alineación de Secuencia , Homología de Secuencia de Aminoácido , Glicoproteína de la Espiga del Coronavirus/química , Glicoproteína de la Espiga del Coronavirus/genética , Glicoproteína de la Espiga del Coronavirus/fisiología , Zoonosis
19.
BMC Infect Dis ; 20(1): 613, 2020 Aug 18.
Artículo en Inglés | MEDLINE | ID: mdl-32811453

RESUMEN

BACKGROUND: Strongyloidiasis is caused by the helminth Strongyloides stercoralis and is well-recognised amongst transplant recipients. Serious complications, including Strongyloides hyperinfection which is a syndrome of accelerated autoinfection, or disseminated disease, can occur post-transplantation, resulting in significant morbidity and mortality. Here we present the first published case we are aware of, describing post-transplant Strongyloides hyperinfection in an HIV-positive kidney transplant patient. We discuss the diagnostic challenges and the role of pre-transplant screening. CASE PRESENTATION: A 58-year-old African-American male, originally from the Caribbean, received a deceased donor kidney transplant for presumed focal segmental glomerulosclerosis. He was known to be HIV-positive, with a stable CD4 count, and an undetectable viral load. Five months post-transplant, he developed gastrointestinal symptoms and weight loss. He had a normal eosinophil count (0.1-0.2 × 109/L), negative serum cytomegalovirus DNA, and negative blood and stool cultures. His Strongyloides serology remained negative throughout. A diagnosis of Strongyloides hyperinfection was made by the histological examination of his duodenum and lung, which identified the parasites. He completed his course of treatment with Ivermectin but exhibited profound deconditioning and required a period of total parenteral nutrition. He was subsequently discharged after a prolonged hospital admission of 54 days. CONCLUSIONS: This case highlights the challenges in diagnosing Strongyloides infection and the need to maintain a high index of clinical suspicion. Non-invasive techniques for the diagnosis of Strongyloides may be insufficient. Routine pre-transplant serological strongyloidiasis screening is now performed at our centre.


Asunto(s)
Seropositividad para VIH/fisiopatología , VIH/inmunología , Trasplante de Riñón/efectos adversos , Strongyloides stercoralis/aislamiento & purificación , Estrongiloidiasis/diagnóstico , Estrongiloidiasis/etiología , Receptores de Trasplantes , Afroamericanos , Animales , Antiparasitarios/uso terapéutico , Seropositividad para VIH/virología , Humanos , Ivermectina/uso terapéutico , Masculino , Persona de Mediana Edad , Estrongiloidiasis/tratamiento farmacológico , Estrongiloidiasis/parasitología , Donantes de Tejidos , Resultado del Tratamiento
20.
Lancet Haematol ; 7(8): e594-e600, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32735838

RESUMEN

Burkitt lymphoma is a rare and aggressive non-Hodgkin lymphoma with three classifications: endemic, sporadic, and immunodeficiency-related. High-intensity chemotherapeutic regimens have considerably improved overall survival for patients with Burkitt lymphoma. In this Review of HIV-associated Burkitt lymphoma, we summarise expert opinion and provide general recommendations for the treatment of Burkitt lymphoma in patients with HIV on the basis of retrospective and prospective studies, taking into consideration immune status, CD4 cell counts, the presence of systemic disease, and the risk of CNS involvement or relapse. We also discuss the role of rituximab and antiretroviral therapy. We highlight the reasons behind the possible different mechanisms of lymphomagenesis in HIV-associated Burkitt lymphoma and endemic Burkitt lymphoma, which indicate that HIV might have either a direct or indirect oncogenic role in Burkitt lymphoma. We discuss the possible mechanisms by which HIV and HIV proteins could directly contribute to lymphomagenesis. Identifying these mechanisms might lead to the development of therapies that have fewer toxic effects than high-intensity chemotherapeutic regimens.


Asunto(s)
Linfoma de Burkitt/patología , Infecciones por VIH/complicaciones , VIH/patogenicidad , Linfoma de Burkitt/epidemiología , Linfoma de Burkitt/etiología , Infecciones por VIH/virología , Humanos , Incidencia
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