Analysis of serious non-AIDS events among HIV-infected adults at Latin American sites.

OBJECTIVE: Acquired immune deficiency appears to be associated with serious non-AIDS (SNA)-defining conditions such as cardiovascular disease, liver and renal insufficiency and non-AIDS-related malignancies. We analysed the incidence of, and factors associated with, several SNA events in the LATINA retrospective cohort. MATERIALS AND METHODS: Cases of SNA events were recorded among cohort patients. Three controls were selected for each case from cohort members at risk. Conditional logistic models were fitted to estimate the effect of traditional risk factors as well as HIV-associated factors on non-AIDS-defining conditions. RESULTS: Among 6007 patients in follow-up, 130 had an SNA event (0.86 events/100 person-years of follow-up) and were defined as cases (40 with cardiovascular events, 54 with serious liver failure, 35 with non-AIDS-defining malignancies and two with renal insufficiency). Risk factors such as diabetes, hepatitis B and C virus coinfections and alcohol abuse showed an association with events, as expected. The last recorded CD4 T-cell count prior to index date (P = 0.0056, with an average difference of more than 100 cells/µL) and area under the CD4 cell curve in the year previous to index date (P = 0.0081) were significantly lower in cases than in controls. CD4 cell count at index date was significantly associated with the outcome after adjusting for risk factors. CONCLUSIONS: The incidence and type of SNA events found in this Latin American cohort are similar to those reported in other regions. We found a significant association between immune deficiency and the risk of SNA events, even in patients under antiretroviral treatment.

The influence of an essential fatty acid deficient-diet on the reproductive performance of female rats.

Several parameters of the reproductive function were studied in albino rats of the Wistar strain fed an essential fatty acid-deficient (EFAD) diet, a linoleic acid-sufficient (EFAS) diet or a commercial diet (CD). The frequency of irregular estrous cycles, with an increased incidence of prolonged diestrus, was significantly higher in EFAD and EFAS groups than in the CD group. There were no significant differences between EFAD and EFAS rats in any of the estrous cycle parameters studied. The EFAD rats showed the following changes in reproductive performance in respect to EFAS and CD dams: prolonged period of gestation, reduced litter size and increased pup mortality during delivery and the first 48 neonatal hours. From this time to weaning, EFAD and EFAS pups had a similar rate of mortality and were different in this respect from the CD group. These results support previous reports indicating that linoleic acid is essential to the maintenance of normal pregnancy and the survival of newborn rats. Nevertheless, we cannot conclude that impairment of the estrous cycle and sucking mortality until weaning were primarily due to the absence of linoleic acid in the maternal diet. The possible role of alpha-linolenic acid in the reproductive is discussed.