Improvement in lipid profiles in antiretroviral-experienced HIV-positive patients with hyperlipidemia after a switch to unboosted atazanavir.

OBJECTIVE: The primary objective was to compare the change in fasting low-density lipoprotein (LDL) cholesterol from baseline to week 12 between patients receiving an atazanavir-containing regimen and those receiving comparator protease inhibitor (PI) regimens. DESIGN: AI424-067 was a 48-week, open-label, randomized, prospective study of 246 patients on PI-based regimens with hyperlipidemia [fasting LDL cholesterol >130 mg/dL (>3.4 mmol/L)] and with HIV RNA <50 copies per milliliter. Patients were randomized to switch to atazanavir (400 mg once daily) on day 1 (immediate switch) or maintain current PI regimen for the first 24 weeks, then switch to atazanavir (delayed switch). METHODS: Plasma lipid levels were compared with baseline values at weeks 12, 24, and 48. Safety, viral load, and CD4 profiles were also evaluated. RESULTS: At week 12, the mean percent changes in LDL cholesterol from baseline for the immediate-switch and delayed-switch groups were -15% and +1%, respectively (P < 0.0001). Favorable LDL cholesterol levels in the immediate-switch group were sustained through week 48. Both groups maintained comparable virologic control. Switching to atazanavir did not produce a significant change in safety or tolerability. CONCLUSIONS: A switch-either immediate or delayed-from a boosted or unboosted PI to unboosted atazanavir in patients with hyperlipidemia was associated with improvements in plasma lipid parameters without loss of virological suppression.

HIV prevalence among blood donors in a blood bank in Curitiba (Brazil).

There still is no cure for the acquired immunodeficiency syndrome (AIDS). Its etiologic agent is the human immunodeficiency virus (HIV), and transmission occurs through sexual relationships, contacts with blood, and vertically (mother to child). In this study, we sought to determine the prevalence of HIV among blood donors at a blood bank in Curitiba. We studied 213,666 blood donations made from March 1, 1992, to April 25, 1999. Each potential blood donor first answered a questionnaire, submitted to a clinical examination, and filled out a self-exclusion card. Blood was collected and analyzed only from the candidates approved by the first two criteria. Two tests were used to detect HIV: ELISA for screening, and Western-Blot for confirmation. The results were analyzed statistically by determining the 95% confidence interval. Of the total number of donors, 156,942 were men, and 56,724 were women. There were 319 cases of HIV infection (244 men, 75 women). There were no significant differences between genders, or among the different age groups, or between first-donation and repeated-donation donors. There was a significant predominance of HIV infection among single individuals compared to married, widowed, and other individuals. The same occurred among married and divorced individuals compared to widowed subjects. The prevalence of HIV among blood donors was 0.149% (0.155% among men and 0.132% among women). The frequency of HIV was statistically identical among new blood donors and repeat donors. A large number of HIV-infected married women was also observed.

HIV prevalence among blood donors in a blood bank in Curitiba (Brazil)

There still is no cure for the acquired immunodeficiency syndrome (AIDS). Its etiologic agent is the human immunodeficiency virus (HIV), and transmission occurs through sexual relationships, contacts with blood, and vertically (mother to child). In this study, we sought to determine the prevalence of HIV among blood donors at a blood bank in Curitiba. We studied 213,666 blood donations made from March 1, 1992, to April 25, 1999. Each potential blood donor first answered a questionnaire, submitted to a clinical examination, and filled out a self-exclusion card. Blood was collected and analyzed only from the candidates approved by the first two criteria. Two tests were used to detect HIV: ELISA for screening, and Western-Blot for confirmation. The results were analyzed statistically by determining the 95 confidence interval. Of the total number of donors, 156,942 were men, and 56,724 were women. There were 319 cases of HIV infection (244 men, 75 women). There were no significant differences between genders, or among the different age groups, or between first-donation and repeated-donation donors. There was a significant predominance of HIV infection among single individuals compared to married, widowed, and other individuals. The same occurred among married and divorced individuals compared to widowed subjects. The prevalence of HIV among blood donors was 0.149 (0.155 among men and 0.132 among women). The frequency of HIV was statistically identical among new blood donors and repeat donors. A large number of HIV-infected married women was also observed.

Manifestaçöes oculares em portadores do HIV: perfil de um grupo de pacientes e revisäo da literatura / Ocular manifestations in patients with HIV infection: features of a group of patients and literature review

O intuito de tal estudo é observar a prevalência de alteraçöes oculares numa populaçäo de pacientes portadores de HIV e avaliar a efetividade do exame oftalmoscópico sob midríase realizado por estudantes de medicina na detecçäo do envolvimento fundoscópico nestes pacientes e observar a ocorrência de sintomas oculares e alteraçöes fundoscópicas nestes pacientes. Foram avaliados pacientes portadores do HIV, em tratamento no Sistema Unico de Saúde em Curitiba, entre julho de 1996 e abril de 1997. As variáveis observadas foram: idade, sexo, presença de atividade laboral, existencia de sintomas oculares e as medicaçöes anti-retrovirais sistêmicas utilizadas. Um total de 120 pacientes foram submetidos a oftalmoscopia monocular direta por näo especialistas que, ao considerarem os pacientes como tendo alteraçöes fundoscópicas, encaminhavam-nos ao oftalmologista para realizaçäo de oftalmoscopia binocular indireta. Correlacionando-se o exame fundoscópico näo especializado, os sintomas e a avaliaçäo especializada dos pacientes, pode-se afirmar que o clínico pode desempenhar um papel importante no diagnóstico precoce de lesöes córioretinianas na Aids. Concluiu-se que os sintomas oculares mais frequentes foram visäo embaçada e moscas volantes e as alteraçöes oculares mais comuns, manchas algodonosas e turvaçäo de meios.(au)

Epidemiologia da Síndrome da Imunodeficiência Adquirida em prostitutas / Epidemiology of Acquired Immunodeficiency Syndromein prostitutes

Este trabalho é o resultado do estudo da prevalência do vírus tipo 1 da imunodeficiência humana (HIV-1) com identificaçäo dos prováveis fatores de risco e co-prevalência do HIV-1 com o antígeno de superfície do vírus da hepatite B (HBsAG) realizado em prostitutas na cidade portuária de Paranaguá, no Estado do Paraná, Brasil, no ano de 1992. A obtençäo dos dados foi possível através de questionário, havendo coleta de sangue para análise da presença dos anticorpos contra o HIV-1 e também da presença do antígeno de superfície do vírus da hepatite B. A frequência da soropositividade para o HIV-1 foi de 4,5 por cento e do HBsAG de 3,0 por cento. A presença do HBsAG está estatisticamente relacionada com a positividade do HIV-1. O fato de näo usar preservativo por näo ver importância e o contato com parceiros bissexuais se mostraram como fatores de risco estatisticamente significativos para a infecçäo pelo HIV-1