Low Quality of Life, Falls, and Pre-Frailty are Associated with Depressive Symptoms in Virologically Suppressed PLWHIV in Salvador, Brazil.

Depression is the leading cause of years lived with disability worldwide and PLWHIV present a higher risk of developing depressive symptoms. We aimed to evaluate depressive symptoms and their predictors in virologically suppressed PLWHIV. We conducted a cross-sectional study with 200 PLWHIV. Depressive symptoms were defined as scoring ≥ 14 points in the Beck Depression Inventory II. Most of the participants (58.5%) were men, with a median age of 54 years (IQR: 46.25-59.00). Depressive symptoms' prevalence was 19.5% and they were associated with being divorced/widowed (aOR: 2.93, CI 95%: 1.17-7.37), recurrent falls (aOR: 4.24, CI 95%: 1.07-16.85), pre-frailty (aOR: 3.55, CI 95%: 1.47-8.57), and lower scores in all HRQoL dimensions. Although virologically suppressed PLWHIV presented lower prevalence of depressive symptoms than reported in previous studies in Brazil and South America, they were associated with falls and frailty, highlighting the need for screening.

RESUMEN: La depresión es la principal causa de años vividos con discapacidad en todo el mundo y las PVVIH presentan un mayor riesgo de desarrollar síntomas depresivos. Nuestro objetivo fue evaluar los síntomas depresivos y sus predictores en PVVIH que tienen supresión viral. Fue realizado un estudio de corte transversal incluyendo 200 PVVIH. La presencia de síntomas depresivos fue definida con una puntuación ≥ 14 puntos en el Inventario de Depresión de Beck II. La mayoría de los participantes (58.5%) fueron hombres, la mediana de edad fue de 54 años (RIQ: 46.25­59.00), y la prevalencia de síntomas depresivos fue de 19.5%. La depresión estuvo asociada con ser divorciado/viudo (ORa: 2.93, IC 95%: 1.17­7.37), caídas recurrentes (ORa: 4.24, IC 95%: 1.07­16.85) y prefragilidad (ORa: 3.55, IC 95%: 1.47­8.57). Los pacientes con síntomas depresivos tuvieron puntuaciones más bajas en todas las dimensiones de la escala de calidad de vida. Aunque encontramos una baja prevalencia de síntomas depresivos en PVVIH con supresión virológica en comparación con estudios previos en Brasil y Sudamérica, los factores asociados resaltan la importancia de la identificación temprana de caídas y fragilidad en esta población.

Temporomandibular disorders in patients with HIV: a cross-sectional study.

Untreated HIV infection leads to severe immunodeficiency and can be associated with an accelerated aging process and a higher prevalence of frailty. Systemic changes are known to cause greater oral manifestations and decreased orofacial function. However, there is no investigation on Temporomandibular Disorders (TMD) in this population. This study aims to assess the prevalence of TMD in individuals living with HIV/AIDS. This cross-sectional study included HIV patients, with undetectable plasma viral load, under follow-up in the infectious disease's outpatient clinic at the Federal University of Bahia hospital. We recorded socio-demographic data, Fried's frailty criteria, Research Diagnostic Criteria for Temporomandibular Disorder, and Beck's Depression Inventory (BDI) through the application of structured questionnaires and extra-oral examination findings. Data analysis was conducted on SPSS-v18. The sample consisted of 198 patients. The prevalence of TMD was (33.8 %), most affecting females (46.6 %). Difficulty in opening the mouth and parafunctional habits were the main symptoms of the disease, as well as functional limitations. The mean of the BDI score was higher in TMD group than in those without TMD (11.01 ± 8.61 vs. 7.60 ± 7.52 valor de p = 0.004). Logistic regression showed an association between sex (OR=2.305, 95 % CI 1.243‒4.275) and depression (OR = 1.045, 95 % CI 1.005‒1.087) and TMD in HIV patients. The present study observed the prevalence of symptoms associated with TMD as difficulty opening the mouth, muscle fatigue, and joint noises in patients with chronic HIV and associated with depression. Highlights the importance of a broader view of the health of individuals living with HIV.

HIV, HTLV, and Hepatitis B and C Infection in Blood Donors in Bahia, Brazil from 2008 to 2017.

Although blood transfusion is an important therapeutic resource, transfusion-transmitted infections (TTIs) are still a cause for concern. Measures to mitigate this risk involve improvement of donor screening criteria and improvements in laboratory tests, especially the use of nucleic acid test (NAT). In this retrospective study we evaluated HIV, HTLV, HCV and HBV infection rates in blood donors of the Hematology and Hemotherapy Foundation of Bahia (Hemoba), Brazil, through serological and NAT results and the characteristics of donors. From February/2008 to December/2017, 777,446 blood donations were made. Most donors were male, aged 25-44 years, black and mixed race, and single or divorced. The density-type incidence (DTI; per 100,000) for each virus was 91.1 for HBV; 66.5 for HCV; 54.3 for HIV; and 33.9 for HTLV, with a decreasing trend observed over the period studied, except in the last biennium. NAT detected only 1 donor in immunological window for HIV (0.46/100,000 donations) and 3 donors in immunological window for HBV (1.8/100,000 donations). Serological positivity for all viruses studied was higher in the metropolitan region of Salvador, the state capital. Conclusion: DTI rates show a decreasing trend over the years studied, with a predominance of HBV infection. NAT allowed the detection of donors in immunological window periods, having an important role in improving transfusion safety.

Frequency of Falls and Associated Risk Factors in People Living With HIV: A Systematic Review With Meta-Analysis and Meta-Regression.

BACKGROUND: Falls are considered as a predictive marker of poorer outcomes for people living with HIV (PLWHIV). However, the available evidences on the predictive value of falls are controversial. Our aim is to summarize the existing data about falls in PLWHIV. METHODS: A literature search was conducted using electronic databases (MEDLINE, Embase, and LILACS) for original observational studies. The primary outcome was any and recurrent falls' frequency in PLWHIV, and secondary outcomes were factors associated with falls. We conducted a random-effects meta-analysis with meta-regression to obtain a summary frequency of falls and recurrent falls. RESULTS: The pooled frequency for any fall was 26% [95% confidence interval (CI): 19% to 34%], compared with 14% for recurrent falls (95% CI: 9% to 22%). In studies comparing PLWHIV and people without HIV, we found no difference for any (pooled odds ratio 1.03, 95% CI: 0.90 to 1.17) or recurrent falls (pooled odds ratio 1.08, 95% CI: 0.92 to 1.27) between groups, but falls in middle-aged PLWHIV might be more associated with subjacent clinical conditions such as cognitive impairment, polypharmacy, use of medications with action in the central nervous system, and frailty, classic risk factors for falls in the elderly. CONCLUSIONS: The overall frequency of falls in PLWHIV seems to be lower than that presented by some initial studies, and several factors associated with falls are shared with elderly adults. Although both PLWHIV and people without HIV presented similar frequency of falls, we found that these events might be qualitatively different; therefore, an appropriate method to evaluate falls in this population to prevent adverse outcomes is warranted.

Seroprevalence and factors associated with Human Immunodeficiency virus, Human T lymphotropic virus and Hepatitis B/C infections in parturient women of Salvador - Bahia, Brazil.

BACKGROUND: The heterogeneity in detection rates of Human immunodeficiency virus, (HIV), Human T lymphotropic virus (HTLV) and Hepatitis B and C infections among pregnant women and the continuous exposure to risk factors limits the adoption of preventive and control actions. OBJECTIVE: To evaluate the HIV, HTLV, Hepatitis B and C seroprevalence rates, and associated risk factors in parturient women in Salvador, Brazil. METHODS: This was a cross-sectional study in 2099 parturient women attended in two public maternity hospitals in Salvador, Brazil. One blood sample was drawn for serological screening and socio-demographic, obstetric and clinical data were collected. RESULTS: HIV seroprevalence rate was 1.5% (of which 0.6% were new cases); seroprevalence rates for HTLV, HBV, and HCV were 0.4%, 0.4%, and 0.1%, respectively. Univariate analysis showed a significant association between socio-demographic and behavioral factors with retroviral infections, while viral hepatitis was mainly associated with parenteral exposure. In a multivariate analysis, multiple sexual partners (OR 3.3; 95% CI: 1.1-9.2), history of sexual/domestic violence (OR 2.8; 95% CI: 1.1-6.9), syphilis co-infection (OR 2.6; 95% CI: 1.0-6.9), use of alcohol or drugs (OR 2.5; 95% CI: 1.2-5.5), and low schooling level (OR 2.3; 95% CI: 1.1-4.9) were independent risk factors for HIV infection. History of stillbirth and low birth weight infants was significantly associated with HTLV positive status, showing a negative impact on gestation. CONCLUSIONS: The seroprevalence rates for HIV, HCV, HBV, and HTLV were similar to that found in previous studies in other Brazilian regions. The high individual, socioeconomic, and social vulnerability detected in seropositive parturient women indicates the need to improve coverage and effectiveveness of STDs control with prevention, detection and monitoring strategies, focusing in pregnant women exposed to high biopsychosocial risk.

Temporomandibular disorders in patients with HIV: a cross-sectional study

Abstract Untreated HIV infection leads to severe immunodeficiency and can be associated with an accelerated aging process and a higher prevalence of frailty. Systemic changes are known to cause greater oral manifestations and decreased orofacial function. However, there is no investigation on Temporomandibular Disorders (TMD) in this population. This study aims to assess the prevalence of TMD in individuals living with HIV/AIDS. This cross-sectional study included HIV patients, with undetectable plasma viral load, under follow-up in the infectious disease's outpatient clinic at the Federal University of Bahia hospital. We recorded socio-demographic data, Fried's frailty criteria, Research Diagnostic Criteria for Temporomandibular Disorder, and Beck's Depression Inventory (BDI) through the application of structured questionnaires and extra-oral examination findings. Data analysis was conducted on SPSS-v18. The sample consisted of 198 patients. The prevalence of TMD was (33.8 %), most affecting females (46.6 %). Difficulty in opening the mouth and parafunctional habits were the main symptoms of the disease, as well as functional limitations. The mean of the BDI score was higher in TMD group than in those without TMD (11.01 ± 8.61 vs. 7.60 ± 7.52 valor de p = 0.004). Logistic regression showed an association between sex (OR=2.305, 95 % CI 1.243‒4.275) and depression (OR = 1.045, 95 % CI 1.005‒1.087) and TMD in HIV patients. The present study observed the prevalence of symptoms associated with TMD as difficulty opening the mouth, muscle fatigue, and joint noises in patients with chronic HIV and associated with depression. Highlights the importance of a broader view of the health of individuals living with HIV.

Seroprevalence and factors associated with Human Immunodeficiency virus, Human T lymphotropic virus and Hepatitis B/C infections in parturient women of Salvador - Bahia, Brazil

Abstract Background The heterogeneity in detection rates of Human immunodeficiency virus, (HIV), Human T lymphotropic virus (HTLV) and Hepatitis B and C infections among pregnant women and the continuous exposure to risk factors limits the adoption of preventive and control actions. Objective To evaluate the HIV, HTLV, Hepatitis B and C seroprevalence rates, and associated risk factors in parturient women in Salvador, Brazil. Methods This was a cross-sectional study in 2099 parturient women attended in two public maternity hospitals in Salvador, Brazil. One blood sample was drawn for serological screening and socio-demographic, obstetric and clinical data were collected. Results HIV seroprevalence rate was 1.5% (of which 0.6% were new cases); seroprevalence rates for HTLV, HBV, and HCV were 0.4%, 0.4%, and 0.1%, respectively. Univariate analysis showed a significant association between socio-demographic and behavioral factors with retroviral infections, while viral hepatitis was mainly associated with parenteral exposure. In a multivariate analysis, multiple sexual partners (OR 3.3; 95% CI: 1.1-9.2), history of sexual/domestic violence (OR 2.8; 95% CI: 1.1-6.9), syphilis co-infection (OR 2.6; 95% CI: 1.0-6.9), use of alcohol or drugs (OR 2.5; 95% CI: 1.2-5.5), and low schooling level (OR 2.3; 95% CI: 1.1-4.9) were independent risk factors for HIV infection. History of stillbirth and low birth weight infants was significantly associated with HTLV positive status, showing a negative impact on gestation. Conclusions The seroprevalence rates for HIV, HCV, HBV, and HTLV were similar to that found in previous studies in other Brazilian regions. The high individual, socioeconomic, and social vulnerability detected in seropositive parturient women indicates the need to improve coverage and effectiveveness of STDs control with prevention, detection and monitoring strategies, focusing in pregnant women exposed to high biopsychosocial risk.