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1.
Braz J Infect Dis ; 11(1): 16-9, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17625720

RESUMEN

This study evaluates clinical, virological and immunological responses to antiretroviral (ARV) therapy based on Lopinavir/ritonovir (LPV/r) in previously protease -inhibitor-experienced children. The study included 29 Brazilian children (median age = 5.91 years) who had failed previous ARV therapy and had begun a regimen based on LPV/r. At 12 months follow-up, a good virological response to LPV/r therapy was defined as achieving an undetectable viral load or as a decrease in plasma HIV RNA levels to > 1 log. A good immunological response was defined as an increase in CD4+ cell count from baseline sufficient to attain a better CDC immune stage classification. The number of infectious episodes 12 months before and 12 months after beginning LPV/r was assessed. Sixteen (55.2%) and 19 (65.5%) of 29 patients exhibited good virological and immunological responses, respectively. Baseline CD4+ values (>500) predicted both virological and immunological responses (p<0.05). Older children were less likely to develop an immunological response (p<0.001) than younger children. Nine children receiving 3 ARV drugs plus LPV/r showed an immunological response (100%) compared to 10/20 (50%) children receiving 2 drugs plus LPV/r (p=0.01). A lower number (n<5) of infectious episodes was noted after 12 months follow-up in children using the LPV/r regimen (p=0.006). There was a positive correlation between children whose baseline CD4+ values were greater than 500 cells/mm(3) and virological responses. Although virological responses to therapy were seen in about half the children (55.2%), the use of HAART containing LPV/r provided clinical and immmunological benefits.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Terapia Antirretroviral Altamente Activa , Inhibidores de la Proteasa del VIH/uso terapéutico , Pirimidinonas/uso terapéutico , Ritonavir/uso terapéutico , Síndrome de Inmunodeficiencia Adquirida/inmunología , Síndrome de Inmunodeficiencia Adquirida/virología , Recuento de Linfocito CD4 , Niño , Preescolar , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Lopinavir , ARN Viral , Resultado del Tratamiento , Carga Viral
2.
Arq Neuropsiquiatr ; 63(3B): 828-31, 2005 Sep.
Artículo en Portugués | MEDLINE | ID: mdl-16258664

RESUMEN

The CNS infection by HIV-1 in infancy could be present immediately after infection or became manifest later. Microcephalia, mental retardation, pyramidal signs, humor and behavioral disorders and antiretroviral therapy complications are common. This is an observational, sectional and descriptive study about findings on neurological examination of 173 patients in a group of children and adolescents infected and exposed to HIV-1 in perinatal period. Most of them had more than one neurological finding or different diagnosis. The more common findings were: encephalopathy, mental retardation, language delay, pyramidal signs, hyporeflexia. The neurological examination was abnormal in 67% of all patients even in seroreverters. We suggest that this group has a high risk to neurological disease and the development of co-morbidity is directly correlated to clinical deterioration by HIV-1 infection.


Asunto(s)
Enfermedades Virales del Sistema Nervioso Central/complicaciones , Discapacidades del Desarrollo/etiología , Infecciones por VIH/complicaciones , VIH-1 , Adolescente , Distribución por Edad , Brasil , Enfermedades Virales del Sistema Nervioso Central/fisiopatología , Niño , Preescolar , Comorbilidad , Estudios Transversales , Discapacidades del Desarrollo/fisiopatología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Lactante , Masculino , Reflejo Anormal/fisiología , Estudios Retrospectivos , Distribución por Sexo
3.
Braz. j. infect. dis ; 11(1): 16-19, Feb. 2007. tab
Artículo en Inglés | LILACS | ID: lil-454677

RESUMEN

This study evaluates clinical, virological and immunological responses to antiretroviral (ARV) therapy based on Lopinavir/ritonovir (LPV/r) in previously protease -inhibitor-experienced children. The study included 29 Brazilian children (median age = 5.91 years) who had failed previous ARV therapy and had begun a regimen based on LPV/r. At 12 months follow-up, a good virological response to LPV/r therapy was defined as achieving an undetectable viral load or as a decrease in plasma HIV RNA levels to > 1 log. A good immunological response was defined as an increase in CD4+ cell count from baseline sufficient to attain a better CDC immune stage classification. The number of infectious episodes 12 months before and 12 months after beginning LPV/r was assessed. Sixteen (55.2 percent) and 19 (65.5 percent) of 29 patients exhibited good virological and immunological responses, respectively. Baseline CD4+ values (>500) predicted both virological and immunological responses (p<0.05). Older children were less likely to develop an immunological response (p<0.001) than younger children. Nine children receiving 3 ARV drugs plus LPV/r showed an immunological response (100 percent) compared to 10/20 (50 percent) children receiving 2 drugs plus LPV/r (p=0.01). A lower number (n<5) of infectious episodes was noted after 12 months follow-up in children using the LPV/r regimen (p=0.006). There was a positive correlation between children whose baseline CD4+ values were greater than 500 cells/mm³ and virological responses. Although virological responses to therapy were seen in about half the children (55.2 percent), the use of HAART containing LPV/r provided clinical and immmunological benefits.


Asunto(s)
Niño , Preescolar , Humanos , Terapia Antirretroviral Altamente Activa , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Inhibidores de la Proteasa del VIH/uso terapéutico , Pirimidinonas/uso terapéutico , Ritonavir/uso terapéutico , Síndrome de Inmunodeficiencia Adquirida/inmunología , Síndrome de Inmunodeficiencia Adquirida/virología , Estudios de Seguimiento , Estudios Longitudinales , ARN Viral , Resultado del Tratamiento , Carga Viral
4.
J. pediatr. (Rio J.) ; 77(1): 52-4, jan.-fev. 2001.
Artículo en Portugués | LILACS | ID: lil-283081

RESUMEN

Objetivo: Enfatizar aspectos importantes para o diagnóstico e manejo clínico de pacientes com actinomicose cervicofacial na infância. Casuística e método: O presente estudo é um relato de caso de actinomicose na forma cervicofacial, acompanhando de revisão da literatura dos últimos anos através dos bancos de dados Lilacs e Medline. Resultados: Paciente do sexo masculino acompanhado na enfermaria de moléstias infecciosas pediátricas por actinomicose cervicofacial. O diagnóstico foi realizado através de biópsia de nódulo cervical e isolamento da bactéria. O antibiótico utilizado foi a penicilina para o actimomices, por 14 dias. Alta após diminuição do nódulo, com orientação de amoxicilina por mínimo de 6 meses e acompanhamento ambulatorial. Conclusão: O diagnóstico precoce da actinomicose resulta em tratamento adequado e imediato, evitando-se o acometimento de áreas nobres em SNC, face e pescoço


Asunto(s)
Humanos , Masculino , Niño , Actinomicosis
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