[Survival of HIV women and HAART therapy]. / Supervivencia de las mujeres infectadas por el VIH tras la aparición del TARGA.

OBJECTIVES: To assess antiretroviral treatment in women with HIV infection, to evaluate the evolution of the disease and to establish the survival rate of these patients. DESIGN: A retrospective study performed from 1985 to December, 2004. Seventy-five women, chosen randomly from all patients attending the Out-patients Department, Arnau de Vilanova Hospital, Spain. All patients were over 18 years of age, with HIV infection and undergoing antiretroviral treatment. Patients were divided into two groups according to the starting date of therapy, before or after the year 1997 when a significant change in antiretroviral therapy took place, referring both to the number of drugs used and their potency. METHODS: A comparison was made regarding the epidemiological and demographic profile, the initial and final treatment, the efficacy of antiretroviral treatment, the evolution of the HIV infection and the survival rate between both groups of patients. RESULTS: Sixty-six point seven per cent (66.7%) of the patients in the first group and 85.2% of patients in the second had negative viral loads at study end. Forty-seven point nine per cent (47.9%) of patients starting treatment before 1997, maintained CD4 lymphocyte counts above 500 cells/mL compared with 59.3% of the patients who started treatment after 1997. There were only 6 deaths, which corresponded to the first group of patients. CONCLUSIONS: The data obtained from our study suggests that antiretroviral treatment is effective in both groups of patients, and has enabled good evolution and lengthened the survival rate.

[Can we improve the prevention of tuberculosis? Analysis of the application of chemoprophylaxis]. / Podemos mejorar la prevención de la tuberculosis? Análisis de la aplicación de la quimioprofilaxis.

To analyze the situations that make chemoprophylaxis for tuberculosis difficult. One hundred twenty-eight patients consecutive (106 HIV negative and 22 HIV positive) diagnosed of tuberculosis (TB) were studied. The patients were interviewed and a questionnaire was filled out in order to identify risk groups and determine what steps had been taken to prevent TB. In the HIV negative group, 63 (57.8%) had at least one risk factor. The most common were contact with persons with active TB (31.1%), former TB (15.1%), rapid weight loss or chronic malnutrition (13.2%) and residence in closed institutions (5.6%). Of the 51 (48.1%) for whom evaluation of chemoprophylaxis was indicated, 43 (84.3%) had been examined by a physician within the past five years; only 10 (23.3%) of them, however, had been checked for TB and isoniazide had been prescribed for only 4 (9.3%). In the HIV positive group, 13 (72.2%) of those for whom evaluation of chemoprophylaxis was indicated had been seen by a physician; 12 (97.7%) of them were given tuberculin tests checked for TB and isoniazide was prescribed for 4 (30.7%). None of the patients in either group who were prescribed a full course of prophylaxis actually took the drug enough. Most HIV negative patients for whom evaluation of chemoprophylaxis was indicated had been examined by a physician in the five years before disease was detected; less than a quarter of them were checked for TB, however. This situation is probably a consequence of the structure of health care in Spain as it affects TB control. Nearly all the HIV positive patients were checked for the disease, as they benefited from protocolized health care.

Supervivencia de las mujeres infectadas por el VIH tras la aparición del TARGA / Survival of HIV women and HAART therapy

Objetivo: Valorar la eficacia del tratamiento antirretroviral en mujeres con infección por VIH, evaluar la evolución de la enfermedad y establecer la supervivencia. Diseño: Estudio retrospectivo que comprende desde el año 1985 hasta Diciembre de 2004. Incluye 75 mujeres elegidas aleatoriamente de entre todas las pacientes del Servicio de Consultas Externas del Hospital Arnau de Vilanova, mayores de 18 años, con infección por VIH y con tratamiento antirretroviral. Las pacientes se han dividido en dos grupos en función de la fecha de inicio de la terapia, antes o después de 1997, ya que a partir de este año se produjo un cambio significativo en la terapia antirretroviral. Método: Se realizó una comparación del perfil epidemiológico y demográfico, del tratamiento inicial y final, de la eficacia del tratamiento antirretroviral, de la evolución de la infección y de la supervivencia en los dos grupos de pacientes. Resultados: Un 66.7% de las pacientes del primer grupo y un 85.2% de las pacientes del segundo tuvieron cargas virales negativas al final del estudio. El 47,9% de las pacientes que iniciaron tratamiento antes de 1997 consiguieron mantener recuentos de linfocitos CD4 superior a 500 células/ml frente al 59,3% de las pacientes que iniciaron tratamiento a partir de 1997. Sólo hubo 6 fallecidos correspondiendo al primer grupo de las pacientes. Conclusiones: los datos obtenidos en nuestro estudio sugieren que el tratamiento antirretroviral ha sido eficaz en los dos grupos de pacientes lo que ha permitido una buena evolución de las mismas y prolongar su supervivencia

Objectives: To assess antiretroviral treatment in women with HIV infection, to evaluate the evolution of the disease and to establish the survival rate of these patients. Design: A retrospective study performed from 1985 to December, 2004. Seventy-five women, chosen randomly from all patients attending the Out-patients Department, Arnau de Vilanova Hospital, Spain. All patients were over 18 years of age, with HIV infection and undergoing antiretroviral treatment. Patients were divided into two groups according to the starting date of therapy, before or after the year 1997 when a significant change in antiretroviral therapy took place, referring both to the number of drugs used and their potency. Methods: A comparison was made regarding the epidemiological and demographic profile, the initial and final treatment, the efficacy of antiretroviral treatment, the evolution of the HIV infection and the survival rate between both groups of patients. Results: Sixty-six point seven per cent (66.7%) of the patients in the first group and 85.2% of patients in the second had negative viral loads at study end. Forty-seven point nine per cent (47.9%) of patients starting treatment before 1997, maintained CD4 lymphocyte counts above 500 cells/mL compared with 59.3% of the patients who started treatment after 1997. There were only 6 deaths, which corresponded to the first group of patients. Conclusions: The data obtained from our study suggests that antiretroviral treatment is effective in both groups of patients, and has enabled good evolution and lengthened the survival rate

Asociación de tuberculosis y alcohol en pacientes de una unidad de infecciosos / Assotiation between alcohol comsumption and TBC in an infectious diseaasses unit

Estudio prospectivo sobre la asociación de alcohol con la tuberculosis (TBC). En una población de 70 pacientes ingresados en la unidad de infecciosos con el diagnóstico de TBC pulmonar. Se valora el sexo, estado civil y el consumo de alcohol (gramos/día). Se comparan los resultados con un grupo control de 70 personas no tuberculosas, apareadas por edad, sexo y estado civil. Encontramos los siguientes resultados: El consumo de Alcohol se asocia a Tuberculosis pero sólo en los hombres (¿sesgó de respuesta?). Entre los bebedores la intensidad de consumo es mayor en los enfermos de TBC. Entre los enfermos de TBC no hay diferencias de intensidad de consumo por sexo, mientras que en los no tuberculosos, los hombres consumen más cantidad de alcohol. Hay una asociación clara entre TBC y alcohol en el grupo de los no casados (solteros, separados, viudos) (AU)

Prospective study of the association between alcohol consumption and TBC. In a population of 70 patients studied in the Infectious Diseases Unit with the diagnosis of pulmonary TBC; the following parameters were evaluated: sex, civil status and the consumption of alcohol (grams/day). The results were compared with a control group of 70 non –TBC patients, matched by age, sex and civil status. Results: The consumption of alcohol is associated with Tuberculosis, only in the males sex (answer slant). Among the drinkers, the consumption of alcohol was larger in TBC patients. In TBC patients, there were no differences of consumption intensity in regard to sex, while in those without tuberculosis, the men consumed more quantity of alcohol. There is a clear association between TBC and alcohol in the group of those not married ( single, separated, widowers) (AU)