RESUMO
OBJECTIVE: To document antiretroviral use in Latin America during the last decade. METHODS: We collected indicators from 79 HIV health care centres in 14 Latin American Spanish-speaking countries for 2013-2017. Indicators were analysed by age, sex and other characteristics and weighted by the estimated people under care (PUC) population in each country. RESULTS: We gathered information on 116 299 PUC. One-third belonged to centres reporting a shortage of at least one antiretroviral therapy (ART) drug for >30 days during 2017. At end 2017, 95.1% of PUC were receiving ART. During 2013-2017, 45 329 people living with HIV were admitted to 39 centres. ART initiated during the first year after admission increased from 76.7% in 2013 to 83.8% in 2017. In 35 centres across the study period, 71.7% of PUC started ART with tenofovir disoproxil fumarate and lamivudine, and zidovudine use decreased. The third most common ART drug, EFV, reached 64.8%. Raltegravir and other alternatives increased annually to almost 10% of total use in 2017. CONCLUSIONS: Initial ART in Latin America is not based on the most recent scientific evidence and recommendations; use of drugs with higher efficacy and safety profiles and guarantee of ART availability continues to be a public health challenge.
Assuntos
Fármacos Anti-HIV , Infecções por HIV , Fármacos Anti-HIV/uso terapêutico , Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , América Latina/epidemiologia , Tenofovir/uso terapêuticoRESUMO
Presentamos el caso de un paciente del sexo masculino, de 24 años de edad, adicto endovenoso, HIV positivo, quién desarrolló una micobacteriosis diseminada con localización cutánea por Mycobacterium bovis. Se comentan aspectos clínicos e incidencia de las micobacteriosis tuberculosas y no tuberculosas, la poca frecuencia de las provocadas por Mycobacterium bovis y la buena respuesta al tratamiento específico en nuestro paciente a pesar de su importante inmunosupresión (AU)
Assuntos
Humanos , Masculino , Adulto , Síndrome da Imunodeficiência Adquirida/complicações , Infecções Oportunistas Relacionadas com a AIDS/etiologia , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções por Mycobacterium não Tuberculosas/etiologia , Manifestações Cutâneas , Mycobacterium bovis , Vacina BCG/efeitos adversosRESUMO
Presentamos el caso de un paciente del sexo masculino, de 24 años de edad, adicto endovenoso, HIV positivo, quién desarrolló una micobacteriosis diseminada con localización cutánea por Mycobacterium bovis. Se comentan aspectos clínicos e incidencia de las micobacteriosis tuberculosas y no tuberculosas, la poca frecuencia de las provocadas por Mycobacterium bovis y la buena respuesta al tratamiento específico en nuestro paciente a pesar de su importante inmunosupresión