RESUMO
We investigated the characterization of different HIV-1 subtypes present in French Guiana by use of three different methods. Serological methods were used for the initial screening, which were then confirmed by the heteroduplex mobility assay (HMA). The V3 env region was subsequently sequenced for phylogenetic analysis, to confirm the subtype of the samples, and to assign a subtype to samples that gave results that were difficult to interpret or discordant by serology or HMA. A total of 221 HIV-1 seropositive samples were typed; 110 of them were confirmed by HMA and 16 were sequenced. Of the 221 samples tested 210 patients (95%) were found to be infected with subtype B, 10 (4.5%) were infected with subtype A, and one patient was infected with subtype F. Phylogenetic analysis demonstrated that the strains from French Guiana were closely related to the subtype A and B subtypes, and that one strain was closely related to an F subtype (100% bootstrap value). Four strains from French Guiana clustered in the subtype A (99% bootstrap value) and the other strains were associated with subtype B (100% bootstrap value). The geographic position of French Guiana suggested that HIV-1 was probably introduced into the country via several routes, and thus the pattern of the HIV-1 epidemic might evolve in the near future.
Assuntos
Variação Genética , Proteína gp120 do Envelope de HIV/genética , Infecções por HIV/virologia , HIV-1/genética , Fragmentos de Peptídeos/genética , Sorodiagnóstico da AIDS , Sequência de Aminoácidos , Sequência de Bases , DNA Viral , Guiana Francesa , Proteína gp120 do Envelope de HIV/classificação , Infecções por HIV/sangue , Infecções por HIV/diagnóstico , Infecções por HIV/imunologia , HIV-1/classificação , HIV-1/imunologia , Análise Heteroduplex , Humanos , Dados de Sequência Molecular , Fragmentos de Peptídeos/classificação , FilogeniaAssuntos
Terapia Antirretroviral de Alta Atividade , Surtos de Doenças/prevenção & controle , Infecções por HIV/tratamento farmacológico , HIV-1/efeitos dos fármacos , Terapia Antirretroviral de Alta Atividade/efeitos adversos , Contagem de Linfócito CD4 , Guiana Francesa/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Risco , Fatores Socioeconômicos , Carga ViralRESUMO
OBJECTIVE: The aim of this study is to analyse the characteristics of HIV pregnant women in French Guiana then to evaluate the HIV mother to child transmission rate (MTCT) and determine the pronostic factors associated with MTCT. PATIENTS AND METHOD: An epidemiological study has been led including all deliveries in French Guiana from January 1998 to December 2000. For each case a standardized questionnaire has been gathered including epidemiological, clinical and biological data and an univariate analysis has been realized. A hundred and forty-eight women have been included in the study among 135 women came for delivery. RESULTS: The factors associated with increased MTCT in our study were no antiretroviral therapy before delivery, the lack of follow-up during pregnancy and no antiretroviral therapy in children. The HIV mother to child transmission rate was 6,5% despite the availability of antiretroviral therapies. DISCUSSION AND CONCLUSION: This rate may be explained by the difficulties of follow-up in HIV infected women. Much more needs to be done to improve access to care for women coming from foreign countries. This may be indispensable to reduce the HIV mother to child transmission rate in French Guiana.
Assuntos
Infecções por HIV/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Fármacos Anti-HIV/uso terapêutico , Feminino , Guiana Francesa/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Gravidez , PrognósticoRESUMO
Risk factors for death in an HIV-infected cohort in French Guiana were studied in 1374 patients between 1996 and 2005. Of these patients, 48.5% were male and 76% were immigrants. Covariates were measured at the time of consultation. There were 223 deaths. Addictions [adjusted hazard ratio (HR)=13; 95% confidence interval (CI) 5.5-30.6; P<0.001], age>60 years (HR=1.5; 95% CI 0.9-2.5; P=0.13), male gender (HR=1.5; 95% CI 1.03-2.5; P=0.03) and CD4 count<50 cells/microL (HR=9.1; 95% CI 5.1-16.3; P<0.001) were independently associated with death. These results suggest that strategies promoting early diagnosis and better follow-up of addicted patients would have a significant impact on mortality.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/mortalidade , Infecções por HIV/mortalidade , HIV , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Adulto , Distribuição por Idade , Causas de Morte , Transmissão de Doença Infecciosa , Feminino , Seguimentos , Guiana Francesa/epidemiologia , Infecções por HIV/epidemiologia , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco , Distribuição por Sexo , MigrantesRESUMO
This paper describes the structure and contents of EC301, a standardized testing battery for the evaluation of brain-damaged adults in the area of calculation and number processing. The battery was administered to 180 normal subjects stratified by education (3 levels), age (3) and gender. EC301 is composed of a large variety of tasks dealing with basic arithmetic skills, and their linguistic, spatial, and mnesic dimensions. The three main notational systems for numbers--Arabic digits, written verbal, and spoken verbal number forms--are explored. Analysis of error rates indicated the effect of some demographic factors (principally, education; incidentally, gender) on normal performance in some tasks.