Through 288 weeks, once-daily TDF+3TC+EFV demonstrated sustained antiretroviral activity with continued immunologic recovery. TDF treatment was not associated with renal adverse events or limb fat loss in antiretroviral-naïve patients.

Although HIV/hepatitis C virus (HCV) coinfection has been recognized worldwide in individuals exposed to blood-borne and sexually transmitted diseases (STD), limited data are available on the epidemiology of this coinfection in Brazil. A cross-sectional study was carried out to estimate the prevalence of HCV seropositivity in a cohort of people living with HIV/AIDS in Santos, Brazil, and to investigate potential risk factors for HCV infection. Anti-HCV antibodies were sought by using two immunoenzymatic assays. Overall HCV seroprevalence was 36.2% (95% confidence interval [CI] 31.9-40.4%). However, it was significantly higher (84.8%, 95% CI 78.2-91.3%) among intravenous drug users (IDU) as compared to non-IDU (20.9%, 95% CI 16.8-25.1%) (p < 0.001). Multiple logistic regression analysis revealed that HCV seropositivity among IDU was independently associated with needle sharing (adjusted odds ratio [adjOR] = 4.28, p = 0.07) and with serologic evidence of exposure to other bloodborne agents: HBV (adjOR = 4.39, p = 0.01) and HTLV-I/II (adjOR = 6.43, p = 0.02). In contrast, no association with lifetime number of sexual partners, history of STD, or of sex with commercial sex workers (CSW) could be demonstrated. Among non-IDU, HCV seropositivity was independently associated with sexual partnership with IDU (adjOR = 2.15, p = 0.08) and with HBV seropositivity (adjOR = 1.71, p = 0.05), but not with engaging in oral or anal receptive intercourse or having sex with CSW. Results indicate that exposure to blood and sexual partnership with IDU constitute the main risk factors for HCV acquisition among HIV-positive patients in Santos, Brazil. Prevention of HCV spread in this population should thus include harm reduction measures and information on safer sex practices for both IDU and their sexual partners.

In virologically suppressed patients, switching d4T to TDF as part of a once-daily regimen with 3TC and EFV resulted in maintenance of virologic suppression and continued CD4 cell increases through 144 weeks, with significant improvements in metabolic parameters.

Registraram-se, nos últimos vinte anos, casos autóctones de malária por Plasmodium vivax no Município de Peruíbe (24,19ºS e 47,00ºW), Litoral Sul do Estado de São Paulo, com presença de portadores assintomáticos ou oligossintomáticos associada ou não a parasitemias subpatentes. O problema na área é também conhecido como "bromélia-malária"; os vetores pertencem ao subgênero Kerteszia: Anopheles (K.) cruzii e A. (K.) bellator. A partir do segundo semestre de 1984 foram realizados, semestralmente, inquéritos sorológicos visando a dois objetivos: detectar possíveis fontes de infecção inaparente e obter o perfil sorológico da população, visando à melhoria do conhecimento da dinâmica da transmissão da malária e seu controle no foco. Este compreende 10 localidades, com população de cerca de 3000 pessoas, cuja mobilidade associa-se à presença de visitantes à aldeia indígena; à fazenda de cacau, que incorpora mão-de-obra transitória; em casas de temporada e existência de grupos nos quais a rotatividade se dá em função do processo de posse da terra. Como atividade econômica destaca-se a agricultura de banana e de cacau, além dos cultivos de subsistência. A técnica sorológica utilizada - reação de imunofluorescência indireta (RIFI) - foi processada com antígenos de P. vivax. O valor diagnóstico da RIFI foi confirmado pela identificação de alguns casos autóctones antes que as gotas espessas se revelassem positivas. A distribuição de freqüências de títulos na população foi comparável ao padrão de área de baixa endemicidade. Os soro-positivos predominaram entre o sexo masculino e nos grupos etários acima de 15 anos, faixas a que pertencem os indivíduos produtivos na agricultura e que apresentam uma relação mais estreita com a mata.

Because HTLV-I, HTLV-2, and HIV share identical modes of transmission, simultaneous or subsequent infections with these retroviruses are to be expected. The population of Santos, the largest port in Latin America, includes large numbers of female commercial sex workers and intravenous drug users, presumably having been exposed to retroviral infection. To evaluate the seroprevalence of HTLV infection and their associated risk factors, a cross-sectional survey was carried out in 499 HIV-infected individuals from Santos, Brazil. HTLV testing consisted of enzyme immunoassays for serologic screening and confirmatory Western blot testing. Overall HTLV-I and HTLV-2 seroprevalences were 6.0% (95% confidence interval [CI], 3.9-8.1) and 7.4% (95% CI, 5.1-9.7), respectively. Multivariate logistic regression for statistical analysis revealed HTLV-I infection to be independently associated with: intravenous drug use (IDU) (odds ratio [OR]. 2.99; 95% CI, 1.09-8.20), seropositivity to hepatitis C virus (HCV) (OR, 3.03; 95% CI, 1.02-9.01) and< 3 years of education (OR, 4.73; 95% CI, 1.56-14.41). HTLV-2 infection was associated with: IDU (OR, 3.22; 95% CI, 1.33-7.84), HCV seropositivity (OR, 5.40; 95% CI, 1.86-15.66) and nonwhite race (OR, 3.32; 95% CI, 1.58-7.00). Results indicate that HIV-infected individuals living in Santos are at similarly high risk of being exposed to HTLV-1 and HTLV-2. IDU constitutes the main risk factor for HTLV acquisition in this population, and there is no significant risk associated with sexual practice.