Goal: To assess body mass index (BMI) changes in people living with HIV (PLHIV) and using antiretroviral therapy (ART) with dolutegravir (DTG) and its associated factors. Methods: Retrospective and prospective cohorts of PLHIV who started ART with DTG or used DTG after changing the therapeutic regimen, from Belo Horizonte, between February/2017 and March/2020. Data were gathered from clinical records of the Drug Logistics and Laboratory Test Control Systems. BMI changes were analyzed in the following week intervals 1-24(t24), 25-48(t48), 49-72(t73), and 73-96(t96) using the Wilcoxon test and generalized estimation equation (GEE) model, at 5% significance level. Results: A total of 614 individuals were included and average was 38.4 years old. Most were men (85.5%) and 52.3% had started ART with DTG. These individuals, and the immunosuppressed ones, showed significant increases in BMI when compared to those who used DTG after switching therapeutics or the non-immunosuppressed ones (p-value <0.05). After 96 weeks, individuals starting ART with DTG had a mean increase in BMI of 1.02 Kg/m2, whereas those who used DTG after the therapeutic change had an increase of 0.56 Kg/m2 (p<0.05). DTG use length, ART type, immune status, baseline BMI, and age were associated (p<0.05) with BMI increases. Conclusions: We observed an increase in BMI both in individuals starting ART with DTG use and those using it after changing the therapeutic regimen.
Over time, a growing increase in human pollutants in the aquatic environment has been observed. The global presence of residues in water bodies reinforces the need to develop improved methods to detect them and evaluate their ecotoxicological effects in the aquatic environment. Thus, this study aimed to present the main assays using B. glabrata as a biological model for ecotoxicological studies. We performed a systematic literature review with data published up to June 2022 in the Science Direct, PubMed, and SciELO databases. Twenty-six studies were selected for this review after screening. B. glabrata has been studied as an ecotoxicological model for different substances through toxicity, embryotoxicity, cytotoxicity, genotoxicity and bioaccumulation assays. Studies evaluating the impact of Biomphalaria glabrata exposure to several substances have reported toxic effects, behavioral and reproductive effects, and effects on their offspring. This review presents various assays using Biomphalaria glabrata as a biological model for ecotoxicological studies. The increasing number of studies conducted with the snail provides a preview of the snail’s potential as a biological model for ecotoxicological studies.
Over time, a growing increase in human pollutants in the aquatic environment has been observed. The global presence of residues in water bodies reinforces the need to develop improved methods to detect them and evaluate their ecotoxicological effects in the aquatic environment. Thus, this study aimed to present the main assays using B. glabrata as a biological model for ecotoxicological studies. We performed a systematic literature review with data published up to June 2022 in the Science Direct, PubMed, and SciELO databases. Twenty-six studies were selected for this review after screening. B. glabrata has been studied as an ecotoxicological model for different substances through toxicity, embryotoxicity, cytotoxicity, genotoxicity and bioaccumulation assays. Studies evaluating the impact of Biomphalaria glabrata exposure to several substances have reported toxic effects, behavioral and reproductive effects, and effects on their offspring. This review presents various assays using Biomphalaria glabrata as a biological model for ecotoxicological studies. The increasing number of studies conducted with the snail provides a preview of the snail's potential as a biological model for ecotoxicological studies.
As terapias antirretrovirais são utilizadas como forma de melhorar a expectativa de vida das pessoas vivendo com HIV. Com a redução dos efeitos adversos, a terapia dupla com dolutegravir (DTG) mais lamivudina (3TC) vêm se mostrando uma opção viável. No entanto, mesmo apresentando uma eficácia similar à terapia tripla, ainda há a ausência de enfoque nas taxas de descontinuação do tratamento. Por este motivo, o objetivo com esse trabalho foi avaliar a taxa de descontinuação da terapia antirretroviral dupla com DTG mais 3TC em pessoas vivendo com HIV. Foi realizada uma revisão sistemática nas bases de dados PubMed, SciElo e Scopus, a partir da seleção de estudos de coorte que relataram a taxa de descontinuação com uso da terapia dupla com DTG mais 3TC. Foram selecionados 14 artigos, oito estudos retrospectivos e seis estudos prospectivos. A população foi composta por 2.666 indivíduos, com idade média de 50,4 anos, sendo 75,2% do sexo masculino. A taxa de descontinuação da terapia dupla com DTG mais 3TC descrita nos estudos variou de 0,0% a 22,4%. Um total de 364 indivíduos descontinuaram a terapia dupla com DTG mais 3TC, sendo a taxa de descontinuação observada de 13,7% (IC95% 13,0-14,4%). Os principais motivos para descontinuação foram eventos neuropsiquiátricos (19,5%), falha virológica (10,7%) e toxicidade gastrointestinal (8,8%). Mesmo com os benefícios fornecidos pela terapia dupla, alguns fatores ainda contribuem para a descontinuação do tratamento, sendo possível observar ainda uma alta taxa de descontinuação do tratamento utilizando a terapia dupla de DTG mais 3TC. Incluir o resumo.
Objective: To estimate the consumption and quantity of unaltered antiretrivirals (ARV) eliminated into the environment and to carry out a literature research on aquatic ecotoxicological studies of ARV used in Brazil. Methodology: We requested from one of the ARV dispensing units in the city of Belo-Horizonte (BH) the amount of ARV dispensed in the years 2018-2019-2020. Considering the amount dispensed in 2020, the daily dose, and the elimination rate, the amount of drug in unchanged form in the environment was estimated. For entire municipality of BH and Brazil, we used epidemiological data were used regarding individuals using antiretroviral therapy (ART) in 2020, the proportion of people living with HIV using the main ART regimen, following the same estimation methodology used previously. Structured and individual searches were carried out for each ARV used in Brazil, relating it to ecotoxicology, through Google Scholar, National Center for Biotechnology Information and Scifinder, in addition to the use of the fass.se platform. Results: Four articles presented results of acute or chronic toxicity in ecotoxicological models involving ARV. Dolutegravir and efavirenz were found to be highly toxic in ecotoxicological models. In 2020, approximately 2,167kg of ARVs in unchanged form were released into the environment in BH. In Brazil it was 112,274kg. Conclusion: It is urgent to quantify the main ARV in water bodies. With these data together with ecotoxicological data it will be possible to establish risk criteria for possible measures to control or mitigate these contaminants in the environment, especially actions to improve wastewater/water treatment.
Introdução: A pandemia de COVID-19 evidenciou a necessidade de desenvolver ferramentas para a divulgação de informações seguras em saúde, especialmente para pessoas vivendo e convivendo com vírus da imunodeficiência humana. Objetivo: Descrever a elaboração de boletins informativos para pessoas que vivem e convivem com vírus da imunodeficiência humana no contexto da pandemia de COVID-19. Métodos: Os boletins informativos são publicações periódicas desenvolvidas por professores, pesquisadores, alunos da pós-graduação e da graduação da Universidade Federal de Minas Gerais integrantes do projeto de extensão “Ações integradas para orientação às pessoas que vivem e convivem com vírus da imunodeficiência humana frente à pandemia de COVID-19”. Os boletins são elaborados seguindo seis etapas principais: i) busca em bases de dados, ii) seleção dos estudos e revisão da literatura, iii) escrita, iv) formatação, v) revisão e vi) publicação. Para alcançar leitores com diferentes níveis de escolaridade e letramento em saúde, os boletins são escritos em linguagem acessível, utilizando ferramentas de design e layout apropriados, ilustrações educativas, esquemas e infográficos, disponibilizados no website Pensando Nisso e salvos em PDF para facilitar o compartilhamento por meios digitais. Resultados: O primeiro boletim foi publicado em julho de 2020 e abordou temas como: riscos e ações para o enfrentamento da COVID-19 para pessoas vivendo com vírus da imunodeficiência humana, terapia antirretroviral e COVID-19, acesso aos antirretrovirais durante a pandemia e interações medicamentosas. O segundo boletim foi publicado em novembro de 2020, com os seguintes temas: características, principais sintomas e tratamento (casos leves, moderados e graves) da COVID-19 para pessoas vivendo com vírus da imunodeficiência humana e desfechos em pacientes hospitalizados. Conclusão: Os boletins informativos constituem importantes ferramentas de compartilhamento de informações seguras e confiáveis no contexto da infecção pelo vírus da imunodeficiência humana e da pandemia de COVID-19. Ações como essa contribuem para a promoção da saúde integral das pessoas que vivem com vírus da imunodeficiência humana, fornecendo subsídios para a tomada de decisão e manutenção de medidas preventivas.
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