Finding a better first antiretroviral regimen is one of the strategies used to improve span and quality of life of HIV/AIDS patients. 891 patients were followed during 24 months or until interruption/abandonment of treatment, changing regimen or death. At the end of 6 months, 69% of the patients were still being treated with the first regimen, 54% at 12 months, 48% at 18 months and 39% at 24 months. AZT-3TC-EFV was the most prescribed regimen and with the lesser discontinuation. NNRTI regimens showed high effectiveness and durability compared to PI regimens. Irregular medication dispensation was the only risk factor for failure/interruption of treatment in multivariate analyses. Intolerance/adverse effects were mainly responsible for first regimen discontinuation, followed by abandonment/non-adherence and virologic failure. Results showed significant difference between causes of interruption of first HAART with higher percentage of intolerance/adverse effects with PI regimens and higher immunologic failure with NNRTI regimens. Even with the availability of more potent and tolerable drugs, lack of adherence to HAART and high level of adverse effects are still the most important barriers to prolonged success of treatment. This study adds relevant information about durability and effectiveness of HAART in the first decade of its use in Brazil.

We assessed the performance of HIV-1 genotyping tests in rescue therapy. Patients were divided into two groups: group 1 (genotyped), included those switching to new antiretroviral drugs based on HIV-1 genotyping data, and group 2 (standard of care -SOC), comprised those in rescue therapy who had not used this test. This was an open and non-randomized study, with 74 patients, followed up for a mean period of 12 months, from February 2002 to May 2003. The groups differed in the duration of antiretroviral use, experience with diverse drug classes (non-nucleoside reverse transcriptase inhibitors and protease inhibitors) and viral load <2.6 log 10 copies/mL at any time during treatment. In 23 patients (group 1), the switch in antiretroviral (ARV) regimen was based on genotyping data; this test was not used for 51 patients (group 2). Two CD 4 + lymphocyte counts and viral load counts were made for each patient during the study. Data from the pharmacy where patients received antiretroviral agents, medical charts, and direct interviews with patients to assess compliance to treatment, were analyzed. In the genotyped group, the average drop in viral load was 2.8 log 10 , compared with a 1.5 log 10 difference in group 2; the difference was significant in the first assessment performed six months after switching (p=0.001). Considering the patients with viral load < 2.6 log 10 (400 copies/mL) after switching, the patients in group 1 had a better performance in the first assessment (73.9% versus 31.1% in groups 1 and 2, respectively); this difference was significant (p=0.001). In multivariate analysis, the variables associated with a greater drop in viral load in the first assessment were the patients whose switching was based on genotyping (group 1), those with a past history of viral load < 2.6 log 10 and correct use of antiretroviral agents. In conclusion, the genotyping test and adherence were found to be independent factors for success in the management of patients who failed treatment.

O objetivo deste trabalho foi avaliar a qualidade microbiológica e as características físicas e químicas de polpas de maracujá congeladas comercializadas em dois supermercados da cidade de Machado/MG, com intuito de verificar a adequação do produto aos padrões estabelecidos pelas legislações vigentes. As seguintes análises foram realizadas: coliformes a 35oC, pesquisa de Salmonella spp., contagem de bolores e leveduras, pH, acidez titulável, sólidos solúveis, sólidos totais, açúcares solúveis totais e cor (valor L*, ângulo hue e croma). Todas as polpas de maracujá analisadas apresentaram valores menores que 0,3 NMP.g-1 para coliformes a 35°C, ausência de Salmonella spp. em 25 g e contagem de bolores e leveduras menores que 5x10³ UFC.g-1, estando em conformidade aos padrões microbiológicos da ANVISA e do MAPA para polpa de frutas. As polpas de maracujá congeladas, comercializadas nos supermercados, apresentaram valores de pH, acidez titulável, sólidos solúveis e sólidos totais dentro dos padrões de identidade e qualidade estabelecidos pela legislação vigente para polpa de maracujá. Os teores de açúcares solúveis totais das polpas de maracujá congeladas comercializadas nos supermercados A e B, foram de 4,69% e 3,79%, respectivamente. Conclui-se que as polpas de maracujá congeladas comercializadas em Machado/MG, encontram-se dentro dos padrões estabelecidos pela legislação vigente, indicando que as condições higiênico-sanitárias satisfatórias do produto não comprometerão a saúde e o bem-estar dos consumidores, e que os supermercados apresentaram boas condições de armazenamento e comercialização.

Finding a better first antiretroviral regimen is one of the strategies used to improve span and quality of life of HIV/AIDS patients. 891 patients were followed during 24 months or until interruption/abandonment of treatment, changing regimen or death. At the end of 6 months, 69% of the patients were still being treated with the first regimen, 54% at 12 months, 48% at 18 months and 39% at 24 months. AZT-3TC-EFV was the most prescribed regimen and with the lesser discontinuation. NNRTI regimens showed high effectiveness and durability compared to PI regimens. Irregular medication dispensation was the only risk factor for failure/interruption of treatment in multivariate analyses. Intolerance/adverse effects were mainly responsible for first regimen discontinuation, followed by abandonment/non-adherence and virologic failure. Results showed significant difference between causes of interruption of first HAART with higher percentage of intolerance/adverse effects with PI regimens and higher immunologic failure with NNRTI regimens. Even with the availability of more potent and tolerable drugs, lack of adherence to HAART and high level of adverse effects are still the most important barriers to prolonged success of treatment. This study adds relevant information about durability and effectiveness of HAART in the first decade of its use in Brazil.