A freqüência de infecções hematogênicas por Candida (candidemia) tem aumentado consideravelmente, especialmente em unidades de terapia intensiva e ou de assistência a pacientes críticos 2 3 4 7 8 14 15 17 20 24 . O aumento na freqüência de candidemia tem sido observado particularmente entre pacientes em uso de antibióticos, terapia imunossupressora, nutrição parenteral, e em pacientes expostos a múltiplos procedimentos invasivos 11 24 .Espécies do gênero Candida, em particular Candida albicans, têm emergido como importantes patógenos nosocomiais, estando associadas a quase 80% de todas as infecções fúngicas nosocomiais, representando a maior causa de fungemia 2 24 . Candidemia é a quarta causa mais comum de infecção na corrente sangüínea em hospitais terciários, e sua ocorrência tem sido associada à longa permanência hospitalar e alta mortalidade 5 10 18 21 . ABSTRACTWe conducted a prospective, observational, laboratory-based study on candidemia to investigate the incidence of candidemia, species distribution and clinical conditions between September 2003 and March 2004 in a private tertiary hospital in Recife, northeastern Brazil. Cases of candidemia were defined as occurrences of isolation of Candida spp from blood cultures. The incidence rate was calculated per 1,000 admissions. A total of 5,532 patients were admitted to the hospital during the study period, and 1,745 blood cultures were processed. Twenty-one episodes of candidemia were observed in 18 patients. The incidence rate of candidemia was 3.9 episodes per 1,000 admissions. Non-albicans species accounted for more than 50% of the cases, and Candida parapsilosis (33%) and Candida tropicalis (24%) predominated. Eleven (61%) patients died. The incidence of candidemia was higher than that observed in a Brazilian multicenter study. Candidemia was caused predominantly by non-albicans species.
Introduction: Studies disagree as to whether there is a greater prevalence of hypertension among HIV/AIDS patients and the role of antiretroviral therapy. Objective: Evaluate the prevalence of hypertension and risk factors in a cohort of HIV-infected patients, with emphasis on antiretroviral therapy. Method: Case-control study conducted at baseline of a cohort, between June/2007 and December/2008 in Pernambuco/Brazil. Blood pressure was classifi ed as normal, prehypertension, and hypertension. Results: Of 958 patients, 245 (25.6%) had hypertension (cases), 325 (33.9%) had prehypertension, and 388 (40.5%) were normotensive (controls). Comparison between hypertensive and normotensive patients showed that traditional factors, such as age > 40 (OR = 3.06, CI = 1.91-4.97), male gender (OR = 1.85, CI = 1.15-3.01), BMI > 25 (OR = 5.51, CI = 3.36-9.17), and triglycerides > 150 mg/dL (OR = 1.69, CI = 1.05-2.71), were independently associated with hypertension. Duration of antiretroviral therapy and CD4 > 200 cells/mm 3 were associated with hypertension in univariate analysis, but did not remain in fi nal model. Type of antiretroviral schema and lipodystrophy showed no association with hypertension. Conclusion: Hypertension in HIV/AIDS patients is partially linked to invariable factors, such as age and sex. Efforts should be directed toward controlling reversible factors, particularly excessive weight gain and unsuitable diet.
Introduction: Apart from masking the diagnosis of AIDS in patients with HIV/AIDS, human T-cell lymphotropic virus (HTLV), when present, also increases the risk of myelopathies and neurological disease in these patients. Methods: Disease prevalence was estimated by ELISA and confirmed by Western blot. Results: The coinfection rate was 1.5% (11/720); 10 of 11 patients had HTLV-1, and the remaining one had HTLV-2. The majority were male, over 40 years old, and of pardo color (ethnicity). Conclusions:There was no association between the risk factors examined and HTLV/HIV coinfection. This is the first study to report the occurrence of HTLV-2 in Pernambuco.
The aim was to identify factors associated with non-initiation of prophylactic treatment of latent tuberculosis infection (LTBi) in persons living with HIV/AIDS (PLWA), based on a prospective cohort study of PLWA ≥ 18 years of age in two referral services for HIV/AIDS. Of the 232 patients eligible for treatment of LTBi, 69.8% initiated treatment. Following multivariate logistic regression analysis, only treatment in one of the two referral services was associated with non-initiation of treatment for LTBi (p < 0.001). TB incidence in the cohort was 0.6/100 person-years. TB incidence in patients that initiated treatment of LTBi was 0.4/100 person-years, compared to 1.2/100 person-years in those that did not initiate treatment, but the difference was not statistically significant. The study’s most interesting finding was that the main factor associated with the likelihood of treatment for LTBi was the health service where the patient was treated.
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