BackgroundTo determine the prevalence and associated factors with chronic kidney disease (CKD) in a cohort of HIV-positive individuals with undetectable viral load on HAART.MethodsFrom March, 2009 to September 2009, 213 individuals between 18-70 years, period on HAART ≥12 months, viral load < 50 copies/mm3, and CD4 ≥ 200 cells/mm3, were consecutively enrolled at the outpatient clinic of Hospital de Clínicas, Porto Alegre, Brazil. Exclusion criteria were obesity, malnourishment, amputee, paraplegic, previous history of renal disease, pregnancy and hepatic insufficiency. Renal function was determined by estimated glomerular filtration rate (eGFR) assessed by the modification of diet in renal disease. CKD was defined as an eGFR less or equal than 60 ml/min/1.73 m2, for a period of at least 3 months. Poisson regression was used to determine factors associated with CKD.ResultsCKD was diagnosed in 8.4% of the population, and after adjustment, the risk factors were hypertension (RR = 3.88, 95%CI, 1.84 - 8.16), time on HAART (RR = 1.15, 95%CI,1.03–1.27) and tenofovir exposure (RR = 2.25, 95%CI, 1.04–4.95). Higher weight (RR = ,0.88 95%CI, 0.82–0.96) was associated to normal function.ConclusionsCKD was a common finding in this cohort of patients and was related to hypertension, time on HAART and tenofovir exposure. We suggest a more frequent monitoring of renal function, especially for those with risk factors to early identify renal impairment.

In this cohort of well-controlled HIV-positive individuals, patients with lower weight or body mass index had a higher chance of presenting elevated plasma concentrations of efavirenz. Therapeutic drug monitoring to adjust dose might be a helpful tool to decrease efavirenz dose in order to minimize costs and adverse effects.

Objetivo: Revisar na literatura o Sarcoma de Kaposi em pacientes com HIV/SIDA, descrevê-lo, apontar sua clínica a fim de auxiliar no diagnóstico e apresentar as opções de tratamento. Método: O resumo foi realizado a partir da análise de artigos científicos, selecionando aqueles com conteúdo diretamente ligado ao tema. Resultado: o Sarcoma de Kaposi foi descrito pela primeira vez em 1872, como um tumor mesenquimal, angioproliferativo com infiltrado inflamatório causado pelo vírus herpes humano 8, caracterizado por lesões nodulares hiperpigmentadas. Hoje, é considerada a principal malignidade relacionada a Síndrome de Imunodeficiência Adquirida, e, por poder acometer qualquer sistema do corpo, pode comprometer de maneira significativa a qualidade de vida do portador do sarcoma. Considerações finais: O Sarcoma de Kaposi é uma neoplasia pouco prevalente, porém, com o aumento da infecção pelo HIV diagnosticada tardiamente, vem ganhando espaço no sistema de saúde, sendo necessário saber o identificar, uma vez que o diagnóstico e o tratamento precoce podem diminuir a morbimortalidade das pessoas com HIV.

This study aimed to assess the association between tobacco smoking and body composition in patients with HIV/AIDS in combination antiretroviral therapy (cART). This is a cross-sectional study with people of HIV followed in specialized care service for HIV patients located in the South of Brazil. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was used to assess smoking and other psychoactive substance use. Body mass index (BMI) was calculated as the ratio of body weight (in kilograms) to squared height (in meters). Patients also had their body composition evaluated with a multi-frequency bioelectrical impedance (Bodystat® Quadscan 4000, RU) to estimate skeletal muscle index (SMI). In total, 320 subjects were included in the study. The prevalence of smoking was 54.7%. Tobacco smoking was associated with malnutrition, lower body mass index scores, and lower skeletal muscle mass index. It is concluded that there is a high prevalence of smoking among patients with HIV/AIDS and that this behavior is associated with worse body composition. Thus, it is suggested to implement strategies to support smoking cessation among people with HIV/AIDS.

Objective: Describe the profile of the HIV/AIDS patients who use psychoactive substances; relate the use of psychoactive substances and Antiretroviral Therapy (ART) to non-adherence; and identify the main barriers for non-adherence. Methods: A cross-sectional study in a population of HIV/AIDS patients under ART prescription. Non-adherence to ART was considered when the patients presented a viral load higher than 40 copies per mL. The use of psychoactive substances was evaluated by Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Results: From 320 HIV/AIDS patients analyzed, 18.8% were not adhering to ART, 25.8% used alcohol, 21.7% smoked and 29.7% used some illicit psychoactive substance. The barriers were: high number of pills to be taken; fear that other people may know they are sick; difficulty of taking so many pills (if they do not feel sick); and they do not believe in the efficacy of the treatment (would rather try alternative treatments). Conclusion: Patients under higher risk are not white and young, from lower social classes, and use psychoactive substances. Strategies should focus on the promotion of adherence considering the barriers reported.