Tendência da epidemia de casos de aids no Sul do Brasil no período de 1986 a 2008

Lazarini, Flaviane Mello; Melchior, Regina; González, Alberto Durán; Matsuo, Tiemi

doi:10.1590/s0034-89102013005000003

Cited by 12 publications

(13 citation statements)

References 24 publications

(25 reference statements)

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“…These studies have attributed it to higher proportion of late diagnosis in this age group [21],[22], higher prevalence of comorbidity, and decreased immune response with age [18]. This finding is particularly important because recent data from southern Brazil have indicated an increase in new cases among individuals over 50 [23]. …”

Section: Discussionmentioning

confidence: 99%

Survival of AIDS patients in Sao Paulo-Brazil in the pre- and post-HAART eras: a cohort study

Tancredi¹,

Waldman

2014

BMC Infect Dis

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BackgroundBrazil was the first middle-income country to provide free and universal access to AIDS treatment. Understanding the impact of this policy is key to promote ongoing improvement of current intervention strategies. The aim of this study was to compare mortality rates and survival in a cohort of AIDS patients before and after the introduction of antiretrovirals (ARV) and to investigate predictors of survival.MethodsA retrospective cohort study of AIDS patients aged 13 years or more living in the city of Sao Paulo was conducted. All patients were recruited from an STD/HIV outpatient clinic between 1988 and 2003 and followed up until 2005. We estimated AIDS mortality rates in person-years (py) and carried out a survival analysis using the Kaplan-Meier method. The Cox proportional hazards model was used to assess predictors of survival in AIDS patients.ResultsThe study cohort comprised 6,594 patients. The yearly mean mortality rates were 17.6, 23.2, and 7.8 per 1,000 py for the study periods 1988-1993, 1994-1996, and 1997-2003, respectively. Median survival time was 13.4 and 22.3 months for patients entering the study in the first and second study periods and survival time was 108 months or more in 72% of those entering the study during 1997-2003. Factors independently associated with shorter survival included: AIDS diagnosis during the 1994-1996 (HR 2.0) and 1988-1993 (HR 3.2) periods; 50 years of age or more (HR 2.0); exposure category of injection drug users (IDU) (HR 1.5); 8 years of schooling or less (HR 1.4); no schooling (HR 2.1); and CD4+ counts between 350 and 500 cells/mm3 (HR 1.2) and less than 350 cells/mm3 at AIDS diagnosis (HR 1.3).ConclusionsThe study showed a strong impact following the introduction of HAART in 1996 with decreased AIDS mortality, increased survival rates, and benefits with early introduction of HAART. However, some groups of patients were less likely to benefit from the new drug regimens. Public policies promoting health equity create an enabling environment helping AIDS control programs in developing countries to achieve their goals as effectively as in developed countries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0599-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Survival of AIDS patients in Sao Paulo-Brazil in the pre- and post-HAART eras: a cohort study

Tancredi¹,

Waldman

2014

BMC Infect Dis

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“…In many parts of the world where IDU has been a major driver of the HIV epidemic, sexual transmission of HIV from PWID to their sexual partners has increased (5, 11, 32). IDU-concentrated epidemics are likely to have initiated heterosexually transmitted epidemics in Argentina, Brazil, China, Indonesia, the Netherlands, and Ukraine (5).…”

Section: Drug-using Populations and The Hiv Epidemicmentioning

confidence: 99%

Drug use as a driver of HIV risks

El‐Bassel

Shaw

Dasgupta

et al. 2014

Current Opinion in HIV and AIDS

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Purpose of Review We reviewed papers published in 2012–2013 that focused on re-emerging and emerging injection and non-injection drug use trends driving HIV risk behaviors and transmission in some parts of the world. Recent Findings While HIV incidence has declined in many countries, HIV epidemics remain at troubling levels among key drug using populations including females who inject drugs (FWID), FWID who trade sex, sex partners of people who inject drugs (SP-PWID), young PWID, and people who use non-injection drugs in a number of low- and middle- income countries such as in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa. Summary HIV epidemics occur within contexts of global economic and political forces, including poverty, human rights violations, discrimination, drug policies, trafficking, and other multi-level risk environments. Trends of injection and non-injection drug use and risk environments driving HIV epidemics in Central Asia, Eastern Europe, Southeast Asia, and parts of Africa call for political will to improve HIV and substance use service delivery, access to combination HIV prevention, and harm reduction programs.

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“…The main drugs used were lamivudine, zidovudine, lopinavir, ritonavir, levothyroxine, omeprazole, ranitidine, lactulose and risperidone ( Table 2). The mean number of medications taken was 10.5 ± 3-9, [16][17][18][19][20][21][22][23] Disparities in the definition of elderly among these published papers is also evident. Some of them used the age criterion of ≥ 50 years, 9,16,18,20,21 while others adopted ≥ 60 years.…”

Section: Resultsmentioning

confidence: 99%

Human immunodeficiency virus in institutionalized elderly people

Gorzoni¹,

Pires

Faria

et al. 2016

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: A search in the SciELO and PubMed databases showed few studies on human immunodeficiency virus (HIV) positive individuals in long-term care institutions (LTCIs), thus prompting the present study. The aim of this study was to ascertain whether there were any HIV-positive individuals in LTCIs for the elderly. total lymphocyte count/6 and total lymphocyte count x 0.8 x 0.2 or 0.3. RESULTS: Four men were HIV-positive, with mean age 71.2 ± 8.6 years, LTCI stay 74.2 ± 38.1 months and length of HIV diagnosis 24.5 ± 17 months (confirmed by HICC standard screening). Three had stroke sequelae; one, dementia syndrome; two, seropositivity for syphilis; two, hepatitis B and one, hepatitis C. The main drugs used were lamivudine, zidovudine, lopinavir, ritonavir, levothyroxine, omeprazole, ranitidine, lactulose and risperidone. The estimated CD4 count was 341 ± 237/mm 3 . CONCLUSIONS: HIV-positive individuals are present in LTCIs, diagnosable through serological screening and treatable with antiretroviral drugs. linfócitos CD4 baseada em: número total de linfócitos/6 e número total de linfócitos x 0,8 x 0,2 ou 0,3. RESULTADOS: Quatro homens eram HIV-positivos. Eles tinham 71,2 ± 8,6 anos de idade; 74,2 ± 38,1 meses na ILPI e 24,5 ± 17 meses de soropositividade (diagnósticos realizados como triagem padrão da CCIH). Havia sequelas de acidente vascular cerebral em 3 e síndrome demencial em 1; sorologias positivas para sífilis em 2, vírus hepatite B em 2 e C em 1. Os principais fármacos utilizados eram: lamivudina, zidovudina, lopinavir, ritonavir, levotiroxina, omeprazol, ranitidina, lactulona e risperidona. O CD4 foi estimado em 341 ± 237/mm 3 RESUMO

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Tendência da epidemia de casos de aids no Sul do Brasil no período de 1986 a 2008

Cited by 12 publications

References 24 publications

Survival of AIDS patients in Sao Paulo-Brazil in the pre- and post-HAART eras: a cohort study

Survival of AIDS patients in Sao Paulo-Brazil in the pre- and post-HAART eras: a cohort study

Drug use as a driver of HIV risks

Human immunodeficiency virus in institutionalized elderly people

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