EVOLUTION OF PATIENTS WITH AIDS AFTER cART: CLINICAL AND LABORATORY EVOLUTION OF PATIENTS WITH AIDS AFTER 48 WEEKS OF ANTIRETROVIRAL TREATMENT

Abstract

SUMMARYCombination Antiretroviral Therapy (cART) aims to inhibit viral replication, delay immunodeficiency progression and improve survival in AIDS patients. The objective of this study was to compare two different schemes of cART, based on plasma viral load (VL) and CD4 + T lymphocyte count, during 48 weeks of treatment. For this purpose, 472 medical charts of a Specialized Outpatient Service were reviewed from 1998 to 2005. Out of these, 58 AIDS patients who had received a triple drug scheme as the initial treatment were included in the study and two groups were formed: Group 1 (G1): 47 individuals treated with two nucleoside reverse-transcriptase inhibitors (NRTI) and one non-nucleoside reverse-transcriptase inhibitor; Group 2 (G2): 11 patients treated with two NRTI and one protease inhibitor. In G1 and G2, 53.2% and 81.8% respectively were patients with an AIDS-defining disease. The T CD4 + lymphocyte count increased progressively up until the 24 th week of treatment in all patients, while VL became undetectable in 68.1% of G1 and in 63.6% of G2. The study concluded that the evolutions of laboratory tests were similar in the two treatment groups and that both presented a favorable clinical evolution.

The Initial Months of Antiretroviral Therapy and Its Influence on AGEs, HMGB1, and sRAGE Levels in Asymptomatic HIV-Infected Individuals

“…Likewise, in this study, 70% of the patients showed fewer than 500 cells/mm 3 and a nadir of 335.7 cells/mm 3 at M0. However, similar to a previous study performed by our research group [34], the gain of CD4+ T cells after cART was more evident in patients who had lower counts at M0.…”

Associação entre o uso de antirretrovirais no tratamento para HIV e alterações físicas e metabólicas

“…Por outro lado, esta combinação apresenta mais frequentemente a ocorrência de eventos gastrointestinais e disfunções do metabolismo dos lipídeos e da glicose, quando comparados a esquemas que envolvem NNRTI (CAVENAGLI et al, 2012). Fukumoto et al (2013) observou em seu estudo que esquemas terapêuticos contendo NNRTI foi mais frequentemente usado (81%) em relação aos IP (18,9%). A preferencia ao uso de NNRTI foi justificada pela presença de alterações metabólicas associadas ao uso de IP.…”

“…Além disto, a falência terapêutica pode ocorrer por diversos fatores e incluem complicações inadequadas, presença de co-morbidades, resistência viral prévia a um ou mais agentes antirretrovirais, absorção gastrointestinal alterada, interações entre drogas e um esquema terapêutico de baixa potência (FUKUMOTO et al, 2013). Fonseca et al (2012) avaliou o esquema terapêutico de 229 pacientes e observou que 72,9% (167 pacientes) receberam um tratamento inapropriado, o que proporcionou um alto índice de abandono, motivados pelos efeitos indesejados ao organismo.…”

Quality of life and handgrip strength of HIV patients diagnosed with neurotoxoplasmosis

“…The use of a protease inhibitor in ART with two nucleoside reverse transcriptase inhibitors is the second treatment line, being highly effective in reducing the plasma viral load of RNA/HIV-1 17 . Although the use of the protease inhibitor was similar in both groups, 85% of TCD4 lymphocytes were adequate in the SNT group, possibly due to the use of the therapy, which inhibits viral replication and delays the progression of immunodeficiency 18 .…”

“…Regarding the immunodeficiency situation of patients, all patients from group with neurotoxoplasmosis had Aids and half of the SNT group developed Aids. The emergence of the side effects of ART makes many patients discontinue the use of the medication, leaving them prone to opportunistic infections, among them toxoplasmosis/neurotoxoplasmosis 17,18 . Toxoplasmosis is the leading cause of central nervous system (CNS) damage in Aids.…”