A síndrome da imunodeficiência adquirida e as doenças endêmicas no Brasil

Abstract

Revista da Sociedade Brasileira de M edicina Tropical 2 9 (6 ):5 3 1 -5 3 5 , nov-dez, 1996.

Human immunodeficiency virus/acquired immunodeficiency syndrome and tropical diseases: a Brazilian perspective

“…Leishmaniasis and other endemic prevalent diseases -As reviewed previously by Ferreira (1996), its important to point out that some infectious diseases endemic in Brazil do not have their epidemiological an clinical course changed in function of the co-infection with HIV-1, others, however, like leishmaniasis, Chagas disease, strongyloidiasis, histoplasmosis, and paracoccidioidomycosis have important changes in its clinical-evolutive pictures. Indeed, reactivation of Chagas disease with central nervous system and cardiac involvement have already been described in Aids patients (Rocha et al 1994, Ferreira et al 1997.…”

Chagasic meningoencephalitis: case report of a recently included AIDS-defining illness in Brazil

“…The progressive increase of Chagas disease cases in urban populations, as a result of massive migration from rural areas to major cities, associated to the interiorization of the epidemic infection caused by the human immunodeficiency virus (HIV) 7 , have created the conditions for emergence of a higher number of co-infection cases. Consequently, in the presence of severe immunodeficiency there is a possibility of chronic Chagasic infection reactivation, which is manifested by severe forms of neurological (75 -90% of cases) or myocardial (30% of cases) involvement 15,[18][19][20]24,25,27 .…”

“…Several studies have demonstrated the opportunistic nature of Chagas disease reactivation in AIDS patients 9,12,[14][15][16][17][18]28 , which suggests that it should be considered an AIDS-defining illness 1,11,20,26 . Despite that established by the Centers for Disease Control and Prevention 8 , the Brazilian Ministry of Health has recently included reactivation of Chagas disease (meningoencephalitis and/or myocarditis) in the list of AIDSdefining events 6 .…”

Concomitância de leishmanioses e infecção pelo vírus da imunodeficiência humana (HIV): estudo de quatro casos

“…Reações tóxicas tem sido relatadas por vários autores, incluindo pancreatite aguda 2 , provavelmente desenvolvida pelo nosso primeiro paciente, ao fazer uso da medicação por 10 dias. A resposta terapêutica à anfotericina B tem sido eficaz em até 100% dos casos, em algumas séries 12 , embora recidivas possam ocorrer após suspensão da mesma. Outras drogas tais como a pentamidina, o alopurinol, a aminosidina e os derivados azólicos já foram utilizados, isoladamente ou em combinação, em casos esporádicos de coinfecção Leishmania e HIV, com resultados variáveis 6 24 .…”

“…A mortalidade destes doentes, mesmo adequadamente tratados, é elevada, podendo chegar até a 25% dos casos, durante o mês que se segue ao final da terapêutica 12 .…”