Clinical and laboratory profile of HIV-positive patients at the moment of diagnosis in Bahia, Brazil

Abstract

In Brazil, current trends of the AIDS epidemic include an increase in transmission through heterosexual contact, predominantly from men to women, with more cases of AIDS in women and more children contaminated by vertical transmission. There is also a high proportion of cases in poor people or people living in small towns. HIV-infected patients with high levels of immunodeficiency are frequently hospitalized after their first visit to the clinic due to opportunistic infections, characteristic of advanced disease. This study characterized the clinical and laboratory pattern of AIDS in a sample of patients attended for the first time in the AIDS clinic of the Federal University of Bahia Hospital (HUPES) in Salvador, Brazil. We revised medical charts of cases of subjects registered at the outpatient AIDS clinic from January 1997 to December 2003. The demographics, clinical data, and laboratory characteristics were analyzed to determine the degree of immunodeficiency at the time of admission. A total of 377 patients were evaluated (58.6% were male, with a mean sample age of 33.4 years). The most frequent clinical manifestations were asthenia, weight loss, fever, anemia, dermatitis, oral thrush and diarrhea. CDC criteria were not adequate to define the initial cases. After admission to the outpatient clinic, nearly 25% of the patients were hospitalized immediately, indicating delay in the diagnosis. In Bahia, the initial presentation of HIV-infected patients to health care assistance is occurring at a late stage of the disease, when signs and symptoms of immunodeficiency are already established. Efforts are necessary to construct strategies to make an early diagnosis of these patients, improve the quality of care, and guarantee the benefits of antiretroviral therapy, when it is indicated.

Gender differences in oral manifestations among HIV-infected Brazilian adults

“…In the current study, 987 individuals were analysed, 750 of which were male and 237 female. These numbers are in accord with several studies that found a higher prevalence of men among HIV‐infected individuals. Although this study presents a lower prevalence for women than for men, when evaluating the frequency over the years a trend towards an increasing number of women and a declining number of infected men from the early 1990s was observed.…”

Long-term immune and virological response in HIV-infected patients receiving antiretroviral therapy

“…Among the socio‐demographic characteristics, only female gender was associated with increased likelihood of immune success. This association may be related to differential healthcare behaviours between women and men, wherein women seek health services and treatment earlier as observed by Sa et al . in a study conducted in a public, clinical HIV service in Salvador in north‐eastern Brazil.…”

Anemia em Pacientes HIV-Positivo Atendidos em um Hospital Universitário de Pernambuco – Nordeste do Brasil

“…Esse dado corrobora com uma pesquisa realizada por Sá et al, com 377 pacientes infectados pelo HIV em um hospital na Bahia (54,2%) 26 . Entretanto, ao longo da série histórica, tem sido observado um aumento proporcional de casos entre a população com primeiro grau completo, passando de 16%, em 1999, para 29% em 2007 2 .…”