Estimando o Risco Cardiovascular em Pacientes Infectados pelo HIV

Bittencourt, Márcio Sommer

doi:10.36660/abc.20190747

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…Morbidity and mortality resulting from HIV infection have been progressively reduced after the advent of combination antiretroviral therapy (cART) [ 1 , 2 ]. However, the longer survival provided by cART has been accompanied by a higher frequency of comorbidities, mainly associated with cardiovascular diseases (CVD), in a multifactorial manner that is still not well understood [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

High Concordance between D:A:Dr and the Framingham Risk Score in Brazilians Living with HIV

Souza

Valadares

Dias

et al. 2023

Viruses

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People living with HIV (PLHIV) have twice the risk of developing cardiovascular diseases, making it essential to identify high cardiovascular risk (CVR). However, there is no validated CVR calculator for PLHIV in Brazil. We performed a cross-sectional study with 265 individuals living with HIV, aged 40 to 74 years, to assess the agreement between three CVR scores: Framingham Risk Score (FRS), Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score, and a specific for PLHIV, Reduced Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:Dr). We assessed agreement using the weighted Kappa coefficient and the Bland-Altman plot. The median age was 52 years (47–58), 58.9% were men, 34% were hypertensive and 8.3% had a detectable viral load. There was an almost perfect agreement between D:A:Dr x FRS (k = 0.82; 95% CI 0.77–0.87; p < 0.001), and substantial agreement between FRS vs. ASCVD (k = 0.74; 95% CI 0.69–0.79; p < 0.001) and between D:A:Dr vs. ASCVD (k = 0.70; 95% CI 0.64–0.76; p < 0.001). The Bland-Altman plot revealed greater discordance between scores as the CVR increased. Our results suggest that the FRS and the D:A:Dr are adequate to classify the CVR in this population, and the D:A:Dr score can be used as an alternative to the FRS in Brazil, as other international guidelines have already advocated.

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Section: Introductionmentioning

confidence: 99%

High Concordance between D:A:Dr and the Framingham Risk Score in Brazilians Living with HIV

Souza

Valadares

Dias

et al. 2023

Viruses

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HIV-Associated Hypertension: Risks, Mechanisms, and Knowledge Gaps

Prakash,

Swami Vetha,

Chakraborty

et al. 2024

Circulation Research

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HIV type 1 (HIV-1) is the causative agent of AIDS. Since the start of the epidemic, HIV/AIDS has been responsible for ≈40 million deaths. Additionally, an estimated 39 million people are currently infected with the virus. HIV-1 primarily infects immune cells, such as CD 4+ (cluster of differentiation 4 + ) T lymphocytes (T cells), and as a consequence, the number of CD 4+ T cells progressively declines in people living with HIV. Within a span of ≈10 years, HIV-1 infection leads to the systemic failure of the immune system and progression to AIDS. Fortunately, potent antiviral therapy effectively controls HIV-1 infection and prevents AIDS-related deaths. The efficacy of the current antiviral therapy regimens has transformed the outcome of HIV/AIDS from a death sentence to a chronic disease with a prolonged lifespan of people living with HIV. However, antiviral therapy is not curative, is challenged by virus resistance, can be toxic, and, most importantly, requires lifelong adherence. Furthermore, the improved lifespan has resulted in an increased incidence of non-AIDS–related morbidities in people living with HIV including cardiovascular diseases, renal disease, liver disease, bone disease, cancer, and neurological conditions. In this review, we summarize the current state of knowledge of the cardiovascular comorbidities associated with HIV-1 infection, with a particular focus on hypertension. We also discuss the potential mechanisms known to drive HIV-1–associated hypertension and the knowledge gaps in our understanding of this comorbid condition. Finally, we suggest several directions of future research to better understand the factors, pathways, and mechanisms underlying HIV-1–associated hypertension in the post-antiviral therapy era.

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Perfil epidemiológico da Covid-19 em um município do sudoeste do estado do Maranhão

Pinheiro¹,

Viana²

2022

Revista Científica Multidisciplinar Núcleo do Conhecimento

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Contexto: a Covid-19 constitui, atualmente, um dos principais problemas de saúde pública. Nesse contexto, monitorar sua magnitude e fatores associados pode auxiliar na definição de políticas públicas para o seu enfrentamento. Questão norteadora: qual o perfil epidemiológico da Covid-19 no município de Sítio Novo – MA? Objetivo: caracterizar o perfil epidemiológico da Covid-19 no município de Sítio Novo, Estado do Maranhão, no período de maio a dezembro de 2020. Métodos: os dados foram coletados no período de maio a dezembro de 2020 utilizando os softwares Microsoft Excel 2016, SPSS e teste de comparação pelo método Qui-Quadrado, com p-valor <0,05 de significância epidemiológica. Para análise dos dados, utilizaram-se os registros: das bases nacionais dos programas eSUS-VE-Notifica-COVID; do Sistema de Informações sobre Mortalidades; da base estadual do Programa Notifica-COVID-Maranhão; e informações do Boletim Epidemiológico Municipal. Resultados e conclusões: dos 1465 casos que compuseram a amostra, a maior incidência comparada a população geral ocorreu em: pessoas do sexo feminino, adultos, amarelos e indígenas, com ensino médio, trabalhadores da saúde e residentes na zona urbana, tendo as doenças cardiorrespiratórias e a diabetes mellitus como as principais comorbidades. Quanto à mortalidade, houve maior prevalência em: sexo masculino, idosos, indígenas, aposentados, analfabetos, residentes na zona urbana. Constatou-se, também, que a existência de doenças cardiorrespiratórias prévias culminou com a maior letalidade. Durante o período avaliado, a taxa de transmissão era de 1,15 e a de recuperação ficou em 95,56%. Por fim, entende-se que esse estudo possibilitou conhecer as características gerais da Covid-19 no município de Sítio Novo – MA e servirá como base da elaboração de Políticas Públicas eficazes no controle da Covid-19.

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Estimando o Risco Cardiovascular em Pacientes Infectados pelo HIV

Cited by 4 publications

References 7 publications

High Concordance between D:A:Dr and the Framingham Risk Score in Brazilians Living with HIV

High Concordance between D:A:Dr and the Framingham Risk Score in Brazilians Living with HIV

HIV-Associated Hypertension: Risks, Mechanisms, and Knowledge Gaps

Perfil epidemiológico da Covid-19 em um município do sudoeste do estado do Maranhão

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