Sobrevida e processos infecciosos em pacientes com AIDS: análise de acordo com os níveis séricos iniciais de vitamina A

Abstract

Resumo Pacientes com AIDS (n=39) foram acompanhados por um período máximo de 36 meses, após os quais se analisou os tipos e topografias das complicações infecciosas apresentadas e a sobrevida dos mesmos, correlacionado-se esses parâmetros com os níveis de vitamina A que apresentavam no início do seguimento clínico. Vinte e um (53,8%)pacientes tinham níveis de retinol no soro abaixo de 1,6µmol/L, dos quais 12 (57%) abaixo de 1,05µmol/L. Não houve associação de carência de vitamina A com os tipos ou topografias das complicações infecciosas que ocorreram durante o período de seguimento. Muito embora a sobrevida média no final dos 36 meses tenha sido semelhante nos dois grupos, os pacientes com carência de retinol apresentaram menor probabilidade de sobrevida nos primeiros 24 meses de acompanhamento (8,44 meses x 16,42 meses; p= 0,003). Palavras-chaves: AIDS. Vitamina A. Sobrevida. Infecções.Abstract Patients with AIDS (n = 39) were followed up for a maximum period of 36 weeks, after which the types and topographies of infectious complications presented and patient survival were analyzed and correlated with the vitamin A levels presented by the patients at the beginning of clinical follow-up. Twenty-one (53,8%) patients presented serum retinol levels below 1.6µmol/L, 12 (57%) of whom had values lower than 1.05µmol/L. There was no correlation between low serum vitamin A levels and the types or topographies of the infectious complications that occurred during the follow-up period. Although mean survival at the end of the 36 months follow-up period was similar for the two groups, patients with retinol deficiency presented a lower probability of survival during the first 24 months of follow-up compared to patients without hypovitaminosis A (8.44 x 1.42 months; p = 0.003).

Vitamin A and the eye: an old tale for modern times

“…The treatments of several diseases that cause digestive disturbances and/or absorption of lipids and vitamin A have improved in recent decades leading to increased life expectancy and improved the clinical control of hypovitaminosis A allowing the majority of patients to lead a normal life. However, the majority of these patients will develop xerophthalmia (the specific term for hypovitaminosis A-related dry eye), which may progress to more severe ocular damage and other clinical manifestations of vitamin A depletion (25)(26)(27) . Acquired diseases associated with malabsorption syndrome known to cause hypovitaminosis A include chronic pancreatitis caused by chronic alcoholism, liver and pancreas autoimmunity, Crohn's disease, and ulcerative colitis, among other diseases affecting the digestive system (28) .…”