Profile of patients diagnosed with AIDS at age 60 and above in Brazil, from 1980 until June 2009, compared to those diagnosed at age 18 to 59

Knowledge about HIV/AIDS in older adults using the services of Family Health Strategy

INTRODUCTION

This study evaluated knowledge about HIV/AIDS in elders using the services of Family Health Strategy.

METHODS

Cross-sectional, descriptive, and analytical study involving 238 participants. Mini-Mental State Examination and QHIV3I were applied.

RESULTS

About 30% of participants had active sexual lives and 5.5% used condoms consistently. The question with the highest score of right answers was about transmission through needles (95%) and the lowest (52.5%) was about whether individuals infected with the virus always displayed symptoms.

CONCLUSIONS

It is necessary to train health professionals to develop actions that encourage elders to take preventive measures.

Human immunodeficiency virus in institutionalized elderly people

CONTEXT AND OBJECTIVE:

A search in the SciELO and PubMed databases showed few studies on human immunodeficiency virus (HIV) positive individuals in long-term care institutions (LTCIs), thus prompting the present study. The aim of this study was to ascertain whether there were any HIV-positive individuals in LTCIs for the elderly.

DESIGN AND SETTING:

Cross-sectional study in which the Hospital Infection Control Committee (HICC) of a 405-bed LTCI was consulted.

METHODS:

The medical records of 405 individuals interned in the LTCI who had been tested for HIV infection were requested for analysis of the following variables: [1] age and gender; [2] length of stay at LTCI (months); [3] causes and diagnoses on admission to LTCI according to International Classification of Diseases, 10th edition; [4] date of HIV diagnosis; [5] seropositivity for syphilis and hepatitis B and C viruses; [6] medications used at last prescription in medical file; and [7] mean CD4 lymphocyte count based on: total lymphocyte count/6 and total lymphocyte count x 0.8 x 0.2 or 0.3.

RESULTS:

Four men were HIV-positive, with mean age 71.2 ± 8.6 years, LTCI stay 74.2 ± 38.1 months and length of HIV diagnosis 24.5 ± 17 months (confirmed by HICC standard screening). Three had stroke sequelae; one, dementia syndrome; two, seropositivity for syphilis; two, hepatitis B and one, hepatitis C. The main drugs used were lamivudine, zidovudine, lopinavir, ritonavir, levothyroxine, omeprazole, ranitidine, lactulose and risperidone. The estimated CD4 count was 341 ± 237/mm3.

CONCLUSIONS:

HIV-positive individuals are present in LTCIs, diagnosable through serological screening and treatable with antiretroviral drugs.

Evaluation of late presentation for HIV treatment in a reference center in Belo Horizonte, Southeastern Brazil, from 2008 to 2010

Introduction

Since 1996 Brazil has provided universal access to free antiretroviral therapy, and as a consequence, HIV/AIDS patients’ survival rate has improved dramatically. However, according to scientific reports, a significant number of patients are still late presenting for HIV treatment, which leads to consequences both for the individual and society. Clinical and immunological characteristics of HIV patients newly diagnosed were accessed and factors associated with late presentation for treatment were evaluated.

Methods

A cross-sectional study was carried out in an HIV/AIDS reference center in Belo Horizonte, Minas Gerais, in Southeastern Brazil from 2008 to 2010. Operationally, patients with late presentation (LP) for treatment were those whose first CD4 cell count was less than 350 cells/mm³ or presented an AIDS defining opportunistic infection. Patients with late presentation with advanced disease (LPAD) were those whose first CD4 cell count was less than 200 cells/mm³ or presented an AIDS defining opportunistic infection. LP and LPAD associated risk factors were evaluated using logistic regression methods.

Results

Five hundred and twenty patients were included in the analysis. The median CD4 cell count was 336 cells/mm³ (IQR: 130–531). Two hundred and seventy-nine patients (53.7%) were classified as LP and 193 (37.1%) as LPAD. On average, 75% of the patients presented with a viral load (VL) >10,000 copies/ml. In multivariate logistic regression analysis the factors associated with LP and LPAD were age, being symptomatic at first visit and VL. Race was a factor associated with LP but not with LPAD.

Conclusion

The proportion of patients who were late attending a clinic for HIV treatment is still high, and effective strategies to improve early HIV detection with a special focus on the vulnerable population are urgently needed.