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Dias RFG, Bento LO, Tavares C, Ranes Filho H, Silva MACD, Moraes LC, Freitas-Vilela AA, Moreli ML, Cardoso LPV. Epidemiological and clinical profile of HIV-infected patients from Southwestern Goias State, Brazil. Rev Inst Med Trop Sao Paulo 2018; 60:e34. [PMID: 30043938 PMCID: PMC6056885 DOI: 10.1590/s1678-9946201860034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/16/2018] [Indexed: 11/22/2022] Open
Abstract
Knowledge about epidemiological distribution patterns of HIV infection in different geographic regions is relevant to understand the dynamics of the disease in Brazil. This study aims to characterize the epidemiological and clinical profile of HIV-infected patients from Southwestern Goias State, from 2005 to 2015. A standardized questionnaire was used to collect clinical-epidemiological, virological, and immunological data from the medical records of all HIV-infected patients (n=539) who were followed at the regional reference center of Jatai, Goias State, Brazil, from 2005 to 2015. We detected the prevalence of male patients and the heterosexual route of transmission, as well as an expressive number of young women infected with HIV. The HIV infection was more prevalent in reproductive ages (55.3%). Most patients presented clinical manifestations related to HIV infection at the time of diagnosis. Twenty-four patients presented coinfection with hepatitis C virus, syphilis, hepatitis B virus, leprosy or Chagas disease. Pneumonia caused by Pneumocystis jirovecii was the most common opportunistic infection, followed by neurotoxoplasmosis, tuberculosis, and neurocryptococcosis. Combined antiretroviral therapy improved CD4+ T-cell counts: the mean CD4+ T-cell counts after treatment was twice as high as those found at the first medical appointment; and highly active antiretroviral therapy promoted viral suppression in a significant number of patients. Considering the increasing distribution of HIV infection to the interior of Brazil, this descriptive study outlines the clinical-epidemiological characteristics of HIV infection in Southwestern Goias and contributes to develop local prevention strategies and public service plans.
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Affiliation(s)
- Regyane Ferreira Guimarães Dias
- Universidade Federal de Goiás, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Jataí, Goiás, Brazil.,Secretaria Municipal de Saúde, Serviço de Assistência Especializada, Jataí, Goiás, Brazil
| | - Luciana Oliveira Bento
- Universidade Federal de Goiás, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Jataí, Goiás, Brazil.,Secretaria Municipal de Saúde, Serviço de Assistência Especializada, Jataí, Goiás, Brazil
| | - Camila Tavares
- Universidade Federal de Goiás, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Jataí, Goiás, Brazil
| | - Hélio Ranes Filho
- Universidade Federal de Goiás, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Jataí, Goiás, Brazil.,Secretaria Municipal de Saúde, Serviço de Assistência Especializada, Jataí, Goiás, Brazil.,Universidade Federal de Goiás, Curso de Medicina, Unidade Acadêmica Especial de Ciências da Saúde, Jataí, Goiás, Brazil
| | | | | | - Ana Amélia Freitas-Vilela
- Universidade Federal de Goiás, Curso de Medicina, Unidade Acadêmica Especial de Ciências da Saúde, Jataí, Goiás, Brazil
| | - Marcos Lázaro Moreli
- Universidade Federal de Goiás, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Jataí, Goiás, Brazil
| | - Ludimila Paula Vaz Cardoso
- Universidade Federal de Goiás, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Jataí, Goiás, Brazil.,Universidade Federal de Goiás, Curso de Medicina, Unidade Acadêmica Especial de Ciências da Saúde, Jataí, Goiás, Brazil.,Universidade Federal de Goiás, Programa de Pós-Graduação em Biologia da Relação Parasito-Hospedeiro, Goiânia, Goiás, Brazil
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Traebert J, Traebert E, Schuelter-Trevisol F, Cortez Escalante JJ, Schneider IJC. The burden of AIDS: a time series analysis of thirty-five years of the epidemic in Brazil. AIDS Care 2018; 30:1413-1420. [PMID: 29625531 DOI: 10.1080/09540121.2018.1456642] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Although traditional epidemiological information, such as mortality rate and prevalence or incidence rates, is relevant to the understanding of AIDS epidemiology in Brazil, a more complete indicator would be recommended. The aim of this study was to estimate the burden of AIDS and its trends in Brazil from 1980 to 2015. An ecological study using secondary data on mortality, morbidity and demography was carried out. Data were collected from official health information sources. Disability-adjusted life years (DALY) index was estimated by year. Trend analysis of the rates were performed using a segmented linear regression method. There were 826,452 confirmed HIV/AIDS cases and 302,614 deaths from AIDS-related causes in the studied period. The greatest burden occurred between 1994 and 1996, with a significant increase in the burden of AIDS for both sexes. The burden of AIDS in Brazil remains high, with a tendency to increase significantly the DALY rates in the study period. However, trend reversals in the DALY rates and in the mortality component, with a consequent increase in the morbidity component, were identified from 1995 onwards.
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Affiliation(s)
- Jefferson Traebert
- a Programa de Pós-Graduação em Ciências da Saúde , Universidade do Sul de Santa Catarina , Palhoça , Brazil
| | - Eliane Traebert
- a Programa de Pós-Graduação em Ciências da Saúde , Universidade do Sul de Santa Catarina , Palhoça , Brazil
| | - Fabiana Schuelter-Trevisol
- a Programa de Pós-Graduação em Ciências da Saúde , Universidade do Sul de Santa Catarina , Palhoça , Brazil
| | - Juan Jose Cortez Escalante
- b Organizacão Pan-Americana da Saúde/Organizacão Mundial da Saúde , Unidade Técnica de Doenças Transmissíveis e Análise de Situação em Saúde , Brasília , Brazil
| | - Ione Jayce Ceola Schneider
- c Programa de Pós-Graduação em Ciências da Reabilitação , Universidade Federal de Santa Catarina , Araranguá , Brazil
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Raboni SM, Ribeiro CE, Almeida SM, Telles JPM, Azevedo M, Schaitza GA. Impact of public health strategies on reducing AIDS mortality in southern Brazil. Int J STD AIDS 2016; 28:54-62. [PMID: 26729764 DOI: 10.1177/0956462415624075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In Brazil, all patients who fulfill the criteria for AIDS have had free access to antiretroviral therapy since 1996. We performed this cross-sectional study to evaluate the causes of death among 643 HIV-infected patients over three non-consecutive years (2000, 2006, and 2010), using their epidemiological, clinical, and laboratory data. The causes of death were classified as AIDS-defining or non-AIDS-defining conditions. We observed a progressive increase in the prevalence of HIV infection over the study period, although there was also a decrease in the mortality rate for various groups, and especially among pediatric patients. An AIDS-defining condition was recorded as the cause of death for approximately 30% of the patients. There was also a high frequency (>70%) of infectious and parasitic diseases, including opportunistic infections, and the most common diagnoses were septicemia, pneumonia, tuberculosis, and pneumocystosis. Acute respiratory failure was the underlying cause of death in 30% of these cases. Despite advances in HIV therapy, the mortality rate remains high in Brazil. As few Brazilian studies have investigated HIV/AIDS-related mortality, it is important to evaluate and improve the mortality notification databases, in order to provide information regarding the effects of HIV and to guide the implementation of appropriate healthcare measures.
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Affiliation(s)
- Sonia M Raboni
- 1 Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil.,2 Virology Laboratory, Universidade Federal do Paraná, Curitiba, Brazil
| | - Clea E Ribeiro
- 1 Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil.,3 Secretaria Municipal de Saúde de Curitiba, Paraná, Curitiba, Brazil
| | - Sergio M Almeida
- 4 Faculdades e Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil
| | | | - Marcos Azevedo
- 5 Faculdade Evangélica de Curitiba, Paraná, Curitiba, Brazil
| | - Gustavo A Schaitza
- 1 Infectious Diseases Division, Universidade Federal do Paraná, Curitiba, Brazil
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