2015, Number 3
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Rev Cubana Invest Bioméd 2015; 34 (3)
Opportunistic diseases observed in HIV/aids patients with onset of aids and antiretroviral treatment
Hernández RD, Pérez ÁJ, Can PA
Language: Spanish
References: 23
Page: 254-263
PDF size: 241.75 Kb.
ABSTRACT
Introduction: onset of aids is a form of presentation of the disease that is
characterized by altered general condition, wornout syndrome, serious opportunistic
infections, neoplasias and neurological alterations. The antiretroviral treatment has
increased the life expectancy of these patients.
Objectives: to identify the opportunistic diseases associated to the clinical condition
under study and their linking to the CD4+ T lymphocyte count and the viral load as
well as to evaluate the mortality in the studied group and its relationship with
opportunistic diseases.
Methods: prospective, observational and cross-sectional study of a sample of 55
patients. The size of the sample depended on the total universe of HIV/aids patients
in the medicine service of "Pedro Kouri" Tropical Medicine Institute. The study took
into account those subjects who were diagnosed with onset of aids and presented
with opportunistic diseases during one year.
Results: infectious opportunistic diseases such as neurotoxoplasmosis (21.8 %) and
pneumonia caused by
Pneumocystis jirovecii (12.7 %) were the predominant defining
events of aids. There was no statistically significant association with low CD4+ T
lymphocyte count and high viral load. In patients over 50 years of age with more than
one opportunistic disease, the risk of dying was 4.72 times higher than in the rest of
the group.
Conclusions: infectious opportunistic diseases as neurotoxoplasmosis and
Pneumocystis jirovecii were the prevailing defining events of aids. Aids-associated
mortality in patients aged over 50 years increased in individuals who presented more
than one opportunistic disease. These results are useful for the design of treatment
strategies that reduce the occurrence of opportunistic diseases and improve even
more the survival of HIV/aids patients.
REFERENCES
Weiss RA. Special anniversary review: twenty-five years of human immunodeficiency virus research: successes and challenges. Clin Exp Immunol. 2008;152:201-10.
Informe ONUSIDA. 2014 [citado feb 2015]. Disponible en: http://www.unaids.org/en/resources/campaigns/2014/2014gapreport/videofootage
Oropesa L, Sánchez L, Berdasquera D, Gala A, Pérez J, Lantero MI. Debut clínico de Sida en Cuba. Rev Cubana Med Trop. 2007;59(2):127-33.
Klatt EC. Pathology of AIDS. Versión 22. Savannah:Mercer University School of Medicine. 2011:44-56.
Ministerio de Salud Pública de Cuba. Programa Nacional de prevención y control de las ITS/VIH/sida. Información para el equipo de salud. La adherencia al tratamiento antirretroviral en personas con VIH. La Habana: MINSAP; Jun 2009.
Las personas mayores y el VIH. 2014 [citado Feb 2015]. Disponible en: http://www.adsinfonet.org
Silverberg MJ, Leyden W, Horberg MA, DeLorenze GN, Klein D, Quesenberry CP, et al. Older age and the response to and tolerability of antiretroviral therapy. Arch Intern Med. 2007;167:684-91.
Bhavan KP. The aging of the HIV epidemic. Curr HIV/AIDS Rep. 2008;5(3):150–8.
VIH/sida y las infecciones. 2014 [citado feb 2015]. Disponible en: http://www.nlm.nih.gov/medlineplus/spanish/toxoplasmosis/html
Steven Deeks G, Verdin E, McCune JM. Immunosenescence and HIV. Current Opinion in Immunology. 2012;24:1–6.
Ho YC, Sun HY, Chen MY, Hsieh SM, Sheng WH, Chang SC, et al. Clinical presentation and outcome of toxoplasmic encephalitis in patients with human immunodeficiency virus type 1 infection. J Microbiol Immunol Infect. 2008;41(5):386-92.
Arce Mendoza AY, Rosas Taraco AG, Morales San Claudio PC, Solís Soto JM. Tuberculosis: mecanismos de defensa, inmunopatogénesis y biomarcadores de susceptibilidad y resistencia. Ciencia UANL. 2008 Jul-Sep;XI(3).
Mangili A, Murman DH, Zampini AM, Wanke CA. Nutrition and HIV infection: review of weight loss and wasting in the era of highly active antiretroviral therapy from the nutrition for healthy living cohort. Clinical Infectious Diseases. 2006;42(6):836-42.
Domínguez Odio R, Nold Ortega R, Llorente Aguilera YB, Ramírez Arias MC. Estado de los conocimientos sobre alimentación y nutrición de las personas que viven con VIH/sida. Influencia en la prevención del síndrome de desgaste. Rev Cubana Aliment Nutr. 2011;21(2):263-74.
Charles B, Hicks MD. Low CD4-Cell Counts - Not Just About OI Risk. AIDS Clinical Care ©. Massachusetts Medical Society; 2008.
Naeger DM, Martin JN, Sinclair E, Hunt PW, Bangsberg DR. Cytomegalovirus- Specific T Cells Persist at Very High Levels during Long-Term Antiretroviral Treatment of HIV Disease. PLoS ONE. 2010;5(1). Disponible en http://www.ncbi.nlm.nih.gov/pubmed/20126452
Cello JP, Day LW. Idiopathic AIDS enteropathy and treatment of gastrointestinal opportunistic pathogens. Gastroenterology. 2009;136(6):1952–65.
Reyes Corcho A, Mosquera Fernandez MA, Bouza Jimenez Y, Perez Avila J, Hernandez V, Jam Morales B, et al. Impacto de la terapia antirretroviral de alta eficacia en la respuesta clínica e inmunovirológica en enfermos Sida. Rev Cubana Med Trop. 2007;9(2):127-33.
Aberg JA. Aging, inflammation, and HIV infection. Top Antivir Med. 2012 Aug- Sep;20(3):101-5.
Warley E, Tamayo Antabak N, Desse J, De Luca A, Warley F, Fernández Galimberti G, et al. Desarrollo de neoplasias e infecciones definitorias de sida después de iniciar la terapia antirretroviral de alta eficacia. Medicina. Ciudad Autónoma de Buenos Aires: Revista Medicina. 2010 Ene-Feb;70(1):49-72.
Delaugerre C, Gallien S, Flandre P, Mathez D, Amarsy R, Ferret S, et al. Impact of low-level-viremia on HIV-1 drug-resistance evolution among antiretroviral treatedpatients. PLoS One. 2012;7(5):e36673.
V Congreso Centroamericano de ITS, VIH, sida. 2012 [citado Feb 2015]. Disponible en: www.concasida2007.org
Centers for Disease Control and Prevention, U.S. Centers for Disease Control and Prevention, MMWR: Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. 2009 Mar;24(58):1-198.