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ISSN 1817-5996 (Electronic)

2017, Number S1

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Rev Cub de Reu 2017; 19 (S1)

Characteristics and forms of expression Autoimmune-Rheumatic HIV/AIDS infection in the Cuban epidemic. An update

Reyes LGA, Millán MJC, Perez ÁJ, Guibert TM, Pujol CYD, Sayoux GM

Language: Spanish
References: 44
Page: 159-169
PDF size: 297.52 Kb.


ABSTRACT

The infection VIH-AIDS constitute a major problem of health in the world, in particular in undevelopment countries. Subsaharian Africa has received the major impact. The rheumatic manifestations are included in the clinical spectrum of these mortal desease.The objective: was to know the general prevalence of musculoskeletal manifestations and rheumatic diseases in these patients, and his clinical caracterizations, at the end of the year 2000 and to develop an update of his changing spectrum considering the increasesupervivence, and new forms of expression after the introduction of the antiretroviral drugs with high efficiency.
Methods: We estudied a Cuban cohort of 350 patients atended in the Institute of Tropical Medicine Havana Cuba betwen 1986-2000 with thwe diagnosis of VIH-AIDS infection. Were included all that wished to participate in the study, and exclude the patients no agree, very severe illness, and in clinical profilacticaislamient. The final universe were 240 patients, 230 adults and 10 children VIH (+) between 62 pregnants infected womans. The diagnosis of HIV infection was performed by a positive ELISA and confirmatory Western Blott positive test: the diagnosis of rheumatic diseases by the classification criteria of American college of rheumatology (ACR) and rheumatologist criteria and experience.
Results: Sociodemographic dates shown that hight prevalence of masculine sex, 28 years old promedy, an adquisicion of infection by transmission homosexual preference. The prevalence of rheumatic manifestations were observed in 46 %, arise the arthralgias with 35 %, spondiloarthropathy in general was found in 8.6 %, Reyter syndrome 7(3 %), in adults. The children 39(60.9 %), were borne alive and negative for VIH infection, 10(15.6 %), were VIH+, 3 dead, and the more frequently rheumatic manifestation was arthralgias,, myalgias, SILD, and hiperganmaglobulinemia in the laboratory findings. All the children were afected for pondostatural deficiency.
Conclusions: These study suggest that musculoskeletal, rheumatic manifestations and diseases result higly prevalent in Cubans patients infected with VIH-AIDS. Arise the arthro- myalgias complaints, and seronegativespondyloartropathies with a severe evolution and low frecuency of musculoskeletal infection. The pediatric set is also impacted for these manifestations. Thesestudy resume a large experience and we discussed about the new spectrum of clinical manifestations after the introduction of antirretroviral therapy and offered the first preliminary date about these new forms of expression in the Cuban VIH-AIDS epidemy. We observe a decrease of inflammatory spondiloarthropathies, with the ocurrence of metabolic syndromes, and low level of mineral density, and osteonecrosis with a new syndrome of inmune reconstitutions.


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