medigraphic.com
ISSN 1729-519X (Print)

2019, Number 4

<< Back Next >>

Revista Habanera de Ciencias Médicas 2019; 18 (4)

Clinical and laboratory findings in patients with late diagnosis of AIDS

Vidal TY, González RD, de Armas RY

Language: Spanish
References: 20
Page: 593-606
PDF size: 672.63 Kb.


ABSTRACT

Introduction: Late diagnosis of HIV is a major problem with important consequences for the people infected with this virus and the society in general.
Objectives: To characterize patients with late diagnosis of HIV infection and their evolution six months after diagnosis.
Material and Methods: We conducted a prospective longitudinal study which included 248 cases with positive diagnosis of HIV infection during admission at the Pedro Kourí Tropical Medicine Institute between January 2015 and December 2016. They were divided into two comparison groups which included patients with late diagnosis (n=79) and those with no late diagnosis (n=169) of the disease.
Results: Advanced age and male sex were factors related to the late diagnosis of HIV infection. Fever (31.7%) and respiratory symptoms (20.3%) were the most frequent forms of presentation, whereas Pneumocystis jirovecii pneumonia was the disease with the highest incidence at the time of diagnosis. Half of the patients were found to have severe immunosuppression at the time of diagnosis. Patients with late diagnosis showed a significantly diminished survival six months after being diagnosed compared with those patients with early diagnosis. Viral load and CD4+ T count were laboratory parameters with a high predictive value of mortality.
Conclusions: Late diagnosis of HIV leads to a high risk of mortality, which is higher in those with affectation of the viral load and low CD4+ T cell count.


REFERENCES

  1. Agustí C, Martín-Rabadán M, Zarco J, Aguado C, Carrillo R, Codinachs R, et al. Diagnóstico precoz del VIH en atención primaria en España. Resultados de una prueba piloto de cribado dirigido basado en condiciones indicadoras, criterios conductuales y de origen. Atención Primaria [Internet]. 2018; 50(3):159-65. [Consultado: 11/01/2019]. Disponible en: https://www.sciencedirect.com/science/article/ pii/S0212656716305194

  2. Morales-Sánchez M, Del Prado-Morales M, Del Prado-Morales A. La prevención social del VIH/SIDA. Un desafío pendiente. Santiago [Internet]. 2015; 127:229-50. [Consultado: 11/01/2019]. Disponible en: https://go.galegroup.com/ps/anonymous?id=GA LE%7CA308294292&sid=googleScholar&v=2.1&i t=r&linkaccess=abs&issn=00489115&p=IFME&s w=w

  3. Ruiz-Navarro MD. Diagnóstico tardío de la infección por VIH. Anales del Sistema Sanitario de Navarra [Internet]. 2014; 37(3):313-5. [Consultado: 11/01/2019]. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttex t&pid=S1137-66272014000300001

  4. Gargallo-Bernad C, Sangrós-González FJ, Arazo- Garcés P, Martínez-Álvarez R, Malo-Aznar C, Gargallo-Bernad A, et al. Oportunidades perdidas en el diagnóstico de la infección por el virus de inmunodeficiencia humana en la Comunidad de Aragón. Importancia del diagnóstico tardío. Enfermedades Infecciosas y Microbiología Clínica [Internet]. 2019; 37(2):100-8. [Consultado: 11/01/2019]. Disponible en: https://www.sciencedirect.com/science/article/ pii/S0213005X18301630

  5. Lamotte Castillo JA. Infección por VIH/SIDA en el mundo actual. Medisan [Internet]. 2014;18:993-1013. [Consultado: 11/01/2019]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext &pid=S1029-30192014000700015

  6. Massip NT, Martí PH, Gallego RM, Tristá MC, Rodríguez R, Smith LA, et al. Pautas para la atención integral al paciente con infección por VIH/SIDA; Ciudad de La Habana: MINSAP. 2009. [Consultado: 11/01/2019]. Disponible en: www.sld.cu/sida/files/.../informacion_practica_ para_la_atencion_integral_a_pvs-2009.pdf

  7. MINSAP. Programa de Prevención y Control del VIH/SIDA; Ciudad de La Habana; 2017 [Consultado: 11/01/2019]. Disponible en: https://hivhealthclearinghouse.unesco.org/.../cu ba-plan-estrategico-its_vih_sida-2014_2017

  8. MINSAP. Plan Estratégico Nacional ITS/VIH/SIDA 2007-2011. [Consultado: 11/01/2019]. Disponible en: www.sld.cu/galerias/pdf/sitios/.../anexo_2,_pla n_estrategico__2007-2011.pdf

  9. Camoni L, Regine V, Raimondo M, Salfa MC, Boros S, Suligoi B. The continued ageing of people with AIDS in Italy: recent trend from the national AIDS Registry. Ann Ist Super Sanita [Internet]. 2014; 50(3). [Consultado: 19/02/2019]. Disponible en: https://www.scielosp.org/scielo.php?pid=S0021- 25712014000300012&script=sci_arttext&tlng=e n

  10. De Coul ELO, Van Sighem A, Brinkman K, Van Benthem BH, Van der Ende ME, Geerlings S, Reiss P. Factors associated with presenting late or with advanced HIV disease in the Netherlands, 1996– 2014: results from a national observational cohort. BMJ Open [Internet]. 2016; 6(1). [Consultado: 19/02/2019]. Disponible en: https://bmjopen.bmj.com/content/6/1/e009688 .short

  11. Buetikofer S, Wandeler G, Kouyos R, Weber R, Ledergerber B. Prevalence and risk factors of late presentation for HIV diagnosis and care in a tertiary referral centre in Switzerland. Swiss medical weekly [Internet]. 2014. 144:w13961. [Consultado: 19/02/2019]. Disponible en: https://pdfs.semanticscholar.org/4eeb/8ee6866 1de4c8feba8f3b372f7cbfc2b1e62.pdf

  12. Kelley CF, Barbour JD, Hecht FM. The Relation between Symptoms, Viral Load, and Viral Load Set Point in Primary HIV Infection. J Acquir Immune Defic Syndr [Internet]. 2007;45:445. [Consultado: 19/02/2019]. Disponible en: https://journals.lww.com/jaids/Fulltext/2007/08 010/Performance_Characteristics_of_a_New_Le ss.10.aspx

  13. Gaines H, Von Sydow M, Pehrson PO, et al. Clinical picture of primary HIV infection presenting as a glandular-fever-like illness. Br Med J [Internet]. 2008; 297:1363. [Consultado: 19/02/2019]. Disponible en: https://www.bmj.com/content/297/6660/1363. short

  14. Irribarren JA, Rivas González P, Amador Prous C, Velasco Arribas M. Manifestaciones clínicas de la infección por el VIH en diferentes áreas geográficas. Enferm Infecc Microbiol Clin [Internet]. 2008; Supl 5:6-11. [Consultado: 19/02/2019]. Disponible en: https://www.sciencedirect.com/science/article/ pii/S0213005X08764991

  15. Murray JF. Pulmonary complications of HIV-1 infection among adults living in Sub-Saharan Africa. Int J Tuberc Lung Dis [Internet]. 2015;9:826-35. [Consultado: 19/02/2019]. Disponible en: https://www.ingentaconnect.com/content/iuatl d/ijtld/2005/00000009/00000008/art00002

  16. Oropesa González L, Sánchez Valdés L, Berdasquera Corcho D, Gala González A, Pérez Ávila JL, Lantero M. Debut clínico de SIDA en Cuba. Rev Cubana Med Trop [Internet]. 2007; 59(2). [Consultado: 19/02/2019]. Disponible en: http://scielo.sld.cu/scielo.php?pid=S0375- 07602007000200009&script=sci_arttext&tlng=p t

  17. Xie J, Hsieh E, Sun MQ, Wang HL, Lv W, Fan HW, Li TS. Delays in HIV diagnosis and associated factors among patients presenting with advanced disease at a tertiary care hospital in Beijing, China. PLoS ONE [Internet]. 2017; 12(8). [Consultado: 19/02/2019]. Disponible en: https://journals.plos.org/plosone/article?id=10. 1371/journal.pone.0182335

  18. Abrahantes Rodríguez Y, Pérez Ávila J, Kourí Cardellá V, Fonseca Gómez C, Baly Gil A, Tápanes Fernández T. Factores asociados a la progresión rápida a SIDA en individuos cubanos. Rev Cubana Med Trop [Internet]. 2010; 69(2). [Consultado: 19/02/2019]. Disponible en: http://scielo.sld.cu/scielo.php?pid=S0375- 07602010000200010&script=sci_arttext&tlng=e n

  19. Hernández Requejo D, Pérez Ávila J, Can Pérez A. Enfermedades oportunistas en pacientes VIH/SIDA con debut de SIDA que reciben tratamiento antirretroviral. Revista Cubana de Investigaciones Biomédicas [Internet]. 2015;34(3). [Consultado: 19/02/2019]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext &pid=S0864-03002015000300006

  20. Puente Saní V, Deroncerés A, De Jesús I. Inicio del SIDA o diagnóstico tardío de la infección por el virus de la inmunodeficiencia humana. Medisan [Internet]. 2016;20:1009- 12.[Consultado: 19/02/2019]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext &pid=S1029-30192016000800001




2020     |     www.medigraphic.com