Galisteu Katia Jaira, Cardoso Luciana Ventura, Furini Adriana Antônia da Cruz, Schiesari Júnior Arlindo, Cesarino Claudia Bernardi, Franco Célia, Baptista Andrea Regina de Souza, Machado Ricardo Luiz Dantas
Centro de Investigação de Microrganismos, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil.
Faculdade Integradas Padre Albino, Catanduva, São Paulo, Brazil.
Rev Soc Bras Med Trop. 2015 Mar-Apr;48(2):149-56. doi: 10.1590/0037-8682-0299-2014.
In this study, clinical-laboratory and epidemiological characteristics are described for a group of 700 individuals with HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome) in the ART (antiretroviral therapy) era at a teaching hospital that provides a quaternary level of care, with an emphasis on opportunistic infections (OIs), co-infections and immune profile.
A retrospective cross-sectional study of AIDS cases was conducted from 1998 to 2008 by reviewing medical records from the Base Hospital/FUNFARME (Fundação Faculdade Regional de Medicina), São José do Rio Preto, São Paulo, Brazil.
The individuals were 14 to 75 years of age, and 458 were males. Heterosexuals accounted for 31.1% of all patients. Eighty-three percent were on ART, and 33.8% of those presented difficulties with treatment adherence. OIs were analyzed from medical records, and Pneumocystis jiroveci pneumonia was the most prevalent, regardless of the LTCD4+ (TCD4+ Lymphocytes) levels. Individuals whose viral loads were ≥10,000 showed a 90% greater chance of neurotoxoplasmosis. For P. jiroveci pneumonia, neurotoxoplasmosis, esophageal candidiasis, pulmonary tuberculosis and neurocryptococcosis, the chances of infection were higher among patients with LTCD4+ levels below 200 cells/mm3. HIV/hepatitis C virus (HCV) and HIV/hepatitis B virus (HBV) co-infections were significantly associated with death.
OIs remain frequent in the ART era even in populations where the access to medical care is considered satisfactory.
在本研究中，描述了一家提供四级医疗服务的教学医院中，700名处于抗逆转录病毒治疗（ART）时代的人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）患者的临床实验室和流行病学特征，重点关注机会性感染（OIs）、合并感染和免疫状况。
通过回顾巴西圣保罗州里奥普雷图市圣若泽基础医院/地区医学基金会（FUNFARME）1998年至2008年的艾滋病病例医疗记录，进行了一项回顾性横断面研究。
患者年龄在14至75岁之间，男性有458人。异性恋者占所有患者的31.1%。83%的患者正在接受抗逆转录病毒治疗，其中33.8%的患者在治疗依从性方面存在困难。从医疗记录中分析机会性感染情况，无论TCD4+淋巴细胞水平如何，耶氏肺孢子菌肺炎最为常见。病毒载量≥10,000的个体患神经型弓形虫病的几率高90%。对于耶氏肺孢子菌肺炎、神经型弓形虫病、食管念珠菌病、肺结核和神经隐球菌病，TCD4+水平低于200个细胞/mm3的患者感染几率更高。HIV/丙型肝炎病毒（HCV）和HIV/乙型肝炎病毒（HBV）合并感染与死亡显著相关。
即使在被认为医疗服务可及性良好的人群中，机会性感染在抗逆转录病毒治疗时代仍然很常见。
