Navegando por Palavras-chave "Human immunodeficiency virus"
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- ItemAcesso aberto (Open Access)Avaliação da presença de resistência transmitida e/ou polimorfismos aos antirretrovirais raltegravir, darunavir e etravirina, em indivíduos infectados pelo vírus da imunodeficiência humana tipo 1 (HIV-1) agrupados de acordo com o tempo de infecção(Universidade Federal de São Paulo (UNIFESP), 2017-04-27) Arnold, Rafael [UNIFESP]; Komninakis, Shirley Vasconcelos [UNIFESP]; http://lattes.cnpq.br/6529080329230878; http://lattes.cnpq.br/2444349818713004; Universidade Federal de São Paulo (UNIFESP)ABSTRACT Infections caused by the HIV have reached alarming levels all over the world, being Brazil the most affected country in Latin America. High recombination rate of the viral genome, associated with the high frequency of polymorphisms, selective pressure caused by antiretrovirals, and the transmission of strains resistant to drugs put in check the efficacy of the treatment, especially when considering the late presenters, once the degradation of the immune system and consequently a decrease in life quality and expectation are seen. This study evaluated and differentiated the transmitted resistance and polymorphisms towards the antiretrovirals Raltegravir, Darunavir and Etravirine in individuals with late diagnosis (n= 17) versus recent infection (n=22) by HIV-1. Integrase, protease and reverse transcriptase were amplified via nested-PCR and sequenced through Next Generation Sequencing using the MiSeq, Illumina platform. Mutations and polymorphisms with a frequency lower than 1% were excluded from the analysis. Clinical data of the late presenters showed that the damage caused in the immune system led these individuals to develop AIDS defining comorbities as well as presenting low levels of TCD4+ lymphocytes, although presenting immune reconstitution above 30% since an adequate drug combination was used, the levels of TCD4+ lymphocytes remained low, compromising the treatment as well as the prognostic. In this group, two mutations for Etravirine were found (V106I and E138Q) one for Raltegravir (T97A) and none for Darunavir. In the recently infected individuals, no resistance mutation for Darunavir or Raltegravir was found, but for Etravirine the accessory mutation A98G was found in two individuals, as well as the major mutations K101P and V179E in three and two individuals respectively. K103N was found in both groups and in several individuals, which may lead to a negative impact on the treatment. The difference in the viral diversity found when both groups were compared was not statistically significant. More attention should be given to the protease inhibitors, which in both groups were significantly present. A better use of the large amount of data generated is possible, under the suggestion of using the multiplex technique through DNA barcoding, reducing the time spend in the development of the procedures, as well as the financial expenses.
- ItemSomente MetadadadosLipodystrophy, lipid profile changes, and low serum retinol and carotenoid levels in children and adolescents with acquired immunodeficiency syndrome(Elsevier B.V., 2010-06-01) Beraldo Battistini, Tania Regina; Sarni, Roseli Oselka Saccardo [UNIFESP]; Suano de Souza, Fabiola Isabel [UNIFESP]; Pitta, Tassiana Sacchi; Fernandes, Ana Paula; Hix, Sonia; Affonso Fonseca, Fernando Luiz; Tardini, Priscila Chemiotti; Santos, Valter Pinho dos; Lopez, Fabio Ancona [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To assess serum retinol and levels of carotenoids in children and adolescents with acquired immunodeficiency syndrome (AIDS) and to correlate low serum retinol and carotenoid levels with the presence of lipodystrophy, lipid profile changes, lipid peroxidation, and insulin resistance.Methods: A cross-sectional, controlled observational study was carried out with 30 children and adolescents with AIDS (mean age 9.1 y) receiving antiretroviral therapy (median length of treatment 28.4 mo), including 30 uninfected healthy controls matched forage and gender. Clinical and laboratory assessments were performed to determine nutritional status, presence of lipodystrophy, serum concentrations of retinol, beta-carotene, lycopene, lipid profile (high-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triacylglycerols), lipid peroxidation (thiobarbituric acid-reactive substances), glycemia, and serum insulin (homeostasis model assessment for insulin resistance, cutoff point >3). Statistical analysis was done with chi-square test and Student's t test.Results: Lipodystrophy was observed in 53.3% of patients with AIDS, and dyslipidemia was detected in 60% and 23% of subjects with human immunodeficiency virus and control subjects, respectively (P = 0.004). A higher prevalence of retinol deficiency (60% versus 26.7%, P = 0.009) and beta-carotene deficiency (23.3% versus 3.3%, P = 0.026) was found in the group with human immunodeficiency virus than in the control group. No correlation was found for low retinol and beta-carotene levels, changes in lipid and glucose metabolism, or lipodystrophy in children and adolescents with AIDS.Conclusion: Despite the high frequency of dyslipidemia, lipodystrophy, and retinol and beta-carotene deficiencies, it was not possible to demonstrate a correlation of these findings with lipid peroxidation and insulin resistance. More studies are needed to investigate the causes of retinol and beta-carotene deficiencies in this population and the clinical consequences of these findings. (C) 2010 Elsevier Inc. All rights reserved.
- ItemAcesso aberto (Open Access)Montando um quebra-cabeça para compreender o que tem e seguir com a vida: a criança vivenciando a revelação de ter HIV/AIDS(Universidade Federal de São Paulo (UNIFESP), 2014-12-17) Freitas, Hilda Maria Barbosa de [UNIFESP]; Ribeiro, Circea Amalia [UNIFESP]; http://lattes.cnpq.br/2300731487624854; http://lattes.cnpq.br/6224232709367683; Universidade Federal de São Paulo (UNIFESP)Estudo de abordagem qualitativa, que objetivou compreender o significado de vivenciar o processo de revelação do diagnóstico de HIV/aids na infância e desenvolver um modelo teórico. O referencial teórico utilizado foi o Interacionismo Simbólico e o metodológico, a Teoria Fundamentada nos Dados (TFD), Grounded Theory. O cenário foi o Serviço de Infectologia Pediátrico de um Hospital Universitário - RS e os sujeitos 13 crianças em idade escolar e/ou adolescentes que tiveram a revelação do HIV/aids até os 12 anos de idade. Os dados foram coletados por meio de uma entrevista semiestruturada e analisados concomitantemente. A análise permitiu compreender que, saber que tem o HIV/aids nem sempre é uma novidade à criança, pois muitas já desconfiam de algo e desenvolvem estratégias para descobri-lo, mas ter essa revelação é sempre uma vivência difícil, interagindo com sentimentos e reações. Ela também avalia que é importante, para aceitar as medicações que anteriormente recusava, além de considerar que tem o direito de saber seu diagnóstico e que a revelação deve ocorrer na infância, sendo importante que isso aconteça antes da adolescência. A integração das categorias permitiu a identificação da categoria central MONTANDO UM QUEBRA-CABEÇA PARA COMPREENDER O QUE TEM E SEGUIR COM A VIDA e a construção do Modelo Teórico representativo dessa vivência. O aprofundamento do conhecimento em relação ao processo de revelação do HIV/aids na infância proporciona subsídios aos profissionais de saúde no desenvolvimento das ações de cuidado junto à criança e seus familiares e na prestação de uma assistência qualificada.
- ItemSomente MetadadadosRenal abnormalities in a cohort of HIV-infected children and adolescents(Springer, 2016) Leão, Flavia Vanesca Felix [UNIFESP]; Succi, Regina Célia de Menezes [UNIFESP]; Machado, Daisy Maria [UNIFESP]; Gouvea, Aida de Fatima Thome Barbosa [UNIFESP]; Carmo, Fabiana Bononi do [UNIFESP]; Beltrao, Suenia Vasconcelos [UNIFESP]; Cançado, Maria Aparecida de Paula [UNIFESP]; Carvalhaes, Joo Tomas de Abreu [UNIFESP]Background This study aimed to identify the prevalence of renal abnormalities and the evolution of glomerular filtration rate (GFR) among human immunodeficiency virus (HIV)-infected children and adolescents followed up in an infectious disease outpatient pediatric clinic. Methods We performed a cohort study of 115 children and adolescents. Outcomes of two evaluations for urinalysis, microalbuminuria/urinary creatinine ratio, urinary retinol-binding protein (uRBP) concentration, and estimated GFR (eGFR) were obtained for each patient, with an average interval of 6 months between evaluations. These changes were correlated with gender, age, race, body mass index (BMI), height-for-age (H/A) percentile, clinical and immunological classification of HIV infection, use of antiretroviral therapy (ART), HIV viral load (VL), and CD4+ T-lymphocyte count. Results Mean patient age at the time of inclusion in the study was 12.6 +/- 3.2 years
- ItemSomente MetadadadosThe success of endosseous implants in human immunodeficiency virus-positive patients receiving antiretroviral therapy A pilot study(Amer Dental Assoc, 2011-09-01) Oliveira, Marcio Augusto de; Gallottini, Marina Helena; Pallos, Debora; Maluf, Paulo Sérgio Zaidan [UNIFESP]; Jablonka, Fernando; Ortega, Karem Lopez; Universidade Federal de São Paulo (UNIFESP)Background. In a pilot study, the authors aimed to determine the success rate of dental implants placed in patients who were positive for human immunodeficiency virus (HIV) and were receiving different regimens of highly active anti-retroviral therapy (HAART). They considered patients' levels of cluster of differentiation (CD) 4(+) cells and viral load, and they attempted to verify whether patients with baseline biochemical signs of bone mineral density loss could experience osseointegration impairment.Materials and Methods. One of the authors, a dentist, placed dental implants in the posterior mandibles of 40 volunteers, divided into three groups: one composed of HIV-positive patients receiving protease inhibitor (PI)-based HAART; a second composed of HIV-positive patients receiving nonnucleoside reverse transcriptase inhibitor based HAART (without PI); and a control group composed of HIV-negative participants. The authors assessed pen-implant health six and 12 months after implant loading. They analyzed the success of the implants in relation to CD4(+) cell counts, viral load and baseline pyridinoline and deoxypyridinoline values.Results. The authors followed 59 implants for 12 months after loading. Higher baseline levels of pyridinoline and deoxypyridinoline found in HIV-positive participants did not interfere with osseointegration after 12 months of follow-up. Average pen-implant bone loss after 12 months was 0.49 millimeters in group 1, 0.47 mm in group 2, and 0.55 mm in the control group.Conclusions. The placement of dental implants in HIV-positive patients is a reasonable treatment option, regardless of CD4(+) cell count, viral load levels and type of antiretroviral therapy. Longer, follow-up periods are necessary to ascertain the predictability of the long-term success of dental implants in these patients.Clinical Implications. Limited published scientific evidence is available to guide clinicians in regard to possible increased risks associated with dental implant placement in HIV-positive patients.