Trata-se de um estudo transversal, de abordagem qualitativa e quantitativa que teve por objetivo avaliar os aspectos referentes à adesão irregular aos antirretrovirais por pessoas vivendo com HIV/aids. O estudo foi aprovado pelo Comitê de Ética da Escola de Enfermagem de Ribeirão Preto e pela Unidade de Pesquisa Clínica do Hospital das Clínicas de Ribeirão Preto. A coleta de dados ocorreu no período de outubro de 2017 a abril de 2018, em duas unidades de internação especializadas em tratamento das pessoas com HIV/aids, de um hospital público do interior paulista sendo organizada em duas etapas: Aplicação do questionário elaborado pelo pesquisador e consulta ao prontuário eletrônico. A partir disso, a entrevista semiestruturada foi gravada e posteriormente transcrita e revisada pelo próprio pesquisador. Os dados quantitativos coletados foram organizados em planilhas do Microsoft® Office Excel 2011 for Windows. Logo após, os dados foram transferidos para o banco de dados definitivo e analisados por meio do software IBM®SPSS, versão 23.0 for Windows. A análise e processamento dos dados qualitativos foram realizados pela Classificação Hierárquica Descendente com base fundamentada no Discurso do Sujeito Coletivo. Identificou-se que a adesão irregular aos antirretrovirais está intimamente ligada a aspectos do contexto social, econômico e cultural em que estão inseridas as PVHA. Apesar do tratamento no Brasil ser gratuito, as questões financeiras mencionadas têm relação com o cotidiano da vida social e exercem influência no uso regular do medicamento. Participaram do estudo 50 indivíduos hospitalizados. A média de idade dos pacientes foi de 42 anos e a média do tempo de diagnóstico de HIV foi de 12 anos. Analisando as características clínicas, percebeu-se que 86,4% dos indivíduos tinham mais de cinco anos de diagnóstico e mantinham parceria afetiva sexual (84,6%) em relação aos que não mantinham (81,1%). Outras condições foram relatadas: necessidade de apoio familiar; uso de álcool e outras drogas e dificuldades com a adaptação à apresentação medicamentosa. As principais dificuldades enfrentadas por pessoas vivendo com HIV/aids hospitalizadas e que estão em adesão irregular são os efeitos adversos causados pelo medicamento, os problemas financeiros, o estigma social e familiar e o uso de álcool e drogas. Mais de 80% dos participantes apresentaram diagnóstico de HIV há mais de cinco anos. / This is a cross-sectional, qualitative and quantitative study whose objective was to evaluate the aspects related to irregular adherence to antiretrovirals by people living with HIV / AIDS. The study was approved by the Ethics Committee of the Ribeirão Preto School of Nursing and the Clinical Research Unit of the Ribeirão Preto \"Hospital das Clínicas\". The data of collection took place from October 2017 to April 2018, in two hospitalization units specialized in the treatment of people with HIV / AIDS, from a public hospital in the interior of São Paulo. It was organized in two stages: Application of the questionnaire prepared by the researcher and consult the electronic medical record. From this, the semi-structured interview was recorded and later transcribed and revised by the researcher himself. The quantitative data collected was organized into Microsoft® Office Excel 2011 for Windows spreadsheets. Shortly after the data was transferred to the definitive database and analyzed using IBM®SPSS software, version 23.0 for Windows. The analysis and processing of the qualitative data were performed by the Descending Hierarchical Classification based on the Discourse of the Collective Subject. It has been identified that irregular adherence to antiretrovirals is closely linked to aspects of the social, economic and cultural context in which PLWHA are inserted. Although the treatment in Brazil is free, the mentioned financial issues are related to the daily life of social life and influence the regular use of the drug. Fifty hospitalized individuals participated in the study. The mean age of the patients was 42 years and the average time of diagnosis of HIV was 12 years. Analyzing the clinical characteristics 86.4% of the individuals had more than five years of diagnosis maintained a sexual affective partnership (84.6%) compared to those who did not maintain (81.1%). Other conditions were reported: need for family support; use of alcohol and other drugs and difficulties with adaptation to drug presentation. The main difficulties faced by people living with HIV / AIDS who are hospitalized and who are in irregular adherence are the adverse effects caused by the drug, financial problems, social and family stigma, alcohol and drug use. More than 80% of participants had been diagnosed with HIV for more than five years.

A identificação de ateroma de carótida em radiografia panorâmica de pacientes com alterações sistêmicas que predispõem a aterosclerose é mais frequente do que em amostras da população em geral. O uso da terapia antirretroviral combinada (TARVc), que prolongou a sobrevida dos pacientes portadores do HIV (HIV+), também contribuiu para o aumento da incidência de alterações metabólicas e provavelmente de complicações cardiovasculares. Este estudo teve o objetivo de investigar a prevalência de imagens suspeitas de ateromas de carótida (ISAC) em radiografias panorâmicas de pacientes HIV+ em tratamento no Centro de Atendimento de Pacientes Especiais (CAPE) da Faculdade de Odontologia da Universidade de São Paulo, bem como tentar identificar variáveis associadas à ocorrência destas imagens. Foram avaliadas 300 radiografias de pacientes de ambos os gêneros e com média de idade de 40 anos (18-73 anos). A prevalência de radiografias com ISAC foi de 8,2% (25/300). Estes pacientes apresentaram a média de idade significativamente maior do que a dos pacientes sem ISAC (p= 0,008) e a mediana do nadir de CD4 significativamente menor (p=0,019). O uso do medicamento lopinavir/r (LPV/r) estava associado a chance 2,8 vezes maior para presença de ISAC (OD=2,79 1,12-6,95 IC=95%, p=0,045). Conclui-se que quanto maior a idade maior a probabilidade de ocorrência de ISAC e que as variáveis significativas encontradas (nadir de CD4 e LPV/r) são compatíveis com os fatores de risco cardiovascular observados em pacientes portadores do HIV, relacionados tanto à gravidade da infecção como ao uso de medicamentos. / The identification of calcified carotid artery atheroma (CCAA) in panoramic radiography of patients with systemic diseases that predispose the atherosclerosis is more frequent than in the general population samples. The use of high active antiretroviral therapy (HAART), which prolonged the life of patients with HIV (HIV+), also increase the incidence of cardiovascular complications, probably by the use of protease inhibitors (PI). This study aimed to investigate the prevalence of suspected images of CCAA in panoramic radiographs of HIV+ patients in treatment in the Special Care Dentistry Center of the University of São Paulo, São Paulo, Brazil, as well as trying to identify variables associated with these images. Three hundred radiographs of patients of both genders, with a mean age of 40 years (18-73 years) were evaluated. The prevalence of CCAA suspected images was 8.2% (25/300). This patients showed the mean age significantly higher than that of the patients without CCAA images (p = 0.008) and the CD4 nadir median significantly lower (p = 0.019). The use of HAART with lopinavir/r (LPV/r) was associated with a greater chance for CCAA images (OD 2.79, CI 95% 1.12-6.95; p = 0.045). In conclusion, patients with higher age are more susceptible to CCAA suspected image and the significant variables found (CD4 nadir and LPV/r) are compatible with the cardiovascular risk factors in patients HIV+, related both to the severity of the infection and the use of antiretroviral.

Thesis (M.Sc.)--Memorial University of Newfoundland, 2005. / Includes bibliographical references.

<p>This study focuses on socio-cultural issues, which affect Kavango women&rsquo / s decision to participate in the PMTCT programme. It investigates the treatment methods used by HIV-positive pregnant women for themselves and their unborn babies, neonatally, during pregnancy and after delivery, particularly in relation to the prevention of transmission of HIV. The thesis further investigates whether women choose alternative services such as traditional healers for medical attention during pregnancy, birth and post-natally. The research aims to establish and describe the role of local notions and practices concerning anti-retrovirals on the aforementioned programme. Ethnographic and thus qualitative research methods were used to gather and analyze data. I spent three months working as a nurse in two health facilities that offer PMTCT in Rundu, Kavango. I also held semi-structured and open-ended interviews, formal and informal discussions, formal and informal focus groups with nurses, community counselors, pregnant women, women who had recently given birth in the health care facility and traditional health care practitioners. In the case of the latter, I utilized narratives of healing to understand their perception of HIV/AIDS, their beliefs and practices as well as their healing methods. Furthermore, I employed other informal conversations outside the formal research participants. The study shows that there is a paucity of partner involvement and in some cases women have to first seek permission from their partner before enrolling into the programme. My research findings further indicate that women utilized various traditional herbal medicines for themselves and their babies as part of their cultural beliefs and practices. It was evident that some of these, such as Likuki, affect women&rsquo / s participation in and adherence to the protocols of the PMTCT programme. </p>

Background: Some studies have suggested that the risk of preeclampsia in HIV positive pregnant women has increased since the use of HAART became routine. There is also a concern that HIV positive women on HAART have a higher risk of adverse fetal outcomes compared to HIV negative women. Methods: In this matched retrospective cohort study, the risk of preeclampsia and adverse fetal outcomes was examined in 91 HIV positive pregnant women receiving HAART and 273 HIV negative pregnant women. Multivariate logistic regression models were used to adjust for confounding factors. Results: The risk of preeclampsia and preterm birth did not differ significantly between HIV positive and HIV negative women. HIV treated with HAART was an independent predictor for giving birth to a low birthweight baby. Conclusions: HIV positive women on HAART do not have a higher risk of preeclampsia. They do however have a higher risk for lower birthweight infants.

Background: Some studies have suggested that the risk of preeclampsia in HIV positive pregnant women has increased since the use of HAART became routine. There is also a concern that HIV positive women on HAART have a higher risk of adverse fetal outcomes compared to HIV negative women. Methods: In this matched retrospective cohort study, the risk of preeclampsia and adverse fetal outcomes was examined in 91 HIV positive pregnant women receiving HAART and 273 HIV negative pregnant women. Multivariate logistic regression models were used to adjust for confounding factors. Results: The risk of preeclampsia and preterm birth did not differ significantly between HIV positive and HIV negative women. HIV treated with HAART was an independent predictor for giving birth to a low birthweight baby. Conclusions: HIV positive women on HAART do not have a higher risk of preeclampsia. They do however have a higher risk for lower birthweight infants.

<p>This study focuses on socio-cultural issues, which affect Kavango women&rsquo / s decision to participate in the PMTCT programme. It investigates the treatment methods used by HIV-positive pregnant women for themselves and their unborn babies, neonatally, during pregnancy and after delivery, particularly in relation to the prevention of transmission of HIV. The thesis further investigates whether women choose alternative services such as traditional healers for medical attention during pregnancy, birth and post-natally. The research aims to establish and describe the role of local notions and practices concerning anti-retrovirals on the aforementioned programme. Ethnographic and thus qualitative research methods were used to gather and analyze data. I spent three months working as a nurse in two health facilities that offer PMTCT in Rundu, Kavango. I also held semi-structured and open-ended interviews, formal and informal discussions, formal and informal focus groups with nurses, community counselors, pregnant women, women who had recently given birth in the health care facility and traditional health care practitioners. In the case of the latter, I utilized narratives of healing to understand their perception of HIV/AIDS, their beliefs and practices as well as their healing methods. Furthermore, I employed other informal conversations outside the formal research participants. The study shows that there is a paucity of partner involvement and in some cases women have to first seek permission from their partner before enrolling into the programme. My research findings further indicate that women utilized various traditional herbal medicines for themselves and their babies as part of their cultural beliefs and practices. It was evident that some of these, such as Likuki, affect women&rsquo / s participation in and adherence to the protocols of the PMTCT programme. </p>

HIV/AIDS is the world's most urgent public health challenge. It is the leading cause of death for young adults worldwide. There is as yet no vaccine and no cure. The high unemployment rate and poverty experienced in South Africa contribute to the high HIV/AIDS infection levels experienced in the country. With the vast majority of HIV/AIDS cases and the growth in the number of people infected who will look towards publicly funded hospitals for medical care, the financial strain on government hospitals and pharmacies will be severe, not only as a result of the sheer number of people seeking healthcare, but also because healthcare for HIV/AIDS patients is more expensive than for most other conditions. Antiretroviral treatment is the main type of treatment for HIV/AIDS. It is not a cure, but it can stop people from becoming ill for many years. The treatment consists of drugs that have to be taken every day for the rest of a patient's life. Antiretroviral treatment has complex and rigorous dosing requirements. The aim of antiretroviral treatment is to keep the amount of HIV/AIDS in the body at a low level. This stops any weakening of the immune system and allows it to recover from any damage that HIV/AIDS might have caused already. Medication compliance means taking the medications exactly as prescribed by the doctor for the amount of time intended. Medication noncompliance, on the other hand, means taking medications in any way other than what the doctor prescribed. While noncompliance may not seem like a big deal, it can have serious consequences. The challenge of optimizing adherence to anti-retroviral treatment remains paramount in the treatment of HIV/AIDS. The purpose of this study is to establish the cost of a patient defaulting anti-retroviral treatment per month, and to determine the financial and economic impact that defaulting patients has on General de la Rey and Thusong Hospital Complex Pharmacies. The study further aims to prove that the risk of patient defaulting is a barrier to achieve organisational excellence through healthcare delivery. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2009.

HIV/AIDS is the world's most urgent public health challenge. It is the leading cause of death for young adults worldwide. There is as yet no vaccine and no cure. The high unemployment rate and poverty experienced in South Africa contribute to the high HIV/AIDS infection levels experienced in the country. With the vast majority of HIV/AIDS cases and the growth in the number of people infected who will look towards publicly funded hospitals for medical care, the financial strain on government hospitals and pharmacies will be severe, not only as a result of the sheer number of people seeking healthcare, but also because healthcare for HIV/AIDS patients is more expensive than for most other conditions. Antiretroviral treatment is the main type of treatment for HIV/AIDS. It is not a cure, but it can stop people from becoming ill for many years. The treatment consists of drugs that have to be taken every day for the rest of a patient's life. Antiretroviral treatment has complex and rigorous dosing requirements. The aim of antiretroviral treatment is to keep the amount of HIV/AIDS in the body at a low level. This stops any weakening of the immune system and allows it to recover from any damage that HIV/AIDS might have caused already. Medication compliance means taking the medications exactly as prescribed by the doctor for the amount of time intended. Medication noncompliance, on the other hand, means taking medications in any way other than what the doctor prescribed. While noncompliance may not seem like a big deal, it can have serious consequences. The challenge of optimizing adherence to anti-retroviral treatment remains paramount in the treatment of HIV/AIDS. The purpose of this study is to establish the cost of a patient defaulting anti-retroviral treatment per month, and to determine the financial and economic impact that defaulting patients has on General de la Rey and Thusong Hospital Complex Pharmacies. The study further aims to prove that the risk of patient defaulting is a barrier to achieve organisational excellence through healthcare delivery. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2009.

1) Antecedentes y objetivos.En adultos, la interrupción del tratamiento antirretroviral(IPT) guiada por CD4+ incrementa de forma significativa el riesgo de enfermedades oportunistas o muerte; la experiencia en niños es escasa. El estudio pretende evaluar la seguridad de una IPT única, entendida como una forma de reducir la exposición a los antirretrovirales, en una población pediátrica con una respuesta prolongada óptima a TARGA de primera línea.2) Pacientes y métodosSerie de casos prospectiva, con grupo de comparación. Criterios de inclusión: a. infección VIH de transmisión vertical; b. TARGA de primera línea, iniciada durante la fase aguda de la infección VIH (grupo A) o la fase crónica (grupo B); y al menos durante los últimos 24 meses: c. ausencia de condiciones clínicas relacionadas con el VIH, d. carga viral indetectable (ARN-VIH) (para el grupo B), y e. recuento normal de la cifra de CD4+ (>350 cél./mm3) o el porcentaje (>25%).Se recluta un grupo de comparación (grupo C) de pacientes que cumplen los mismos criterios de inclusión para pacientes tratados en la fase crónica de la infección VIH, pero que no serán sometidos a una IPT.3) Resultados. IPT en la fase aguda de la infección VIH: Se incluyen 6 pacientes.Un mes tras la IPT, se observa un repunte de la carga viral plasmática (valorm mediano: 4.6 log copias/mL); la viremia se estabiliza posteriormente. Los pacientes han permanecido una mediana de 39 meses en IPT. Tres pacientes han reiniciado TARGA, dos debido a una inmunodepresión libre de síntomas, y uno por deseo de los padres. A pesar de la progresiva inmunodepresión, no se han hallado diferencias con respecto a la evolución clínica entre los periodos pre y post-IPT. Todos los pacientes que han reiniciado TARGA han tenido una respuesta virológica e inmunológica óptimas. IPT en la fase crónica de la infección VIH: Se incluyen 25 pacientes, de los cuales 12 se someten a una IPT. Un mes tras la IPT, se observa un repunte de la carga viral plasmática (valor mediano: 4.7 log copias/mL); la viremia se estabiliza posteriormente. Tres pacientes han reiniciado TARGA precozmente, entre 2 y 4 meses de la IPT, debido a una inmunodepresión libre de síntomas. El resto ha permanecido una mediana de 39 meses en IPT. A pesar de la progresiva inmunodepresión, no se han hallado diferencias en la evolución clínica con respecto al grupo de comparación. Otros dos pacientes han reiniciado TARGA tardíamente, debido a una inmunodepresión libre de síntomas. Todos los pacientes que han reiniciado TARGA han tenido una respuesta virológica e inmunológica óptimas.4) Conclusiones.Se ha observado una inmunodepresión progresiva tras la IPT en la población seleccionada de pacientes, aunque no se han producido eventos clínicos mayores. / 1) Background and Aims. In adults, CD4-guided planned treatment interruptions (PTI) significantly increase the risk of opportunistic disease or death; experience in children is still very scarce. We evaluate the safety of a single PTI, intended as a sparing regimen, in pediatric patients with long-term optimal response to first-line HAART.2) Patients and Methods.Interventional case series. Inclusion criteria: a. verticallytransmitted HIV infection; b. first-line HAART, initiated during acute infection (group A) or chronic infection (group B); and at least a 24-month period of: c. no HIV-relatedclinical conditions, d. undetectable plasmatic HIV-RNA (for group B), and e. normal CD4 cell count (>350 cells/mm3) or percentage (>25%). A comparison group (group C) of patients fulfilling the inclusion criteria for patients treated during chronic infection but not undergoing PTI was used.3) Results.PTI in acute HIV infection: 6 patients were included. One month after PTI, HIV viral load had increased (median value: 4.6 log copies/mL); viremia stabilized thereafter. The patients have remained off therapy a median time of 39 months.Three patients had to reinitiate HAART, two because of symptom-free immunosuppression and one because of parents' wish. Despite progressiveimmunosuppression, differences in clinical evolution were not observed with respect to the pre-PTI period, during HAART. In those patients resuming treatment, an optimal virological and immunological response was observed. PTI in chronic HIV infection: Twenty-five patients were included, 12 underwent PTI. One month afterPTI, HIV viral load had increased (median value: 4.7log copies/mL); viremia stabilized thereafter. Three girls had to resume therapy within 2-4 months because of symptom-free immunosuppression. The rest remained off therapy a median time of 39 months. Despite progressive immunosuppression, differences in clinical evolution were not observed with respect to the comparison group. Two additional girls had toreinitiate HAART. In those patients resuming treatment, an optimal virological andimmunological response was observed.4) Conclusions. Progressive immunosuppression was observed after a single PTI in selected HIV-infected children, although major clinical events did not occur.