Um grande número de medicamentos utilizados no tratamento contra o HIV agem procurando inibir a ação das proteínas transcriptase reversa e protease. Mutações existentes nas sequências dessas proteínas podem estar relacionadas à resistência aos medicamentos e podem prejudicar o desempenho de um tratamento. O estudo do genótipo dos vírus pode ajudar na tomada de escolhas específicas em tratamentos para cada indivíduo, tornando maiores a chance de sucesso. Com a maior acessibilidade a exames de genotipagem, uma grande quantidade de sequências do vírus está disponível, contendo um grande volume de informação. Padrões de ocorrência de mutações são exemplos de informações contidas nessas sequências e são importantes por estarem relacionados à resistência aos medicamentos. Um dos caminhos que pode ser capaz de nos levar ao entendimento desses padrões de mutações é a aplicação de técnicas de agrupamento e biclustering. Essas técnicas visam a geração de grupos ou biclusters que possuam dados com propriedades em comum. São empregadas em casos em que não há grande quantidade de informação prévia e existem poucas hipóteses sobre os dados. Assim, pode-se encontrar os padrões de mutações que ocorrem nessas sequências e tentar relacioná-los com a resistência aos medicamentos, utilizando métodos de agrupamento e bicluster em sequências de protease e transcriptase reversa. Existem alguns sistemas que tentam predizer a resistência ou susceptibilidade das sequências, porém, devido à grande complexidade dessa relação, ainda é necessário esclarecer o vínculo entre combinações de mutações e níveis de resistência fenotípica. Desta forma, a principal contribuição deste trabalho é o desenvolvimento de um framework baseado na aplicação dos algoritmos KMédias e Bimax às sequências de transcriptase reversa e protease de pacientes infectados com HIV, em uma codificação binária. O presente trabalho também introduz uma representação visual dos grupos e biclusters baseada em dados de microarranjos para casos em que se tem grandes volumes de dados, de forma a facilitar a visualização da informação extraída e a caracterização dos grupos e biclusters no domínio da doença. / Drugs used in HIV treatment intend to inhibit protease and reverse transcriptase. Mutations in the sequences of these proteins can be related to drug resistance and can reduce treatment efficacy. Studying virus genotype may help choosing specific treatments for each patient, increasing success probability. As genotyping tests become available, a great amount of virus sequences, which comprehend lots of information, are more accessible. Patterns of mutation are examples of information comprised in the sequences and are important since are related to drug resistance. One way that can lead to the understanding of these mutation patterns is the use of clustering and biclustering techniques. These techniques search for clusters or biclusters comprising data with similar attributes. They are used when there is not a lot of previous information and there are few hypothesis about the data. Therefore, it may be possible to find patterns of mutations in the sequences and to relate them to drug resistance using clustering and biclustering techniques with protease and reverse transcriptase sequences. There are a few systems that predict drug resistance according to the sequence of the virus, however, due to the complexity of the relationship, it is still necessary to elucidate the connection between mutation combinations and the level of phenotypic resistance. Accordingly, this work main contribution is the development of a framework based on Kmeans and Bimax algorithms with protease and reverse transcriptase sequences from HIV patients in a binary form. This work also presents a visual representation of the clusters and biclusters based on microarray data suitable for large data volumes, helping the visualization of information extracted from data and cluster and bicluster characterization in the disease domain.

Abstract Throughout history, many diseases have carried considerable stigma, including leprosy tuberculosis, cancer, mental illness and many STDs. Now HIV/AIDS is the topmost in the list of diseases that leads to devastating patient stigmatization. Despite international efforts to tackle HIV/AIDS, stigma and discrimination remain among the most poorly understood aspects of the epidemic. In the face of numerous intervention strategies, HIV/AIDS continues to spread and to pose a threat to the socio-economic transformation of South Africa. The broad objective of this study was to investigate how the stigmatisation of HIV-Positive women is made manifest and look at how successful the National Association of people living with HIV/AIDS (NAPWA) in South Africa has been in achieving their objectives and goals of changing the perceptions people have about HIV/AIDS and creating awareness about the debilitating effect stigmatisation has in the society, especially when it viciously targets HIV-positive women. A case study approach was used to examine the experiences of HIV/AIDS infected/affected women and NAPWA administrators. Methods used in the collection of data were self-administered questionnaires, participant observation and archival evidence in the form of documents. Through these methods, the study investigated ways in which the stigmatisation of HIV-positive women was made manifest, the role of NAPWA in fighting HIV/AIDS stigmatisation, how successful NAPWA has been in the fight against the stigmatisation of people infected and affected by HIV/AIDS in South Africa, challenges faced by NAPWA in the fight against HIV stigmatisation and discrimination, weaknesses of NAPWA and what impact all these have in the spread of HIV/AIDS. The research results show that HIV-positive women suffer stigmatisation and that; organisations of people living with HIV/AIDS (e.g. NAPWA-SA) play a major role in eradicating the stigma attached to HIV/AIDS. It also suggests that APWAs in effect help to reduce the spread of the disease and prolong the life span of those infected by it. All this not withstanding, the study also discovered that APWAs like NAPWA-SA need the support of government and stakeholders in South Africa to fully implement their strategies and programmes geared towards reducing stigma and the spread of HIV/AIDS.

MSc (Med), Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand / Three separate recent publications used genome-wide RNA interference (RNAi) to screen for novel host factors that are required for HIV-1 infection and replication. This was achieved using small interfering RNAs (siRNAs) to silence the expression of ~21 000 human genes and determining the effect of each gene’s loss of function on HIV-1 replication. Collectively, several hundred genes have now been implicated as novel HIV-1 host factors (termed HIV-1 Dependency Factors, HDFs). However, differences in study design resulted in little overlap and limited interpretive value from the three published datasets. To identify novel HDFs that are potential targets for anti-HIV therapy, five putative HDFs (SPTBN1, TMED2, KIAA1012, PRDM14 and SP110) were chosen for validation. RNAi effecters (both siRNAs and expressed short hairpin RNAs) were used to silence the selected genes. Gene suppression was measured by quantitative RT-PCR assay and two candidate genes were studied further (SPTBN1 and SP110) based on efficient mRNA inhibition (over 90%). As efforts to deliver the RNAi effecters to a T-cell line were unsuccessful, the effect of this knockdown on HIV-1 replication (both early- and late-stage) was assessed in cultured TZM-bl cells, a HeLa-derived cell line that expresses HIV-1 entry receptors and an integrated luciferase reporter for HIV-1 transcriptional activity (also used in the first genome-wide RNAi screen). An initial viral challenge assay with Subtype C-enveloped pseudovirus showed a 60% decrease in TZM-bl luciferase reporter activity in cells with suppressed SPTBN1 function, while knockdown of SP110 showed no effect on reporter activity. The final experiment, using fully-replicating Subtype B virus, showed a 75% decrease in late-stage viral replication when SPTBN1 expression was suppressed. In addition, SP110 suppression was confirmed to have no effect on TZM-bl reporter activity during any stage of HIV-1 replication. In conclusion, SPTBN1, but not SP110, is required for late-stage HIV-1 replication, though these results need to be confirmed in CD4+ T-cells. The absence of several important viral accessory factors from vi the virus used in the genome-wide screen may explain these findings and emphasises the need for using physiologically representative viral and cellular models to study the viral/cellular interactome.

HIV/AIDS is prevalent among adolescent youth in South Africa particularly among adolescent girls. Numerous efforts have been made to contain the pandemic through HIV prevention information in schools and through community and mass media campaigns, but all these efforts seem not to have an impact on the sexual behaviour of the youth. Reports from various studies concluded that although these programmes increase adolescents’ knowledge they have a minimal impact on their sexual behaviour. The current study explores perceptions of HIV/AIDS among a group of adolescent girls (between 14 and 19 years old) as well as the impact of these perceptions on their sexual practices and development. The results revealed that perceptions of HIV/AIDS appear to have an impact on adolescent girls’ sexual practices.

Department of Obstetrics and Gynaecology University of the Witwatersrand Johannesburg February 2015 A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Masters in Medicine, in the branch of Obstetrics and Gynaecology. / HIV accelerates the development of cervical cancer by up to15 years. South Africa is currently in the midst of an HIV epidemic. With limited facilities for colposcopy it is vital to identify risk factors within the HIV positive population resulting in positive margins after Large Loop Excision of the Transformation Zone (LLETZ) and persistence of cytological abnormalities on follow-up Pap smears. Objective: The primary objective was to determine the patient risk factors, pre and during colposcopy and LLETZ biopsy, which resulted in the histological involvement of margins of the LLETZ biopsy and persistent cervical dysplasia on follow-up Pap smears. Secondary objectives included determining follow up rate of patients at the clinic as well as the correlation between the original Pap smear cytology grade and the histological grade found on histology of the LLETZ biopsy. Methods: A retrospective review of the files of HIV seropositive patients was done at the colposcopy clinic at Charlotte Maxeke Johannesburg Academic Hospital after the roll out of antiretroviral treatment for the period 1 April 2004 to 31 October 2012. Patients with abnormal pap smears during this time were referred to the colposcopy clinic where a colposcopy and LLETZ biopsies were done. Demographic and clinical data in regards to age, gravidity, contraception, CD4 count, antiretroviral usage, and referral time was collected. Data from the clinical description of the colposcopy and histology of the LLETZ biopsy was also collected. Patients followed up again after 6 months when a repeat pap smear was done. The results of these Pap smears were also collected. Data was then analysed and variate and multivariate logistical regression was used to find statistically significant correlations. Results: A total of 480 files were found to have complete clinical records. One hundred and sixty eight (42.71%) patients had both endo and ectocervical margins clear. Predictive factors for the involvement of endocervical margins was the doctor performing the procedure (p-value <0.01) cytology of the original Pap smear (p value <0.01) and the grade of histological abnormality found at time of LLETZ (p-value <0.01). The statistically significant predictive factors for ectocervical margin involvement was the visualization of the transformation zone at colposcopy (p-value <0.01), the size of lesion found at colposcopy (p-value <0.01), the use of combined oral contraceptive pill (OCP) (p-value 0.02) and the histological grade of abnormality found on the LLETZ biopsy. Age, parity, CD4 count, use of antiretroviral drugs, length of time from Pap smear to colposcopy and use of contraception other than OCP were not found to be statistically significant in our sample population for the involvement of either endo or ectocervical margins. Statistically significant risk factors for the recurrence of intraepithelial lesions on follow up Pap smear was having both endo and ectocervical margin involvement on histology (p-value 0.01) The Ectocervical margin alone was found to have a p-value of <0.01. Abnormal cytology on follow up Pap smear was found in 58.69% of patients. The follow up rate at the clinic was 46.04%. Correlation of cytological grade and histological grade of cervical intraepithelial neoplasm in our sample population was found to be adequate (p-value <0.01). Conclusion: Incomplete incision of the intraepithelial lesion was found to be a significant risk factor for the recurrence of cytological abnormality in patients undergoing LLETZ biopsy. Identifying patients at increased risk for recurrence is important to ensure close follow up in this patient population.

The study explores pertinent issues around a comprehensive provision of antiretroviral drugs to HIV positive pregnant women in South Africa from a human rights perspective. Although these drugs have been proven to significantly reduce the transmission of HIV from a pregnant mother to her newborn baby/babies at birth, the South African government for over five years refused to roll them out in the public health sector. Reasons that were provided in this regard were multifaceted and have included claims regarding their alleged toxicity, potential side effects, huge cost, inadequate infrastructure, etc until March 2004 when it announced to start a national rollout program. It is in light of this that the study sets out to explore some of the key positions within the government and amongst activist groups on the health rights of HIV positive pregnant women, and how these different positions have evolved in response to each other. In particular, the paper aims at examining how discourses of human rights were employed, and how they have impacted on the Social Work discipline. It further focuses on developing a Social Work perspective on the human rights of HIV positive pregnant women in South Africa, thereby contributing to the discipline’s professional value base and body of knowledge, which inform, inter alia, its advocacy role and social action approach. The research project was embedded in a theoretical framework often referred to as ‘standpoint research’. An archival study of local and international literature and policy documents was conducted. This was complemented with a limited qualitative study. Semi-structured interviews were conducted with a purposive sample of five interviewees representing a cross-section of positions on the topic. This data was analyzed using a three step coding procedure that allowed for categorizing, connecting, and systematically relating the gathered data to each other and to the reviewed literature. The research findings indicate that the South African government’s absence of consistency and apparent lack of political will to rollout the drugs have contributed to the deterioration of the right of HIV positive pregnant women to access health care services. The role of civil society organizations in helping to realize, promote and protect the health and related human rights of this group is emphasized. It was also found that the different strategies employed to this end speak well to Social Work’s value base, and some of its methods and approaches to practice. Social Work is therefore well placed to join and support those efforts of other segments of civil society that have been investigated in this paper. The paper concludes by making recommendations towards, inter alia, the need for the South African government to adhere to the values enshrined in the country’s Constitution; to work closely and transparently with different organs of civil society; and simultaneously implement the said ARV rollout program while building and strengthening its infrastructural capacity. The various roles Social Work could, and should, assume with regards to improving the human rights of HIV positive pregnant women in this regard are also highlighted.

Thesis (Ph.D. (Virology))--University of the Witwatersrand, Faculty of Health Sciences, 2012 / The majority of HIV-1 infections around the world occur via sexual intercourse and women, especially in developing countries, are disproportionately affected. Recently a number of strategies have been proposed to control the spread of HIV, among these the use of microbicides to prevent the sexual transmission of the virus. A clinical trial of 1% tenofovir gel that conferred up to 39% protection provided a proof-of-concept that an anti-HIV microbicide is feasible. Various other compounds, acting at different stages of HIV-1 life cycle, are also being investigated as potential microbicides. These include the lectins Griffithsin (GRFT), cyanovirin-N (CV-N) and scytovirin (SVN). GRFT was isolated from the red algae griffithsia sp. while CV-N and SVN were isolated from the blue green alga Nostoc ellipsosporum and the cyanobacterium Scytonema varium, respectively. These lectins bind mannose-rich glycans found on the surface of HIV-1 envelope and act as entry inhibitors. Although HIV-1 subtype C is the main cause of infections around the world, almost all studies conducted with GRFT, CV-N and SVN are based on subtype B viruses. The Chapter Two sought to establish the neutralization sensitivity of HIV-1 subtype C viruses to the three lectins, using both a cell line and primary cells, and compared this sensitivity to subtype B. This Chapter also examined mannose-rich glycans on HIV-1 that are involved in GRFT, CV-N and SVN binding. The conclusion from this study was that the neutralization of subtype C viruses by these lectins is similar to subtype B and that the 234 and 295 mannose-rich glycans were involved in their interaction with the virus. In general these data supported further studies on the use of GRFT, CV-N and SVN for prevention of HIV-1 subtype C sexual transmission. In Chapter Three, the ability of GRFT to expose the CD4 binding site (CD4bs) on HIV-1 gp120 is explored. I found that this exposure resulted in the enhancement of HIV-1 binding to plates coated with anti-CD4bs antibodies b12 and b6 or the CD4 receptor mimetic CD4-IgG2. This lectin also synergized with b12 and HIVpositive plasma containing antibodies to the CD4bs to neutralize the virus. Furthermore, the glycan at position 386, which shields the CD4bs, was shown to be involved in both GRFT enhancement of HIV-1 binding to b12 and b6 and in the synergistic interaction between the lectin and these antibodies. The importance of this study is that it investigated in details the effect of GRFT binding on HIV-1 envelope and also suggests this lectin can be used in combination with anti-HIV-1 antibodies to synergistically enhance the anti-viral activity. In Chapter Four I investigated GRFT, CV-N and SVN inhibition of the virus binding to the DC-SIGN receptor and their inhibition of the DCSIGN transfer of HIV-1 to target cells. These lectins only moderately inhibited the virus binding to the receptor while they potently inhibited its transfer to target cells. However, the inhibition of transfer was stronger when the virus bound the lectins after binding the DC-SIGN receptor compared to when it bound the lectins prior to binding the receptor. These three lectins can, therefore, inhibit the sexual transmission of HIV-1 since the DCSIGN- mediated transfer of the virus to susceptible cells is pivotal to this mode of transmission. Chapter Five is an investigation of the ability of HIV-1 subtype C to escape GRFT, CV-N and SVN, which involved growing the virus under escalating concentrations of these compounds. This was to know how this virus behaves under conditions of continuous exposure to the lectins. I found that HIV-1 subtype C became increasingly resistant to the lectins and viral envelope sequence analysis showed that this was associated with the deletion of mannose-rich glycans on gp120. Furthermore, of the 11 potential mannose-rich glycosylation sites on gp120 seven (230, 234, 241, 289, 339, 392 and 448) were involved in GRFT, CV-N and SVN resistance. Thus, the conclusion was that although these three lectins are potent inhibitors of HIV-1 infection, the virus is also able to escape their neutralization by deleting mannose-rich glycans on its envelope. However, the fact that escape to these lectins involved multiple deglycosylation and was only partial suggests that HIV-1 subtype C escape from GRFT, CV-N and SVN in a microbicide formulation may not be an easy process. We discuss the implications of these findings in Chapter Six and suggest future studies that could complement data presented in this thesis. Overall our data show that GRFT, CV-N and SVN can prevent the sexual transmission of both free and DC-SIGN associated HIV-1 particles and supports further development of these lectins as microbicides against HIV-1.

Introdução: A infecção pelo HIV associada com o adoecimento por tuberculose influencia na dinâmica de ambas patologias.Objetivo: Avaliar a prevalência e fatores associados da coinfecção HIV/tuberculose em indivíduos com tuberculose no período de 2003 a 2011, notificados no município de Ribeirão Preto - SP. Metodologia: Trata-se de um estudo descritivo, transversal, retrospectivo; tendo como sujeito todos os indivíduos com a coinfecção HIV/tuberculose, residentes no município de Ribeirão Preto, que foram diagnosticados, e tiveram seu caso notificado e cadastrado no programa TBweb. Os dados foram obtidos inicialmente a partir do Sistema de Informações para tuberculose no Estado de São Paulo, TBweb. Após a seleção, foi realizado a técnica de \"linkage\" entre os bancos de dados SINAN, SISCEL e SICLOM que contem informações do HIV/aids. Os dados foram analisados por meio do programa Statistical Package for the Social Sciences (SPSS), versão 17.0 for Windows, utilizando-se estatística descritiva, teste qui- quadrado e Odds Ratio. Resultados: Dos 1.277 indivíduos com tuberculose cadastrados no TBweb entre 2003 e 2011, 338 apresentavam a coinfecção HIV/tuberculose, mostrando uma prevalência de 26,5%. Em relação às características demográficas, 244 (72,2%) eram do sexo masculino, a faixa etária predominante foi de 35 a 44 anos (45,0%). Quanto à raça/cor, 151 (44,7%) eram branca. Quanto ao tipo de caso, 308 (91,1%) dos casos eram novos. Referente ao encerramento do caso, a maioria dos indivíduos (58,9%) com a coinfecção HIV/tuberculose obteve cura. A forma clínica mais encontrada foi a pulmonar em 201 (59,5%) casos, seguida pela extrapulmonar em 90 (26,6%) indivíduos. No que diz respeito à identificação de qual doença foi notificada em primeiro lugar, evidenciou- se que a maioria 246 (72,8%) teve o registro do caso de HIV/aids antes de ter a notificação de tuberculose. Com relação à contagem de linfócitos TCD4+, 189 (55,9%) apresentaram taxas menores que 200 células/mm³ de sangue, 201 (59,5%) faziam uso de terapia antirretroviral e 102 (30,2%) apresentaram carga viral entre 1.001 e 100.000 cópias. Conclusão: A prevalência de indivíduos coinfectados foi de 26,5% taxa superior a nacional, sendo a maioria do sexo masculino, com faixa etária predominante em idade produtiva, com baixa contagem de linfócitos TCD4+, com o diagnóstico do HIV/aids anterior ao de tuberculose, evidenciando a necessidade de mais ações voltadas para a prevenção de ambas as doenças / Introduction: HIV infection associated with tuberculosis affects the dynamics of both pathologies. Objective: To assess the prevalence and factors associated with HIV/tuberculosis co-infection in individuals with tuberculosis between 2003 and 2011, registered in the municipality of Ribeirão Preto - SP. Methodology: This is a descriptive, cross-sectional, retrospective study; the subjects were all individuals with HIV/tuberculosis co-infection, residents of the municipality of Ribeirão Preto, who had been diagnosed, notified and registered in the TBweb program, the tuberculosis information system of the state of São Paulo. Data were initially obtained from TBweb. After the selection, the database was created using the linkage technique between the TBweb, SINAN, SISCEL and SICLOM databases, which contain information on HIV/Aids. Data were analyzed by means of the Statistical Package for the Social Sciences (SPSS), version 17.0 for Windows, using descriptive statistics, chi-square test and Odds Ratio. Results: Out of the 1277 individuals with tuberculosis registered in the TBweb between 2003 and 2011, 338 presented HIV/tuberculosis co-infection, showing a prevalence of 26.5%. Regarding demographic characteristics, 244 (72.2%) were male and the predominant age range was between 35 and 44 years (45.0%). As for race/skin color, 151 (44.7%) were Caucasian. A total of 308 (91.1%) cases were new. Regarding the outcome of the case, most of the individuals (58.9%) with the HIV/tuberculosis co-infection were cured. Pulmonary tuberculosis was the most common clinical form of the disease, found in 201 (59.5%) cases, followed by extrapulmonary tuberculosis in 90 (26.6%) individuals. With regard to the identification of which disease was notified first, most cases, 246 (72.8%), had records of the HIV/aids case prior to the notification of tuberculosis. A total of 189 (55.9%) individuals had a CD4-Positive T-Lymphocyte count lower than 200 cells/mm³ of blood, 201 (59.5%) followed antiretroviral therapy and 102 (30.2%) had a viral load between 1,001 and 100,000 copies. Conclusion: The prevalence of co-infected individuals was 26.5%, which is above the national rate. Most individuals were male, in a productive age and had a low CD4-Positive T- Lymphocyte count, with a prior diagnosis of HIV/aids to that of tuberculosis, evidencing the need for more actions aimed at the prevention of both diseases

Efeitos colaterais têm sido associados à terapia anti-retroviral em portadores da infecção pelo HIV. Entre esses, destaca-se a a síndrome da lipodistrofia, caracterizada por hiperlipidemia e lipodistrofia. A lipodistrofia é manifestada por alterações na forma do corpo, com aumento progressivo da circunferência abdominal e torácica, aparecimento de gordura dorsocervical com expansão da circunferência do pescoço; e lipoatrofia, com perda de tecido adiposo na face, nas nádegas e nos membros superiores e inferiores. O presente estudo, seccional e descritivo, realizado com 84 pacientes atendidos em um ambulatório de dislipidemias específico para os portadores do HIV, abordou, através da técnica do auto-relato, a ocorrência da lipodistrofia e as principais repercussões relacionadas ao seu aparecimento. Dos 84 pacientes, 40 (47,61%) apresentavam alterações corporais. Para 65,00% deles, as alterações na sua aparência física constituem uma \"marca registrada\", capaz de revelar a soropositividade para infecção pelo HIV, o que acarreta sérias conseqüências para sua saúde afetivo-emocional. Além da lipodistrofia, as alterações metabólicas, que incluem as dislipidemias estão associadas ao risco elevado para o surgimento de doenças coronarianas. Do total de pacientes avaliados, 8 (9,52%) deles eram hipertensos, 1 (1,19%) relatou infarto agudo do miocárdio e 1 (1,19%) acidente vascular cerebral após ter iniciado a terapia anti-retroviral. Os achados deste estudo reforçam a relevância da temática, e ressaltam a necessidade de novos estudos com uma abordagem não somente dos parâmetros biológicos da síndrome da lipodistrofia, mas também do seu impacto psicossocial, fornecendo subsídios para a integralidade e qualidade da assistência de enfermagem prestada a esses pacientes. / Collateral effects have being connected to anti-retroviral therapy in patients with HIV infection. Among them, we observe the lipodystrophy syndrome that is characterized by hyperlipidemia and lipodystrophy. The lipodystrophy is manifested by alterations in the body shape, with the progressive enlargement of abdominal and chest perimeter, the appearing of dorsocervical fat with expansion of the neck perimeter; and the lipoatrophy, with loss of fat tissue on the face, on the buttocks and in the superior and inferior members. This research, sectional and speech, done in 84 patients in an ambulatory specialized for HIV patients, approached through the auto-telling technique, the occurrence of lipodystrophy and its main repercussions related to its appearance. From these 84 patients, 40 (47,61%) show body alterations. For 65,00% of them, the alterations in their physical appearance constitute a \"stigma\", able to reveal the HIV-positive to the HIV infection, that leads serious consequences to their affective-emotional health. Besides the lipodystrophy, the metabolically alterations, that includes the dislipidemias are associated the high risk of coronaries diseases. The total of evaluated patients, 8 (9,52%) of them were hypertense, 1 (1,19%) showed acute infarct of myocardium and 1 (1,19%) had a stroke after had initiated an anti-retroviral therapy. The results found in this research reinforce the relevance of the thematic, and show up the need of new studies with an approach of the biological parameters of the lipodystrophy syndrome, but its psychosocial impact as well, giving support for its integrality and quality of the nursing assistance given to these patients.

Com a introdução de uma nova classe de antiretrovirais integrantes da terapia anti-retroviral altamente ativa (HAART) para o tratamento das infecções pelo vírus da imunodeficiência humana, começaram a ser descritos inúmeros efeitos secundários.Na tentativa de se estabelecer um modelo animal para o estudo destes efeitos buscou-se uma espécie com similaridade no perfil e metabolismo lipídico. Iniciou-se estudo em Mesocricetus auratus. Foram avaliados o perfil lipídico e glicêmico,função hepática e renal, níveis de auto-anticorpos anti ox-LDL, perfil eletrocardiográfico, alterações histopatológicas renais e cardíacas nos animais sob dieta hiperlipídica e normal,tratados com Indinavir, inibidor de protease utilizado na HAART. Observou-se uma diminuição da sobrevida nos animais tratados com indinavir, aumento do nível sérico de triglicérides e glicose, redução de auto-anticorpos anti ox-LDL,aumento do segmento QRS no eletrocardiograma, presença de fibrose renal e cardíaca, hipercelularidade glomerular nos animais tratados com a droga com ou sem dieta hiperlipídica quando comparados com os controles. Concluimos que Mesocricetus auratus se apresenta como um bom modelo para o desvendamento dos mecanismos patológicos observados na HAART. / With the introduction of a new antiretroviral class use, integrants of highly active anti-retroviral therapy (HAART) for the treatment of infections by human immunodeficiency virus, several side effects started to be described.To establish an animal model for the study of these side effects, was chosen specie that have similarities in the lipidic profile and metabolism. A study in Mesocricetus auratus was started. It was evaluated the lipidic and glicemic profile ,hepatic and renal function, the levels of auto-antibodies against ox-LDL, electrocardiographic profile and renal and cardiac histopathological alterations in these animals under hyperlipidic and normal diets,treated with Indinavir, a protease inhibitor used in HAART.It was observed a decrease in the survival rate in the animals treated with Indinavir; an increase of the triglycerides and glucose serum level; reduction of anti ox-LDL auto-antibodies; increased QRS segment in the electrocardiogram; presence of renal and cardiac fibrosis; glomerular hypercellularity in the animals treated with the drug, with or without hyperlipidic diet when compared with the controls. We conclude that the Mesocricetus auratus is a good model for disclosure of the pathological mechanisms generated by HAART.