Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2007. / Härtill 4 uppsatser.

Thematic Paper (M.C.T.M. (Clinical Tropical Medicine))--Mahidol University, 2006. / LICL has E-Thesis 0011 ; please contact computer services. LIRV has E-Thesis 0011 ; please contact circulation services.

Thematic Paper (M.C.T.M. (Clinical Tropical Medicine))--Mahidol University, 2007. / LICL has E-Thesis 0024 ; please contact computer services. LIRV has E-Thesis 0024 ; please contact circulation services.

Thesis (D.P.H.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed on June 25, 2009). Includes bibliographical references.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / Background and objectives: An understanding of the effect of HAART on different aspects of health, including nutritional status, of HIV-infected individuals in South Africa is needed to ensure that appropriate population-specific guidelines and policies can be developed. This study aimed to investigate the impact of HAART on nutritional status, focusing on changes in anthropometric measures, and to explore the relationship between these measures and immunological and virological response to HAART. Methods: A prospective study of 30 adult females was carried out at a clinic in Cato Manor, KwaZulu-Natal. Anthropometric measurements, including weight, mid-upper arm circumference (MUAC), waist circumference, hip circumference, body mass index (BMI) and waist-to-hip ratio (WHR), were performed at baseline and 12 and 24 weeks after commencing HAART. Laboratory values, including CD4 lymphocyte count, viral load, albumin and haemoglobin as well as bioelectrical impedance analysis data, including lean body mass (LBM), fat mass (FM) and body fat percentage (BF%), were collected at baseline and after 24 weeks on HAART. Results: Overall, there was a statistically significant increase in all anthropometric measures, except WHR and LBM. The mean weight change was 3.4±5.8kg (p=0.006). Fifty percent of the subjects had a BMI above normal at baseline and mean BMI increased from 25.6±5.7kg/m2 to 27.3±5.6kg/m2 (p=0.007). Seventy percent of subjects gained weight, 18.5% had a stable weight and 11.1% lost weight. The weight gain in most subjects was attributable to a gain in FM while in subjects who lost weight, the loss consisted mainly of LBM. Some patients with stable body weight experienced changes in the relative proportions of fat and lean mass. Six patients showed evidence of disproportionate gains and losses in body circumference measurements which may be indicative of fat redistribution. Subjects with lower CD4 lymphocyte counts experienced greater increases in weight, BMI, FM and BF%. The strongest correlation was observed with FM (rs=-0.53; p=0.00). Greater increases in weight, BMI, MUAC, waist circumference, hip circumference, FM and BF% were seen in those with lower baseline haemoglobin. Baseline viral load and albumin did not correlate significantly with changes in any anthropometric variables. Change in CD4 count was only significantly associated with baseline MUAC (rs=0.40; p=0.04). Change in viral load was significantly correlated with baseline weight, LBM, FM, BF% and MUAC with the strongest correlation being with weight (rs=0.44; p=0.01). No significant association was found between anthropometric changes and changes in CD4 count and viral load between baseline and the 24-week visit. Conclusion: Overall, subjects experienced a significant increase in most anthropometric measures. There appears to be a relationship between some anthropometric and laboratory measures but this needs clarification. The findings of this study demonstrate the value of including circumference measurements and body composition techniques as part of nutritional status assessment and demonstrate the need for studies to determine the prevalence and significance of overweight and obesity in the HIV-infected population. Research is needed to determine the best methods of bringing about the most favourable anthropometric changes to enhance the health of patients on HAART.

Thesis (MNutr)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Introduction A paucity of data exists regarding growth patterns and nutrition-related problems in infants (<12 months) on antiretroviral treatment (ART) and the infant feeding knowledge, beliefs, attitude and practices of their caregivers. Aim To describe the growth and nutrition-related problems of infants (<12 months) attending the Antiretroviral (ARV) clinic at Red Cross Children’s Hospital, as well as the knowledge, attitudes, beliefs and practices of their caregivers concerning infant feeding. Methods A cross-sectional, descriptive study was conducted with census sampling. Thirty infants and 31 caregivers were included in the sample. Anthropometric measurements were performed and interviewer-administered questionnaires were utilised to obtain the knowledge, attitude, beliefs and practices of the caregivers. The mean Z-score of each measurement as well as the weight-for-age, length-for-age, weight-forlength and bodymass index-for-age for each infant were determined, analysed, interpreted and described according to the World Health Organisation (WHO) growth standards for children. Results Thirty-nine percent (n=11) of the mothers (n=28) did not receive infant feeding counselling prior to delivery, while only 9 (32%) received the minimum number of at least 4 sessions, as prescribed by the Department of Health. It was not assessed whether the counselling occurred before delivery. The mean age of the infants was 6.9 (SD 3.3) months. Eighty-three percent (n=25) had an opportunistic infection prior to data collection. Twenty-three percent (n=7) were underweight-forage and 40% (n=12) of the infants were stunted. Vomiting and diarrhoea were the most common nutrition-related problems experienced. A statistical significant positive correlation (p=0.003) was found between an infant’s duration on ART and W/A z-score. Only two caregivers were breastfeeding at the time of data collection, but 34% (n=10) of the other caregivers had at some stage breastfed their infant. Formula feeding practices were poor. Sixty-two percent (n=18) were not preparing the feeds correctly and only six (21%) were correctly cleaning and sterilising the bottles. Thirty-nine percent (n=11) of the infants were not receiving an adequate amount of milk per day. Sixty-five percent (n=11) of the infants (>six months) did not receive a diet the previous day which met the minimum WHO dietary diversity indicator and only 18% (n=3) received a minimum acceptable diet. Caregivers had an average knowledge concerning infant feeding. Thirteen percent (n=4) knew the correct definition of exclusive breast- or formula feeding. Sixty-eight percent (n=21) did not know what mixed feeding meant, or the dangers associated with it. Most caregivers (n=25, 81%) knew that oral rehydration solution had to be given when infants developed diarrhoea, but only 48% (n=15) knew how to prepare it and only 6% (n=2) knew how to administer it. Seventy-five percent (n=9) of caregivers did not know what should be done when experiencing breast problems. Sixty-four percent (n=19) of the caregivers believed that if a HIV-positive woman breastfeeds she would definitely transmit HIV to her infant. Conclusion The infant sample showed a variety of erratic growth patterns with a high prevalence of underweight and stunting. Infant feeding knowledge of caregivers was average, but not deemed sufficient to translate into appropriate, safe and optimal infant feeding practices. The breastfeeding prevalence was low. Formula preparation, feeding and hygiene practices were poor and dietary intake of infants was not optimal. The quality and quantity of HIV infant feeding counselling sessions received at antenatal clinic visits were poor and need to be addressed. / AFRIKAANSE OPSOMMING: Inleiding Daar is 'n tekort aan data oor groeipatrone en voedingsverwante probleme by babas (<12 maande) op antiretrovirale behandeling asook die babavoedingkennis, -oortuigings, -houdings en -praktyke van hul versorgers. Doelwit Om ondersoek in te stel na die groei- en voedingsverwante probleme by babas (<12 maande) in die antiretrovirale kliniek by Rooikruis-kinderhospitaal, sowel as die babavoedingkennis, - oortuigings, -houdings en -praktyke van hul versorgers. Metodes 'n Beskrywende dwarssnitstudie is met sensussteekproefneming onderneem. Dertig babas en 31 versorgers is by die steekproef ingesluit. Antropometriese metings was gedoen en onderhoude was met behulp van vraelyste gevoer ten einde inligting oor die versorgers se kennis, houdings, oortuigings en praktyke te bekom. Elke baba se gemiddelde z-telling per meting sowel as die gewig-vir-ouderdom, lengte-vir-ouderdom en liggaamsmassa-indeks-vir-ouderdom was volgens die Wêreldgesondheidsorganisasie (WGO) se groeistandaarde vir kindersbepaal, ontleed, vertolk en beskryf. Resultate Altesaam 39% (n=11) van die moeders (n=28) het nie voor die bevalling voorligting oor babavoeding ontvang nie, terwyl slegs 9 (32%) die Departement van Gesondheid se voorgeskrewe minimum 4 sessies, deurloop het. Dit was nie bepaal of hierdie sessies voor die bevalling ontvang was nie. Die gemiddelde ouderdom van die babas was 6,9 (standaardafwyking 3,3) maande. 'n Totaal van 83% (n=25) het voor data-insameling 'n opportunistiese infeksie gehad, 23% (n=7) was ondergewig-vir-ouderdom, en 40% (n=12) van die babas se lengtegroei was ingekort. Die algemeenste voedingsverwante probleme was braking en diarree. Daar blyk 'n statisties beduidende positiewe korrelasie (p=0.003) te wees tussen die duur van die baba se antiretrovirale behandeling en sy/haar gewig-vir-ouderdom-z-telling. Slegs twee versorgers het hul babas ten tyde van die studie geborsvoed, hoewel 34% (n=10) van die versorgers in 'n stadium geborsvoed het. Voedingspraktyke met die gee van melkformule was swak. Altesaam 62% (n=18) het die melkformule verkeerd aangemaak en slegs ses (21%) het die bottels behoorlik skoongemaak en gesteriliseer. Nege-en-dertig persent (n=11) van die babas het te min melk per dag ontvang. Vyf-en-sestig persent (n=11) van die babas (>6 maande) se melkinname die vorige dag het nie aan die minimum WGO aanbevole dieetdiversiteitsaanwyser voldoen nie, en slegs 18% (n=3) het 'n minimum aanvaarbare dieet gevolg. Versorgers se kennis ten opsigte van babavoeding was gemiddeld, met net 13% (n=4) wat die korrekte omskrywing van eksklusiewe bors- of formulevoeding geken het. 'n Totaal van 68% (n=21) het nie geweet wat gemengde voeding beteken of watter gevare dit inhou nie. Die meeste versorgers (n=25, 81%) het geweet dat orale rehidrasie oplossing toegedien moet word wanneer babas aan diarree ly, maar slegs 48% (n=15) het geweet hoe om dit aan te maak en 'n skrale 6% (n=2) hoe om dit toe te dien. Vyf-en-sewentig persent (n=9) van die versorgers het nie geweet wat om te doen as hulle probleme met hul borste ervaar nie. Altesaam 64% (n=19) van die versorgers het geglo dat 'n MIV-positiewe vrou definitief haar baba MIV sal gee indien sy hom/haar sou borsvoed. Samevatting Die steekproef babas het 'n verskeidenheid onreëlmatige groeipatrone getoon en baie was ondergewig of het ook dwerggroei getoon. Versorgers se kennis van babavoeding was gemiddeld, maar nie voldoende om tot toepaslike, veilige en optimale babavoedingspraktyke aanleiding te gee nie. Die voorkoms van borsvoeding was laag. Melkformulevoorbereiding, - voeding en -higiëne was swak, en babas se voedinginname was nie ideaal nie. Die gehalte van en hoeveelheid voorligting oor MIV-babavoeding met besoeke aan voorgeboorteklinieke was swak en moet aangespreek word.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / This systematic review and meta-analysis tries to determine whether there is an association between the use of protease inhibitors (PIs) and the incidence of diabetes mellitus (DM) and/or metabolic syndrome (MS) in HIV-infected patients. A systematic literature search was performed using MEDLINE/PubMed, CENTRAL, LILACS, and EMBASE. Included articles were observational studies published on or prior to November 2015 that met specific inclusion criteria. Pooled relative risks (RRs) and hazard ratios (HRs) were calculated. Nine articles met the inclusion criteria, describing 13,742 HIV patients. Use of PIs was associated with the development of MS (RR: 2.11; 95% CI 1.28–3.48; p-value 0.003). No association between the use of PIs and development of DM was found: the HR for the incidence of DM among patients using PIs was 1.23 (95% CI 0.66–2.30; p-value: 0.51) and the RR was 1.25 (95% CI 0.99–1.58; p-value 0.06). Use of PIs in HIV-infected patients is associated with an increased risk of MS. No evidence of an increased risk of DM was found. However, because MS is a precursor to DM, it is possible that studies with a longer follow-up duration are needed in order to detect an association between PI use and onset of DM. / First, we would like to thank our families for all their support. Second, we would like to thank the Universidad Peruana de Ciencias Aplicadas, the Health Sciences Department, and the School of Medicine for their support and for all the tools they have provided throughout this process. Finally, we want to thanks to Dr Gwenyth O. Lee and Dr Daniela E. Kirwan for their comments. / Revisión por pares

Considerando a infecção pelo HIV uma condição crônica e de alta prevalência no ambiente carcerário, este estudo objetivou analisar os desafios relacionados à regularidade no uso da terapia antirretroviral (TARV) pelas pessoas vivendo com HIV em unidades prisionais (UP) da região de Ribeirão Preto (RP), São Paulo. Tratase de um estudo descritivo, do tipo inquérito. Foram incluídos indivíduos reclusos há mais de seis meses, com diagnóstico de HIV e em uso de TARV. Utilizou-se um banco de dados contendo variáveis sociodemográficas, clínicas e de acompanhamento dos casos; adesão à TARV e ações desenvolvidas pelas equipes de saúde das UP para o monitoramento da ingestão medicamentosa. Os dados foram analisados por meio de técnicas descritivas e testes de associação (Quiquadrado e Exato de Fisher). Identificou-se 67 indivíduos em uso de TARV, dos quais, 80,6% cumpriam pena em regime fechado e 38,8% possuíam de dois a cinco anos de clausura. Houve o predomínio de homens (79,1%); 25 a 39 anos (52,2%); não brancos (64,2%); solteiros (47,8%); ensino fundamental I e II (67,1%); possuíam profissão (88,1%) e ganhavam de um a três salários mínimos (50,7%) antes da reclusão. Quanto ao perfil clínico e de acompanhamento: 44,8% diagnosticaram HIV na prisão; 86,6% faziam acompanhamento em serviço de assistência especializada em HIV (SAE); 41,7% interromperam o tratamento em algum momento; 31,3% possuíam TCD4+ acima de 500 cópias e em 62,7% a carga viral era indetectável. Identificou-se o uso de drogas ilícitas (71,6%) e lícitas (80%) prévias ao encarceramento. Em relação ao atraso na entrega da TARV, 70,3% referiram nunca ou quase nunca ocorrer tal situação; 42,2% referiram nunca ou quase nunca perderem consultas nos SAE; 79,1% informaram que nunca ou quase nunca recebem os resultados dos exames laboratoriais processados fora das UP. Sobre o questionamento acerca do uso da TARV nos últimos sete dias: 76,1% tomaram medicamentos fora do horário; 80,6% deixaram de tomar medicamentos; 91% tomaram menos ou mais compridos. Em 58,2% dos casos houve retirada regular da TARV junto às unidades dispensadoras de medicamentos situadas na rede pública de saúde de Ribeirão Preto. Quanto às ações desenvolvidas dentro das UP voltadas ao monitoramento da TARV, considerou-se regular apenas o questionamento sobre o uso contínuo dos medicamentos, sendo que as demais foram insatisfatórias. A adesão à TARV apresentou associação estatisticamente significante com o sexo feminino (p=0,028); o uso de drogas lícitas (p=0,006) e a interrupção do acompanhamento médico (p=0,014) estiveram associadas à não adesão. Os achados deste estudo permitem refletir sobre a complexidade da assistência prestada às pessoas que vivem com HIV/aids no ambiente prisional, principalmente no que tange o monitoramento do uso da TARV, sinalizando a necessidade de desenvolvimento e incorporação de estratégias de intervenção que qualifiquem a produção do cuidado em saúde na perspectiva integral e resolutiva, capaz de produzir impactos condizentes com os desafios que perpassam a prevenção e o manejo do HIV / Considering that the HIV/aids infection constitutes a chronic condition with high prevalence in prisons, this study aimed to analyze the challenges related to regularity in the use of antiretroviral therapy (ART) by people living with HIV in prisons (UP) in the region of Ribeirão Preto (PR), São Paulo. This is a descriptive, inquiry-type study. We included individuals who had been incarcerated for more than six months, diagnosed with HIV/aids and using ART. We used a database containing sociodemographic and clinical information and variables on the case follow-up, ART adherence and actions developed by PU health teams to monitor drug intake. Data were analyzed using descriptive techniques and association tests (Chi-square and Fisher\'s Exact). A total of 67 individuals using ART were identified, of whom 80.6% were in closed regime and 38.8% had two to five years of incarceration. There was a predominance of men (79.1%); 25 to 39 years old (52.2%); non-white (64.2%); single (47.8%); elementary education I and II (67.1%); having a profession (88.1%) and earning one to three minimum wages (50.7%) before incarceration. In regard of the clinical and follow-up profile: 44.8% had HIV diagnosed in prison; 86.6% were attending a specialized HIV care service (SAE); 41.7% discontinued treatment at some point of time; 31.3% had TCD4+ over 500 copies and in 62.7% of participants the viral load was undetectable. The use of illicit drugs (71.6%) and licit drugs (80%) prior to incarceration was also identified. Regarding delays in ART delivery, 70.3% reported that a delayed delivery never or almost never occurred; 42.2% reported that they never or almost never miss appointments in SAE; 79.1% reported that they never or almost never receive the results of laboratory tests processed outside the PU. Regarding the use of ART in the last seven days: 76.1% took medicines outside medication time; 80.6% stopped taking medicines; 91% took a higher or a lower dosage. In 58.2% of the cases, the withdrawal of ART from the drug dispensing units located in the public health network of RP was regular. Regarding the actions developed within the PUs aimed at ART monitoring, the questioning about the continuous use of the drugs was assessed as regular and the others were unsatisfactory. Adherence to ART had a statistically significant association with woman (p = 0.028). The use of licit drugs (p = 0.006) and interruption of medical follow-up (p = 0.014) were associated with non-adherence. The findings of this study allow us to reflect on the complexity of care provided to people living with HIV/aids in prisons, especially regarding the monitoring of ART, suggesting the need for development and incorporation of strategies that qualify the health care delivery towards an integral and resolutive perspective, capable of producing impacts that are consistent with the challenges of HIV prevention and management

Submitted by Haroudo Xavier Filho (haroudo.xavierfo@ufpe.br) on 2016-03-22T18:32:27Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Neyla Alves_Versão digital.pdf: 1629049 bytes, checksum: aa72b7e3881142a178e5534aa4064d95 (MD5) / Made available in DSpace on 2016-03-22T18:32:27Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Neyla Alves_Versão digital.pdf: 1629049 bytes, checksum: aa72b7e3881142a178e5534aa4064d95 (MD5) Previous issue date: 2015-03-02 / CAPES / CNPq / HIV/aids (Vírus da Imunodeficiência Humana/aids) é considerado uma pandemia, envolvendo mais de 70 milhões de infecções e 35 milhões de mortes desde o primeiro relato na década de 80. O HIV tipo 1 (HIV-1) infecta principalmente linfócitos T CD4+ e linhagens de macrófagos, tendo sua patogenicidade definida pela depleção de LT CD4+. Além disso, a condição de infecção por HIV-1 é bastante complexa e dependente de diversos fatores relacionados à variabilidade dos indivíduos no que diz respeito à suscetibilidade à infecção e à progressão para a aids, sendo observada a ativação imunológica generalizada. Envolvida na modulação das respostas imunes inata e adaptativa encontra-se a vitamina D, que desempenha papel no metabolismo mineral e apresenta efeito pleiotrópico no crescimento e diferenciação celulares. Seus efeitos imunológicos são dados a partir da ligação com o receptor de vitamina D (VDR) de diversas células, regulando a liberação de citocinas, a função e proliferação de linfócitos T e a produção de peptídeos antimicrobianos como a catelicidina. O VDR atua modulando a ação dessa vitamina induzindo a resposta imune local e variações genéticas presentes no gene codificador do VDR podem levar à diminuição de sua atividade e, consequentemente, ao prejuízo para o papel da vitamina D. Nos indivíduos infectados pelo HIV, os níveis de deficiência dessa vitamina são altos e fatores como raça, insuficiência renal, pouca exposição à luz ultravioleta e exposição as drogas anti-HIV, como o Efavirenz, estão associados a essa deficiência, respectivamente, sendo determinantes para a susceptibilidade à infecção pelo HIV e a predição da progressão da doença. Sendo assim, neste trabalho foram estudados seis polimorfismos de base única (SNPs) (rs3890733, rs476048, rs1540339, rs2248098, rs2228570 e rs11568820) presentes no gene do receptor de vitamina D (VDR) e sua influência na resposta dos pacientes à Terapia Antirretroviral (TARV). Foram recrutados 107 pacientes acompanhados e tratados no Hospital Dia do Instituto de Medicina Integral Professor Fernando Figueira (IMIP), subdivididos em quatro grupos: I- Sucesso Terapêutico, II- Falha Terapêutica, III- Sucesso Imunológico, IV- Falha Imunológica, e analisadas variáveis clínicas e epidemiológicas, como gênero, idade, peso e etnia. Não foram observadas associações estatísticas nas análises isoladas entre os polimorfismos dos genes do VDR com a falha virológica ou a resposta imunológica. Porém, nas análises multivariadas, o genótipo C/C do rs1540339 mostrou-se associado com o gênero no sucesso virológico (OR=0,08, p=0,04). Em adição, a análise envolvendo peso, etnia e gênero e o rs3890733 mostrou associação com a resposta imunológica para os genótipos C/C e T/T no modelo sobredominante (OR=0,21, p=0,024). Os resultados indicam a importância do receptor de vitamina D em infecções por HIV-1 e poderão contribuir para o entendimento da variabilidade das respostas dos pacientes à TARV. / HIV/aids (Human Immunodeficiency Virus/aids) is considered a pandemic, involving more than 70 million infections and 35 million deaths since the first report in the 80’s. HIV type 1 (HIV-1) infects mainly T lymphocytes CD4 + and macrophage lineages, and their pathogenicity is defined by the depletion of CD4 +. Furthermore, the condition of HIV- 1 infection is very complex and dependent on many factors related to the individual variability, regarding the susceptibility to infection and progression to AIDS, generalized immune activation being observed. Involved in the modulation of innate and adaptive immune responses is vitamin D, which plays a role in mineral metabolism and has pleiotropic effects on cell growth and differentiation. Their immune effects are data from binding to the vitamin D receptor (VDR) in various cells, regulating the release of cytokines, the function and proliferation of T lymphocytes and the production of antimicrobial peptides as cathelicidin. The VDR acts modulating the action of vitamin D by inducing local immune responses and genetic variations present in the VDR encoding gene can lead to reduction of its activity and consequently, disfunction in the role of vitamin D. In HIV-infected individuals, this vitamin deficiency levels are high and factors such as race, kidney failure, lower exposure to ultraviolet light and exposure to anti- HIV drugs, such as Efavirenz, are associated with this deficiency, being determinants on the susceptibility to HIV infection as well as prediction of disease progression. Therefore, in this work we studied six single nucleotide polymorphisms (SNPs) (rs3890733, rs476048, rs1540339, rs2248098, rs2228570 and rs11568820) present in the D vitamin receptor gene (VDR) and its influence on patients’ response to Antiretroviral Therapy (ART). We recruited 107 patients followed from the Hospital Day Integrative Medicine Institute Professor Fernando Figueira (IMIP), subdivided into four groups: I. Therapeutic Success, II. Therapeutic Failure, III. Immune Success, IV. Immune Failure, and analyzed clinical and epidemiological variables, such as gender, age, weight and ethnicity. No statistically significant associations were observed in the isolated analyzes between polymorphisms of the VDR gene with therapeutic failure or immune response. However, in multivariate analyzes, the rs1540339 C/C genotype was associated with gender in therapeutic success (OR = 0.08, p = 0.04). In addition, analysis involving weight, ethnicity and gender and the rs3890733 showed association with the immune response to the C/C genotype and T/T in overdominant model (OR = 0.21, p = 0.024). The results indicate the importance of vitamin D receptor in HIV- 1 infections and may contribute to the understanding of variability of patient’s various responses to ART.

Submitted by Franciele Moreira (francielemoreyra@gmail.com) on 2017-09-21T19:59:43Z No. of bitstreams: 2 Dissertação - Max Weyler Nery - 2007.pdf: 1699711 bytes, checksum: d80084feaadd8efb9292ed3849018d55 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-09-22T11:41:38Z (GMT) No. of bitstreams: 2 Dissertação - Max Weyler Nery - 2007.pdf: 1699711 bytes, checksum: d80084feaadd8efb9292ed3849018d55 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-09-22T11:41:38Z (GMT). No. of bitstreams: 2 Dissertação - Max Weyler Nery - 2007.pdf: 1699711 bytes, checksum: d80084feaadd8efb9292ed3849018d55 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2007-03-30 / Background: in a decade of highly active antiretroviral therapy (HAART), morbidity and mortaliy of aids remarkable decreased, however prolonged treatment has been associated with adverse effects, mainly metabolic abnormalities. Objective: to determine the prevalence and risk factors for dyslipidemia among patients on HAART, in Goiânia-Goiás-Brazil. Methods: a cross-sectional study was conducted in adults on HAART, during 2005 and 2006. Patients were interviewed; their medical and laboratory records abstracted and blood obtained for lipid measurements. Dyslipidemia was defined as CT  240 mg/dL, LDL  160 mg/dL, TG > 200 and/or HDL < 40 mg/dL. Case-control approach and multiple logistic regression analysis were applied (SPSS 11.0). Protocol was approved by Ethical Committee of Federal University of Goiás. Results: 113 patients were recruited; mean age 39.3; 68.1% males; 51.9% with undetectable HIV-1 viral load; 42.4% with CD4 + > 350 cel/mL. Half (50.4%) of them were on nucleoside reverse transcriptase inhibitors (NTRIs) plus non-nucleoside reverse transcriptase inhibitors (NNTRIs); 42.5% were on NTRI plus protease inhibitors (PIs). Prevalence of dyslipidemia was 66.7%, being HDL<40mg/dL (53.5%) the most frequent abnormally, followed by TG > 200 mg/dL (36.1%). Patients on PIs based regimen showed a 5.2 higher risk (CI95% 1.8-14.8) of dyslipidemia after adjusting by gender, age and HIV/aids disease onset. Conclusion: disclosed a high prevalence of dyslipemia and point out for interventions programs to reduce future cardiovascular events. / Introdução: em dez anos de terapia antirretroviral potente (HAART) houve uma importante redução da morbi-mortalidade da aids, entretanto, o uso prolongado dessas drogas tem sido associado com efeitos adversos frequentes, sobretudo, alterações metabólicas. Objetivo: determinar a prevalência e avaliar fatores de risco para dislipidemias em pacientes em uso de HAART, em Goiânia-Goiás-Brasil. Método: estudo de prevalência conduzido em adultos utilizando HAART, entre 2005 e 2006. Realizada entrevista, revisão de prontuários e coleta de sangue para avaliação do perfil lipídico. Considerou-se dislipidemias quando CT  240 mg/dL, LDL  160 mg/dL, TG > 200 mg/dL e/ou HDL < 40 mg/dL. Abordagem tipo caso-controle com análise de regressão logística múltipla. Protocolo aprovado pelo Comitê de Ética da Universidade Federal de Goiás. Resultados: recrutados 113 pacientes, média de idade de 39,3 anos; 68,1% do sexo masculino; 51,9% com carga viral não detectável e 42,4% com CD4> 350 cel/mL. Metade (50,4%) usava inibidores da transcriptase reversa análogo nucleosídeo (ITRNs) com inibidores da transcriptase reversa análogo não nucleosídeo (ITRNNs) e 42,5% usavam ITRNs com inibidores de protease (IPs). A prevalência de dislipidemia foi de 66,7%, sendo a alteração mais frequente HDL < 40 mg/dL (53,7%), seguida de TG > 200 mg/dL (36,1%). Pacientes em uso de esquemas contendo IPs apresentaram risco 5,2 vezes maior (IC95% 1,8-14,8) de dislipidemia, após ajuste por sexo, idade e tempo de HIV/aids. Conclusão: foi evidenciada elevada frequência de dislipidemia, sinalizando para a necessidade de intervenções com a finalidade de reduzir eventos cardiovasculares futuros.