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style="font-size: 10pt / font-family: &quot / Times New Roman&quot / ,&quot / serif&quot / ">Background: The care and treatment for people with HIV/AIDS (PLWHA) at the Kagera regional hospital began in February 2005. It is important to evaluate quality of life (QOL) of highly active anti-retroviral therapy (HAART) recipients periodical to assess HAART&rsquo / s effectiveness. This study aimed to assess the health-related QOL (HRQOL) of HAART recipients and determine factors associated with it, two years after the programme had started at the kagera regional hospital in Tanzania. Results: The HRQOL of HAART recipients was generally lower than that of the general population. However, the general health perceptions (p=0.191) and mental health (p=0.161) means score of HAART recipients were not different from those of the Tanzanian general population. About 89% of the HAART recipients reported better health than in the previous years. Chronic diseases were associated with lower HRQOL of HAART recipients independently of other factors. HAART recipients with chronic diseases co-morbidity were more likely to score below the general population&rsquo / s mean score for mental health (p=0.007). While the effect of chronic diseases on HRQOL among those who recorded CD4+ cell increase was negative (OR=13.6,95%CI=3.7 / 49.9), there was no effect on those who did not have such an increase. Adherence to ARVs and CD4+ cell count were not associated with HRQOL. &nbsp / &nbsp / &nbsp / &nbsp / &nbsp / &nbsp / <span style=""> <o:p></o:p></span></span></p> <p style="margin-bottom: 0.0001pt / line-height: normal / " class="MsoNormal"><span style="font-size: 12pt / font-family: &quot / Times New Roman&quot / ,&quot / serif&quot / "><o:p>&nbsp / </o:p></span></p> <span style="font-size: 12pt / font-family: &quot / Times New Roman&quot / ,&quot / serif&quot / "><span style="">&nbsp / </span><span style="">&nbsp / </span><span style="">&nbsp / </span><span style="">&nbsp / </span><span style=""> </span><o:p></o:p></span></p> <p>&nbsp / </p>

HIV drug resistance (HIVDR) has emerged as a major clinical and public health challenge in many resource poor countries especially in Africa. HIVDR testing has become increasingly important and is of significant value in the management of HIV. The use of low cost technologies and procedures in testing HIVDR is being recommended. HIVDR computer interpretation algorithms make use of artificial intelligence and other computer technologies to predict HIVDR, and are recommended for use in resource poor countries. However, there is little known about the knowledge, attitude and perception of HIVDR computer algorithms by doctors in developing countries who are supposed to use computer algorithms. This study aimed to determine the knowledge, attitude and perception regarding computer interpretation algorithms of the 4th and 5th year medical students at Nelson R. Mandela School of Medicine, University of KwaZulu Natal in South Africa. Primary data collection was done using a questionnaire administered to a convenience sample of 216 4th and 5th year medical students. The study revealed that 90% of the respondents were aware of HIV drug resistance testing in South Africa but only 4% had knowledge of the computer interpretation algorithms. The study revealed that although the UKZN medical students are not aware of computer interpretation algorithms, majority are willing to use them in the future. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 6 uppsatser.

Thesis (Dr.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2006. / Includes bibliographical references (leaves 114-126).

Thesis (MMed) -- Stellenbosch University, 2010. / Bibliography / Objective: The objective of this retrospective cohort study is to assess whether demographic and anthropometric parameters, laboratory tests, co-morbidity, co-infection, treatment regimen, IRIS and adherence to treatment predict the expected response to HAART and differences if any, in the pattern of response as measured by CD4 count, weight gain and haemoglobin levels in two cohorts of patients in Roma, The Kingdom of Lesotho. Method: Data were collected randomly from a computerised database of the Antiretroviral Centre of the hospital and two cohorts of 151 subjects in each of the two arms of the study were identified from hospital records from January 2008. Each of these subjects was followed up over a period of 12 months with data obtained for at least 2 visits within the 12 month span. Data were obtained at baseline, 3 months and also at 6 and 12 months marks. Data on characteristics were compared between the two arms. Variables that may be potential confounders were identified and univariate and multivariate logistic regression analyses were carried out to establish differences independent of confounding factors for the combined endpoints as well as for each endpoint separately. Results: In all 302 patients had their records analysed and comparison of clinical and immunological response patterns in patients taking AZT and TDF-containing ART regimens and the possible prediction of which the regimen would be better and within which population. Despite the perceived mismatch between two NRTIs it can be concluded from the results of this study that, overall, the inclusion of AZT in treatment regimen showed a modest protective effect over the TDF counterpart as measured by the endpoints of the discriminative powers of the Receiver Operating Curves of the explanatory variables being 66% , 77% and 66% for CD4, Haemoglobin and Weight respectively, and 63%, 70% and 65% for the same variables in the AZT and TDF arms of the study respectively. Conclusion: In a population of HIV patients on treatment in resource-limited settings AZT-containing regimens appear to show a slight improvement over the TDF-containing ones.

Purpose of the study - Identify predictors of mortality and develop a related care plan for patients who are on antiretroviral therapy (ART) in Gondar, Ethiopia. Design - A quantitative, retrospective cohort study was conducted analysing medical records of HIV patients who presented to Gondar University Hospital (GUH), Gondar, and started ART between 1 January 2007 and 30 June 2010. Results - In defining the predictors of mortality, the findings in bivariate analysis revealed: female sex, CD4 cell count ≤ 50/μl, CD4 cell count 51-199/μl, a haemoglobin concentration ≤8g/dl, a history of oral candidiasis, tuberculosis and Cryptococcus meningitis were all statistically significant. A female sex, CD4 cell count ≤ 50/μl and CD4 cell count 51-199/μl maintain their significance level in the multivariate analysis. Conclusions - The study therefore recommends that clinicians and case managers be vigilant of these predictors of mortality while managing HIV patients who are on ART / Health Studies / M.A. (Public Health)

Made available in DSpace on 2015-07-22T20:49:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-12-31 / A terapia anti-retroviral (TARV) contribui para a diminuição da morbidade e da mortalidade, com conseqüente aumento da sobrevida. No Brasil, há diferenças regionais relativas à dinâmica da epidemia do HIV e ao seu enfrentamento no grupo das gestantes e das crianças com HIV/AIDS. Este estudo verifica o tempo de sobrevida após o diagnóstico de aids em 914 crianças infectadas por transmissão vertical, entre os anos de 1983 e 1998 e acompanhadas até 2002, nas cinco regiões brasileiras. O tempo decorrido do nascimento ao diagnóstico de infecção pelo HIV, ao longo dos anos, apresenta uma diminuição, principalmente nos estados das regiões Sul e Sudeste. Houve melhora significativa da sobrevivência, mais de 75% dos casos ainda estavam vivendo quatro anos após o diagnóstico, no grupo de 1997 e 1998. Esta análise brasileira mostra ser possível para um país em desenvolvimento, estabelecer um sistema efetivo de acesso gratuito e universal à TARV, mesmo com dificuldades regionais para a organização de uma infra-estrutura ideal de saúde, tendo como resultado um aumento significativo na sobrevivência. / Antiretroviral therapy contributes to decreasing morbidity and mortality, and consequently increasing survival. In Brazil, there are regional differences about HIV epidemic dynamics and in confront among pregnant women and children with HIV/AIDS. This study verifies survival time after AIDS diagnosis in 914 children infected by mother-to-child transmission, between 1983 and 1998 and followed until 2002, in the five Brazilian regions. Time between birth and HIV diagnosis, along the years, decreased mainly in the states of South and South-East regions. There was a significant improvement in survival; more than 75% of cases still living four years after diagnosis in the 1997-1998 group. This Brazilian study demonstrates that even with regional inequalities for organizing an ideal structure of health care it is possible for a developing country to establish an effective system of universal and free access to HAART and having a significant increase in survival. / TEDE / BV UNIFESP: Teses e dissertações / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2015-07-22T20:50:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-08-26. Added 1 bitstream(s) on 2015-08-11T03:25:27Z : No. of bitstreams: 1 Publico-00273.pdf: 185690 bytes, checksum: 37d322315cf1719837773ccc6521625a (MD5) / Embora não muito comum, o curso clínico da co-infecção do vírus da hepatite B (VHB) e do vírus da hepatite delta (VHD) geralmente é pior. Um prognóstico ainda pior pode ser esperado em pacientes co-infectados HBV-HDV e com infecção pelo vírus da imunodeficiência humana (HIV). Entretanto, existem poucos dados na literatura sobre o tema, especialmente na era HAART. Nesse estudo, um total de 26 pacientes com co-infecção HBV-HDV, 16 HIV-positivos e 10 HIV-negativos, foram retrospectivamente analisados. Parâmetros hepáticos e virológicos de laboratório na última visita (ALT, HBV-DNA e HDVRNA) foram comparados entre os grupos. É importante ressaltar que todos pacientes infectados pelo HIV haviam recebido, sempre no contexto do HAART, medicamentos orais com atividade anti-VHB por um período prolongado de tempo. Contudo, esse foi o caso de somente dois indivíduos HIV-negativos. A proporção de pacientes com fibrose hepática avançada foi comparável nos dois grupos (40% em ambos) assim como, a taxa de mortalidade. Nós fazemos a hipótese de que a terapia anti-VHB por tempo prolongado no contexto do HAART, poderia beneficiar o prognóstico hepático dos pacientes infectados pelos vírus HIV-HBV-HDV. / TEDE / BV UNIFESP: Teses e dissertações

Fundação de Amparo a Pesquisa no Estado do Rio Grande do Sul / The aim of this study was to uncover the experiences of young people who lives the HIV antiretroviral therapy. This is a phenomenological research. Data collection was made through phenomenological interviews from March to June 2015, after the approval of the Ethics Committee of the Federal University of Santa Maria. Participants were 10 young people aged 15 to 24 years, doing treatment with antiretrovirals in an Adult and Pediatric Clinic of Infectious Diseases. Young people who had some cognitive and mental limitation and those who did not know the HIV diagnosis were excluded. The number of young people participating in the study was not previous determined. In phenomenology the criteria that determines the end of interviews is the convergence and sufficiency of meanings expressed in the statements, enabling the uncover of the phenomenon. Analysis was made based on the theoretical-philosophical and methodological Heideggerian framework, uncovering by the vague and median the understanding of young women living with HIV antiretroviral therapy means that discover the diagnosis was the worst, a shock, isolated. They accepted what happened and then have to overcome; start the drugs was another shock. Taking medicines is complicated, but they have to take it to get well and take care of each other. They have strategies with the help of others and know the treatment; they are afraid to tell the diagnosis to others and also to die, they have had experiences in the family or in society that occurred due to illness. Take medications becomes a normal thing, turning life different; they have life expectantly to do what they like and plan the future. In the interpretative analysis, the meanings that emerged were the factuality, which reflects the events and the discovery of the disease which the young person is released without any modification possibilities. The occupation, which is the fulfillment of the medicine, in which the young is concerned to maintain health and keep your life. The talking, as young people repeat what they hear about the use of medications. Many times the young man makes use of the drug thinking of his son, girlfriend, revealing the care of another. The fear, afraid to tell their diagnosis, as it may suffer prejudice. Also fear death, because of the life risk is a possibility that is configured as a threat. They uncover the fear in structural dread moment, something familiar that has not happened yet, but that could happen. The possibility of being in the world was announced possible by having a life with expectations. The findings of this study indicate the needs of a healthcare that values the uniqueness of young people living with HIV, in coexistence with family and friends, expressed by the care for another daily, and being-in-the-world-with-other. Thus, want to do what they love and plan the future. / O objetivo foi desvelar os sentidos do jovem que vivencia a terapia antirretroviral para o HIV. Investigação qualitativa, fenomenológica. A produção dos dados ocorreu por meio da entrevista fenomenológica no período de março a junho de 2015, após aprovação do Comitê de Ética em Pesquisa da Universidade Federal de Santa Maria sob CAAE 39430314.5.0000.5346. Os participantes dessa investigação foram 10 jovens de 15 à 24 anos em tratamento com antirretrovirais em um Ambulatório de Doenças Infecciosas Adulto e Pediátrico. Foram excluídos os jovens que apresentaram alguma limitação cognitiva e mental e os que não sabiam do diagnóstico do HIV. O número de jovens que participaram do estudo não foi determinado, pois em fenomenologia o critério que expressa o encerramento das entrevistas é a convergência e suficiência dos significados expressos nos depoimentos, possibilitando o desvelamento do fenômeno. Foi desenvolvida analise fundamentada no referencial teórico-filosófico-metodológico Heideggeriano, desvelando na compreensão vaga e mediana do jovem que vive com HIV a TARV significa que descobrirem o diagnóstico foi a pior fase, um choque, se isolaram. Depois aceitaram que aconteceu e então tem que superar; iniciarem os medicamentos foi outro choque. Tomar os remédios é complicado, mas tem que tomar, para ficarem bem e cuidarem do outro. Para isso contam com estratégias, com a ajuda de outras pessoas e se interam do tratamento; têm medo de contar do diagnóstico para as outras pessoas e também de morrer, uma vez que, já tiveram experiências na família ou na sociedade que ocorreram devido a doença. Tomar os medicamentos passa a ser algo normal, tornando a vida diferente; ter vida com expectativa para fazerem o que gostam e planejarem o futuro. Na análise interpretativa, os sentidos que emergiram foram a facticidade, que reflete nos acontecimentos e na descoberta da doença a qual o jovem está lançado e sem possibilidades de modificações. A ocupação, que é o cumprimento do tomar o medicamento, em que o jovem se ocupa para manter a saúde e continuar sua vida. O falatório, pois os jovens repetem aquilo que ouvem acerca do uso das medicações. Por muitas vezes o jovem faz uso do medicamento pensando em seu filho, namorada, desvelando o cuidar do outro. O temor, tem medo de contar o seu diagnóstico, visto que pode vir a sofrer preconceito. Também teme a morte, pois o risco de vida é uma possibilidade que se configura como a ameaça. Desvela o medo no momento estrutural do pavor, de algo familiar que ainda não aconteceu, mas que pode vir a acontecer. E o poder ser no mundo foi anunciado pela possibilita de ter uma vida com expectativas. Os achados deste estudo apontam a necessidade de realizar um cuidado em saúde que valorize as singularidades dos jovens vivendo com HIV, que na convivência com seus familiares e amigos, manifestou a relação de cuidar do outro cotidianamente, sendo ser-no-mundo-com-os-outros. Assim, pretende fazer o que gosta e planejar o futuro.

NTRODUÇÃO: Embora haja cada vez mais provas de que a co-infecção pelo HCV piora a evolução da hepatotoxicidade relacionada ao HIV, as influências dos diferentes fatores associados a este permanecem mal compreendidas. Este estudo está destinado a avaliar os dados epidemiológicos, laboratoriais e HAART e sua associação com a evolução da taxa de progressão da fibrose (FPR), em doentes co-infectados acompanhados em centros de referência para o tratamento de HIV/VHC na cidade de São Paulo, Brasil. MÉTODOS: 938 prontuários de patientes coinfectados foram revisados para este estudo e 102 preencheram os critérios de inclusão. Um estudo transversal, avaliando os aspectos sócioepidemiológicos, laboratoriais e biópsia hepática foi realizado e correlacionado o grau de fibrose hepática e a FPR encontrada. RESULTADOS: A população foi caracterizada por indivíduos homens (83,3%), de meia-idade (42,9 anos), brancos (53,9%), com o principal fator de risco de aquisição de ambas as infecções foi através da utilização de drogas ilícitas (72,5%), principalmente intravenosa e presença de consumo de álcool (75,5%), com predominância do genótipo 1 de HCV (56,9%) e tempo médio de uso de antirretrovirals de 7,9 anos (DP = 3,6 a). A avaliação histológica não mostrou qualquer relação entre maior grau de fibrose na biópsia hepática relacionados com a exposição da antirretrovirals ou mesmo na FPR. Abuso de drogas ilícitas, incluindo cocaína inalada e intravenosa relacionam-se com taxas mais elevadas fibrose hepática e FPR. CONCLUSÃO: Os resultados enfatizam a necessidade de incentivar a retirada do consumo de drogas ilícitas da população de pacientes coinfectados HIV/VHC em uso de qualquer regime antirretroviral. O nosso estudo não encontrou nenhuma relação entre a utilização de regimes baseados em IP ou NNRTI e um pior prognóstico da fibrose hepática ou FPR na população avaliada. / BACKGROUND: Although there\'s growing evidence that the co-infection with HCV worsens the evolution of the HIV-related hepatotoxicity, the influence of the different factors associated to this remains poorly understood.This study intended to evaluate the epidemiological, laboratorial and HAART associated to the evolution of the fibrose progression rate (FPR) in co-infected patients followed in reference centers for the treatment of HIV/HCV in the city of São Paulo, Brazil. METHODS: 938 medical charts of co-infected patientes were reviewed for this study.and 102 fullfilled the inclusion and exclusion criteria to participate. A cross-sectional study evaluating socio-epidemiological aspects, laboratorial assesment and liver biopsy was performed and correlated with the fibrosis rate and the fibrosis progression rate (FPR). RESULTS: The population was characterized by male (83,3%), middle-age (42,9 years), white (53,9%) individuals, with a main risk factor of adquisition of both the infections trough illicit drugs-use (72,5%), mainly intravenous and alcohol consumption (75,5%), with predominance of HCV genotype 1 (56,9%) with a medium time of use of antiretrovirals of 7,9 years (SD=3,6 y). Histologic evaluation showed no relation between higher fibrosis degree in the liver biopsy related to the exposure of the antiretrovirals or even in the fibrosis progression rate (FPR). Illicit drugs abuse, including inaled and intravenous cocaine , were related to higher liver fibrosis rates and FPR. CONCLUSION: Our results emphasize the necessity of encourage the withdraw of ilicit drugs consumption in the HIV/HCV co-infected population in use of any antiretroviral regimen. Our study does no find any relation between the use of IP or NNRTI-based regimens and the poor prognosis of the liver fibrosis in this population.