Epidemiological Patterns of AIDS in a Reference Center from Catanduva, São Paulo State, Brazil

Abstract

Objective: Hereby we present the epidemiological and clinical profile of HIV-infected population before and during the highly active antiretroviral therapy (HAART) era from a tertiary care hospital in the Southeastern region of Brazil. Methods: A retrospective, cross-sectional and descriptive study was carried out, this involved the analysis of the medi-cal records of patients diagnosed with HIV-1/AIDS admitted to Hospital Escola Emílio Carlos, located in the munici-pality of Catanduva, State of S?o Paulo, Brazil. Results: In both pre-HAART and HAART periods, HIV-1 infection was more prevalent in men. Heterosexuality and secondary education were associated with AIDS in the HAART period. Statistically significant association was only observed for co-infection with HIV-1/Hepatitis C in the pre-HAART era and the number of patients with opportunistic infection (OI) was lower in the HAART period. Among all OI it is worth mentioning pulmonary pneumocystosis, which despite being common in two periods, its occurrence was considerably greater in the pre-HAART era. Concerning the distribution of OIs according to the HIV-1 viral load and serial count of T CD4+ lymphocytes, a significant association was observed. The association between the number of deaths by OIs and death in the 1st year of diagnosis in the HAART treatment was significant. Conclusions: The clinical and epidemiological profile of a specialized HIV-1/AIDS center in Catanduva, Southeastern Brazilian region, is consistent with the epidemiology of AIDS in the country.

Share and Cite:

A. Schiesari Jr., K. Galisteu, L. Cardoso, V. Schiesari, A. Furini, A. Rossit and R. Machado, "Epidemiological Patterns of AIDS in a Reference Center from Catanduva, São Paulo State, Brazil," Open Journal of Medical Microbiology, Vol. 2 No. 3, 2012, pp. 47-53. doi: 10.4236/ojmm.2012.23007.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] UNAIDS, "2009 AIDS Epidemic Update," 2009.
http://data.unaids.org/pub/Report/2009/2009_epidemic_update_en.pdf
[2] T. C. Quinn, “HIV Epidemiology and the Effects of Antiviral Therapy on Long-Term Consequences,” AIDS, Vol. 22, Suppl. 3, 2008, pp. S7-S12. doi:10.1097/01.aids.0000327510.68503.e8
[3] C.-H. Yang, Y.-F. Huang, C.-F. Hsiao, et al., “Trends of Mortality and Causes of Death among HIV-Infected Patients in Taiwan, 1984-2005,” HIV Medicine, Vol. 9, No. 7, 2008, pp. 535-543. doi:10.1111/j.1468-1293.2008.00600.x
[4] F. Bonnet, C. Lewden, T. May, et al., “Opportunistic Infections as Causes of Death in HIV-Infected Patients in the HAART Era in France,” Scandinavian Journal of Infectious Diseases, Vol. 37, No. 6-7, 2005, pp. 482-487. doi:10.1080/00365540510035328
[5] UNAIDS, “AIDS Epidemic Update, 2007—Latin America Regional Summary,” 2008. http:// www.unAIDS.org.
[6] Brazil, Ministry of Health, “Bulletin Epidemiological of Sexually Transmitted Disease Program/AIDS,” Preliminary Version, 2009. http://www.aids.gov.br.
[7] A. M. Brito, E. A. Castilho, C. L. Szwarcwald, “AIDS and HIV Infection in Brazil: A Multifaceted Epidemic,” Revista da Sociedade Brasileira de Medicina Tropical, Vol. 34, No. 2, 2001, pp. 207-217.
[8] M. G. P. Fonseca and F. I. Bastos, “Twenty-Five Years of the AIDS Epidemic in Brazil: Principal Epidemiological Findings, 1980-2005,” Cadernos de Saúde Pública, Vol. 23, Suppl. 3, 2007, pp. S333-S344. doi:10.1590/S0102-311X2007001500002
[9] R. R. Prado and E. A. Castilho, “The Aids Epidemic in the State of S?o Paulo: Application of the Full Bayesian Space-Time Model” Revista da Sociedade Brasileira de Medicina Tropical, Vol. 42, No. 5, 2009, pp. 537-542.
[10] M. A. Hacker, A. Kaida, R. S. Hogg, et al., “The First Ten Years: Achievements and Challenges of the Brazilian Program of Universal Access to HIV/AIDS Comprehensive Management and Care, 1996-2006,” Cadernos de Saúde Pública, Vol. 23, Suppl. 3, 2008, pp. 345-359. doi:10.1590/S0102-311X2007001500003
[11] L. S. Melo, H. R. Lacerda, E. Campelo, et al., “Survival of AIDS Patients and Characteristics of Those Who Died over Eight Years of Highly Active Antiretroviral Therapy, at a Referral Center in Northeast Brazil,” Brazilian Journal of Infectious Diseases, Vol. 12, No. 4, 2008, pp.69-77. doi:10.1590/S1413-86702008000400003
[12] S. L. Souza, P. V. Feitoza, J. R. Araújo, et al., “Causes of Death among Patients with Acquired Immunodeficiency Syndrome Autopsied at the Tropical Medicine Foundation of Amazonas,” Revista da Sociedade Brasileira de Medicina Tropical, Vol. 41, No. 3, 2008, pp. 247-251. doi:10.1590/S0037-86822008000300005
[13] E. C. Soares, V. Saraceni, M. Lauria, et al., “Tuberculosis as a Disease Defining Acquired Immunodeficiency Syndrome: Ten Years of Surveillance in Rio de Janeiro, Brazil,” Jornal Brasileiro de Pneumologia, Vol. 32, No. 5, 2006, pp. 444-448. doi:10.1590/S1806-37132006000500012
[14] C. A. Schmaltz, F. M. Sant’Anna, S. C. Neves, et al., “Influence of HIV Infection on Mortality in a Cohort of Patients Treated for Tuberculosis in the COntext of Wide Access to HAART, in Rio de Janeiro, Brazil, ” Journal of Acquired Immune Deficiency Syndromes, Vol. 52, No. 5, 2009, pp. 623-628. doi:10.1097/QAI.0b013e3181b31e56
[15] N. J. S. Santos, A. Tayra, S. R. Silva, et al., “Changes in the Profile of the Epidemic and Prospects for Epidemiological Surveillance,” Revista Brasileira de Epidemiologia, Vol. 5, No. 2, 2002, pp. 286-310.
[16] M. A. Hacker, I. C. Leite, A. Renton, et al., “Reconstructing the AIDS Epidemic among Injection Drug Users in Brazil,” Cadernos de Saúde Pública, Vol. 22, No. 4, 2006, pp. 751-760. doi:10.1590/S0102-311X2006000400014
[17] M. G. Fonseca, C. L. Szwarcwald and F. I. Bastos, “A Sociodemographic Analysis of the AIDS Epidemic in Brazil, 1989-1997,” Cadernos de Saúde Pública, Vol. 36, No. 6, 2002, pp. 678-685. doi:10.1590/S0034-89102002000700004
[18] State Secretary of the Health of S?o Paulo, State Program of DST/Aids, “Bulletin Epidemiologist AIDS and DST,” 2009. http://www.aids.gov.br/taxonomy/term/2709/all
[19] Brazil, Ministry of Health, “The Politics of the Ministry of Health for the Integral Attention to Users of Alcohol and Other Drugs,” 2003. http://bvsms.saude.gov.br/bvs/publicacoes/pns_alcool_drogas.pdf
[20] N. F. Crum, R. H. Riffenburgh, S. Wegner, et al., “Comparisons of Causes of Death and Mortality Rates among HIV-Infected Persons: Analysis of the Pre-, Early, and Late HAART (Highly Active Antiretroviral Therapy) Eras,” Journal of Acquired Immune Deficiency Syndromes, Vol. 41, No. 2, 2006, pp. 194-200. doi:10.1097/01.qai.0000179459.31562.16
[21] C. M. Lowndes, F. I. Bastos, K. M. Giffin, et al., “Differential Trends in Mortality from AIDS in Men and Women in Brazil (1984-1995),” AIDS, Vol. 14, No. 9, 2000, pp. 1269-1273. doi:10.1097/00002030-200006160-00025
[22] Brazil, Ministry of Health, “Counseling for STD/HIV in Primary Care,” 2006, http:// www.aids.gov.br.
[23] V. Y. Soares, C. E. Lúcio Filho, L. I. Carvalho, et al., “Clinical and Epidemiological Analysis of Patients with HIV/AIDS Admitted to a Reference Hospital in the Northeast Region of Brazil, ” Revista do Instituto de Medicina Tropical de S?o Paulo, Vol. 50, No. 6, 2008, pp. 327-332. doi:10.1590/S0036-46652008000600003
[24] M. S. Sá, J. Sampaio, T. Haguihara, et al., “Clinical and Laboratory Profile of HIV-Positive Patients at the Moment of Diagnosis in Bahia, Brazil,” Brazilian Journal of Infectious Diseases, Vol. 11, No. 4, 2007, pp. 395-398. doi:10.1590/S1413-86702007000400004
[25] S. Schwarcz, L. Hsu, J. W. Dilley, et al., “Late Diagnosis of HIV Infection: Trends, Prevalence, and Characteristics of Persons Whose HIV Diagnosis Occurred within 12 Months of Developing AIDS, ” Journal of Acquired Immune Deficiency Syndromes, Vol. 43, No. 4, 2006, pp. 491-494. doi:10.1097/01.qai.0000243114.37035.de
[26] K. N. Althoff, S. J. Gange, M. B. Klein, et al., “Late Presentation for Human Immunodeficiency Virus Care in the United States and Canada,” Clinical Infectious Diseases, Vol. 50, No. 11, 2010, pp. 1512-1520. doi:10.1086/652650
[27] A. Mocroft, A. N. Phillips, J. Gatell, et al., “Normalisation of CD4 Counts in Patients with HIV-1 Infection and Maximum Virological Suppression Who Are Taking Combination Antiretroviral Therapy: An Observational Cohort Study,” The Lancet, Vol. 370, No. 9585, 2007, pp. 407413. doi:10.1016/S0140-6736(07)60948-9
[28] R. Detels, P. Tarwater, J. P. Phair, et al., “Effectiveness of Potent Antiretroviral Therapies on the Incidence of Opportunistic Infections before and after AIDS Diagnosis”. AIDS, Vol. 15, No. 3, 2001, pp. 347-355. doi:10.1097/00002030-200102160-00008
[29] J. M. Alter, “Epidemiology of Viral Hepatitis and HIV Co-Infection,” Journal of Hepatology, Vol. 44, Suppl. 1, 2006, pp. S6-S9. doi:10.1016/j.jhep.2005.11.004
[30] M. B. Victoria, F. S. Victoria, K. L. Torres, et al., “Epidemiology of HIV/HCV Coinfection in Patients Cared for at the Tropical Medicine Foundation of Amazonas,” Brazilian Journal of Infectious Diseases, Vol. 14, No. 2, 2010, pp. 135-140. doi:10.1590/S1413-86702010000200004
[31] M. A. French, “Immune Reconstitution Inflammatory Syndrome: A Reappraisal,” Clinical Infectious Diseases, Vol. 48, No. 1, 2009, pp. 101-107. doi:10.1086/595006
[32] H. C. Lane, “Pathogenesis of HIV Infection: Total CD4+ T-Cell Pool, Immune Activation, and Inflammation,” Topics in HIV Medicine, Vol. 18, No. 1, 2010, pp. 2-6.
[33] S. V. Kulkarni, R. Kairon, S. S. Sane, et al., “Opportunistic Parasitic Infections in HIV/AIDS Patients Presenting with Diarrhoea by the Level of Immunesuppression,” Indian Journal of Medical Research, Vol. 103, No. 1, 2009, pp. 63-66.
[34] S. Assefa, B. Erko, G. Medhin, et al., “Intestinal Parasitic Infections in Relation to HIV/AIDS Status, Diarrhea and CD4 T-Cell Count,” BMC Infectious Diseases, Vol. 9, 2009, pp.155. doi:10.1186/1471-2334-9-155
[35] A. Ebrahimzadeh and E. J. Bottone, “Persistent Diarrhea Caused by Isopora belli: Therapeutic Response to Pyrimethamine and Sulfadiazine,” Diagnostic Microbiology and Infectious Disease, Vol. 26, No. 2, 1996, pp. 87-89. doi:10.1016/S0732-8893(96)00175-7
[36] F. J. Zhang, Z. H. Dou, Y. Ma, et al., “Five-Year Outcomes of the China National Free Antiretroviral Treatment Program,” Annals of internal medicine, Vol. 151, No. 4, 2009, pp. 241-251.
[37] D. B. Hanna, M. R. Pfeiffer, L. V, Torian, et al., “Concurrent HIV/AIDS Diagnosis Increases the Risk of Short-Term HIV-Related Death among Persons Newly Diagnosed with AIDS, 2002-2005,” AIDS Patient Care and STDS, Vol. 22, No. 1, 2008, pp. 17-28. doi:10.1089/apc.2007.0042
[38] H. B. Krentz, G. Kliewer and M. J. Gill, “Changing Mortality Rates and Causes of Death for HIV-Infected Individuals Living in Southern Alberta, Canada from 1984 to 2003,” HIV Medicine, Vol. 6, No. 2, 2005, pp. 99-106. doi:10.1111/j.1468-1293.2005.00271.x

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.