RESUMO
BACKGROUND: There is an association not yet known, between high levels of HIV-1 RNA and HIV-associated nephropathy (HIVAN). There is also a barely known association between HIV-1 RNA levels and HIV-associated glomerular disease. OBJECTIVE: To determine the association between high HIV-1 RNA levels and alterations in glomerular filtration rate (GFR) in patients with HIV infection. MATERIAL AND METHODS: We conducted a prospective trial involving 198 seropositive HIV patients. three groups were formed: 53 patients with abnormal GFR (group I); 48 patients with proteinuria greater than 300 mg and less than 1 g in 24 h urine collection and/or with urinary cast (group 2); and 87 patients without nephropathy (group 3). We carried out comparative analysis for the most common factors associated with nephropathy in HIV seropositive patients. RESULTS: Within factors associated with nephropathy, only RNA-HIV-1 plasma levels had a statistically significant association with altered GFR. (p = 0.008). CONCLUSION: High levels of HIV-1 RNA are associated with initial forms of HIV- associated glomerulopathy, which do not have a rapid course to end- stage renal disease, but that do cause glomerular dysfunction, that could be subjected to early interventions.
Assuntos
Nefropatia Associada a AIDS/virologia , HIV-1/genética , Proteinúria/etiologia , RNA Viral/sangue , Nefropatia Associada a AIDS/sangue , Adulto , Contagem de Linfócito CD4 , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Estudos Prospectivos , Carga ViralRESUMO
Diversas alteraciones hepáticas se han encontrado en las enfermedades reumáticas. La hepatitis crónica activa (HCA) es una de ellas, aunque sus reportes según la revisión de la literatura que hemos efectuado, son escasos. El objetivo de este trabajo es presentar 7 casos de HCA asociados a enfermedades reumáticas autoinmunes, manejados en nuestro servicio. Todos los pacientes son del sexo femenino, con edad entre la cuarta y sexta décadas de la vida. Bioquímicamente muestran elevación de enzimas hepáticas, ligeramente de la bilirrubinas, y positividad para antígenos de VHC y VHB. No existe patrón obstructivo de conductos biliares por ultrasonido o gamagrafía. De las 7, tres cumplen criterios para AR y 4 para LEG. La supervivencia y clase funcional son satisfactorias. Consideramos que un fondo común de predisposición a la autoinmunidad puede intervenir en el desarrollo de ambas entidades