RESUMO
This review addresses relevant aspects of Chagas disease in the immunocompromised host. Chagas disease--one of the world's most neglected diseases-has become a global public health concern. Novel transmission modalities, such as organ transplantation, evidence of parasite persistence in chronically infected individuals--with the potential for reactivation under immunosuppression--and the prolonged survival of immunosuppressed patients call for an appraisal of the disease in this particular setting. The management and outcome of solid organ transplantation in the infected recipient with special focus on heart transplantation is addressed. The guidelines for management and the outcome of the recipients of organs from infected donors are discussed, and comments on haematopoietic stem cell transplantation are included. Finally, Chagas disease in other situations of impairment of the immune system, such as HIV/AIDS and autoimmune diseases, are considered. Immunosuppression has become an increasingly frequent condition that might modify the natural history of Trypanosoma cruzi infection. A number of strategies are available for Chagas disease management in the immunosuppressed patient. First, according to recent recommendations from the health authorities in Argentina, most infected patients would benefit from being treated at diagnosis. This has not been validated for patients with different immunosuppressive disorders. A different strategy would involve treating only patients with documented reactivation (either parasitaemia or clinical manifestations). These different approaches are discussed. To reach a diagnosis of parasitaemia, monitoring is essential, either with conventional methods or with molecular techniques that are not yet available in all centres. Collaborative studies are needed to improve the level of evidence, which will allow for better guidelines.
Assuntos
Antiprotozoários/uso terapêutico , Doença de Chagas/epidemiologia , Doença de Chagas/patologia , Hospedeiro Imunocomprometido , Doença de Chagas/diagnóstico , Doença de Chagas/tratamento farmacológico , Saúde Global , Humanos , Resultado do TratamentoRESUMO
Strongyloides stercoralis is a nematode that causes severe infections in immunocompromised patients. The low parasitic burden of chronically infected patients makes diagnosis difficult to achieve by conventional methods. Here, an in-house (IH) method for the isolation of parasite DNA from stools and a PCR assay for the molecular diagnosis of S. stercoralis were optimized. DNA yield and purity improved with the IH method which included a step of incubation of stool samples with a glycine-SDS buffer and mechanical disruption prior to DNA extraction. For the PCR assay, the addition of bovine serum albumin was required to neutralize inhibitors present in stool. The analytical sensitivity of the PCR using DNA as template, isolated with the IH method, was superior to the commercial one. This study demonstrates that a combined method that adds the step of glycine-SDS buffer incubation plus mechanical disruption prior to DNA isolation with the commercial kit increased PCR sensitivity to levels of the IH method. Finally, our assay was tested on 17 clinical samples. With the IH method for DNA isolation, a S. stercoralis specific band was detected by PCR in the first stool sample in all patients (17/17), while with the commercial kit, our S. stercoralis-specific band was only observed in 7 samples. The superior efficiency of the IH and combined methods over the commercial kit was demonstrated when applied to clinical samples with low parasitic burden. These results show that the DNA extraction procedure is a key to increase sensitivity of the S. stercoralis PCR assay in stool samples. The method developed here could help to improve the molecular diagnosis of S. stercoralis.
Assuntos
DNA de Helmintos/isolamento & purificação , Fezes/parasitologia , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/diagnóstico , Adulto , Animais , DNA de Helmintos/genética , Humanos , Larva , Reação em Cadeia da Polimerase , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Especificidade da Espécie , Strongyloides stercoralis/genética , Estrongiloidíase/parasitologiaRESUMO
OBJECTIVE: Acquired immune deficiency appears to be associated with serious non-AIDS (SNA)-defining conditions such as cardiovascular disease, liver and renal insufficiency and non-AIDS-related malignancies. We analysed the incidence of, and factors associated with, several SNA events in the LATINA retrospective cohort. MATERIALS AND METHODS: Cases of SNA events were recorded among cohort patients. Three controls were selected for each case from cohort members at risk. Conditional logistic models were fitted to estimate the effect of traditional risk factors as well as HIV-associated factors on non-AIDS-defining conditions. RESULTS: Among 6007 patients in follow-up, 130 had an SNA event (0.86 events/100 person-years of follow-up) and were defined as cases (40 with cardiovascular events, 54 with serious liver failure, 35 with non-AIDS-defining malignancies and two with renal insufficiency). Risk factors such as diabetes, hepatitis B and C virus coinfections and alcohol abuse showed an association with events, as expected. The last recorded CD4 T-cell count prior to index date (P = 0.0056, with an average difference of more than 100 cells/µL) and area under the CD4 cell curve in the year previous to index date (P = 0.0081) were significantly lower in cases than in controls. CD4 cell count at index date was significantly associated with the outcome after adjusting for risk factors. CONCLUSIONS: The incidence and type of SNA events found in this Latin American cohort are similar to those reported in other regions. We found a significant association between immune deficiency and the risk of SNA events, even in patients under antiretroviral treatment.
Assuntos
Doenças Cardiovasculares/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/imunologia , Hospedeiro Imunocomprometido , Hepatopatias/epidemiologia , Neoplasias/epidemiologia , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/epidemiologia , Síndrome da Imunodeficiência Adquirida/imunologia , Adulto , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4 , Doenças Cardiovasculares/imunologia , Métodos Epidemiológicos , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Hepatopatias/imunologia , Masculino , Pessoa de Meia-Idade , Neoplasias/imunologia , Insuficiência Renal/epidemiologia , Insuficiência Renal/imunologia , América do Sul/epidemiologiaRESUMO
The incidence of fungemia has increased over the past decade. Multiple-species candidemia (MSC) has been infrequently reported. From 1998 to 2004, of 155 patients with diagnosis of candidemia at the Hospital de Clinicas (University of Buenos Aires), seven cases of MSC were identified (6 adults and 1 newborn) and compared with 21 cases of similar age and sex with monomicrobial candidemia. There were no differences in clinical data and outcome, except for the mediana duration of hospital stay (39 days for patients with MSC vs. 18 days for patients with monomicrobial candidemia, the mean time of central venous catheter permanence previous to candidemia (32 days for patients with MSC vs. 12 days for patients with monomicrobial candidemia and the duration of candidemia (5 days for MSC and 1 day for monomicrobial candidemia. In conclusion, although MSC episodes are less common than those caused by monomicrobial candidemia, modifiable risk factors such as duration of hospitalization and central venous catheter permanence account for the development of MSC.
Assuntos
Candida/classificação , Candidíase/epidemiologia , Candidíase/microbiologia , Fungemia/epidemiologia , Fungemia/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Los episodios de candidemia han aumentado en la última década. Sin embargo, la publicación de casos de candidemias causadas por múltiples especies (CME) es infrecuente. De un total de 155 candidemias diagnosticadas entre 1998 y 2004 en el Hospital de Clínicas de la Universidad de Buenos Aires, se identificaron 7 casos de CME (6 adultos y 1 neonato), cuyos datos clínicos y evolutivos se compararon con 21 casos de candidemias producidas por una única especie de Candida (CUE) en pacientes de similar edad e igual sexo. No se hallaron mayores diferencias clínicas o evolutivas entre los pacientes con CME y CUE; sin embargo, la mediana del tiempo de internación y del tiempo promedio de permanencia de los catéteres venosos centrales con anterioridad a la candidemia (39 y 32 días para los pacientes con CME vs. 18 y 12 días para aquellos con CUE, respectivamente) resultaron ser factores predisponentes relevantes. La duración de la candidemia fue más prolongada en los pacientes con CME que en los afectados por CUE (5 días vs. 1 día). En conclusión, aunque los episodios de CME son menos frecuentes que los causados por una única especie de Candida, factores de riesgo potencialmente controlables como el tiempo de internación y el tiempo de utilización de catéteres venosos centrales tienen mayor importancia en el desarrollo de CME.
The incidence of fungemia has increased over the past decade. Multiple-species candidemia (MSC) has been infrequently reported. From 1998 to 2004, of 155 patients with diagnosis of candidemia at the Hospital de Clínicas (University of Buenos Aires), seven cases of MSC were identified (6 adults and 1 newborn) and compared with 21 cases of similar age and sex with monomicrobial candidemia. There were no differences in clinical data and outcome, except for the mediana duration of hospital stay (39 days for patients with MSC vs. 18 days for patients with monomicrobial candidemia, the mean time of central venous catheter permanence previous to candidemia (32 days for patients with MSC vs. 12 days for patients with monomicrobial candidemia and the duration of candidemia (5 days for MSC and 1 day for monomicrobial candidemia. In conclusion, although MSC episodes are less common than those caused by monomicrobial candidemia, modifiable risk factors such as duration of hospitalization and central venous catheter permanence account for the development of MSC.
Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Candida/classificação , Candidíase/epidemiologia , Candidíase/microbiologia , Fungemia/epidemiologia , Fungemia/microbiologia , Fatores de RiscoRESUMO
The aim of this study was to characterize methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered from different infectious sites of hospitalized patients at two university hospitals. Fourteen isolates were analyzed by repetitive sequence based PCR (Rep-PCR), randomly amplified polymorphic DNA assay (RAPD-PCR), and pulsed-field gel electrophoresis (PFGE). We found that a prevalent clone of MRSA, susceptible to rifampin, minocycline, and trimethoprim/sulfamethoxazole (RIF(s), MIN(s), TMS(s)) was present in both hospitals in replacement of the multiresistant MRSA South American clone, previously described in these hospitals. The staphylococcal chromosomal cassette (SCCmec) type I element was detected in this new clone.
Assuntos
Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana Múltipla , Hospitais Universitários/estatística & dados numéricos , Resistência a Meticilina , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Academias e Institutos/estatística & dados numéricos , Argentina/epidemiologia , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana , Infecção Hospitalar/epidemiologia , Farmacorresistência Bacteriana Múltipla/genética , Eletroforese em Gel de Campo Pulsado , Humanos , Meticilina/farmacologia , Resistência a Meticilina/genética , Minociclina/farmacologia , Proteínas de Ligação às Penicilinas , Reação em Cadeia da Polimerase , Técnica de Amplificação ao Acaso de DNA Polimórfico , Rifampina/farmacologia , América do Sul/epidemiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/classificação , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/genética , Combinação Trimetoprima e Sulfametoxazol/farmacologia , Saúde da População UrbanaRESUMO
The aim of this study was to characterize methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered from different infectious sites of hospitalized patients at two university hospitals. Fourteen isolates were analyzed by repetitive sequence based PCR (Rep-PCR), randomly amplified polymorphic DNA assay (RAPD-PCR), and pulsed-field gel electrophoresis (PFGE). We found that a prevalent clone of MRSA, susceptible to rifampin, minocycline, and trimethoprim/sulfamethoxazole (RIF S, MIN S, TMS S) was present in both hospitals in replacement of the multiresistant MRSA South American clone, previously described in these hospitals. The staphylococcal chromosomal cassette (SCCmec) type I element was detected in this new clone.
El objetivo de este trabajo fue la caracterización de aislamientos de Staphylococcus aureus meticilina-resistentes (SAMR), provenientes de diferentes procesos infecciosos de pacientes internados en dos hospitales universitarios. Catorce aislamientos fueron analizados mediante la PCR de secuencias repetitivas (Rep-PCR), la amplificación al azar de ADN polimórfico (RAPD-PCR) y la electroforesis de campo pulsado (PFGE). Encontramos que un clon prevalente de SAMR, sensible a rifampicina, minociclina y trimetoprima-sulfametoxazol (RIF S, MIN S, TMS S) estaba presente en ambos hospitales, reemplazando al clon SAMR y multi-resistente previamente descrito en estos mismos hospitales. En este nuevo clon se detectó el cassette cromosómico estafilocócico SCCmec tipo I.
Assuntos
Humanos , Infecção Hospitalar/microbiologia , Farmacorresistência Bacteriana Múltipla , Hospitais Universitários/estatística & dados numéricos , Resistência a Meticilina , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Academias e Institutos/estatística & dados numéricos , Argentina/epidemiologia , Técnicas de Tipagem Bacteriana , Proteínas de Bactérias/genética , Infecção Hospitalar/epidemiologia , Farmacorresistência Bacteriana Múltipla/genética , Eletroforese em Gel de Campo Pulsado , Resistência a Meticilina/genética , Meticilina/farmacologia , Minociclina/farmacologia , Reação em Cadeia da Polimerase , Técnica de Amplificação ao Acaso de DNA Polimórfico , Rifampina/farmacologia , América do Sul/epidemiologia , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/classificação , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/genética , Combinação Trimetoprima e Sulfametoxazol/farmacologia , Saúde da População UrbanaRESUMO
The aim of this study was to characterize methicillin-resistant Staphylococcus aureus (MRSA) isolates recovered from different infectious sites of hospitalized patients at two university hospitals. Fourteen isolates were analyzed by repetitive sequence based PCR (Rep-PCR), randomly amplified polymorphic DNA assay (RAPD-PCR), and pulsed-field gel electrophoresis (PFGE). We found that a prevalent clone of MRSA, susceptible to rifampin, minocycline, and trimethoprim/sulfamethoxazole (RIF(s), MIN(s), TMS(s)) was present in both hospitals in replacement of the multiresistant MRSA South American clone, previously described in these hospitals. The staphylococcal chromosomal cassette (SCCmec) type I element was detected in this new clone.
RESUMO
Andes virus was identified in 1995 as the etiologic agent of Hantavirus Pulmonary Syndrome (HPS) in Southern Argentina. We describe herein the main clinical characteristics of 25 HPS confirmed cases acquired in this area between 1993 and September 1999. The mean age was 34 years (range 11-70), with 72% males. Clinical characteristics were similar to those previously reported for Sin Nombre virus (SNV) cases. However, in this group of patients we also observed conjuntival injection in 10/25 (42%), facial flushing in 8/25 (33%), pharyngeal congestion in 7/25 (29%) and petechiae in 3/25 (12%). On the other hand, BUN was increased in 83% of cases (mean 0.77 g/l range 0.31-2.01). Mean serum creatinine concentration was 26.8 mg/l (range: 8.1-110 mg/l) with serum creatinine being higher than 20 mg/l in 8/15 patients (53%). Urinalysis was abnormal in 12/12 cases and was characterized by presence of proteins, red blood cells and granular casts. Aminotransferases were increased in 90% of cases with levels 5-10 times over normal values in 50% of cases. Serum creatine kinase concentration was elevated in 11/14 cases. Two patients required hemodialysis. Case fatality rate was 44% (11/25) and 10 of these cases died among the first 10 days of illness. Mononuclear myocarditis was observed in two cases, a finding that has not been reported for SNV cases. During the 1996 HPS outbreak in Southern Argentina due to Andes virus, there were epidemiological and molecular evidences of person-to-person transmission, a feature not previously shown for other members of the hantavirus genus. These data would also be indicative of some distinctive clinical characteristics of HPS caused by Andes virus, with more frequent renal involvement than in SNV cases.
Assuntos
Síndrome Pulmonar por Hantavirus/complicações , Adolescente , Adulto , Idoso , Argentina/epidemiologia , Criança , Surtos de Doenças , Ensaio de Imunoadsorção Enzimática , Feminino , Orthohantavírus/genética , Síndrome Pulmonar por Hantavirus/mortalidade , Síndrome Pulmonar por Hantavirus/patologia , Humanos , Masculino , Pessoa de Meia-Idade , RNA Viral/análise , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
A total of 73 patients with baseline CD4+ cell counts >/=350 cells/mm3 who were receiving combination antiretroviral therapy (ART) were randomized to receive subcutaneous interleukin-2 (IL-2; n=36) in addition to ART or to continue ART alone (n=37). Subcutaneous IL-2 was delivered at 1 of 3 doses (1.5 million international units ¿MIU, 4.5 MIU, and 7.5 MIU per dose) by twice-daily injection for 5 consecutive days every 8 weeks. After 24 weeks, the time-weighted mean change from baseline CD4+ cell count was 210 cells/mm3 for recipients of subcutaneous IL-2, compared with 29 cells/mm3 for recipients of ART alone (P<.001). There were no significant differences between treatment groups for measures of plasma human immunodeficiency virus RNA (P=.851). Subcutaneous IL-2 delivered at doses of 4.5 MIU and 7.5 MIU resulted in significant increases in CD4+ cell count (P=.006 and P<.001, respectively), compared with that seen in control patients. These changes were not significant in the 1.5 MIU dose group compared with that in the control patients (P=.105). Side effects that occurred from subcutaneous IL-2 administration were generally low grade, of short duration, and readily managed in an outpatient environment.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Interleucina-2/uso terapêutico , Adulto , Fármacos Anti-HIV/efeitos adversos , Contagem de Linfócito CD4 , Linfócitos T CD8-Positivos/imunologia , Didanosina/uso terapêutico , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada , Feminino , Infecções por HIV/imunologia , Humanos , Indinavir/uso terapêutico , Injeções Subcutâneas , Interleucina-2/administração & dosagem , Interleucina-2/efeitos adversos , Lamivudina/uso terapêutico , Contagem de Linfócitos , Masculino , Nelfinavir/administração & dosagem , Nevirapina/administração & dosagem , RNA Viral/sangue , Ritonavir/administração & dosagem , Saquinavir/administração & dosagem , Estavudina/uso terapêutico , Zalcitabina/administração & dosagem , Zidovudina/administração & dosagemRESUMO
Andes virus was identified in 1995 as the etiologic agent of Hantavirus Pulmonary Syndrome (HPS) in Southern Argentina. We describe herein the main clinical characteristics of 25 HPS confirmed cases acquired in this area between 1993 and September 1999. The mean age was 34 years (range 11-70), with 72
males. Clinical characteristics were similar to those previously reported for Sin Nombre virus (SNV) cases. However, in this group of patients we also observed conjuntival injection in 10/25 (42
), facial flushing in 8/25 (33
), pharyngeal congestion in 7/25 (29
) and petechiae in 3/25 (12
). On the other hand, BUN was increased in 83
of cases (mean 0.77 g/l range 0.31-2.01). Mean serum creatinine concentration was 26.8 mg/l (range: 8.1-110 mg/l) with serum creatinine being higher than 20 mg/l in 8/15 patients (53
). Urinalysis was abnormal in 12/12 cases and was characterized by presence of proteins, red blood cells and granular casts. Aminotransferases were increased in 90
of cases with levels 5-10 times over normal values in 50
of cases. Serum creatine kinase concentration was elevated in 11/14 cases. Two patients required hemodialysis. Case fatality rate was 44
(11/25) and 10 of these cases died among the first 10 days of illness. Mononuclear myocarditis was observed in two cases, a finding that has not been reported for SNV cases. During the 1996 HPS outbreak in Southern Argentina due to Andes virus, there were epidemiological and molecular evidences of person-to-person transmission, a feature not previously shown for other members of the hantavirus genus. These data would also be indicative of some distinctive clinical characteristics of HPS caused by Andes virus, with more frequent renal involvement than in SNV cases.
RESUMO
The evaluation of viral load as virological marker and its clinical and immunological correlation are presented. The first viral load studies were performed during 1996 at the National Reference Center for AIDS in Argentina in HIV-1 positive patients derived from different Hospitals in Buenos Aires. The study included 216 HIV-1 positive patients, 49 females and 167 males. Plasma was used for evaluating viral load and a second sample was obtained in 25 of the 216 patients for their monitoring. Viral load was performed using bDNA technique (Quantiplex HIV RNA assay 2.0, Chiron Corporation, USA). Other parameters such as CD4 count determined by flow cytometry and clinical stages according to CDC classification were obtained in order to correlate clinical and immunological status of the patients. When CD4 count was compared with viral load, the results showed a trend of viral RNA increase in plasma along with a decrease in CD4+ lymphocytes. This trend was also observed to correlate with the progression to AIDS disease. In all groups of patients, considering either CD4 counts or clinical status, ranges of viral load values were broad. Thus, as shown by percentiles 25 and 75, patients with CD4 counts < 200/ml, presented viral load values between 18,395 c/ml to 215,425 c/ml and patients with > 200/ml viral RNA showed values from < 10,000 to 35,180 c/ml. Patients with CDC's A and B stages presented values from < 10,000 to 45,160 c/ml and 87,000 c/ml respectively, while patients classified as C had 10,582 to 215,000 c/ml. Results of two consecutive samples in the 25 patients showed the usefulness of this technique for monitoring antiretroviral therapy. Nevertheless, despite the tendency of viral load to increase along with the progression of the disease, the broad range of values suggested the importance of using both virological and immunological parameters for the management of HIV infected patients.
Assuntos
Infecções por HIV/virologia , HIV-1/isolamento & purificação , RNA Viral/sangue , Viremia/virologia , Adolescente , Adulto , Idoso , Fármacos Anti-HIV/uso terapêutico , Biomarcadores , Contagem de Linfócito CD4 , Criança , Pré-Escolar , Progressão da Doença , Estudos de Avaliação como Assunto , Feminino , Seguimentos , Infecções por HIV/sangue , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Hibridização de Ácido NucleicoRESUMO
Se realizaron los primeros estudios de carga viral en pacientes HIV-1 positivos provenientes de diferentes instituciones asistenciales de la Ciudad de Buenos Aires. Se evaluó la carga viral como marcador virológico y su correlación con la clínica y el recuento de los linfocitos CD4+ para 216 pacientes HIV-1 positivos. La técnica utilizada fue bDNA (Quantiplex HIV RNA 2.0 assay, Chiron Corporation). Se observó una tendencia al aumento de la carga viral en los pacientes con menor cantidad de linfocitos CD4+ y en los estadíos clínicos con sintomatología. En pacientes que no recibieron ninguna terapia antirretroviral se encontraron valores desde < 10000 copias de ARN viral/ml de plasma hasta 48995 c/ml. En aquéllos que recibieron terapia antirretroviral se observó mayor variación en los valores de la carga viral como lo mostró un rango de < 10000 c/ml hasta 96605 c/ml. Se obtuvieron muestras consecutivas en 25 pacientes y se observaron diferencias entre ambas muestras que permitieron corroborar la utilidad de la técnica en el seguimiento de los pacientes infectados con HIV (AU)
Assuntos
Humanos , Biomarcadores/sangue , Síndrome da Imunodeficiência Adquirida/diagnóstico , Síndrome da Imunodeficiência Adquirida/sangue , Carga Viral/métodos , Contagem de Linfócito CD4 , ArgentinaRESUMO
Se realizaron los primeros estudios de carga viral en pacientes HIV-1 positivos provenientes de diferentes instituciones asistenciales de la Ciudad de Buenos Aires. Se evaluó la carga viral como marcador virológico y su correlación con la clínica y el recuento de los linfocitos CD4+ para 216 pacientes HIV-1 positivos. La técnica utilizada fue bDNA (Quantiplex HIV RNA 2.0 assay, Chiron Corporation). Se observó una tendencia al aumento de la carga viral en los pacientes con menor cantidad de linfocitos CD4+ y en los estadíos clínicos con sintomatología. En pacientes que no recibieron ninguna terapia antirretroviral se encontraron valores desde < 10000 copias de ARN viral/ml de plasma hasta 48995 c/ml. En aquéllos que recibieron terapia antirretroviral se observó mayor variación en los valores de la carga viral como lo mostró un rango de < 10000 c/ml hasta 96605 c/ml. Se obtuvieron muestras consecutivas en 25 pacientes y se observaron diferencias entre ambas muestras que permitieron corroborar la utilidad de la técnica en el seguimiento de los pacientes infectados con HIV