RESUMO
Severe thrombocytopenia during or after the course of Zika virus infection has been rarely reported. We report 7 cases of severe thrombocytopenia and hemorrhagic signs and symptoms in Guadeloupe after infection with this virus. Clinical course and laboratory findings strongly suggest a causal link between Zika virus infection and immune-mediated thrombocytopenia.
Assuntos
Trombocitopenia/etiologia , Infecção por Zika virus/complicações , Adolescente , Adulto , Idoso , Pré-Escolar , Feminino , Guadalupe/epidemiologia , Hemorragia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Trombocitopenia/patologia , Infecção por Zika virus/epidemiologiaRESUMO
Since the pathogen ecology differs between Caribbean regions, specific differences in the most frequent clinical presentations of acquired immunodeficiency syndrome (AIDS) may be expected. We therefore conducted the present retrospective cohort study in order to describe the main AIDS-defining events in Guadeloupe and to compare them with those observed in Metropolitan France and in French Guiana. We discuss the local pathogen ecology, the diagnostic limitations of hospitals in overseas territories and the drivers of the epidemic.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Síndrome da Imunodeficiência Adquirida/epidemiologia , Epidemias , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comparação Transcultural , Feminino , França/epidemiologia , Guiana Francesa/epidemiologia , Guadalupe/epidemiologia , Humanos , Masculino , Notificação de Abuso , Pessoa de Meia-Idade , Vigilância da População , Estudos Retrospectivos , Comportamento Sexual , População Urbana , Adulto JovemRESUMO
A retrospective cohort study was conducted to determine the incidence and the predictive factors of depression in a cohort of 2737 HIV/AIDS-infected patients in Guadeloupe followed for a total of 8402 patient-years. The incidence rate of first observed depression was 2.2 per 100 person-years (95% confidence interval [CI], 1.9-2.6). A single failure Cox proportional hazards model showed that the 1997-2000 inclusion period (hazard ratio [HR] = 1.60; 95% CI = 1.10-2.40;p = 0.01), the 2001-2009 inclusion period (HR = 1.50; 95% CI = 1.02-2.40;p = 0.04), the more advanced CDC stage (HR = 2.30; 95% CI = 1.30-3.10;p = 0.000) and the annual frequency of visits > 10 (HR = 2.30; 95% CI = 1.70-3.30;p = 0.000) were associated with an increased risk of depression. Incidence of depression in this HIV cohort was high and the hazard function showed three peaks of depression (2, 7 and 12 years). Physicians should be vigilant to psychological distress throughout life with HIV.