RESUMO
Introduction: The presence of metabolic syndrome and cardiovascular risk in HIV positive patients has been overlooked in patients with HIV infection. Objectives: To evaluate the frequency of metabolic syndrome and compare cardiovascular risk stratification according to the Framingham, PROCAM, and SCORE equations in HIV patients. Methodology: A cross-sectional study of 760 HIV-infected adults from January 2016 to December 2018. The presence of metabolic syndrome was assessed using the ATP-III criteria, and the cardiovascular risk score was examined. Results: The most frequent comorbidities were smoking, hypercholesterolemia, and high blood pressure. Student's T test was carried out, showing differences in the classification of low to moderate risk. The number of HIV-infected male patients identified as having moderate cardiovascular risk according to the Framingham risk equation was two folds compared to those with the PROCAM and SCORE systems. Conclusions: This study showed a high prevalence of patients with low cardiovascular risk. It is appropriate to consider cardiovascular risk factors in patients with HIV, since they are very frequently associated with adverse outcomes of this type.
Introducción: La presencia del síndrome metabólico y el riesgo cardiovascular en pacientes VIH positivos ha sido desestimado en pacientes con infección por VIH. Objetivos: Evaluar la frecuencia del síndrome metabólico y comparar la estratificación del riesgo cardiovascular según las ecuaciones de Framingham, PROCAM y SCORE en pacientes con VIH. Metodología: estudio transversal de 760 adultos infectados por el VIH en el periodo enero de 2016-diciembre de 2018. Se evaluó la presencia de síndrome metabólico a través de los criterios del ATP-III y se examinó la puntuación de riesgo cardiovascular. Resultados: Las comorbilidades más frecuentes fueron el tabaquismo, la hipercolesterolemia y la hipertensión arterial. Se realizó la prueba T de Student, y a partir de ella se lograron apreciar diferencias en categorización de riesgo bajo a moderado. El número de pacientes varones infectados por el VIH identificados como de riesgo cardiovascular moderado según la ecuación de riesgo de Framingham fue mayor del doble en comparación con los sistemas PROCAM y SCORE. Conclusiones: El estudio mostró una alta prevalencia de pacientes con bajo riesgo cardiovascular. Es pertinente considerar los factores de riesgo cardiovascular en pacientes con VIH, ya que estos se encuentran frecuentemente asociados con desenlaces adversos de este tipo.
Introdução: A presença da síndrome metabólica e do risco cardiovascular em pacientes HIV positivos tem sido negligenciada em pacientes com infecção por HIV. Objetivos: Avaliar a frequência da síndrome metabólica e comparar a estratificação do risco cardiovascular de acordo com as equações de Framingham, PROCAM e SCORE em pacientes com HIV. Metodologia: estudo transversal de 760 adultos infectados com HIV no período de Janeiro de 2016-Dezembro de 2018. A presença de síndrome metabólica foi avaliada através de critérios ATP-III e a pontuação de risco cardiovascular foi examinada. Resultados: As comorbilidades mais frequentes foram o tabagismo, a hipercolesterolêmia e a hipertensão. Realizou-se o teste T Student, e a partir dele foram apreciadas as diferenças de categorização de risco baixo a moderado. O número de pacientes masculinos infectados com HIV identificados como de risco cardiovascular moderado de acordo com a equação de risco de Framingham foi mais do dobro em comparação com o PROCAM e SCORE. Conclusões: O estudo mostrou uma elevada prevalência de pacientes com baixo risco cardiovascular. É pertinente considerar fatores de risco cardiovascular em pacientes com HIV, uma vez que estes estão frequentemente associados a resultados cardiovasculares adversos.
Assuntos
HIV , Prevalência , Fatores de Risco , MortalidadeRESUMO
BACKGROUND: A low prevalence of HIV in sickle cell disease (SCD) patients has been reported in the literature though mechanisms for this are not understood. METHODS: HIV risk behaviors were compared between SCD cases and non-SCD controls using a self-administered audio computer-assisted self-interview. SCD cases were recruited from a multi-center SCD cohort established in Brazil; controls were recruited from SCD social contacts. Categorical variables were analyzed using Chi-Square or Fisher exact test. Continuous variables were compared using the Mann-Whitney U test. RESULTS: There were 152 SCD cases and 154 age/location matched controls enrolled at three participating Brazilian centers during 2016-17. No significant differences in number of sexual partners (lifetime or previous 12 months), male-to-male sex partners or intravenous drug use were observed. Cases received more transfusions, surgeries, and acupuncture treatment. CONCLUSIONS: Besides the risk of transfusion-transmitted HIV, which is now exceedingly rare, SCD and non-SCD participants demonstrated similar HIV risk behaviors. Causes other than risk behaviors such as factors inherent to SCD pathophysiology may explain the reported low prevalence of HIV in SCD.
Assuntos
Anemia Falciforme/epidemiologia , Infecções por HIV/epidemiologia , Comportamentos de Risco à Saúde , Adolescente , Adulto , Idoso , Transfusão de Sangue , Brasil/epidemiologia , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Parceiros Sexuais , Abuso de Substâncias por Via IntravenosaRESUMO
The purpose of this manuscript is to assess and compare HIV risk behaviors among early adolescents after a three-year pilot study. A total of 135 public and private junior high schools students completed the intervention protocol. A self-administered questionnaire was given at baseline and at the end of the third year (fourth measure). Descriptive and inferential analyses were performed using SPSS 20.0. About 60% of the students were 14 years old at the fourth measure. The proportion of students that did not report at least one HIV risk behavior at baseline and those that reported any risk behavior at the fourth measure was lower in the intervention group (45.0%) than in the control group (54.5%). The proportion of students that reported at least one HIV risk behavior at baseline and those that did not report any HIV risk behavior at the fourth measure was higher in the intervention group than in the control group (33.3% vs. 8.3%). The proportion of students engaging in HIV risk behaviors was higher in the control group than in the intervention group at the fourth measure, suggesting that A Supportive Model for HIV Risk Reduction in Early Adolescence (ASUMA) intervention might be a promising initiative to reduce adolescents' engagement in HIV risk behaviors.