RESUMO
Objective: To discuss the relationship between the presence of lipodystrophy in patients with HIV / AIDS and outline actions that optimize quality of life better. Method: This is a research type of qualitative literature. Data collection was conducted during the months of July and August 2011, through the database of the Electronic Library of Brazilian Scientific Journals (SciELO Brazil) and pubmed. We use the following keywords for search: HIV / AIDS and Lipodystrophy. Results: Based on reading the articles grouped the main changes related to lipodystrophy in three categories: 1) psychosocial changes, 2) bodily changes, and 3) metabolic disorders. Conclusion: Given the complexity of the effects caused by lipodystrophy, highlights the importance of multidisciplinary team with these clients and their families seeking comprehensive care and promote quality of life.
Objetivo: Discutir a relação entre a presença de lipodistrofia em pacientes portadores do vírus HIV/AIDS e esboçar ações que otimizem uma qualidade de vida melhor. Método: trata-se de uma pesquisa do tipo bibliográfica de natureza qualitativa. A coleta de dados foi realizada durante os meses de julho e agosto de 2011, através do banco de dados da Biblioteca Eletrônica de Periódicos Científicos Brasileiros (SciELO Brasil) e pubmed. Utilizamos os seguintes descritores para a busca: HIV/AIDS e Lipodistrofia. Resultados: Baseado na leitura dos artigos agrupamos as principais alterações relacionadas com a lipodistrofia em três categorias: 1)alterações psicossociais; 2) alterações corporais; e 3) alterações metabólicas. Conclusão: Tendo em vista a complexidade das repercussões ocasionadas pela lipodistrofia, destaca-se a importância do trabalho da equipe multiprofissional com essa clientela e seus familiares, buscando a integralidade da assistência e promoção da qualidade de vida.
Objetivo: Analizar la relación entre la presencia de lipodistrofia en pacientes con VIH / SIDA y las acciones de esquema que optimizan la calidad de vida mejor. MÉTODOS: Se trata de un tipo de literatura de investigación cualitativa. La recolección de datos se realizó durante los meses de julio y agosto de 2011, a través de la base de datos de la biblioteca electrónica de revistas científicas brasileñas (SciELO Brasil) y PubMed. Utilizamos las siguientes palabras clave para la búsqueda: VIH / SIDA y la lipodistrofia. Resultados: A partir de la lectura de los artículos agrupados los principales cambios relacionados con la lipodistrofia en tres categorías: 1) los cambios psicosociales, 2) los cambios corporales, y 3) trastornos metabólicos. Conclusión: Dada la complejidad de los efectos causados por la lipodistrofia, pone de relieve la importancia del equipo multidisciplinario con estos clientes y sus familias en busca de una atención integral y promover la calidad de vida.
Assuntos
Humanos , Masculino , Feminino , Equipe de Assistência ao Paciente , Promoção da Saúde , Síndrome de Lipodistrofia Associada ao HIV/prevenção & controle , BrasilRESUMO
INTRODUCTION: Lipodystrophy is related to the use of highly active antiretroviral therapy (HAART) and can cause aesthetic stigma and increase the risk of developing cardiovascular diseases. Physical activity may be a valid alternative for the treatment and prevention of lipodystrophy. However, few studies address this issue. The objective of this study was to assess lipodystrophy related to highly active antiretroviral therapy in HIV/AIDS patients with different physical activity habits. METHODS: The sample was composed of 42 HIV/AIDS patients taking HAART medication who were visiting the Counseling and Testing Center (CTC) in Presidente Prudente. The level of physical activity was obtained using the International Physical Activity Questionnaire (IPAQ); lipodystrophy was diagnosed using a self-report questionnaire that was administered to the patient and then followed up by medical confirmation. The percentage of trunk fat was estimated by dual X-Ray absorptiometry (DEXA). Information about sex, age, length of HAART treatment, CD4+ T lymphocyte count (CD4) and viral load was also collected. RESULTS: A higher prevalence of lipodystrophy was observed in the sedentary group when compared to the physically active group, which indicates that physical activity may be a protective factor in relation to the occurrence of lipodystrophy. The group that had a higher CD4 had a higher proportion of lipodystrophy and a higher proportion of younger and physically active individuals. The patients with lipodystrophy had a higher percentage of trunk fat and were more sedentary than active individuals. CONCLUSIONS: A physically active lifestyle has a protective effect against the occurrence of lipodystrophy related to HAART.
Assuntos
Terapia Antirretroviral de Alta Atividade/efeitos adversos , Infecções por HIV/tratamento farmacológico , Síndrome de Lipodistrofia Associada ao HIV/induzido quimicamente , Atividade Motora , Comportamento Sedentário , Absorciometria de Fóton , Adulto , Composição Corporal , Brasil/epidemiologia , Contagem de Linfócito CD4 , Feminino , Síndrome de Lipodistrofia Associada ao HIV/diagnóstico , Síndrome de Lipodistrofia Associada ao HIV/epidemiologia , Síndrome de Lipodistrofia Associada ao HIV/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estatísticas não Paramétricas , Inquéritos e Questionários , Carga ViralRESUMO
INTRODUCTION: Lipodystrophy is related to the use of highly active antiretroviral therapy (HAART) and can cause aesthetic stigma and increase the risk of developing cardiovascular diseases. Physical activity may be a valid alternative for the treatment and prevention of lipodystrophy. However, few studies address this issue. The objective of this study was to assess lipodystrophy related to highly active antiretroviral therapy in HIV/AIDS patients with different physical activity habits. METHODS: The sample was composed of 42 HIV/AIDS patients taking HAART medication who were visiting the Counseling and Testing Center (CTC) in Presidente Prudente. The level of physical activity was obtained using the International Physical Activity Questionnaire (IPAQ); lipodystrophy was diagnosed using a self-report questionnaire that was administered to the patient and then followed up by medical confirmation. The percentage of trunk fat was estimated by dual X-Ray absorptiometry (DEXA). Information about sex, age, length of HAART treatment, CD4+ T lymphocyte count (CD4) and viral load was also collected. RESULTS: A higher prevalence of lipodystrophy was observed in the sedentary group when compared to the physically active group, which indicates that physical activity may be a protective factor in relation to the occurrence of lipodystrophy. The group that had a higher CD4 had a higher proportion of lipodystrophy and a higher proportion of younger and physically active individuals. The patients with lipodystrophy had a higher percentage of trunk fat and were more sedentary than active individuals. CONCLUSIONS: A physically active lifestyle has a protective effect against the occurrence of lipodystrophy related to HAART.
INTRODUÇÃO: A lipodistrofia relacionada ao uso de terapia antirretroviral (TARV) pode causar estigma estético e elevar o risco de doenças cardiovasculares. A atividade física pode ser uma alternativa válida para o tratamento e prevenção da lipodistrofia. Entretanto, poucos estudos tratam dessa temática. O objetivo deste estudo foi verificar a ocorrência de lipodistrofia relacionada ao uso de TARV em portadores de HIV/AIDS, com diferentes hábitos de atividades físicas. MÉTODOS: A casuística foi formada por 42 portadores de HIV em uso de TARV, do Centro de Testagem e Aconselhamento de Presidente Prudente. Para obtenção do nível de atividade física aplicou-se o Questionário Internacional de Atividade Física (IPAQ); a lipodistrofia foi diagnosticada pelo autorrelato do paciente e a confirmação médica. O percentual de gordura de tronco foi estimado pela absortometria por raio-X de dupla energia (DEXA). Foram coletados também dados referentes a sexo, idade, tempo de uso de TARV, valores de CD4 e carga viral. RESULTADOS: Verificou-se maior ocorrência de lipodistrofia no grupo sedentário quando comparado ao ativo, além de fator protetor da prática da atividade física em relação à ocorrência da lipodistrofia. O grupo com valores mais elevados de CD4 também apresentou maior proporção de sujeitos com lipodistrofia, além de maior proporção de ativos e de indivíduos com menor faixa etária. Os acometidos pela lipodistrofia apresentaram maiores valores de percentual de gordura de tronco, bem como, os sedentários em relação aos ativos. CONCLUSÕES: O estilo de vida fisicamente ativa resultou em efeito protetor para ocorrência da lipodistrofia relacionada ao uso da TARV.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Antirretroviral de Alta Atividade/efeitos adversos , Infecções por HIV/tratamento farmacológico , Síndrome de Lipodistrofia Associada ao HIV/induzido quimicamente , Atividade Motora , Comportamento Sedentário , Absorciometria de Fóton , Composição Corporal , Brasil/epidemiologia , Síndrome de Lipodistrofia Associada ao HIV/diagnóstico , Síndrome de Lipodistrofia Associada ao HIV/epidemiologia , Síndrome de Lipodistrofia Associada ao HIV/prevenção & controle , Fatores de Risco , Estatísticas não Paramétricas , Inquéritos e Questionários , Carga ViralRESUMO
The advent of highly active antiretroviral therapy (HAART) improved HIV infection prognosis. However, adverse metabolic and morphologic effects emerged, highlighting a lack of investigation into the role of nutritional interventions among this population. The present study evaluated the impact of a nutritional counseling program on prevention of morphologic and metabolic changes in patients living with HIV/AIDS receiving HAART. A 12-month randomized clinical trial was conducted with 53 adults of both genders in use of HAART. Subjects were allocated to either an intervention group (IG) or a control group (CG). Nutritional counseling was based on the promotion of a healthy diet pattern. Anthropometrical, biochemical, blood pressure, and food intake variables were assessed on four separate occasions. Sub scapular skin-fold results showed a significant tendency for increase between time 1 (Mean IG = 14.9 mm; CG = 13.6 mm), time 3 (Mean IG = 16.7 mm; CG = 18.2 mm), and time 4 (Mean IG = 16.4 mm; CG = 17.7 mm). Lipid percentage intake presented a greater increase among controls (time 1 mean = 26.3%, time 4 mean = 29.6%) than among IG subjects (time 1 mean = 29.1%, time 4 mean = 28.9%). Moreover, participants allocated to the IG presented an increase in dietetic fiber intake of almost 10 grams. The proposed nutritional counseling program proved to be effective in improving diet by reducing fat consumption and increasing fiber intake.
Assuntos
Terapia Antirretroviral de Alta Atividade/efeitos adversos , Aconselhamento , Infecções por HIV/tratamento farmacológico , Síndrome de Lipodistrofia Associada ao HIV/prevenção & controle , Necessidades Nutricionais , Adulto , Índice de Massa Corporal , Brasil , Suplementos Nutricionais , Feminino , Síndrome de Lipodistrofia Associada ao HIV/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Educação de Pacientes como Assunto , Prognóstico , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , Adulto JovemRESUMO
The aim of this study was to verify the relationship between habitual physical activity and body fat in HIV/AIDS subjects on highly active antiretroviral therapy. This was a cross-sectional study covering 169 men and 51 women. It was conducted at the AIDS Clinic of the School of Medicine, University of São Paulo. The dependent variables analysed were central subcutaneous fat (CSF) and waist-to-hip-ratio (WHR). The independent variable was the score for leisure time physical activity (LTPA). The control variables were sex, age, education, energy intake, body mass index, smoking, diagnosis of AIDS, T-CD4+ lymphocyte levels and duration of use of protease inhibitors. Multiple linear regressions were used for statistical analysis. After controls, there was significant negative correlation for LTPA with CSF (beta=-2.849; Pvariable=0.013; r2(adjusted)=0.65; Pmodel<0.001), and LTPA was in the limit of the significance with WHR (beta=-0.005; Pvariable=0.073; r2(adjusted)=0.41; Pmodel<0.001). Physical activity contributed towards preventing fat accumulation in HIV/AIDS subjects.