We describe temporal trends in the mortality rates and factors associated with AIDS non-AIDS related at Evandro Chagas Clinical Research Institute (IPEC), Oswaldo Cruz Foundation (FIOCRUZ).Adult patients enrolling from 1986 through 2009 a minimum follow up of 60 days were included. Vital status was exhaustively checked using patients' medical charts, active contact individuals family members by linkage Rio de Janeiro Mortality database previously validated algorithm. The CoDe protocol used...

Tuberculosis is the most frequent opportunistic infection and leading cause of death among persons living with HIV in several low middle-income countries. Mortality rates during tuberculosis treatment causes HIV-1/TB co-infected patients may differ based on immunosuppression severity, timing diagnosis prompt initiation antiretroviral therapy. This was a retrospective observational study conducted clinical cohort HIV-1/Aids National Institute Infectious Diseases Evandro Chagas, Rio de...

Abstract Introduction People living with HIV (PLHIV) on antiretroviral therapy (ART) experience high rates of non‐communicable diseases (NCDs). These co‐morbidities often accumulate and older adults may suffer from multimorbidity. Multimorbidity has been associated loss quality life, polypharmacy, increased risk frailty mortality. Little is known the trends or predictors NCD multimorbidity in PLHIV low‐ middle‐income countries. Methods We examined adult initiating ART between 2003 2014 using...

In high-income settings, the spectrum of morbidity and mortality experienced by Human Immunodeficiency Virus (HIV)-infected individuals receiving combination antiretroviral therapy (cART) has switched from predominantly AIDS-related to non-AIDS-related conditions. context universal access care, we evaluated whether that shift would apply in Brazil, a middle-income country with treatment, as compared France.Two hospital-based cohorts HIV-infected were used for this analysis: ANRS CO3...

Background: Recent studies have shown substantial increases in the survival of AIDS patients developed countries and Brazil as a result antiretroviral therapy (ART) prophylaxis for opportunistic infections. This study compares rates using Brazilian Ministry Health 2004 Centers Disease Control Prevention (CDC) 1993 case definitions large HIV/AIDS referral centre Rio de Janeiro. Methods: Survival after diagnosis was assessed clinic-based cohort 1415 individuals Kaplan–Meier method Cox...

Studies on the long-term safety and tolerability of HAART are scarce in developing countries. has been universally available Brazil since 1997, providing a unique opportunity to evaluate incidence risk factors for discontinuation or modification. We analyzed retrospective data from 670 treatment-naive patients followed at HIV cohort Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, who first received between January 1996 December 2006. Our four...

With successful antiretroviral therapy, non-communicable diseases, including malignancies, are increasingly contributing to morbidity and mortality among HIV-infected persons. The epidemiology of AIDS-defining cancers (ADCs) non-AIDS-defining (NADCs) in populations Brazil has not been well described. It is known if cancer trends similar those other countries where therapy also widely available.We performed a retrospective analysis clinical cohorts at Instituto Nacional de Infectologia...

Antiretroviral therapy (ART) agents potentially associated with adverse metabolic profiles are commonly used in low- and middle-income countries. We assessed risk factors for cardiovascular disease (CVD)-related morbidity mortality a cohort of HIV-infected, ART-treated adults Rio de Janeiro, Brazil.Hospital records data between 2000-2010 were examined incident CVD-related ICD-10 Coding Death HIV diagnoses among ≥18 years old on ART, enrolled an observational cohort. Poisson regression models...

We report such a case of malignant syphilis in 42-year-old HIV-infected man, co-infected with hepatitis B virus, who presented neurolues and the classical skin lesions lues maligna. The serum VDRL titer, which was 1:64 at presentation, increased to 1:2,048 three months after successful therapy penicillin, decreasing 15 later 1:8.

Opportunistic illnesses still account for a huge proportion of hospitalizations and deaths among HIV-infected patients in the post combination antiretroviral therapy (cART) era, particularly middle- low-income countries. The aim this study was to assess predictors top four most incident opportunistic (tuberculosis, esophageal candidiasis, cerebral toxoplasmosis Pneumocystis jiroveci pneumonia) an HIV clinical cohort from middle-income country cART era. A total 2835 infected participants aged...

Increased access to highly active antiretroviral therapy (HAART) by human immunodeficiency virus postive (HIV⁺) individuals has become a reality worldwide. In Brazil, HAART currently reaches over half of HIV-infected subjects. the context remarkable HIV-1 genetic variability, related variants, called quasispecies, are generated. HIV quasispecies generated during infection can influence persistence and pathogenicity, representing challenge treatment. However, clinical relevance minority is...

Hyperglycemia occurs in tuberculosis (TB), but the long-term impact is unknown. We estimated prevalence of hyperglycemia and compared TB treatment outcomes 1-year mortality rate according to glycemic status noted during treatment.We conducted a retrospective cohort analysis adult patients who had HIV coinfection started receiving at Instituto Nacional de Infectologia Evandro Chagas, Brazil, between 2010-2015. Diabetes Mellitus (DM) were defined American Association. After excluding for known...

World-wide, the notable expansion of HIV/AIDS treatment programs in resource-limited settings has lead to an increasing number patients need second-line cART. To adequately address and prepare for this scenario, critical assessments outcomes cART are particularly relevant where monitoring strategies may be inadequate. We evaluated virologic combination antiretroviral therapy (cART) among HIV-infected individuals from Brazil. This study was conducted at Instituto Nacional de Infectologia...

Background Reliable information on severe morbidity is essential for identifying priorities case management and to guide resource allocation within the health sector. Methods This study describes overall, AIDS- non-AIDS-related as well mortality its determinants in an urban cohort of HIV-infected individuals from a public healthcare institution, Evandro Chagas Research Institute (IPEC) Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. Severe morbid events were defined all clinical diagnoses...

The use of highly active antiretroviral therapy has resulted in changes comorbidity profile people living with HIV (PLHIV), increasing non-AIDS-related events. occurrence cardiovascular events is greater PLHIV, but the mechanism responsible for it still controversial. This article aimed to investigate factors associated progression PLHIV using HAART. A 15-years cohort study 1135 was conducted Rio de Janeiro-Brazil. Clinical stratified five states: No comorbidities (s1), arterial hypertension...

In this study, we evaluated trends in hospitalization rates, length of stay and in-hospital mortality a cohort HIV-infected patients Rio de Janeiro, Brazil, from 2007 through 2013. Among the 3991 included patients, 1861 hospitalizations occurred (hospitalization rate 10.44/100 person-years, 95% confidence interval 9.98–10.93/100 person-years). Hospitalization rates decreased annually (per year incidence ratio 0.92, 0.89–0.95) as well (median 15 days vs. 11 2013, p-value for trend < 0.001),...

Few studies on AIDS that evaluate factors associated with treatment failure have considered the slow evolution of disease and multiple health state transitions following use antiretrovirals. In this article we study progression between different stages disease, focusing therapy adherence using a sample 722 HIV+ patients followed up for 3 years. States were defined classifications CD4 cell count: s1 (CD4 ≥ 500); s2 (350 ≤ < s3 350). The states modeled multi-state models. Antiretroviral...

The 30-day readmission rate is an indicator of the quality hospital care and transition to outpatient setting. Recent studies suggest HIV infection might increase risk although estimates rates are unavailable among HIV-infected individuals living in middle/low-income settings. Additionally, factors that may populations poorly understood.Thirty-day were estimated for adults from Instituto Nacional de Infectologia Evandro Chagas/Fiocruz cohort Rio Janeiro, Brazil, January 2007 December 2013....

Retention in early HIV care has been associated with decreased mortality and improved viral suppression, however the consequences of poor retention Brazil remain unknown. We assessed effect on a Brazilian HIV-infected clinical cohort. The analysis included ART-naïve, adults linked to at Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz between 2000 2010, who did not become pregnant nor participate trial during first two years (early care). Poor was defined as less than...

There is a paucity of data on cardiovascular disease (CVD) among people living with HIV (PLHIV) in resource-limited countries. We assessed factors associated CVD and the impact prevalent all-cause mortality PLHIV antiretroviral therapy Brazil.

We present a case of papular-purpuric "gloves and socks" syndrome (PPGSS) in an adult male with acute parvovirus B19 infection. The patient displayed the classical features fever, oral lesions, purpura on hands feet, but purpuric lesions feet evolved to superficial skin necrosis, feature not previously described this syndrome. believe is first reported PPGSS occurring Brazil.

Diabetes mellitus (DM) is a major cause of morbidity worldwide and known factor leading to increased risk death, especially in conjunction with other factors. In this study, we evaluated the prevalence DM among HIV-infected patients its association overall mortality. All 18 years or older who were followed Instituto Nacional de Infectologia Evandro Chagas (INI) cohort from January 1991 December 2011 included. Time-updated covariables included status, calendar year, combination antiretroviral...