[Development of AIDS-related malignancies and infections after starting HAART].
In order to evaluate the incidence rate and possible risk factors associated with AIDS-related malignancies and infections (ARMI) we performed data analysis of clinical charts of HIV patients in two hospital cohorts, that started high activity antiretroviral therapy (HAART) between July 2003 and October 2007. Trimethoprim-sulfamethoxazole and Azithromycin prophylaxis was provided according to current guidelines. We evaluated development of ARMI six months after-starting HAART and its association with clinical and epidemiological variables. Of 235 patients analyzed -118 women (50.2%) and 117 men (49.8%)- 11 presented ARMI: 3 pulmonary TB and 3 lymph nodes TB cases, 3 cases with meningeal Cryptococcus, one Chagas's disease presenting brain mass and one with non-Hodgkin lymphoma. ARMI incidence: 4.7%. A CD4 cell count < 100/150 was associated with risk of developing ARMI. The mean CD4 cell count was 73 in patients who developed ARMI and 143 in those who did not. No association was found with the other analyzed variables. In the CD4 cell count < 150 group one out of 4 patients with reactive serology presented Chagas's disease causing brain mass; none of the 46 patients with reactive serology presented toxoplasmosis encephalitis. The incidence rate of ARMI was 4.7%. TB in first place and cryptococcosis in second were the AIDS events more frequently observed. A low CD4 cell count was the only observed risk factor statistically associated with development of ARMI. The role of prophylaxis in this population should be re-evaluated.
Unidad de Infectología, Hospital Dr. Diego Paroissien, Buenos Aires, Argentina. eduwarley@yahoo.com.ar
Eduardo
E
Warley
Natalia
N
Tamayo Antabak
Javier
J
Desse
Adriana
A
De Luca
Fernando
F
Warley
Guillermo
G
Fernández Galimberti
Graciela
G
D'Agostino
Luis
L
Quintas
Edgardo
E
Szyld
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000517:prevention & control; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy*; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001118:Argentina / Q000453:epidemiology; D017963:Azithromycin / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D019562:Viral Load
D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D017963:Azithromycin
Desarrollo de neoplasias e infecciones definitorias de sida después de iniciar la terapia antirretroviral de alta eficacia.