title: Opportunistic infections among individuals with HIV-1/AIDS in the highly active antiretroviral therapy era at a Quaternary Level Care Teaching Hospital.
abstract: BACKGROUND
  In this study, clinical-laboratory and epidemiological characteristics are described for a group of 700 individuals with HIV (human immunodeficiency virus)/AIDS (acquired immunodeficiency syndrome) in the ART (antiretroviral therapy) era at a teaching hospital that provides a quaternary level of care, with an emphasis on opportunistic infections (OIs), co-infections and immune profile.
  
  
  METHODS
  A retrospective cross-sectional study of AIDS cases was conducted from 1998 to 2008 by reviewing medical records from the Base Hospital/FUNFARME (Fundação Faculdade Regional de Medicina), São José do Rio Preto, São Paulo, Brazil.
  
  
  RESULTS
  The individuals were 14 to 75 years of age, and 458 were males. Heterosexuals accounted for 31.1% of all patients. Eighty-three percent were on ART, and 33.8% of those presented difficulties with treatment adherence. OIs were analyzed from medical records, and Pneumocystis jiroveci pneumonia was the most prevalent, regardless of the LTCD4+ (TCD4+ Lymphocytes) levels. Individuals whose viral loads were ≥10,000 showed a 90% greater chance of neurotoxoplasmosis. For P. jiroveci pneumonia, neurotoxoplasmosis, esophageal candidiasis, pulmonary tuberculosis and neurocryptococcosis, the chances of infection were higher among patients with LTCD4+ levels below 200 cells/mm3. HIV/hepatitis C virus (HCV) and HIV/hepatitis B virus (HBV) co-infections were significantly associated with death.
  
  
  CONCLUSIONS
  OIs remain frequent in the ART era even in populations where the access to medical care is considered satisfactory.
authors.affiliation: Centro de Investigação de Microrganismos, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil.
authors.forename: Katia Jaira
authors.initials: KJ
authors.lastname: Galisteu
authors.affiliation: Centro de Investigação de Microrganismos, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil.
authors.forename: Luciana Ventura
authors.initials: LV
authors.lastname: Cardoso
authors.affiliation: Centro de Investigação de Microrganismos, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil.
authors.forename: Adriana Antônia da Cruz
authors.initials: AA
authors.lastname: Furini
authors.affiliation: Faculdade Integradas Padre Albino, Catanduva, São Paulo, Brazil.
authors.forename: Arlindo
authors.initials: A
authors.lastname: Schiesari Júnior
authors.affiliation: Centro de Investigação de Microrganismos, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil.
authors.forename: Claudia Bernardi
authors.initials: CB
authors.lastname: Cesarino
authors.affiliation: Hospital de Base, São José do Rio Preto, São Paulo, Brazil.
authors.forename: Célia
authors.initials: C
authors.lastname: Franco
authors.affiliation: Departamento de Microbiologia e Parasitologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
authors.forename: Andrea Regina de Souza
authors.initials: AR
authors.lastname: Baptista
authors.affiliation: Seção de Parasitologia, Instituto Evandro Chagas, Ananindeua, Pará, Brazil.
authors.forename: Ricardo Luiz Dantas
authors.initials: RL
authors.lastname: Machado
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015497:HIV-1; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D019562:Viral Load; D055815:Young Adult