No abstract

The increase of cases of patients with chronic obstructive pulmonary disease in HIV positive patients is a reality since the TAAE era. In its beginning, infectious respiratory diseases were the most frequent and prevalent. Different factors were associated to this entity such as the HIV virus itself, antiretroviral treatment, tobacco habit, the use of marijuana, anemia, coinfection with HCV, BMI, nadir and current value of CD4 and viral load. The control of the patient through dyspnea assessment scales and complementary studies such as spirometry, chest CT, 6-minute walk test and carbon dioxide diffusion test have provided tools to contribute to the diagnosis, treatment and prevention of the complications inherent in COPD. Our patient presented a severe respiratory obstruction with FCV less than 70%, FEV1 less than 80%, FEV1/CFV ratio less than 70%, diffusion test less than 80% and central emphysema and paralobulillar CT. Its CD4 values and viral load within normal parameters.

<p>El tratamiento antirretroviral en los pacientes con VIH ha logrado la cronificación de la enfermedad por lo cual estos pacientes llegan a edades más avanzadas. La hipertensión arterial representa una gran preocupación para nuestros pacientes. Un adecuado control metabólico, y la instauración de un tratamiento correcto, son aspectos que necesariamente deben analizarse.</p>

Background: Perinatal HIV-infected children survive and live close to normal life from the effect of highly active antiretroviral therapy (HAART). The information of these grown-up children and adolescents in Thailand has been limited. Objectives: To describe the demographic, HIV-related health status, and social characteristics of perinatal HIV-infected adolescents at Siriraj Hospital, Mahidol University.Methods: This is a cross-sectional descriptive analysis of demographic, CD4, HIV-RNA, antiretroviral therapy (ART), education, and living status of adolescents, ages 12-18 years old who were followup at Siriraj hospital. Data were collected from medical record in January 2010.Results: Of the 81 adolescents, mean age 14.7 years, 41 (50.6%) were female. Fifty four (66.7%) were living with biological father and/or mother, 22 (27.2%) living with relatives, and 5 (6.2%) living in foster families. Ninety-eight percent were attending regular school, while 2.5% had left school. By self report, 32 (39.5%) were sexually active. Of the 81 adolescents with medical information available, 69 (85.2%) had HIV RNA < 40 copies/mL, and 78 (96.3%) had CD4 > 200 cells/mm3. Forty-one (50.6%) were receiving protease inhibitor-based regimens, 38 (46.9%) receiving non nucleoside reverse transcriptase inhibitor-based regimens, and 2 (2.5%) receiving lamivudine monotherapy holding regimen, mostly from poor adherence. Conclusion:Perinatal HIV-infected adolescents in Bangkok were in good immunologic status but a quarter had virologic failure. Social and education supports should be included in comprehensive care to improve the outcomes.