HIV infection and AIDS in a small municipality in Southeast Brazil

Abstract

ObjectiveStudies on the aspects of HIV infection in small Brazilian municipalities are invaluable to appropriately design control strategies, better allocate resources, and improve health care services. The objective of the study was to assess the clinical and epidemiological aspects of HIV infection in a small municipality. Methods A descriptive study was carried out in Miracema, a small municipality in the northwestern area of the state of Rio de Janeiro, Brazil, between July 1999 and December 2003. All HIV-infected adult patients followed up at the local HIV/AIDS Program were included. Clinical and epidemiologic characteristics were prospectively assessed through standardized questionnaires. Results A total of 65 adult patients who attended the local HIV/AIDS Program were analyzed. Most (34) were women (male to female ratio: 0.9). An absolute predominance of patients who were born in Miracema or neighboring municipalities (94%), lived in Miracema (90.7%), were single (70.8%), attributed the acquisition of HIV infection to unprotected heterosexual intercourse (72.3%) and had a past history of snorting cocaine (27.7) was found Central nervous system disorders (including five cases of cryptococcal meningitis) and acute pulmonary pneumocystosis-like respiratory failure were major causes of morbidity. Most patients (56.9%) were at presented in advanced stages of HIV infection. ConclusionsThe predominance of patients on advanced stages of HIV infection suggest the existence of a large pool of undiagnosed cases in the community. A major feature of the cohort was an inverted male to female ratio. Further investigations over a broader geographic area are urgently needed for better understanding the clinical and epidemiological characteristics of HIV infection in small Brazilian municipalities and rural areas. Resumo Objetivo

Clinical and epidemiological analysis of patients with HIV/AIDS admitted to a reference hospital in the northeast region of Brazil

“…Of the 828 patients investigated, 254 died (30.7%) and of these, 194 (76.4%) died during the initial attendance and 44 (17.3%) within the first 48 h of hospitalization. The average number of admittances per patient was 1.5 ± 1.4 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). The number of infectious complications at death was of 2.1 ± 1.1 (0-8) and 231 (90.9%) patients presented up to three opportunistic infections at death.…”

“…The low M:W rate obtained can be partially explained by sexual exposure as the most probable form of HIV transmission, with prominence of heterosexual behavior. The increase in heterosexual cases is a decisive factor concerning the increased female participation in the epidemic 9,11,12 . These data reflect the importance of interrupting the epidemiological chain that is occurring in our region, through preventive policies focusing on female participation in the epidemic.…”

Diversidade genética do vírus da imunodeficiência humana tipo 1 (HIV-1) em mulheres infectadas de uma cidade do nordeste do Brasil

“…Os resultados obtidos mostram uma tendência atual da dispersão do HIV-1, às cidades do interior, atingindo preferencialmente as mulheres e as camadas sociais mais pobres, como foi verificado no Estado do Rio de Janeiro, onde foi encontrada uma proporção elevada de mulheres infectadas (1,1 homem/ mulher) 14 . Em nosso Centro, Referências ainda encontramos uma proporção de 2,3 homens/ mulher infectada.…”

Epidemiologic features of HIV infection in three municipalities of inner Rio de Janeiro State, Brazil

“…One of the major features of the current Brazilian AIDS epidemic is its spread towards small cities and the innermost parts of the country 6,7,12 . Small Brazilian cities are being challenged to provide care to an increasing number of HIV-infected patients, yet they generally have a much less comprehensive health infrastructure to deal with the multidisciplinary aspects of HIV infection.…”