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| Author(s): |
Márcio Cristiano de Melo
Total Authors: 1
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| Document type: | Master's Dissertation |
| Press: | Campinas, SP. |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas |
| Defense date: | 2016-02-23 |
| Examining board members: |
Maria Rita Donalisio Cordeiro;
Maria Amélia de Sousa Mascena Veras;
Priscila Maria Stolses Bergamo Francisco;
Adriano Marçal Pimenta;
Juliana Luporini do Nascimento
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| Advisor: | Maria Rita Donalisio Cordeiro |
| Abstract | |
The survival study of people with AIDS is useful to evaluate the status of the epidemic, particularly the impact of interventions. The use of Highly Active Antiretroviral Therapy (HAART) since 1996 has been associated with increased survival of patients. Tuberculosis is a major disease associated with HIV infection, but survival in patients with co-infection AIDS/Tuberculosis is not well established in Brazil. The objective of this study was to analyze the survival of patients time with co-infection AIDS/Tuberculosis according to socio demographic, epidemiological, clinical, and the utilization of health services in the South and Southeast of Brazil. This is a retrospective cohort study. The sample of medical records of individuals older than 13 years diagnosed with AIDS, reported in the Information System for Notifiable Diseases in 1998 and 1999 with follow-up of 10 years. There were 2091 cases of AIDS, 517 (24.7%) of those had diagnosis for tuberculosis, and 379 (73.3%) were male. After analysis of the survival curves by Kaplan-Meier method was adjusted the multiple regression model of Cox, the risk ratio of dying among co infected/non co-infected was 1.31 (95% CI 1.11-1.54). The variables positively associated with longer survival were: being female (HR = 0.81 CI95%: 0.68-0.95), higher education (HR = 0.54 CI95%: 0.37-0.78), CD4 diagnostic criteria (HR = 0.55 CI95%: 0.45-0.66) and no presence of cancer (HR = 0.71 CI95%: 0.52-0.98). Variables associated negatively with survival were: age ? 60 years (HR = 3.20 CI95%: 2.01-5.09), blood exposure (HR = 1.41 CI95%: 1.18-1 70), irregular use of ARV (HR = 7.31 CI95%: 5.87-9.10), no information to hepatitis B (HR = 1.79 CI95%: 1.33-2.40), co-infection AIDS-tuberculosis (HR 1.31 CI95%: 1.11-1.53) and two or more opportunistic infections (HR = 2.05 95% CI: 1.65-2.54). Despite the progress, some challenges remain, including overcoming inequalities, early diagnosis, and ensuring the availability and adherence to treatment with drug combination with lower toxicity and ease intake. AIDS and tuberculosis are two chronic diseases can be analyzed as markers of quality of care and AIDS life expectancy in Brazil (AU) | |
| FAPESP's process: | 14/08068-6 - Survival of patients with AIDS and co-infection with Mycobacterium tuberculosis in South and Southeast |
| Grantee: | Márcio Cristiano de Melo |
| Support Opportunities: | Scholarships in Brazil - Master |