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Navegando ÂNIMA por Autor "Alencastro, Paulo Ricardo"
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Artigo de Periodico Acesso aberto Characteristics Associated to Lipodystrophy Syndrome among HIVInfected Patients Naive and on Antiretroviral Treatment(2012) Alencastro, Paulo Ricardo; Wolff, Fernando Hertz; Schuelter-Trevisol, Fabiana; Ikeda, Maria Letícia; Brandão, Ajácio Bandeira de Mello; Barcellos, Nêmora T.; Fuchs, Sandra CostaAbstract Background: HIV-associated lipodystrophy involves changes in complex metabolic networks that are associated with increased cardiovascular risk. It has been associated with the use of combined antiretroviral treatment (cART), particularly Protease Inhibitors (PI) and thymidine analogs. This study aims to evaluate characteristics and use of ART associated with lipodystrophy, lipohypertrophy, and lipoatrophy among HIV-infected patients. Methods: A cross-sectional study was conducted in HIV-infected patients of both genders, aged 18 years or older, who sought care at an HIV/AIDS referral service for diagnostic confirmation or treatment between June 2006 and December 2008. Results: 1240 out of 1295 patients with HIV infection were included. Among patients on cART, women had a higher risk of lipohypertrophy than men, as well as a time since diagnosis of HIV greater than 6 years (versus <3 years). For lipoatrophy, age, education, lifestyle, and body mass index were associated with increased risk. Metabolic parameters were higher among patients on ART; and cART and PI use were independently associated with lipohypertrophy, lipoatrophy and lipodystrophy. The use of PI can be regarded as responsible for 13% of the association of ART and lipodystrophy, and of 11.5% for the thymidine analogs use, independent of gender, skin color, smoking, CD4, and BMI. Conclusions: Risk factors for lipodystrophy, lipoatrophy and lipohypertrophy are marked among ART users, but also among ART naïve patients.Artigo de Periodico Acesso aberto People living with HIV on ART have accurate perception of lipodystrophy signs: a cross‑sectional study(2017) Alencastro, Paulo Ricardo; Barcellos, Nêmora T; Wolff, Fernando H; Ikeda, Maria Letícia Rodrigues; Schuelter-Trevisol, Fabiana; Brandão, Ajácio M B; Fuchs, Sandra CBACKGROUND: The prevalence of lipodystrophy ranges from 31 to 65%, depending on the criteria adopted for diagnosis. The usual methods applied in the diagnosis vary from self-perception, medical examination, skinfolds measurements, or even imaging assessment for confirmation of fat distribution changes. Although several methods have been developed, there is no gold standard for characterization of LA and LH, or mixed forms. This study aimed to compare self-reported signs of lipodystrophy with objective measures by skinfolds and circumferences, and to evaluate the prevalence of lipoatrophy (LA) and lipohypertrophy (LH) among subjects living with HIV/AIDS on ART. METHODS: A cross-sectional study enrolled participants living with HIV/AIDS receiving ART, aged 18 years or older from an outpatient health care center, in Southern Brazil. Self-reported body fat enlargement in the abdomen, chest or breasts, and dorsocervical fat pad were used to determine LH, while LA was identified by self-reported fat wasting of the face, neck, legs, arms or buttocks. Measurements were obtained with a scientific caliper for infraorbital, buccal, and submandibular skinfolds, and using an inelastic tape to measure circumferences of waist, hip, neck, and arm. LH and LA were established by the presence of at least one self-reported sign. RESULTS: Comparisons of self-reported signs with objective measurements for men and women were carried out in 815 participants on ART, out of 1240 participants with HIV infection. Self-report of decreased facial fat and sunken cheeks was associated with lower infraorbital, buccal, and submandibular skinfolds. Participants who reported buffalo hump had, on average, greater neck circumference, as well as those who have increased waist circumference also reported abdominal enlargement, but no buttock wasting. Men were most commonly affected by lipoatrophy (73 vs. 53%; P < 0.001), and women by lipohypertrophy (79 vs. 56%; P < 0.001). CONCLUSION: In conclusion, self-reported signs of lipodystrophy and lipoatrophy are prevalent, differ by gender, and are associated with objective measurements in people living with HIV/AIDS.