Effectiveness of antiretroviral therapy in reducing viral load in people living with HIV in Southwest of Goiás, Brazil
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.206561Keywords:
Acquired immunodeficiency syndrome, Clinical evolution, Opportunistic infections, Sustained virologic responseAbstract
Introduction: The person living with HIV (PLHIV) without adequate treatment has lymphocyte depletion, thus leading to a state of immunodeficiency. Thus, for the virus to be suppressed and PLHIV to have a good quality of life, also reducing transmission and favoring virus control, it is necessary to use antiretroviral therapy (ART). Objective: To verify the effect of antiretroviral drugs on viral suppression in HIV-infected patients. Methods: This is a descriptive, longitudinal and quantitative study, in which 95 medical records of patients newly diagnosed with HIV infection were evaluated, between 2018 and 2020, monitored by the Testing and Counseling Center and Specialized Outpatient Service (TCC/SOE), from the municipality of Jataí, Goiás, Brazil. Sociodemographic, clinical and immunological information contained in the medical records was collected. The collected data were analyzed using descriptive and inferential statistics, using the BioEstat 5.3 program, adopting p<0.05. Results: The study showed a predominance of males (71.6%), with a median age of 30 years, single (68.4%), heterosexuals (44.2%), with exposure through sexual intercourse (98.9%). The most used therapeutic regimen was tenofovir + lamivudine + dolutegravir (87.8%), being adequate for increasing CD4+ T lymphocyte count (p<0.001) and decreasing viral load (p<0.001) in the period between exams, of 9 months and 6 months respectively. Conclusion: It is concluded, according to the proposed method and objective, that ART was efficient in reducing the viral load and improving the immune system of PLHIV treated at the TCC/SOE in Jataí, emphasizing the importance of early treatment.
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References
Unaids. Global HIV & AIDS statistics — Fact sheet; 2022. Disponível em https://www.unaids.org/en/resources/fact-sheet.
Brasil. Ministério da Saúde. Boletim epidemiológico HIV/Aids - 2022, Brasília; 2022. Disponível em: https://www.gov.br/aids/pt-br/centrais-de-conteudo/boletins-epidemiologicos/2022/hiv-aids/boletim_epidemiologico_hiv_aids_-2022.pdf/view.
Trujillo-Cáceres SJ, Castillo J, Alvarez-Moreno C, Valbuena A, Acuña L. Burden and magnitude of risk in HIV/AIDS in the Colombian health system: a real-world data approach. Infectio 2021;25(3):163-8. doi: https://doi.org/10.22354/in.v25i3.941.
Akbari M, Fararouei M, Haghdoost AA, Gouya MM, Kazerooni PA. Survival and associated factors among people living with HIV/AIDS: A 30-year national survey in Iran. J Res Med Sci 2019;24(5):1-7. doi: https://doi.org/10.4103/jrms.JRMS_630_18.
Brasil. Ministério da Saúde. Protocolo Clínico e Diretrizes Terapêuticas para Manejo da Infecção pelo HIV em Adultos. Brasília; 2018. Disponível em: https://www.gov.br/aids/pt-br/centrais-de-conteudo/pcdts/2013/hiv-aids/pcdt_manejo_adulto_12_2018_web.pdf/view.
Gupta-Wright A, Fielding K, Oosterhout JJV, Alufandika M, Grint DJ, Chimbayo E, et al. Virological failure, HIV-1 drug resistance, and early mortality in adults admitted to hospital in Malawi: an observational cohort study. Lancet HIV 2020;7(9):e620-e628. doi: https://doi.org/10.1016/S2352-3018(20)30172-7.
Cao Z, Li J, Chen H, Song C, Shen Z, Zhou X, et al. Effects of HIV-1 genotype on baseline CD4+ cell count and mortality before and after antiretroviral therapy. Sci Rep 2020;10(1):e15875. doi: https://doi.org/10.1038/s41598-020-72701-4.
Smith CJ, Ryom L, Weber R, Morlat P, Pradier C, Reiss P, et al. Trends in underlying causes of death in people with HIV from 1999 to 2011 (D:A:D): a multicohort collaboration. Lancet 2014;384:241-8. doi: https://doi.org/10.1016/S0140-6736(14)60604-8.
Pilcher CD, Ospina-Norvell C, Dasgupta A, Jones D, Hartogensis W, Torres S, et al. The effect of same-day observed initiation of antiretroviral therapy on HIV viral load and treatment outcomes in a US Public Health Setting. J Acquir Immune Defic Syndr 2017;74(1):44-51. doi: https://doi.org/10.1097/QAI.0000000000001134.
Marks G, Patel U, Stirratt M, Mugavero MJ, Mathews WC, Giordano TP, et Al. Single viral load measurements overestimate stable viral suppression among HIV patients in care: clinical and public health implications. J Acquir Immune Defic Syndr 2016;73(2):205-12. doi: https://doi.org/10.1097/QAI.0000000000001036.
Pereira ACG, Assenço R, Tupinambás JT, Fonseca MO, Tupinambás U. Efetividade do tratamento antirretroviral nas primeiras 48 semanas após seu início, Belo Horizonte, Minas Gerais - 2010 a 2013. Rev Med Minas Gerais 2017;27:1-6. doi: http://www.dx.doi.org/10.5935/2238-3182.20170066.
Ford N, Migone C, Calmy A, Kerschberger B, Kanters S, Nsanzimana S, et al. Benefits and risks of rapid initiation of antiretroviral therapy. AIDS 2018;32(1):17-23. doi: https://doi.org/10.1097/QAD.0000000000001671.
Labhardt ND, Ringera I, Leione TI, Klimkait T, Muhairwe J, Amstutz A, et al. Effect of offering same-day ART vs usual health facility referral during home-based HIV testing on linkage to care and viral suppression among adults with HIV in Lesotho. JAMA 2018; 319(11):1103-12. doi: https://doi.org/10.1001/jama.2018.1818.
Muccini C, Crowell TA, Kroon E, Sacdalan C, Ramautarsing R, Seekaew P, et al. Leveraging early HIV diagnosis and treatment in Thailand to conduct HIV cure research. BMC 2019;16:e25. doi: https://doi.org/10.1186/s12981-019-0240-4.
Pimentel GS, Ceccato MGB, Costa JO, Mendes JC, Bonolo PF, Silveira MR. Quality of life in individuals initiating antiretroviral therapy: a cohort study. Rev Saude Publica 2020;54:e146. doi: https://doi.org/10.11606/s1518-8787.2020054001920.
Rava M, Domínguez-Domínguez L, Bisbal O, López-Cortés LF, Busca C, Antela A, et al. Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004-2018. PLoS One 2021;16(4):e0249864. doi: https://doi.org/10.1371/journal.pone.0249864.
Buetikofer S, Wandeler G, Kouyos R, Weber R, Ledergerber B. Prevalence and risk factors of late presentation for HIV diagnosis and care in a tertiary referral centre in Switzerland. Swiss Med Wkly 2014;144:w13961. doi: https://doi.org/10.4414/smw.2014.13961.
Ferreira BE, Oliveira IM, Paniago AMM. Qualidade de vida de pessoas que vivem com HIV/Aids e sua relação com os linfócitos CD4 +, carga viral e tempo de diagnóstico. Rev Bras Epidemiol 2012;15(1):75-84. doi: https://doi.org/10.1590/S1415-790X2012000100007.
Segatto AFM, Freitas Junior IF, Santos VR, Alves KCP, Barbosa DA, Portelinha Filho AM, et al. Lipodytrophy in HIV/Aids patients with different levels of physical activity while on antiretroviral therapy. Rev Soc Bras Med Trop 2011;44(4):420-4. doi: https://doi.org/10.1590/S0037-86822011000400004.
Scherzer R, Heymsfield SB, Lee D, Powderly WG, Tien PC, Bacchetti P, et al. Decreased limb muscle and increased central adiposity are associated with 5 year all cause mortality in HIV infection. AIDS 2011;25:1405-14. doi: https://doi.org/10.1097/QAD.0b013e32834884e6
Rodrigues VCC, Lopes GF, Silveira GEL, Sousa IB, Sena MM, Lopes TSS, et al. Factors associated with the knowledge and attitude of adolescents regarding male condom use. Rev Bras Enferm 2021;74(4):e20190452. doi: https://doi.org/10.1590/0034-7167-2019-0452.
Pérez-Jiménez D, Pérez-Acosta E, Guzmán-Ortega JM, Martínez-Maldonado JA. Internet study about risk factors associated with HIV among heterosexuals in Puerto Rico. P R Health Sci J 2021;40(1):26-32. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087157/
Passos TS, Almeida-Santos MA, Hora AB, Oliveira CCC. Condom use and vulnerabilities to sezually transmitted infections in quilombola communities: a descriptive study, Sergipe, Brazil, 2016-2017. Epidemiol Serv Saude 2021;30(2):e2020617. doi: https://doi.org/10.1590/S1679-49742021000200011.
Caixeta AKS, Souza LSM, Fernandes EV, Dias RFG, Menezes Filho HR, Gouvêa-e-Silva LF. People living with HIV/AIDS in southwest Goiás: sociodemographic, clinical and laboratory characterization in the year 2018. Rev Med (São Paulo) 2023;102(1):e-195987. doi: https://doi.org/10.11606/issn.1679-9836.v102i1e-195987.
Brasil. Ministério da Saúde. Protocolo Clínico e Diretrizes terapêuticas para profilaxia Pré-Exposição (PrEP) de risco à infecção pelo HIV. Brasília-DF: Ministério da Saúde; 2022. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/protocolo_clinico_profilaxia_prep.pdf.
Figueira CN, Ribeiro VF, Souza LI, Brito ER, Berretta OCP, Takanashi SYL, et al. Evolução clínica de pacientes infectados pelo HIV de um ambulatório do município de Santarém, Pará, Brasil. RBCS 2021;25(4):665-74. doi: https://doi.org/10.22478/ufpb.2317-6032.2021v25n4.58630.
Taquette SR, Souza LMBM. HIV-AIDS prevention in the conception of HIV-positive young people. Rev Saude Publica 2019;53:e80. doi: https://doi.org/10.11606/s1518-8787.2019053001174.
Watanabe BT, Araujo IB, Menezes Filho HR, Oliveira DM, Vignoto EF, Gouvêa-e-Silva LF. Health Condition of HIV patients: evaluation of metabolic syndrome and cardiovascular risk. J Health Scie, 2022;24(4):277-82. doi: https://doi.org/10.17921/2447-8938.2022v24n4p277-282.
Oliveira LS, Caixeta LM, Martins JLR, Segati KD, Moura RS, Daher MC, et al. Adherence to antiretroviral therapy and correlation with adverse effects and coinfections in people living with HIV/AIDS in the municipality of Goiás State. Rev Soc Bras Med Trop 2018;51(4):436-444. doi: https://doi.org/10.1590/0037-8682-0467-2017.
Díaz YMS, Orlando-Narváez SA, Ballester-Arnal R. Risk behaviors for HIV infection. A review of emerging trends. Cien Saude Colet 2019;24(4):1417-26. doi: https://doi.org/10.1590/1413-81232018244.02322017.
Raimondi GA, Teixeira FB, Moreira C, Barros NF. Corpos (Não) Controlados: Efeitos dos Discursos sobre Sexualidades em uma Escola Médica Brasileira. Rev Bras Educ Med 2019;43(3):16-26. doi: https://doi.org/10.1590/1981-52712015v43n3RB20180142.
Alecrim DJD, Ceccato MDGB, Dourado I, Kerr L, Brito AM, Guimarães MDC. Factors associated with exchanging sex for money in men who have sex with men in Brazil. Cien Saude Colet 2020;25(3):1025-1039. doi: https://doi.org/10.1590/1413-81232020253.18052018.
Perez TA, Chagas EFB, Pinheiro OL. Health functional literacy and adherence to antiretroviral therapy in people living with HIV. Rev Gaucha Enferm 202142:e20200012. doi: https://doi.org/10.1590/1983-1447.2021.20200012.
Mocellin LP, Winkler GB, Stella IM, Vieira PC, Beck C, Behar PRP, et al. Characterization of deaths and therapeutic itineraries investigated by the Porto Alegre AIDS Mortality Committee, Brazil, in 2015. Epidemiol Serv Saude 2020;29(3):e2019355. doi: https://doi.org/10.5123/S1679-49742020000300009.
Silva LCC, Araújo AJ, Queiroz AMD, Sales MPU, Castellano MVCO. Smoking control: challenges and achievements. J Bras Pneumol 2016;42(4):290-8. doi: https://doi.org/10.1590/S1806-37562016000000145.
Novotny T, Hendrickson E, Soares ECC, Sereno AB, Kiene SM. HIV/AIDS, tuberculosis, and tobacco in Brazil: a syndemic that call for integrated interventions. Cad Saude Publica 2017;33(4):e00124215. doi: https://doi.org/10.1590/0102-311X00124215.
Mehari EA, Muche EA, Gonete KA. Virological suppression and its associated factors of dolutegravir based regimen in a resource-limited setting: an observational retrospective study in Ethiopia. HIV AIDS 2021;13:709-17. doi: https://doi.org/10.2147/HIV.S316776.
Brasil. Ministério da Saúde. Protocolo clínico e diretrizes terapêuticas para prevenção da transmissão vertical de HIV, sífilis e hepatites virais. Brasília; 2022. Disponível em: http://www.aids.gov.br/pt-br/pub/2022/protocolo-clinico-e-diretrizes-terapeuticas-para-prevencao-da-transmissao-vertical-de-hiv.
Hoenigl M, Chaillon A, Moore DJ, Morris SR, Mehta SR, Gianella S, et al. Rapid HIV viral load suppression in those initiating antiretroviral therapy at first visit after HIV diagnosis. Sci Rep 2016;6:32947. doi: https://doi.org/10.1038/srep32947.
Vogler IH, Alfieri DF, Damazio H, Gianjacomo HDB, Almeida ERD, Reiche EMV. Safety of monitoring antiretroviral therapy response in HIV-1 infection using CD4+ T cell count at long-term intervals. Cad Saude Publica 2018;34(10):e00009618. doi: https://doi.org/10.1590/0102-311X00009618.
Mendicino CCP, Moodie EEM, Guimarães MDC, Pádua CAM. Immune recovery after antiretroviral therapy initiation: a challenge for people living with HIV in Brazil. Cad Saude Publica 2021;37(9):e00143520. doi: https://doi.org/10.1590/0102-311X00143520.
Brasil. Ministério da Saúde. HIV/Aids; 2021 Disponível em https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/h/aids-hiv.
Lima DGL, Arruda EAG, Lima AJA, Oliveira BE, Fonteles MMF. Factors determining changes in initial antiretroviral therapy. Rev Assoc Med Bras 2012;58(2):222-8. doi: https://doi.org/10.1590/S0104-42302012000200019.
Cunha GH, Lima RCRO, Lopes MVI, Galvão MTG, Siqueira LR, Fontenele MSM. Mortality, survival and prognostic factors of people with in intensive care unit. Rev Esc Enferm USP 2021;55:e20210121. doi: https://doi.org/10.1590/1980-220X-REEUSP-2021-0121.
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Copyright (c) 2024 Daniela Jordana Santos da Silva, Beatriz Toyama Watanabe, Giovana de Souza Gonçalves, Stefany Melo Brasil, Hélio Ranes de Menezes Filho, Eduardo Vignoto Fernandes, Luiz Fernando Gouvêa-e-Silva
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