Epidemiological study and resistance patterns to the anti-tuberculosis drugs in mycobacteria and hiv co-infected patients in a reference hospital in Fortaleza, CearÃ
nÃo hà === The HIV infection and the tuberculosis (TB) are together the main causes of death for infectious agents in the world, being approximately 13 million people infected with both causative agents. The HIV-infected individuals show increased susceptibility for active tuberculosis, being the im...
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Universidade Federal do CearÃ
2007
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Online Access: | http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=2504 |
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HIV SÃndrome de ImunodeficiÃncia Adquirida HIV Mycobacterium tuberculosis Tuberculosis Risk Factors Acquired Immunodeficiency Syndrome DOENCAS INFECCIOSAS E PARASITARIAS |
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HIV SÃndrome de ImunodeficiÃncia Adquirida HIV Mycobacterium tuberculosis Tuberculosis Risk Factors Acquired Immunodeficiency Syndrome DOENCAS INFECCIOSAS E PARASITARIAS BrÃulio Matias de Carvalho Epidemiological study and resistance patterns to the anti-tuberculosis drugs in mycobacteria and hiv co-infected patients in a reference hospital in Fortaleza, Cearà |
description |
nÃo hà === The HIV infection and the tuberculosis (TB) are together the main causes of death for
infectious agents in the world, being approximately 13 million people infected with both
causative agents. The HIV-infected individuals show increased susceptibility for active
tuberculosis, being the imunosupression caused by the virus the main risk factor for the
development for active TB. This study investigated the profile of Mycobacterium tuberculosis
drug resistance and evaluated the factors related to the development of TB in HIV infected
patients who were treated at HSJ, which is a reference hospital in infectious diseases in Fortaleza,
CearÃ, Brazil. During the period of July 2003 until June 2006, 208 patients with clinical and/or
laboratorial diagnosis of micobacteriosis or tuberculosis and infection for the HIV were taken
care in this hospital. The TB/HIV co-infected patients were older (average: 40 years, p= 0.0025)
than the control group, being approximately 4 years older. The majority of the patients were male
(80.8%, p= 0.0005) and they had shown a risk to develop TB of 43.0% greater compared to the
female sex. The risk to develop the TB disease was two times higher in the patients with lower
educational levels (less than eight years of schooling) and they represented 85.9% of the patients
(p=0.000). The history of previous contact with TB patients and previous treatment for TB were
also found to be risk factors for TB. The imunosupression level was higher in TB-HIV coinfected
patients being the CD4+ lymphocytes count average of 169 cells/mm Â(p=0.000) and the
viral load logarithm average of 4,36 (p=0.0013). The clinical forms most frequents were
pulmonary (45.7%), extrapulmonary (28.4%) and disseminated (25.9%). Of the samples that
were submitted to identification, 81.2% were M. tuberculosis and 12.8% were not M.
tuberculosis. The resistance frequency to one drug and multi-resistance were the same (5.9%).
Overall, these observations are important for establishing political strategies of public health to
improve the conditions at the regional level. === A infecÃÃo pelo vÃrus HIV e a TB estÃo entre as principais causas de morte por agentes
infecciosos no mundo, aproximadamente 13 milhÃes de pessoas estÃo infectadas com ambos
agentes causadores. Os indivÃduos infectados pelo HIV apresentam susceptibilidade aumentada
para tuberculose ativa, sendo a imunossupressÃo determinada pelo vÃrus o principal fator de risco
para o desenvolvimento da doenÃa tuberculose. Este trabalho investigou o perfil de resistÃncia do
Mycobacterium tuberculosis e os fatores epidemiolÃgicos relacionados ao desenvolvimento da
doenÃa em pacientes co-infectados pelo HIV atendidos no Hospital SÃo Josà de DoenÃas
Infecciosas (HSJ), o qual à referÃncia em doenÃas infecciosas em Fortaleza, Estado do CearÃ,
Brasil. Foram analisados, no perÃodo de julho de 2003 atà junho de 2006, 208 pacientes com
diagnÃstico clÃnico e/ou laboratorial de micobacteriose ou tuberculose e infecÃÃo pelo HIV
atendidos no HSJ. Os pacientes co-infectados TB/HIV apresentavam idade superior aos pacientes
do grupo controle (mÃdia de 40 anos, p= 0,0025), tendo aproximadamente 4 anos a mais. O sexo
masculino apresentou maioria significante (80,8%, p= 0,0005) e teve risco 43,0% superior ao
sexo feminino de desenvolver TB. O risco de adquirir TB foi duas vezes maior nos pacientes com
escolaridade baixa, que representavam 85,9% dos pacientes (p=0,000). A histÃria de contato
prÃvio com pacientes com TB e de tratamento prÃvio para TB foram considerados fatores de risco
para TB nesta populaÃÃo. O nÃvel de imunossupressÃo foi maior nos pacientes co-infectados TBHIV
com contagem mÃdia de linfÃcitos T CD4+ de 169 cels/mm (p=0,000), assim como o
logaritmo da carga viral com mÃdia de 4,36 (p=0,0013). As formas clÃnicas mais freqÃentes
foram: pulmonar (45,7%), extrapulmonar (28,4%) e disseminada (25,9%). Das amostras que
foram realizadas identificaÃÃo, 81,2% foram identificadas como M. tuberculosis e 12,8% como
nÃo M. tuberculosis. A freqÃÃncia de resistÃncia a uma droga e multi-resistÃncia foram iguais
(5,9%). Esses resultados fornecem informaÃÃes importantes para o estabelecimento de estratÃgias
de polÃticas de saÃde pÃblicas mais adequadas a nÃvel regional. |
author2 |
Thalles Barbosa Granjeiro |
author_facet |
Thalles Barbosa Granjeiro BrÃulio Matias de Carvalho |
author |
BrÃulio Matias de Carvalho |
author_sort |
BrÃulio Matias de Carvalho |
title |
Epidemiological study and resistance patterns to the anti-tuberculosis drugs in mycobacteria and hiv co-infected patients in a reference hospital in Fortaleza, Cearà |
title_short |
Epidemiological study and resistance patterns to the anti-tuberculosis drugs in mycobacteria and hiv co-infected patients in a reference hospital in Fortaleza, Cearà |
title_full |
Epidemiological study and resistance patterns to the anti-tuberculosis drugs in mycobacteria and hiv co-infected patients in a reference hospital in Fortaleza, Cearà |
title_fullStr |
Epidemiological study and resistance patterns to the anti-tuberculosis drugs in mycobacteria and hiv co-infected patients in a reference hospital in Fortaleza, Cearà |
title_full_unstemmed |
Epidemiological study and resistance patterns to the anti-tuberculosis drugs in mycobacteria and hiv co-infected patients in a reference hospital in Fortaleza, Cearà |
title_sort |
epidemiological study and resistance patterns to the anti-tuberculosis drugs in mycobacteria and hiv co-infected patients in a reference hospital in fortaleza, cearã |
publisher |
Universidade Federal do Cearà |
publishDate |
2007 |
url |
http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=2504 |
work_keys_str_mv |
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_version_ |
1718894124681134080 |
spelling |
ndltd-IBICT-oai-www.teses.ufc.br-7902019-01-21T22:25:12Z Epidemiological study and resistance patterns to the anti-tuberculosis drugs in mycobacteria and hiv co-infected patients in a reference hospital in Fortaleza, Cearà Estudo epidemiolÃgico e perfil de resistÃncia Ãs drogas anti-tuberculose em pacientes co-infectados com TB/HIV em hospital de referÃncia em Fortaleza-Cearà BrÃulio Matias de Carvalho Thalles Barbosa Granjeiro Cristiane Cunha Frota Roberto da Justa Pires Neto Jorge Luiz Nobre Rodrigues ValÃria GÃes Ferreira Pinheiro HIV SÃndrome de ImunodeficiÃncia Adquirida HIV Mycobacterium tuberculosis Tuberculosis Risk Factors Acquired Immunodeficiency Syndrome DOENCAS INFECCIOSAS E PARASITARIAS nÃo hà The HIV infection and the tuberculosis (TB) are together the main causes of death for infectious agents in the world, being approximately 13 million people infected with both causative agents. The HIV-infected individuals show increased susceptibility for active tuberculosis, being the imunosupression caused by the virus the main risk factor for the development for active TB. This study investigated the profile of Mycobacterium tuberculosis drug resistance and evaluated the factors related to the development of TB in HIV infected patients who were treated at HSJ, which is a reference hospital in infectious diseases in Fortaleza, CearÃ, Brazil. During the period of July 2003 until June 2006, 208 patients with clinical and/or laboratorial diagnosis of micobacteriosis or tuberculosis and infection for the HIV were taken care in this hospital. The TB/HIV co-infected patients were older (average: 40 years, p= 0.0025) than the control group, being approximately 4 years older. The majority of the patients were male (80.8%, p= 0.0005) and they had shown a risk to develop TB of 43.0% greater compared to the female sex. The risk to develop the TB disease was two times higher in the patients with lower educational levels (less than eight years of schooling) and they represented 85.9% of the patients (p=0.000). The history of previous contact with TB patients and previous treatment for TB were also found to be risk factors for TB. The imunosupression level was higher in TB-HIV coinfected patients being the CD4+ lymphocytes count average of 169 cells/mm Â(p=0.000) and the viral load logarithm average of 4,36 (p=0.0013). The clinical forms most frequents were pulmonary (45.7%), extrapulmonary (28.4%) and disseminated (25.9%). Of the samples that were submitted to identification, 81.2% were M. tuberculosis and 12.8% were not M. tuberculosis. The resistance frequency to one drug and multi-resistance were the same (5.9%). Overall, these observations are important for establishing political strategies of public health to improve the conditions at the regional level. A infecÃÃo pelo vÃrus HIV e a TB estÃo entre as principais causas de morte por agentes infecciosos no mundo, aproximadamente 13 milhÃes de pessoas estÃo infectadas com ambos agentes causadores. Os indivÃduos infectados pelo HIV apresentam susceptibilidade aumentada para tuberculose ativa, sendo a imunossupressÃo determinada pelo vÃrus o principal fator de risco para o desenvolvimento da doenÃa tuberculose. Este trabalho investigou o perfil de resistÃncia do Mycobacterium tuberculosis e os fatores epidemiolÃgicos relacionados ao desenvolvimento da doenÃa em pacientes co-infectados pelo HIV atendidos no Hospital SÃo Josà de DoenÃas Infecciosas (HSJ), o qual à referÃncia em doenÃas infecciosas em Fortaleza, Estado do CearÃ, Brasil. Foram analisados, no perÃodo de julho de 2003 atà junho de 2006, 208 pacientes com diagnÃstico clÃnico e/ou laboratorial de micobacteriose ou tuberculose e infecÃÃo pelo HIV atendidos no HSJ. Os pacientes co-infectados TB/HIV apresentavam idade superior aos pacientes do grupo controle (mÃdia de 40 anos, p= 0,0025), tendo aproximadamente 4 anos a mais. O sexo masculino apresentou maioria significante (80,8%, p= 0,0005) e teve risco 43,0% superior ao sexo feminino de desenvolver TB. O risco de adquirir TB foi duas vezes maior nos pacientes com escolaridade baixa, que representavam 85,9% dos pacientes (p=0,000). A histÃria de contato prÃvio com pacientes com TB e de tratamento prÃvio para TB foram considerados fatores de risco para TB nesta populaÃÃo. O nÃvel de imunossupressÃo foi maior nos pacientes co-infectados TBHIV com contagem mÃdia de linfÃcitos T CD4+ de 169 cels/mm (p=0,000), assim como o logaritmo da carga viral com mÃdia de 4,36 (p=0,0013). As formas clÃnicas mais freqÃentes foram: pulmonar (45,7%), extrapulmonar (28,4%) e disseminada (25,9%). Das amostras que foram realizadas identificaÃÃo, 81,2% foram identificadas como M. tuberculosis e 12,8% como nÃo M. tuberculosis. A freqÃÃncia de resistÃncia a uma droga e multi-resistÃncia foram iguais (5,9%). Esses resultados fornecem informaÃÃes importantes para o estabelecimento de estratÃgias de polÃticas de saÃde pÃblicas mais adequadas a nÃvel regional. 2007-08-31 info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/masterThesis http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=2504 por info:eu-repo/semantics/openAccess application/pdf Universidade Federal do Cearà Programa de PÃs-GraduaÃÃo em Microbiologia MÃdica UFC BR reponame:Biblioteca Digital de Teses e Dissertações da UFC instname:Universidade Federal do Ceará instacron:UFC |