کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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1073642 | 949795 | 2010 | 5 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Effect of a healthcare gender gap on progression of HIV/AIDS defined by clinical-biological criteria among adults from Cordoba City (Argentina) from 1995 to 2005 Effect of a healthcare gender gap on progression of HIV/AIDS defined by clinical-biological criteria among adults from Cordoba City (Argentina) from 1995 to 2005](/preview/png/1073642.png)
ObjectiveTo establish the influence of clinical status at diagnosis and of gender on progression of HIV/AIDS determined by clinical-biological factors in patients from Cordoba City (Argentina) from 1995 to 2005).MethodsGender and clinical and laboratory data were evaluated by descriptive statistics, non-parametric survival analysis, and generalized linear models at the beginning of the study (diagnosis) and at the end (hospital records, n=209).ResultsAt diagnosis, women (n=28, 13.4%) had a higher probability of being asymptomatic than men (n=181, 86.6%). High viremia was associated with advanced clinical stages, but was inversely related to CD4 count. Truncated Kaplan-Meier curves were similar for both sexes. The probability of not having AIDS criteria at the end of the study was higher in patients without these criteria at diagnosis. Women had a higher probability of having AIDS at the end of the follow-up than men. In contrast, men had a higher prevalence of venereal diseases (n=38, 21%), dysmetabolic profile (n=14, 7.7%) and positive serology for opportunists (n=31, 17.1%). Marker diseases were mainly represented by internal mycosis and waste syndrome, although less specific findings (anemia, oral lesions) were also associated with progression.ConclusionsUsing an integrative approach, high viremia was critically linked to clinical and lymphocyte impairment. Early diagnosis was a major determinant of clinical course, with women having a worse prognosis. However, men were diagnosed in clinically advanced stages and with other non-HIV-related entities, which could affect progression. These findings should be integrated into the planning of preventive strategies.
ResumenObjetivosEstablecer la influencia de la condición médica al diagnóstico y del sexo en la evolución del VIH/Sida determinada por factores clínico-biológicos en pacientes de la ciudad de Córdoba (Argentina, 1995–2005).MétodosEl sexo, los datos clínicos y los de laboratorio fueron evaluados por estadística descriptiva, análisis de supervivencia no paramétrico y modelos lineales generalizados al inicio (diagnóstico) y al final del estudio (registro hospitalario, 209 casos).ResultadosLas mujeres (n=28, 13,4%) tienen mayor probabilidad de estar asintomáticas que los hombres (n=181, 86,6%) en el momento del diagnóstico. La viremia alta está asociada con estadios clínicos avanzados, pero está inversamente relacionada con el de CD4. Las curvas truncadas de Kaplan-Meier son similares para ambos sexos. La probabilidad de no tener criterios de sida al final del estudio está incrementada para los pacientes diagnosticados sin ellos. Además, las mujeres tienen mayor probabilidad de presentar sida que los hombres al finalizar el seguimiento recuento. No obstante, ellos mostraron una elevada prevalencia de enfermedades venéreas (n=38, 21%), perfil dismetabólico (n=14, 7,7%) y serología para oportunistas (n=31, 17,1%). Las enfermedades marcadoras fueron principalmente micosis internas y síndrome consuntivo, aunque hallazgos menos específicos (anemia, lesiones orales) también se asociaban a la progresión.ConclusionesUtilizando un enfoque integrador, la viremia estuvo muy ligada al empeoramiento clínico y linfocitario, siendo el diagnóstico temprano un determinante mayor de evolución, con las mujeres teniendo peor pronóstico. Sin embargo, los hombres fueron diagnosticados avanzados clínicamente, con otros problemas no asociados al VIH que podrían afectar su evolución. Estos resultados deberían ser integrados en el planeamiento sanitario de prevención.
Journal: Gaceta Sanitaria - Volume 24, Issue 3, May–June 2010, Pages 204–208