Name: GIVAGO GOMES DA SILVA
Publication date: 31/08/2020
Advisor:
Name |
Role |
|---|---|
| BLIMA FUX | Co-advisor * |
| CRISPIM CERUTTI JUNIOR | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| ANGELICA ESPINOSA BARBOSA MIRANDA | Internal Examiner * |
| BLIMA FUX | Co advisor * |
| CRISPIM CERUTTI JUNIOR | Advisor * |
| SANDRA FAGUNDES MOREIRA DA SILVA | External Examiner * |
Summary: Introduction: The description of acquired immunodeficiency syndrome (AIDS) occurred in
the early 1980s by the Center for Disease Control and Prevention in the United States of
America. The classic characteristic of the infection is the depletion of CD4 + T lymphocytes,
with the consequent manifestation of AIDS-defining diseases, such as extrapulmonary
tuberculosis and toxoplasmosis. Objective: To evaluate the clinical and epidemiological
profile of patients undergoing antiretroviral therapy at the medication dispensing unit of
Hospital Universitário Cassiano Antônio de Moraes - UDM / HUCAM before and after the
institution of dolutegravir (DTG) as the first line of treatment. Methods: Retrospective cohort
study based on secondary data obtained from Logistic Control System for Therapeutic Drugs
(SICLOM) OPERACIONAL and Control System for Laboratory Tests of the National
Network of Lymphocytes CD4+/CD8+ Count and HIV Viral Load (SISCEL) of patients
beginning antiretroviral therapy treated at the UDM / HUCAM. The study included patients
aged 18 years or older and who were being followed up on an outpatient basis at HUCAM.
The variables studied were: age, gender, marital status, education, CD4 count and viral load.
The statistical program used was SPSS version 20 (IBM). In the step of bivariate analysis,
tests applied for comparison of categorical variables were Chi-square and Fisher Exact. The
comparison of continuous variables involved tests for comparison of means or non-parametric
tests. The step of multivariate analysis verified the association between the intervening
variables and two different outcomes, namely viral load and discordant immunological
response, using binomial logistic regression. The measure of association was represented by
the odds ratio (OR) and its respective 95% confidence interval. In the binary logistic
regression step, the enter method was used for all variables with a p-value <0.2 in the
bivariate analysis. The statistical significance was set at the 5% level. Results: In the group
prior to the DTG, there was a predominance of males (67.5%), non-white color / race
(60.3%), to have born in the state of Espírito Santo (74.2%) and a marital status in the
category of unmarried (85.2%). Regarding education, 59.3% had a high level of education.
The mean age presented by this group was 44.2 ± 11.8 years (mean ± standard deviation)
(95% CI: 42.5-45.9). Regarding the DTG group, there was also a predominance of males
(69.8%), non-white color / race (77.4%), to have born in the state of Espírito Santo (73.6%)
and an unmarried marital status (88.7%). Regarding education, 50.9% had a high level of
education. The mean age of this group was 40.7 ± 14 (95% CI: 37.2-44.5). The study revealed
that individuals treated with DTG were almost ten times more likely to have an undetectable
final viral load have been treated before the introduction of DTG. Those undergoing treatment
prior to DTG were less likely to have a discordant immune response. Conclusion: The
present study identified a profile of male individuals, young adults, with a non-white declared
race, of unmarried marital status, with a high level of education and born in Espírito Santo.
There was a higher probability of undetectable final viral load and discordant immunological
response among those treated with DTG.
