Catàleg general VIH/sida
Evaluation of HIV-infection control, risk behaviours and comorbidities among inmates in Mexico
ResumIntroduction: A high prevalence of HIV infection in prisons has been recognized as a significant health problem in developed countries. To this point, it is important to evaluate our prison health-system to see if the model of care is adequate or not and to look for new care strategies to achieve good HIV-control into prisons. Materials and methods: Cross-sectional, retrospective study of HIV-positive prisoners. To describe the main risk behaviours for HIV-infection, its control, the prevalence of comorbidities and other co-infections in prisoners who were treated in the HIV-Unit of Hospital Civil de Guadalajara, Mexico. All HIV-infected prisoners who were receiving medical care at our HIV-unit from May 1st 2013 to May 31st 2014 were included. Data were obtained from an electronic database of medical records. Results: A total of 88 patients were included, 95% were male, with a median age of 36 years, all Hispanic. The principal risk factors to HIV- infection were unprotected heterosexual intercourse (55%), following of homo/bisexual intercourse, intravenous drug use (45 and 33%, respectively). The 71% of patients were in an advanced stage of HIV infection and 72% of the patients on HIV-treatment, reached HIV control with undetectable viral load. The 21% had Syphilis. We found a serologic evidence of Hepatitis C co-infection in 33%, the majority was genotype 1a and none received HCV treatment, moreover, the 8% of patients had serologic markers for hepatitis B. Regarding opportunistic infections; pulmonary tuberculosis was the most frequent (36%), followed by disseminated histoplasmosis (10%). The principal comorbidity was dyslipidaemia in 42 and 16% had meta- bolic syndrome. The 89% used to smoke daily, 76% used any kind of drug (principally, marijuana and cocaine) and 85% were alcohol consumers. Conclusions: Efficiency of highly active antiretroviral therapy (HAART) among our prisons is higher compared to other cohorts ; however, the high frequency of comorbidities, smokers and drugs users, could increase the mortality and complicate HIV-infection by itself [2,3]; moreover, the high prevalence of HCV and HBV could be indicative of potentially risky blood-borne exposures or unprotected sexual contacts. So, new care strategies are needed for integral treatment of these patients . (Extraído del documento)
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- Póster presentado en el congreso HIV Drug Therapy 2015 Americas, celebrado en México del 16 al 18 de abril de 2015.