ANA PAULA ROCHA VEIGA
Índice h a partir de 2011
2
Projetos de Pesquisa
Unidades Organizacionais
LIM/56 - Laboratório de Investigação em Dermatologia e Imunodeficiências, Hospital das Clínicas, Faculdade de Medicina
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Resultados de Busca
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- Incomplete recovery of the CD4+/CD8+ratio is associated with the late introduction of antiretroviral therapy among people living with HIV infection(2024) PRATES, Gabriela da Silva; MONTEIRO, Mariana Amelia; OLIVEIRA, Ericka Constantinov; NASCIMENTO, Najara Ataide de Lima; VEIGA, Ana Paula Rocha; FERREIRA, Mauricio Domingues; POLIS, Thales Jose Bueno; CAETANO, Gabriela Prandi; SOARES, Beatriz Rodrigues Pellegrina; MAGRI, Marcello Mihailenko Chaves; PEREIRA, Luisa Oliveira; FONSECA, Luiz Augusto Marcondes; ALVES, Wagner Silva; DUARTE, Alberto Jose da Silva; CASSEB, Jorge Simao do RosarioDespite being subject to lower AIDS-related mortality rates and having a higher life expectancy, patients with HIV are more prone to develop non-AIDS events. A low CD4+/CD8+ ratio during antiretroviral therapy identifies people with heightened immune senescence and increased risk of mortality. In clinical practice, finding determinants of a low CD4+/CD8+ ratio may be useful for identifying patients who require close monitoring due to an increased risk of comorbidities and death. We performed a prospective study on the evolution of the CD4(+)/CD8(+) ratio in 60 patients infected with HIV (80% males), who were subjected to two different antiretroviral regimens: early and deferred therapy. The initial CD4(+)/CD8(+) ratio was <= 1 for 70% of the patients in both groups. Older age, CD4(+) cell count at inclusion, Nadir CD8(+)T-cell count, and Initial CD4(+)/CD8(+) ratio <= 1 were risk factors for lack of ratio recovery. In the multivariate analysis, a CD4(+)/CD8(+) ratio > 1 at the start of the treatment was found to be a determinant factor in maintaining a CD4(+)/CD8(+) ratio > 1. The nadir CD4(+)T-cell count was lower in the deferred therapy group (p=0.004), and the last CD4(+)/CD8(+) ratio <= 1 was not associated with comorbidities. Ratio recovery was not associated with the duration of HIV infection, time without therapy, or absence of AIDS incidence. A greater improvement was observed in patients treated early (p=0.003). In contrast, the slope of increase was slower in patients who deferred treatment. In conclusion, the increase in the CD4+/CD8+ ratio occurred mostly for patients undergoing early strategy treatment and its extension did not seem to be related to previous HIV-related factors.
- TUBERCULOSIS AMONG HIV-1-INFECTED SUBJECTS IN A TERTIARY OUT-PATIENT SERVICE IN SAO PAULO CITY, BRAZIL(2012) CASSEB, Jorge; FONSECA, Luiz Augusto M.; MEDEIROS, Lucas A.; GONSALEZ, Claudio R.; LAGONEGRO, Eduardo R.; VEIGA, Ana Paula Rocha; SILVA, Daniela C. Da; MENDONCA, Marcelo; DUARTE, Alberto J. S.TB is currently considered to be the most important infectious disease among HIV-1-infected subjects in developing countries, such as Brazil. A retrospective analysis of TB cases was performed, occurring from January 1995 to December 2010 in our cohort of 599 HIV positive patients. The primary outcome was the occurrence of active TB. Forty-one TB cases were diagnosed over this period of 16 years, among 599 HIV positive patients in an open cohort setting in the city of Sao Paulo, Brazil. All-time lowest mean CD4 T cell count at the time of TB diagnosis was 146 and 186 cells/mm(3), respectively. The mean HIV viral load was 5.19 log(10) copies/mL, and 59% of the patients were on HAART. TB incidence was 1.47 per 100 person-years, for a total follow-up time of 2775 person-years. The probability of surviving up to 10 years after diagnosis was 75% for TB patients as opposed to 96% for patients with other, non-TB opportunistic diseases (p = 0.03). TB can be considered a public health problem among people living with HIV in Brazil despite of the widespread use of antiretrovirals for the treatment of HIV infection/AIDS.
- SARS-CoV-2/COVID-19: Clinical Course Among Subjects HIV-1-Infected in Sao Paulo(2022) MONTEIRO, Mariana A. A.; PRATES, Gabriela S. S.; NASCIMENTO, Najara A. A. de Lima; VEIGA, Ana Paula R.; MAGRI, Marcello M. C.; POLIS, Thales J. B.; GASCON, Maria R. P.; FERREIRA, Mauricio D. D.; TIBERTO, Larissa; PEREIRA, Luisa O. O.; ALVES, Wagner; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.; CASSEB, JorgeIntroduction: People living with Human Immunodeficiency Virus (HIV) are under risk for co-infection with SARS-CoV-2. This population may be more prone to complications from COVID-19 due to persistent inflammation caused by HIV and higher incidence of metabolic syndromes, cardiovascular diseases, and malignancies, as well as being considered elderly at 50 years of age. The objective of this study was to report SARS-CoV-2 infection frequency, clinical evolution, and mortality in HIV-positive patients on antiretroviral therapy. Methods: The period of inquiry ranged from January to September 2020. Due to the social distance and the suspension of in-person medical care during the time of the investigation, we sent electronic questions about demographic, epidemiological, and clinical data to 403 HIV-infected patients. Results: Among 260 patients who answered the questionnaire, thirty-nine patients (15%) had suggestive symptoms and were tested for SARS-CoV-2 infection. Of this, 11 had positive results (32.4%) and no patient died of COVID-19 complications. Nine were male (3.4%), and the mean age of the patients with positive results was 43.2 years (+/- 9.6). 107 patients (41.1%) were over 50 years of age and their mean T-CD4(+) cell count was 768. Eleven patients (4.2%) had a detectable HIV RNA viral load and 127 (48.8%) had comorbidities. These variables were not associated with an increased risk for infection. Conclusion: The frequency of SARS-COV2 infection among HIV-infected is similar to the general population, and the clinical course is associated with the presence of comorbidities and not due to the HIV infection. However, new studies should be done to assess if this vulnerable population could answer the vaccine anti-SARS-Cov2.
- Fighting HIV/AIDS in a developing country: lessons from a small cohort from the largest Brazilian city(2020) CASSEB, Jorge; VEIGA, Ana Paula R.; MAGRI, Marcello M. C.; MONTEIRO, Mariana A.; ROCHA, Rosana C.; GASCON, Maria Rita P.; DOMINGUES-FERREIRA, Mauricio; POLIS, Thales J. B.; NASCIMENTO, Najara A. de Lima; LIMONGELLI, Isadora; OLIVEIRA, Icaro S.; PRANDI, Gabriela Caetano; COSTA, Livia M. C. B. Villares; FONSECA, Luiz A. M.; DUARTE, Alberto J. S.
- Efficacy of vitamin D supplementation among persons living with HIV/AIDS in Sao Paulo city, Brazil(2021) ALMEIDA-AFONSO, Rosa; FINAMOR, Danilo; FONSECA, Luiz Augusto M.; VEIGA, Ana P. Rocha; MONTEIRO, Mariana A.; MAGRI, Marcello; DUARTE, Alberto J. S.; CASSEB, JorgeHypovitaminosis D is now considered a pandemic, especially among more vulnerable populations and in HIV-infected subjects, with 80% presenting levels below 30 ng/mL. As there is no consensus on the more adequate dosage needed to correct such deficiency, the objective of this study was to evaluate 25 (OH) vitamin D supplementation in HIV-1 patients deficient of vitamin D. A total of 73 HIV-1-infected patients were included, drawn from a cohort of 435 patients; 37 patients were randomized to the active group, supplemented once a week with 50,000 UI vitamin D by mouth (group 1) and 36 to the placebo group (group 2). The study period ranged from June 2016 to September 2017. Variables involved in vitamin D metabolism and risk factors associated with hypovitaminosis were evaluated. The mean age was 45 years and 31.5 % were women. Vitamin D supplementation was effective in normalizing serum levels after six months in group 1 (mean 35 ng/mL compared to 21 ng/mL for the placebo group; p = 0.04). No patient reached blood levels considered toxic (>100 UI). Efavirenz use can negatively influence vitamin D levels and supplementation is necessary as a likely adjunct to improving CD4+ T cells, resulting in greater effectiveness of the treatment. A weekly oral dose of 50,000 IU of vitamin D was sufficient to normalize the vitamin deficiency, safely and with good adherence among persons living with HIV/AIDS in Brazil. (C) 2021 Sociedade Brasileira de Infectologia.