Dermatoses infecciosas em pacientes portadores de HIV/AIDS no Núcleo de Medicina Tropical do Pará
The skin is the largest and most visible organ in the human body. Consequently, it presents the most varied types of pathological manifestations. In HIV immunosuppressed patients, there is a decline in the number and function of antigen presenting cells and CD4+ T cells, making the skin more vul...
| Autor principal: | SANTOS, Yasmin Amorim dos |
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| Outros Autores: | ROCHA, Helena Peixoto |
| Grau: | Trabalho de Conclusão de Curso - Graduação |
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2023
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https://bdm.ufpa.br:8443/jspui/handle/prefix/6103 |
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oai:https:--bdm.ufpa.br:8443:prefix-61032023-09-13T03:05:34Z Dermatoses infecciosas em pacientes portadores de HIV/AIDS no Núcleo de Medicina Tropical do Pará SANTOS, Yasmin Amorim dos ROCHA, Helena Peixoto XAVIER, Marília Brasil http://lattes.cnpq.br/0548879430701901 Infecções de pele Vírus da imunodeficiência humana Síndrome da imunodeficiência humana Skin infections Human immunodeficiency syndrome CNPQ::CIENCIAS DA SAUDE:: MEDICINA The skin is the largest and most visible organ in the human body. Consequently, it presents the most varied types of pathological manifestations. In HIV immunosuppressed patients, there is a decline in the number and function of antigen presenting cells and CD4+ T cells, making the skin more vulnerable to opportunistic and neoplastic infectious agents. This study aims to describe the prevalence and clinical and epidemiological characteristics of infectious dermatoses in patients with HIV/AIDS in a specialized outpatient clinic. A retrospective cohort study of patients with HIV/AIDS enrolled at the Núcleo de Medicina Tropical (NMT) of the Federal University of Pará (UFPA) was carried out between March 1999 and March 2021, with a sample of 544 patients. Data were analyzed using Microsoft Word, Excel and Bioestat 5.5 software, using the chi-square or Fisher's exact test, and Student's T test, or the equivalent nonparametric Mann-Whitney test. Results with p ≤ 0.05 (bilateral) were considered statistically significant. The results show that the patients were male (66.2%), aged between 40 and 59 years, single (65.8%), residing in Belém or Ananindeua (81.6%), coming from UREDIPE (58 .1%), diagnosed with AIDS (16.2%), using ART (94.9%), CD4+ from 1 to 300 (23.3%) and CD4+ above 300 (13.8%). About 100% of the patients in the study had skin changes, and more than half had at least two skin changes, that is, at least 50% had at least two combinations of dermatoses. As for the dermatological diagnosis, 16.9% of the individuals had dermatitis and 11.9% had prurigo; 27.6% of the subjects had an elementary papule lesion, 24.8% had erythema and 17.1% had a hyperchromic macula. As for the individual drugs used, 18.4% of the individuals used lamivudine, 9% AZT, 8.6% efavirenz. Of the 41 subjects during the observation period from 6 months to 1 year, 17.1% had Kaposi's sarcoma, which is a higher proportion than expected. Regarding the association with the use of ART, there were no significant associations related to dermatological diagnoses, there were no significant differences in relation to age, when compared to the presence of elementary lesions. It was found that there are several types of dermatological manifestations that can manifest in HIV-infected individuals, at different stages of immunosuppression. In addition, it is observed that these skin lesions can be the first signs that the patient presents, as well as, they are considered important clinical indicators for monitoring the immune system. Thus, dermatoses can be a good clinical marker to detect the clinical stage and diagnose HIV infection; in addition, there may be a significant increase in the number of dermatoses in advanced stages. A pele é o maior e mais visível órgão do corpo humano. Consequentemente apresenta os mais variados tipos de manifestações patológicas. Nos pacientes imunodeprimidos pelo HIV existe um declínio no número e na função das células apresentadoras de antígenos e células T CD4+, tornando a pele mais vulnerável aos agentes infecciosos oportunistas e neoplásicos. Este estudo objetiva descrever a prevalência e as características clínicas e epidemiológicas de dermatoses infecciosas em pacientes portadores de HIV/AIDS em um ambulatório de referência especializada. Foi realizado um estudo de coorte retrospectivo de pacientes portadores de HIV/AIDS matriculados no Núcleo de Medicina Tropical (NMT) da Universidade Federal do Pará (UFPA), entre o período de março de 1999 até março de 2021, tendo como amostra 544 pacientes. Os dados foram analisados nos softwares Microsoft Word, Excel e Bioestat 5.5, por meio do teste qui-quadrado ou exato de Fisher, e teste T Student, ou o equivalente não paramétrico teste de Mann-Whitney. Os resultados com p ≤ 0,05 (bilateral) foram considerados estatisticamente significativos. Os resultados apontam que os pacientes eram do sexo masculino (66,2%), com idade de 40 a 59 anos, solteiro (65,8%), residência em Belém ou Ananindeua (81,6%), procedentes da UREDIPE (58,1%), com diagnóstico de AIDS (16,2%), usavam TARV (94,9%), CD4+ de 1 a 300 (23,3%) e CD4+ acima de 300 (13,8%). Cerca de 100% dos pacientes do estudo apresentaram alterações cutâneas, sendo que mais da metade apresentou ao menos duas alterações cutâneas, ou seja, há pelo menos 50% apresentaram pelo menos duas combinações de dermatoses. Quanto ao diagnóstico dermatológico, 16,9% dos indivíduos tiveram dermatite e 11,9% prurigo; 27,6% dos indivíduos tinham lesão elementar pápula, 24,8% eritema e 17,1% mácula hipercrômica. Já quanto aos fármacos individuais utilizados, 18,4% dos indivíduos usavam lamivudina, 9% AZT, 8,6% efavirenz. Dos 41 indivíduos do tempo de observação 6 meses a 1 ano, 17,1% tinham sarcoma de Kaposi, sendo essa proporção maior que o esperado. Em relação à associação com uso de TARV, não houve associações significativas relacionadas aos diagnósticos dermatológicos não houve diferenças significativas em relação à idade, quanto comparada com relação à presença de lesão elementar. Constatou-se que existem diversos tipos de manifestações dermatológicas podem se manifestar em indivíduos infectados pelo HIV, em diferentes estágios de imunossupressão. Além disso, observam-se que essas lesões cutâneas podem ser os primeiros sinais que o paciente apresenta, bem como, são considerados importantes indicadores clínicos para o monitoramento do sistema imunológico. Assim, as dermatoses podem ser um bom marcador clínico para detectar o estágio clínico e diagnosticar a infecção pelo HIV; além disso, pode haver um aumento significativo do número de dermatoses em estágios avançados. 2023-09-12T13:44:36Z 2023-09-12T13:44:36Z 2022 Trabalho de Conclusão de Curso - Graduação ROCHA, Helena Peixoto; SANTOS, Yasmin Amorim dos. Dermatoses infecciosas em pacientes portadores de HIV/AIDS no Núcleo de Medicina Tropical do Pará. Orientadora: Marília Brasil Xavier. 2022. 70 f. Trabalho de Conclusão de Curso (Bacharelado em Medicina) - Faculdade de Medicina, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, 2022. Disponível em: https://bdm.ufpa.br:8443/jspui/handle/prefix/6103. Acesso em:. https://bdm.ufpa.br:8443/jspui/handle/prefix/6103 Acesso Aberto Disponível na Internet via correio eletrônico: bibsaude@ufpa.br |
| institution |
Biblioteca Digital de Monografias - UFPA |
| collection |
MonografiaUFPA |
| topic |
Infecções de pele Vírus da imunodeficiência humana Síndrome da imunodeficiência humana Skin infections Human immunodeficiency syndrome CNPQ::CIENCIAS DA SAUDE:: MEDICINA |
| spellingShingle |
Infecções de pele Vírus da imunodeficiência humana Síndrome da imunodeficiência humana Skin infections Human immunodeficiency syndrome CNPQ::CIENCIAS DA SAUDE:: MEDICINA SANTOS, Yasmin Amorim dos Dermatoses infecciosas em pacientes portadores de HIV/AIDS no Núcleo de Medicina Tropical do Pará |
| topic_facet |
Infecções de pele Vírus da imunodeficiência humana Síndrome da imunodeficiência humana Skin infections Human immunodeficiency syndrome CNPQ::CIENCIAS DA SAUDE:: MEDICINA |
| description |
The skin is the largest and most visible organ in the human body. Consequently, it
presents the most varied types of pathological manifestations. In HIV
immunosuppressed patients, there is a decline in the number and function of antigen presenting cells and CD4+ T cells, making the skin more vulnerable to opportunistic
and neoplastic infectious agents. This study aims to describe the prevalence and
clinical and epidemiological characteristics of infectious dermatoses in patients with
HIV/AIDS in a specialized outpatient clinic. A retrospective cohort study of patients with
HIV/AIDS enrolled at the Núcleo de Medicina Tropical (NMT) of the Federal University
of Pará (UFPA) was carried out between March 1999 and March 2021, with a sample
of 544 patients. Data were analyzed using Microsoft Word, Excel and Bioestat 5.5
software, using the chi-square or Fisher's exact test, and Student's T test, or the
equivalent nonparametric Mann-Whitney test. Results with p ≤ 0.05 (bilateral) were
considered statistically significant. The results show that the patients were male
(66.2%), aged between 40 and 59 years, single (65.8%), residing in Belém or
Ananindeua (81.6%), coming from UREDIPE (58 .1%), diagnosed with AIDS (16.2%),
using ART (94.9%), CD4+ from 1 to 300 (23.3%) and CD4+ above 300 (13.8%). About
100% of the patients in the study had skin changes, and more than half had at least
two skin changes, that is, at least 50% had at least two combinations of dermatoses.
As for the dermatological diagnosis, 16.9% of the individuals had dermatitis and 11.9%
had prurigo; 27.6% of the subjects had an elementary papule lesion, 24.8% had
erythema and 17.1% had a hyperchromic macula. As for the individual drugs used,
18.4% of the individuals used lamivudine, 9% AZT, 8.6% efavirenz. Of the 41 subjects
during the observation period from 6 months to 1 year, 17.1% had Kaposi's sarcoma,
which is a higher proportion than expected. Regarding the association with the use of
ART, there were no significant associations related to dermatological diagnoses, there
were no significant differences in relation to age, when compared to the presence of
elementary lesions. It was found that there are several types of dermatological
manifestations that can manifest in HIV-infected individuals, at different stages of
immunosuppression. In addition, it is observed that these skin lesions can be the first
signs that the patient presents, as well as, they are considered important clinical
indicators for monitoring the immune system. Thus, dermatoses can be a good clinical
marker to detect the clinical stage and diagnose HIV infection; in addition, there may
be a significant increase in the number of dermatoses in advanced stages. |
| author_additional |
XAVIER, Marília Brasil |
| author_additionalStr |
XAVIER, Marília Brasil |
| format |
Trabalho de Conclusão de Curso - Graduação |
| author |
SANTOS, Yasmin Amorim dos |
| author2 |
ROCHA, Helena Peixoto |
| author2Str |
ROCHA, Helena Peixoto |
| title |
Dermatoses infecciosas em pacientes portadores de HIV/AIDS no Núcleo de Medicina Tropical do Pará |
| title_short |
Dermatoses infecciosas em pacientes portadores de HIV/AIDS no Núcleo de Medicina Tropical do Pará |
| title_full |
Dermatoses infecciosas em pacientes portadores de HIV/AIDS no Núcleo de Medicina Tropical do Pará |
| title_fullStr |
Dermatoses infecciosas em pacientes portadores de HIV/AIDS no Núcleo de Medicina Tropical do Pará |
| title_full_unstemmed |
Dermatoses infecciosas em pacientes portadores de HIV/AIDS no Núcleo de Medicina Tropical do Pará |
| title_sort |
dermatoses infecciosas em pacientes portadores de hiv/aids no núcleo de medicina tropical do pará |
| publishDate |
2023 |
| url |
https://bdm.ufpa.br:8443/jspui/handle/prefix/6103 |
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1787238473635201024 |
| score |
11.675608 |