Herpes Zoster- a higher incidence among patients with HIV
Despite the significant decrease in the age of ART - Acronym used in scientific circles for "standard therapy antiretroviral" (Antiretroviral Therapy), The incidence of herpes zoster among patients with HIV was three times higher than the general population, according to data published by the medical journal Clinical Infectious Diseases, published in the United States.
The risk of herpes zoster was associated with to the degree of immunodeficiency and was greatly reduced by ART. Researchers at the Pierre Louis Institute for Epidemiology and Public Health in Paris wrote: "In addition, among naive, inexperienced patients under ART treatment, we found that the risk of herpes increased moderately during the first months before declining sharply thereafter ".
The researchers evaluated the incidence of herpes zoster and risk factors among HIV patients based on the French Hospital database, from 1992 to 2011. They compared the incidence in this population with the occurrence of shingles in the general population of 2005 to 2008, through a public health surveillance network (made up of general medical volunteers) known as Réseu Sentinelles.
The research involved patients with HIV 91.044 583.125 people / year at risk. Herpes zoster was diagnosed in patients 7.167 1992 the 2011. The degree of incidence fell significantly by 2.955 100.000 people / year before the period of default antiretroviral therapy (ART, in English), of the 1992 1996, 628 for by 100.000 people / year in the latest period of ART - 2009 the 2011. The decrease is explained by the operation of the ART (rr = 0.6, 95% ci, 0.57-0.64). Associated risk factors include herpes zoster low number of lymphocytes (CD 4), high levels of RNA (ribonucleic acid) in a ratio of low levels CD4 / CD8 (to evaluate the progression of HIV infection), and a history of AIDS.
In an analysis of the ART inexperienced patients, the risk of zoster was significantly higher within the first six months of ART. In a model adjusted for current CD4 count and plasma HIV RNA measurement, the risk was significantly higher among 3 6 months and months of treatment (RR = 1,39, 95% ci, 1,16-1,66).
The degree of incidence of herpes zoster in the general population of the 2005 2008, decreased with age, unlike patients with HIV. After regular search by gender and age, the risk of herpes zoster was 2.7 times higher than among people with HIV. The normal incidence rates were higher among patients aged 15 44 the years.
"The overall decrease in the incidence of shingles among HIV-infected patients ART is probably related to restoration and enhancement of immunity as well as viral control, "the researchers wrote. "This evolution may continue in the future while ART is started earlier and has the highest CD4 (lymphocyte) cell count as recommended by the most recent scientific guidelines. However, clinicians and patients should be wary of the transient increase in herpes zoster risk in the first six months of treatment. "
Translation: Márcio Catanho - Bachelor of Arts / translator and reviewer.
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Edição: Claudio Souza s