COVID-19! HIV and Coronavirus

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AIDS

COVID-19! HIV and Coronavirus, is it really HIV and the New Coronavirus, the so-called?

I told my wife, Mara, and I also told a longtime friend that she “found me” on the net, that the combination of HIV and Coronavirus is and will almost certainly be a game changer! The world and all its ills, without the Coronavirus and the world after the coronavirus, which it will generate, is generating 15 million new jobs today, April 01, 2020 and it's not April Fool's Day!
A virus that will hopefully bring an awareness of the need for support and respect, may be the arrival of the long awaited return !!!!

Perhaps it will be, the world of society where good labor relations! From love to neighbor. The value of other people's lives.

Well, I went overboard, I ended up going on a tour! The fact is that, for these or those reasons, we must, anguishingly fight, face and win, the capitalized Corona Virus and, likewise, HIV!

Still digesting, I have access to a video that I intend to incorporate in this text, at the end of it, because it is well established the fact that we are going through, with statements by the UN and WHO, the worst moment of Nossa after the Second World War that just ended , once and for all with the detonation of two hydrogen bombs and, one of them, devastated and calcined a city and 250.00 inhabitants instantly, in a fraction of a second!

Digressions made, let's go to the text:

People with COVID-19 and HIV in Brazil and HIV

This interim guidance looks at special considerations for people with HIV and their healthcare professionals in the United States in relation to COVID-19. Information and data about COVID-19 is evolving rapidly. This guidance includes general information to be considered. Doctors should consult updated sources for more specific recommendations on COVID-19.

Guidance in reference to COVID-19 for people with HIV in Brazil

In current reports, individuals aged> 60 years and with diabetes, hypertension, cardiovascular disease or lung disease are at higher risk of death, with a cause related to COVID-19 caused by SARS-CoV-2.

  • Data limited to currently available do not indicate that the course of COVID-19 disease in people with HIV differs from that in people without HIV.
  • Prior to the advent of effective combined antiretroviral therapy (ART), advanced HIV infection (ie, CD4 cell count <200 / mm3) was a risk factor for complications from other respiratory infections.
  • It is not yet known whether this is also true for COVID-19.
  • Some people with HIV have other comorbidities like, for example, cardiovascular disease or lung disease that increase the risk of a more severe course of COVID-19 disease.
  • Chronic smokers are also at risk for a more serious course.
  • So, until we know more, yes, additional care is needed for all people with HIV, especially those with advanced HIV or poorly controlled HIV.
  • Every effort should be made to help people with HIV maintain an adequate supply of ART and all other concomitant medications.
  • As influenza and pneumococcal vaccines should be kept up to date.
  • People with HIV must follow all applicable recommendations to prevent the spread of COVID-19 and they are the same:

The Text Continues after this reading tip. Right-click the title and click open in another tab. It is something else to read, which is relevant to this reading.

Thank you for coming here. You, coming to the blog, reading it, looking for me or Beto Volpe.

People! You are the ones who lead me to stay here, despite everything and everyone !!! Even my aunt, a woman so wise, cultured, that she literally traveled the world !!!!

God, what a great responsibility you have given me!

A Little More About COVID-19 in Brazil and People With HIV

Antiretroviral therapy

People with HIV should:

Eu i will say something more about this duty ahead.

  • Keep at least a 30-day supply on hand - and ideally a 90-day supply - antiretroviral drugs (ARV) and other drugs.
  • Talk to your pharmacists and / or healthcare providers about changing mail delivery when possible. I know it may seem like an episode beyond imagination, but it never hurts to try or, at least, ask one of these pharmacy professionals to prepare your medication withdrawal while you are “outdoors”.
  • People for whom a regime change is planned should consider postponing the change until it is possible to closely monitor and monitor.
  • Lopinavir / ritonavir (LPV / r) has been used as an unsuitable treatment for patients with COVID-19 and clinical trials are underway worldwide. They were and have painfully failed. I have things to be translated. But I run out of time!
  • If protease inhibitors (PIs) are not yet part of a person's ARV regimen, their regimen must not be changed to include an IP to (allegedly) prevent or treat COVID-19except in the context of a clinical trial and in consultation with an HIV specialist.
  • In a small open study, 199 patients hospitalized with COVID-19 were randomized to 14 days of LPV / r plus standard treatment or standard treatment alone. There was no difference statistically significant between the two groups in relation to the time of clinical improvement or mortality.1

On Clinical or Laboratory Monitoring Visits Related to HIV Care:

    • Together with their health professionals, people with HIV and their care providers -opens in another tab, healthcare professionals should assess the risks and benefits of attending, or not attending, HIV-related clinical consultations in person at this time. Factors to be considered include the extent of local transmission of COVID-19, the health needs that will be addressed during the consultation and the status of that moment in the person's HIV clinical condition, such as CD4 cell count , HIV viral load as well as health status in general.
    • Telephone or virtual visits for routine or non-urgent care and adherence advice can replace face-to-face meetings.
    • For people with suppressed HIV viral load and in stable health, routine medical and laboratory visits should be postponed as far as possible as possible.

People with HIV and in opioid treatment programs such as methadone

  • Physicians who care for people with HIV enrolled in opioid treatment programs, usually in pain clinics, should consult these establishments initially by telephone, videoconference for updated guidance on how to avoid (painful) treatment interruptions. Controlling methadone use can, and should, provide additional guidance.

Orientation to specific populations

Pregnant women with HIV:

  • Currently, there is information regarding to COVID-19 and pregnancy and care for mothers who contracted COVID-19 !.
  • Immunological and physiological changes during pregnancy generally increase a pregnant person's susceptibility to viral respiratory infections, possibly including COVID-19. As previously noted in other Coronavirus infections, but it implies informing that the risk of serious illness, morbidity or mortality with COVID-19 may be greater among pregnant women than in the general population.2
  • Although limited, currently available data do not indicate that pregnant women are more susceptible to COVID-19 infection or that pregnant women with COVID-19 have more serious illnesses.6,7 Adverse pregnancy results, such as fetal distress and premature birth, have been observed in a small series of pregnant women with COVID-19 infection and have been reported with infections by SARS and MERS during pregnancy.3-5
  • The findings of a small group of pregnant women with COVID-19 found no evidence of vertical transmission of COVID-19, although at least one case of neonatal COVID-19 has been described.7-9

Children with HIV:

  • From the very limited and available data, children seem less likely to become seriously ill with COVID-19 infection than older adults.10-12
  • However, there may be subpopulations of children at increased risk for more serious COVID-19 disease; in coronavirus and non-COVID-19 infection studies in children, younger age, underlying pulmonary pathology and immunocompromised conditions were associated with more severe results.13 (understood Pedro Bó?)
  • Infants and children with HIV must be up to date on all immunizations, including influenza and pneumococcal vaccines.

Guidance for people with HIV in self-isolation or quarantine due to exposure to healthcare professionals in SARS-CoV-2

The professionals of health should:
  • Check that patients have adequate supplies of all medications and expedite drug refills as needed.
  • Draw up a plan to evaluate patients if they develop symptoms related to COVID-19, including for possible transfer to a health facility for COVID-19 care if needed.

You, recently diagnosed, may be surprised, but within this pandemic, we also have duties.

The duty to ensure safety and minimize impacts on the transmission chain until o level zero, if level zero can be obtained.

We have to think about other people inside clinics and other treatment centers, such as CRT-A and Casa da AIDS, for example, and “Lá em Casa”, a pioneering and excellent service when it comes to improving health. physical condition of people living with HIV.

But look: You should try to think like this: Each host (that's what we have become) is, for a given virus, a kind of test tube. There, he replicates, finds problems, or not, but if he finds problems and sooner or later, you can bet on that, he will find difficulties! Do you know what he will try to do? Adapt, change (mutation). Maybe he can do it. Maybe not, I don't know. But I know that if it changes, and it can change a lot, it can become something even more dangerous! Our duty is to prevent the viral entity in you from finding, in another host, the opportunity that he, perhaps and fortunately, did not find in

Sense 8 or Godless at home during the COVID-9 Pandemic?

What's worse. You will only have realized this for hours and hours, even days after your final episode of Sense 8 cannot be seen by you, permanently.

Cable TV stations have placed a red band with a very large source that the UN has declared that this pandemic may reach apocalyptic proportions. I remember photographing this thing, but I'm not sure it was on the damaged cell phone or the one I was forced to buy. If I find the image, I will try to find and see if I can publish without being crucified by the TV station. So we come to this point:

People with HIV should:
    • Contact your doctor to inform them that are self-insulating or quarantined.
    • Specifically, inform the doctor about the amount of ART drugs and other essential drugs they have on hand.

Guidance for people with HIV who have fever or respiratory symptoms and who seek assistance and evaluation

The professionals of health should:
  • Follow the guidelines of the Ministry of Health and your state governors. And our President-elect, Jair Messias Bolsonaro, when he is being sensible!, As well as the guidelines of the health departments on infection control, screening, diagnosis and management.
People with HIV should:
  • Follow those of the Ministry of Health. In a perfect world, it should be like this and, for now, we are well covered by Minister of Health Luiz Henrique Mandetta, an island of sobriety in the middle of a rough ocean!
  • In case of replacement of the Minister I will come back here!
  • If they develop fever and symptoms (for example, coughing, difficulty breathing), they should call the doctor for medical advice.
  • Call the clinic in advance, before introducing, to the caregivers.
  • Use respiratory and hand hygiene and cough etiquette when you come to the health facility and request a face mask as soon as they arrive.

If they need to attend a clinic or an emergency unit without calling in advance, they should alert the registry team immediately after symptoms arrive, so that steps can be taken to prevent transmission of COVID-19 in the healthcare environment. Specific actions include putting a mask on the patient and placing it quickly in a room or other space separate from other people.

Guidelines for the management of people with HIV who develop COVID-19 disease

When hospitalization is not necessary, the person with HIV should:

  • Manage symptoms at home with supportive care for symptomatic relief.
  • Maintain close communication with your doctor and report if symptoms progress (for example, prolonged fever for> 2 days, shortness of breath).
  • Continue ART therapy and other medications as prescribed.
When the person with HIV is hospitalized:
  • ART must and must continue. If antiretroviral drugs are not on the hospital form, administer medication from patients' home supplies. My personal experience recommends that if you are aware, lucid and can control your medication, do so. Hospital nurses in general are unable to understand that there is a reason for the prescription to be done in a way, as they insist on doing it in “their form””. ARV drug substitutions should be avoided. If necessary, doctors can consult recommendations on ARV drugs that can be exchanged contacting the outpatient clinics where HIV + COVID-19 patients take care of themselves.
  • For patients who receive an intravenous infusion of ibalizumab (IBA) (IV) every 2 weeks as part of their ARV regimen, doctors must arrange with the hospital doctor so that the patient can continue to administer this medication without interruption.
  • For critically ill patients who need tube feeding, some ARV drugs are available in liquid formulations and some, but not all, pills can be crushed. Doctors should consult an infectious disease specialist with a specialization in HIV and / or pharmacist to assess the best way for a patient with a feeding tube to continue an effective ARV regimen. Information may be available on the drug label or in this document from the Immunodeficiency Clinic at Toronto General Hospital.
Upon receiving investigative (research) or unlabeled treatment for COVID-19:
  • Currently, there is no approved treatment for COVID-19. Several drugs under investigation and marketed are being evaluated in clinical trials to treat COVID-19 or may also be available via compassionate use or use off label.

What is off-label material or medicine? Can medication or material classified as off-label be used? (art. 3 of RN 424/2017)

The medication called off-label is one whose indication of the assisting professional differs from that stated in the package insert. The off-label material, on the other hand, is the one whose indication of an assistant professional differs from that contained in the material's use manual. There is no medical or dental board, as the medication and material whose clinical indication is different from that registered by Anvisa are not mandatory coverage by operators. See more here, in another tab!

  • For patients receiving treatment with COVID-19, physicians should assess the potential for drug interactions between treatment with COVID-19 and ART of the patient and other medications. Information on possible drug interactions can be found on product labels, drug interaction resources, clinical trial protocols or investigator brochures.

When available, physicians may consider including patients in a clinical trial that evaluates the safety and effectiveness of experimental treatment for COVID-19. People with HIV should not be excluded from these studies.

Additional guidance for HIV clinicians
  • During the outbreak of COVID-19, doctors should ask healthcare professionals to waive restrictions on the amount of medication. Whenever possible, Health Centers should provide patients with a supply of at least 90 days.
  • People with HIV may need additional assistance with food, housing, transportation and child care during times of crisis and economic fragility. To improve the involvement of care and the continuity of ART, physicians should make every effort to assess their patients' need for additional social assistance and connect them to resources, including navigation services whenever possible.
  • During this crisis, distance and social isolation can exacerbate mental health and substance use problems for some people with HIV.
  • Physicians should assess and address these patient concerns and provide additional consultations, preferably virtual, as appropriate and / or necessary.
  • Disk AIDS in +0800 16 2550 it's working.

More information on the management of ART in adult, pregnant and pediatric patients, as well as recommendations for prophylaxis and treatment of specific opportunistic infections, can be found in the medical practice guidelines for HIV / AIDS.

ANVISA provides information on COVID-19 for people with HIV.

This interim guidance was prepared by the following working groups of the AIDS Advisory Research Council:

  • HHS Panel on Antiretroviral Guidelines for Adults and Adolescents
  • HHS Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV
  • HHS Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission
  • HHS Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV
  • HHS Panel on Opportunistic Infections in Children Exposed to HIV and Infected with HIV

I already finished this text.

If you have found a typo, spelling or even a grotesque Portuguese error send an email to seropositivowebsite@gmail.com and I will fix it as soon as possible.

Thank you

Last updated: March 20, 2020; Last: March 20, 2020

Translated by Cláudio Souza from the original in Interim Guidance for COVID-19 and Persons with

Definitive review pending

This document is constantly updated at the source and I advise you to register to follow the blog!

This interim guidance was prepared by the following working groups of the AIDS Advisory Research Council:

  • HHS Panel on Antiretroviral Guidelines for Adults and Adolescents
  • HHS Panel on Antiretroviral Therapy and Medical Management of Children Living with HIV
  • HHS Panel on Treatment of Pregnant Women with HIV Infection and Prevention of Perinatal Transmission
  • HHS Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV
  • HHS Panel on Opportunistic Infections in Children Exposed to HIV and Infected with HIV

Last updated: March 20, 2020; Last: March 20, 2020

References
  1. Cao B, Wang Y, Wen D, et al. A trial of lopinavir-ritonavir in adults hospitalized with severe Covid-19. N Engl J Med. 2020. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32187464.
  2. Society for Maternal-Fetal Medicine, Dotters-Katz S, Hughes BL. Coronavirus (COVID-19) and Pregnancy: What Maternal-Fetal Medicine Subspecialists Need to Know. 2020. Available at: https://s3.amazonaws.com/cdn.smfm.org/media/2267/COVID19-_updated_3-17-20_PDF.pdf.
  3. Siston AM, Rasmussen SA, Honein MA, et al. Pandemic 2009 influenza A (H1N1) virus illness among pregnant women in the United States. JAMA. 2010;303(15):1517-1525. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20407061.
  4. Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature. J Microbiol Immunol Infect. 2019;52(3):501-503. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29907538.
  5. Wong SF, Chow KM, Leung TN, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol. 2004;191(1):292-297. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15295381.
  6. Liu Y, Chen H, Tang K, Guo Y. Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy. J Infect. 2020. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32145216.
  7. Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395(10226):809-815. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32151335.
  8. Li Y, Zhao R, Zheng S, et al. Lack of vertical transmission of Severe Acute Respiratory Syndrome Coronavirus 2, China. Emerg Infect Dis. 2020; 26 (6). Available at: https://www.ncbi.nlm.nih.gov/pubmed/32134381.
  9. Wang S, Guo L, Chen L, et al. A case report of neonatal COVID-19 infection in China. Clin Infect Dis. 2020. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32161941.
  10. Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2,143 pediatric patients with 2019 coronavirus disease in China. Pediatrics. 2020. Available at: https://pediatrics.aappublications.org/content/pediatrics/early/2020/03/16/peds.2020-0702.full.pdf.
  11. Cruz AZ, S. COVID-19 in children: initial characterization of pediatric disease. Pediatrics. 2020. Available at: https://pediatrics.aappublications.org/content/pediatrics/early/2020/03/16/peds.2020-0834.full.pdf.
  12. Shen K, Yang Y, Wang T, et al. Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: experts' consensus statement. World J Pediatr. 2020. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32034659.
  13. Ogimi C, Englund JA, Bradford MC, Qin X, Boeckh M, Waghmare A. Characteristics and outcomes of coronavirus infection in children: The role of viral factors and an immunocompromised state. J Pediatric Infect Dis Soc. 2019; 8 (1): 21-28. Available at: https://www.ncbi.nlm.nih.gov/pubmed/29447395.
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The currency has always been that of social exclusion and I have even hesitated between continuing or not!

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We are Borg!

If not bored by the empty hours, at least by suicide due to the absolute lack of purpose that my life would have and the terrible impression of parasitosis that would come to affect me. So, I couldn't stop.

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Hi! Guys, thanks for getting this far! Your attention and interest is our greatest interest, we work here, me and mara, in order to inform you, make some clarity in some nebulous points of "all of this".

However, we lack financial resources.

If you like work, if you are able to help and want to help, often the cost of a silly day-to-day for us, will certainly make a difference because, we know, the hummingbird, carrying water on the tip of your beak will make all the difference in the effort to put out the forest fire!

Think about it!

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