Severe infection increases cardiovascular risk among HIV-infected individuals

Abstract Background The identification and management of cardiovascular risk factors became a major clinical issue among HIV-infected individuals in the post-cART era. As in the past decades the link between acute infections and cardiovascular diseases became clear in the general population, we sorted to investigate the role of severe infections on incident cardiovascular diseases (CVDs) among HIV-infected individuals. Methods HIV-infected individuals aged ≥18 years, with no history of CVD were followed from January 2000 to December 2013 until the occurrence of the first CVD event, death or end of study, whichever occurred first. To explore the effect of severe infections on the incidence of CVD we used extended Cox regression models and stratified post-hospitalization follow-up time into three periods:  12 months post discharge. Results One hundred-eighty four persons from 3384 HIV-infected individuals developed incident CVD events during the follow-up (incidence rate = 11.10/1000 PY (95%CI: 9.60–12.82)). Risk of an incident CVD was 4-fold higher at < 3 months post-hospitalization for severe infections (adjusted hazard ratio [aHR], 4.52; 95% confidence interval [CI] 2.46–8.30), after adjusting for sociodemographic and clinical factors as well as comorbidities. This risk remained significant up to one year (3–12 months post hospital discharge aHR 2.39, 95% CI 1.30–4.38). Additionally, non-white race/ethnicity (aHR 1.49, 95% CI 1.10–2.02), age ≥ 60 years (aHR 2.01, 95% CI 1.01–3.97) and hypertension (aHR 1.90, 95% CI 1.38–2.60) were associated with an increased risk of CVD events. High CD4 (≥ 500 cells/mm3: aHR 0.41, 95% CI 0.27–0.62) and cART use (aHR 0.21, 95% CI 0.14–0.31) reduced the risk of CVD events. Conclusions We provide evidence for a time-dependent association between severe infection and incident cardiovascular disease in HIV-infected individuals. cART use, and high CD4 count were significantly associated with reduced hazards of CVD

Addressing travelers’ perception of risk in pre-travel care: Reports from a travel clinic in Rio de Janeiro, Brazil

Abstract INTRODUCTION: Travel medicine is aimed at promoting health risk reduction. However, travelers’ perception of risk is subjective and may influence implementation of recommendations. This study reports on travelers’ perception of risk, pre-travel characteristics, and recommended interventions. METHODS: This is a descriptive cross-sectional study. RESULTS: This study included 111 individuals. Most travelers (74%) perceived their risk as low. Significant differences in travel-related risk perception between practitioners and travelers were observed (Gwet’s agreement coefficient [AC1] 0.23; standard error 0.10; 95% confidence interval 0.02-0.44). CONCLUSIONS: Future studies should investigate the relationship between travelers’ perception of risk and implementation of recommendations

Clinical Manifestations of Zika Virus Infection, Rio de Janeiro, Brazil, 2015

Submitted by Sandra Infurna ([email protected]) on 2017-02-21T13:34:08Z No. of bitstreams: 1 jose_carbinoneto_etal_IOC_2016.pdf: 409109 bytes, checksum: 0c6a4605afc160b5e33702f48dc0a6ee (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2017-02-21T13:42:13Z (GMT) No. of bitstreams: 1 jose_carbinoneto_etal_IOC_2016.pdf: 409109 bytes, checksum: 0c6a4605afc160b5e33702f48dc0a6ee (MD5)Made available in DSpace on 2017-02-21T13:42:13Z (GMT). No. of bitstreams: 1 jose_carbinoneto_etal_IOC_2016.pdf: 409109 bytes, checksum: 0c6a4605afc160b5e33702f48dc0a6ee (MD5) Previous issue date: 2016Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Secretaria Municipal de Saúde do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Secretaria Municipal de Saúde do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Secretaria Municipal de Saúde do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil