Empirical data on the consequences of the novel coronavirus disease (COVID-19) pandemic on HIV care are lacking. We surveyed people living with HIV (PLWH) in different countries to investigate ...whether their medical follow-up and psychosocial well-being had been compromised due to COVID-19 and associated restrictions.
In April 2020, a cross-sectional survey among PLWH was conducted using a web-based multilingual questionnaire. The research tool assessed HIV follow-up, psychosocial well-being, COVID-19 (flu-like) symptoms and prevention measures. Consenting respondents provided answers anonymously.
Three hundred seventeen PLWH were included (mean age 43.4 ± 11.7; 71.6% men); 60.3% of participants resided in Belgium and Brazil. One hundred forty (44.2%) reported experiencing a cold with at least one flu-like symptom since January 2020. Of the 18 who reported COVID-19 test results, 4 (22.2%) were positive. Seventy-four (23.3%) respondents screened positive for major depressive disorders, whereas 72 (22.7%) had generalized anxiety disorders. Fifty-six (17.7%) respondents reported difficulties in obtaining antiretroviral medications because of COVID-19-related measures. Adaptations of HIV care during the COVID-19 outbreak included greater quantities of antiretroviral refill in 67 (21.1%), phone consultations in 25 (7.9%), and new refill sites in 12 (3.9%). Factors associated with a reduced risk of experiencing flu-like symptoms included flu vaccination during the past 12 months (P = 0.005) and adaptations of HIV care during the COVID-19 pandemic (P = 0.010).
COVID-19 and associated restrictive measures seem detrimental to the well-being and follow-up of PLWH. We recommend that health systems devise innovative approaches for antiretroviral provision and psychosocial support to PLWH during such outbreaks.
A infecção pelo vírus da hepatite C (HCV) é um problema de saúde associado a maior risco de morbidade e mortalidade. No entanto, estudos sobre mortalidade por causas não hepática entre os indivíduos ...coinfectados com o HCV e o vírus da imunodeficiência humana (HIV) demonstraram resultados inconsistentes. O objetivo deste estudo foi investigar a contribuição da coinfecção HCV e HIV na mortalidade por todas as causas e por causas hepáticas, em uma grande coorte de doadores de sangue no Brasil.
É um estudo de coorte retrospectiva realizado com doadores de sangue, entre 1994 e 2013, na Fundação Pró-Sangue - Hemocentro de São Paulo (FPS). Foram incluídos 36 doadores de sangue coinfectados com HCV/HIV, 5.782 não infectados por HCV e HIV, e 2.652 infectados apenas com HCV. Os registros do banco de dados FPS e do Sistema de Informações sobre Mortalidade (SIM) foram vinculados por meio da técnica Record Linkage (RL). Os desfechos de mortalidade foram classificados com base nos códigos da CID-10 (10ª Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde) apresentados como causa da morte na certidão de óbito. A medida de Hazard Ratio (HR) foi estimada para os desfechos usando modelos de regressão múltipla de Cox.
Dentre todas as causas de morte, RL identificou 14 óbitos entre doadores coinfetados com HCV/HIV, 190 entre soronegativos para HCV/HIV e 209 entre infectados apenas por HCV. Doadores coinfectados com HCV/HIV apresentaram risco 6,63 vezes maior de morte por todas as causas quando comparados aos infectados somente por HCV (IC 95%: 3,83-11,48; p < 0,001) e risco 14,57 vezes maior de morte por todas as causas em relação aos soronegativos (IC 95%: 8,42-25,22; p < 0,001). Entre apenas as causas hepáticas de morte, RL identificou 3 óbitos entre os coinfectados com HCV/HIV, 6 entre soronegativos e 73 entre monoinfetados com HCV. Doadores coinfectados com ambos os vírus tiveram risco 95,76 vezes maior de morte por causas hepáticas do que os soronegativos para HCV/HIV (IC 95%: 23,54-389,52; p < 0,001), e apresentaram um risco 4,16 vezes maior de morte quando comparados aos infectados por apenas HCV (IC 95%: 1,3-13,34; p = 0,016).
Os dados sugerem que intervenções específicas são urgentes e necessárias no caso dos doadores de sangue co-infectados com HCV/HIV, mesmo após tratamento específico e resposta virológica sustentada, a fim de evitar complicações hepáticas e não hepáticas, e morte.
Background The objectives of the present study are to report the impact of projects such as the Magic lab coat team, which employ arts, focusing on clowning, for the community and, under the ...perspective of training health professionals. Methods The actions were developed because of an extension action entitled Magic lab coat team having as a partner hospital, hostels, schools, and charities. The protagonists of this action are medical students, who dress as clowns, bringing joy, humanity and various teachings to the patient and health professionals. Results The activities developed contributed to the teaching-learning process of medical students involved by providing a more humanized training and improvement of communication, expression, and empathy skills. Conclusion The presence of medical students characterized as clowns and focused not only on the clinical picture of patients, allow the well-being of patients, and reconnects them to the focus of all medical practice: the human relationship. The project offers contributions by softening the environment of various health scenarios and influencing the training of health students.
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