Concordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCV
Ano de defesa: | 2016 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | , |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de Santa Maria
Centro de Ciências da Saúde |
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Ciências da Saúde
|
Departamento: |
Medicina
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://repositorio.ufsm.br/handle/1/17671 |
Resumo: | The Acquired Immunodeficiency Syndrome (AIDS) caused by the human immunodeficiency virus (HIV) is a serious, emergent, pandemic disease, considered of the biggest problems in the world. The introduction of Highly Active Antirretroviral Therapy (HAART) allowed immune deficiency reduction caused by the virus, decrease morbidity associated with AIDS and, consequently, the increased life expectancy. The aging of this population has been accompanied by high cardiovascular risk, and the mechanisms responsible for this increase are not entirely clear. It is believed that chronic inflammation generated by the HIV virus and hepatitis C virus (HCV), the metabolic changes related to the viruses and antiretroviral therapy are related to the cardiovascular morbidity and mortality. Knowing the cardiovascular risk of these patients through the use of clinical risk scores is important in order to plan possible interventions which can reduce the risks. This transversal study evaluated the prevalence of cardiovascular risk in 128 patients divided into three groups: 52 patients with monoinfected by HIV, 33 subjects with monoinfection by HCV, 33 subjects coinfected by HIV / HCV, at the University Hospital of Santa Maria - Brazil. For that, different clinical risk scores were applied: the Framingham Risk Score (FRS), the Reynolds Risk Score (RRS) and Global Risk Score (GRS). We evaluated the concordance and correlation between the methods and the percentage of patients who were reclassified after the application of different scores. The prevalence of cardiovascular risk among all the populations studied was 8.7% for FRS, 4.3% for RRS and 48.1% for GRS. HCV patients showed higher risk prevalence when compared to other patients. FRS classified more patients as low risk in all population subgroups, suggesting that it is a score that underestimates the risk for HIV and HCV populations. At our study, 9.6% of HIV monoinfected population had moderate to high risk according to FRS, while 50% had moderate to high risk of the GRS, showing that depending on the method used to assessment the risk, patients are reclassified, which implies in different measures and prevention interventions. The risk scores were weak concordance and correlation with each other, independent of the evaluated subgroup. This study emphasizes the need to establish specific risk scores for the HIV population. |
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2019-08-01T21:06:36Z2019-08-01T21:06:36Z2016-08-12http://repositorio.ufsm.br/handle/1/17671The Acquired Immunodeficiency Syndrome (AIDS) caused by the human immunodeficiency virus (HIV) is a serious, emergent, pandemic disease, considered of the biggest problems in the world. The introduction of Highly Active Antirretroviral Therapy (HAART) allowed immune deficiency reduction caused by the virus, decrease morbidity associated with AIDS and, consequently, the increased life expectancy. The aging of this population has been accompanied by high cardiovascular risk, and the mechanisms responsible for this increase are not entirely clear. It is believed that chronic inflammation generated by the HIV virus and hepatitis C virus (HCV), the metabolic changes related to the viruses and antiretroviral therapy are related to the cardiovascular morbidity and mortality. Knowing the cardiovascular risk of these patients through the use of clinical risk scores is important in order to plan possible interventions which can reduce the risks. This transversal study evaluated the prevalence of cardiovascular risk in 128 patients divided into three groups: 52 patients with monoinfected by HIV, 33 subjects with monoinfection by HCV, 33 subjects coinfected by HIV / HCV, at the University Hospital of Santa Maria - Brazil. For that, different clinical risk scores were applied: the Framingham Risk Score (FRS), the Reynolds Risk Score (RRS) and Global Risk Score (GRS). We evaluated the concordance and correlation between the methods and the percentage of patients who were reclassified after the application of different scores. The prevalence of cardiovascular risk among all the populations studied was 8.7% for FRS, 4.3% for RRS and 48.1% for GRS. HCV patients showed higher risk prevalence when compared to other patients. FRS classified more patients as low risk in all population subgroups, suggesting that it is a score that underestimates the risk for HIV and HCV populations. At our study, 9.6% of HIV monoinfected population had moderate to high risk according to FRS, while 50% had moderate to high risk of the GRS, showing that depending on the method used to assessment the risk, patients are reclassified, which implies in different measures and prevention interventions. The risk scores were weak concordance and correlation with each other, independent of the evaluated subgroup. This study emphasizes the need to establish specific risk scores for the HIV population.A Síndrome da Imunodeficiência Adquirida (SIDA) causada pelo vírus da imunodeficiência humana (HIV) é uma doença pandêmica grave, emergente, considerada um dos maiores problemas de saúde mundial. A introdução da terapia antirretroviral de alta eficácia permitiu a redução da deficiência imunológica causada pelo vírus, diminuição da morbimortalidade associadas a SIDA e, consequentemente, o aumento da expectativa de vida. O envelhecimento dessa população tem sido acompanhado por elevado risco cardiovascular, sendo que os mecanismos responsáveis por este aumento não são totalmente esclarecidos. Acredita-se que o processo inflamatório crônico gerado pelo vírus HIV e da hepatite C (HCV), as alterações metabólicas relacionados aos vírus e a terapia antirretroviral estejam relacionados a morbimortalidade cardiovascular. Conhecer o risco cardiovascular desses pacientes através da aplicação de escores de risco clínicos é importante, a fim de planejar possíveis intervenções que possam reduzi-lo. Esse estudo transversal avaliou a prevalência do risco cardiovascular em 128 pacientes, divididos em três grupos: 52 pacientes com monoinfecção pelo HIV, 33 monoinfectados pelo HCV, 33 coinfectados HIV/HCV, no Hospital Universitário de Santa Maria – Brasil. Para isso, foram aplicados diferentes escores clínicos de risco: Escore de Risco de Framingham (ERF), Escore de Risco de Reynolds (ERR) e Escore de Risco Global (ERG). Foram avaliadas a concordância e a correlação entre os métodos e o percentual de pacientes que foram reclassificados após a aplicação dos diferentes escores. A prevalência de risco cardiovascular entre toda a população estudada foi 8,7% pelo ERF, 4,3% pelo ERR e 48,1% pelo ERG. Os pacientes HCV apresentaram maior prevalência de risco quando comparado aos demais pacientes. O ERF classificou mais pacientes como baixo risco em todos os subgrupos da população, sugerindo ser um escore que subestime o risco na população HIV e HCV. No nosso estudo 9,6% da população monoinfectada pelo HIV teve risco de moderado a alto pelo ERF, enquanto 50% teve risco de moderado a alto pelo ERG, demostrando que dependendo do método utilizado para avaliação do risco, os pacientes são reclassificados, o que implica em diferentes medidas e intervenções de prevenção. Os escores de risco tiveram fraca concordância e correlação entre si, independente do subgrupo avaliado. Esse estudo enfatiza a necessidade de se criar escores de risco específicos para a população HIV.porUniversidade Federal de Santa MariaCentro de Ciências da SaúdePrograma de Pós-Graduação em Ciências da SaúdeUFSMBrasilMedicinaAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessHIVHepatite CEscore de risco cardiovascularEscore de risco de FraminghamEscore de risco de Reynolds e escore de risco globalHepatitis CRisk cardiovascular scoreFramingham risk scoreScore Reynolds risk and global risk scoreCNPQ::CIENCIAS DA SAUDE::MEDICINAConcordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCVConcordance of cardiovascular risk score in HIV and HCV infected individuals.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisBeck, Maristela de Oliveirahttp://lattes.cnpq.br/5466354015919916Pedro, Fabio Lopeshttp://lattes.cnpq.br/3151589084035930Schwarzbold, Alexandre Vargashttp://lattes.cnpq.br/5057171339596380http://lattes.cnpq.br/4172753751100874Librelotto, Paula Rubin Facco400100000006600bbbabd09-6e2a-41b2-9620-6ee13ecef72260173579-6bbe-44f0-bd91-b756a64ad74d7b8ef781-fe46-452d-97ac-eff0fe189ee4ba1a6e68-1ed2-4670-b93a-90cc92a19314reponame:Manancial - Repositório Digital da UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGCS_2016_LIBRELOTTO_PAULA.pdfDIS_PPGCS_2016_LIBRELOTTO_PAULA.pdfDissertação de Mestradoapplication/pdf585398http://repositorio.ufsm.br/bitstream/1/17671/1/DIS_PPGCS_2016_LIBRELOTTO_PAULA.pdf70678293de0c7bfc75477f4626194fedMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; 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dc.title.por.fl_str_mv |
Concordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCV |
dc.title.alternative.eng.fl_str_mv |
Concordance of cardiovascular risk score in HIV and HCV infected individuals. |
title |
Concordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCV |
spellingShingle |
Concordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCV Librelotto, Paula Rubin Facco HIV Hepatite C Escore de risco cardiovascular Escore de risco de Framingham Escore de risco de Reynolds e escore de risco global Hepatitis C Risk cardiovascular score Framingham risk score Score Reynolds risk and global risk score CNPQ::CIENCIAS DA SAUDE::MEDICINA |
title_short |
Concordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCV |
title_full |
Concordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCV |
title_fullStr |
Concordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCV |
title_full_unstemmed |
Concordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCV |
title_sort |
Concordância dos escores de risco cardiovascular em indivíduos infectados pelo HIV e HCV |
author |
Librelotto, Paula Rubin Facco |
author_facet |
Librelotto, Paula Rubin Facco |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Beck, Maristela de Oliveira |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5466354015919916 |
dc.contributor.referee1.fl_str_mv |
Pedro, Fabio Lopes |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/3151589084035930 |
dc.contributor.referee2.fl_str_mv |
Schwarzbold, Alexandre Vargas |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/5057171339596380 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/4172753751100874 |
dc.contributor.author.fl_str_mv |
Librelotto, Paula Rubin Facco |
contributor_str_mv |
Beck, Maristela de Oliveira Pedro, Fabio Lopes Schwarzbold, Alexandre Vargas |
dc.subject.por.fl_str_mv |
HIV Hepatite C Escore de risco cardiovascular Escore de risco de Framingham Escore de risco de Reynolds e escore de risco global |
topic |
HIV Hepatite C Escore de risco cardiovascular Escore de risco de Framingham Escore de risco de Reynolds e escore de risco global Hepatitis C Risk cardiovascular score Framingham risk score Score Reynolds risk and global risk score CNPQ::CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Hepatitis C Risk cardiovascular score Framingham risk score Score Reynolds risk and global risk score |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::MEDICINA |
description |
The Acquired Immunodeficiency Syndrome (AIDS) caused by the human immunodeficiency virus (HIV) is a serious, emergent, pandemic disease, considered of the biggest problems in the world. The introduction of Highly Active Antirretroviral Therapy (HAART) allowed immune deficiency reduction caused by the virus, decrease morbidity associated with AIDS and, consequently, the increased life expectancy. The aging of this population has been accompanied by high cardiovascular risk, and the mechanisms responsible for this increase are not entirely clear. It is believed that chronic inflammation generated by the HIV virus and hepatitis C virus (HCV), the metabolic changes related to the viruses and antiretroviral therapy are related to the cardiovascular morbidity and mortality. Knowing the cardiovascular risk of these patients through the use of clinical risk scores is important in order to plan possible interventions which can reduce the risks. This transversal study evaluated the prevalence of cardiovascular risk in 128 patients divided into three groups: 52 patients with monoinfected by HIV, 33 subjects with monoinfection by HCV, 33 subjects coinfected by HIV / HCV, at the University Hospital of Santa Maria - Brazil. For that, different clinical risk scores were applied: the Framingham Risk Score (FRS), the Reynolds Risk Score (RRS) and Global Risk Score (GRS). We evaluated the concordance and correlation between the methods and the percentage of patients who were reclassified after the application of different scores. The prevalence of cardiovascular risk among all the populations studied was 8.7% for FRS, 4.3% for RRS and 48.1% for GRS. HCV patients showed higher risk prevalence when compared to other patients. FRS classified more patients as low risk in all population subgroups, suggesting that it is a score that underestimates the risk for HIV and HCV populations. At our study, 9.6% of HIV monoinfected population had moderate to high risk according to FRS, while 50% had moderate to high risk of the GRS, showing that depending on the method used to assessment the risk, patients are reclassified, which implies in different measures and prevention interventions. The risk scores were weak concordance and correlation with each other, independent of the evaluated subgroup. This study emphasizes the need to establish specific risk scores for the HIV population. |
publishDate |
2016 |
dc.date.issued.fl_str_mv |
2016-08-12 |
dc.date.accessioned.fl_str_mv |
2019-08-01T21:06:36Z |
dc.date.available.fl_str_mv |
2019-08-01T21:06:36Z |
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http://repositorio.ufsm.br/handle/1/17671 |
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http://repositorio.ufsm.br/handle/1/17671 |
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por |
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por |
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400100000006 |
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600 |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
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Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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Programa de Pós-Graduação em Ciências da Saúde |
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UFSM |
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Brasil |
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Medicina |
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Universidade Federal de Santa Maria Centro de Ciências da Saúde |
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