Aspectos clínico-epidemiológicos de pacientes com o vírus da imunodeficiência humana e marcadores sorológicos para o vírus da hepatite B

JUSTIFICATIVA E OBJETIVOS: O virus da imunodeficiencia humana (HIV) e da hepatite B utiliza a mesma rota de transmissao,sendo a prevalencia do virus da hepatite B (VHB) em pacientes infectados pelo HIV maior que aquela encontrada na populacao geral. O objetivo deste estudo foi conhecer os aspectos clinico-epidemiologicos dos pacientes com HIV que apresentam marcadores sorologicos para o VHB. METODOS: Realizou-se um estudo retrospectivo e transversal, no periodo de dezembro de 2006 a marco de 2007, sendo revisados 1000 prontuarios de pacientes atendidos na "Casa Dia", Belem/PA. RESULTADOS:Dos pacientes, 85,4% nao fizeram sorologia para VHB e 73,20% haviam recebido vacina anti-VHB. Observou-se que 88% dos participantes residem no estado do Para, sendo 91% do sexo masculino, 73% solteiros e 76% tem idade entre 30 e 49 anos. Analisando os fatores de risco, pode-se observar que houve quantidades iguais de heterossexuais e homossexuais e 91% dos pacientes nao usavam preservativos durante as relacoes sexuais. Dos pacientes, 15% apresentavam linfocito T CD4+ menor que 200celulas/mm3. Em relacao aos marcadores sorologicos de hepatite B, 76% apresentavam anti-HBc IgG positivos e 48%, anti-HBs.As manifestacoes clinicas associadas ao HIV estavam presentes em 93,94% dos pacientes, sendo as mais frequentes: astenia seguida de tosse e sintomas dispepticos. CONCLUSAO: Apesar da semelhanca nas vias de transmissao do VHB e HIV justificarem o encontro de maior risco de infeccao pelo VHB, os resultados encontrados mostram que a incidencia dos marcadores sorologicos para VHB nos pacientes HIV positivos estudados nao sao significativos. BACKGROUND AND OBJECTIVES: The human immunodeficiency virus (HIV) and hepatitis B virus use the same transmission path, and the prevalence of hepatitis B virus (HBV) infection in patients infected with HIV is greater than that found in the general population. The objective of this study was to know the clinical-epidemiological aspects of HIV-positive patients with serologic markers for HBV. METHODS: A retrospective, cross-sectional study was conducted, between December 2006 and March 2007, with 1000 medical reports of patients cared at Casa Dia, in the city of Belem, state of Para, being revised. RESULTS: Of the patients, 85.4% did not undergo serologic tests for hepatitis B and 73.20% had received HBV vaccine. It was observed that 88% of participants reside in the state of Para, with 91% being male, 73% single and 76% aged between 30 and 49 years. Analyzing the risk factors, it can be observed that there was an equal number of heterosexuals and homosexuals, and 91% of the patients did not wear condoms during sexual intercourse. Of the patients, 15% had CD4+ T lymphocytes lower than 200 cells/mm3. Regarding serological markers of hepatitis B, 76% had positive IgG anti-HB cand 48%, anti-HBs. The clinical manifestations associated with HIV were present in 93.94% of patients, the most common being: asthenia followed by cough and gastrointestinal symptoms.CONCLUSION: Although the similarity of transmission pathways of HBV and HIV can explain the finding of an increased risk of HBV infection, our results show that the incidence of serological markers for hepatitis B in HIV-positive patients of Casa Dia are not significant.