Prevalencia de criptococosis en pacientes con VIH, Hospital de Infectología
Fecha
2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
El objetivo del presente estudio fue determinar la prevalencia de Criptococosis en pacientes con VIH en el Hospital de Infectología. El estudio fue de enfoque cuantitativo, analítico, retrospectivo y transversal, que analizó las historias clínicas de 99 pacientes con la enfermedad durante el periodo del 1 de enero del 2016 hasta el 31 de diciembre del 2017. Para el análisis estadístico se empleó el programa SPSS versión 21. La prevalencia de criptococosis en pacientes con VIH durante el periodo de estudio fue del 5%, se encontró un predominio en el sexo masculino con el 87%, en pacientes adultos jóvenes con el 77% y en adultos medios con el 21%. El sitio más común de infección por criptococosis fue el sistema nervioso central, se encontró 77% de criptococosis meníngea. El 27% (22) correspondieron a casos nuevos y el 73% (60) fueron recaídas. El criptococo neoformans (89%) fue el microorganismo que con mayor frecuencia se aisló de los cultivos realizados. El índice de mortalidad fue del 22%. Los principales factores de riesgo en la población de pacientes analizados fueron: conteo CD4+ < 200 células/mm3 (80%), carga viral > 400.000 virus/mm3 (74%), otras infecciones oportunistas (71%) y la enfermedad renal crónica (66%). Se encontró asociación estadísticamente significativa entre la criptococosis con los factores de riesgo antes mencionados (p < 0,05). Se concluye que el conteo CD4+ < 200 células/mm3 aumenta 13 veces el riesgo de criptococosis y la carga viral > 400.000 virus/mm3 aumenta 10 veces el riesgo de criptococosis.
The objective of the present study was to determine the prevalence of Cryptococcosis in patients with HIV at the Infectology Hospital. The study was a quantitative, analytical, retrospective and transversal approach that analyzed the medical records of 99 patients with the disease during the period from January 1, 2016 to December 31, 2017. For the statistical analysis, the SPSS program was used version 21. The prevalence of cryptococcosis in HIV patients during the study period was 5%, a predominance was found in the male sex with 87%, in young adult patients with 77% and in middle adults with 21%. The most common site of infection by cryptococcosis was the central nervous system, 77% of meningeal cryptococcosis was found. 27% (22) corresponded to new cases and 73% (60) were relapses. Cryptococcus neoformans (89%) was the microorganism that was most frequently isolated from the cultures carried out. The mortality rate was 22%. The main risk factors in the population of patients analyzed were: CD4 + count <200 cells / mm3 (80%), viral load> 400,000 viruses / mm3 (74%), other opportunistic infections (71%) and chronic kidney disease (66%). A statistically significant association was found between cryptococcosis with the aforementioned risk factors (p <0.05). It is concluded that the CD4 + count <200 cells / mm3 increases the risk of cryptococcosis 13 times and the viral load> 400,000 virus / mm3 increases the risk of cryptococcosis 10 times.
The objective of the present study was to determine the prevalence of Cryptococcosis in patients with HIV at the Infectology Hospital. The study was a quantitative, analytical, retrospective and transversal approach that analyzed the medical records of 99 patients with the disease during the period from January 1, 2016 to December 31, 2017. For the statistical analysis, the SPSS program was used version 21. The prevalence of cryptococcosis in HIV patients during the study period was 5%, a predominance was found in the male sex with 87%, in young adult patients with 77% and in middle adults with 21%. The most common site of infection by cryptococcosis was the central nervous system, 77% of meningeal cryptococcosis was found. 27% (22) corresponded to new cases and 73% (60) were relapses. Cryptococcus neoformans (89%) was the microorganism that was most frequently isolated from the cultures carried out. The mortality rate was 22%. The main risk factors in the population of patients analyzed were: CD4 + count <200 cells / mm3 (80%), viral load> 400,000 viruses / mm3 (74%), other opportunistic infections (71%) and chronic kidney disease (66%). A statistically significant association was found between cryptococcosis with the aforementioned risk factors (p <0.05). It is concluded that the CD4 + count <200 cells / mm3 increases the risk of cryptococcosis 13 times and the viral load> 400,000 virus / mm3 increases the risk of cryptococcosis 10 times.
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Criptococosis, Virus de inmunodeficiencia humana, Estudios retrospectivos, Epidemiología analítica, Hospital de Infectología Dr. José Daniel Rodríguez Maridueña, Cantón Guayaquil, Ecuador, Factores de riesgo, Prevalencia