Ults showed that one-third of our patients were first informed of

Ults showed that one-third of our patients were first informed of their HIV disease during the current hospitalization and a large proportion of those with known HIV disease at admission had been hospitalized previously. Although a majority of the patients who knew about their HIV infection before hospitalization reported prior use of HAART, most HAART users reported at least one recent interruption in therapy. These results suggest that strategic improvements to Brazil’s national AIDS program need to address early testing and treatment adherence among marginalized populations. Older age and daily per capita household income ,USD 2.00 were independently associated with malnutrition at hospitalization. We also found that prior or current HAART use was statistically associated with higher CD4 cell count and lower viral load, but neither HAART use nor CD4 cell count was associated with malnutrition. These findings may be due to the fact that this patient population had both inconsistent HAART use and a median CD4 cell count below a level protective against malnutrition. Additionally, we did not find an association between malnutrition and tuberculosis, which was identified in one-third of the patients in our study. Malnutrition in HIV-infected persons is a well-described risk for reactivation and primary progression oftuberculosis, and conversely, tuberculosis get Octapressin itself may result in malnutrition [36,37]. The absence of an association between CD4 cell count, prior or current HAART use, and certain medical conditions (e.g., tuberculosis) with malnutrition suggests that the effect of poverty on nutritional status in HIV may not necessarily be mediated by comorbidities. The mechanisms by which poverty increases the likelihood of malnutrition in HIV and non-HIV populations have been studied in other settings [38,39]. It is critical that future studies elucidate the mechanisms between poverty and malnutrition in Brazil 15755315 and advance our understanding of how to develop effective interventions. We found an increased prevalence of malnutrition among patients with chronic diarrhea in the univariate analysis. This association might have achieved statistical significance in the multivariable analysis if we had a larger patient sample. While access to effective antiretroviral therapy remains the foundation of HIV treatment strategies, our results suggest that AIDS-related morbidity may be further MedChemExpress 68181-17-9 reduced by renewed attention to chronic diarrhea as a clinical condition that contributes to malnutrition. HIV-related enteropathy reduces the immunologic capacity of the gastrointestinal tract and results in villous atrophy [40], which leads to diarrhea and malabsorption. This process can be further aggravated by opportunistic enteric pathogens [41].Table 3. Patient characteristics associated with malnutrition (BMI ,18.5 kg/m2) at hospitalization among patients with AIDS.BMI ,18.5 kg/m2 (N = 55) n 55 55 55 55 , 2.00 2.00?4.99 5.00?9.99 10.00 55 55 At hospitalization{ 55 16 (29) 16 (29) 7 (13) 43 54 54 17 (31) 72 29 (54) 72 32 (74) 57 6 (9) 41 (72) 23 (32) 17 (24) 20 (29) 20 (29) 16 (29) 70 24 (34) #2 years prior 3?0 years prior 11 years prior 26 (47) 71 32 (45) 18 (33) 72 17 (24) 6 (11) 18 (25) 1.00 1.26 (0.84?.90) 0.95 (0.64?.41) 1.00 1.11 (0.66?.88) 1.11 (0.66?.88) 1.35 (0.72?.53) 1.08 (0.64?.82) 1.65 (1.11?.46) 1.24 (0.82?.89) 1.42 (0.99?.04) 15 (27) 19 (26) 18 (33) 23 (32) 55 16 (29) 72 12 (17) 2.29 (1.07?.91) 1.76 (0.81?.81) 1.76 (0.80?.89) 8 (15) 72.Ults showed that one-third of our patients were first informed of their HIV disease during the current hospitalization and a large proportion of those with known HIV disease at admission had been hospitalized previously. Although a majority of the patients who knew about their HIV infection before hospitalization reported prior use of HAART, most HAART users reported at least one recent interruption in therapy. These results suggest that strategic improvements to Brazil’s national AIDS program need to address early testing and treatment adherence among marginalized populations. Older age and daily per capita household income ,USD 2.00 were independently associated with malnutrition at hospitalization. We also found that prior or current HAART use was statistically associated with higher CD4 cell count and lower viral load, but neither HAART use nor CD4 cell count was associated with malnutrition. These findings may be due to the fact that this patient population had both inconsistent HAART use and a median CD4 cell count below a level protective against malnutrition. Additionally, we did not find an association between malnutrition and tuberculosis, which was identified in one-third of the patients in our study. Malnutrition in HIV-infected persons is a well-described risk for reactivation and primary progression oftuberculosis, and conversely, tuberculosis itself may result in malnutrition [36,37]. The absence of an association between CD4 cell count, prior or current HAART use, and certain medical conditions (e.g., tuberculosis) with malnutrition suggests that the effect of poverty on nutritional status in HIV may not necessarily be mediated by comorbidities. The mechanisms by which poverty increases the likelihood of malnutrition in HIV and non-HIV populations have been studied in other settings [38,39]. It is critical that future studies elucidate the mechanisms between poverty and malnutrition in Brazil 15755315 and advance our understanding of how to develop effective interventions. We found an increased prevalence of malnutrition among patients with chronic diarrhea in the univariate analysis. This association might have achieved statistical significance in the multivariable analysis if we had a larger patient sample. While access to effective antiretroviral therapy remains the foundation of HIV treatment strategies, our results suggest that AIDS-related morbidity may be further reduced by renewed attention to chronic diarrhea as a clinical condition that contributes to malnutrition. HIV-related enteropathy reduces the immunologic capacity of the gastrointestinal tract and results in villous atrophy [40], which leads to diarrhea and malabsorption. This process can be further aggravated by opportunistic enteric pathogens [41].Table 3. Patient characteristics associated with malnutrition (BMI ,18.5 kg/m2) at hospitalization among patients with AIDS.BMI ,18.5 kg/m2 (N = 55) n 55 55 55 55 , 2.00 2.00?4.99 5.00?9.99 10.00 55 55 At hospitalization{ 55 16 (29) 16 (29) 7 (13) 43 54 54 17 (31) 72 29 (54) 72 32 (74) 57 6 (9) 41 (72) 23 (32) 17 (24) 20 (29) 20 (29) 16 (29) 70 24 (34) #2 years prior 3?0 years prior 11 years prior 26 (47) 71 32 (45) 18 (33) 72 17 (24) 6 (11) 18 (25) 1.00 1.26 (0.84?.90) 0.95 (0.64?.41) 1.00 1.11 (0.66?.88) 1.11 (0.66?.88) 1.35 (0.72?.53) 1.08 (0.64?.82) 1.65 (1.11?.46) 1.24 (0.82?.89) 1.42 (0.99?.04) 15 (27) 19 (26) 18 (33) 23 (32) 55 16 (29) 72 12 (17) 2.29 (1.07?.91) 1.76 (0.81?.81) 1.76 (0.80?.89) 8 (15) 72.