Gastrointestinal Symptoms in HIV-Infected Patients: Female Sex and Smoking as Risk Factors in an Outpatient Cohort in Brazil.

Annelisa Silva E Alves De Carvalho Santos Santos,Marianne De Oliveira Falco,Erika Aparecida Silveira,Dimitrios Paraskevis

doi:10.1371/journal.pone.0164774

Annelisa Silva E Alves De Carvalho Santos Santos, Marianne De Oliveira Falco + Show 2 more

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https://doi.org/10.1371/journal.pone.0164774

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Journal: PloS one	Publication Date: Oct 17, 2016
Citations: 9	License type: CC BY 4.0

Affiliation: Universidade Federal de Goiás

Abstract

This study aimed to estimate the incidence of gastrointestinal symptoms (GIS) and associated factors in an outpatient cohort of people living with HIV/AIDS (PLWHA) followed between October 2009 and July 2011. We evaluated nausea and/or vomiting, dyspepsia, heartburn, diarrhea, constipation, and flatulence. The outcome variable was the presence of three or more GIS. Sociodemographic (sex, skin color, age, income, years of schooling), lifestyle (smoking status, alcohol consumption, physical activity level), clinical (antiretroviral therapy, time of HIV infection, CD4 lymphocyte count, viral load), and anthropometric (nutritional status and waist circumference) variables were investigated. Data on sociodemographic and lifestyle variables were collected through a pre-tested and standardized questionnaire. CD4 count was determined by flow cytometry and viral load by branched DNA (bDNA) assays for HIV-1. All variables were analyzed at a p<0.05 significance level. Among 290 patients, the incidence of three or more GIS was 28.8% (95% CI 23.17 to 33.84) and 74.48% presented at least one symptom. Female gender (IR 2.29, 95% CI 1.63 to 3.22) and smoking status (IR 1.93, 95% CI 1.30 to 2.88) were risk factors for the presence of three or more GIS after multivariate Poisson regression. A high incidence of gastrointestinal symptoms was found among PLWHA, and it was significantly associated with female sex and tobacco use. Those results reinforce the relevance of investigating the presence of GIS in PLWHA as it may affect treatment adherence.

Highlights

Despite the decline in the number of new cases of HIV infection in recent years, the number of people living with HIV/AIDS (PLWHA) is increasing
Regarding sociodemographic and lifestyle characteristics, the presence of three or more gastrointestinal symptoms (GIS) was associated with female sex (IR: 2.26, 95% confidence interval (CI): 1.60–3.20); first (IR: 2.00, 95% CI: 1.23–3.24) and second tertiles of income (IR: 1.72, 95% CI: 1.03–2.87); and smoking status (IR: 1.90, 95% CI: 1.26–2.86) (Table 2)
The use of NNRTI was a protective factor for the incidence of three or more GIS (IR: 0.59, 95% CI: 0.39–0.89)

Summary

Introduction

Despite the decline in the number of new cases of HIV infection in recent years, the number of people living with HIV/AIDS (PLWHA) is increasing. The number of individuals living with the disease exceeds 35 million [1]. The increasing number of PLWHA is mainly due to the use of antiretroviral drugs to treat HIV infection, contributing to a significant reduction in morbidity and mortality related to PLOS ONE | DOI:10.1371/journal.pone.0164774. The disease becomes a chronic condition with new perspectives for management and treatment [3,4]. Antiretroviral therapy (ART) has contributed substantially to increase PLWHA life expectancy, short and long-term adverse effects may compromise adherence to drug treatment and impair quality of life [5,6]

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