Adesão de pessoas adoecidas de AIDS (Síndrome da Imunodeficiência Adquirida) à terapia antiretroviral: estudo clínico e laboratorial à partir da orientação de Enfermagem

• Ano de defesa: 2011
• Autor(a) principal: BRASILEIRO, Marislei de Sousa Espíndula
• Orientador(a): CUNHA, Luiz Carlos da
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Goiás
• Programa de Pós-Graduação: Doutorado em Ciencias da Saude
• Departamento: Ciencias da Saude
• País: BR
• Palavras-chave em Português: Síndrome de imunodeficiência adquirida; terapia; cromatografia líquida de alta pressão; assistência de enfermagem; monitoramento
• Palavras-chave em Inglês: Acquired immunodeficiency syndrome; therapy; high-pressure liquid chromatography; nursing care; monitoring
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE
• Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tde/1518

Adherence to antiretroviral therapy reduces the risk of treatment failure, toxicity and resistance, so the therapeutic monitoring is necessary in the treatment of infection by human immunodeficiency virus. The aim of this study was to determine, through clinical and laboratory studies, the compliance of individuals sickened by HIV / AIDS with antiretroviral therapy before and after three nursing interventions. The study design was analytical, descriptive, prospective and quantitative, using data from medical records, interviews and blood sampling for plasma levels of efavirenz by HPLC analysis, including subjects with a diagnosis of HIV / AIDS, attended at the Hospital for Diseases Tropical Goiânia - Goiás and treated with zidovudine/ lamivudine and efavirenz. The results of analysis of data from 15 subjects indicate a socio-demographic profile, predominantly male, young, heterosexual. After nursing intervention, there was a change in 48% of the diagnoses. We also noticed a positive change in the rates of CD4, corresponding to 14%. As viral count, an increase of subjects with undetectable loads of 1 st to 2 nd nursing intervention (20%, or 73.3% to 93.3%). Chromatographic analysis of plasma of the subjects indicated that 60% of them had adequate medication adherence, and 40% increased adhesion between the 1st and 2nd visits by nurses, 10% between the 1st and 3rd and 10% between the 2nd and 3rd queries. The factor that was associated with high concentration rate after adjustment in nursing diagnoses and prescriptions was having difficulty using the antiretroviral in the same time. It was also demonstrated significant difference between mean plasma concentrations of efavirenz from the 1st, 2nd and 3rd interventions. Considering the reference measurement of plasma concentrations of efavirenz, the method of accession had a sensitivity and specificity, with high proportion of agreement between the rate of CD4, nursing diagnosis and analysis of the plasma of subjects. Conclusions: the systematization of nursing care and determination of plasma concentrations should be incorporated into the routine outpatient care, for better monitoring of adherence to antiretroviral therapy of individuals sickened by HIV / AIDS.