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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2004 April;163(2):31-5

language: Italian

Significant differences between male and female sex in a personal series of AIDS patients

Pellicanò S., Calzone R., Terra M., Terra L.

Divisione di Malattie Infettive, Ospedale «S. Giovanni di Dio», ASL 5, Crotone


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Aim. Women are the group at the highest risk of HIV infection today; their disease tends to have a greater propensity to progress and they die before men owing to a delay in diagnosis or in commencing treatment. The aim of this paper is to assess whether physiological, social or psychological factors characterise HIV infection in the female sex.
Methods. In January 1990 - August 2003 we handled 437 AIDS patients, 375 males (86%) and 67 females (14%). Between April 1994 and December 1996 we also followed 15 patients, 11 males (86%) and 4 females (14%) through the home care department.
Results. In our study, women at seroconversion presented a higher number of CD4 than men and this difference remained constant till death; the viral load proved less than in men but this difference tends to disappear over time; the change in lipid levels was greater in women; the redistribution of fats in women mainly involved breast and waist. Factors associated with malnutrition were: lack of appetite, oral and/or oesophageal lesions, anxiety, depression, diarrhoea, poor socioeconomic condition, teeth loss. Social research showed better compliance in women enjoying home care and/or with adequate nutritional, psychological and social support.
Conclusion. Our study established that there are significant differences in the 2 sexes with respect to progress towards AIDS and the clinical course of the disease. Suitable management of the infection in seropositive patients must include dietological counselling and adequate psycho-social support. The differences in sex frequency with respect to CD4 and the viral load could represent grounds for a review of the guidelines for women originally intended for a prevalently male population.

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