ABSTRACT
Background: The incidence oflymphoma increases enormously inpatients infecten with the human immunodeficiency virus (HIV). Aim: To describe the incidence, clinical and histológica! characteristics, treatments and survival of lymphomas associated with HTV infection. Material and Methods: Retrospective review of medical records ofpatients with HIV and lymphoma, treated in a public hospital, between January 2001 and June 2009. Results: Twenty-two mole patients were included but 14 had immunohistochemical confirmation ofthe lymphoma. The accumulated incidence for thisperiod was 2.8 percent. The median age at lymphoma diagnosis was 39.5 years. Twelvepatients (86 percent) had non-Hodgkin lymphoma (NHI) and two (14 percent) Hodgkin lymphoma. The main pathological type of non-Hodgkin lymphomas was diffuse large B cell in seven cases (50 percent). The mean CD4 cell count and viral load were 83 cell/mm³ (33.5-113.5) and 26.000 RNA copies/ml (1210-196500), respectively Twelve patients (86 percent) had B type symptoms of lymphoma at the moment of diagnosis. Eleven patients (29 percent) received chemotherapy with or without radiotherapy, onepatient (7 percent) received radiotherapy alone and two patients (14 percent) received palliative symptomatic treatment. Six cases (43 percent) received highly active antiretroviral therapy simultaneously with chemotherapy. Global mortality in this series was 57 percent (8patients) with a median survival time of 5.8 months (2.6-26.2). Conclusions: In this series ofpatients infected with HIV, a predominance of aggressive histológica! subtypes of lymphomas and low complete remission rates, were observed.
Subject(s)
Adult , Female , Humans , Male , Hodgkin Disease , Lymphoma, AIDS-Related , Chile/epidemiology , Epidemiologic Methods , Hodgkin Disease/classification , Hodgkin Disease/epidemiology , Hodgkin Disease/therapy , Lymphoma, AIDS-Related/diagnosis , Lymphoma, AIDS-Related/epidemiology , Lymphoma, AIDS-Related/therapyABSTRACT
La respuesta inmunitaria frente a microbacterias es de tipo celular, existiendo en pacientes VIH (+) un riesgo elevado de infecciones diseminadas. Se presenta caso de hombre de 46 años, que presenta infección por VIH de 16 años de evolución sin control. Ingresa presentando síntomas sistémicos, y desarrolla 3 adenopatías cervicales fistulizadas, adenopatía torácicas y abdominales, y masa suprarrenal izquierda. Institulo de Salud Pública confirma Mycobacterium intracellulare. Completa 1 año de tratamiento con claritromicina, etambutol y rifampicina, asintomático en controles a 2 años. Se describe diagnóstico, manejo y evolución, y se revisa historia, epidemiología, presentación y tratamiento de micobacteriosis en pacientes VIH.
The immune response to mycobacterium infection is of cellular type, existing in HIV (+) patients a higher risk of disseminated infections. We present a 46 years old male patient, that presents HIV infection of 16 years of evolution without control. He was admitted presenting systemic symptoms, and developed 3 cervical fistulized lynephadenopathies, thoracic and abdominal lymphadenopathies, and left adrenal mass. Institute of Public Health confirms Mycobacterium intracellulare. Patient completes 1 year of treatment with claritromicin, ethambutol and rifampicin, asymtomatic in controls for 2 years. We describe the diagnosis, clinical managment and evolution, and a review of the history, epidemiology, presentation and treatment of mycobacteriosis in HIV patients.
Subject(s)
Humans , Male , Middle Aged , HIV , Mycobacterium avium-intracellulare Infection , Chile , Macrolides/therapeutic useABSTRACT
La profilaxis en cirugía se define como la administración de antibióticos con el fin de prevenir infecciones asociadas a procedimientos quirúrgicos. La comprensión de la fisiopatología de la infección de la herida operatoria es la clave de los principios básicos de la antibioprofilaxis. Ella nos enseña cómo se produce la contaminación bacteriana durante el acto quirúrgico, cómo está constituida la flora endógena removida según el tipo de cirugía y la importancia que tiene la existencia de un período vulnerable en el momento de administración de los antimicrobianos. Estos principios básicos son: la administración del antibiótico previa al inicio del acto quirúrgico para cubrir el período vulnerable; la elección del antibiótico que cubra la mayor cantidad de especies de la flora bacteriana contaminante; que sea poco tóxico; que no se use en infecciones severas; y la administración del fármaco en dosis plena. Las indicaciones más aceptadas de antiprofilaxis en cirugía son: las heridas limpias-contaminadas (cuyo beneficio ha sido documentado estadísticamente) y las heridas limpias donde la infección pudiera tener consecuencias catastróficas (por ejemplo cirugía cardíaca)