ABSTRACT
El panorama creciente de infecciones virales severas, que amenazan la vida de los pacientes, la disponibilidad de técnicas de diagnósticos virológico rápido y los conocimientos patogénicos más acabados con biología molecular, han estimulado el desarrollo explosivo de fármacos antivirales. Como consecuencia nace la necesidad de incorporar a las decisiones clínicas la evaluación in vitro de algunos de estos medicamentos y la aparición de resistencia durante tratamientos prolongados, como ha sido el dramático caso de la infección por VIH/SIDA. Se revisan los antivirales licenciados para el uso médico y el grado de aplicación clínica de los estudios de susceptibilidad in vitro alcanzado en la actualidad
Subject(s)
Antiviral Agents/pharmacology , In Vitro Techniques , Microbial Sensitivity Tests , Virus Diseases/drug therapy , Acyclovir/pharmacology , Antiviral Agents/classification , Antiviral Agents/metabolism , Drug Resistance, Microbial , Virus Diseases/diagnosis , Virus Diseases/genetics , Virus ReplicationABSTRACT
We characterized clinical manifestations and the risk to develop AIDS in a cohort of 32 patients infected with human immunodeficiency virus without AIDS. A multivariate analysis was performed to determine association between the progression of infection and control variables (socioeconomic level, age, sex and sexual preferences) and causal variables (psychosocial changes, significant clinical events, stress scoring and sexual activity). The cumulative AIDS incidence, defined as CD4 lymphocyte count below 200 cells/cmü was 50 percent at 6.5 years and 82 percent at 8 years. Using clinical criteria to define AIDS, 50 percent developed tha disease at 8 years of follow up. Among studied factors, only age (faster progression at higher age) and time of evolution were associated with progression. In stages before AIDS, the most frequent diseases were acute diarrhea, sexual transmission diseases, oral candidiasis, sinusitis and varicella zoster infections. The reduction of CD4 lymphocytes below 200 cells/cmü always preceded the symptoms of the disease. Two patients have remained more than eight years without clinical or immunological deterioration
Subject(s)
Humans , Male , Female , Adult , Adolescent , Middle Aged , HIV Infections/epidemiology , Natural History of Diseases , Cohort Studies , AIDS-Related Opportunistic Infections/epidemiology , Disease-Free Survival , Substance-Related Disorders/epidemiology , Survival Analysis , Acquired Immunodeficiency Syndrome/epidemiologyABSTRACT
A raíz de un caso de un niño con linfoma de Burkitt, en tratamiento quimioterápico con neutropenia, el cual desarrolla un síndrome febril con neumonia intersticial y en el que se demuestra una infección por CMV, los autores discuten el enfrentamiento diagnóstico y terapéutico