The Effect of Combination Therapy of Zidovudine, Lamivudine, and Indinavir in HIV Infected Patients / 감염

BACKGROUND: To evaluate the clinical efficacy, safety and tolerance of combination therapy of zidovudine, lamivudine and indinavir in HIV infected patients. METHODS: We reviewed medical records of HIV infected patients who had received combination therapy of zidovudine, lamivudine and indinavir at the Seoul National University Hospital between May 1998 and March 1999. The clinical end point was the time to the development of the opportunistic infection or death. Changes in plasma HIV-1 RNA levels and CD4 cell counts before and after combination treatments were also evaluated. RESULTS: Fifty-two patients were included in this study. Of these, 25 patients (48%) had continued the treatment more than 6 months, whereas 12 patients (23%) were lost to follow-up, and 15 patients (29%) had discontinued the treatment. The causes of discontinuation of the treatment were adverse drug effects in 67% (10/15), economic problem in 20% (3/15) and the development of drug resistance in 13% (2/15). Of the 25 patients who had been treated more than 6 months, 4 patients were excluded because they had not taken the necessary tests at the scheduled time points. Of the 21 evaluable patients, 3 patients (14%) developed opportunistic infections, but no patients died. In seventeen patients (81%), HIV RNA-1 titers decreased below the detectable level by 6 months of treatment. The mean decrease of HIV-1 RNA titer after 6 months of treatment was 2.65 log10 copies/mL. The mean increase of CD4 cell counts was 111 cells/mm3. CONCLUSION: Combination therapy of zidovudine, lamivudine and indinavir was effective in decrease of viral load and increase of CD4 cell counts. Half of the patients could not continue the combination therapy more than 6 months because of the adverse drug effects and/or economical problem.

A Case of Oropharyngeal Anthrax by Eating Raw Bovine Liver / 감염

An outbreak of anthrax occurred in a village of Kyungsangbookdo province in February, 1994. The source of infection was raw meat and liver from an infected cow. Among those who ate the meat or liver, 28 developed gastrointestinal anthrax, and 3 patients died. We report a patient with anthrax tonsillitis. She ate raw bovine liver. The diagnosis was confirmed by the isolation of Bacillus anthracis from a tonsillarswab. Epidemiologically anthrax in Korea occurs as an outbreak of gastrointestinal anthrax by the ingestion of beef. Gastrointestinal anthrax should be considered in the differential diagnosis of a food-borne outbreak caused by ingestion of raw bovine meat.

Seroprevalence of HIV Infection in Patients with Sexually Transmitted Diseases / 감염

To assess the prevalence of HIV infection in patients with sexually-transmitted diseases(STD), we screened STD patients who visited STD clinics in Seoul area during the period of April 1993-Octorber 1993. Blood samples were collected by unlinked anonymous method, and antibodies against HIV were screened. Fi-ve hundred and thirty patients with STD werescreened. Median age of the patients was 23 year. Male to female ratio was 1:2.8. None of the patients had HIV antibody. The prevalence of HIV infection in STD patients was estimated to be less than 5%.