ABSTRACT
OBJECTIVE: To study initial antiretroviral therapies indicated for HIV-infected patients during the 2001-2003 period regarding effectiveness, survival and safety. METHOD: A descriptive, retrospective study of clinical and drug-related variables of naïve HIV-infected patients through pharmacotherapeutic history. RESULTS: Mean CD4+ lymphocytes counts were 209.6 cells/mm3. Pneumonia by Pneumocystis carinii was the most commonly found condition at antiretroviral treatment onset. Most commonly used therapies included those based on a non-nucleoside reverse transcriptase inhibitor (NNRTI) combined with two nucleoside reverse transcriptase inhibitors (NRTIs). The longest mean survival was achieved by using combinations of three nucleoside reverse transcriptase inhibitors. The primary reason for initial antiretroviral therapy discontinuation were adverse effects, with stavudine exhibiting the poorest tolerability. CONCLUSIONS: Therapies based on non-nucleoside reverse transcriptase inhibitors and protease inhibitors (PIs) have shown similar effectiveness to increase CD4+ cell counts. Regarding viral load decreases, protease inhibitors were most effective. Therapies using three nucleoside reverse transcriptase inhibitors resulted in peak survival.
Subject(s)
Anti-Retroviral Agents/therapeutic use , Antiretroviral Therapy, Highly Active , HIV Seropositivity/drug therapy , HIV Seropositivity/mortality , Adult , Female , Humans , Male , Retrospective Studies , Survival RateABSTRACT
Objetivo: Estudiar los tratamientos antirretrovirales de inicioindicados en pacientes VIH durante el periodo 2001-2003, suefectividad, supervivencia y seguridad.Método: Estudio descriptivo retrospectivo de las variables clínicasy farmacológicas de los pacientes VIH naïve a través de lahistoria farmacoterapéutica.Resultados: La media de linfocitos CD4+ ha sido 209,6 células/mm3. La neumonía por Pneumocystis carinii ha sido la principalenfermedad presente al iniciar tratamiento antirretroviral.Las terapias más utilizadas han sido las basadas en la utilización deun inhibidor de la transcriptasa inversa no análogo de los nucleósidos(ITINN) combinado con dos inhibidores análogos (ITIAN). Lascombinaciones de tres inhibidores de la transcriptasa inversa análogosde los nucleósidos presentaron la mayor supervivenciamedia. El principal motivo de suspensión de terapia inicial hansido los efectos adversos, siendo la estavudina el peor tolerado.Conclusiones: Las terapias basadas en inhibidores de la transcriptasainversa no análogos de los nucleósidos e inhibidores de laproteasa (IPs) han demostrado una efectividad similar en el incrementode células CD4+. En la disminución de los niveles de cargaviral los inhibidores de la proteasa han resultado más efectivos. Lasterapias con tres inhibidores de la transcriptasa inversa análogos delos nucleósidos han presentado la mayor supervivencia
Objective: To study initial antiretroviral therapies indicatedfor HIV-infected patients during the 2001-2003 period regardingeffectiveness, survival and safety.Method: A descriptive, retrospective study of clinical anddrug-related variables of naïve HIV-infected patients throughpharmacotherapeutic history.Results: Mean CD4+ lymphocytes counts were 209.6cells/mm3. Pneumonia by Pneumocystis carinii was the mostcommonly found condition at antiretroviral treatment onset. Mostcommonly used therapies included those based on a non-nucleosidereverse transcriptase inhibitor (NNRTI) combined with twonucleoside reverse transcriptase inhibitors (NRTIs). The longestmean survival was achieved by using combinations of three nucleosidereverse transcriptase inhibitors. The primary reason for initialantiretroviral therapy discontinuation were adverse effects,with stavudine exhibiting the poorest tolerability.Conclusions: Therapies based on non-nucleoside reversetranscriptase inhibitors and protease inhibitors (PIs) have shownsimilar effectiveness to increase CD4+ cell counts. Regarding viralload decreases, protease inhibitors were most effective. Therapiesusing three nucleoside reverse transcriptase inhibitors resulted inpeak survival
Subject(s)
Male , Female , Humans , HIV Infections/drug therapy , Anti-Retroviral Agents/therapeutic use , Viral Load/statistics & numerical data , CD4 Antigens , Reverse Transcriptase Inhibitors/pharmacokinetics , Protease Inhibitors/pharmacokinetics , Effectiveness , Treatment Outcome , Antiretroviral Therapy, Highly Active/statistics & numerical dataABSTRACT
We present a possible case of a hypersensitivity reaction to parenteral nutrition in a surgical patient of 61 years, weighing 49 kg, who presented facial, thoracic, and underarm erythema, proximal to the peripheral line, accompanied by pruritus: the symptoms disappeared after discontinuing the nutrition and after administration of dexchlorpheniramine. Analysis of the possible causes of this manifestation takes place, as well as of the components of the parenteral nutrition, route of administration, and concomitant medication.
