ABSTRACT
OBJECTIVE: To assess responses to indinavir (IDV)-ritonavir (RTV)-based regimens among HIV-1 infected patients with prior failure of protease inhibitors, and to assess the effects of adherence to therapy and pre-existing genotypic and phenotypic resistance on this response. METHODS: Twenty-eight patients initiating salvage regimens with IDV-RTV (800 mg and 200 mg twice daily, respectively) plus one or more reverse transcriptase inhibitor (RTI) were identified retrospectively. Genotypic and phenotypic susceptibilities to multiple antiretroviral agents were determined on viral samples collected at initiation of the salvage regimens, and adherence to therapy was determined through patient self-reporting. Response to therapy (viral RNA
Subject(s)
HIV Infections/drug therapy , HIV Protease Inhibitors/therapeutic use , HIV-1 , Indinavir/therapeutic use , Ritonavir/therapeutic use , Drug Resistance, Viral , Drug Therapy, Combination , Female , Follow-Up Studies , Genotype , HIV Infections/virology , HIV Protease/genetics , HIV-1/drug effects , HIV-1/genetics , Humans , Male , Patient Compliance , Phenotype , Retrospective Studies , Salvage Therapy/methods , Treatment Failure , Viral LoadABSTRACT
Large, ulcerative lesions over the skin, scalp, and oral mucosa were observed in a patient with acquired inmunodeficiency syndrome (AIDS) receiving chronic suppressive therapy with fluconazole. Candida glabrata was recovered in culture from biopsy material, and was found to be resistant to fluconazole and itraconazole. Treatment with amphotericin B resulted in marked improvement. The reported frequency of infections with Candida spp. resistant to fluconazole has increased in recent years. We review the literature regarding fluconazole resistant infections in patients with AIDS, discuss the possible mechanisms of resistance, and management options
Subject(s)
Humans , Male , Candidiasis/etiology , Fluconazole/therapeutic use , Acquired Immunodeficiency Syndrome/complications , Candida/drug effects , Candida albicans/drug effects , Fluconazole/administration & dosage , Fluconazole/adverse effects , HIV Infections , Infection ControlABSTRACT
Ocho pacientes con SIDA fueron sometidos a biopsia de hígado para determinar el espectro de enfermedad de hígado en esta condición. Las indicaciones para biopsua fueron fiebre, hepatomegalia o alteración en las enzimas hepáticas. En siete pacientes se realizó prueba de perfil de hepatitis. Las biopsias se tiñeron con H & E, reticulina, PAS, tinte FITE pra bacilos ácidos-resistentes y plata, se examinaron por microscopía electrónica y todas se cultivaron para bacilos ácido-resistentes y hongos. Cinco de 8 pacientes (62.5%) tenían historial de abuso de drogas intravenosas, 3(37.5%) eran homosexuales. La edad media era de 37 años (30-43), y la duración de enfermedad era de 8 meses (2-15). Siete (100%) tenían algún marcador de hepatitis B, 6 de 7 (85.7%) tenían anticuerpos de hepatitis A. Todos los pacientes estaban recibiendo por lo menos un agente hepatotóxico. Los hallazgos histológicos incluyeron hígado graso (2/8), granulomas de schistosomiasis (1/8), hepatitis crónica activa (3/8). Los estudios de bacteriológia fueron negativos en todos. Concluimos que los pacientes con SIDA tenían una incidencia alta de anormalidades hepáticas, pero no se identificaron cambios hepáticos específicos o patognomónicos
