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1.
Neth J Med ; 70(4): 190-2, 2012 May.
Article in English | MEDLINE | ID: mdl-22641627

ABSTRACT

This case report describes a female HIV-positive patient diagnosed with pelvic actinomycosis using 16S rRNA gene sequence analysis. Actinomycosis is notoriously difficult to diagnose by microbiological culture. 16S rRNA gene sequence analysis allows rapid definitive diagnosis of actinomycosis and is potentially of great value in a clinical setting. This is the first report of pelvic actinomycosis in an HIV-1 infected patient.


Subject(s)
Abdominal Abscess/microbiology , Actinomycosis/diagnosis , HIV Infections/diagnosis , HIV-1 , Pelvis/microbiology , Abdominal Abscess/etiology , Abdominal Abscess/pathology , Actinomycosis/complications , Actinomycosis/drug therapy , Adult , Anti-Bacterial Agents/therapeutic use , Female , HIV Infections/complications , HIV Infections/pathology , Humans , Tomography, X-Ray Computed
2.
HIV Med ; 9(4): 234-8, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18366447

ABSTRACT

OBJECTIVES: Optimal plasma concentrations of antiretroviral drugs are required during pregnancy to treat maternal HIV infection and prevent mother-to-child transmission. We investigated the effect of pregnancy on nevirapine (NVP) plasma concentrations. METHODS: We included all HIV-1-infected women for whom NVP plasma concentrations were available as part of routine patient care at two university hospitals. Plasma NVP concentrations were compared for pregnant (n=45) and non-pregnant (n=152) women. Univariate and multivariate linear regression analyses were used to identify and adjust for other confounding factors associated with NVP plasma concentrations. For pregnant women who had a plasma NVP concentration available both during and outside pregnancy, a paired analysis was performed. RESULTS: Steady-state NVP plasma concentrations were lower in pregnant women: 5.2 mg/L (interquartile range 3.9-6.8) vs. 5.8 mg/L (4.3-7.7) (P=0.08). After adjusting for confounders, both pregnancy (regression coefficient=-0.90 mg/L, P=0.046) and African descent (regression coefficient=+1.13 mg/L, P=0.005) influenced NVP concentrations significantly. The paired analysis showed mean concentrations of 4.8 mg/L during pregnancy and 5.8 mg/L outside pregnancy (paired t-test, P=0.073). CONCLUSIONS: Pregnancy has a moderate but significant lowering effect on NVP plasma concentrations. Being of African descent compensates for the lowering effect of pregnancy on NVP concentrations.


Subject(s)
HIV Infections/blood , Nevirapine/blood , Pregnancy Complications, Infectious/blood , Reverse Transcriptase Inhibitors/blood , Adult , Africa/ethnology , Case-Control Studies , Female , HIV Infections/drug therapy , HIV Infections/transmission , HIV-1/drug effects , Humans , Infectious Disease Transmission, Vertical/prevention & control , Middle Aged , Netherlands , Nevirapine/pharmacology , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Reverse Transcriptase Inhibitors/pharmacology
3.
Ned Tijdschr Geneeskd ; 148(41): 2005-8, 2004 Oct 09.
Article in Dutch | MEDLINE | ID: mdl-15553994

ABSTRACT

Since 1 January 2004, pregnant women in the Netherlands have been universally screened for HIV infection. Three HIV-infected, pregnant women aged 28, 24 and 33 years respectively, illustrate some of the problems that may be encountered in this situation, as well as the treatment options available to prevent the transmission of HIV from mother to child. The first patient had a positive antibody test early in pregnancy for which she did not need treatment, the second had a positive antibody test late in pregnancy and the third was seropositive and on medication, but had the wish to become pregnant. A vaginal delivery is possible when highly active antiretroviral therapy (HAART) of the mother is started in good time and the plasma HIV-RNA is < 400 copies/ml at the time of delivery. In this situation the risk of transmission is reduced to around 1%. However, if HIV infection is diagnosed late in pregnancy or, despite HAART, the plasma HIV-RNA is not expected to be < 400 copies/ml, an elective caesarean section is scheduled at 38 weeks of pregnancy. In all instances the neonate is treated for 28 days with antiretrovirals, as post-exposure prophylaxis. If a woman with a known HIV infection wants to become pregnant, the choice of antiretroviral regimen and when this is started is determined by her treatment history and the potential toxic effects of the medication on the foetus.


Subject(s)
HIV Infections/transmission , HIV-1 , Infectious Disease Transmission, Vertical/prevention & control , Pregnancy Complications, Infectious/drug therapy , Adult , Antiretroviral Therapy, Highly Active , Female , HIV Infections/drug therapy , HIV Infections/prevention & control , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications, Infectious/prevention & control , Pregnancy Outcome , Prenatal Care , Risk Factors , Viral Load
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