HCM - Egreso - Diarrea en Paciente con VIH

Maria A. Ovalles P. Residente de primer nivel

[object Object],[object Object],[object Object],[object Object],Girardi E, . Impact of the HIV epidemic on the spread of other diseases. AIDS 2000; 14(Suppl 3):S47–56.

[object Object],[object Object],Miller V, et al. Relations among CD4 lymphocyte count nadir, antiretroviral therapy, and HIV-1 disease progression: results from the EuroSIDA study. Ann Intern Med 1999; 130:570–7.

Ponce, S. SIDA. Aspectos clínicos y terapeuticos. 2000 PAÍSES EN DESARROLLO PAÍSES DESARROLLADOS Citomegalovirus (45%) Salmonella sp (25%) E. Histolytica (25%) Cryptosporidium (15%) Giardia lamblia (15%) Campylobacter jejuni (10%) Mycobacterium avium (5%) Herpes simple (5%) Cryptosporidium (45%) Blastocystis hominis (34%) Isospora belli (15%) Giardia lamblia (4 – 13%) E. Histolytica

[object Object],[object Object],Etiology of Chronic Diarrhea in Antiretroviral-Naïve Patients with HIV Infection Admitted to Norodom Sihanouk Hospital, Phnom Penh, Cambodia. Clinical Infectious Diseases 2006; 43:925–32

[object Object],[object Object],[object Object],[object Object],Practice Guidelines for the Management of Infectious Diarrhea. Clinical Infectious Diseases 2001; 32:331–50

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[object Object],[object Object],Treating Opportunistic Infections among HIV-Infected Adults and Adolescents: Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. Clinical Infectious Diseases 2005;40:S131–S235

[object Object],[object Object],[object Object],[object Object],Kaushik, K. (2007) Evaluation of staining techniques, antigen detection and nested PCR for the diagnosis of cryptosporidiosis in HIV seropositive and seronegative patients Clin Infec Dis.

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clinical Chemistry 51: 2415-2418, 2005.

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Weiss LM, Vossbrinck CR. Microsporidiosis: molecular and diagnostic aspects. Adv Parasitol 1998; 40:351–95.

[object Object],[object Object],Dore GJ, Li Y; McDonald A; Ree H, et al. Impact of highly active antiretroviral therapy on individual AIDS-defining illness incidence and survival in Australia. J AIDS 2002; 29:388–95.

[object Object],[object Object],[object Object],[object Object],Kingsley C. Yogurt Containing Probiotic Lactobacillus rhamnosus GR-1 and L. reuteri RC-14 Helps Resolve Moderate Diarrhea and Increases CD4 Count in HIV/AIDS Patients. J Clin Gastroenterol 2008;42:239–243)

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Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America

ANTIMICROBIANOS Treating Opportunistic Infections among HIV-Infected Adults and Adolescents: Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. Clinical Infectious Diseases 2005;40:S131–S235 ATB DOSIS ALTERNATIVA Cryptosporidium Sintomático Nitrazoxanida 500mg BID (CIII) Paromicina 25mg/Kg (CIII) Microsporidium Albendazol 400 mg BID 4 semanas CD4 > 200 cel Nitrazoxanida Itraconazol Fumagilin 60mg OD Isospora Cyclospora Trimetoprim-Sulfametoxazol (AII) 160 mg /800 mg QID 10 días luego BID por 3 semanas Ciprofloxacina

ANTIMICROBIANOS Treating Opportunistic Infections among HIV-Infected Adults and Adolescents: Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. Clinical Infectious Diseases 2005;40:S131–S235 ATB DOSIS OPCIÓN M. avium Claritromicina (AI) 500 mg BID Azitromicina (AII) Etambutol (AI) 15 mg/Kg QID Rifabutin (CI) Fluoroquinolonas o amikacina (CIII) Salmonella Fluoroqunolona: Ciprofloxacina (AIII) 500-750 mg BID 7-14 dias CD4 < 200cel: 4-6 sem TMP-SMX Cefalosporinas de 3 era (BIII)

ANTIMICROBIANOS Treating Opportunistic Infections among HIV-Infected Adults and Adolescents: Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. Clinical Infectious Diseases 2005;40:S131–S235 ATB DOSIS Citomegalovirus ,[object Object],5 mg/kg/12 h EV 14 ,[object Object],60 mg/kg/8 h o 90 mg/kg/12 h, EV por 14 a 21 días a 21 días

ANTIMICROBIANOS Treating Opportunistic Infections among HIV-Infected Adults and Adolescents: Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association/Infectious Diseases Society of America. Clinical Infectious Diseases 2005;40:S131–S235 ATB DOSIS ALTERNATIVA Cryptococcus ,[object Object],2 semanas Fluconazol ,[object Object],[object Object],8 semanas Itraconazol 200mg VO BID

Prophylaxis against Opportunistic Infections in Patients with Human Immunodeficiency Virus Infection. N Engl J Med 2000;343(9):672.

[object Object],[object Object],The Impact of Primary Prophylaxis for Cryptococcosis on Fluconazole Resistance in Candida Species J Acquir Immune Defic Syndr Volume 47, Number 5, April 15, 2008

VIRUS DE INMUNODEFICIENCIA HUMANA

REFENCIAS BIBLIOGRAFICAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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