Treatment of Opportunistic Infections Associated with Human Immunodeficiency Virus Infection

2011 ◽  
pp. 978-986
Author(s):  
David B. Clifford
Keyword(s):  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Opportunistic Infections ◽  
Immunodeficiency Virus

scholarly journals Human immunodeficiency virus infection with multiple opportunistic infections: lessons learnt from a non-adherent patient

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Manish Soneja ◽  
Anivita Aggarwal ◽  
Parul Kodan ◽  
Nitin Gupta
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Cytomegalovirus Infection ◽  
Opportunistic Infections ◽  
Pneumocystis Carinii ◽  
Adherent Patient ◽  
Immunodeficiency Virus ◽  
Adherence Counselling

Abstract We report a case of advanced human immunodeficiency virus (HIV) infection with multiple opportunistic infections (Pneumocystis carinii pneumonia, cryptosporidiosis, oesophagal candidiasis and cytomegalovirus infection). The patient was presumed to be adherent on antiretroviral therapy (ART) and was initiated on respective treatments for the opportunistic infections but continued to deteriorate. On further reviewing, he was found to be poorly adherent to ART and was advised enhanced adherence counselling after which his condition improved. We report this case to emphasize the importance of adherence to ART medications in the management of patients with HIV.

scholarly journals Oral Candidal Infections and Antimycotics

2000 ◽  
Vol 11 (2) ◽  
pp. 172-198 ◽  
Author(s):  
A.N.B. Ellepola ◽  
L.P. Samaranayake
Keyword(s):  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Oral Cavity ◽  
Human Immunodeficiency Virus Infection ◽  
Drug Concentration ◽  
Opportunistic Infections ◽  
Clinical Manifestations ◽  
Antifungal Effect ◽  
Therapeutic Implications ◽  
Immunodeficiency Virus

The advent of the human immunodeficiency virus infection and the increasing prevalence of compromised individuals in the community due to modern therapeutic advances have resulted in a resurgence of opportunistic infections, including oral candidoses. One form of the latter presents classically as a white lesion of "thrush" and is usually easily diagnosed and cured. Nonetheless, a minority of these lesions appears in new guises such as erythematous candidosis, thereby confounding the unwary clinician and complicating its management. Despite the availability of several effective antimycotics for the treatment of oral candidoses, failure of therapy is not uncommon due to the unique environment of the oral cavity, where the flushing effect of saliva and the cleansing action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. This problem has been partly circumvented by the introduction of the triazole agents, which initially appeared to be highly effective. However, an alarming increase of organisms resistant to the triazoles has been reported recently. In this review, an overview of clinical manifestations of oral candidoses and recent advances in antimycotic therapy is given, together with newer concepts, such as the post-antifungal effect (PAFE) and its possible therapeutic implications.

scholarly journals Clarithromycin lowers plasma zidovudine levels in persons with human immunodeficiency virus infection.

1997 ◽  
Vol 41 (8) ◽  
pp. 1709-1714 ◽  
Author(s):  
M A Polis ◽  
S C Piscitelli ◽  
S Vogel ◽  
F G Witebsky ◽  
P S Conville ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Drug Interactions ◽  
Maximum Concentration ◽  
Opportunistic Infections ◽  
Simultaneous Administration ◽  
Time Curve ◽  
Antiretroviral Agents ◽  
Immunodeficiency Virus

The use of antiretroviral agents and drugs for the treatment and prophylaxis of opportunistic infections has lengthened the survival of persons with AIDS. In the era of multidrug therapy, drug interactions are important considerations in designing effective and tolerable regimens. Clarithromycin has had a significant impact on the treatment of disseminated Mycobacterium avium complex infection, and zidovudine is the best-studied and one of the most widely used antiretroviral agents in this population. We conducted a study to determine the maximally tolerated dose of clarithromycin and the pharmacokinetics of clarithromycin and zidovudine individually and in combination. Mixing studies were conducted to simulate potential interaction in the gastric environment. The simultaneous administration of zidovudine and clarithromycin had little impact on the pharmacokinetics of clarithromycin or of its major metabolite. However, coadministration of zidovudine and clarithromycin at three doses (500 mg orally [p.o.] twice daily [b.i.d.], 1,000 mg p.o. b.i.d., and 2,000 mg p.o. b.i.d.) reduced the maximum concentration of zidovudine by 41% (P < 0.005) and the area under the concentration-time curve from 0 to 4 h for zidovudine by 25% (P < 0.05) and increased the time to maximum concentration of zidovudine by 84% (P < 0.05), compared with zidovudine administered alone. Mixing studies did not detect the formation of insoluble complexes due to chelation, suggesting that the decrease in zidovudine concentrations results from some other mechanism. Simultaneous administration of zidovudine and clarithromycin appears to decrease the levels of zidovudine in serum, and it may be advisable that these drugs not be given at the same time. Drug interactions should be carefully evaluated in persons with advanced human immunodeficiency virus infection who are receiving multiple pharmacologic agents.

scholarly journals Prevalence aetiology and clinical spectrum of abnormal adrenal functions in human immunodeficiency virus infection

2019 ◽  
Vol 6 (03) ◽  
pp. 4384-4389
Author(s):  
Ajay Nathan ◽  
KS Brar ◽  
Arun K Valsan ◽  
Nimitha K Mohan ◽  
Gautam Singh
Keyword(s):  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Early Stage ◽  
Statistical Tests ◽  
Clinical Spectrum ◽  
Response To Treatment ◽  
Immunodeficiency Virus

Aim: To find Prevalence, Aetiology and Clinical Spectrum of abnormal adrenal functions in Human Immunodeficiency Virus infection. To diagnose and treat adrenal dysfunction in various stages of HIV infection and see the response to treatment if required. Material & Methods: 100 patients with HIV infection being admitted to our hospital was evaluated for abnormal adreno cortical functions. Immune dysfunction was assessed with CD4 count. Statistical tests (chi squared test) were applied to the collected data to find out any significant correlations. Results: The overall prevalence of adrenocortical abnormalities in HIV positive patients was 14% which included hypocortisolemia in 3% and hypercortisolemia in 11% of patients. Frequency of hypocortisolemia was significantly associated with presence of HIV infection with opportunistic infections and low CD4 counts (less than 50cells). In patients having hypercortisolemia, ONDST (Over night dexamethasone suppression test) was done and it showed reduction of serum cortisol to expected level (suppressed to <1.8 mcg/dl). Adjustment disorders and drugs mainly efavirnz more than nevirapine was incriminated in the same. Conclusion: HPA axis dysfunction is frequently encountered in HIV infected patients. The commonest dysfunction was hypercortisolemia probably due to elevated cytokines. Hypercortisolemia is a feature of early stage HIV infection. The likelihood of adrenal insufficiency increases as the disease advances and patient enters a more immunocompromised state. Hypocortisolemia should be treated regardless of the existence of associated symptoms. Hypercortisolemia in the absence of features of Cushing’s syndrome is common and should not promote treatment or specific studies.

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