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Cosme A, Pardo E, Felipo F, Iribarren JA. Abdominal pain in a HIV-infected patient. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2005; 97:196-210. [PMID: 15839814 DOI: 10.4321/s1130-01082005000300008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Badía X, Podzamczer D, Moral I, Roset M, Arnaiz JA, Loncà M, Casiró A, Rosón B, Gatell JM, Grinberg N, Puentes T, Furst MJL, Julio Méndez S, Lupo S, Suárez C, Agostini M, Cassetti I, Bologna R, Salud H, Cahn P, Patterson P, Krolewiecki A, David DO, Luna N, Cruceta A, Pich J, Varea S, Carné X, Mallolas J, Clotet B, Romeu J, Cruz L, Arrizabalaga J, Iribarren JA, Rodríguez F, Von Wichmann MA, Jimeno B, Pulido F, Rubio R, Flores J, González-Lahoz J, Rodríguez-Rosado R, Núñez M. Health-Related Quality of Life in HIV Patients Switching to Twice-Daily Indinavir/Ritonavir Regimen or Continuing with Three-Times-Daily Indinavir-Based Therapy. Antivir Ther 2004. [DOI: 10.1177/135965350400900615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To evaluate health-related quality of life (HRQoL) changes in patients treated with indinavir three-times daily after switching to a twice-daily indinavir/ritonavir regimen or continuing with the same regimen. Methods Patients on HAART including indinavir three-times-daily with undetectable viral load were randomly assigned to continue with this therapy or to change to a twice-daily indinavir/ritonavir (800/100 mg) regimen. The Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire was used as the HRQoL measure. Results A total of 118 patients participated in the study, of which 59 (50%) were randomly assigned to continue with the three-times-daily regimen. Patients had a mean age of 39 years and 80% of them were male. At baseline, subjects included in the three-times-daily group presented a significantly greater number of symptoms than subjects in the twice-daily group, but no statistically significant differences were observed in MOS-HIV scores between the groups. In the intention-to-treat (ITT) analysis, a reduction in HRQoL scores was observed in both groups, which was greater in the twice-daily group. In the per protocol analysis, reduction of HRQoL was minimal. Conclusions A HRQoL deterioration, greater in the twice-daily group, was observed in this study in the ITT analysis, while HRQoL remained stable in both groups in patients who continued with and tolerated the allocated regimen.
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Berenguer J, Laguna F, López-Aldeguer J, Moreno S, Arribas JR, Arrizabalaga J, Baraia J, Casado JL, Cosín J, Polo R, González-García J, Iribarren JA, Kindelán JM, López-Bernaldo de Quirós JC, López-Vélez R, Lorenzo JF, Lozano F, Mallolas J, Miró JM, Pulido F, Ribera E. Prevención de las infecciones oportunistas en pacientes adultos y adolescentes infectados por el VIH. Recomendaciones de GESIDA/Plan Nacional sobre el Sida. Año 2003. Enferm Infecc Microbiol Clin 2004. [DOI: 10.1157/13058025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Berenguer J, Laguna F, López-Aldeguer J, Moreno S, Arribas JR, Arrizabalaga J, Baraia J, Casado JL, Cosín J, Polo R, González-García J, Iribarren JA, Kindelán JM, López-Bernaldo de Quirós JC, López-Vélez R, Lorenzo JF, Lozano F, Mallolas J, Miró JM, Pulido F, Ribera E. Prevention of opportunistic infections in adult and adolescent patients with HIV infection. GESIDA/National AIDS Plan guidelines, 2004 [correction]. Enferm Infecc Microbiol Clin 2004; 22:160-76. [PMID: 14987537 DOI: 10.1016/s0213-005x(04)73057-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To provide an update of guidelines from the Spanish AIDS Study Group (GESIDA) and the National AIDS Plan (PNS) committee on the prevention of opportunistic infections in adult and adolescent HIV-infected patients. METHODS These consensus recommendations have been produced by a group of experts from GESIDA and/or the PNS after reviewing the earlier document and the scientific advances in this field in the last years. The system used by the Infectious Diseases Society of America and the United States Public Health Service has been used to classify the strength and quality of the data. RESULTS This document provides a detailed review of the measures for the prevention of infections caused by viruses, bacteria, fungi and parasites in the context of HIV infection. Recommendations are given for preventing exposure and for primary and secondary prophylaxis for each group of pathogens. In addition, criteria are established for the withdrawal of prophylaxis in patients who respond well to highly active antiretroviral therapy (HAART). CONCLUSIONS HAART is the best strategy for the prevention of opportunistic infections in HIV-positive patients. Nevertheless, prophylaxis is still necessary in countries with limited economic resources, in highly immunodepressed patients until HAART achieves beneficial effects, in patients who refuse to take or who cannot take HAART, in those in whom HAART is not effective, and in the small group of infected patients with inadequate recovery of CD4+ T lymphocyte counts despite good inhibition of HIV replication.
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Soriano V, Miró JM, García-Samaniego J, Torre-Cisneros J, Núñez M, del Romero J, Martín-Carbonero L, Castilla J, Iribarren JA, Quereda C, Santín M, González J, Arribas JR, Santos I, Hernández-Quero J, Ortega E, Asensi V, del Pozo MA, Berenguer J, Tural C, Clotet B, Leal M, Mallolas J, Sánchez-Tapias JM, Moreno S, Gatell JM, Téllez MJ, Rubio R, Ledesma E, Domingo P, Barreiro P, Pedreira J, Romero M, González-Lahoz J, Lissen E. Consensus conference on chronic viral hepatitis and HIV infection: updated Spanish recommendations. J Viral Hepat 2004; 11:2-17. [PMID: 14738553 DOI: 10.1046/j.1365-2893.2003.00491.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Chronic hepatitis B and C represent a leading cause of morbidity and mortality among human immunodeficiency virus (HIV)-infected patients worldwide. New treatment options against both hepatitis B (HBV) and C (HCV) viruses have prompted us to update previous recommendations for the management of coinfected individuals. Fifteen topics (nine related to HCV, five to HBV and one to both viruses) were selected for this purpose. A panel of Spanish experts in the field was invited to review these areas and propose specific recommendations, which were scored according to the Infectious Disease Society of America (IDSA) grading system. These guidelines represent a comprehensive and updated overview on the management of hepatitis B and C in HIV-infected patients.
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Iribarren JA, Ramos JT, Guerra L, Coll O, de José MI, Domingo P, Fortuny C, Miralles P, Parras F, Peña JM, Rodrigo C, Vidal R. [Prevention of vertical transmission and treatment of infection caused by the human immunodeficiency virus in the pregnant woman. Recommendations of the Study Group for AIDS, Infectious Diseases, and Clinical Microbiology, the Spanish Pediatric Association, the National AIDS Plan and the Spanish Gynecology and Obstetrics Society]. Enferm Infecc Microbiol Clin 2001; 19:314-35. [PMID: 11747790 DOI: 10.1016/s0213-005x(01)72652-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
MESH Headings
- AIDS Serodiagnosis
- Abnormalities, Drug-Induced/etiology
- Acidosis, Lactic/chemically induced
- Acidosis, Lactic/epidemiology
- Adult
- Animals
- Anti-HIV Agents/administration & dosage
- Anti-HIV Agents/adverse effects
- Anti-HIV Agents/therapeutic use
- Antiretroviral Therapy, Highly Active
- Breast Feeding/adverse effects
- Cesarean Section
- Clinical Trials as Topic
- Delivery, Obstetric
- Drug Resistance, Viral
- Drug Therapy, Combination
- Family Health
- Female
- Fetal Diseases/etiology
- Fetal Diseases/virology
- HIV Infections/drug therapy
- HIV Infections/epidemiology
- HIV Infections/prevention & control
- HIV Infections/transmission
- HIV Protease Inhibitors/administration & dosage
- HIV Protease Inhibitors/adverse effects
- HIV Protease Inhibitors/therapeutic use
- HIV Reverse Transcriptase/antagonists & inhibitors
- Humans
- Infant, Newborn
- Infectious Disease Transmission, Vertical/prevention & control
- Informed Consent
- Male
- Maternal-Fetal Exchange
- Neoplasms, Experimental/chemically induced
- Preconception Care
- Pregnancy
- Pregnancy Complications, Infectious/drug therapy
- Pregnancy Complications, Infectious/epidemiology
- Prenatal Care
- Rats
- Reproductive Techniques
- Reverse Transcriptase Inhibitors/administration & dosage
- Reverse Transcriptase Inhibitors/adverse effects
- Reverse Transcriptase Inhibitors/therapeutic use
- Spain/epidemiology
- Viral Load
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Moreno S, Podzamczer D, Blázquez R, Iribarren JA, Ferrer E, Reparaz J, Peña JM, Cabrero E, Usán L. Treatment of tuberculosis in HIV-infected patients: safety and antiretroviral efficacy of the concomitant use of ritonavir and rifampin. AIDS 2001; 15:1185-7. [PMID: 11416725 DOI: 10.1097/00002030-200106150-00018] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Antela A, Iribarren JA, Clotet B, Guerra L. [Consensus documents and clinical guidelines on resistance to antiretroviral agents]. Enferm Infecc Microbiol Clin 2001; 19:47-52. [PMID: 11428061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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59
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Camino X, Iribarren JA, Arrizabalaga J, Rodríguez F, Von Wichmann AM. [Causes of mortality among patients infected with the human immunodeficiency virus in the era of highly active antiretroviral therapy]. Enferm Infecc Microbiol Clin 2001; 19:85-6. [PMID: 11333581 DOI: 10.1016/s0213-005x(01)72572-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gatell JM, Blanco JL, Alcamí J, Antela A, Arrizabalaga J, Casado JL, Clotet B, Delgado R, Erice A, Guerra L, Guerrero A, Iribarren JA, Leal M, López JC, Menéndez-Arias L, Miró JM, Moreno S, Pérez JL, Pumarola T, Rubio R, Ruiz L, Santamaría JM, Soriano V, Telenti A, Viciana P. [GESIDA Consensus document on the use of resistance studies in clinical practice]. Enferm Infecc Microbiol Clin 2001; 19:53-60. [PMID: 11428062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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von Wichmann MA, Camino X, Txoperena G, Arrizabalaga J, Rodríguez-Arrondo F, Iribarren JA. [Administration of granulocyte colony-stimulating factor in patients infected with human immunodeficiency virus and prolonged neutropenia]. Enferm Infecc Microbiol Clin 2001; 19:19-23. [PMID: 11256242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Persistent neutropenia is frequent in HIV infected patients with severe immunodeficiency. G-CSF induces proliferation and differentiation of granulocyte precursors. Our objective has been to assess the response to G-CSF therapy on patients with advanced HIV disease and prolonged neutropenia. METHODS A retrospective analysis of databases containing demographic information, analytic controls and hospitalizations related to neutropenia for patients attending our Infectious Diseases Unit from December 1, 1992 to January 30, 98. The episodes with absolute neutrophil counts lower than 1,000 x 10(6)/l at least during 7 days which descend below 500 x 10(6)/l at any moment were included. RESULTS 36 episodes were included. 9 episodes started on treatment with G-CSF. The median duration was 9 (3-76) weeks. Hospitalization with fever related to neutropenia was significantly less frequent in episodes which received G-CSF (22.2%) than episodes without (66.7%). CONCLUSION In this study, a significantly lower risk of hospitalization due to fever and neutropenia was associated with administration of G-CSF in patients with absolute neutrophil counts lower than 500 x 10(6)/l.
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Miró JM, Antela A, Arrizabalaga J, Clotet B, Gatell JM, Guerra L, Iribarren JA, Laguna F, Moreno S, Parras F, Rubio R, Santamaría JM, Viciana P. [Recommendation of GESIDA (AIDS Study Group)/National Plan on AIDS with respect to the anti-retroviral treatment in adult patients infected with the human immunodeficiency virus in the year 2000 (I)]. Enferm Infecc Microbiol Clin 2000; 18:329-51. [PMID: 11109725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE To update the recommendations for antiretroviral therapy in adult HIV-infected persons according to the new scientific advances and the existence of new antiretroviral drugs in the last two years. METHODS The antiretroviral therapy recommendations have been condensed by a panel of experts from the Spanish AIDS Study Group (Grupo de Estudio de sida-GESIDA) of the Spanish Infectious Diseases and Clinical Microbiology Society (SEIMC) and from the Clinical Advisory Panel of the Secretariat of the Spanish National Plan on AIDS (SPNS) of the Ministry of Health. Three levels of evidence have been established depending if the data came from randomised and controlled studies, from cohort or case-control studies or from descriptive studies and expert opinions. For that purpose we have reviewed the advances in HIV pathophysiology and results of efficacy (clinical, virologic and immunologic) and security (toxicity) from clinical trials involving antiretroviral therapy lasting at least 12 months, from cohort studies and pharmacokinetic and security data of antiretroviral drugs, presented in international conferences or published in biomedical journals in the last two years. In each situation we have established either to recommend or to consider or not recommend antiretroviral therapy. RESULTS Nowadays, antiretroviral therapy consisting of at least three drugs constitutes the election therapy for chronic HIV infection, since it delays clinical progression, increases significantly the survival and diminishes hospital admissions and associated costs. The decision to start antiretroviral therapy must be based upon three elements: presence or absence of symptoms, plasma viral load and CD4+ cells counts. Thus, in asymptomatic cases with a high CD4+ cells count (> 500/microL) and low viral load (< 10,000 copies/ml by branched DNA [bDNA] or < 20,000 copies/ml by reverse-transcription polymerase chain reaction [RT-PCR] or nucleic acid sequence based amplification [NASBA]) we recommend to delay antiretroviral therapy. In symptomatic patients we recommend to start it, and in asymptomatic patients, we could recommend or consider antiretroviral therapy initiation depending on the risk of progression, established by the viral load and the CD4+ cells count. In any case, if therapy is started, the objective must be to reach an undetectable viral load (< 50 copies/ml). The adherence to antiretroviral therapy plays a key role for its initial moment and for the duration of the antiviral response, antiretroviral therapy can achieve a restoration of cellular immunity in the advanced patients. There are few therapeutic options in failing patients due to cross-resistance. Resistance studies can be useful in this setting. The toxicity is a new and limiting factor of antiretroviral therapy which requires to look for new therapeutic options. Antiretroviral therapy criteria for acute infection, pregnancy, post-exposure prophylaxis and when to use resistance testing are discussed. CONCLUSIONS In this moment, there is a more conservative attitude towards starting antiretroviral therapy than in previous recommendations in which a virus eradication was considered. On the other hand, the high number of disposable drugs, the more sensitive monitorization methods (plasma viral load) and the possibility of performing resistance studies make therapeutic strategies more dynamic and individualised for each patient and situation. In any case, it is mandatory to ensure a perfect adherence to antiretroviral therapy from the patients.
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Belzunegui J, De Dios JR, Intxausti JJ, Iribarren JA. Septic arthritis caused by Stenotrophomonas maltophilia in a patient with acquired immunodeficiency syndrome. Clin Exp Rheumatol 2000; 18:265. [PMID: 10812507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Camino X, Rodríguez-Arrondo F, Arrizabalaga J, Iribarren JA, von Wichmann MA. [Multiple abscesses (cerebral, splenic, cutaneous) and pulmonary infection]. Enferm Infecc Microbiol Clin 1999; 17:189-90. [PMID: 10365514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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65
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Pulido F, Iribarren JA, Kindelan JM, Moreno S. [Diagnosis and treatment of mycobacterial infections in patients with HIV/AIDS]. Enferm Infecc Microbiol Clin 1998; 16 Suppl 1:20-8. [PMID: 9859616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Mycobacterial infection remains as a frequent complication associated to HIV infection. Although the widespread use of HAART has intensely decreased incidence of disseminated Mycobacterium avium (MAC) infection, it does not seem that it has affected tuberculosis occurrence so intensely. In spite of the intense search of new methods of rapid diagnosis, in the clinical practice the diagnosis of the mycobacterial illnesses continues based on culture, although the appearance of new media has allowed to shorten the time of growth. The combination of isoniazid (INH), rifampin (RIF) and pirazinamide (PZ) (with ethambutol [ETB] when primary resistance to INH is higher than 4%), remains as the elective treatment for tuberculosis in HIV infected patients. Due to the interaction between RIF and some antiretovirals drugs, such as proteasa inhibitors, a change in the usual regimens could be necessary. Combinations without RIF or antiretroviral therapy with drugs not interacting with RIF (nucleosides, ritonavir or nevirapin) have been suggested. The emergence of strains of Mycobacterium tuberculosis resistant to the antituberculosis drugs, the lack of adherence to treatment, and the frequency of adverse events hinders even more the control of the tuberculosis and they demand a narrow follow up of these patients. The treatment of the disseminated infection by MAC has improved in the last years with the generalization of the combinations including macrolides as claritromicin or azitromicin with ETB. The doubt persists about what combination is more effective, although like in other opportunists infections associated with a severe immunodeficiency, using antiretrovirals combinations that enhance the immune system could be a fundamental therapeutic approach.
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MESH Headings
- AIDS-Related Opportunistic Infections/diagnosis
- AIDS-Related Opportunistic Infections/drug therapy
- Anti-Bacterial Agents
- Anti-HIV Agents/adverse effects
- Anti-HIV Agents/pharmacology
- Anti-HIV Agents/therapeutic use
- Antitubercular Agents/adverse effects
- Antitubercular Agents/pharmacology
- Antitubercular Agents/therapeutic use
- Drug Interactions
- Drug Resistance, Microbial
- Drug Resistance, Multiple
- Drug Therapy, Combination/adverse effects
- Drug Therapy, Combination/pharmacology
- Drug Therapy, Combination/therapeutic use
- HIV Protease Inhibitors/adverse effects
- HIV Protease Inhibitors/pharmacology
- HIV Protease Inhibitors/therapeutic use
- Humans
- Incidence
- Mycobacterium/drug effects
- Mycobacterium/growth & development
- Mycobacterium/isolation & purification
- Mycobacterium Infections/diagnosis
- Mycobacterium Infections/drug therapy
- Mycobacterium Infections/epidemiology
- Mycobacterium Infections, Nontuberculous/diagnosis
- Mycobacterium Infections, Nontuberculous/drug therapy
- Mycobacterium avium-intracellulare Infection/diagnosis
- Mycobacterium avium-intracellulare Infection/drug therapy
- Mycobacterium avium-intracellulare Infection/epidemiology
- Treatment Failure
- Tuberculosis/diagnosis
- Tuberculosis/drug therapy
- Tuberculosis/epidemiology
- Tuberculosis, Multidrug-Resistant/diagnosis
- Tuberculosis, Multidrug-Resistant/drug therapy
- Tuberculosis, Multidrug-Resistant/epidemiology
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Rodríguez Arrondo F, Arrizabalaga J, von Wichmann MA, Iribarren JA. [Diabetes mellitus and protease inhibitors. A complication to take into account]. Med Clin (Barc) 1998; 111:801. [PMID: 9922978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Rodríguez Arrondo F, von Wichmann MA, Arrizabalaga J, Iribarren JA, Garmendia G, Idígoras P. [Pulmonary cavitation lesions in patients infected with the human immunodeficiency virus: an analysis of a series of 78 cases]. Med Clin (Barc) 1998; 111:725-30. [PMID: 9922954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND To assess the clinical, radiologic and microbiological features of lung cavitation and HIV infection. Evaluation of the differences related to this disease in the last years. PATIENTS AND METHODS Retrospective review of all patients with lung cavitation and HIV infection admitted at our hospital from January 1989 until December 1994 and prospective study of all patients with the same characteristics during 1995 and 1996. Lung cavitation was defined as any parenchymal lesion, with air content, visible in a simple X-ray and greater than 1 cm of diameter. Criteria for confirmed, probable or possible diagnosis were defined. RESULTS 78 cases of lung cavitation have been identified in 73 patients. The radiologic patterns included unilobar and multilobular involvement in 31 and 47 cases, respectively. Cavities were multiple and single in 40 and 38 cases respectively. Findings with fine needle aspiration biopsy (FNAB) were diagnostic in 11 out of 14 cases. A clinical diagnosis was performed in all 78 cases, with microbiological results in 69 cases (88.5%): Mycobacterium tuberculosis in 20, Pneumocystis carinii in nine, Pseudomonas aeruginosa in nine, Staphylococcus aureus in eight (5 endocarditis with cavitary septic emboli), Rhodococcus equi in six, P. aeruginosa and S. aureus in three, Salmonella enteritidis in three, Cryptococcus neoformans in two, Aspergillus fumigatus in two and others in 7 cases. Confirmed, probable and possible diagnosis was considered in 54, 15 and 9 cases, respectively. Thirteen episodes of spontaneous pneumothorax were found. CONCLUSIONS The lung cavitation rate is low, compared with the number of admissions related to HIV infection; nevertheless, many of them are in close relationship with HIV infection, and most of them are caused by treatable infections. It is important to know the clinical and radiological characteristics, in order to establish an early diagnosis and an appropriate therapy. Pseudomonas aeruginosa is becoming an important cause of lung cavitation. In our series, spontaneous pneumo-thorax was not related to Pneumocystis carinii pneumonia in 61.5% of cases.
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Rodríguez-Arrondo F, Aguirrebengoa K, De Arce A, Arrizabalaga J, Iribarren JA, Von Wichmann MA, Goenaga MA. Candidal meningitis in HIV-infected patients: treatment with fluconazole. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1998; 30:417-8. [PMID: 9817525 DOI: 10.1080/00365549850160747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Although mucocutaneous candidiasis is a common occurrence in HIV-infected patients, candidal meningitis is uncommon. We report 3 cases of candidal meningitis in HIV-positive patients, all intravenous drug abusers, and we discuss the clinical course and outcome, the treatment with fluconazole and possible prophylaxis.
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Moreno S, Arrizabalaga J, Gatell JM, Clotet B, Aguirrebengoa K, Antela A, Iribarren JA, Laguna F, Miró JM, Ocaña I, Rubio R, Viciana P, Podzamczer D. [Recommendations for antiretroviral treatment in 1998. AIDS Working Group of the Spanish Society for Infectious Diseases and Clinical Microbiology (SEIMC)]. Enferm Infecc Microbiol Clin 1998; 16:374-6. [PMID: 9835154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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von Wichmann MA, Rodríguez Arrondo F, Iribarren JA, Arrizabalaga J, Asumendi L, Zubizarreta J. [Fever and petechiae developing over several days]. Enferm Infecc Microbiol Clin 1998; 16:379-80. [PMID: 9835156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Arrizabalaga J, Casas A, Camino X, Iribarren JA, Rodríguez Arrondo F, Von Wichmann MA. [The usefulness of the desensitization to rifampin in the treatment of mycobacterial disease in patients with AIDS]. Med Clin (Barc) 1998; 111:103-4. [PMID: 9706604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Hypersensitivity reactions to rifampin are relatively uncommon, but they may result in cessation of therapeutic medications. PATIENTS AND METHODS We report our experience with oral desensitization protocol to rifampin in a group of 35 HIV-positive patients with mycobacterial disease who had some hypersensitivity reaction to this drug. RESULTS Adverse reactions with this protocol were few and easily treated. CONCLUSIONS Oral desensitization to rifampin is safe and effective, allowing some of these patients (60%) to reintroduce the drug and to reduce the time of treatment.
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Castiella A, Iribarren JA, López P, Barrio J, Von Wichmann MA, Alzate LF, Arrizabalaga J, Rodríguez F, Arenas JI. AIDS-associated cholangiopathy in a series of ten patients. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE PATOLOGIA DIGESTIVA 1998; 90:419-30. [PMID: 9708007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To present the clinical, biological, radiologic and cholangiographic findings in patients with clinical suspicion of AIDS associated cholangiopathy in our hospital. PATIENTS AND METHODS We have revised the clinical charts of 10 patients admitted in our hospital from 1991 to 1995. RESULTS Ultrasonography and/or abdominal CT were carried out on all the patients. Biliary tract dilatation was observed in 11 cases. From the 12 ERCP, biliary tract was fulfilled in 11. In 5 cases papillary stenosis was diagnosed, sclerosing cholangitis in 2, normal biliary tract in 3 and acute cholangitis in one case. Sphincterotomy was done in 5 patients, with clinical improvement. In one case, another sphincterotomy was needed because of reestenosis. CONCLUSIONS ERCP is very important in the diagnosis of AIDS associated cholangiopathy. Endoscopic sphincterotomy relieves abdominal pain in these patients. Cholangiopathy occurs in very immunocompromised HIV positive patients. Survival is very short.
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Larren M, Pensado L, Martín A, Zunzunegui A, Seoane J, Rodríguez Arrondo F, Arrizabalaga J, Iribarren JA, von Wichmann MA, Hernández J. [Prospective 3-month study of intravascular catheter complications in HIV-infected patients: relation between phlebitis and infection]. Enferm Infecc Microbiol Clin 1998; 16:219-23. [PMID: 9666584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the etiology of phlebitis (chemical or infectious) and the prevalence of infections related to intravascular catheters (IRIC) in patients with HIV infection admitted to a 22-bed Infectious Disease Unit with a high rate of HIV infection. MATERIAL AND METHODS A 3-month prospective study from November 1, 1994 to January 31, 1995 was carried out following a formula for data collection of all the intravenous catheters used during that time period. Cultures of the catheters withdrawn on Wednesdays and those with signs of phlebitis were performed. RESULTS One hundred fifty-two intravenous catheters in 71 patients with HIV infection with a mean age of 37 years (range: 21-73) and mean hospital stay of 10.2 days were reported. During the study period 42 phlebitis were produced, of which 37 catheters (7 central and 30 peripheral) were processed. Of the 37 phlebitis processed, 29 (78.9%) were considered to be of physiochemical origin. Of the 21 catheters withdrawn Wednesday, 18 were processed, 8 with phlogotic signs, 2 with IRCI, equivalent to 1.9 IRCI/100 days of catheterization. During the study period no local or severe systemic infections related to the catheter were reported. Staphylococcus epidermidis was the organism involved in all the cases of IRCI. CONCLUSIONS Despite the high number of immunosuppressed patients in related to HIV infection, a greater incidence of IRCI was not found in these patients. The most frequent cause of phlebitis by catheter was of chemical origin.
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von Wichmann MA, Castiella A, Rodriguez-Arrondo F, Iribarren JA, Arrizabalaga J, Lopez P. Pseudomonas aeruginosa cholangitis in a HIV patient. Am J Gastroenterol 1998; 93:483-4. [PMID: 9517673 DOI: 10.1111/j.1572-0241.1998.481_5.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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75
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Arruabarrena IM, Von Wichmann MA, Iribarren JA, Arrizabalaga J, Rodríguez F. [Favorable evolution of a myocardial abscess using medical treatment in an HIV-positive patient]. Enferm Infecc Microbiol Clin 1998; 16:156. [PMID: 9611888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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