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Titolo:
Discontinuation of secondary prophylaxis for opportunistic infections in HIV-infected patients receiving highly active antiretroviral therapy
Autore:
Soriano, V; Dona, C; Rodriguez-Rosado, R; Barreiro, P; Gonzalez-Lahoz, J;
Indirizzi:
Hosp Carlos III, Inst Salud Carlos III, Infect Dis Serv, Madrid, Spain Hosp Carlos III Madrid Spain Carlos III, Infect Dis Serv, Madrid, Spain
Titolo Testata:
AIDS
fascicolo: 4, volume: 14, anno: 2000,
pagine: 383 - 386
SICI:
0269-9370(20000310)14:4<383:DOSPFO>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
PNEUMOCYSTIS-CARINII PNEUMONIA; CYTOMEGALOVIRUS RETINITIS; TOXOPLASMIC ENCEPHALITIS; MAINTENANCE THERAPY; AIDS PATIENTS; DISEASE; PYRIMETHAMINE; SULFADIAZINE; INITIATION; RECOVERY;
Keywords:
opportunistic infections; prophylaxis; immune restoration; antiretroviral therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Soriano, V Calle Rafael Calvo 7,2 A, Madrid 28010, Spain Calle Rafael Calvo 7,2 A Madrid Spain 28010 drid 28010, Spain
Citazione:
V. Soriano et al., "Discontinuation of secondary prophylaxis for opportunistic infections in HIV-infected patients receiving highly active antiretroviral therapy", AIDS, 14(4), 2000, pp. 383-386

Abstract

Background: Immune reconstitution following the introduction of highly active antiretroviral therapies (HAART) has lead to a remarkable reduction in the incidence of opportunistic infections (OI) in subjects with advanced HIV disease. Moreover, discontinuation of primary prophylaxis for some OI canbe attempted without risk in patients experiencing a favourable response to treatment. However, data on the feasibility of discontinuing secondary prophylaxis are much more scarce, and restricted mainly to the withdrawal of maintenance treatment for cytomegalovirus (CMV) retinitis. Patients and methods: Retrospective review of the clinical outcome at 18 months in HIV-infected patients in whom discontinuation of secondary prophylaxis, for different OI, was recommended 3 months after the introduction of HAART, if both CD4 counts >100 x 10(6) CD4 lymphocytes/l and plasma HIV-RNA< 500 copies/ml had been achieved. Results: Fifty-three subjects were analysed. Secondary chemoprophylaxis was discontinued for the following OI: Pneumocystis carinii pneumonia (PCP) (n = 29), cerebral toxoplasmosis (n = 9), disseminated Mycobacterium avium complex infection (n = 7), CMV retinitis (n = 5), recurrent oroesophageal candidiasis (n = 5), Visceral leishmaniasis (n = 2), recurrent herpes tester (n = 2), and chronic mucocutaneous herpes simplex infection (n = 1). In sixindividuals, OI prophylaxis was discontinued for two or more entities, Only two episodes of OI were recorded in these individuals during 18 months offollow-up. One developed tuberculous lymphadenitis despite having a good response to treatment, and another suffered a new episode of PCP after voluntary treatment interruption for 6 weeks. Conclusion: Secondary prophylaxis for OI can be attempted without major risk in HIV-infected patients experiencing a favourable response to HAART. The benefit of this intervention should reduce costs, drug side-effects and pharmacologic interactions, and indirectly will improve patient's quality oflife and adherence to antiretroviral treatment. (C) 2000 Lippincott Williams & Wilkins.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/09/20 alle ore 23:28:40