scholarly journals CerebralMycobacterium aviumabscesses: Late immune reconstitution syndrome in an HIV-1-infected patient receiving highly active antiretroviral therapy

2005 ◽  
Vol 16 (3) ◽  
pp. 187-189 ◽  
Author(s):  
Claude Fortin ◽  
Danielle Rouleau
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Immune Reconstitution ◽  
Immune Reconstitution Syndrome ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
The Central Nervous System ◽  
Brain Abscesses ◽  
Cd4 Cell ◽  
Suppurative Infection

A patient who developed an atypical manifestation ofMycobacterium aviumcomplex (MAC) infection almost two years after starting effective highly active antiretroviral therapy is described. The recurrence, manifested as brain abscesses in the central nervous system, was an uncommon form of MAC disease usually reported postmortem. An increased CD4 cell count, localized and suppurative infection, and the absence of systemic evidence of infection were consistent with a late immune reconstitution syndrome. The present case report adds to the understanding of MAC disease in HIV-infected patients.

Pulmonary cryptosporidiosis in an AIDS patient: successful treatment with paromomycin plus azithromycin

2005 ◽  
Vol 16 (7) ◽  
pp. 515-517 ◽  
Author(s):  
F Palmieri ◽  
S Cicalini ◽  
N Froio ◽  
E B Rizzi ◽  
D Goletti ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Combination Therapy ◽  
Respiratory Tract ◽  
Highly Active Antiretroviral Therapy ◽  
Favourable Outcome ◽  
Antimicrobial Treatment ◽  
Cd4 Cell Count ◽  
Highly Active ◽  
Intestinal Involvement ◽  
Cd4 Cell

Extra-intestinal cryptosporidiosis, especially of the biliary and respiratory tract, is likely in the course of an intestinal involvement, whereas it is rare without such a localization. We report a case of pulmonary cryptosporidiosis without apparent intestinal involvement in an AIDS patient, with favourable outcome after antimicrobial combination therapy with paromomycin plus azithromycin. The successful response to antimicrobial treatment was subsequently maintained by effective highly active antiretroviral therapy (HAART). We suggest that respiratory cryptosporidiosis should be investigated in HIV-infected patients with pulmonary symptoms and low CD4 cell count, and, if detected, treatment should include HAART plus the combination of paromomycin and azithromycin.

Initiation of highly active antiretroviral therapy in advanced AIDS with CD4 < 50 cells/mm3 in a resource-limited setting: efficacy and tolerability

2005 ◽  
Vol 16 (3) ◽  
pp. 243-246 ◽  
Author(s):  
Somnuek Sungkanuparph ◽  
Sasisopin Kiertiburanakul ◽  
Weerawat Manosuthi ◽  
Wiphawee Kiatatchasai ◽  
Asda Vibhagool
Keyword(s):  
Antiretroviral Therapy ◽  
Cell Count ◽  
Highly Active Antiretroviral Therapy ◽  
Adverse Drug Events ◽  
Opportunistic Infections ◽  
Transcriptase Inhibitor ◽  
Cd4 Cell Count ◽  
Hiv Rna ◽  
Highly Active ◽  
Cd4 Cell

In developing countries, patients often present late with advanced AIDS and a very low CD4 cell count. A retrospective cohort study was conducted in HIV-infected patients who had been initiated into highly active antiretroviral therapy (HAART) with CD4 cell count <50 cells/mm3. There were 159 patients of mean age 36.6 years and 60.4% had previous major opportunistic infections. Mean CD4 was 22 cells/mm3 and 80% had HIV RNA>100,000 copies/mL. The majority of HAART regimens is non-nucleoside reverse transcriptase inhibitor-based (81.8%). In as-treated analysis, 50, 71.2, 79.7, 79.4, and 80.1% of patients achieved undetectable HIV RNA (<50 copies/mL) at 12, 24, 36, 48, and 60 weeks, respectively. The corresponding mean CD4 counts were 95, 125, 166, 201, and 225 cells/mm3. Twenty two patients (13.8%) had adverse drug events and half of these had to discontinue HAART. Initiation of HAART in advanced AIDS with CD4 cell count <50 cells/mm3 is effective, safe, and well tolerated and should not be delayed.

Paradoxical recurrent meningitis following therapy of cryptococcal meningitis: an immune reconstitution syndrome after initiation of highly active antiretroviral therapy

2002 ◽  
Vol 13 (10) ◽  
pp. 724-726 ◽  
Author(s):  
Mark D King ◽  
Carl A Perlino ◽  
Jay Cinnamon ◽  
John A Jernigan
Keyword(s):  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Cryptococcal Meningitis ◽  
Immune Reconstitution ◽  
Immune Reconstitution Syndrome ◽  
Recurrent Meningitis ◽  
Cryptococcal Infection ◽  
Highly Active ◽  
Previous Diagnosis ◽  
Histopathologic Findings

We report a case of paradoxical recurrent meningitis in response to initiation of highly active antiretroviral therapy in a patient receiving maintenance fluconazole for a previous diagnosis of cryptococcal meningitis. We describe the unusual radiographic and histopathologic findings which are consistent with an immune reconstitution induced paradoxical inflammatory response to residual cryptococcal infection.

Sign in / Sign up

Export Citation Format

Share Document