AIDS-associated diarrhea and wasting in northeast Brazil is associated with subtherapeutic plasma levels of antiretroviral medications and with both bovine and human subtypes of Cryptosporidium parvum
| Autor: | Richard K. Brantley, Nathan M. Thielman, Maria Gilson Sistrom, Terezinha M.J. Silva, Richard L. Guerrant, K. Robert Williams, Aldo A. M. Lima, Honorine D. Ward |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Diarrhea Male Microbiology (medical) medicine.medical_specialty malabsorption Anti-HIV Agents ddI Population lcsh:QR1-502 Cryptosporidiosis HIV Wasting Syndrome lcsh:Microbiology lcsh:Infectious and parasitic diseases Feces Internal medicine medicine Animals Humans lcsh:RC109-216 education Wasting Didanosine D4T Cryptosporidium parvum Acquired Immunodeficiency Syndrome education.field_of_study AIDS-Related Opportunistic Infections biology business.industry Stavudine HIV Cryptosporidium Middle Aged biology.organism_classification Infectious Diseases Immunology Cattle Drug Therapy Combination Female medicine.symptom business pharmacokinetics Brazil medicine.drug |
| Zdroj: | Brazilian Journal of Infectious Diseases, Volume: 7, Issue: 1, Pages: 16-22, Published: FEB 2003 Brazilian Journal of Infectious Diseases v.7 n.1 2003 Brazilian Journal of Infectious Diseases Brazilian Society of Infectious Diseases (BSID) instacron:BSID Brazilian Journal of Infectious Diseases, Vol 7, Iss 1, Pp 16-22 |
| ISSN: | 1413-8670 |
| DOI: | 10.1590/s1413-86702003000100003 |
| Popis: | Advanced HIV infection is frequently complicated by diarrhea, disruption of bowel structure and function, and malnutrition. Resulting malabsorption of or pharmacokinetic changes in antiretroviral agents might lead to subtherapeutic drug dosing and treatment failure in individual patients, and could require dose adjustment and/or dietary supplements during periods of diarrheal illness. We determined the plasma levels of antiretroviral medications in patients that had already been started on medication by their physicians, in an urban infectious diseases hospital in northeast Brazil. We also obtained blood samples from patients hospitalized for diarrhea or AIDS-associated wasting, and we found reduced stavudine and didanosine levels in comparison with outpatients without diarrhea or wasting who had been treated at the same hospital clinic. There was a predominance of the protozoal pathogens Cryptosporidium and Isospora belli, typical opportunistic pathogens of AIDS-infected humans, in the stool samples of inpatients with diarrhea. We conclude that severe diarrhea and wasting in this population is associated with both protozoal pathogens and subtherapeutic levels of antiretroviral medications. |
| Databáze: | OpenAIRE |
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