Antimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal

Jo Seddon1, Sanjay Bhagani21Department of Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK; 2Department of Infection and Immunity, Royal Free Hospital NHS Trust, London, UKAbstract: The widespread use of antiretroviral therapy (ART) has entirely changed the management of human...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Seddon J, Bhagani S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Immunologic diseases. Allergy RC581-607
Acceso en línea:	https://doaj.org/article/1360416626ee4852a3eb5b404d1991d5
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:1360416626ee4852a3eb5b404d1991d5
record_format	dspace
spelling	oai:doaj.org-article:1360416626ee4852a3eb5b404d1991d52021-12-02T06:23:57ZAntimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal1179-1373https://doaj.org/article/1360416626ee4852a3eb5b404d1991d52011-04-01T00:00:00Zhttp://www.dovepress.com/antimicrobial-therapy-for-the-treatment-of-opportunistic-infections-in-a6953https://doaj.org/toc/1179-1373Jo Seddon1, Sanjay Bhagani21Department of Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK; 2Department of Infection and Immunity, Royal Free Hospital NHS Trust, London, UKAbstract: The widespread use of antiretroviral therapy (ART) has entirely changed the management of human immunodeficiency virus (HIV) infection and dramatically reduced the rates of opportunistic infections (OI). However, OI continue to cause significant morbidity and mortality in both developed countries, where presentation with advanced HIV infection is common, and also in developing countries where ART is less widely available. Evidence to direct OI guidelines is partly limited by the fact that many large-scale studies date from the pre-ART era and more recent studies are sometimes poorly powered due to the falling rates of OI. Treatment of OI is now known to be as much about antimicrobials as about immune reconstitution with ART, and recent studies help guide the timing of initiation of ART in different infections. OI have also become complicated by the immune reconstitution inflammatory syndrome phenomenon which may occur once successful immune recovery begins. Trimethoprim-sulfamethoxazole has long been one of the most important antibiotics in the treatment and prevention of OI and remains paramount. It has a broad spectrum of activity against Pneumocystis jiroveci, toxoplasmosis, and bacterial infections and has an important role to play in preventing life-threatening OI. New advances in treating OI are coming from a variety of quarters: in cytomegalovirus eye disease, the use of oral rather than intravenous drugs is changing the face of therapy; in cryptococcal meningitis, improved drug formulations and combination therapy is improving clearance rates and reducing drug toxicities; and in gut disease, the possibility of rapid immune restitution with ART is replacing the need for antimicrobials against cryptosporidia and microsporidia.Keywords: HIV, AIDS, opportunistic infections, treatment, antimicrobials Seddon JBhagani SDove Medical PressarticleImmunologic diseases. AllergyRC581-607ENHIV/AIDS: Research and Palliative Care, Vol 2011, Iss default, Pp 19-33 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607
spellingShingle	Immunologic diseases. Allergy RC581-607 Seddon J Bhagani S Antimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal
description	Jo Seddon1, Sanjay Bhagani21Department of Infectious Diseases, Imperial College Healthcare NHS Trust, London, UK; 2Department of Infection and Immunity, Royal Free Hospital NHS Trust, London, UKAbstract: The widespread use of antiretroviral therapy (ART) has entirely changed the management of human immunodeficiency virus (HIV) infection and dramatically reduced the rates of opportunistic infections (OI). However, OI continue to cause significant morbidity and mortality in both developed countries, where presentation with advanced HIV infection is common, and also in developing countries where ART is less widely available. Evidence to direct OI guidelines is partly limited by the fact that many large-scale studies date from the pre-ART era and more recent studies are sometimes poorly powered due to the falling rates of OI. Treatment of OI is now known to be as much about antimicrobials as about immune reconstitution with ART, and recent studies help guide the timing of initiation of ART in different infections. OI have also become complicated by the immune reconstitution inflammatory syndrome phenomenon which may occur once successful immune recovery begins. Trimethoprim-sulfamethoxazole has long been one of the most important antibiotics in the treatment and prevention of OI and remains paramount. It has a broad spectrum of activity against Pneumocystis jiroveci, toxoplasmosis, and bacterial infections and has an important role to play in preventing life-threatening OI. New advances in treating OI are coming from a variety of quarters: in cytomegalovirus eye disease, the use of oral rather than intravenous drugs is changing the face of therapy; in cryptococcal meningitis, improved drug formulations and combination therapy is improving clearance rates and reducing drug toxicities; and in gut disease, the possibility of rapid immune restitution with ART is replacing the need for antimicrobials against cryptosporidia and microsporidia.Keywords: HIV, AIDS, opportunistic infections, treatment, antimicrobials
format	article
author	Seddon J Bhagani S
author_facet	Seddon J Bhagani S
author_sort	Seddon J
title	Antimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal
title_short	Antimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal
title_full	Antimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal
title_fullStr	Antimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal
title_full_unstemmed	Antimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal
title_sort	antimicrobial therapy for the treatment of opportunistic infections in hiv/aids patients: a critical appraisal
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/1360416626ee4852a3eb5b404d1991d5
work_keys_str_mv	AT seddonj antimicrobialtherapyforthetreatmentofopportunisticinfectionsinhivaidspatientsacriticalappraisal AT bhaganis antimicrobialtherapyforthetreatmentofopportunisticinfectionsinhivaidspatientsacriticalappraisal
_version_	1718399917632782336

Antimicrobial therapy for the treatment of opportunistic infections in HIV/AIDS patients: a critical appraisal

Ejemplares similares