Data/hora: 01/06/2024 17:33:30

Provedor de dados: | Brazilian Journal of Infectious Diseases
País: | Brazil
Título: | Recurring Candida albicans esophagitis in a HIV-infected patient undergoing long-Term antiretroviral therapy, and with absent-negligible immunodeficiency
Autores: | Manfredi,Roberto; Sabbatani,Sergio; Calza,Leonardo.
Data: | 2007-12-01
Ano: | 2007
Palavras-chave: | Esophageal candidiasis; HIV infection; CD4+ lymphocyte count; HIV viral load; Recurring opportunistic disease; Antiretroviral therapy; Negligible or absent immunodeficiency.
Resumo: | A patient with HIV infection developed the first episode of AIDS-defining opportunism (severe Candida albicans esophagitis) with an underlying CD4+ lymphocyte count of 1,025 cells/µL. After treatment with a highly active antiretroviral therapy (HAART), taken with insufficient compliance and leaving a residual viral load, our patient suffered from two relapses of esophageal candidiasis, which occurred three months and seven years later, when his CD4+ lymphocyte count was 930 and 439 cells/µL, respectively, and a viral load slightly above 10(4) copies/mL was still present. Also in the HAART era, Candida esophagitis remains one of the most common AIDS-defining diseases, but a presentation with a concurrent CD4+ count above 1,000 cells/µL remains a rare exception, as well as the two isolated, subsequent relapses, occurred with a CD4+ count ranging from 439 to 930 cells/µL, and a residual HIV viremia due to insufficient adherence to the prescribed HAART regimens. Our case report represents the opportunity to revisit the epidemiology and, especially, the pathogenesis of this opportunistic fungal complication in HIV-infected patients and in other subjects at risk, on the ground of an extensive literature review, and to explore possible alternative supporting factors other than the crude absolute CD4+ lymphocyte count, with emphasis on the possible role of a persisting HIV viremia, and other potential contributing factors. Clinicians engaged with immunocompromised patients and subjects with HIV disease, should be aware that a Candida esophagitis may occur and relapse also when the cell-mediated immunity, as measured by a simple CD4+ cell count, do not show relevant abnormalities.
Tipo: | Info:eu-repo/semantics/article
Idioma: | Inglês
Identificador: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702007000600016
Editor: | Brazilian Society of Infectious Diseases
Relação: | 10.1590/S1413-86702007000600016
Formato: | text/html
Fonte: | Brazilian Journal of Infectious Diseases  v.11 n.6 2007
Fonte: | info:eu-repo/semantics/openAccess