Abstract:
OBJECTIVE:To update antiretroviral recommendations in antiretroviral therapy (ART) in HIV-infected children and adolescents. METHODS:Theses guidelines have been formulated by a panel of members of the Plan Nacional sobre el SIDA (PNS) and the Asociacion Espanola de Pediatria (AEP) by reviewing the current available evidence of efficacy, safety, and pharmacokinetics in pediatric studies. Three levels of evidence have been defined according to the source of data: Level A: randomized and controlled studies; Level B: Cohort and case-control studies; Level C: Descriptive studies and experts' opinion. RESULTS:When to start ART should be made on an individual basis, discussed with the family, considering the risk of progression according to age, CD4 and viral load, the ART-related complications and adherence. The ART goal is to reach a maximum and durable viral suppression. This is not always possible, even with clinical and immunologic improvement. The difficulties of permanent adherence and side-effects are resulting in a more conservative trend to initiate ART, and to less toxic and simpler strategies. Currently, combinations of at least three drugs are of first choice both in acute and chronic infection. They must include 2 NA 1 1 NN or 2 NA 1 1 PI. ART is recommended in all symptomatic patients and, with few exceptions, in all infants in the first year of life. Older asymptomatic children should start ART according to CD4 count, especially CD4 percentage, that vary with age. Despite potent salvage therapies, it is common not to reach viral undetectability. Therapeutical options when ART fails are scarce due to cross-resistance. The cause of failure must be identified. Occasionally, there exists clinical and/or immunological progression, and a change of therapy with at least two new drugs still active for the patient, is warranted with the aim of increasing the CD4 count to a lower level of risk. Toxicity and adherence must be regularly monitored. Some aspects about post exposure prophylaxis and coinfection with HCV or HBV are discussed. CONCLUSIONS:A higher level of evidence with regard to ART effectiveness and toxicity in pediatrics is currently available, leading to a more conservative and individualized approach. Clinical symptoms and CD4 count are the main determinants to start and change ART.
journal_name
Enferm Infecc Microbiol Clinjournal_title
Enfermedades infecciosas y microbiologia clinicaauthors
Ramos JT,de José MI,Polo R,Fortuny C,Mellado MJ,Muñoz-Fernández MA,Beceiro J,Bertrán JM,Calvo C,Chamorro L,Ciria L,Guillén S,González-Montero R,González-Tomé MI,Gurbindo MD,Martín-Fontelos P,Martínez-Pérez J,Moreno D,doi
10.1157/13074970subject
Has Abstractpub_date
2005-05-01 00:00:00pages
279-312issue
5eissn
0213-005Xissn
1578-1852pii
13074970journal_volume
23pub_type
共识发展会议,杂志文章,评审abstract:BACKGROUND:Visceral leishmaniasis (VL) is an endemic parasitosis in Spain with a frequency which is increasing, specially among those patients with HIV infection. METHODS:The clinical characteristics of 36 episodes of VL in 20 patients with HIV infection diagnosed in the authors' center from January 1988 to October 19...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:The mortality of severe tetanus (grades II-III) remains high today, being greater than 20% with a large number of complications, due to the lengthy stay of these patients in the ICU. METHODS:A review of 13 cases of severe tetanus over the last 5 years was performed analyzing age, entrance, previous immuniza...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章,评审
doi:
更新日期:1997-05-01 00:00:00
abstract::The relevance of mixed genital infections in our area was evaluated, and we report their clinical and epidemiological features for both viral types. We evaluated overall 54 Herpes simplex virus (HSV) isolates from 44 patients seen at the clinic of sexually transmitted diseases (STD) of the Sevilla School of Medicine d...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00
abstract:INTRODUCTION:Primary lymphoma is the most common neoplasm of the central nervous system (CNS) in AIDS patients. METHODS:We retrospectively reviewed the clinical manifestations, neuroimaging findings, diagnostic methods used, histological characteristics, detection of Epstein-Barr virus (EBV) DNA by PCR in cerebrospina...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章,评审
doi:10.1016/s0213-005x(04)73105-5
更新日期:2004-06-01 00:00:00
abstract::The diagnostic effectiveness of a new test for the detection of bacteriuria (Filtrachek-UTI) was compared with Gram stain and semiquantitative culture in 955 urine samples. 276 of these were from inpatients (108 males and 168 females), and 677 from outpatients (206 males and 471 females). Overall 229 positive cultures...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:1989-08-01 00:00:00
abstract:INTRODUCTION:The pathophysiological changes that determine the severity of dengue are still not well known, therefore it is important to study the probable relationship with the host genetic. METHODS:We analyzed the possible association between the FcγRIIa polymorphism and clinical signs in individuals who suffered de...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1016/j.eimc.2012.05.011
更新日期:2012-12-01 00:00:00
abstract::Bacteremia due to Campylobacter is a rare infection. Patients with HIV infection are an important risk group for this condition. We describe here two patients with Campylobacter bacteremia and advanced HIV infection. One case was due to C. jejuni infection in a drug addict, being also isolated C. jejuni in stool sampl...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Extrapulmonary tuberculosis is a relatively frequent disease in patients with HIV infection. This may be observed coinciding with pulmonary involvement or without diagnostic data of the same. Within extrapulmonary involvement, gastrointestinal involvement is one of the least frequently observed and its diagn...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
abstract:INTRODUCTION:Colonization plays a major role in the epidemiology and pathogenesis of Staphylococcus aureus infections. The child population is one of the most susceptible to colonization; however, community and children studies are limited in Colombia. OBJECTIVE:To assess the clonal relationship of S.aureus strains is...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1016/j.eimc.2015.04.008
更新日期:2016-03-01 00:00:00
abstract::Atazanavir (ATV) is an HIV protease inhibitor (IP) with a high in vitro activity against HIV-1, that demonstrates a high additive activity in the presence of other antiretrovirals and a synergic activity with other PI. Oral absorption is greater than 68%, maximum concentration (C(max)) being reached approximately 2 to...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章,评审
doi:10.1016/S0213-005X(08)76613-8
更新日期:2008-12-01 00:00:00
abstract::In spite of being described over 60 years, Q fever is still a little known disease. The exact prevalence is also unknown, but probably the number of cases of Q fever is underestimated. There is much variation in the clinical presentation, including severe forms with a poor prognosis. Acute cases often present as an as...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章,评审
doi:10.1016/S0213-005X(10)70005-7
更新日期:2010-01-01 00:00:00
abstract::New drugs will soon be incorporated into the echinocandin class of antifungals. The first to be released on to the market will be anidulafungin. The pharmacokinetic characteristics of this drug clearly distinguish it from the only representative of this family of antifungal agents available to date: caspofungin. Speci...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章,评审
doi:10.1016/s0213-005x(08)76588-1
更新日期:2008-12-01 00:00:00
abstract:INTRODUCTION:To describe clinical features, complications, serotypes and antibiotic resistance in pneumococcal pneumonia in our environment after the generalization of the heptavalent conjugate vaccine (PCV-7) in paediatrics. MATERIAL AND METHODS:Prospective study of episodes of pneumococcal pneumonia, with positive c...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1016/j.eimc.2010.09.014
更新日期:2011-04-01 00:00:00
abstract:INTRODUCTION:We assessed agreement among 3 assays for determining susceptibility to imipenem (IMP) and meropenem (MPM) of Acinetobacter baumannii (Ab) heteroresistant to carbapenems (Hr-CP). METHODS:Thirty Ab clinical isolates belonging to 6 clones (REP-PCR) were studied, in which IMP and MPM MICs were between < or = ...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:2008-10-01 00:00:00
abstract::The resistance pattern observed in the antibiogram of an isolate should be the sum of its natural resistance pattern, characteristic of the species, plus the acquired resistances. In Enterobacteriaceae, the production of inactivating enzymes is the main mechanism of resistance to beta-lactams and aminoglycosides. Each...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章,评审
doi:10.1016/j.eimc.2010.05.002
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to know the clinical and etiologic features of community-acquired pneumonia (CAP) in elderly patients requiring hospital admission. METHODS:A prospective study of 36 consecutive patients aged over 70 years, admitted to a general hospital was performed. Standard analytical de...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:St. Louis encephalitis virus (SLEV) is a re-emerging arbovirus in South America, with reported cases in humans in Argentina and Brazil. This fact indicates that there is an urgent need to increase the current knowledge about this virus in order to control and prevent future cases. Exhaustive epidemiologica...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1157/13114389
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:Streptococcus agalactiae is a well-recognized pathogen in the obstetric population and is a cause of invasive infection in adults with underlying diseases. Nevertheless, the role of S. agalactiae in urinary tract infections in the adult non-pregnant population treated in outpatient health care centers has ...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1016/s0213-005x(04)73040-2
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Use of selective Clostridium difficile culture as a diagnostic method for C. difficile associated disease requires to prove the toxigenic ability of the isolates. Toxin B detection by cell culture assay after growing the microorganism in enriched broth is the standard method, but it delays the final diagnosi...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract::The effectiveness of different methodologies to identify antigenemia and antibodies against HIV at the time of viral primary infection was evaluated. To this end, 6 consecutive serum samples of a patient who had had symptomatic seroconversion were assessed. The detection of antigenemia was earlier than that of antibod...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:1990-08-01 00:00:00
abstract::Methicillin-resistant Staphylococcus aureus (MRSA) is an increasingly common cause of hospital acquired pneumonia (HAP) and the second most frequently isolated pathogen from patients who die from HAP. High-risk units for MRSA colonization such as intensive care (ICU's) are the most affected. Multiple risk factors for ...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1157/13091219
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:The purpose of this work was to study the molecular basis of beta-lactamase production in ampicillin-resistant strains of Salmonella spp. METHODS:It was performed analytical isoelectric focusing of beta-lactamases produced by a group of 33 strains selected in basis of their resistance phenotype. Plasmid pro...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract::Fever of intermediate duration (FID) is defined as non-localized fever occurring in the community, lasting from one to four weeks, and having no diagnostic orientation after basic clinical, analytical and radiological evaluations are completed. These may include careful recording of clinical history, physical examinat...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章,评审
doi:10.1016/s0213-005x(03)72904-8
更新日期:2003-03-01 00:00:00
abstract:INTRODUCTION:Trypanosoma cruzi infection is a major imported parasitic disease in Spain, because of the increase of immigrants from endemic areas. Since the laboratory diagnosis during the chronic phase is based on detection of anti-T. cruzi IgG antibodies, our aims were to compare 10 tests for determining anti-T. cruz...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1016/j.eimc.2009.07.005
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:To assess the relevance of correct identification and interpretation of susceptibility testing of Aeromonas spp. bacteremia isolates using newly developed molecular methods in comparison to previous conventional methods. MATERIAL AND METHODS:The study included 22 patients with bacteremia due to Aeromonas hyd...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1016/j.eimc.2015.02.020
更新日期:2016-02-01 00:00:00
abstract:INTRODUCTION:Vancomycin-resistant enterococci (VRE) among haemodialysis patients has increased rapidly and, to date, there is no report of this incidence in Portugal. METHODS:A total of 121 faecal samples were collected from haemodialysis patients, and then tested for VRE. Antimicrobial resistance, virulence and multi...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1016/j.eimc.2013.09.001
更新日期:2014-03-01 00:00:00
abstract:INTRODUCTION:A growing number of immigrants are using the public health services for HIV in Spain. We describe the sociodemographic, epidemiological, and clinical characteristics of a cohort of naïve HIV-infected subjects (CoRIS cohort) according to their place of origin. METHODS:CoRIS is an open, hospital-based cohor...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章,多中心研究
doi:10.1016/j.eimc.2008.10.007
更新日期:2009-08-01 00:00:00
abstract:INTRODUCTION:Bacterial/fungal coinfection and superinfections contribute to the increased morbi-mortality of viral respiratory infections (RIs). The main objective of this study was to determine the incidence of these infections in hospitalized patients with COVID-19. METHOD:Retrospective observational study of all pa...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1016/j.eimc.2020.11.003
更新日期:2020-12-03 00:00:00
abstract:INTRODUCTION:To describe demographic aspects of a prospective multicentric nationwide study on Escherichia coli and Klebsiella pneumoniae producing extended spectrum b -lactamases (ESBL) in Spain, between March and June 2000. METHODS:352 E. coli and K. pneumoniae strains showing a phenotype compatible to ESBL producti...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章,多中心研究
doi:
更新日期:2003-02-01 00:00:00
abstract:INTRODUCTION:Cancer patients may constitute a special risk group for the development of infective endocarditis (IE) because they are often subjected to invasive procedures. The aim of this study is to determine the differential clinical profile and prognosis of patients with IE and cancer. METHODS:A retrospective obse...
journal_title:Enfermedades infecciosas y microbiologia clinica
pub_type: 杂志文章
doi:10.1016/j.eimc.2016.10.011
更新日期:2018-02-01 00:00:00