Open AccessCLINICAL-EPIDEMIOLOGICAL CHARACTERISTIC OF AIDS-ASSOCIATED CRYPTOCOCCOSIS: DIAGNOSTICS AND THERAPEUTIC ASPECTS OF THE PROBLEM
Author(s) -
A. B. Konkova-Reidman,
A. A. Veksei,
Н. В. Смирнова,
O. A. Pischulova
Publication year - 2018
Publication title -
èpidemiologiâ i infekcionnye bolezni
Language(s) - English
Resource type - Journals
eISSN - 2411-3026
pISSN - 1560-9529
DOI - 10.18821/1560-9529-2018-23-4-156-164
Subject(s) - cryptococcosis , itraconazole , fluconazole , medicine , epidemiology , amphotericin b , immunology , antiretroviral therapy , disease , mycosis , immune system , antifungal , opportunistic infection , human immunodeficiency virus (hiv) , dermatology , viral disease , viral load
Introduction Currently, cryptococcosis is among the three most life-threatening opportunistic infections in AIDS patients. Materials and methods. The analysis of cases of cryptococcosis in HIV-infected patients in the world, the Russian Federation and the Chelyabinsk region using the methods of descriptive and analytical epidemiology. Two clinical cases of verified cryptococcosis were analyzed in detail in patients in the phase of HIV infection progression in the absence of antiretroviral therapy. Results. The manifestation of the disease was observed in the phase of progression of HIV infection in the absence of antiretroviral therapy with low immune status of patients (CD4 + lymphocyte level less than 100 cells in 1 μl of blood). The diagnosis is verified on the basis of a complex of clinical, instrumental, biochemical, immunological and mycological methods. Successful courses of treatment with antifungal drugs: amphotericin B, itraconazole, fluconazole. Conclusions. The definition of cryptococcal antigen is not a method for evaluating the effectiveness of treatment due to its long-term persistence in CSF and serum, even with successful treatment. Prescribing antiretroviral therapy significantly increases the effectiveness of cryptococcosis treatment. In AIDS patients, antifungal therapy is stopped only after effective for 3-6 months ART (the number of CD4 + lymphocytes in the blood is more than 100-200 cells/μl).