Synonym(s)
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Major AIDS-defining opportunistic infections and tumors.
Pathogen / Cause |
Opportunistic infection or tumor |
|
Protozoa |
Toxoplasma gondii |
cerebral or disseminated toxoplasmosis |
Cryptosporidium parvum |
chronic intestinal cryptosporidiosis |
|
Isospora belli |
chronic intestinal isosporidiosis |
|
| ||
Fungi |
Pneumocystis carinii |
Pneumocystis carinii pneumonia |
Candida spp. |
Candida esophagitis, bronchitis, tracheitis or pneumonia |
|
Cryptococcus neoformans |
extrapulmonary cryptococcosis |
|
Histoplasma capsulatum |
disseminated or extrapulmonary histoplasmosis
|
|
| ||
Viruses |
herpes simplex |
chronic herpes simplex ulcers or bronchitis, pneumonia, esophagitis |
Cytomegalovirus |
CMV retinitis, generalized CMV infection (not of liver or spleen) |
|
Jakob Creutzfeld virus |
||
HIV virus |
HIV encephalopathy, wasting syndrome |
|
| ||
Bacteria |
Salmonella spp. |
rec. Salmonella septicemias |
Mycobacterium tuberculosis |
Tuberculosis of any localization |
|
M. avium intracellulare |
Non-tuberculous mycobacterioses of any localization
|
|
| ||
Tumors |
|
Kaposi's sarcoma |
malignant lymphomas (e.g. Burkitt's lymphoma, primary cerebral lymphoma) | ||
invasive cervical carcinoma |
Note: In Thailand, Talaromyces marneffei infection is the third most common AIDS-defining disease after tuberculosis and cryptococcosis.
Therapy of non-dermatological opportunistic infections and tumors in AIDS patients
Disease |
Clinic |
Diagnostics |
Therapy |
Pneumocystis carinii pneumonia |
Dry cough, fever, progressive dyspnea on exertion, loss of weight, decrease in performance. |
Auscultation usually o.b.; hypoxemia, LDH, ESR ↑. |
Cotrimoxazole (e.g., Eusaprim forte) 4 times 1920 mg/day p.o. for 3 weeks. |
X-ray thorax: interstitial drawing proliferation especially middle and lower fields. | |||
Alternative: Pentamidine inhalations (e.g. Pentacarinate) 200 mg for 4 days or Atoquavon (Wellvone) 3 times 750 mg/day p.o. for 3 weeks. | |||
Histology, PCR (provoked sputum, BAL, transbronchial biopsy). | |||
| |||
Cerebral toxoplasmosis. |
Subacute onset of mono- or hemiparesis, sensory disturbances, visual field defects, vigilance reduction, change in character, headache, fever, epileptic seizures. |
CT or NMR: One or more space-occupying lesions with annular or patchy KM uptake and perifocal edema. Pathogen detection by PCR. |
Pyrimethamine (Daraprim) day 1 200 mg, then 100 mg/day p.o. plus sulfadiazine (e.g., Sulfadiazin-Heyl) 3-4 times 2 g/day p.o. for 4-6 weeks. |
Alternative: atovaquone (Wellvone) 4 times 750 mg/day p.o. | |||
| |||
Candida esophagitis |
Dysphagia, tenesmus, diarrhea, weight loss, retrosternal pain. |
Candida detection. |
Fluconazole (Diflucan) 400 mg/day p.o. for 2-3 weeks. |
Alternative: itraconazole (Sempera) 100-200 mg/day p.o. 2 times. | |||
| |||
CMV retinitis |
Limited visual field, threat of blindness. |
Characteristic ocular fundus changes |
Foscarnet (foscavir) initial 2 times 90 mg/kg bw/day i.v. in 500 ml NaCl 0.9% for 2-3 weeks; maintenance therapy: 90 mg/kg bw i.v. 5 days/week for life. |
Alternative: Ganciclovir (Cymeven) 2 times 5 mg/kg bw/day i.v. for 3 weeks, then maintenance therapy with 6 mg/kg bw i.v. 5 days/week. | |||
Alternative: Intravitreal injections or implantation of a drug depot (pellets) by specialized ophthalmologists. |
Secondary prophylaxis of opportunistic infections in AIDS
Disease |
Substance |
Dosage |
Preparation |
Pneumocystis carinii pneumonia |
Cotrimoxazole |
480 mg/day p.o. or 960 mg 3 times/week |
Eusaprim forte |
Dapsone |
100 mg 2 times/week p.o. |
Dapsone fatol |
|
Toxoplasmosis |
Cotrimoxazole |
480 mg/day p.o. |
Eusaprim forte |
Alternative: Pyrimethamine |
50-75 mg/day p.o. |
Daraprim |
|
Alternative: Folinic acid |
5 mg/day p.o. |
Lederfolate |
|
Systemic candidiasis |
Fluconazole |
50 mg/day p.o. or 3 times 100 mg/week |
Diflucan |
Alternative: Itraconazole |
100 mg/day p.o. |
Sempera |
|
Aspergillosis |
Itraconazole |
400-600 mg/day p.o. |
Sempera |
Alternative: Amphotericin B |
0.75 mg/kg bw i.v. 2-3 times/week |
Amphotericin B |
|
Cryptococcosis |
Fluconazole |
200 mg/day p.o. |
Diflucan |
Alternative: Itraconazole |
400 mg/day p.o. |
Sempera |
|
Histoplasmosis |
Itraconazole |
200-400 mg/day p.o. |
Sempera |
Alternative: Fluconazole |
200-400 mg/day p.o. |
Diflucan |
|
Atypical mycobacteriosis |
Rifabutin |
300 mg/day p.o. |
Mycobutin |
Alternative: Azithromycin + Rifabutin |
1200 mg/week p.o. + 300 mg/week p.o. |
Ultreon + mycobutin |
|
Alternative: Clarithromycin |
2 times 500 mg/day p.o. |
Klacid, Mavid |
|
Herpes zoster |
Aciclovir |
2 times 400-800 mg/day p.o. |
Aciclovir |
CMV retinitis |
Ganciclovir (alternating with foscarnet) |
5-6 mg/kg bw 5 times/week i.v. |
Cymeven |
Foscarnet |
90-120 mg 5 times/week i.v. |
Foscavir |
LiteratureThis section has been translated automatically.
- Hamouda O (2003) HIV/AIDS surveillance in Germany. J Acquir Immune Defic Syndr 32: S49-54
- Kelly JA et al (2003) The newest epidemic: a review of HIV/AIDS in Central and Eastern Europe. Int J STD AIDS 14: 361-371
- Knodela J et al. The impact of the AIDS epidemic on older persons. AIDS 16: S77-83
- Letvin NL et al (2003) Immunopathogenesis and immunotherapy in AIDS virus infections. Nat Med 9: 861-866
- Sabin CA (2002) The changing clinical epidemiology of AIDS in the highly active antiretroviral therapy era. AIDS 16: S61-68
- Scadden DT (2003) AIDS-related malignancies. Annu Rev Med 54: 285-303
- Weiss RA (2003) HIV and AIDS: looking ahead. Nat Med 9: 887-891
Incoming links (24)
Acquired immune deficiency syndrome; Aids embryopathy; Aids full picture; Aids-related complex; Atovaquon; Campylobacter; Dermatitis-arthritis syndromes; Foscarnet; Ganciclovir; Gynecomastia; ... Show allOutgoing links (4)
Aids-related complex; Hiv infection; Infections opportunistic; Talaromyces marneffei infections;Disclaimer
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