Infección por Cystoisospora belli en pacientes con VIH: análisis de casos con diferente evolución clínica

Silva-Díaz, Heber; Fernández-Valverde, Darwin; Hernández-Córdova, Gustavo; Failoc-Rojas, Virgilio E.

doi:10.4067/s0716-10182017000400347

Cited by 5 publications

(5 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…El porcentaje de coccidiosis intestinal y criptosporidiosis obtenido es mayor al hallado por otros autores (12,13,14) ,explicándose esto tanto en la situación de los pacientes en relación con el Tratamiento Antirretroviral de Gran Actividad (TARGA) como en la fase de la infección, así en éste trabajo todos los pacientes en estudio se encontraban con TARGA y el 15 % de los pacientes positivos para para estas infecciones lo habían abandonado en algún momento del proceso de la enfermedad, siendo posible entonces el incremento de infecciones parasitarias secundarias (16) .…”

Section: Resultsunclassified

“…siempre están presentes. Al respecto, un estudio previo realizado en una serie de casos clínicos de cistoisoporosis en pacientes con infección VIH y diarrea recurrente, reportó distinta evolución clínica, donde algunos pacientes podrían experimentar infección persistente y diarrea recurrente a pesar de una adecuada respuesta al TARGA y profilaxis secundaria con cotrimoxazol (16) .…”

Section: Resultsunclassified

See 1 more Smart Citation

Frecuencia de coccidiosis y criptosporidiosis intestinal en pacientes diarreicos e infección con el virus de la inmunodeficiencia humana, en un hospital de Chiclayo, Perú

Vargas¹

2019

Rev Exp Med

View full text Add to dashboard Cite

Determinar la frecuencia de coccidiosis y criptosporidiosis intestinal en pacientes diarreicos e infección con el virus de la inmunodeficiencia humana (VIH), admitidos en un hospital de Chiclayo, Perú; así como, relacionarlo con el tiempo de diagnóstico, cantidad linfocitos T CD4+ y carga viral. Material y Método. Estudio observacional, prospectivo y transversal analítico. La muestra fue de 34 pacientes con infección por VIH y diarrea, durante el periodo marzo a diciembre del 2015. Para la detección de parásitos se realizó examen directo, concentración por flotación Sheather Sugar y tinción Ziehl Neelsen modificado; y para los factores, análisis documental de registros. Resultados. 22 pacientes tuvieron parásitos intestinales; 11 con coccidios intestinales, Cystosospora belli (36 %) y Cryptosporidium sp (14 %). No se observó asociación entre tiempo de diagnóstico (p=0,157), cantidad linfocitos T CD4+ (p=0,754) y carga viral (p=1,000), y la coccidiosis y criptosporidiosis intestinal. Conclusiones. La coccidiosis y criptosporidiosis intestinal son infecciones frecuentes y que cuasan diarrea en pacientes con VIH en tiempos de Tratamiento Antirretroviral de gran actividad (TARGA).

show abstract

Section: Resultsunclassified

Frecuencia de coccidiosis y criptosporidiosis intestinal en pacientes diarreicos e infección con el virus de la inmunodeficiencia humana, en un hospital de Chiclayo, Perú

Vargas¹

2019

Rev Exp Med

View full text Add to dashboard Cite

show abstract

“…In conclusion, this hypothesis helps to understand the presence of unizoite stages in blood (Velásquez et al 2016), the pathway by which the bile ducts become infected causing acalculous cholecystitis and cholangiopathy (Benator et al 1994;Walther and Topazian 2009) and unizoites in the liver being able to behave like hypnozoites that favour relapses and treatment failures (Markus 1991;Montalvo et al 2013;Silva-Díaz et al 2017). Further studies are needed to test this hypothesis.…”

Section: Discussionmentioning

confidence: 96%

Cystoisospora belli, liver disease and hypothesis on the life cycle

Velásquez

Etchart²,

Astudillo

et al. 2022

Parasitol Res

View full text Add to dashboard Cite

Cystoisospora belli causes chronic diarrhoea, acalculous cholecystitis, cholangiopathy and disseminated cystoisosporosis in patients with AIDS. Clinical manifestations and histological stages during C. belli infection in a patient with AIDS and liver disease were described. It was possible to identify sporozoite-like structures in the villus epithelium of the duodenum, close to the vascularization that underlies the basal membrane and unizoite tissue cysts near to the vascularization in the lamina propria. Unizoite tissue cysts were found inside of sinusoids in the liver communicating with the central vein and with a bile canaliculus and portal spaces. Based on these findings a hypothesis on C. belli life cycle could consider that the route of migration of unizoite tissue cysts up the liver is via the portal blood. The unizoite tissue cysts located in hepatic portal vein could migrated via sinusoid to central vein and general circulation through the venous system. The unizoite tissue cysts could also return via bile canaliculus to bile duct to portal triad. This hypothesis allows to understand the presence of unizoite stages in blood, the pathway by which the bile ducts become infected and unizoites in the liver being able to behave like hypnozoites that favour relapses and treatment failures.

show abstract

“…The persistence of C. belli in our patient was probably due to several concomitant factors, which might explain how the infection persists despite immune reconstitution. Various hypotheses have been made [4,5], such as failure of recovery of immune response specifically to C. belli, drug malabsorption, resistance to TMP-SMX, or sequestration of the parasite in lymphoid tissue. In our case, it is not clear whether the concomitant presence of visceral untreated Kaposi sarcoma might have played a potential role (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Recurrent and fatal diarrhea caused by Cystoisospora belli in a man with HIV infection

Petri,

Angeli,

Tedesco

et al. 2024

HIV & AIDS Review

View full text Add to dashboard Cite

Cystoisospora belli causes intestinal infection in immunocompromised hosts, including human immunodeficiency viruses (HIV)-positive patients, especially from tropical and sub-tropical areas, with watery and recurrent diarrhea, leading in advanced cases to malabsorption and death. Microbiological diagnosis is limited by intermittent or low shedding of oocysts in stool; therefore, endoscopy may be necessary to identify the pathogen in histological samples. Trimethoprim-sulfamethoxazole (TMP-SMX) represents the treatment of choice, and alternative agents are used in recurrences, but limited efficacy is described. Here, we present recently observed case of severe and fatal infection due to C. belli in a HIV-positive 40-year-old man from Brazil, revealing several limitations in diagnosis and therapy, which need to be investigated further. In particular, it is still not clear how the infection persisted over time leading to malabsorption, kidney injury, and subsequent death, even if a reasonable immune reconstitution was demonstrated. Additionally, we investigated what mechanisms might cause, whether failure of recovery of the immune response specifically to C. belli, drug malabsorption, resistance to TMP-SMX, sequestration into lymphoid tissue, or co-presence of visceral untreated Kaposi sarcoma. Also, the appropriate dosage and way of administration of the best therapeutic regimen were examined, since there is a lack of literature on these issues. Globalization and wider use of immunosuppressive therapies underline the importance of maintaining adequate awareness, also in HIV-negative and non-immigrant populations.

show abstract

Infección por Cystoisospora belli en pacientes con VIH: análisis de casos con diferente evolución clínica

Cited by 5 publications

References 8 publications

Frecuencia de coccidiosis y criptosporidiosis intestinal en pacientes diarreicos e infección con el virus de la inmunodeficiencia humana, en un hospital de Chiclayo, Perú

Frecuencia de coccidiosis y criptosporidiosis intestinal en pacientes diarreicos e infección con el virus de la inmunodeficiencia humana, en un hospital de Chiclayo, Perú

Cystoisospora belli, liver disease and hypothesis on the life cycle

Recurrent and fatal diarrhea caused by Cystoisospora belli in a man with HIV infection

Contact Info

Product

Resources

About