RESUMEN
Antiretroviral therapy represents an essential element in the approach to treatment and prevention of human immunodeficiency virus (HIV). It has changed the fatal disease to a manageable chronic condition and is the most effective prevention of its human-to-human transmission. Knowledge regarding biological characteristics of the virus, its behavior in a human host and our understanding of these phenomena have been extended by clinical experience, new clinical data and recent scientific progress. The development of new drugs becomes a modifier for the existing therapeutic strategy and preference. Certain points are more specific than in the previous guidelines. Definitions of certain clinical and laboratory conditions have been specified more accurately. The indications of specific antiretroviral agents and pitfalls of their use in lifelong antiretroviral treatment are also described more in detail. The document is a result of a general consensus among infectious disease specialists working with HIV patients in the Czech Republic. It should serve as a basic instrument for clinicians recommending treatment of HIV infection as well as a foundation for the society when dealing with both state authorities and health care payers.
Asunto(s)
Infecciones por VIH , Profilaxis Posexposición , Adulto , Antirretrovirales/uso terapéutico , República Checa , Infecciones por VIH/tratamiento farmacológico , HumanosRESUMEN
Presented are general principles of care for HIV-infected persons following their admission to an AIDS care center, initiation of antiretroviral therapy and follow-up. Scientific research, drug development and new clinical data in recent years have led to a change in certain therapeutic perspectives and preferences for the treatment of HIV infection. Certain conditions are better specified, which affect the choice of antiretroviral regimens. Procedures and criteria for monitoring the effect of treatment and indication of post-exposure prophylaxis are specified. The development of this document was based on the latest updates of the most prominent international and European recommendations. It also reflects some of the new scientific information published in recent months. However, general recommendations cannot fully cover all the possible alternatives. They only state basic principles based on current clinical studies, clinical observation and practice. The present document should be the basic source of information for physicians involved in the treatment of patients with HIV infection and should provide a quick reference when selecting treatment regimens in terms of modern pharmacotherapy as well as information on the pitfalls of this treatment. Finally, it should be a support for negotiations between the professional society, state authorities and health care payers.This updated version of the guidelines follows the 2012 edition; once again, they are supplemented by a modified tabular overview.
Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Profilaxis Posexposición , Adulto , Hospitalización , Humanos , Guías de Práctica Clínica como AsuntoRESUMEN
The HLA-B*57:01 allele is associated with a hypersensitivity reaction to abacavir, and its prevalence varies in different populations. The aim of the study was to investigate HLA-B*57:01 prevalence in the Czech HIV-infected population. HLA-B*57:01 prevalence in our cohort was 5.33%, which is similar to the situation in other Central European countries.
Asunto(s)
Hipersensibilidad a las Drogas/epidemiología , Antígenos HLA-B , Fármacos Anti-VIH/efectos adversos , Estudios Transversales , República Checa/epidemiología , Didesoxinucleósidos/efectos adversos , Hipersensibilidad a las Drogas/diagnóstico , Infecciones por VIH/sangre , Infecciones por VIH/tratamiento farmacológico , Antígenos HLA-B/sangre , Humanos , PrevalenciaRESUMEN
In our practice, we encounter patients with fever and increase in inflammatory markers. The cause of their difficulties is often hard to discover. The investigation of such patients is described the importance of history, physical examination, laboratory tests and special examinations including imaging methods. After infectious aetiology is excluded, especially in cases of discrepancy between high C-reactive protein (CRP) levels and low procalcitonin levels, a systemic disease should be diagnosed in cooperation with rheumatologists. Positron emission tomography has proved useful for diagnosing large vessel vasculitis. The case report of a 60-year-old female is presented who had severe fatigue, neck pain, occasionally raised temperature and steadily increasing CRP levels. She was diagnosed with large vessel vasculitis. After treatment with immunosuppressive doses of corticosteroids her condition gradually improved. In the discussion, facts about diagnosis, pathophysiology and treatment of the disease are summarized.
Asunto(s)
Proteína C-Reactiva/análisis , Fiebre de Origen Desconocido/etiología , Vasculitis/diagnóstico , Femenino , Humanos , Persona de Mediana Edad , Vasculitis/sangre , Vasculitis/complicacionesRESUMEN
Invasive Haemophilus influenzae b (Hib) diseases are rarely observed in children with vaccination against Hib. Immunisation of infants against Hib was introduced in the Czech Republic in 2001. The first case of meningitis with isolation of Hib in child immunised with Hib vaccine since starting routine vaccination is described. Clinical course of meningitis was mild and was identical with previously manifestation of Hib meningitis.