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Nursing Pharmacology: Antiviral Drugs
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Antiviral Drugs
Anti-viral drugs with activity against HIV (Human Immunodeficiency Virus)
HIV-1 Pathophysiology/Pathogenesis: HIV Disease Presentations
Opportunistic protozoal infections of the G.I. tract can cause diarrhea in HIV-infected individuals.2
The most
common protozoa in this regard include cryptosporidia, microsporidia and
Isospora belli.2
Cryptosporidial infection exhibits a broad range of clinical presentations, from intermittent diarrhea in those HIV-infected individuals in the earlier stages to life-threatening diarrhea in HIV infected individuals who are severely immunocompromised.
For those HIV-infected patients who are untreated and who exhibit CD4+ T cell counts of <300/µL, cryptosporidosis occurs with an incidence of about 1%/year.
Most of the time, 75% of cases, diarrhea is associated with crampy abdominal pain; furthermore, about 25% of individuals also experience nausea and vomiting.
Cryptosporidia may also, in the HIV-infected individual, cause biliary tract disease which can lead to cholecystitis presenting with or without cholangitis and pancreatitis resulting from papillary stenosis.
Cryptosporidia diagnosis may be established either by small intestine biopsy or stool examination.2
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Cryptosporidosis prevalence depends on geographic region.8
Regions with highest rates appear in developing countries.
Cryptosporidosis cases most frequently occur in young children, an observation suggesting that host immune response status is an important factor in susceptibility.
Individuals infected with HIV and exhibiting pronounced immunodeficiency may experience cryptosporidosis not only involving the gastrointestinal tract but also the hepatobiliary and respiratory tracts.8
Effective
management of cryptosporidosis in this patient subset depends on
administration of antiviral drugs.8
In HIV patients with CD4+ T cell counts >1000/µL, cryptosporidosis may be seen in about 25% of patients.
This percentage rises to about 50% in patients with CD4+ T cell counts <100/µL.8
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