후천면역결핍 증후군 환자에서 항레트로바이러스 치료에 의한 면역재건 중 발생한 거대세포바이러스 장관염과 공장 천공 1예
A Case of Cytomegalovirus Enterocolitis and Jejunal Perforation During Immune Reconstitution with Highly Active Antiretroviral Treatment
1
조회
0
다운로드
0
인용
0
참고문헌
초록
면역재건후 증후군(Immune reconstitution syndrome, IRS)은 HIV 감염환자에서 항레트로바이러스 치료(HAART)에 의한 면역재건중 발생하는 현상이다. IRS는 HARRT 시작시 무증상감염이 있거나 이미 기회감염이 존재할 때 면역재건이 이루어지면서 오히려 임상상이 악화되는 것을 말한다. AIDS환자에서 거대세포바이러스 관련 IRS는 주로 안와를 침범하지만 드물게 장관, 폐 등을 침범할 수도 있다. 저자들은 HAART 시작 후 공장천공을 동반한 장관염의 형태로 나타난 거대세포바이러스 관련 IRS 1예를 경험하여 성공적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Immune reconstitution syndrome (IRS) in HIV-infected patients is an adverse consequence of the restoration of pathogen-specific immune responses during the initial months of highly active antiretroviral treatment(HAART). Previously subclinical infections are unmasked or pre-existing opportunistic infections clinically deteriorate as host immunopathological inflammatory responses are switched on. While the eye is the area where Cytomegalovirus(CMV)-associated IRS occurs most often in patients with AIDS, it also can present with intestinal or pulmonary involvement. We present a case report of an HIV-infected patient in whom CMV enterocolitis and jejunal perforation developed after HAART.
참고문헌 (16)
- "Cytomegalovirus diseases in AIDS patients", 30, pp.358~364 (1998)
- "Cytomegalovirus infection in patients with HIV infection", 66, pp.113~124 (1999)
- "Cytomegalovirus disease in the highly active antiretroviral therapy era", 5, pp.257~265 (2003)
- "Decline in the AIDS and death rates in the EuroSIDA study:an observational study: an observational study", 362, pp.22~29 (2003)
- "Paradoxical worsening of tuberculosis following antiretroviral therapy in patients with AIDS", 158, pp.157~161 (1998)
- "The immune reconstitution inflammatory syndrome", 5, pp.67~79 (2003)
- "Ileal perforation due to cytomegalovirus enteritis in a patients with acquired immune deficiency syndrome", 30, pp.217~221 (2005)
- "A case of ileal perforation associated with cytomegaloviral enteritis in a patients with acquired immune defiency syndrome", 18, pp.931~936 (1998)
- "Intestinal perforation due to cytomegalovirus infection in patients with AIDS", 33, pp.1037~40 (1990)
- "Immune reconstution syndrome in HIV:Validating a case definition and identifying clinical predictors in persons initiating antiretroviral therapy", 42, pp.1639~1646 (2006)
- "Incidence and risk factor immune reconstitution inflammatory syndrome during highly active antiretroviral therapy", 19, pp.399~406 (2005)
- "Immune restoration disease after the treatment of immunodeficient HIV-infected patients with highly active antiretroviral therapy", 1, pp.107~115 (2000)
- "Immune reconstitution inflammatory syndrome in HIV", 19, pp.20~25 (2006)
- "Acute cytomegalovirus infection in AIDS patients with CD4＋ counts above 100X106 cells", L following combination antiretroviral therapy including protease inhibitors, 1997, pp.11, 1659~1660
- "Immune reconstitution CMV pneumonitis", 76 (2000)
- "Treatment of tuberculosis in HIV infected persons in the era of highly active antiretroviral therapy", 16, pp.75~83 (2002)