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Diagnostik und Therapie der HIV-assoziierten Krankheiten

  • R. Lüthy
  • F. Colla
  • R. Schläpfer
  • M. Täuber
  • W. Siegenthaler
Chapter

Zusammenfassung

Die Verfasser beschreiben die Symptomatik der unterschiedlichen Krankheitszustände, angefangen von der akuten HIV-Infektion, über die opportunistischen Infektionen wie Pneumocystis-carinii-Pneumonie, Candida-Stomatitis/Ösophagitis, Toxoplasmose, Herpes-Virus-Infektionen, Mykobakteriosen, Kryptosporidiose und Isosporiasis, bis hin zu den HIV-assoziierten Neoplasien und Erkrankungen des Nervensystems. Ausführlich wird auch auf die Therapiemöglichkeiten eingegangen unter Angabe der Dosierung, Dauer der Therapie, Nebenwirkungen und Erfolgsquoten.

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Literatur

  1. 1.
    Abrams D, Lewis B, Beckslead J (1984) Persistent diffuse lymphadenopathy in homosexual men: Endpoint or prodrome? Ann Intern Med 100:801–808PubMedCrossRefGoogle Scholar
  2. 2.
    Adam H, Flepp M, Lüthy R, Fehr J, Rhyner K (1987) Malignant lymphomas in anti-HIV-positive patients. Abstract P7, 3. Int. Conf. on malignant Lymphoma, Lugano, SchweizGoogle Scholar
  3. 3.
    Allegra CJ, Chabner BA, Tuazon CU, Ogata-Arakaki D (1987) Trimetrexate for the treatment of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. N Engl J Med 317:978–985PubMedCrossRefGoogle Scholar
  4. 4.
    Berk RN, Wall SD, McArdle CB, McCutchan JA, Clemett AR, Rosenblum JS, Premkumer A, Megibow AJ (1984) Cryptosporidiosis of the stomach and small intestine in patients with AIDS. Am J Radiol 143:549–554Google Scholar
  5. 5.
    Bishburg E, Sunderam G, Reichmann LB, Kapila R (1986) Central nervous system tuberculosis with the aquired immunodeficiency syndrome and AIDS related complex. Ann Intern Med 105:210–213PubMedCrossRefGoogle Scholar
  6. 6.
    Brady EM, Margolis ML, Korzeniowski OM (1984) Pulmonary cryptosporidiosis in acquired immune deficiency syndrome. JAM A 252:89–90CrossRefGoogle Scholar
  7. 7.
    Broaddus C, Dake MD, Stulbarg MS, Blumenfeld W, Hadley WK, Golden JA, Hopewell PC (1985) Bronchoalveolar lavage und transbronchial biopsy for the diagnosis of pulmonary infections in the aquired immunodeficiency syndrome. Ann Intern Med 102:747–752PubMedCrossRefGoogle Scholar
  8. 8.
    Centers for Disease Control (CDC) (1985) Revision of the case definition of AIDS for national reporting — United States. Morbid Mortal Weekly Report 34:373–375Google Scholar
  9. 9.
    Centers for Disease Control (CDC) (1985) Oral viral lesion (hairy leukoplakia) associated with acquired immunodeficiency syndrome. Morbid Mortal Weekly Report 34:549–550Google Scholar
  10. 10.
    Centers for Disease Control (CDC) (1982) Cryptosporidio-sis: assessment of chemotherapy of males with acquired immune deficiency syndrome (AIDS). Morbid Mortal Weekly Report 12:589–592Google Scholar
  11. 11.
    Chachoua A, Dietrich D, Krasinski K, Greene J, Laubenstein L, Wernz J, Buhles W, Koretz S (1987) 9-(1,3-dihy-droxy-2-propoxy-methyl)guanine (ganciclovir) in the treatment of Cytomegalovirus gastrointestinal disease with the acquired immunodeficiency syndrome. Ann Intern Med 107:133–137PubMedCrossRefGoogle Scholar
  12. 12.
    Chandrasekar PH (1987) “Cure” of chronic cryptospori-diosis during treatment with azidothymidine in a patient with the acquired immune deficiency syndrome. Am J Med 83:187PubMedCrossRefGoogle Scholar
  13. 13.
    Coleman DL, Dodek PM, Luce JM (1983) Diagnostic utility of fibroptic bronchoscopy in patients with Pneumocystis carinii pneumonia and the acquired immune deficiency syndrome. Am Rev Resp Dis 128:795–799PubMedGoogle Scholar
  14. 14.
    Cooper DA, Gold J, MacLean P, Donovan B, Finlayson R, Barnes TG, Michelmore HM, Brooke P (1985) Acute AIDS retrovirus infection. Lancet 1:537–540PubMedCrossRefGoogle Scholar
  15. 15.
    Dehovitz JA, Pape JW, Boncy M, Johnson WD (1986) Clinical manifestation and therapy of Isospora belli infection in patients with the aquired immunodeficiency syndrome. N Engl J Med 315:87–90PubMedCrossRefGoogle Scholar
  16. 16.
    Duarte PA, Chow CC, Simmons F, Ruskin J (1984) Fatal hepatitis associated with ketoconazole therapy. Arch Int Med 144:1069–1070CrossRefGoogle Scholar
  17. 17.
    Editorial (1984): Needlestick transmission of HTLV-II1 from a patient infected in Africa. Lancet II: 1376–1377Google Scholar
  18. 18.
    Fernandez R, Mouradian J, Metroka C, Davis J (1983) The prognostic value of histopathology in persistent generalized lymphadenopathy in homosexual men. N Engl J Med 309:185–186PubMedGoogle Scholar
  19. 19.
    Flepp M, Rhyner K, Lüthy R, Greminger P, Vurma-Rupp U, Wolfisberg C, Burnens A, Siegenthaler W (1988) Mykobakteriosen bei Patienten mit HIV-Infektion. Dtsch Med Wochenschr (im Druck)Google Scholar
  20. 20.
    Gabuzda DH, Hirsch MS (1987) Neurological manifestations of infection with human immunodeficiency virus. Ann Intern Med 107:383–391PubMedCrossRefGoogle Scholar
  21. 21.
    Gillin JS, Urmacher C, West R, Shike M (1983) Disseminated Mycobacterium avium-intracellulare infection in acquired immunodeficiency syndrome mimicking Whipple’s disease. Gastroenterology 85:1187–1191PubMedGoogle Scholar
  22. 22.
    Gold JWM, Armstrong D (1986) Continuing high risk for AIDS in a cohort of homosexual men with persistent unexplained lymphadenopathy: Follow-up of the first 93 patients. Abstract Nr. 12, 4. International symposium on infections in the immunocompromised host, Ronne by SwedenGoogle Scholar
  23. 23.
    Gold JWM, Weikel CS, Godbold J (1985) Unexplained persistent lymphadenopathy in homosexual men and the acquired immune deficiency syndrome. Medicine 64:203–213PubMedCrossRefGoogle Scholar
  24. 24.
    Golden JA, Sjoerdsma A, Santi DV (1984) Pneumocystis carinii pneumonia treated with alpha-difluoromethylorni-thine: A prospective study among patients with the acquired immunodeficiency syndrome. West J Med 141:613–623PubMedCentralPubMedGoogle Scholar
  25. 25.
    Golden JA, Hollander H, Stulbarg MS, Gamsu G (1986) Bronchoalveolar lavage as the exclusive diagnostic modality for Pneumocystis carinii pneumonia. Chest 90:1 8–22CrossRefGoogle Scholar
  26. 26.
    Greene JB, Sidhu GS, Lewin S, Levine JF, Masur H, Simberkoff MS, Nicholas P, Good RC, Zolla-Pazner SB, Pollock AA, Papper ML, Holzman RS (1982) Mycobacterium avium-intracellulare: a cause of disseminated life-threatening infection in homosexuals and drug abusers. Ann Intern Med 97:539–546PubMedCrossRefGoogle Scholar
  27. 27.
    Greenspan D, Greenspan JS, Couant M, Peterson V, Silverman S Jr, Deveonza Y (1984) Oral “hairy” leukoplakia in male homosexuals: evidence of association with both papilloma virus and a herpes-group virus. Lancet 11:831–834CrossRefGoogle Scholar
  28. 28.
    Haverkos HW (1987) Assessment of therapy for Toxo-plasma-encephalitis. Am J Med 82:907–914PubMedCrossRefGoogle Scholar
  29. 29.
    Haverkos HW, Juranek DD, Pollard RA (1984) Assessment of therapy for Pneumocystis carinii pneumonia. Pneumocystis carinii pneumonia therapy project group. Am J Med 76:501–508PubMedCrossRefGoogle Scholar
  30. 30.
    Hawkins CC, Gold JWM, Whimbey E, Kiehn TE, Brannon P, Cammarata R, Brown AE, Armstrong D (1986) Mycobacterium avium complex infections in patients with the acquired immuno-deficiency syndrome. Ann Intern Med 105:184–188PubMedCrossRefGoogle Scholar
  31. 31.
    Henry K, Cantrill H, Fletcher C, Chinnock BJ, Balfour HH Jr (1987) Use of intravitreal ganciclovir (dihydroxy-propoxy-methyl guanine) for cytomegalovirus retinitis in a patient with AIDS. Am J Ophthalmol 103:17–23PubMedGoogle Scholar
  32. 32.
    Hinnannt KL, Rotterdam HZ, Bell ET, Tapper ML (1986) Cytomegalovirus infections of the alimentary tract: a cli-nico-pathological correlation. Am J Gastroenterol 81:944–950Google Scholar
  33. 33.
    Ho DD, Sarngadharan MG, Resnick L, Dimarzo-Veronese F, Rota TR, Hirsch MS (1985) Primary human T-lympho-tropic virus type III infection. Ann Intern Med 103:880–883PubMedCrossRefGoogle Scholar
  34. 34.
    Hollander H, Golden J, Stulbarg M (1986) Recurrent AIDS-related Pneumocystis carinii pneumonia (PCP): frequency, outcome and prevention. Poster Nr. 283, 2. International Conference on AIDS, ParisGoogle Scholar
  35. 35.
    Hughes WT, Feldman S, Chaudharry SC (1978) Comparison of pentamidine isethionate and trimethoprim-sulfamethoxazole in the treatment of Pneumocystis carinii pneumonia. J Pediatr 92:285–291PubMedCrossRefGoogle Scholar
  36. 36.
    Jacobson MA, De Miranda P, Cederberg DM, Burnette T, Cobb E, Brodie HR, Mills J (1987) Human pharmacokinetics and tolerance of oral ganciclovir. Antimicrob Agents Chemother 31:1251–1254PubMedCentralPubMedCrossRefGoogle Scholar
  37. 37.
    Janoff EN, Relier LB (1987) Cryptosporidium species, a protean protozoan. J Clin Microb 25:967–975Google Scholar
  38. 38.
    Kaplan LD, Wofsy CB, Volberding PA (1987) Treatment of patients with acquired immunodeficiency syndrome and associated manifestations. JAMA 257:1367–1374PubMedCrossRefGoogle Scholar
  39. 39.
    Kazlow PG, Shah K, Benkow KJ, Dische R, LeLeiko NS (1986) Esophageal cryptosporidiosis in a child with acquired immune deficiency syndrome. Gastroenterology 91:1301–1303PubMedGoogle Scholar
  40. 40.
    Koretz SH, Merigan T (1986) Treatment of serious cytomegalovirus infections with 9-(1,3-dihydroxy-2-propoxy-methyl)guanine in patients with AIDS and other immunodeficiencies. N Engl J Med 314:801–805CrossRefGoogle Scholar
  41. 41.
    Kovacs JA, Allegra CJ, Swan JC (1986) Trimetrexate and BW301 two lipid soluble antifolates exert potent antitoxo-plasmosa effects. Abstract 1104, 26th Interscience Conference on Antimicrob Agents and Chemother, New OrleansGoogle Scholar
  42. 42.
    Laskin OL, Stahl-Bayliss C, Kalman C, Chinnock B, Balfour H, Demby K, Longstreth J (1985) Multidose pharmacokinetics of 9-[2-hydroxy-1-(hydroxymethyl)ethoxyme-thyl]guanin (BW759). Abstract 443, 25th Interscience Conference on Antimicrob Agents and Chemother, MinneapolisGoogle Scholar
  43. 43.
    Leoung GS, Mills J, Hopewell PC, Hughes W, Wofsy C (1986) Dapsone-trimethoprim for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Ann Intern Med 105:45–48PubMedCrossRefGoogle Scholar
  44. 44.
    Levy RM, Bredesen DE, Rosenblum ML (1985) Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): Experience at UCSF and review of the literature. J Neurosurg 62:475–495PubMedCrossRefGoogle Scholar
  45. 45.
    Louie E, Rice LB, Holzmann RS (1986) Tuberculosis in Non-Haitian patients with acquired immunodeficiency syndrome. Chest 90:542–545PubMedCrossRefGoogle Scholar
  46. 46.
    Luft BJ, Brools RG, Conley FK, McCabe RE, Remington JS (1984) Toxoplasmic encephalitis in patients with acquired immune deficiency syndrome. JAMA 252:913–917PubMedCrossRefGoogle Scholar
  47. 47.
    Ma P, Soave R (1983) Three-step stool examination for cryptosporidiosis in 10 homosexual men with protracted watery diarrhea. J Infect Dis 147:824–828PubMedCrossRefGoogle Scholar
  48. 48.
    MacFadden DK, Hyland RH, Inouye T, Edelson JD, Rodrigues CH, Rebuck AS (1987) Corticosteroids as adjunctive therapy in treatment of Pneumocystis carinii pneumonia in patients with acquired immunodeficiency syndrome. Lancet 1:1477–1479PubMedCrossRefGoogle Scholar
  49. 49.
    MacFarlane JT, Editorial (1985) Pneumocystis carinii pneumonia. Thorax 40:561–570PubMedCrossRefGoogle Scholar
  50. 50.
    Macher AM, Bardenstein DS, Zimmerman LE, Steigman CK, Pastore L, Poretz DM, Eron LJ (1987) Pneumocystis carinii choroiditis in a male homosexual with AIDS and disseminated pulmonary and extrapulmonary P. carinii infection. N Engl J Med 316:1092PubMedGoogle Scholar
  51. 51.
    Maurice DM (1987) Use of intravitreal ganciclovir (dihy-droxy propoxymethyl guanine) for cytomegalovirus retinitis in a patient with AIDS (letter). Am J Ophthalmol 103:842–843PubMedGoogle Scholar
  52. 52.
    Mazur H, Tuazon C, Gill V, Grimes G, Baird B, Fauci AS (1987) Effect of combined clofazimine and ansamycin therapy on Mycobacterium avium-intracellulare bacteriae-mia in patients with AIDS. J Infect Dis 155:127–130CrossRefGoogle Scholar
  53. 53.
    McKendrick MW (1985) Oral acyclovir in herpes zoster. Scand J Infect Dis Suppl 47:76–79PubMedGoogle Scholar
  54. 54.
    Mills J (1986) Pneumocystis carinii and Toxoplasma gondii infections in patients with AIDS. Rev Infect Dis 8:1001–1011PubMedCrossRefGoogle Scholar
  55. 55.
    Murray HW, Hillmann JK, Rubin BY, Kelly CD, Jacobs JL (1985) Patients at risk for AIDS-related opportunistic infections. N Engl J Med 313:1504–1510PubMedCrossRefGoogle Scholar
  56. 56.
    Navia BA, Cho ES, Petito CK, Price RW (1986) The AIDS dementia complex: II. Neuropathology. Ann Neurol 19:525–535Google Scholar
  57. 57.
    Navia BA, Petito CK, Gold JW, Cho ES, Jordan BD (1986) Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome. Clinical and neuropathological findings in 27 patients. Ann Neurol 19:224–238PubMedCrossRefGoogle Scholar
  58. 58.
    Nobler MP, Leddy ME, Huh SH (1987) The impact of palliative irradiation an the management of patients with acquired immune deficiency syndrome. J Clin Oncol 5:107–112PubMedGoogle Scholar
  59. 59.
    Parke DW, Font RL (1986) Diffuse toxoplasmic retino-choroiditis. Arch Ophthalmol 104:571–575PubMedCrossRefGoogle Scholar
  60. 60.
    Paya CV, Wold AD, Smith TF (1987) Detection of cytomegalo-virus infections in specimens other than urine by the shell vial assay and conventional tube cell cultures. J Clin Microb 25:755–757Google Scholar
  61. 61.
    Pearson RD, Hewlett EL (1985) Pentamidine for the treatment of Pneumocystis carinii pneumonia and other protozoal disease. Ann Intern Med 103:782–786PubMedCrossRefGoogle Scholar
  62. 62.
    Petito CK, Navia BA, Cho ES, Jordan BD, George DC, Price RW (1985) Vacuolar myelopathy pathologically resembling subacute combined degeneration in patients with the acquired immuno-deficiency syndrome. N Engl J Med 312:874–879PubMedCrossRefGoogle Scholar
  63. 63.
    Pitchenik AE, Ganjei P, Torres A, Evans DA, Rubin E, Baier H (1986) Sputum examination for the diagnosis of Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Am Rev Respir Dis 133:226–229PubMedGoogle Scholar
  64. 64.
    Pitlik SD, Fainstein V, Garza D, Guarda L, Bolivar R, Rios A, Hopfer RL, Mansell PA (1983) Human cryptosporidiosis: spectrum of disease. Arch Intern Med 143:2269–2275PubMedCrossRefGoogle Scholar
  65. 65.
    Portnoy D, Witheside ME, Buckley E, Mac Lead CL (1984) Treatment of intestinal cryptosporidiosis with spiramycin. Ann Intern Med 101:202–204PubMedCrossRefGoogle Scholar
  66. 66.
    Real FX, Oettgen HF, Krown SE (1986) Kaposi’s sarcoma and the acquired immunodeficiency syndrome: Treatment with high and low doses of recombinant leucocyte A Interferon. J Clin Oncol 4:544–551PubMedGoogle Scholar
  67. 67.
    Rothbart PH, Diepersloot RJA, Metslaar HJ, Nooyen Y, Velzing J, Weimar W (1987) Rapid demonstration of cytomegalovirus in clinical specimens. Infection 15:228–231CrossRefGoogle Scholar
  68. 68.
    Rozenbaum W (1986) The treatment of AIDS related infections Abstract Nr. 149, 2. International Conference on AIDS, ParisGoogle Scholar
  69. 69.
    Sands M, Kron MA, Brown RB (1985) Pentamidine: A review. Rev Infect Dis 7:625–634PubMedCrossRefGoogle Scholar
  70. 70.
    Schneebaum CW, Novick DM, Chabon AB, Strutynsky N, Yancowitz SR, Freund S (1987) Terminal ileitis associated with Mycobacterium avium-intracellulare infection in a homosexual man with aquired immunodeficiency syndrome. Gastroenterology 92:1127–1132PubMedGoogle Scholar
  71. 71.
    Schneiderman DJ, Cello JP, Laing FC (1986) Papillary stenosis and sclerosing cholangitis in the acquired immunodeficiency syndrome. Ann Intern Med 106:546–549CrossRefGoogle Scholar
  72. 72.
    Silverman BA, Rubinstein A (1985) Serum lactate dehydrogenase levels in adults and children with acquired immune deficiency syndrome (AIDS) and AIDS-related complex: Possible indicator of B-cell lymphoproliferation and disease activity. Am J Med 78:728–736PubMedCrossRefGoogle Scholar
  73. 73.
    Siegal FP, Lopez C, Hammer GS (1981) Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative Herpes simplex lesions. N Engl J Med 305:1439–1444PubMedCrossRefGoogle Scholar
  74. 74.
    Small CB, Ahmed T, Stahl RE, Lenox T, Singh B, Kasoff S, Wormser GP (1985) Comparison for cerebral toxoplasmosis with primary brain lymphoma in AIDS patients. Interscience Conference on Antimicrob Agents and Chemother, Minneapolis, Abstract 825Google Scholar
  75. 75.
    Snider WD, Simpson DM, Nielsen S, Gold JW, Metroka CE, Posner JB (1983) Neurological complications of acquired immunodeficiency syndrome: Analysis of 50 patients. Ann Neurol 14:403–418PubMedCrossRefGoogle Scholar
  76. 76.
    Volberding PA, Mitsuyasu RT, Golando JP, Spiegel RJ (1987) Treatment of Kaposi’s sarcoma with interferon alfa-2b (Intron A). Cancer 59:620–625PubMedCrossRefGoogle Scholar
  77. 77.
    Volberding PA (1987) The role of chemotherapy of epidemic Kaposi’s sarcoma. Semin Oncol 14:23–26PubMedGoogle Scholar
  78. 78.
    Wharton JM, Coleman DL, Wofsy CB, Luce JM, Blumenfeld W, Hadley WK, Ingram-Drake L, Volberding PA, Hopewell PC (1986) Trimethoprim-sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Ann Intern Med 105:37–44PubMedCrossRefGoogle Scholar
  79. 79.
    Woodman R, Shin K, Pineo G (1985) Primary Non-Hodg-kin’s Lymphoma of the brain. Medicine 64:425–430PubMedCrossRefGoogle Scholar
  80. 80.
    Yarchoan R, Berg G, Brouwers P, Fischl MA, Spitzer AR, Wichmann A, Grafman J, Thomas RV, Safai B, Burnetti A (1987) Response of human-immunodeficiency-virus-asso-ciated neurological disease to 3′-azido-3′deoxythymidine. Lancet 1:132–135PubMedCrossRefGoogle Scholar
  81. 81.
    Young LS, Inderlied CB, Berlin OG, Gottlieb MS (1986) Mycobacterial infections in AIDS Patients, with emphasis on the Mycobacterium avium complex. Rev Infect Dis 8:1024–1033PubMedCrossRefGoogle Scholar
  82. 82.
    Ziegler JL, Beckstead JA, Volberding PR, Abrams DI, Levine AM, Lukes RJ, Gill PS, Burkes RL, Meyer PA, Metroka CE (1984) Non-Hodgkin’s lymphoma in 90 homosexual men. N Engl J Med 311:565–570PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • R. Lüthy
    • 2
  • F. Colla
    • 1
  • R. Schläpfer
    • 1
  • M. Täuber
    • 1
  • W. Siegenthaler
    • 1
  1. 1.Abteilung für Infektionskrankheiten, Departement für Innere MedizinUniversitätsspitalZürichSchewiz
  2. 2.Abteilung für Infektionskrankheiten Medizinische Poliklinik Departement für Innere MedizinUniversitätsspitalZürichSchewiz

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