Infection VIH et splenectomie: trois cas et revue de la litterature. [HIV infection and splenectomy: 3 cases and literature review]

Détails

ID Serval
serval:BIB_15F4A8D3DD6D
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Infection VIH et splenectomie: trois cas et revue de la litterature. [HIV infection and splenectomy: 3 cases and literature review]
Périodique
Schweizerische Medizinische Wochenschrift
Auteur(s)
Greub  G., Erard  P., von Overbeck  J.
ISSN
0036-7672 (Print)
Statut éditorial
Publié
Date de publication
09/1996
Volume
126
Numéro
36
Pages
1524-9
Notes
Case Reports
English Abstract
Journal Article
Review --- Old month value: Sep 7
Résumé
3 splenectomized patients infected by the human immunodeficiency virus (HIV) are described. They all presented with more than 500 CD4/mm3 but, surprisingly, with a CD4 percentage below 15, positive p24 antigenemia and a CD4/CD8 ratio below 0.24. 2 patients had repeated episodes of oropharyngeal candidiasis while their CD4 counts exceeded 800/mm3. These episodes suggested the presence of a certain degree of immuno-suppression and prompted us to introduce anti-HIV therapy. 2 patients also presented with a pulmonary infection, due to Klebsiella pneumoniae and Haemophilus influenzae respectively. The third patient had septicemia due to Streptococcus pneumoniae type 22, despite vaccination and a CD4 count above 700/mm3. In splenectomized HIV-infected patients the number of CD4 lymphocytes should be interpreted with caution, as this number increases after splenectomy. The CD4 percentage and CD4/CD8 ratio correlated better with the clinical stage of HIV infection and gave more valuable indications as to the degree of immunosuppression. A possible correlation between viremia and the number of CD4 lymphocytes in this subset of patients remains to be established. In HIV-infected patients, infections due to S. pneumoniae, H. influenzae, S. aureus and enteric gram-negative bacteria are frequent. After splenectomy, susceptibility to encapsulated bacteria increases even in HIV-negative patients. Early vaccination against the main strains of S. pneumoniae is essential, as vaccinal response is uncertain in patients with less than 400 CD4/mm3.
Mots-clé
AIDS-Related Opportunistic Infections/immunology/prevention & control Adult Bacterial Infections/immunology/prevention & control CD4 Lymphocyte Count CD4-CD8 Ratio Female HIV Infections/*immunology Humans Male *Splenectomy
Pubmed
Web of science
Création de la notice
25/01/2008 15:27
Dernière modification de la notice
20/08/2019 13:45
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