Περίληψη:
Mucosal candidiasis is frequent in immunocompromised HIV-infected highly active antiretroviral (HAART) naive patients or those who have failed therapy. Mucosal candidiasis is a marker of progressive immune deficiency. Because of the frequently marked and prompt immune reconstitution induced by HAART, there is no recommendation for primary antifungal prophylaxis of mucosal candidiasis in the HIV setting in Europe, although it has been evidenced as effective in the pre-HAART era. Fluconazole remains the first line of therapy for both oropharyngeal candidiasis and oesophageal candidiasis and should be preferred to itraconazole oral solution (or capsules when not available) due to fewer side effects. For patients who still present with fluconazole-refractory mucosal candidiasis, oral treatment with any other azole should be preferred based on precise Candida species identification and susceptibility testing results in addition to the optimization of HAART when feasible. For vaginal candidiasis, topical therapy is preferred. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.
Συγγραφείς:
Lortholary, O.
Petrikkos, G.
Akova, M.
Arendrup, M.C.
Arikan-Akdagli, S.
Bassetti, M.
Bille, J.
Calandra, T.
Castagnola, E.
Cornely, O.A.
Cuenca-Estrella, M.
Donnelly, J.P.
Garbino, J.
Groll, A.H.
Herbrecht, R.
Hope, W.W.
Jensen, H.E.
Kullberg, B.J.
Lass-Flörl, C.
Meersseman, W.
Richardson, M.D.
Roilides, E.
Verweij, P.E.
Viscoli, C.
Ullmann, A.J.
Λέξεις-κλειδιά:
amphotericin B; caspofungin; clotrimazole; echinocandin; fluconazole; itraconazole; ketoconazole; miconazole; posaconazole; voriconazole; antifungal agent, acquired immune deficiency syndrome; article; bitter taste; Candida; candidiasis; clinical feature; drug bioavailability; drug efficacy; esophagitis; esophagus candidiasis; follow up; food intake; gastrointestinal symptom; highly active antiretroviral therapy; human; Human immunodeficiency virus infection; liver toxicity; mucocutaneous candidiasis; oropharynx candidiasis; priority journal; side effect; stomach pH; vagina candidiasis; vomiting; Candida; candidiasis; drug effect; evidence based medicine; Human immunodeficiency virus infection; immunocompromised patient; isolation and purification; practice guideline; standard, Antifungal Agents; Antiretroviral Therapy, Highly Active; Candida; Candidiasis; Evidence-Based Medicine; HIV Infections; Humans; Immunocompromised Host
