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Boletín Clínico de la Asociación Médica del Hospital Infantil del Estado de Sonora

2022, Número 2

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Bol Clin Hosp Infant Edo Son 2022; 39 (2)


Infecciones enterales en el niño con VIH

Aguilar-Román AB, Pineda-Gordillo A, Reyes-Gómez U, Quero-Hernández A, López-Cruz G, Reyes-Hernández KL, Perea-Martínez A, Reyes-Hernández MU, Cuevas-López LL, Aguilar-García SF, Vázquez-Paredes LA, de Lara-Huerta J, González-Arenas E, Yalaupari-Mejía JP

Idioma: Español
Referencias bibliográficas: 49
Paginas: 43-51
Archivo PDF: 231.15 Kb.


RESUMEN

A nivel mundial, la diarrea es la segunda causa de muerte en niños menores de 5 años. Los niños infectados por VIH, así como los niños expuestos a VIH no infectados tienen un alto riesgo de mortalidad por diarrea y pueden ser susceptibles a patógenos de mayor riesgo. El VIH tiene un alto impacto en el intestino durante todos los estadios de la infección. Se ha descrito al intestino como el sitio donde existe mayor depleción de linfocitos CD4, además de que la replicación viral causa cambios en la interfase celular existente en las mucosas y altera la fisiología de la microbiota residente. De acuerdo con el conteo de CD4, es posible predecir el riesgo para determinados patógenos. Por arriba de 200 células se reporta Giardia lamblia y Entamoeba histolytica con mayor frecuencia. Entre 50 a 200 células se han reportado Salmonela Invasiva/sistémica, enteritis bacteriana invasiva así como Clostridium difficile. En aquellos pacientes con cuentas por debajo de 50 células, se han aislado más frecuentemente Cryptosporidium parvum, Microsporidium, Isospora belli, Ciclospora y MAC (Mycobacterium avium complex); estos tres últimos son prácticamente exclusivos de pacientes seropositivos para VIH. Actualmente, la Organización Mundial de la Salud (OMS) recomienda que todos los pacientes con infección confirmada por VIH inicien profilaxis con trimetoprim-sulfametoxazol.


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