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

2022, Number 2

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

Enteral infections in the child with HIV

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

Language: Spanish
References: 49
Page: 43-51
PDF size: 231.15 Kb.


ABSTRACT

Worldwide, diarrhea is the second leading cause of death in children under 5 years of age. HIV-infected children as well as uninfected HIV-exposed children are at high risk of mortality from diarrhea and may be susceptible to higher-risk pathogens. HIV has a high impact on the intestine at all stages of infection. The intestine has been described as the site where there is greater depletion of CD4 lymphocytes, in addition to the fact that viral replication causes changes in the cellular interface existing in the mucosa, altering the physiology of the resident microbiota. According to the CD4 count, it is possible to predict the risk for certain pathogens. Giardia lamblia and Entamoeba histolytica are reported more frequently above 200 cells. Invasive / systemic Salmonella, invasive bacterial enteritis as well as Clostridium difficile have been reported between 50 to 200 cells. In those patients with counts below 50 cells, Cryptosporidium parvum, Microsporidium, Isospora belli, Ciclospora and MAC (Mycobacterium avium complex) have been isolated more frequently, the latter three being practically exclusive from HIV-positive patients. Currently, WHO recommends that all patients with confirmed HIV infection initiate prophylaxis with trimethoprim-sulfamethoxazole.


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