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一名感染了艾滋病毒且患有糖尿病肾病和视网膜病变的患者带来的重要临床经验。

An important clinical lesson from a patient infected with HIV with diabetic nephropathy and retinopathy.

作者信息

Martinelli Pasquale, Agangi Annalisa, Sansone Matilde, Napolitano Raffaele, Maruotti Giuseppe Maria

机构信息

University of Naples Federico II, Obstetrics and Gynecology, via Pansini, 5, Naples, 80131, Italy.

出版信息

BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2008.0200. Epub 2009 Feb 20.

Abstract

In resource-rich settings, advances in antiretroviral therapy have reduced the morbidity and increased the life expectancy of patients infected with HIV and consequently increased the likelihood of observing other non-HIV-related diseases in this group of patients. We report a high-risk pregnancy in a 26-year-old woman infected with HIV with complicated insulin-dependent diabetes mellitus. Because of maternal concomitant disease and concerns regarding potential antiretroviral toxicity on maternal disease, an abbreviated regimen of zidovudine prophylaxis was offered to prevent neonatal infection. After the iatrogenic preterm delivery of a healthy and uninfected baby, the patient experienced vulvar oedema and she is now waiting for renal transplantation.In conclusion, our case is one of a range of possible scenarios that may develop in pregnant women who are infected with HIV, reflecting the highly active antiretroviral therapy (HAART)-associated improvements in survival and health.

摘要

在资源丰富的地区,抗逆转录病毒疗法的进展降低了HIV感染患者的发病率,提高了他们的预期寿命,因此在这组患者中观察到其他非HIV相关疾病的可能性增加。我们报告了一名26岁感染HIV且患有复杂的胰岛素依赖型糖尿病的高危孕妇病例。由于母亲合并疾病以及担心抗逆转录病毒药物对母亲疾病的潜在毒性,提供了一种简化的齐多夫定预防方案以预防新生儿感染。在医源性早产下一个健康且未感染的婴儿后,患者出现了外阴水肿,她现在正在等待肾移植。总之,我们的病例是感染HIV的孕妇可能出现的一系列情况之一,反映了高效抗逆转录病毒疗法(HAART)在生存和健康方面带来的改善。

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本文引用的文献

1
Intensive care of patients with HIV infection.HIV感染患者的重症监护
N Engl J Med. 2006 Jul 13;355(2):173-81. doi: 10.1056/NEJMra050836.
4
Prevention of mother-to-child transmission of HIV infection.预防母婴传播艾滋病毒感染。
Curr Opin Infect Dis. 2004 Jun;17(3):247-52. doi: 10.1097/00001432-200406000-00013.
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Trends in diseases reported on U.S. death certificates that mentioned HIV infection, 1987-1999.
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