Debnath Anjan, Reed Sharon L, Morris Sheldon R
Center for Discovery and Innovation in Parasitic Diseases, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093, USA.
Department of Pathology, University of California San Diego, La Jolla, CA 92093, USA.
Pathogens. 2019 Sep 27;8(4):165. doi: 10.3390/pathogens8040165.
This study aimed to determine the presence of giardiasis among HIV patients in San Diego, the rate of failure of metronidazole treatment, and factors associated with treatment failure. We used a 7 year retrospective single-center case series of HIV-infected individuals with giardiasis at University of California San Diego Medical Center. Data were analyzed for the changes in the hematological, biochemical, and immunologic results at pre- and at-diagnosis levels. We also compared the changes at the diagnosis level among patients who were treated successfully and those who experienced treatment failure as defined by retreatment with a second course of antibiotics. In 29 -infected HIV patients, following diagnosis of , there was a non-significant decrement in cluster of differentiation 4 (CD4), but a statistically significant increase in the number of white blood cell (WBC). Other indices did not differ between pre- and at-diagnosis levels. Twenty patients (69%) were treated with a single course of metronidazole or tinidazole and seven patients (24.1%) were treated with more than one course of metronidazole. These seven patients had statistically significant higher hemoglobin at the time of diagnosis, but further studies are required to confirm if this is a consistent finding and if this can predict failure from primary therapy.
本研究旨在确定圣地亚哥艾滋病毒患者中贾第虫病的存在情况、甲硝唑治疗失败率以及与治疗失败相关的因素。我们采用了加利福尼亚大学圣地亚哥分校医学中心7年的回顾性单中心病例系列，研究对象为感染艾滋病毒且患有贾第虫病的个体。分析了诊断前和诊断时血液学、生化和免疫学结果的变化。我们还比较了成功治疗的患者和因再次使用第二疗程抗生素治疗而定义为治疗失败的患者在诊断时的变化。在29例感染艾滋病毒的患者中，诊断出贾第虫病后，分化簇4（CD4）有非显著下降，但白细胞（WBC）数量有统计学意义的增加。其他指标在诊断前和诊断时水平之间没有差异。20例患者（69%）接受了单疗程甲硝唑或替硝唑治疗，7例患者（24.1%）接受了不止一个疗程的甲硝唑治疗。这7例患者在诊断时血红蛋白有统计学意义的升高，但需要进一步研究来确认这是否是一个一致的发现，以及这是否能预测初始治疗的失败。
