Kim Jung Ho, Seong Jae Eun, Ahn Sangmin, Lee Yongseop, Lee Jung Ah, Ahn Jin Young, Jeong Su Jin, Ku Nam Su, Yeom Joon-Sup, Choi Jun Yong
Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Infect Chemother. 2024 Sep;56(3):287-299. doi: 10.3947/ic.2024.0052. Epub 2024 Aug 1.
With advancements in antiretroviral therapy (ART), the average lifespan of people with human immunodeficiency virus (HIV) is increasing, as is the number of older adults with HIV. Accordingly, the number of patients with HIV who undergo surgery or require critical care for various reasons is increasing. Since the prognosis of people with HIV depends on the continuous and effective maintenance of ART, there is a need to consider effectively maintaining ART in people with HIV in these conditions. This case involved a 55-year-old patient with well-controlled HIV who received ART and presented to the emergency room with acute abdominal pain. He was diagnosed with extensive bowel infarction and panperitonitis and received critical care in the intensive care unit, including mechanical ventilation and continuous renal replacement therapy. The patient was administered enteral nutrition via a nasogastric tube. The patient subsequently underwent extensive small bowel resection and developed short bowel syndrome. The patient maintained ART during that period. A literature review related to the use of ART under these conditions is included in this study. This case was discussed at the [Exploring Difficult Cases in HIV Clinics] of the Korean Society for AIDS Conference held in 2023.
随着抗逆转录病毒疗法(ART)的进步,感染人类免疫缺陷病毒(HIV)者的平均寿命在延长,感染HIV的老年人数量也在增加。相应地,因各种原因接受手术或需要重症监护的HIV患者数量正在增加。由于HIV感染者的预后取决于ART的持续有效维持,因此有必要考虑在这些情况下有效维持HIV感染者的ART治疗。该病例涉及一名55岁的HIV感染患者,其病情控制良好,接受ART治疗,因急性腹痛就诊于急诊室。他被诊断为广泛性肠梗死和全腹膜炎,并在重症监护病房接受重症监护,包括机械通气和持续肾脏替代治疗。通过鼻胃管为患者提供肠内营养。患者随后接受了广泛的小肠切除术,并发展为短肠综合征。在此期间患者维持ART治疗。本研究纳入了与在这些情况下使用ART相关的文献综述。该病例在2023年举行的韩国艾滋病学会会议的[HIV诊所疑难病例探讨]中进行了讨论。