RESUMO
Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by invasive serovars of Chlamydia trachomatis. There have been only a few case reports of oropharyngeal C. trachomatis infection complicated with cervical LGV. We report a case of a HIV-positive male patient with cervical LGV that presented a poor evolution despite appropriate treatment.
Assuntos
Atlas Cervical/microbiologia , Infecções por Chlamydia/complicações , Infecções por HIV/microbiologia , Soropositividade para HIV/complicações , Linfogranuloma Venéreo/diagnóstico por imagem , Orofaringe/microbiologia , Antibacterianos/uso terapêutico , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Soropositividade para HIV/microbiologia , Homossexualidade Masculina , Humanos , Linfogranuloma Venéreo/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Sorogrupo , Tomografia Computadorizada por Raios XRESUMO
The aim of this transversal study was to describe the virological and immunological features of HIV-infected youths transferred from pediatric to adult care units since 1997 vs. the non-transferred patients from the Madrid Cohort of HIV-infected children and adolescents in Spain. We included 106 non-transferred and 184 transferred patients under clinical follow-up in 17 public hospitals in Madrid by the end of December 2017. Virological and immunological outcomes were compared in transferred vs. non-transferred patients. ART drug resistance mutations and HIV-variants were analyzed in all subjects with available resistance pol genotypes and/or genotypic resistance profiles. Among the study cohort, 133 (72.3%) of 184 transferred and 75 (70.7%) of 106 non-transferred patients had available resistance genotypes. Most (88.9%) of transferred had ART experience at sampling. A third (33.3%) had had a triple-class experience. Acquired drug resistance (ADR) prevalence was significantly higher in pretreated transferred than non-transferred patients (71.8% vs. 44%; p = 0.0009), mainly to NRTI (72.8% vs. 31.1%; p < 0.0001) and PI (29.1% vs. 12%; p = 0.0262). HIV-1 non-B variants were less frequent in transferred vs. non-transferred (6.9% vs. 32%; p < 0.0001). In conclusion, the frequent resistant genotypes found in transferred youths justifies the reinforcement of HIV resistance monitoring after the transition to avoid future therapeutic failures.