tailieunhanh - Chapter 117. Health Advice for International Travel (Part 7)

Gastrointestinal Illness Decreased levels of gastric acid, abnormal gastrointestinal mucosal immunity, other complications of HIV infection, and medications taken by HIVinfected patients make travelers' diarrhea especially problematic in these individuals. Travelers' diarrhea is likely to occur more frequently, be more severe, be accompanied by bacteremia, and be more difficult to treat. Although uncommon, Cryptosporidium, Isospora belli, and Microsporidium infections are associated with increased morbidity and mortality in AIDS patients. The HIV-infected traveler must be careful to consume only appropriately prepared foods and beverages and may benefit from antibiotic prophylaxis for travelers' diarrhea. Sulfonamides (as used to prevent pneumocystosis) are ineffective because. | Chapter 117. Health Advice for International Travel Part 7 Gastrointestinal Illness Decreased levels of gastric acid abnormal gastrointestinal mucosal immunity other complications of HIV infection and medications taken by HIV-infected patients make travelers diarrhea especially problematic in these individuals. Travelers diarrhea is likely to occur more frequently be more severe be accompanied by bacteremia and be more difficult to treat. Although uncommon Cryptosporidium Isospora belli and Microsporidium infections are associated with increased morbidity and mortality in AIDS patients. The HIV-infected traveler must be careful to consume only appropriately prepared foods and beverages and may benefit from antibiotic prophylaxis for travelers diarrhea. Sulfonamides as used to prevent pneumocystosis are ineffective because of widespread resistance. Other Travel-Related Infections Data are lacking on the severity of many vector-borne diseases in HIV-infected individuals. Malaria is especially severe in asplenic persons and in those with AIDS. The HIV load doubles during malaria with subsidence in 8-9 weeks the significance of this increase in viral load is unknown. Visceral leishmaniasis Chap. 205 has been reported in numerous HIV-infected travelers. Diagnosis may be difficult given that splenomegaly and hyperglobulinemia are often lacking and serologic results are frequently negative. Sandfly bites may be prevented by evening use of insect repellents. Certain respiratory illnesses such as histoplasmosis and coccidioidomycosis cause greater morbidity and mortality among patients with AIDS. Although tuberculosis is common among HIV-infected persons especially in developing countries its acquisition by the short-term HIV-infected traveler has not been reported as a major problem. Medications Adverse events due to medications and drug interactions are common and raise complex issues for HIV-infected persons. Rates of cutaneous reaction . increased cutaneous .