The management of chronic prostatitis in men with HIV.
Prostatitis is a common urologic diagnosis. Although treatment algorithms are available for this poorly understood entity, several adaptations must be made in order to accommodate the therapeutic needs of HIV-positive patients. The most important consideration when treating HIV-infected patients for prostatitis is their current immune status, whether they are immunocompromised or not (non-progressive disease or reconstituted with highly active antiretroviral therapy). A treatment algorithm for those with chronic bacterial prostatitis (Category II), chronic nonbacterial prostatitis (Category IIIA), and prostatodynia (Category IIIB) is presented in this article. In the HIV-positive patient population, there is a greater likelihood for atypical pathogens including fungi, tuberculosis, anaerobes, and viruses. Because the HIV-infected patient is at increased risk for the development of prostatic abscess and urosepsis than the general population, increased monitoring and evaluation and longer-term appropriately directed antimicrobial therapy are required.
Santillo
Vincent M
VM
Columbia University, College of Physicians and Surgeons, Department of Urology, St. Luke's-Roosevelt Hospital, 425 W 59th Street, #3A, New York, NY 10019, USA.
Lowe
Franklin C
FC
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000465:Algorithms; D023241:Antiretroviral Therapy, Highly Active; D002908:Chronic Disease; D015897:Comorbidity; D003558:Cystoscopy; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D017699:Pelvic Pain / Q000209:etiology; D011472:Prostatitis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D011794:Quercetin / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D000077409:Tamsulosin; D014563:Urodynamics
D000317:Adrenergic alpha-Antagonists; D011799:Quinazolines; D013449:Sulfonamides; C047638:alfuzosin; D011794:Quercetin; D000077409:Tamsulosin