Effective treatment of a highly active antiretroviral regimen through jejunostomy.
A 49-year-old woman voluntarily not receiving HIV treatment was admitted to the emergency department showing sepsis and peritonism. She required several surgical procedures for intestinal perforations. Finally, a proximal-terminal jejunostomy and a distal mucous jejunostomy were performed. At this time, her HIV viral load was 531 388 copies/ml and CD4 count was 193 cells/μl. Then, HAART was restarted with lopinavir/ritonavir 400/100 mg plus lamivudine 150 mg/12 hours, and etravirine 400 mg/24 hours. Each drug was dissolved in 20 ml of water and administered through the distal jejunostomy. In 2 months, her HIV viral load decreased in 3·9 log and CD4 count increased in 70 cells/μl. On day 250, an intestinal tract reconstruction was performed and short after highly active antiretroviral therapy (HAART) was restarted orally. Lopinavir/ritonavir, etravirine, and lamivudine administered through a jejunostomy resulted effective in decreasing HIV viral load and increasing CD4 lymphocyte count in a HIV patient who could not receive treatment orally.
Marta
M
Florit-Sureda
Maria
M
Giner-Soriano
Javier Mateu-de
JM
Antonio
Alexia
A
Carmona-Yelo
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D005260:Female; D006801:Humans; D007582:Jejunostomy; D008875:Middle Aged; D019562:Viral Load / Q000187:drug effects
Acquired immunodeficiency syndrome,; Biological availability,; Critical illness,; Drug administration routes,; Highly active antiretroviral therapy,; Jejunostomy