{"id":4006,"date":"2000-12-17T10:40:51","date_gmt":"2000-12-17T10:40:51","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=4006"},"modified":"2014-07-01T10:59:32","modified_gmt":"2014-07-01T10:59:32","slug":"interferon-gamma-treatment-in-azole-resistant-oropharyngeal-candidiasis","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/4006","title":{"rendered":"Interferon-gamma treatment in azole-resistant oropharyngeal candidiasis"},"content":{"rendered":"<p><strong>Simon Collins, HIV i-Base<\/strong><\/p>\n<p><strong>Although C. albicans is one of the infections that generally quickly improve and resolve following the immune response after HAART, in patients whose HIV progresses due to a failing salvage regimen Candida can become a life threatening condition and azole resistant infection is an increasing clinical problem. This anecdotal report from the Gartnavel General Hospital in Glasgow, presented evidence of the successful use of interferon-gamma to treat azole resistant oropharyngeal candidiasis and advanced HIV disease.<\/strong><\/p>\n<p>The 31 year old HIV positive patient presented with recurrent oropharyngeal Candida albicans infection which was known to be clinically and microbiologically resistant to azole therapy (fluconazole MIC &gt; 128 mg\/l and itraconazole MIC &gt; 16 mg\/l). Previous episodes of C. albicans infection since his HIV diagnosis in 1992 had been treated successfully with courses of fluconazole, itraconazole and ketoconazole.<\/p>\n<p>His CD4 count was 7 cells\/mm3 (1%) and viral load was 48,000 copies\/ml. He was highly antiretroviral experienced and at time of presentation was taking abacavir, 3TC and d4T. The patient refused therapy with intravenous amphotericin and therefore, interferon-gamma (1 mg sub-cutaneously three times weekly) was used to attempt to stimulate macrophage function (topical amphotericin and nystatin treatment was continued). Within 3 weeks of commencing this therapy there was a dramatic improvement in symptoms and signs of oropharyngeal candidiasis.<\/p>\n<p>After 4 months interferon-gamma was discontinued and within 4 days there was recurrence of his symptoms. Interferon-gamma treatment was therefore re-introduced successfully.<\/p>\n<p>The mechanism for the antimicrobial effect of IFN-g suggested in this study included macrophage activation, stimulation of antigen presentation, regulation of leucocyte &#8211; endothelium interaction and effects on cell proliferation and apoptosis. IFN-g increases the production of reactive oxygen radicals which then increases the candidiacidal activity of granulocytes.<\/p>\n<p>Reference:<\/p>\n<p>Bodasing N, Seaton RA et al &#8211; Interferon-gamma in resistant oropharyngeal candidiasis in an HIV positive patient. Poster 383. 5th Intl Congress on Drug Therapy in HIV Infection, Glasgow. 22-26 October 2000.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base Although C. albicans is one of the infections that generally quickly improve and resolve following the immune response after HAART, in patients whose HIV progresses due to a failing salvage regimen Candida can become a life &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,31],"tags":[81],"class_list":["post-4006","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-opportunistic-infections-coinfections-and-complications","tag-hiv-5-glasgow-2000"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/4006","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=4006"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/4006\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=4006"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=4006"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=4006"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}