Table of Contents  
LETTER TO THE EDITOR
Year : 2016  |  Volume : 9  |  Issue : 6  |  Page : 773-774  

The most common bacterial infections in HIV-infected patients


1 Infectious Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Basic Sciences Department, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Date of Web Publication16-Nov-2016

Correspondence Address:
Seyed Hossein Shahcheraghi
Infectious Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-2870.194234

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How to cite this article:
Shahcheraghi SH, Ayatollahi J, Niri MD, Fazilati A. The most common bacterial infections in HIV-infected patients. Med J DY Patil Univ 2016;9:773-4

How to cite this URL:
Shahcheraghi SH, Ayatollahi J, Niri MD, Fazilati A. The most common bacterial infections in HIV-infected patients. Med J DY Patil Univ [serial online] 2016 [cited 2024 Mar 29];9:773-4. Available from: https://journals.lww.com/mjdy/pages/default.aspx/text.asp?2016/9/6/773/194234

Sir,

Infections are the important cause of morbidity and mortality in HIV-infected patients worldwide in both developed and developing countries. [1] Many studies have proved that severe bacterial infections, particularly pneumonia, still occurred at high rates even in the absence of severe CD4 cell depletion. [1]

According to WHO data, among patients infected with HIV, tuberculosis occurs in about 30% of patients and causes approximately 25% of deaths due to AIDS worldwide. [2] The incidence of atypical mycobacterial infections is rare, but it is increasing as the AIDS population grows. [2]

Sexually transmitted infections (STIs) among people living with HIV may be indicative of ongoing risk behaviors and are important comorbidity conditions that may enhance the risk of HIV and STIs transmission. [3] The incidence of STIs among HIV-infected individuals is approximately 1.5-3.0 times greater compared to individuals without HIV. [3] Both ulcerative and nonulcerative STIs promote HIV transmission by augmenting HIV infectivity and susceptibility by biological mechanisms and unprotected sexual encounters. [3] It is well-established that STIs are associated with increased genital HIV viral load even in patients on highly active antiretroviral therapy with undetectable HIV viral loads in blood plasma. [3] Treponema pallidum, Chlamydia trachomatis, and Neisseria gonorrhoeae infections are most frequently observed in HIV-infected individuals. [3]

Streptococcus pneumoniae is the agent in HIV-infected adults which has been confirmed in various etiological studies from Africa. [4] In HIV-infected adults, pneumococcus has been investigated to be implicated in 20% of bacterial pneumonia, 40% of pneumonia with an identified organism, and 70% of pneumonia with positive blood cultures. [4] Pneumococcal pneumonia carries a mortality of about 10-15% with slightly higher mortality in patients with bacteremia related to pneumococcal pneumonia, which has been roughly unchanged since the advent of antibiotic therapy. [4]

Genital mycoplasmas, including Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma parvum, and Ureaplasma urealyticum may reach colonization rates of even up to 80% in healthy, sexually active women. [4],[5] Mycoplasma infections are often elusive or subclinical in nature, and it is not always possible to prove the pathogenic nature of these bacteria. [5] Infection with bacterial vaginosis and genital mycoplasmas may increase the risk of HIV acquisition and the rates of HIV shedding in the genital tract. [4],[5]

Methicillin-resistant Staphylococcus aureus (MRSA) infections in HIV-infected patients are considered as an important morbidity factor. Host immune dysfunction in these patients causes a higher risk for MRSA bacteremia infections. [5]

It has been demonstrated that CD4 + T-cells are selectively increased in the inflammatory milieu associated with Helicobacter gastritis. [5],[6] While a comprehensive explanation for the mechanism by which increased CD4 + cells perpetuate Helicobacter pylori gastritis has not yet been elucidated, a likely factor is gastric epithelial permeability. [5],[6] H. pylori is known to increase gastric permeability (which is essential for providing the organisms with adequate nutrients), directly as well as indirectly through its attendant inflammatory response. [5],[6]

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  References Top

1.
Saeed NK, Farid E, Jamsheer AE. Prevalence of opportunistic infections in HIV-positive patients in Bahrain: A four-year review (2009-2013). J Infect Dev Ctries 2015;9:60-9.  Back to cited text no. 1
    
2.
Lucejko M, Grzeszczuk A, Rogalska M, Flisiak R. Incidence of tuberculosis and mycobacteriosis among HIV-infected patients - Clinical and epidemiological analysis of patients from North-Eastern Poland. Pneumonol Alergol Pol 2013; 81:502-10.  Back to cited text no. 2
    
3.
Chen YC, Liu HY, Li CY, Lee NY, Li CW, Ko WC, et al. The rising trend of sexually transmitted infections among HIV-infected persons: A population-based cohort study in Taiwan, 2000 through 2010. J Acquir Immune Defic Syndr 2015;68:432-8.  Back to cited text no. 3
    
4.
Albrich WC, Madhi SA, Adrian PV, van Niekerk N, Telles JN, Ebrahim N, et al. Pneumococcal colonisation density: A new marker for disease severity in HIV-infected adults with pneumonia. BMJ Open 2014;4:e005953.  Back to cited text no. 4
    
5.
Redelinghuys MJ, Ehlers MM, Dreyer AW, Lombaard H, Olorunju SA, Kock MM. A cross-sectional study on the relationship of age, gestational age and HIV infection to bacterial vaginosis and genital mycoplasma infection. BMJ Open 2015;5:e008530.  Back to cited text no. 5
    
6.
Huson MA, Stolp SM, van der Poll T, Grobusch MP. Community-acquired bacterial bloodstream infections in HIV-infected patients: A systematic review. Clin Infect Dis 2014;58:79-92.  Back to cited text no. 6
    



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