25% of people living with HIV in Spain are undiagnosed, which can favor the appearance of opportunistic infections

The ace opportunistic infections (IO) continues to be a major cause of morbidity and mortality in people with HIV infectionand occur in a context where infected people have their severely weakened immune systemin particular because of a delay in the diagnosis of aids virus and have not yet started antiretroviral therapy (ART).

Opportunistic infections continue to be a major cause of morbidity and mortality in people infected with HIV.

In order to update the recommendations of prevention and treatment various opportunistic infections in HIV-infected patients, GeSIDAAIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), published a new edition of your document in which he condenses, in a summarized, clear and concise manner, indications on the prophylaxis and treatment of multiple opportunistic diseases (parasites, fungal, viral, mycobacterial, bacterial and imported parasites or fungi), as well as a vaccination schedule with the specifics of the HIV-infected patients.

opportunistic infections

Currently, it is estimated that approximately one 25% of subjects infected with HIV in Spainor are undiagnosed or not appropriately monitored for their HIV status. All this contributes to the existence of an important breeding ground for the appearance of opportunistic infections. In our environment, the fact that patients who were not known to be infected for HIV and who start with an OI.

In our environment, the fact of patients who had no evidence of HIV infection and who start with an OI is particularly significant.

“A very large proportion of the diagnostic delay it falls to the immigrant population, which may present imported infections for which there are fewer alerts and clinical suspicions in our environment. For these reasons, the treatment of opportunistic infections remains a highly topical issue in the care of patients infected with HIV”, underline the coordinators of this new edition of the recommendations document, physicians Marie Velasco, of the University Hospital Fundación Alcorcón; Yes Michael Torralbaof the University Hospital of Guadalajara.

“A very significant part of the diagnostic delay is due to the immigrant population”.

The pneumonia for Pneumocystis jiroveciithe tuberculosis and the esophageal candidiasis Those are the three other incident infections in Spain, reaching 50-60% of all people diagnosed in the country. More specifically, over the period 2012-2020, pneumonia by Pneumocystis jirovecii was the AIDS-defining illness the most common (27.3%), followed by tuberculosis in any location (16.8%) and esophageal candidiasis (11.4%).

“A correct immunovirological evolution does not completely prevent an OI.”

“It should be remembered that despite HAART, there are infections that continue to be more frequent in HIV-infected subjects than in the general population, even with an improvement in the number of CD4+ lymphocytes, such as pneumococcal pneumonia, shingles or tuberculosis. Therefore, a correct immunovirological evolution it does not completely avoid an IO”, underline the coordinators of the document. This is why these experts attach particular importance to remembering that once an opportunistic infection has been diagnosed, it is necessary to start antiretroviral therapy within the first two weeks of diagnosis With a few exceptions such as cryptococcal meningitis due to increased mortality. In addition to the treatment and prophylaxis of this type of infection, the document also insists on the need to encourage compliance with the vaccination schedule.

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