Effective treatment of a highly active antiretroviral regimen through jejunostomy. (June 2014)

• Record Type: Journal Article
• Authors: Florit-Sureda, Marta; Giner-Soriano, Maria; Antonio, Javier Mateu-de; Carmona-Yelo, Alexia
• Is Part Of: Journal of chemotherapy. Volume 26:Number 3(2014:Jun.)
• Page Start: 176
• Page End: 179
• Publication Date: 2014-06
• Subjects: Acquired immunodeficiency syndrome, -- Biological availability, -- Critical illness, -- Drug administration routes, -- Highly active antiretroviral therapy, -- Jejunostomy; Chemotherapy -- Periodicals; Drug Therapy -- Periodicals; 615.58
• DOI: 10.1179/1973947813Y.0000000140
• Languages: English
• ISSNs: 1120-009X

Abstract

Abstract : 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.