TA5. Tratamentul cu Itraconazol (Orungal) la pacientii cu deficit imun celular
Au fost tratati cu Itraconazol (Orungal) 20 de pacienti cu candidoza (localizare bucala si genitala) si onicomicoza candidozica in cadrul unor boli care evolueaza cu deficit imun celular (5 cazuri HIV pozitive, 5 cazuri diabet, 4 cazuri tuberculoza activa, 6 cazuri cu insuficienta renala cronica, dializati).
Inainte si dupa tratament s-a investigat valoarea deficitului imun celular prin determinarea CD4+, CD8+, TNFa, valorile serice ale IL-2.
Pacientii care au candidoza au fost tratati cu Itraconazol (Orungal) 200 mg/zi timp de 15 zile.
Pacientii cu onicomicoza candidozica au fost tratati cu Itraconazol 400 mg/zi timp de o saptamana, a 5-a si a 9-a saptamana.
Dupa acest tratament 12 pacienti (8 cu candidoza orala/genitala si 4 cu onicomicoza) au prezentat examenul clinic si de laborator (direct si cultura) negativ. Dintre acestia numai 8 au prezentat valori imbunatatite ale parametrilor imuni testati, la inceputul tratamentului. Restul de 8 cazuri (4 candidoze bucale/genitale, 4 onicomicoze) au necesitat repetarea tratamentului initial cu imbunatatirea parametrilor imuni.
Actiunea antimicotica a itraconazolului este prezenta si la pacientii cu deficit imun fiind influentata de gradul si persistenta acestui deficit.
TA5. Itraconazole Treatment (Orungal) in Cellular Immune Defficient Patients
Twenty patients with candidosis (oral and genital localisation) and onicomicosis (by Candida albicans) were treated with Itraconazole (Orungal). They have presented cellular immune defficiences (5 cases HIV pozitive, 5 cases diabetes mellitus, 4 cases active tuberculosis, 6 cases cronic renale failure, dyalised).
Before and after the treatment cellular immune defficiency was investigated by CD4+, CD8+, TNFa and IL-2 determinations.
Patients with candidosis were treated with Itraconazole 400 mg/day during 1 week, treatment that was repeated in the 5th and in the 9th week.
After this treatment, 12 patients (8 with oral/genital candidosis, 4 with onicomicosis) have presented negative clinical and laboratory examinations. Eight of them have presented improvement of the immune parameters tested in the begining of the treatment.
The anti micotic action of Itraconazole is present even in the immune deficiency patients, being influenced by the persistence and the degree of the deficiency.