Skin test responses as predictors of tuberculosis infections and of progression in HIV-infected persons

Article Abstract:

Response to delayed type hypersensitivity (DTH) skin testing may be different in individuals with HIV infection than in those without. This type of testing includes the purified protein derivative (PPD) test for exposure to tuberculosis (TB). A research study found that the incidence of TB was high among HIV-infected individuals from Madrid regardless of whether they are reactive to PPD or anergic. Anergy is a reduction in response to an allergen despite sensitization. Individuals from this population would benefit from preventive treatment for TB. Another study examined DTH and PPD reactivity in predominantly homosexual men. It found over half the men were PPD-negative and nonanergic. Preventive treatment for TB may not be be necessary for individuals from population with a low incidence of TB. A third study found that DTH skin testing may predict the progression of HIV infection. DTH skin testing may be a simple and inexpensive method to evaluate cellular immunity in HIV-positive individuals.

Editorial, Diagnosis, Tuberculosis, Delayed hypersensitivity

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Hyperkalemia in hospitalized patients treated with trimethoprim-sulfamethoxazole

Article Abstract:

Standard treatment with trimethoprim-sulfamethoxazole may cause an increase in blood levels of potassium. Abnormally high blood levels of potassium can lead to a condition called hyperkalemia characterized by irregular heartbeats and, in severe cases, paralysis. Researchers studied the blood chemistry of 80 hospitalized patients treated with trimethoprim-sulfamethoxazole for a variety of infections (study group) and compared these effects to 25 hospitalized patients treated with other antibiotics (the control group). The study group had significantly elevated potassium levels. These levels peaked 4 to 5 days after treatment began. Patients who began treatment with an elevated creatinine blood level experienced a greater increase in potassium levels than those with lower initial creatinine levels, particularly diabetic patients. There was no association between age and potassium levels. There were no significant variations in blood chemistry in the control group.

Causes of, Mineral metabolism, Potassium metabolism

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Trimethoprim-sulfamethoxazole induces reversible hyperkalemia

Article Abstract:

Treatment with high-dose trimethoprim-sulfamethoxazole (Tmp-Smx) for Pneumocystis carinii pneumonia may cause hyperkalemia in patients with HIV infection. Hyperkalemia is abnormally high blood levels of potassium. Among 51 patients hospitalized for HIV infection, 25 were treated with high-dose Tmp-Smx for P. carinii pneumonia and 26 were not been treated with Tmp-Smx (control group). Blood levels of potassium were similar in the two groups of patients before treatment with Tmp-Smx was begun. Potassium concentration increased progressively during treatment with Tmp-Smx among members of the treatment group, but declined after treatment was discontinued. Blood levels of potassium remained the same in patients from the control group. Patients treated with high-dose Tmp-Smx should be monitored closely for increases in their blood levels of potassium.

Health aspects, Physiological aspects, Drug therapy, Potassium in the body

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