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在减肥手术后失去对疹抑制的控制
Shyam Samraj1, Kimberley Olasoji2, Raj Patel2,3
1Department of Guys Campus, Kings GKT Medical School, University of London, London, UK.
International journal of STD & AIDS
|June 25, 2024
概括
腹腔外科手术可以降低生殖器疹 (HSV-2) 的抗病毒有效性. 在Roux-en-Y手术后,从阿西克洛维尔切换到瓦拉西克洛维尔恢复了疹抑制,这表明积极的治疗改变可以预防并发症.
科学领域:
- 病毒学 病毒学
- 胃肠病学 胃肠病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 复发性生殖器疹 (HSV-2) 通常通过抑制性抗病毒疗法进行管理.
- 腹部外科手术,特别是Roux-en-Y手术,对于治疗肥胖越来越常见.
- 腹部外科手术后的胃肠道变化可能会影响药物吸收和疗效.
研究的目的:
- 在Roux-en-Y减肥手术后的抑制治疗期间报告复发性生殖器疹 (HSV-2) 突破病例.
- 研究减肥手术对抗病毒疗效对HSV-2抑制的影响.
- 突出对Roux-en-Y手术后调整抗病毒策略的潜在需要.
主要方法:
- 一名42岁的HSV-2感染女性接受了阿西克洛维尔抑制疗法的病例报告.
- 在Roux-en-Y减肥手术后监测HSV-2复发和并发症.
- 将抗病毒疗法从阿西克洛维尔调整为瓦拉西克洛维尔.
主要成果:
- 尽管剂量升级,但阿西克洛维尔400毫克每天两次对Roux-en-Y手术后的HSV-2抑制变得无效.
- 手术后发生了严重的疹相关并发症.
- 切换到瓦拉西克洛维尔500毫克每天两次成功地恢复了疹抑制.
结论:
- 在Roux-en-Y的减肥手术可以显著改变口服抗病毒药物的药理动力学,如阿西克洛维尔.
- 针对HSV-2的抗病毒疗法可能需要在Roux-en-Y手术后因吸收不良而进行修改.
- 建议在手术前考虑并可能调整疹抗病毒疗法,以防止突破性感染.
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