Immunocompromised individuals

Antibodies against HCV (anti-HCV) in the blood indicate infection with the HCV. If the infection persists for more than 6 months and viral replication is confirmed by HCV RNA levels, then the person has chronic hepatitis C. Chronic disease may be due to an ineffective host immune system against the HCV. Cytotoxic T lymphocytes are ineffective in eradicating the HCV, thus allowing persistent damage to hepatic cells. Therefore, immunocompromised individuals are less likely to eliminate HCV.12... 

Signs and Symptoms Symptoms in immunocompromised individuals may include fever, difficulty breathing (dyspnea), nonproductive cough, bloody sputum (hemoptysis), bloody nose (epistaxis), a vague feeling of bodily discomfort (malaise), pneumonia, weakness, chest pain, and anorexia. May progress to inflammation of the eyes (endophthalmitis), sensitivity to light (photophobia), and/or inflammation of the heart (endocarditis). May also cause abscesses in the heart, kidneys, liver, spleen, other soft tissue, or the bone. If the central nervous system becomes involved, can cause altered mental states and seizures. 

In general, severely immunocompromised individuals should not receive live vaccines. 

The zoster vaccine is recommended for immunocompetent individuals older than 60 years. It should not be used in immunocompromised individuals, including those with HIV or malignancies or in pregnant women. 

Ginseng extracts have also been shown to modulate the immune responsiveness of human leukocytes in vitro. For example, extracts from P. ginseng were reported to increase NK cell function and ADCC in PBMC from both healthy and immunocompromised individuals [18]. In addition, similar extracts and their degradation products displayed anti-complement activity [46]. In contrast to the mouse data described above, a standardized ginseng extract (Gerimax) by itself (no inflammatory stimulus) induced the production of IL-12 (but not IL-10) by PBMC from healthy test subjects [47],... 

What level of immunosuppression will predispose healthy or immunocompromised individuals to increased risk of infections or tumors ... 

Intravenous acyclovir is used in the treatment of herpes simplex encephalitis, neonatal HSV infection, and mucocutaneous HSV infection in immunocompromised individuals. Acyclovir ointment is used in the treatment of initial genital herpes but is not effective for recurrent disease. Ophthalmic acyclovir formulations, although not available in the United States, are effective in the treatment of herpes keratoconjunctivitis. 

Immunocompromised individuals and patients receiving immunosuppressive drugs or cancer chemother-... 

Valacyclovir demonstrates efficacy similar to that of acyclovir but requires less frequent oral dosing. While indicated for the treatment of herpes zoster and the treatment and suppression of HSV, it is not approved for use in immunocompromised individuals or for the therapy of disseminated herpes zoster. 

Foscarnet is approved for the treatment of acyclovir-resistant mucocutaneous HSV infections in immunocompromised individuals. A clinical study indicated that it is more effective than vidarabine. Foscarnet has also been used for the treatment of acyclovir-resistant VZV and nonretinitis forms of CMV infection, although its efficacy is not so well established. 

Intravenous ganciclovir is indicated for the treatment of CMV retinitis in immunocompromised individuals, including those with AIDS, and for the prevention of CMV infection in organ transplant recipients. Oral ganciclovir is less effective than the intravenous preparation but carries a lower risk of adverse effects. It is... 

San Raffaele Telethon Institute for Gene Therapy is developing an adenosine deaminase transduced hematopoietic stem cell therapy for the potential intravenous treatment of adenosine deaminase deficiency in severe combined immunocompromised individuals (ADA-SCID). 

HCMV, a p-herpesvirus, is an opportunistic pathogen in immunocompromised individuals such as AIDS patients and organ transplant recipients [411]. Thus HCMV protease has become a viable target for antiviral chemotherapy [412, 413]. 

Fungal infections can range from superficial, noninvasive diseases of normal children and adults to life-threatening systemic diseases of immunocompromised individuals. The incidence of disseminated infections has grown in the past decade, at least in part as a consequence of changing clinical practices. With the use of effective broad-... 

Conant MA Fungal infections in immunocompromised individuals. Dermatol Clin 1996 14 155-162. 

These are generally not influenced by the genetic predisposition of the exposed individual, but on actual outbreak of infections and the general immune status prior to exposition. This explains why immunosupressive xenobiotics are most likely to have clinical consequences in immunocompromised individuals such as young children, the elderly, and transplant recipients. 

Propionibacterium acnes, commonly isolated from the skin, is the most frequently found anaerobe. Factors and conditions such as blepharitis, dry eye syndrome, meibomian gland dysfunction, and contact lens use may influence the composition of the normal flora or cause disruption to normal epithelial microbial barriers, either of which can lead to disease in susceptible patients. Although immunocompromised individuals may harbor Candida albicans, fungi are considered opportunistic pathogens. Little evidence supports the existence of any indigenous fungi in the normal conjunctival flora. 

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