Vergis E N, Mellors J W
Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. verge+@pitt.edu
Infect Dis Clin North Am. 2000 Dec;14(4):809-25, v-vi. doi: 10.1016/s0891-5520(05)70135-5.
Infection with the human immunodeficiency virus type 1 (HIV-1) results in progressive loss of immune function marked by depletion of the CD4+ T-lymphocytes, leading to opportunistic infections and malignancies characteristic of AIDS. Although both host and viral determinants influence the rate of disease progression, the median time from initial infection to the development of AIDS among untreated patients ranges from 8 to 10 years. The clinical staging of HIV disease and the relative risk of developing opportunistic infections historically relied on the CD4+ T-lymphocyte counts. Although more recent studies have shown the importance of viral load quantitation in determining the rate of disease progression, it is still useful to categorize HIV disease stage on the basis of the degree of immunodeficiency: early disease (CD4+ > 500 cells/mL), mid-stage disease (CD4+ between 200 and 500 cells/mL), and end-stage disease (CD4+ < 50 cell/mL). This article reviews the natural history of HIV disease at each stage of HIV-1 infection with emphasis on acute infection and the major virologic and immunologic determinants of disease progression.
感染1型人类免疫缺陷病毒（HIV-1）会导致免疫功能逐渐丧失，其特征是CD4+ T淋巴细胞耗竭，进而引发艾滋病特有的机会性感染和恶性肿瘤。尽管宿主和病毒因素都会影响疾病进展速度，但未经治疗的患者从初次感染到发展为艾滋病的中位时间为8至10年。HIV疾病的临床分期以及发生机会性感染的相对风险在历史上一直依赖于CD4+ T淋巴细胞计数。尽管最近的研究表明病毒载量定量在确定疾病进展速度方面很重要，但根据免疫缺陷程度对HIV疾病阶段进行分类仍然是有用的：早期疾病（CD4+>500个细胞/毫升）、中期疾病（CD4+在200至500个细胞/毫升之间）和末期疾病（CD4+<50个细胞/毫升）。本文回顾了HIV-1感染各阶段HIV疾病的自然史，重点是急性感染以及疾病进展的主要病毒学和免疫学决定因素。
