Frater John
Department of Infectious Diseases and Microbiology, John Radcliffe Hospital, Oxford, UK.
J HIV Ther. 2002 Nov;7(4):92-6.
Highly active antiretroviral therapy (HAART) has led to a reduction in HIV-related mortality and morbidity. Most patients who have benefited from HAART are infected with HIV-1 subtype B, which predominates in Western Europe, the USA and the rest of the industrialised world. However, most HIV-infected people live in sub-Saharan Africa, Asia and Eastern Europe. In these areas, subtypes other than B are responsible for the epidemic of HIV-1 infection. This review focuses on the clinical significance of HIV-1 infection with a non-B subtype. The increase in availability of HAART to developing countries together with the large number of HIV-1-infected immigrants being treated in the industrialised world means that data on the clinical response to therapy for non-B HIV-1 infections are becoming of greater practical relevance. If antiretroviral agents, which generally target subtype B, are less efficacious in non-B infections, this will have major clinical implications for therapeutic strategies. Data on drug susceptibility, clinical response and the development of resistance in non-B HIV-1 subtypes are discussed here.
高效抗逆转录病毒疗法（HAART）已使与艾滋病相关的死亡率和发病率有所降低。大多数从HAART中受益的患者感染的是HIV-1 B亚型，该亚型在西欧、美国及其他工业化国家占主导地位。然而，大多数艾滋病毒感染者生活在撒哈拉以南非洲、亚洲和东欧。在这些地区，除B亚型外的其他亚型导致了HIV-1感染的流行。本综述重点关注非B亚型HIV-1感染的临床意义。随着HAART在发展中国家的可及性增加，以及工业化国家中大量接受治疗的HIV-1感染移民，这意味着关于非B型HIV-1感染治疗临床反应的数据变得更具实际意义。如果通常针对B亚型的抗逆转录病毒药物在非B感染中疗效较差，这将对治疗策略产生重大临床影响。本文讨论了非B型HIV-1亚型的药物敏感性、临床反应和耐药性发展的数据。
