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[艾滋病中的弓形虫病]

[Toxoplasmosis in AIDS].

作者信息

Leport C, Remington J S

机构信息

Service des Maladies infectieuses et tropicales, Hôpital Bichat-Claude Bernard, Paris.

出版信息

Presse Med. 1992;21(25):1165-71.

PMID:1409466
Abstract

Toxoplasmosis is one of the major opportunistic infections observed in France in 15 to 37 percent of HIV-infected patients. Its main manifestation is encephalitis. Other, less frequent manifestations are chorioretinitis, pneumonia or disseminated toxoplasmosis. The conventional treatment is a combination of pyrimethamine 50-75 mg/day and sulfadiazine 6-8 g/day. Acute therapy should be pursued for at least 3 weeks or until optimal response is achieved, i.e. 6 to 8 weeks in most cases. The pyrimethamine-clindamycin combination in doses of at least 2.4 g/day is a possible alternative. Other drugs are being studied, but there is still a need for new drugs active against the parasite, that could be used in humans. In HIV-infected patients treatment should be maintained lifelong to prevent relapses. Maintenance regimens use the same drugs as acute therapy but in lower doses. The main field of research is primary prophylaxis of toxoplasmosis in HIV-infected patients.

摘要

弓形虫病是法国观察到的主要机会性感染之一,在15%至37%的艾滋病毒感染患者中出现。其主要表现为脑炎。其他较不常见的表现为脉络膜视网膜炎、肺炎或播散性弓形虫病。传统治疗方法是乙胺嘧啶50 - 75毫克/天和磺胺嘧啶6 - 8克/天联合使用。急性治疗应持续至少3周,或直至取得最佳反应,即在大多数情况下为6至8周。乙胺嘧啶 - 克林霉素联合用药,剂量至少为2.4克/天,是一种可能的替代方案。其他药物正在研究中,但仍需要对人体有效的抗寄生虫新药。在艾滋病毒感染患者中,治疗应终身维持以防止复发。维持治疗方案使用与急性治疗相同的药物,但剂量较低。主要研究领域是艾滋病毒感染患者弓形虫病的一级预防。

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