Hawkins Trevor
Southwest CARE Center, University of New Mexico, Santa Fe, 87505, USA.
AIDS Patient Care STDS. 2006 Jan;20(1):6-18. doi: 10.1089/apc.2006.20.6.
In the early years of the AIDS epidemic, HIV infection was associated with visible signs and symptoms, adding to the stigma associated with the disease. Physical manifestations associated with HIV infection included muscle wasting, lymphadenopathy, Kaposi's sarcoma, candidiasis, molluscum contagiosum, and hairy leukoplakia. With the advent of antiretroviral therapy, particularly the introduction of highly active antiretroviral therapy in 1996, many of these outward manifestations of the disease became rare. Ironically, however, the treatments used to control HIV infection (and its visible markers) have themselves been associated with appearance-related side effects. Patients may develop changes in fat distribution, rashes, skin hyperpigmentation, or paronychia. These effects not only have cosmetic and psychological consequences but also may decrease adherence to therapy, potentially causing regimen failure and drug resistance. Newer antiretroviral agents offer improved potency, more convenient dosing, and more treatment options with the potential for fewer side effects and drug interactions, which should foster optimal adherence by the patient. However, these newer drugs are also associated with appearance-related side effects, which must be considered in the selection of treatment regimens. This paper reviews the appearance-related side effects associated with classes of antiretroviral drugs as well as individual agents, including the newer antiretrovirals.
在艾滋病流行的早期，HIV感染与明显的体征和症状相关联，这加剧了与该疾病相关的污名化。与HIV感染相关的身体表现包括肌肉萎缩、淋巴结病、卡波西肉瘤、念珠菌病、传染性软疣和毛状白斑。随着抗逆转录病毒疗法的出现，特别是1996年引入高效抗逆转录病毒疗法后，该疾病的许多这些外在表现变得罕见。然而，具有讽刺意味的是，用于控制HIV感染（及其可见标志物）的治疗方法本身却与外观相关的副作用有关。患者可能会出现脂肪分布改变、皮疹、皮肤色素沉着或甲沟炎。这些影响不仅会产生美容和心理后果，还可能降低对治疗的依从性，从而可能导致治疗方案失败和耐药性。新型抗逆转录病毒药物具有更高的效力、更方便的给药方式以及更多的治疗选择，副作用和药物相互作用可能更少，这应该有助于患者实现最佳依从性。然而，这些新型药物也与外观相关的副作用有关，在选择治疗方案时必须予以考虑。本文综述了与各类抗逆转录病毒药物以及个别药物（包括新型抗逆转录病毒药物）相关的外观相关副作用。
