Calza Leonardo, Manfredi Roberto, Chiodo Francesco
Sezione di Malattie Infettive, Dipartimento di Medicina Clinica Specialistica e Sperimentale, Policlinico S.Orsola, Alma Mater Studiorum Università, Bologna.
Recenti Prog Med. 2006 Dec;97(12):771-80.
Highly active antiretroviral therapy (HAART) has had a significant impact on the natural history of human immunodeficiency virus (HIV) infection, leading to a remarkable decrease in its morbidity and mortality, but is frequently associated with clinical and metabolic complications. Fat redistribution syndrome or lipodystrophy, hyperlipidaemia, insulin resistance and diabetes have been extensively reported in subjects treated with new, potent antiretroviral regimens. The potential long-term consequences of HAART-associated metabolic alterations are not completely understood, but an increased risk of premature coronary artery disease has been reported in young HIV-positive persons receiving HAART. On the other hand, the use of potent and expensive antiretroviral combinations in developing countries is very restricted and is unlikely to slow the AIDS pandemic, leading to a desperate need for a vaccine. Despite 20 years of effort, it is still a long way off, even also considerable progress has been made in understanding this problem.
高效抗逆转录病毒疗法（HAART）对人类免疫缺陷病毒（HIV）感染的自然病程产生了重大影响，导致其发病率和死亡率显著下降，但常伴有临床和代谢并发症。脂肪重新分布综合征或脂肪营养不良、高脂血症、胰岛素抵抗和糖尿病在接受新型强效抗逆转录病毒治疗方案的患者中已有广泛报道。HAART相关代谢改变的潜在长期后果尚未完全明了，但据报道，接受HAART的年轻HIV阳性者患早发性冠状动脉疾病的风险增加。另一方面，在发展中国家，强效且昂贵的抗逆转录病毒联合疗法的使用非常有限，不太可能减缓艾滋病的流行，这导致对疫苗的迫切需求。尽管经过了20年的努力，但即便在理解这一问题方面已经取得了相当大的进展，距离成功仍有很长的路要走。
