Olczak Anita, Pawłowska Małgorzata, Drózdz Wiktor
Klinika i Katedra Chorób Zakaźnych i Hepatologii CM UMK.
Przegl Epidemiol. 2008;62(1):155-62.
The use of antiretroviral therapy has resulted in reduction in HIV related morbidity and mortality but antiretroviral treatment have been associated with long term toxicities. High prevalence of premature osteopenia, osteoporosis and osteonecrosis have been recently detected in patients infected with HIV. The pathogenesis of this bone disorders is still unclear and probably multifactoral. Earlier studies have implicated specific antiretroviral medications as causative factors in the development of osteopenia. Patients not receiving antiretrovirals also have a higher than expected prevalence of reduced BMD, which suggests that HIV itself may be a contributing factor, mediated by immune activation and cytokines. Improved understanding of the pathogenesis of these bone disorders should result in better prevention and treatment.
抗逆转录病毒疗法的使用已降低了与艾滋病病毒相关的发病率和死亡率,但抗逆转录病毒治疗一直与长期毒性相关。最近在感染艾滋病病毒的患者中检测到过早出现骨质减少、骨质疏松和骨坏死的高发生率。这种骨骼疾病的发病机制仍不清楚,可能是多因素的。早期研究认为特定的抗逆转录病毒药物是骨质减少发生的致病因素。未接受抗逆转录病毒治疗的患者骨密度降低的发生率也高于预期,这表明艾滋病病毒本身可能是一个促成因素,由免疫激活和细胞因子介导。对这些骨骼疾病发病机制的更好理解应能带来更好的预防和治疗。