Llibre Josep M, Falco Vicenç, Tural Cristina, Negredo Eugenia, Pineda Juan A, Muñoz Jose, Ortega Enrique, Videla Sebastia, Sirera Guillem, Martinez Esteban, Miralles Celia, Iribarren Josean, Galindo Maria J, Domingo Pere, d'Arminio-Monforte Antonella, Miro Jose M, Clotet Bonaventura
Lluita Contra la SIDA Foundation, University Hospital Germans Trias, Barcelona 08916, Spain.
Curr HIV Res. 2009 Jul;7(4):365-77. doi: 10.2174/157016209788680633.
The spectrum of complications emerging in successfully treated HIV-infected patients has dramatically changed since the advent of HAART. Typical AIDS-defining illnesses have been substituted by new comorbid conditions that threaten even those patients who maintain virologic suppression. Proper management of cardiovascular risk, and early diagnosis of AIDS-related and, particularly, non-AIDS-related malignancies (including papilomavirus-related neoplasms) must be introduced into the routine of care. Hot areas of investigation include HIV-associated neurocognitive disorders, hepatitis B and C coinfection, non-alcoholic fatty liver disease, progressive multifocal leukoencephalopathy and tuberculosis. Bone and kidney long-term toxicities and lipoatrophy remain as issues of paramount importance. The identification and early treatment of immune reconstitution disease is also of major interest, specially in those patients starting their antiretroviral treatment with severe CD4 cell depletion. The present review focuses on these twelve areas of increasing interest for physicians currently facing successfully treated HIV+ patients.
自高效抗逆转录病毒治疗（HAART）出现以来，成功治疗的HIV感染患者中出现的并发症谱发生了巨大变化。典型的艾滋病定义疾病已被新的合并症所取代，这些合并症甚至对那些维持病毒学抑制的患者构成威胁。必须将心血管风险的妥善管理以及艾滋病相关尤其是非艾滋病相关恶性肿瘤（包括乳头瘤病毒相关肿瘤）的早期诊断纳入常规护理。研究的热点领域包括HIV相关神经认知障碍、乙型和丙型肝炎合并感染、非酒精性脂肪性肝病、进行性多灶性白质脑病和结核病。骨骼和肾脏的长期毒性以及脂肪萎缩仍然是至关重要的问题。免疫重建疾病的识别和早期治疗也备受关注，特别是在那些开始抗逆转录病毒治疗时CD4细胞严重耗竭的患者中。本综述聚焦于目前面对成功治疗的HIV阳性患者的医生日益关注的这十二个领域。
