MetroHealth Medical Center and Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Adv Chronic Kidney Dis. 2010 Jan;17(1):59-71. doi: 10.1053/j.ackd.2009.08.013.
Antiretroviral therapy (ART) preserves kidney function in patients with human immunodeficiency virus (HIV)-associated nephropathy (HIVAN). Emerging data also document substantial renal benefits of ART in the general HIV-infected population, which is associated in part with suppression of HIV-1 viral replication. The extent to which the response to ART differs in persons with HIVAN compared with those with other HIV-associated kidney disorders is unknown. Beneficial effects of corticosteroids and angiotensin-converting enzyme inhibitors on kidney function also are suggested by retrospective cohort studies and uncontrolled trials of patients with HIVAN. Underexposure to ART or inadequate ART dosing in HIV-infected patients with CKD may curtail the optimal benefits that may be derived from this therapy.
抗逆转录病毒疗法(ART)可维持人类免疫缺陷病毒(HIV)相关性肾病(HIVAN)患者的肾脏功能。新出现的数据还表明,ART 在一般 HIV 感染人群中也具有显著的肾脏益处,这部分归因于抑制 HIV-1 病毒复制。与其他 HIV 相关肾脏疾病患者相比,HIVAN 患者对 ART 的反应程度存在差异,目前尚不清楚。回顾性队列研究和对 HIVAN 患者的非对照试验也提示皮质类固醇和血管紧张素转换酶抑制剂对肾脏功能具有有益作用。慢性肾脏病(CKD)合并 HIV 感染患者的 ART 治疗不足或剂量不足,可能会限制从这种治疗中获得的最佳获益。