Department of Internal Medicine, Henry Ford Health System, Detroit, MI 48202, USA.
Adv Chronic Kidney Dis. 2010 Jan;17(1):102-10. doi: 10.1053/j.ackd.2009.08.014.
Patients infected with human immunodeficiency virus (HIV) often progress to ESRD. In the era of highly active antiretroviral therapy, the care of these patients has become increasingly complex as survival has improved. Patients infected with HIV who also have ESRD are at risk for critical interactions between medication regimens to treat both of these conditions. Within this population, hemo- and peritoneal dialysis as well as kidney transplantation are life sustaining but present a host of obstacles related to HIV monitoring and risk of transmission, access thrombosis, infection, and rejection. Knowledge of antiretroviral regimens, drug interactions, and HIV resistance as well as the management of ESRD in the presence of HIV infection will improve the care of these unique patients.
感染人类免疫缺陷病毒 (HIV) 的患者常进展为终末期肾病(ESRD)。在高效抗逆转录病毒治疗时代,随着患者生存率的提高,HIV 感染者的生存状况日益复杂,他们的治疗方案也更加复杂。HIV 感染者同时患有 ESRD 时,两种疾病的药物治疗方案之间存在发生严重相互作用的风险。在此人群中,血液透析和腹膜透析以及肾移植可以维持生命,但存在与 HIV 监测和传播风险、血栓形成、感染和排斥反应相关的诸多障碍。了解抗逆转录病毒治疗方案、药物相互作用和 HIV 耐药性,以及在 HIV 感染情况下管理 ESRD,将改善这些特殊患者的护理。