Drew W L, Buhles W, Erlich K S
Laboratory Medicine, University of California, San Francisco.
Infect Dis Clin North Am. 1988 Jun;2(2):495-509.
Herpes viruses (HSV, CMV, VZ) are very frequent in AIDS patients and often exist in a chronic or progressive form. Clinically evident CMV retinitis occurs in approximately 10 per cent of AIDS patients but can be effectively treated with a new nucleoside analogue DHPG (Gancyclovir). Perianal ulcers, proctitis, and other clinical syndromes caused by HSV can be effectively treated with acyclovir (ACV) and HSV recurrences can be prevented by daily administration of ACV. Zoster in a young adult may be the first indication of immunodeficiency due to HIV. Because VZV is less susceptible to ACV than HSV, intravenous ACV or high-dose oral therapy is required to achieve inhibitory blood levels.
疱疹病毒(单纯疱疹病毒、巨细胞病毒、水痘-带状疱疹病毒)在艾滋病患者中非常常见,且常以慢性或进行性形式存在。临床上明显的巨细胞病毒性视网膜炎约发生于10%的艾滋病患者中,但可用一种新的核苷类似物DHPG(更昔洛韦)进行有效治疗。由单纯疱疹病毒引起的肛周溃疡、直肠炎及其他临床综合征可用阿昔洛韦有效治疗,且每日服用阿昔洛韦可预防单纯疱疹病毒复发。年轻成人中的带状疱疹可能是由人类免疫缺陷病毒导致免疫缺陷的首个迹象。由于水痘-带状疱疹病毒比单纯疱疹病毒对阿昔洛韦更不敏感,因此需要静脉注射阿昔洛韦或大剂量口服治疗才能达到抑制血药浓度。