Coulaud J P, Thimossat P
Ann Pathol. 1986;6(4-5):255-60.
The discovery in 1983 of the virus subsequently designated as HIV and its detection in several organs and lymphoid and others cells has led to greater knowledge of the clinical manifestations related to infection with the virus. Certain manifestations seem to be directly related to the viral infection. These are essentially acute infectious manifestations occurring with the primary infection, neurological disorders involving CNS, and more classical manifestations known from the start such as general chronic lymphadenopathy, ARC or full blown AIDS. Others clinical manifestations seem to be indirectly related to the virus, and certain appear to be an immune reaction to the virus (peripheral neuropathy like Landry Guillain Barré syndrome or thrombopenic purpura). Other manifestations such as bronchial or pancreatic carcinomas may be due to virus-induced immunodepression. Finally, some pathological states are probably related to co-infections such as lingual hairy-cell leukoplakia. One of the major current difficulties is the determination of a clinical rather than epidemiological classification of these manifestations so as to carry out a multicentric therapeutic protocol. Further therapeutic trials will be carried out on patients who maintain a subnormal immune status, and only the study of the development of several hundred patients will determine whether the treatment really succeeds by preventing the development to the next stage of the disease.
1983年发现了后来被命名为HIV的病毒,并且在多个器官以及淋巴和其他细胞中检测到该病毒,这使人们对与该病毒感染相关的临床表现有了更多了解。某些表现似乎与病毒感染直接相关。这些主要是初次感染时出现的急性感染表现、累及中枢神经系统的神经紊乱,以及从一开始就已知的更典型表现,如全身性慢性淋巴结病、艾滋病相关综合征(ARC)或全面的艾滋病。其他临床表现似乎与病毒间接相关,某些表现似乎是对病毒的免疫反应(如兰德里-古兰-巴雷综合征样的周围神经病或血小板减少性紫癜)。其他表现,如支气管癌或胰腺癌,可能是由病毒引起的免疫抑制所致。最后,一些病理状态可能与合并感染有关,如舌部毛状细胞白斑。当前的主要困难之一是确定这些表现的临床而非流行病学分类,以便实施多中心治疗方案。将对免疫状态低于正常水平的患者进行进一步的治疗试验,只有对数百名患者的病情发展进行研究,才能确定治疗是否真的通过预防疾病发展到下一阶段而取得成功。