Quagliarello V
Yale J Biol Med. 1982 Sep-Dec;55(5-6):443-52.
A recently recognized syndrome of acquired immunodeficiency (Acquired Immunodeficiency Syndrome-AIDS) has arisen since June 1981. It has received international attention. The clinical spectrum consists of repeated opportunistic infections, rare malignancies, and autoimmune phenomena, occurring in previously healthy adults with no history of an immunologic disorder. The population subset at risk for this syndrome appears to be predominantly homosexual American males and intravenous drug abusers with rare cases being reported in heterosexuals, hemophiliacs, and foreign patients, especially Haitians. The immunologic aberrancy in all patients described appears limited to T-lymphocyte hyporesponsiveness and imbalance of T-helper and suppressor cells. This disordered immunoregulation is a consistent finding in all reported cases and appears to predispose to the opportunistic infections and malignancies which have been associated with a 40 percent mortality. The underlying factor responsible for the immunoregulatory defect is unknown but possible etiologies include a transmissible infectious agent, drug use, chronic antigen stimulation, and spermatozoa exposure. Treatment of the associated infections and malignancies has been a frustrating endeavor as many patients respond incompletely or relapse soon after successful treatment course. Preventive measures, including patient education, physician awareness, and immunomodulating agents, are discussed.
一种新近被确认的获得性免疫缺陷综合征（艾滋病）自1981年6月以来出现。它已受到国际关注。临床谱包括反复的机会性感染、罕见的恶性肿瘤和自身免疫现象，发生在既往健康且无免疫紊乱病史的成年人中。该综合征的高危人群似乎主要是美国男同性恋者和静脉注射吸毒者，异性恋者、血友病患者及外国患者（尤其是海地人）中报告的病例较少。所有已描述患者的免疫异常似乎仅限于T淋巴细胞反应低下以及辅助性T细胞和抑制性T细胞失衡。这种免疫调节紊乱在所有报告病例中均有一致发现，似乎易引发机会性感染和恶性肿瘤，这些与40%的死亡率相关。导致免疫调节缺陷的潜在因素尚不清楚，但可能的病因包括可传播的感染因子、药物使用、慢性抗原刺激和精子接触。对相关感染和恶性肿瘤的治疗一直是一项令人沮丧的工作，因为许多患者反应不完全或在成功治疗疗程后不久复发。文中讨论了预防措施，包括患者教育、医生意识和免疫调节剂。
