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关于艾滋病的五个误解,它们误导了研究和治疗方向。

Five myths about AIDS that have misdirected research and treatment.

作者信息

Root-Bernstein R S

机构信息

Department of Physiology, Michigan State University, East Lansing 48824, USA.

出版信息

Genetica. 1995;95(1-3):111-32. doi: 10.1007/BF01435005.

Abstract

A number of widely repeated and factually incorrect myths have pervaded the AIDS research literature, misdirecting research and treatment. Five of the most outstanding are: 1) that all risk groups develop AIDS at the same rate following HIV infection; 2) that there are no true seroreversions following HIV infection; 3) that antibody is protective against HIV infection; 4) that the only way to treat AIDS effectively is through retroviral therapies; and 5) that since HIV is so highly correlated with AIDS incidence, it must be the sole necessary and sufficient cause of AIDS. A huge body of research, reviewed in this paper, demonstrates the falsity of these myths. 1) The average number of years between HIV infection and AIDS is greater than 20 years for mild hemophiliacs, 14 years for young severe hemophiliacs, 10 years for old severe hemophiliacs, 10 years for homosexual men, 6 years for transfusion patients of all ages, 2 years for transplant patients, and 6 months for perinatally infected infants. These differences can only be explained in terms of risk-group associated cofactors. 2) Seroreversions are common. Between 10 and 20 percent of HIV-seronegative people in high risk groups have T-cell immunity to HIV, and may have had one or more verified positive HIV antibody tests in the past. 3) Antibody, far from being protective against HIV, appears to be highly diagnostic of loss of immune regulation of HIV, and some evidence of antibody-enhancement of infection exists. 4) Non-retroviral treatments of HIV infection, including safer sex practices, elimination of drug use, high nutrient diets, and limited reexposure to HIV and its cofactors have proven to be effective means of preventing or delaying onset of AIDS. 5) Many immunosuppressive factors, including drug use, multiple concurrent infections, and exposure to alloantigens, are as highly correlated with AIDS risk groups as HIV. These data are more consistent with AIDS being a multifactorial or synergistic disease than a monofactorial one.

摘要

一些广泛流传且与事实不符的错误观念充斥在艾滋病研究文献中,误导着研究和治疗方向。其中最突出的五个错误观念是:1)所有风险群体在感染艾滋病毒后发展为艾滋病的速度相同;2)艾滋病毒感染后不存在真正的血清学逆转;3)抗体可预防艾滋病毒感染;4)有效治疗艾滋病的唯一方法是通过逆转录病毒疗法;5)由于艾滋病毒与艾滋病发病率高度相关,它必定是导致艾滋病的唯一必要且充分的病因。本文所综述的大量研究证明了这些错误观念是错误的。1)对于轻度血友病患者,从感染艾滋病毒到发展为艾滋病的平均年数超过20年;年轻的重度血友病患者为14年;老年重度血友病患者为10年;同性恋男性为10年;各年龄段的输血患者为6年;移植患者为2年;围产期感染的婴儿为6个月。这些差异只能根据与风险群体相关的辅助因素来解释。2)血清学逆转很常见。高危群体中10%至20%的艾滋病毒血清阴性者对艾滋病毒具有T细胞免疫力,并且过去可能有过一次或多次经证实的艾滋病毒抗体检测呈阳性。3)抗体非但不能预防艾滋病毒感染,反而似乎高度表明艾滋病毒免疫调节功能丧失,并且存在一些抗体增强感染的证据。4)对艾滋病毒感染的非逆转录病毒治疗方法,包括安全性行为、戒毒、高营养饮食以及减少再次接触艾滋病毒及其辅助因素,已被证明是预防或延缓艾滋病发病的有效手段。5)许多免疫抑制因素,包括吸毒、多种并发感染以及接触同种异体抗原,与艾滋病毒一样,与艾滋病风险群体高度相关。这些数据更符合艾滋病是一种多因素或协同性疾病,而非单因素疾病的观点。

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