Sierra-Madero J G
Departamento de Infectología, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Salud Publica Mex. 1995 Nov-Dec;37(6):520-4.
Early medical intervention in patients with HIV infection is beneficial even in asymptomatic individuals. Medical care in these patients consists of the use of antiretroviral drugs, drugs to prevent opportunistic infections, vaccines and comprehensive psychosocial support. It is important to determine the stage of the natural history of the disease at any given moment. Besides clinical data, the determination of CD4+ T-lymphocytes is useful to make decisions related to the institution of antiretroviral drugs and preventive therapy for opportunistic infections. Present evidence shows a clear benefit of starting antiretroviral drugs in every patient with AIDS or AIDS related complex and also supports the use of these drugs in early stages of the disease. Preventive therapy against Pneumocystis carinii has to be instituted in every patient with CD4 lymphocyte counts below 200/mm3. Prophylactic therapy may also be necessary to prevent tuberculosis, toxoplasmosis and M. avium. It is likely that future studies will show some benefit with the use of additional preventive strategies for other frequent infections such as Cytomegalovirus and Cryptosporidium.
即使对于无症状的HIV感染患者，早期医学干预也是有益的。这些患者的医疗护理包括使用抗逆转录病毒药物、预防机会性感染的药物、疫苗以及全面的社会心理支持。在任何给定时刻确定疾病自然史的阶段都很重要。除了临床数据外，测定CD4+ T淋巴细胞对于做出有关抗逆转录病毒药物的使用和机会性感染预防性治疗的决策很有用。目前的证据表明，对每一位患有艾滋病或艾滋病相关综合征的患者开始使用抗逆转录病毒药物都有明显益处，并且也支持在疾病早期阶段使用这些药物。对于每一位CD4淋巴细胞计数低于200/mm3的患者，都必须实施针对卡氏肺孢子虫的预防性治疗。预防结核病、弓形虫病和鸟分枝杆菌也可能需要进行预防性治疗。未来的研究可能会表明，对其他常见感染（如巨细胞病毒和隐孢子虫）采用额外的预防策略会有一些益处。
