Ponce-de León S, Reyes-Terán G
División de Epidemiología Hospitalaria, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Salud Publica Mex. 1995 Nov-Dec;37(6):525-32.
New concepts regarding the medical care of AIDS patients are described in this paper. Currently, new pharmacologic agents and their combinations with zidovudine are being evaluated in clinical trials to determine their efficacy in the treatment of HIV-infected patients. Nevertheless, zidovudine is still the mainstay of therapy in AIDS patients. Significant findings regarding monotherapy, combination therapy, and immunotherapy for the treatment of HIV infection are also discussed. There is considerable controversy on the optimal time to initiate therapy with antiretroviral agents. The clinician's decision to initiate antiretroviral therapy should consider the expectations of patients in the context of relative benefits and potential toxicities of therapy. The clinician must be aware that rigid universal therapy guidelines for all patients may not be appropriate. Currently available drugs are only palliative and the development of innovative therapeutic strategies for early intervention is indispensable on the basis of recent knowledge of the extremely complex pathogenesis of HIV infection. At present time, the medical care of AIDS patients should be individualized and done in the context of the patient-physician relationship for therapeutic and nontherapeutic decisions.
本文介绍了有关艾滋病患者医疗护理的新概念。目前，新的药物制剂及其与齐多夫定的联合用药正在临床试验中进行评估，以确定其对HIV感染患者的治疗效果。尽管如此，齐多夫定仍然是艾滋病患者治疗的主要药物。文中还讨论了关于HIV感染治疗的单药治疗、联合治疗和免疫治疗的重要发现。对于何时开始使用抗逆转录病毒药物进行治疗，存在相当大的争议。临床医生决定开始抗逆转录病毒治疗时，应在治疗的相对益处和潜在毒性的背景下考虑患者的期望。临床医生必须意识到，对所有患者采用严格统一的治疗指南可能并不合适。目前可用的药物只是缓解性的，基于对HIV感染极其复杂的发病机制的最新认识，开发早期干预的创新治疗策略必不可少。目前，艾滋病患者的医疗护理应个体化，并在医患关系的背景下做出治疗和非治疗决策。
