Katzenstein D A
Center for AIDS Research, Stanford University, California, USA.
West J Med. 1997 May;166(5):319-25.
It has become clear that the acquired immunodeficiency syndrome follows continuous replication of the human immunodeficiency virus (HIV) and a decrease in immune capability, most obviously a decline in the number of CD4 lymphocytes. An understanding of key elements in the infectious life cycle of HIV has led to the development of potent antiretroviral drugs selectively targeting unique reverse transcriptase and protease enzymes of the virus. Completed clinical trials have shown that antiretroviral therapy for HIV infection, begun early, reduces viral replication and reverses the decline in CD4 lymphocyte numbers. Recent studies of combination therapies have shown that decreases in plasma HIV viremia to low levels and sustained increases in CD4 cell numbers are associated with longer survival. Potent combination regimens including protease inhibitors and non-nucleoside reverse transcriptase inhibitors suppress detectable viral replication and have demonstrated clinical benefits in patients with advanced disease. Progress in antiretroviral therapy and methods to monitor responses to treatment are providing new hope in the treatment of HIV infection.
现已明确，获得性免疫缺陷综合征是在人类免疫缺陷病毒（HIV）持续复制以及免疫能力下降（最明显的是CD4淋巴细胞数量减少）之后出现的。对HIV感染生命周期关键要素的了解促使了强效抗逆转录病毒药物的研发，这些药物选择性地靶向病毒独特的逆转录酶和蛋白酶。已完成的临床试验表明，早期开始的针对HIV感染的抗逆转录病毒疗法可减少病毒复制，并逆转CD4淋巴细胞数量的下降。近期对联合疗法的研究表明，血浆HIV病毒血症降至低水平以及CD4细胞数量持续增加与更长的生存期相关。包括蛋白酶抑制剂和非核苷类逆转录酶抑制剂在内的强效联合治疗方案可抑制可检测到的病毒复制，并已在晚期疾病患者中显示出临床益处。抗逆转录病毒疗法的进展以及监测治疗反应的方法为HIV感染的治疗带来了新希望。
