[HIV follow-up. New data on pathophysiology and treatment of psychiatric disturbances in the course of AIDS].

In the article summarized here, the authors present the most important achievements in the research on pathogenesis and treatment of AIDS, with particular consideration of psychiatric disturbances occurring in the course of infection by AIDS. Since the 1 st of January 1993, a new definition of AIDS has been obligatory. This definition is based on immunological criteria (HIV seropositivity and number of limphocytes CD4 < 200/microliter). There is a considerable progress in the scope of laboratory diagnostics of the infection by HIV (a method of polimerase chain reaction has been introduced) and in the laboratory and clinical appraisal of the development of AIDS. An astonishing capability of HIV to mutation has been proved. Asymptomatic HIV carriers show about 10(6) genetically different variants of HIV, and subjects showing symptoms of AIDS may prove over 10(8) HIV variants. This extreme dynamics of HIV causes that even the subjects who are not pharmacologically treated (but who are HIV seropositive) indicate the formation of mutants resistant to medicines applied in the treatment of AIDS. The only one and relatively efficient means of treatment of AIDS is combined therapy applied from the first weeks of the infection by HIV. Professor Luc Montanier, a co-discoverer of HIV virus suggests that the most efficient therapy is that by a medicine known as 3TC, in combination with DDI or DDC and with one of the drugs named anti-proteases. This method of treatment inhibits the activity of virus protease--one of 3 enzymes indispensable for replication of HIV. Recently (at the turn of the years 1995/1996) three medicines from the anti-protease group: saquinavir, ritonavir and indinavir have been admitted to be used for treatment of AIDS by the American agency for the control of drugs and foods. FDA, in the exceptionally short time. In the article there is also a description of a concept represented by R. Price, concerning the origin of psychiatric disturbances in the course of AIDS, as well as some results of recent clinical studies on psychiatric disturbances in the course of AIDS.