Nasierowski T, Matsumoto H
I Klinika Psychiatryczna AM w Warszawie.
Psychiatr Pol. 1997 Mar-Apr;31(2):197-209.
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.
在本文总结的文章中，作者介绍了艾滋病发病机制和治疗研究中的最重要成果，尤其考虑了艾滋病感染过程中出现的精神障碍。自1993年1月1日起，艾滋病的新定义成为强制性规定。该定义基于免疫学标准（HIV血清阳性和CD4淋巴细胞数量<200/微升）。在HIV感染的实验室诊断范围（引入了聚合酶链反应方法）以及艾滋病发展的实验室和临床评估方面都取得了相当大的进展。已证明HIV具有惊人的突变能力。无症状HIV携带者显示出约10^6种基因不同的HIV变体，而出现艾滋病症状的受试者可能有超过10^8种HIV变体。HIV的这种极端动态性导致即使未接受药物治疗（但HIV血清阳性）的受试者也会出现对用于治疗艾滋病的药物产生耐药性的突变体。治疗艾滋病的唯一且相对有效的方法是在感染HIV的最初几周就应用联合疗法。HIV病毒的共同发现者吕克·蒙塔尼耶教授认为，最有效的疗法是使用一种名为3TC的药物，与DDI或DDC以及一种抗蛋白酶药物联合使用。这种治疗方法抑制病毒蛋白酶的活性——病毒蛋白酶是HIV复制所必需的三种酶之一。最近（在1995/1996年之交），美国药品和食品管理局（FDA）在异常短的时间内批准了三种抗蛋白酶类药物：沙奎那韦、利托那韦和茚地那韦用于治疗艾滋病。文章中还描述了R. 普赖斯提出的关于艾滋病过程中精神障碍起源的概念，以及近期关于艾滋病过程中精神障碍的临床研究结果。
