Nevot Falcó S, Bartralot Soler J
Servicio de Pediatría, Sección de Alergia, Hospital General de Manresa.
Allergol Immunopathol (Madr). 1998 May-Jun;26(3):144-50.
An opportunist infection (OI) is understood to be an infection produced by microorganisms that invade a host with impaired immune capacity, such as children with HIV infection. The adequate treatment and chemoprophylaxis of these infections has improved the prognosis of their evolution, although they still present a high morbidity and mortality when they occur. In this sense, the introduction of triple therapy (new antiretroviral inhibitors and protease inhibitors) is likely to produce a prompt decrease in the incidence of OI because of the regression in the degree of immunosuppression that it induces. The degree of immunosuppression is determined by the number of CD4 lymphocytes, the most reliable marker for assessment. Normal CD4 lymphocytes values are different for each age group and have important connotations for the prophylactic measures to be used at each moment depending on the CD4 lymphocyte count. Opportunist infections influence the quality of life of patients. More than 100 microorganisms, including bacteria, viruses, fungi and protozoa, cause OI. This paper describes primary and secondary prophylaxis as well as the treatment of the most frequent opportunist infections (Pneumocystis carinii pneumonia, bacterial infections, Cryptococcus neoformans, Cytomegalovirus, Herpes simple, Varicella-zoster virus. Toxoplasmosis, Mycobacterium tuberculosis, M. avium-intracellulare, M. kansasii).
机会性感染（OI）被理解为微生物对免疫功能受损的宿主（如感染HIV的儿童）造成的感染。对这些感染进行充分的治疗和化学预防改善了其病情发展的预后，不过这些感染一旦发生，仍具有较高的发病率和死亡率。从这个意义上说，三联疗法（新型抗逆转录病毒抑制剂和蛋白酶抑制剂）的引入可能会使机会性感染的发病率迅速下降，因为它能减轻所诱导的免疫抑制程度。免疫抑制程度由CD4淋巴细胞数量决定，CD4淋巴细胞是评估免疫抑制程度最可靠的指标。不同年龄组的CD4淋巴细胞正常数值不同，并且根据CD4淋巴细胞计数，对不同时期所采取的预防措施具有重要意义。机会性感染会影响患者的生活质量。包括细菌、病毒、真菌和原生动物在内的100多种微生物可引发机会性感染。本文介绍了一级和二级预防以及最常见机会性感染（卡氏肺孢子虫肺炎、细菌感染、新型隐球菌、巨细胞病毒、单纯疱疹、水痘 - 带状疱疹病毒、弓形虫病、结核分枝杆菌、鸟分枝杆菌复合群、堪萨斯分枝杆菌）的治疗方法。
