艾滋病抗病毒治疗的新进展

沈银忠+卢洪洲

摘 要 抗病毒治疗的实施和广泛应用已使艾滋病从一种致死性疾病变为一种可以治疗的慢性疾病。随着基础和临床研究的进一步深入，艾滋病抗病毒治疗不断取得新进展。近年来，人们在艾滋病抗病毒治疗的时机与方案、抗病毒治疗的随访、特殊人群和合并其他感染患者的抗病毒治疗等方面提出了很多新的观点。目前认为，所有艾滋病患者均应尽早接受抗病毒治疗，而新型抗艾滋病药物的上市为临床治疗提供了新的选择。有关研究尤其是大型、随机、对照临床试验结果将不断更新和优化艾滋病抗病毒治疗方案，进而不断提高临床抗艾滋病治疗疗效，并使艾滋病最终被治愈也成为可能。为更多的艾滋病患者提供更高效的抗病毒治疗是目前改善艾滋病患者预后的最现实途径。

关键词 艾滋病 抗病毒治疗 特殊人群

中图分类号：R512.91 文献标识码：C 文章编号：1006-1533（2014）21-0009-06

New progress in antiretroviral therapy for HIV-1/AIDS*

SHEN Yinzhong1**， LU Hongzhou1，2***

（1. Department of Infectious Diseases， Shanghai Public Health Clinical Center， Fudan University， Shanghai 201508， China；

2. Department of Infectious Diseases， Huashan Hospital， Fudan University， Shanghai 200040， China）

Abstract HIV-1/AIDS has been transformed from a fatal disease to a treatable chronic one due to the implementation and wide use of antiretroviral therapy （ART）. New progress has been made in ART in recent years along with the advances in clinical and basic research for HIV-1/AIDS， and many new ideas on the timing， regimens and follow-up of ART， and ART for special populations and patients with coinfections have been suggested. Nowadays people agree that all AIDS patients should receive ART as early as possible while some new choices of ART for HIV-1/AIDS can be available for patients with the marketing of some new antiviral drugs. The advances in the clinical research， especially a large-scale randomized clinical trial results， will constantly update and optimize ART regimens， and continuously improve the clinical curative effect of ART， which will make it possible to cure HIV-1/AIDS. Currently， the most realistic way to improve prognosis of patients with AIDS is to provide a high quality of ART for HIV-1/AIDS patients.

Key words AIDS； antiretroviral therapy； special population

高效抗反转录病毒疗法（highly active antiretroviral therapy， HAART）的出现被认为是艾滋病治疗史上里程碑性的事件。HAART能将艾滋病患者体内的人免疫缺陷病毒（human immunodeficiency virus， HIV）-1载量控制至最低水平，从而重建患者机体的免疫功能，降低艾滋病相关疾病的发病率和病死率，改善预后并提高患者的生存质量。HAART还可降低HIV-1的传播力。随着HAART在临床上的广泛实施和应用，艾滋病已不再被认为是一种致死性疾病。目前很多研究都显示，经过有效抗病毒治疗后免疫功能得以重建的艾滋病患者的病死率与普通慢性疾病的病死率相近[1]。……