Respiratory infections in immunocompromised patients.
Respiratory infections in immunocompromised patients.
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DOI：
10.1097/00063198-199905000-00008
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发表时间：
1999-05-01
影响因子：
3.3
通讯作者：
Prentice, H G
中科院分区：
文献类型：
--
作者：
Barry, S M;Lipman, M C;Prentice, H G
通过引入高效抗逆转录病毒疗法，发达国家的艾滋病毒疾病已大大减少，这意味着针对机会性感染的预防性治疗可能会停止；然而，结核病在全世界艾滋病毒感染者和非感染者群体中是一个日益严重的问题。遵守有效的治疗方案，特别是通过直接观察治疗，仍然是结核病控制策略的基石。尽管结核病预防对于发达国家的艾滋病毒结核菌素皮肤反应者有益，但在资源匮乏的环境中，人们对这种方法持保留态度。技术的最新进展，特别是抗原特异性系统的进展，彻底改变了对艾滋病毒免疫学的理解，并有助于阐明巨细胞病毒等疾病的发病机制。在骨髓移植和实体器官移植患者中，定量聚合酶链反应（PCR）预测巨细胞病毒性疾病是一项重要进展，而对于接受骨髓移植的患者，CT扫描已被证明有助于诊断肺曲霉病。
HIV disease has been dramatically reduced in the developed world by the introduction of highly active antiretroviral therapy, with implications that prophylactic therapy against opportunistic infections may be stopped; however, tuberculosis is an escalating problem in the HIV-infected and HIV-noninfected populations worldwide. Compliance with effective treatment regimens, especially through directly observed therapy, remains the cornerstone of tuberculosis control strategies. Although tuberculosis prophylaxis is of benefit for tuberculin skin reactors with HIV in the developed world, several reservations are voiced about this approach in resource-poor settings. Recent advances in technology, particularly in antigen-specific systems, have revolutionized the understanding of HIV immunology and helped to elucidate the mechanisms of pathogenesis in diseases such as cytomegalovirus. In bone marrow transplantation and solid-organ transplantation patients, quantitative polymerase chain reaction (PCR) to predict cytomegalovirus disease is an important advance, and patients who undergo bone marrow transplantation, CT scanning has proven useful in the diagnosis of pulmonary aspergillosis.