The Role of Sexually Transmitted Infections in HIV-1 Progression: A Comprehensive Review of the Literature.
The Role of Sexually Transmitted Infections in HIV-1 Progression: A Comprehensive Review of the Literature.
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DOI：
10.1155/2013/176459
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Crum-Cianflone NF
中科院分区：
文献类型：
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作者：
Chun HM;Carpenter RJ;Macalino GE;Crum-Cianflone NF
由于共用感染途径，艾滋病毒感染者经常与其他性传播感染(STI)合并感染。研究表明HIV与几种性传播感染之间存在双向关系，包括单纯疱疹病毒2型(HSV-2)、乙型和丙型肝炎病毒、人乳头瘤病毒、梅毒、淋病、衣原体和滴虫。HIV-1可能会影响临床表现、治疗结果和性传播感染的进展，如梅毒、单纯疱疹病毒-2以及乙肝和丙型肝炎病毒。同样，性传播感染的存在可能会增加生殖器和血浆中的艾滋病毒-1RNA水平，从而增强艾滋病毒-1的传播性，对公共卫生产生重要影响。关于性传播感染对HIV-1进展的影响，研究最多的是与HIV-1/HSV-2混合感染的相互关系，最近的研究表明，在联合感染的患者中，抗疱疹药物可以延缓CD_4<；200细胞/微米L和抗逆转录病毒治疗的时间。其他慢性性传播感染(乙肝和丙型肝炎)对艾滋病毒-1进展的影响需要进一步研究，但一些研究表明死亡率增加。可治疗的非慢性性传播感染(即梅毒、淋病、衣原体和滴虫)通常对血浆HIV RNA水平没有或短暂影响，这些影响可以通过抗菌治疗来解决；还没有显示出对结果的长期影响。建议今后继续研究艾滋病毒-1和其他性传播感染之间复杂的相互作用。
Due to shared routes of infection, HIV-infected persons are frequently coinfected with other sexually transmitted infections (STIs). Studies have demonstrated the bidirectional relationships between HIV and several STIs, including herpes simplex virus-2 (HSV-2), hepatitis B and C viruses, human papilloma virus, syphilis, gonorrhea, chlamydia, and trichomonas. HIV-1 may affect the clinical presentation, treatment outcome, and progression of STIs, such as syphilis, HSV-2, and hepatitis B and C viruses. Likewise, the presence of an STI may increase both genital and plasma HIV-1 RNA levels, enhancing the transmissibility of HIV-1, with important public health implications. Regarding the effect of STIs on HIV-1 progression, the most studied interrelationship has been with HIV-1/HSV-2 coinfection, with recent studies showing that antiherpetic medications slow the time to CD4 <200 cells/µL and antiretroviral therapy among coinfected patients. The impact of other chronic STIs (hepatitis B and C) on HIV-1 progression requires further study, but some studies have shown increased mortality rates. Treatable, nonchronic STIs (i.e., syphilis, gonorrhea, chlamydia, and trichomonas) typically have no or transient impacts on plasma HIV RNA levels that resolve with antimicrobial therapy; no long-term effects on outcomes have been shown. Future studies are advocated to continue investigating the complex interplay between HIV-1 and other STIs.