Noninfectious pulmonary complications of human immunodeficiency virus infection.
Noninfectious pulmonary complications of human immunodeficiency virus infection.
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DOI：
10.1097/maj.0000000000000318
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发表时间：
2014-12
期刊：
影响因子：
--
通讯作者：
Guidot DM
中科院分区：
文献类型：
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作者：
Staitieh B;Guidot DM
1 型人类免疫缺陷病毒 (HIV-1) 是导致艾滋病发展的逆转录病毒。它对免疫系统的深远影响使宿主容易受到多种机会性感染的影响，而免疫系统健全的个体则不会出现这种情况。在艾滋病流行的最初几年，肺部感染占主导地位，尽管已经开发出有效的抗逆转录病毒疗法，但传染性和非传染性肺部疾病仍然是艾滋病毒感染者发病和死亡的主要原因。除了长期以来已知的免疫抑制和感染风险之外，人们越来越认识到艾滋病毒通过多种不同的机制增加非感染性肺部疾病的风险，包括艾滋病毒相关病毒蛋白的直接组织毒性和合并感染的继发效应。气道、肺实质和肺血管系统疾病以及肺部恶性肿瘤在艾滋病毒感染者中更为常见，或者表现不典型。由于艾滋病毒的肺部感染性并发症众所周知，并且已得到广泛的综述，因此本综述将重点关注艾滋病毒感染者中发生的非传染性肺部疾病的范围，因为这些疾病可能更难以被照顾这一庞大且独特的弱势群体的普通医生和亚专科医生识别。
Human immunodeficiency virus type 1 (HIV-1) is the retrovirus responsible for the development of AIDS. Its profound impact on the immune system leaves the host vulnerable to a wide range of opportunistic infections not seen in individuals with a competent immune system. Pulmonary infections dominated the presentations in the early years of the epidemic, and infectious and noninfectious lung diseases remain the leading causes of morbidity and mortality in persons living with HIV despite the development of effective antiretroviral therapy. In addition to the long known immunosuppression and infection risks, it is becoming increasingly recognized that HIV promotes the risk of noninfectious pulmonary diseases through a number of different mechanisms, including direct tissue toxicity by HIV-related viral proteins and the secondary effects of coinfections. Diseases of the airways, lung parenchyma and the pulmonary vasculature, as well as pulmonary malignancies, are either more frequent in persons living with HIV or have atypical presentations. As the pulmonary infectious complications of HIV are generally well known and have been reviewed extensively, this review will focus on the breadth of noninfectious pulmonary diseases that occur in HIV-infected individuals as these may be more difficult to recognize by general medical physicians and subspecialists caring for this large and uniquely vulnerable population.