艾滋病抗病毒治疗药物不良反应研究进展

Research progress on adverse drug reactions of AIDS antiviral therapy

自第一种艾滋病治疗药物齐多夫定(AZT)问世以来,许多作用于HIV复制过程中不同靶点的逆转录酶、蛋白酶、整合酶制剂等被纳入到抗反转录病毒疗法(ART)体系中。艾滋病不能治愈,因为可用的抗HIV药物都不能有效地清除HIV储存库。艾滋病为一种可防可控的慢性疾病,仍然需要患者终身服药。药物引起的不良反应给HIV感染者带来了极大疾病负担,包括药物性皮疹、消化系统不良反应、药物性肝损伤、肾毒性、骨髓抑制、腹泻、代谢紊乱等,是导致ART中断的主要原因,严重影响HIV感染者身心健康和生活质量。为了解艾滋病抗病毒治疗药物不良反应发生的原因及临床表现,本文对HIV感染者ART后出现药物不良反应及其发生机制进行综述,旨在提高艾滋病抗病毒治疗医务人员对药物不良反应的认识及处置能力。

Since the first drug,Azidothymidine(AZT) was used in treatment of acquired immune deficiency syndrome(AIDS),many reverse transcriptases,proteases and integrases,acting on a number of different targets of HIV replication,have been included into the antiretroviral therapy treatment(ART) system.AIDS is incurable,because none of the current available drugs can effectively eliminate the viral reservoir for HIV.AIDS has emerged as a chronic illness that is manageable with ART.However,HIV-infected individuals need to receive life-long therapy for AIDS prevention.Drug-induced adverse reactions have brought great trouble to people living with HIV,including drug-induced rash,adverse reaction of digestive system,drug-induced liver injury,nephrotoxicity,bone marrow suppression,diarrhea,metabolic disorders and so on,which are the main associated factors with the interruption of ART.It seriously affects the physical,mental and quality of life of people living with HIV.In order to comprehensively understand the associated factors and clinical manifestations of adverse drug reactions in AIDS treatment,this article reviews the adverse drug reactions and their mechanisms in people living with HIV,aiming to improve the awareness and the treatment capacity of adverse drug reactions for healthcare worker.