Курсовая: ВИЧ-инфекция
32
IEAI ?OA?AOA.
Aaaaeaiea
Iiaua aa?eaiou ae?ona NIEAe
Noaoenoeea
No?iaiea ae?oniie /anoeoeu AE*
No?iaiea ae?oniiai aaiiia e yeni?anney aaiia AE*
Aaiu e aaeee AE*
?aaoeyoeey yeni?annee ae?oniuo aaiia
Oai?ee i?ienoiaeaeaiey AE*
Ia?aaea/a AE*-eioaeoeee
Ei-oaeoi?u AE*-eioaeoeee
Iaoiaaiac e eeeieea AE*-eioaeoeee
Iaoiaaiac
Iaoaieciu acaeiiaeaenoaey AE* n ?acee/iuie caaiueyie eiioiiie nenoaiu
Aeeyiea AE* ia O-oaeia?u
Acaeiiaeaenoaea AE* n O-noi?anni?aie
?acoeueoaou acaeiiaeaenoaey AE* n A-eeaoeaie
Iae?ioaae e AE*
Acaeiiaeaenoaea AE* n iiiioeeoaie
Acaeiiaeaenoaea AE* n ae?oaeie eeaoeaie i?aaiecia
Nenoaia eioa?oa?iia i?e AE*-eioaeoeee
Eeeie/aneea i?iyaeaiey
Ia?nenoe?othuay aaia?aeeciaaiiay eeioaaeaiiiaoey
NIEAe-annioeee?iaaiiue eiiieaen
Iiii?ooienoe/aneea eioaeoeee e iiooiee
Iniaaiiinoe eioeoee?iaaiey e caaieaaaiey aeaoae
Ae?on eiioiiaeaoeoeeoa /aeiaaea oeia 2 (AE* 2)
Aaia?aoe/aneia ?ani?ino?aiaiea
No?iaiea ae?ona
Yieaeaieieiaey
Eeeie/aneea ioee/ey
Eaai?aoi?iay aeeaaiinoeea
Aeeaaiinoeea AE*-eioaeoeee
Ea/aiea
Aiciiaeiinoe ?ac?aaioee aaeoeei
Caeeth/aiea
AAAAeAIEA
AE*-eioaeoeey, iiaeiaii iiaea?o, ioaaoeea nae/an ii/oe ana eiioeiaiou.
Ca iaiau/aeii ei?ioeia a?aiy iia noaea i?iaeaiie iiia? iaeei aeey
Anaie?iie i?aaiecaoeee cae?aaiio?aiaiey e III, iooaniea ia aoi?ia ianoi
?ae e na?aea/iininoaeenoua caaieaaaiey.
Iiaeaeoe, ie iaeia aieaciue ia caaeaaaea o/aiui oaeea na?ueaciua
caaaaeee ca noieue iacia/eoaeueiue n?ie. Aieia n ae?onii NIEAea aaaeaony
ia ieaiaoa n ia?anoathueie oneeeyie. Aaeaiany/ii a ie?iaie iao/iie
i?anna ioaeeeothony iiaua naaaeaiey i AE*-eioaeoeee e aa aicaoaeeoaea,
eioi?ua /anoi canoaaeytho ei?aiiui ia?acii iaiyoue oi/eo c?aiey ia
iaoieiaeth yoiai caaieaaaiey.
Iiea caaaaeie aieueoa...
I?aaeaea anaai - iaiaeeaeaiiinoue iiyaeaiey e auno?ioa ?ani?ino?aiaiey
AE*. Aei neo ii? ia ?aoai aii?in i i?e/eiao aai aicieeiiaaiey. Aei neo
ii? iaecaanoia n?aaeiyy e iaeneiaeueiay i?iaeieaeeoaeueiinoue aai
ne?uoiai ia?eiaea.
Onoaiiaeaii, /oi eiaaony ianeieueei ?aciiaeaeiinoae aicaoaeeoaey NIEAea.
Eciai/eainoue aai oieeaeueia, iiyoiio anoue ana iniiaaiey iaeeaeaoue,
/oi iaia?oaeaony i/a?aaeiua aa?eaiou aicaoaeeoaey a ?aciuo ?aaeiiao
ie?a, a yoi iiaeao ?acei ineiaeieoue aeeaaiinoeeo.
Aua caaaaeee: eaeiaa naycue NIEAea o /aeiaaea ni NIEAe-iiaeiaiuie
caaieaaaieyie o aeeaioiuo (iaacueyi, eioae, iaaoe, e?oiiiai ?iaaoiai
neioa) e eaeiaa aiciiaeiinoue ano?aeaaiey aaiia aicaoaeeoaey NIEAea a
ianeaaenoaaiiue aiia?ao ca?iaeuoaauo eeaoie?
Aeaeaa. I?aaiia?ii ee naii iacaaiea? NIEAe ?anoeo?iauaaaony eae neiae?ii
i?eia?aoaiiiai eiioiiaeaoeoeeoa. Eiuie neiaaie, aeaaiue i?eciae aieacie
- ii?aaeaiea eiioiiie nenoaiu. Ii eaaeaeui aiaeii iaeaieeaaaony ana
aieueoa aeaiiuo, aeieacuaathueo, /oi aicaoaeeoaeue NIEAea ii?aaeaao ia
oieueei eiioiioth, ii e ia?aioth nenoaio.
N niaa?oaiii iai?aaeaeaeaiiuie o?oaeiinoyie noaeeeaathony i?e ?ac?aaioea
aaeoeeiu i?ioea ae?ona NIEAea.
E iniaaiiinoyi NIEAea ioiineony oi, /oi yoi, ii-aeaeeiiio, ia?aue a
enoi?ee iaaeeoeeiu i?eia?aoaiiue eiioiiaeaoeoeeo, naycaiiue n eiie?aoiui
aicaoaeeoaeai e oa?aeoa?ecothueeny yieaeaie/aneei ?ani?ino?aiaieai.
Aoi?ay aai iniaaiiinoue - ii/oe i?eoeaeueiia ii?aaeaiea O-oaeia?ia.
O?aouey iniaaiiinoue - yoi ia?aia yieaeaie/aneia caaieaaaiea /aeiaaea,
aucaaiiia ?ao?iae?onaie. A-/aoaa?ouo, NIEAe ii eeeie/aneei e
eaai?aoi?iui iniaaiiinoyi ia iioiae ie ia eaeea ae?oaea i?eia?aoaiiua
eiioiiaeaoeoeeou.
II?AAeAEAIEA IIIssOEss NIEAe.
Oa?iei NIEAe aia?aua iiyaeeny a Aaeaiaaeaeueiii Io/aoa i Caaieaaaaiinoe
e Nia?oiinoe Oeaio?ia ii Eiio?ieth Caaieaaaiee a 1982 aiaeo /oiau
iienaoue ...caaieaaaiea, naea?aeaiii i?aaeiieaaathuaa i aeaoaeoa
eeaoi/iiai caaia eiioieoaoa, ano?a/athuaany aac ecaanoiuo i?e/ei aeey
oiaiueoaiey ?acenoaioiinoe e oie aieacie...
Ia/aeueiue nienie Oeaio?a Eiio?iey Caaieaaaiee i NIEAe-ii?aaeaeythueo
oneiaeyo, eioi?ue aeeth/ae na?eiio Eaiioe, iiaaiioeenoic, eiiieaen
Mycobacterium avium e ae?oaea oneiaey, ianeieueei ?ac aue
iiaeeoeoee?iaai ni cia/eoaeueiuie eciaiaieyie (Oeaio? Eiio?iey
Caaieaaaiee (OeEC), 1985a, 1987a, 1992a).
A ianoiyuaa a?aiy OeEC ii?aaeaeyao NIEAe ai ac?ineii e iiae?inoeiaii
aic?anoa 13 eao e noa?oa eae i?enoonoaea iaeiiai ec 25
NIEAe-eiaeeeaoi?iuo oneiaee, oaeeo eae na?eiia Eaiioe, iiaaiioeenoic
eee aeennaieie?iaaiiue eiiieaen Mycobacterium avium. O aeaoae ieaaeoa 13
eao ii?aaeaeaiea NIEAea noiaeii n oaeiaui o iiae?inoeia e ac?ineuo, ca
eneeth/aieai oiai, /oi a nienie NIEAe-ii?aaeaeythueo oneiaee aoiaeyo
oaeaea eeioieaeiue iiaaiiieo e o?iie/aneea aaeoa?eaeueiua eioaeoeee
(OeEC, 1987b). Aeaeaa aoaeao i?eaaaeai nienie AE*-ia?ea?iuo caaieaaaiee.
Iaeanoue ii?aaeaeaiey n?aaee ac?ineuo e iiae?inoeia auea ?anoe?aia a
1993 aiaeo aeeth/aieai a yoio nienie AE*-eioaeoeee o /aeiaaea ni
nieaeaieai a e?iae eiee/anoaa CD4+ T-eeioioeeoia iaiaa 200 a 1 ii3.
Oaeouea iaaethaeaiey caiaieee e?eoa?ee, iioaeeeiaaiiua a 1987 aiaeo,
eioi?ua auee iniiaaiu ia eeeie/aneeo neiioiiao, a ia ia ii?aaeaeaiee
CD4+ T-eeioioeeoia.
Eoae, oa?iei NIEAe ?anoeo?iauaaaony eae neiae?ii i?eia?aoaiiiai
eiioiiaeaoeoeeoa, ii i?eia?aoaiiuo eiioiiaeaoeoeeoia iiiai, a NIEAe -
iaeei. Iiyoiio naaiaeiy i?aaeeueiaa neacaoue oae: NIEAe - yoi oaeie
i?eia?aoaiiue eiioiiaeaoeoeeo, eioi?ue ioee/aaony io ae?oaeo iaee/eai
ii?aaeaeaiiiai eiiieaena naienoa e niaoeeoe/aneiai aicaoaeeoaey. Ia yoii
niaoeeoe/aneii aicaoaeeoaea aeaeaa e iieaeao ?a/ue.
ENOI?Ess IOE?UOEss AE*.
Ceiie 1980-81 aiaea a ainieoaeue Iueth-Ei?eneiai oieaa?neoaoa iinooieee
ianeieueei /aeiaae n iaciaeiiie aeey a?a/ae oi?iie na?eiiu Eaiioe -
caaieaaaiey, ioe?uoiai aua a 1872 aiaeo Ii?eooeai Eaiioe. Ia eiaea
ieaeieo eiia/iinoae iiyaeythony ocaeee ei?e/iaaaoi-e?aniiai eee
aieoaiaaoi-e?aniiai oeaaoa. Eiiaaea iie ecuycaeythony e iia?oaaaatho,
ii, iau/ii ia ii?aaeatho aioo?aiiea i?aaiu, e ia n/eoathony
ceiea/anoaaiiuie iiooieyie (o aieueoeinoaa aieueiuo na?eiia Eaiioe
aeeeony 8-1 eao e oi?ioi iiaeaeaaony oeieioa?aiaaoe/aneiio ea/aieth).
A NOA e no?aiao Caiaaeiie Aa?iiu na?eiia Eaiioe iaaethaeaaony
/?acau/aeii ?aaeei: 1-2 neo/ay ia 10 ieeeeiiia ianaeaiey, i?e/ai, eae
i?aaeei, oieueei o ioae/ei noa?oa 60 eao. Ioae/eiu aea iinooieaoea a
Iueth-Ei?eneee ainieoaeue auee a aic?anoa 30 eao. Ana iie ieacaeenue
aiiinaenoaeenoaie. Na?eiia Eaiioe i?ioaeaea o ieo ceiea/anoaaiii e
aieueoay /anoue ec ieo iiaeaea a oa/aiea 20 ianyoeaa.
Aaniie 1981 aiaea a?a/e Ein-Aiaeaeaeana iaia?oaeeee aua iaeio eaoaai?eth
aieueiuo - ni ceiea/anoaaiiie oi?iie iiaaiioeenoiie iiaaiiiee. Yoi
caaieaaaiea aucuaaaony i?inoaeoei Pneumocystis carinii e ano?a/aaony
e?aeia ?aaeei o eeoe n iiaeaaeaiiie ooieoeeae eiioiiie nenoaiu -
iai?eia?, iiaeaa?aoeony eioaineaiie eiioiiaeai?anneaiie oa?aiee iinea
o?ainieaioaoeee i?aaiia. Iiaaiioeenoiay iiaaiiiey auea ca?aaeno?e?iaaia
o iieiaeuo ethaeae, eioi?ua oiaea ieacaeenue aiiinaenoaeenoaie.
Eaoii 1981 aiaea a NOA ian/eouaaeinue oaea 116 iiaeiaiuo neo/aaa...
Oioy eeeie/aneay ea?oeia oeacuaaea ia ecaanoiue oaea e oiio a?aiaie
neiae?ii eiioiiaeaoeoeeoa, i?e/eia e iooe caaieaaaiey inoaaaeenue
iayniuie. Iaiaeeaeaiiia iiyaeaiea aieacie, iieieaiiniia ?ani?ino?aiaiea,
no?aiiay naycue ni ceiea/anoaaiiuie iiooieyie, iiaaiioeenoiie
iiaaiiieae, aaiioeeeae, aiiinaenoaeeciii, aaia?e/aneeie aieaciyie,
iaiau/aeii aeeeoaeueiue ne?uoue ia?eiae e ionoonoaea yooaeoeaiuo
n?aaenoa ea/aiey - ana yoi aucaaei oie o a?a/ae e o/aiuo. Ae?on,
ecaanoiue iuia eae aicaoaeeoaeue NIEAea, aue ioe?uo oieueei a 1983
aiaeo, e aai iacuaaee ii-?aciiio.
A?oiia o/aiuo Iaoeeiiaeueiiai einoeoooa ?aea a NOA, ?oeiaiaeeiuo
ecaanoiui eiioiieiaii e ae?onieiaii ?iaa?oii Aaeei, ioe?uea aicaoaeeoaey
O-eeaoi/iiai eaeeica, caaieaaaiey, ca?aaeno?e?iaaiiiai a eiioea 70-o
aiaeia a no?aiao Ea?eaneiai aannaeia e a THaeiie ssiiiee. Eaeeic
i?ioaeae i/aiue oyaeaei: aieueiua iiaeaaee ca 3-4 ianyoea.
Oniaoo Aaeei niinianoaiaaei oi, /oi a na?aaeeia 70-o aiaeia ii
iaia?oaeee oaeoi? ?inoa O-eeaoie, eioi?ue nae/an iacuaatho
eioa?eaeeeiii-2. Yoi iicaieeei eoeueoeae?iaaoue O-eeioioeeou a i?iae?ea.
Aicaoaeeoaeai ino?iai O-eeaoi/iiai eaeeica o /aeiaaea ieacaeny
?ao?iae?on. Aaeei iacaae naie aaaio ae?onii O-eeaoi/iie eaeeaiee
/aeiaaea - HTLV-1. E i?aaeiieiaeee, /oi ii aiciee a Ao?eea, aaea ei
ca?aceeenue i?eiaou Noa?iai Naaoa, aea e /aeiaae oiaea, /oi a Aia?eeo e
no?aiu Ea?eaneiai aannaeia ae?on i?iiee aeaaiaea?y ?aaioi?aiaea.
Auynieeinue, /oi o iiiaeo aeaeia ao?eeaineeo iaacueyi a e?iae
niaea?aeaony aioeoaea e HTLV-1. Iaeioi?ua ?aciiaeaeiinoe ae?ona,
iniaaiii auaeaeaiiua o caeaiuo ia?ouoae e oeiiaica, eiaee iiiai
noiaeiiai n HTLV-1. A aeaeueiaeoai ieacaeinue, /oi HTLV-1 ia?aaeaaony
i?e ia?aeeaaiee e?iae. Auaeaeai aua iaeei ae?on yoie a?oiiu, aucuaathuee
?aaeeia caaieaaaiea e?iae, - HTLV-2.
Eae ?ac a yoi a?aiy a NOA ia/aeanue yieaeaiey NIEAea, iaeiei ec iooae
ia?aaea/e eioi?iai oaeaea auei ia?aeeaaiea e?iae. Iiyoiio Aaeei
i?aaeiieiaeee, /oi HTLV-1 - aicaoaeeoaeue NIEAea. E aeaenoaeoaeueii o
iaeioi?uo aieueiuo oaeaeinue auaeaeeoue aioeoaea e HTLV-1, a o /anoe
oaeaeinue auaeaeeoue e nai ae?on. Iaeiaei Aaeei ioeany.
A?oiia o/aiuo Ianoa?ianeiai einoeoooa a Ia?eaea iiae ?oeiaiaenoaii Ethea
Iiioaiuea, iniauaiiay cia/eoaeueii ooaea a?oiiu Aaeei, auea nicaeaia n
oeaeueth eco/eoue aiciiaeioth naycue ?ao?iae?onia n iiooieaauie
caaieaaaieyie eiioiiie nenoaiu, au?aaeathueieny a oaaee/aiee
eeioaoe/aneeo oceia (eeioaaeaiiiaoee). Aeey auyaeaiey eneiiuo ae?onia
o?aioeocneea o/aiua eniieueciaaee ioe?uoue a?oiiie Aaeei eioa?eaeeei-2.
I?e enneaaeiaaiee iaeiiai iaoeeaioa, aieaaoaai eeioaaeaiiiaoeae a
oa/aiea ianeieueeeo eao, aue auaeaeai ae?on, eaeaioeoeoee?iaaiiue eae
?ao?iae?on. Ii naiei naienoaai ii aue iioiae ia HTLV-1, ii eiae
iaeioi?ua iniaaiiinoe. Caoai aiaeiae/iue ae?on auaeaeeee io aieueiuo
NIEAeii.
A 1983 aiaeo aeo?iae Naeain iaia/aoae noaoueth o?aioeocneeo o/aiuo. Iie
niiauaee i iaee/ee o 2 ec 33 aieueiuo NIEAeii ?ao?iae?ona, eioi?ue, a
ioee/ea io HTLV-1, ia iaeaaeae niiniaiinoueth aeeyoue ia ceiea/anoaaiiia
ia?a?iaeaeaiea O-eeioioeeoia. Aaoi?u aeaee aio iacaaiea LAV (ae?on,
annioeee?iaaiiue n eeioiaaeaiiiaoeae). Ii aucuaaao ia ?aciiiaeaiea, a,
iaiai?io, aeaaeue O-eeioioeeoia.
Iaaeaeo iaaeie a?oiiaie o/aiuo ia/aeny eioaineaiue iaiai eaeayie,
aeieiae/aneeie iaoa?eaeaie. A?oiia Aaeei, iieuecoynue ?ac?aaioaiiuie ath
iaoiaeaie, auaeaeeea io aieueiuo NIEAeii iiaue ?ao?iae?on, iacaaiiue
HTLV-3. Oaeaeinue iieo/eoue iniaoth eeieth O-eeioioeeoia, a eioi?ie
ae?on eioaineaii ?aciiiaeaeny, ii O-eeaoee ia iiaeaaee. A ia/aea 1984
aiaea aia?eeaioeu niiaueee ia ioe?uoii eie ae?ona a ia/aoe. E oiaaea aea
onoaiiaeee, /oi HTLV-3 e LAV eaeaioe/iu. Iiyoiio ae?on noaee iaicia/aoue
eae HTLV-3/LAV. A 1986 aiaeo Eiieoao ii oaeniiiiee e iiiaieeaoo?a
ae?onia i?aaeeiaeee aeaoue aicaoaeeoaeth NIEAea iiaia iacaaiea - HIV/AE*
(ae?on eiioiiaeaoeoeeoa /aeiaaea).
Eoae, aicaoaeeoaeue NIEAea aue ioe?uo /a?ac aeaa aiaea iinea
iioaeeeiaaiey ia?auo noaoae i iiaii caaieaaaiee, a iaoiae aai
aeeaaiinoeee ?ac?aaioai iaiaa /ai /a?ac 2.5 aiaea iinea ia?auo
ioaeeeaoeee. Yoi i?eaaei e oiio, /oi ia ia?aie Iaaeaeoia?iaeiie
eiioa?aioeee ii NIEAeo, ninoiyaoaeny a ai?aea 1985 aiaea a Aoeaioa
ainiiaenoaiaaea aoiinoa?a iioeiecia.
Iaeiaei iiaua o?aaiae aicieeee i?e eco/aiee oieeaeueiuo iniaaiiinoae
aicaoaeeoaey.
INIAAIIINOE AICAOAeEOAEss NIEAea.
AE* aue ioe?uo. ?iaa?o Aaeei e aai nio?oaeieee nia/aea iieaaaee, /oi HIV
e HTLV-1 i?eiaaeeaaeao e iaeiiio naiaenoao - HTLV, oae eae o ieo iiiai
iaueo naienoa. Iaa aicaoaeeoaey iaeaaeatho n?iaenoaii e
O-eeioioeeoai-oaeia?ai n iieaeoeie-?aoeaioi?ii CD4 ia iiaa?oiinoe. Iaa
ae?ona ia?aiinyony i?e ia?aeeaaiee e?iae. A iaieo neo/ayo
ae?oniiineoaeuenoai nii?iaiaeaeaaony iaeiieaieai niioaaonoaothueo
aioeoae a e?iae. Anoue noiaenoai a no?iaiee iaiei/a/iuo (env) aaiia.
Iaeiaei ii ia?a eco/aiey AE* auynieeenue e aai nouanoaaiiua ioee/ey io
HTLV-1. Iie ieacuaatho aeeaiao?aeueii i?ioeaiiieiaeiia iaoieiae/aneia
aeaenoaea: HTLV-1 i?aa?auaao ii?iaeueioth O-eeaoeo a ceiea/anoaaiioth e
aucuaaao aacoaea?aeiia ?aciiiaeaiea O-oaeia?ia, oiaaea eae AE* oaeaaao
yoe eeaoee. Iaiaeeiaeiaui ieacaeinue e eo no?iaiea. Enneaaeiaaiey
A.O.Aueianeiai e E.Iiioaiuea iieacaee, /oi o na?aeoeaaeiu HTLV-1
noa?e/aneay oi?ia, a o AE* iia eiioniaeaeiay.
Nouanoaaiiua ?acee/ey ieacaeenue e a aaiiiao ae?onia. Ii n?aaiaieth n
HTLV-1 aaiii AE* niaea?aeeo ianeieueei aeiiieieoaeueiuo aaiia. Aeaaiue
aaeie na?aeoeaaeiu AE* - ?24 - ia eiaao aiaeiaia o ae?oaeo ?ao?iae?onia.
I?ioeann o?aine?eioeee aaiiia AE* i?ioaeaao a ouny/o ?ac auno?aa, /ai o
eeaoi/iuo aaiia, /oi a cia/eoaeueiie noaiaie iauyniyao ii?aceoaeueioth
nei?inoue ?aciiiaeaiey AE*.
Onoaiiaeaii, /oi AE* noieo aeeaea anaai e eaioeae?onai, aucuaathuei
oyaeaeua o?iie/aneea eioaeoeee o eiiuoiuo aeeaioiuo. Iniaaiii io/aoeeai
aeaeiu noiaenoaa AE* n ae?onii iyaee-aenia, eioi?ue aeaao o?iie/aneoth
eioaeoeeth o iaaoe, i?eaiaeyuoth, eae e NIEAe o ethaeae, e nia?oaeueiiio
enoiaeo.
Iiaeiaii iyaee-aenia, AE* oa?aeoa?ecoaony e?aeiae eciai/eainoueth - iia
a 30 -100, a ii iaeioi?ui aeaiiui e a ieeeeii ?ac auoa, /ai o ae?ona
a?eiia. Eanaaony iia ia oieueei ooaiiia ae?ona auaeaeaiiuo io ?aciuo
aieueiuo, ii e a ?aciia a?aiy aiaea io iaeiiai e oiai aea aieueiiai.
Yoi naienoai ?acei cao?oaeiyao aiciiaeiinoue iieo/aiey aaeoeei i?ioea
AE*.
IIAUA AA?EAIOU AE?ONA NIEAe.
A ai?aea 1986 aiaea a aeo?iaea Naeain auei iioaeeeiaaii niiauaiea, /oi
a?oiia aia?eeaineeo o/aiuo ai aeaaa n Ynnaenii, auaeaeeea o caei?iauo
ethaeae a Naiaaaea ae?on, noiaeiue n ae?onii ao?eeaineeo caeaiuo
ia?ouoae: nuai?ioee ca?aaeaiiuo ethaeae ?aaae?iaaee n aioeaaiaie ae?ona
ia?ouoae, ii ia aeaaaee ?aaeoeee (eee iie auee neaauie) n aioeaaiaie
AE*. I?aaeiieaaaeinue, /oi ae?on iia auoue i?aaeoanoaaiieeii AE*. Aaoi?u
iaeiaiiaaee auaeaeaiiue ae?on HTLV-4.
HTLV-4, iiaeiaii AE*, eioeoee?oao O-oaeia?u, ii ia oaeaaao eo.
Yeaeo?iiiue iee?ineii ia caoeene?iaae aai ioee/ee io AE*. Ii iiaieth
Ynnaena, oioy HTLV-4 eioeoee?oao O-oaeia?u o eeeie/anee caei?iauo
ethaeae, ia eneeth/aii, /oi a iineaaeothuai iie caaieatho.
A eiioea 1986 aiaea Iiioaiuea e nio?oaeieee iauyaeee ia ioe?uoee iiaiai
ae?ona o aeaoo aieueiuo NIEAeii. Ii naiaio no?iaieth ii ia ioee/aeny io
AE*, oiaea oaeaae O-oaeia?u. Ii, a i?ioeaiiieiaeiinoue AE*, a nuai?ioeao
aieueiuo ionoonoaiaaee aioeoaea e iineaaeiaio e AeIE iaieo ae?onia ia
auee eaeaioe/iu. Aaoi?u iaicia/eee iiaue ae?on eae HIV-2 (AE*-2).
Nuai?ioee aieueiuo i?e AE*-2 ?aaae?iaaee n ae?onii caeaiuo ia?ouoae,
iiyoiio Iiioaiuea n/eoaao, /oi o ieo iiaeao auoue iauaa i?ienoiaeaeaiea.
N?aaieoaeueiia eco/aiea aaiiiia AE*-1 e AE*-2 iieacaei, /oi a
yaiethoeeiiiii ieaia AE*-2 aeaeaei ionoieo io AE*-1. Aaoi?u auneacuaatho
i?aaeiieiaeaiea, /oi iaa ae?ona nouanoaiaaee caaeieai aei aicieeiiaaiey
nia?aiaiiie yieaeaiee NIEAea. A iaeioi?uo no?aiao Caiaaeiie Ao?eee
ano?a/aiu oeie/iua neo/ay NIEAea i?e ionoonoaee aioeoae e AE*. Aieueiuo
auaeaeaiu ?ao?iae?onu, eioi?ua iiaeiaii AE*-1, iaeaaeatho n?iaenoaii e
CD4-oaeia?ai e aucuaatho eo aeaaeue. AE*-2 iaia?oaeeaaaony aeaaiui
ia?acii a Caiaaeiie Ao?eea. AE*-2 ?iaenoaaiai aicaoaeeoaeth
NIEAe-iiaeiaiiai caaieaaaiey o iaeae. Ii niiniaai eioeoee?iaaoue ?aciua
aeaeu i?eiaoia, oaeaeaiiua io /aeiaaea ia eanoieoea yaiethoeee, oiaaea
eae AE*-1 ca?aaeaao oieueei ethaeae e oeiiaica. Iiae?iaiaa i AE*-2
aoaeao neacaii ieaea.
Anoue iiaiea, /oi iaiaoiaaiiue ae?on HTLV-4 yaiethoeeiie?iaae a
aaca?aaeiue ae?on ao?eeaineeo caeaiuo ia?ouoae, eioi?ue i?aa?aoeeny a
iaoiaaiiue AE*-2 - i?aaeoanoaaiiee AE*-1.
Eco/aiea NIEAe noeioee?iaaei iienee noiaeiuo aicaoaeeoaeae. Iiieii
AE*-1, a ?aciuo no?aiao, i?aeiouanoaaiii a Caiaaeiie Ao?eea, iaeoatho
?acee/iua AE*-iiaeiaiua aa?eaiou ae?ona, iaoiaaiiua e iaiaoiaaiiua aeey
/aeiaaea. N ae?oaie noi?iiu a yoeo aea no?aiao oee?eoee?otho aa?eaiou
iaacueyiueeo ae?onia - iaoiaaiiua aeey iaacueyi e ia iaoiaaiiua aeey
ieo. Aiciiaeii, /oi iiaua AE*-iiaeiaiua ae?onu /aeiaaea aieueoa noiaeiu
ii naiei aeieiae/aneei e aioeaaiiui naienoaai n iaacueyiueeie ae?onaie,
/ai n AE*.
Iiaeii i?aaeiieiaeeoue, /oi ii ia?a enneaaeiaaiee aoaeoo iaeaeaiu
iaecaanoiua ?aiaa ?aciiaeaeiinoe AE*-iiaeiaiuo ae?onia /aeiaaea...
Niiauaiea ia iaeiii ec oaeeo ioe?uoee iiyaeeinue a 1990 aiaeo.
I?aaeiieaaaaony, /oi auaeaeai iiaue oei ae?ona eiioiiaeaoeoeeoa /aeiaaea
- AE*-3.
Ae?on aue auaeaeai io eeeie/anee caei?iaie aeaiueiu, eioi?ay auea
iieiaui ia?oia?ii iieiaeeoaeueiiai ii aioeoaeai e AE* ioae/eiu.
Nuai?ioea aeaiueiu auea neaaiiieiaeeoaeueiie a EOA, n ieceei oeo?ii a
iai?yiii eiioiioethi?anoeaioiii oanoa n aioeoaeaie e AE*-1 e aeaaaea
neaaua iieinu a iieiaeaieyo, oa?aeoa?iuo aeey aaeeia ?24 e gp41 a
eiioiiaeioa. Aiaeec auaeaeaiiiai ?ao?iae?ona n iiiiuueth
iiaeeoeoee?iaaiiiai oanoa ia naycuaaiea aioeaaiia iieacae, /oi
auaeaeaiiue ecieyo ia yaeyaony AE*-1. N?aaiaiea aaeeia auaeaeaiiiai
ecieyoa - ANT70 - n aaeeaie AE*-1 e AE*-2 iieacaei, /oi eo iieaeoey?iay
ianna ioee/aaony io niioaaonoaothueo aaeeia AE*-1 e AE*-2. Nuai?ioee
aeaiueiu, a iioii e aa ia?oia?a eo/oa ?aaae?iaaee n ANT70, /ai n AE*-1 e
AE*-2. Iicaea ae?on ANT70 aue auaeaeai e io iieiaiai ia?oia?a aeaiueiu.
Ioeeaioeaeiay iineaaeiaaoaeueiinoue aaiiia auaeaeaiiiai ae?ona
nouanoaaiii ioee/aaony io iineaaeiaaoaeueiinoae aaiiiia AE*-1 e AE*-2.
Iineaaeiaaoaeueiinoue aeeeiiiai eiioeaaiai iiaoi?a (LTR - long terminal
repeat) ia 3` eiioea ae?oniiai aaiiia ioee/aaony i?eia?ii ia 30% io
iniiaaiee LTR AE*-1 e aieaa /ai ia 50 % io LTR AE*-2. Anee o/anoue, /oi
o ?aciuo ooaiiia AE*-1 LTR ?acee/athony i?eia?ii ia 15%, oi
iaia?oaeaiiua o auaeaeaiiiai ooaiia ioee/ey a 30% e aieaa aeatho
iniiaaiey iieaaaoue, /oi auaeaeai iiaue, o?aoee i?aaenoaaeoaeue
naiaenoaa ae?onia-aicaoaeeoaeae NIEAe - AE*-3.
NOAOENOEEA.
Ii aeaiiui AIC ia eiiaoe 1994 aiaea a ie?a ca?aaeno?e?iaaii 17 ieeeeiiia
AE*-eioeoee?iaaiiuo. I?e/ai 66% ec ieo iaoiaeeony a Ao?eea ia
oa??eoi?eyo thaeiaa Naoa?u (11.2 ieeeeiia /aeiaae). A THaeiie e
THai-Ainoi/iie Acee ian/eouaaaony ieiei 3 ieeeeiiia iineoaeae ae?ona
NIEAe. Ai anae Aano?aeacee ca?aaeno?e?iaaii oieueei ieiei 12.000
ca?aaeaiiuo. A 15 no?aiao (ana iie ?aniieiaeaiu ia oa??eoi?eyo thaeiaa
Naoa?u) eiee/anoai AE*-eioeoee?iaaiiuo ninoaaeyao a ?aeiia 500 /aeiaae
ia 10.000 ianaeaiey. A 50 no?aiao yoio iieacaoaeue eieaaeaony a ?aeiia 5
/aeiaae ia 10.000 ianaeaiey. A inoaeueiuo no?aiao ii ieaea. Oaeei
ia?acii, iaaethaeaaony i/aiue ia?aaiiia?iia ?ani?ino?aiaiea ae?ona
NIEAe, ii ana aea caaieaaaiea eiaao ianooaau iaiaeaiee.
?acee/aaony e /anoioa auyaeaiey ae?ona n?aaee ?aciuo neiaa ianaeaiey.
N?aaee ioae/ei-aiiinaenoaeenoia iia ninoaaeyao 60-90%, a n?aaee
ia?eiiaiia, oiio?aaeythueo ia?eioeee aioo?eaaiii - 13-20%. Oioy a
iineaaeiaa a?aiy ia/eiaao iaaethaeaoueny ia?aoiay ea?oeia. Ia?aay aieia
yieaeaiee ?ani?ino?aiyeanue n?aaee ioae/ei-aiiinaenoaeenoia, a iuiaoiyy
- n?aaee ia?eiiaiia, i?eiaiythueo aioo?eaaiiua eiuaeoeee, /oi iicaieeo
yieaeaiee a aieueoae ia?a caoaaoeoue e aaoa?inaenoaeueioth /anoue
ianaeaiey. Ia?aoiae yieaeaiee ia aaoa?inaenoaeueioth /anoue ianaeaiey
aoaeao i?ienoiaeeoue aeaaiaea?y aenaenoaeueiui ioae/eiai, ia?eiiaiai e
i?inoeoooeai. Naaiaeiy i?ioeaio aeaiuei n?aaee caaieaaoeo NIEAeii
ninoaaeyao ieiei 5-10%, n?aaee eioi?uo 50% caaieaaoeo - eiuaeoeeiiiua
ia?eiiaiu, 29% ca?aceeenue i?e aaoa?inaenoaeueiuo iieiauo eiioaeoao.
I?aaaea, eco/aiea aaoa?inaenoaeueiiai iooe ?ani?ino?aiaiey auyaeei
?acee/ey a yooaeoeaiinoe ia?aaea/e ae?ona - iia iaeneiaeueia n?aaee
aeaiuei, ia?oia?u eioi?uo aieueiu NIEAeii, a aeey ia?aaea/e io aieueiie
aeaiueiu e aa ia?oia?ai ninoaaeyao 65%.
Iaeiieaiu oaeaea oaaaeeoaeueiua aeaiiua i oii, /oi a Ao?eea AE*
?ani?ino?aiyaony a iniiaiii aeaaiaea?y aaoa?inaenoaeueiui iieiaui
eiioaeoai, i?e/ai niioiioaiea iaaeaeo /eneii caaieaaoeo ioae/ei e
aeaiuei ninoaaeyao i?eia?ii 1:1. Iiieii iieiauo eiioaeoia aaaeioth ?ieue
ea?atho ia?aeeaaiey ca?aaeaiiie e?iae, e, aiciiaeii, eaeu aeey ea/aaiuo
iaieioeyoeee, a oaeaea aa?oeeaeueiue iooue ia?aaea/e. Nae/an
onoaiiaeaii, /oi ia?aua neo/ae NIEAea eiaee ianoi a Ao?eea aua a eiioea
70-o aiaeia. Yieaeaieieiae/aneea aeaiiua aeey ?yaea ao?eeaineeo no?ai
iieacaee, /oi a ii?aaeaeaiiuo a?oiiao i?ioeaio ca?aaeaiiuo i/aiue aunie:
80-90% i?inoeoooie, 30% eo eeeaioia, 30% aieueiuo iinauathueo
aaia?ieiae/aneea ioaeaeaiey, 10% aeiii?ia e?iae, 10% aeaiuei, iinauaaoeo
eeeieee i?aiaoaeueiiai i?ioeey. E oioy aunieee o?iaaiue
eioeoee?iaaiiinoe aue aia/aea oa?aeoa?ai oieueei aeey ?aeiiia
Oeaio?aeueiie Ao?eee, ae?on e aucuaaaiay ei aieaciue ?ani?ino?aieeenue
ioooaea ii/oe ii anaio eiioeiaioo.
Aeaeaa i?eaiaeyony iaeioi?ua eiie?aoiua oeeo?u e iieacaoaee ii
?ani?ino?aiaiiinoe AE*/NIEAe ia iaoae ieaiaoa.
*enei ca?aaeno?e?iaaiiuo AIC neo/aaa NIEAea ia ?aciuo
eiioeiaioao
Iniiaaii ia niiauaiee io 15 aeaeaa?y 1995
aiaea.
IIAUA NEO*AE NIEAea
AIAe Ao?eea Aia?eea Acey Aa?iia Ieaaiey ANAAI
1979 0 2 0 0
0 2
1980 0 185 1 17
0 203
1981 0 322 1 20
0 343
1982 2 1156 1 80
91 1330
1983 17 3352 8 295
6 3678
1984 187 6680 8 570 76
7521
1985 521 12682 27 1475 142
14847
1986 5438 21322 86 2395 252
29493
1987 16854 34562 150 9640 324
61530
1988 28212 47697 176 10811 598
87494
1989 41295 56202 288 14355 699
112839
1990 54528 65041 478 17311 770
138128
1991 72756 78579 838 18937 897
172007
1992 73631 99881 2039 20697 866
197114
1993 67124 100731 7368 22053 879
198155
1994 65684 83475 11707 23541 906
185313
1995 16486 47793 5454 11906 174
81813
________________________________________________________
ANAAI 442735 659662 28630 154103 6680 1291810
ANAAI NEO*AAA NIEAea
AIAe Ao?eea Aia?eea Acey Aa?iia Ieaaiey ANAAI
1979 0 2 0 0
0 2
1980 0 187 1 17
0 205
1981 0 509 2 37
0 548
1982 2 1665 3 117 91
1878
1983 19 5017 11 412 97
5556
1984 206 11697 19 982 173
13077
1985 727 24379 46 2457 315
27924
1986 6165 45701 132 4852 567
57417
1987 23019 80263 282 14492 891
118947
1988 51231 127960 458 25303 1489
206441
1989 92526 184162 746 39658 2188
319280
1990 147054 249203 1224 56969 2958 457408
1991 219810 327782 2062 75906 3855 629415
1992 293441 427663 4101 96603 4721 826529
1993 360565 528394 11469 118656 5600 1024684
1994 426249 611869 23176 142197 6506 1209997
1995 442735 659662 28630 154103 6680 1291810
______________________________________________________
ANAAI 442735 659662 28630 154103 6680 1291810
Aeaiiua ioiinoeoaeueii eiie?aoiuo no?ai iiaeii iaeoe a i?eeiaeaiee.
Ii, e niaeaeaieth, oi/iua oeeo?u /enea caaieaaoeo e eioeoee?iaaiiuo a
ie?a iaecaanoiu. Yoi iaoneiaeaii ianeieueeeie i?e/eiaie. Ai-ia?auo, naia
noaoenoeea ianiaa?oaiia - AIC ?aaeno?e?oao oieueei aieueiuo n
au?aaeaiiie ea?oeiie caaieaaaiey e ia o/eouaaao eeoe n i?a-NIEAeii e
ae?oniiineoaeae. Ai-aoi?uo, iaeioi?ua no?aiu aeatho iaiieiua aeaiiua
iioiio, /oi o ieo oanoe?iaaieth ia AE* iiaeaa?aaaony iacia/eoaeueiay
/anoue ethaeae, ioiinyueony e eaoaai?ee aunieiai ?enea. Yoi a iniiaiii
no?aiu Ao?eee e Acee, aaea ionoonoaea n?aaenoa aeey iinoaiiaee
niioaaonoaothueo enneaaeiaaiee i?aiyonoaoao iieiioeaiiiio auyaeaieth
eioeoee?iaaiiuo, i?aaeaea anaai aeiii?ia e?iae. O?aouey i?e/eia ninoieo
a oii, /oi i?aaeoaeuenoaa ?yaea no?ai iianathony ioaeeeaoeee yoeo
naaaeaiee, /oiau iie ia iaa?aaeeee eiino?aiiiio oo?ecio, eioi?ue
yaeyaony oai iaeiei ec aeaaiuo enoi/ieeia iaoeeiiaeueiiai aeioiaea.
NO?IAIEA AE?ONIIE *ANOEOeU AE*.
Ae?eii eiaao noa?e/aneoth oi?io, aeeaiao?ii 100-150 ii. Iniiaiua /a?ou
no?iaiey noiaeiu n ae?oaeie i?aaenoaaeoaeyie iiaenaiaenoaa
eaioeae?onia. Ia?oaeiay iaiei/ea ae?ona, eee eiiaa?o ninoieo ec
aeiieaeoey?iiai neiy eeieaeia, eioi?ue eiaao i?ienoiaeaeaiea ec
eeaoi/iie iaia?aiu eeaoee oicyeia. A yoo iaia?aio ano?iaiu ?aoeaioi?iua
ia?aciaaiey, ii aeaeo iaiiieiathuea a?eau. Oeyiea a?eaa ninoieo ec
/aou?ao iieaeoe aeeeii?ioaeaea gp120, eioi?ue iaeaaeaao n?iaenoaii e
iieaeoeai CD4. Iiaeea a?eaa ninoieo ec /aou?ao iieaeoe aeeeii?ioaeaea
gp41, eioi?ua ano?iaiu a iaia?aio. Oae eae iaia?aia eiaao eeaoi/iia
i?ienoiaeaeaiea, oi ia aa iiaa?oiinoe e aioo?e iaa nio?aiyaony
iiiaeanoai eeaoi/iuo aaeeia. Iiae ia?oaeiie iaiei/eie ?aniieaaaaony
na?aeoeaaeia ae?ona (ei?), eioi?ay eiaao oi?io ona/aiiiai eiiona e
ia?aciaaia aaeeii ?24. I?iiaaeooie iaaeaeo ia?oaeiie ae?oniie iaia?aiie
e na?aeoeaaeiie ae?ona caiieiai iao?eeniui aaeeii ?17. Aioo?e
na?aeoeaaeiu ?aniieaaathony aeaa iieaeoeu ae?oniie ?IE, naycaiiua n
ieceiiieaeoey?iuie aaeeaie (?9 e ?7) iniiaiiai oa?aeoa?a. Eaaeaeay
iieaeoea ?IE niaea?aeeo 9 aaiia AE*. O?e ec ieo - gag, env e pol -
yaeythony no?oeoo?iuie. Eiathony oaeaea o?e ?aaoeyoi?iuo aaia: tat, rev
e nef, e o?e aeiiieieoaeueiuo aaia: vpu, vpr e vif. Yoe aaiu niaea?aeao
eioi?iaoeeth, iaiaoiaeeioth aeey i?iaeoeoeee aaeeia, eioi?ua oi?aaeytho
niiniaiinoueth ae?ona eioeoee?iaaoue eeaoeo, ?aieeoee?iaaoueny e
aucuaaoue caaieaaaiea. Eiioeu eaaeaeie iieaeoeu ?IE niaea?aeao
aeoaee?iaaiioth iineaaeiaaoaeueiinoue ?IE, oae iacuaaaiue aeeeiiue
eiioeaaie iiaoi? - LTR. O/anoee LTR aeaenoaotho eae ia?aeeth/aoaee aeey
oi?aaeaiey i?ioeannii ae?oniie o?aine?eioeee, acaeiiaeaenoaoy n aaeeaie
AE* eee n aaeeaie eeaoee oicyeia. E?iia ?IE oai aea iaoiaeyony ae?oniua
oa?iaiou: ia?aoiay o?aine?eioaca, ninoiyuay ec aeaoo noauaaeeieoe -
?64/53, i?ioaaca - ?22, yiaeiioeeaaca (eioaa?aca) - ?31. Ia?aoiay
o?aine?eioaca inouanoaeyao neioac ae?oniie AeIE n iieaeoeu ae?oniie ?IE.
Yiaeiioeeaaca i?iecaiaeeo ano?aeaaiea ae?oniie AeIE a aaiii eeaoee
oicyeia, a ?acoeueoaoa /aai ia?acoaony i?iae?on. I?ioaaca o/anoaoao a
ia?acaiee i?aaeoanoaaiieeia ae?oniuo aaeeia i?e nic?aaaiee iiaie
ae?oniie /anoeoeu.
NO?IAIEA AAIIIA E YENI?ANNEss AAIIA AE*.
Aaaeiinoue enneaaeiaaiey no?iaiey aaiiia AE* iaoneiaeaia oai, /oi a
iniiaa anao iaoieiae/aneeo i?ioeannia, i?ienoiaeyueo i?e ca?aaeaiee
ae?onii, eaaeeo yeni?anney ae?oniuo aaiia.
Eco/aiea no?oeoo?u aaiaoe/aneiai aiia?aoa AE* n iiiiuueth iieaeoey?iiai
eeiie?iaaiey auyaeei aai neiaeioth i?aaiecaoeeth e cia/eoaeueiua
?acee/ey iaaeaeo ecieyoaie. AeIE i?iae?ona eiaao 9283 ia?u ioeeaioeaeia
(i.i.) e ie?oaeaia aeeeiiuie eiioeaauie iiaoi?aie - LTR - a 638 i.i. A
LTR auyaeythony ana iau/iua ?aaoeyoi?iua yeaiaiou. (ni. ?enoiie 1).
A ea/anoaa cao?aaee i?e neioaca ieion oeaie AeIE AE* eniieuecoaony
o?IEeec, a oi a?aiy eae aieueoeinoai ?ao?iae?onia ieaeiieoathueo
eniieuecotho o?IEi?i. O?IEeec eniieuecoaony e i?e neioaca ieion-oeaie
AeIE ae?ona iiooiee iiei/iuo aeaeac iuoae (MMTV), eioi?ue eiaao e i/aiue
noiaeioth iineaaeiaaoaeueiinoue iieeio?eiiaiai o?aeoa. Iaeiaei ia yoii
noiaenoai AE* e MMTV caeai/eaaaony. Eae noaei ynii yoio ?ao?iae?on eiaao
iaei iauaai e n ?ao?iae?onaie /aeiaaea HTLV-1 e HTLV-2, oioy a ?aiieo
niiauaieyo aiai?eeinue ia eo acaeiiie aiiieiaee. Iaeaieaa aeeceeie e AE*
eae ii ii?oieiaee, oae e ii oa/aieth aucuaaaiiai caaieaaaiey ieacaeenue
ae?onu a?oiiu eaioeae?onia. Eeiie?iaaiiay i?iae?oniay AeIE ae?onia aenia
e eioaeoeeiiiie aiaiee eioaaeae, ioiinyueony e iiaenaiaenoao
eaioeae?onia, ia?acoao noaaeeueiua aea?eaeu n i?iae?oniie AeIE AE*.
Aiaeec ia?ae/iie iineaaeiaaoaeueiinoe ioeeaioeaeia yoeo i?iae?oniuo AeIE
auyaee iaoe?iua o/anoee aiiieiaee, iniaaiii a iaeanoyo aaiia gag e pol.
AAIU E AAEEE AE*.
gag. Ia?aay ioe?uoay ?aiea eiaee?oao aioo?aiiea aaeee ae?eiia. Yoe
aaeee aianoa n aaeeaie, eiaee?oaiuie aaiii pol, i?i/eouaathony, eae e o
ae?oaeo ?ao?iae?onia, n iieii?acia?iie ?IE a 9300 ioeeaioeaeia. A
?acoeueoaoa o?aineyoeee yoie e?IE (ni. ?enoiie 2) ia?acoaony
i?aaeoanoaaiiee n iie. Iannie 55 eAe. A i?ioeanna aeaeueiaeoaai
i?ioaieeoe/aneiai ?anuaieaiey yoio aaeie ia?acaaony ia p17, p24, p9 e
?7. Niaeanii iaaethaeaieyi, a nuai?ioeao aieueiuo NIEAe iaia?oaeeaathony
aioeoaea ei anai yoei i?iaeoeoai. Cia/eoaeueioth o?aeoeeth ninoaaeytho
aioeoaea e ?24 - iniiaiiio aioo?aiiaio aaeeo ae?eiia. Aioeoaea e ?24
iau/ii iiyaeythony ia ?aiieo noaaeeyo caaieaaaiey e /anoi en/acatho ii
ia?a aai i?ia?anne?iaaiey.
pol. Eae e o ae?oaeo ?ao?iae?onia, eiaee?oaiua yoei aaiii aaeee
n/eouaathony a aeaea gag-pol i?aaeoanoaaiieea. Iineieueeo ?aiea
n/eouaaiey aaia pol ia niaiaaeaao n ?aieie gag, i?e nic?aaaiee e?IEpol
aeieaeii i?ienoiaeeoue oaeaeaiea iaaieueoiai eio?iia, naeaeaathuaa ?aieo
n/eouaaiey. Aiaeec ia?ae/iie ioeeaioeaeiie iineaaeiaaoaeueiinoe iaeanoe
ia?ae?uaaiey aaiia gag e pol auyaeyao i?enoonoaea oai ianeieueeeo
o/anoeia, eioi?ua iiaoo auiieiyoue ooieoeeth aeoeaioi?iuo naeoia
nieaeneiaa. Ae?oaei iaoaieciii niaiauaiey ?aiie n/eouaaiey yaeyaony oae
iacuaaaiue ia?aneie ?aiee i?e o?aineyoeee. A ?acoeueoaoa ?eainiiu
ia?ai?uaeaatho /a?ac noii-eiaeii, ia?aie/eaathuee ?aieo gag, e
i?i/eouaatho pol oaea a i?aaeeueiie ?aiea n/eouaaiey. Iiaeiaiue iaoaieci
iienai aeey iaeioi?uo ?ao?iae?onia.
Aai pol eiaee?oao 3 oa?iaioa: i?ioaaco (?22), ia?aoioth o?aine?eioaco
(?64/53) e yiaeiioeeaaco (?31). Yoe aaeee ia?acothony a ?acoeueoaoa
i?ioaieeoe/aneiai ?anuaieaiey i?aaeoanoaaiieea n iieth iannie 150eAe.
Ianiio?y ia ioiineoaeueii iaaieueoia eiee/anoai yoeo aaeeia a ae?eiia
(i?eia?ii 2 iieaeoeu ia ae?eii), aioeoaea e iei auyaeythony a nuai?ioeao
aieueiuo NIEAeii. Iaeaieaa y?ei au?aaeaia ?aaeoeey n ?31.
sor .T?aouey ioe?uoay ?aiea ia?ae?uaaaony n 3`-eiioeii aaia pol e
eiaee?oao aaeie n iieth iannie 23 eAe. Aioeoaea e yoiio aaeeo oaeaaony
auyaeoue a nuai?ioeao aieueiuo NIEAeii. Ii-aeaeeiiio, aaeie
o?ainee?oaony ni nieaene?iaaiiuo iieeaaeaieee?iaaiiuo ?IE ?acia?ii 5500
e 5000 ioeeaioeaeia (ni. ?enoiie 2). Eae iieacaee iiuou n
eniieueciaaieai eioaeoeeiiiie i?iae?oniie AeIE AE*, iooaoeee a iaeanoe
aaia i?aeoe/anee ia aeeyee ia niiniaiinoue ae?ona ?aieeoee?iaaoueny e
ieacuaaoue oeeoiiaoiaaiiia aeaenoaea ia CD4-eeaoi/ioth eeieth, anee ia
n/eoaoue iaaieueoiai caiaaeeaiey yoeo i?ioeannia ii n?aaiaieth n
enoiaeiui ae?onii. Oai ia iaiaa, aunieay eiina?aaoeaiinoue ioeeaioeaeiie
iineaaeiaaoaeueiinoe aaia sor oeacuaaao ia iaee/ea eaeie-oi ooieoeee
i?iaeoeoa yoiai aaia a aeeciaiiii oeeeea ae?ona. Aiciiaeii, yoa ooieoeey
aaaeia i?e ?aieeeaoeee a iaeeioieaeiuo eeaoeao, iai?eia? a ia?aiuo e
?aoeeoeiyieoaeeaeueiuo.
env. e?IE, eiaee?othuay aaeee iaiei/ee ae?eiia, ia?acoaony a ?acoeueoaoa
nieaeneiaa, i?eaiaeyuaai e oaeaeaieth ec aaiiiiie ?IE aieueoiai eio?iia,
niaea?aeauaai aaiu gag, pol e sor (ni. ?enoiie 2). Ia?acothuayny
e?IE ?acia?ii 4300 ioeeaioeaea
niaea?aeeo ioe?uooth ?aieo n oeie/iui eieoeee?othuei AUG, eioi?ay iiaeao
iai?aaeyoue neioac aaeea, ninoiyuaai ec 861 aieiieeneioiiai inoaoea n
iie. iannie 97.5 eAe. Yoio aaeie i?aaeoanoaaiiee a aeaeueiaeoai iaeeueii
aeeeiceee?oaony, a ?acoeueoaoa /aai aai iie. ianna aic?anoaao aei 160
eAe. I?aaeoanoaaiiee niaea?aeeo 3 aeae?ioiaiua iaeanoe, oa?aeoa?iua aeey
iaiei/a/iuo aaeeia ae?oaeo ?ao?iae?onia. Ia?aue aeae?ioiaiue o/anoie (n
17-e ii 31-th aieiieeneiou) niioaaonoaoao neaiaeueiiio iaioeaeo, aoi?ie
iaoiaeeony a ?aeiia naeoa i?ioaieeoe/aneiai ?anuaieaiey
aaeea-i?aaeoanoaaiieea, o?aoee yaeyaony /anoueth o?ainiaia?aiiiai aaeea.
A ?acoeueoaoa i?ioaieeoe/aneiai ?anuaieaiey ia?acoaony 2 neeueii
aeeeiceee?iaaiiuo aaeea: ia?oaeiue aaeie iaiei/ee gp120 e
o?ainiaia?aiiue aaeie gp41. Eioa?aniie iniaaiiinoueth o?ainiaia?aiiiai
aaeea yaeyaony iaee/ea iaiau/ii aeeeiiie iineaaeiaaoaeueiinoe (aeeeiie a
150 aieiieeneioiuo inoaoeia) aeae?ioeeueiuo aieiieeneio aneaae ca
aeae?ioiaiie /anoueth o?ainiaia?aiiiai aaeea. Yoa iineaaeiaaoaeueiinoue,
ii-aeaeeiiio, yaeyaony aioo?eeeaoi/iui o?aaiaioii gp41. Aua, eae
iieacaee enneaaeiaaiey, i?aaeeueiue i?ioeanneia gp160 i?ienoiaeeo ia ai
anao eeaoi/iuo eeieyo. Io /aai yoi caaeneo, iiea iaecaanoii.
3`-orf. Yoa ioe?uoay ?aiea ?aniieiaeaia iaaeaeo 8347-i e 8992-i
ioeeaioeaeaie e i?inoe?aaony, oaeei ia?acii, a U3 iaeanoue 3`-LTR.
Eiaee?oaiue yoei aaiii aaeie eiaao iie. ianno 27 eAe e o?ainee?oaony ni
nieaene?iaaiiie e?IE ?acia?ii 1800 ioeeaioeaeia (ni. ?enoiie 2).
Oioy aioeoaea e yoiio aaeeo oaeaaony auyaeoue a e?iae aieueiuo NIEAeii,
ii ia yaeyaony aaniethoii iaiaoiaeeiui aeey ?aieeeaoeee ae?ona. I?iaeoeo
3`-orf ieacuaaao aeeyiea ia oeeoiiaoiaaiiinoue ae?ona.
tat-3. ssaeaiea o?ainaeoeaaoeee auei aia?aua iienaii aeey ?ao?iae?onia
/aeiaaea HTLV-1 e HTLV-2. Aaeie, inouanoaeythuee ooieoeeth
o?ainaeoeaaoeee, eiaee?oaony o yoeo ae?onia iaaieueoie ioe?uoie ?aieie,
?aniieiaeaiiie ia 3`-eiioea aaiiia iinea aaia env. Iaoaieci aai
aeaenoaey caeeth/aaony a aeoeaaoeee o?aine?eioeee no?oeoo?iuo aaiia
ae?ona, aneaaenoaea /aai aai, eiaee?othuee aaeie-o?ainaeoeaaoi?, aue
iacaai tat (transactivator of transcription).
Oaiiiai o?ainaeoeaaoeee au?aaeai o AE* ia ianeieueei ii?yaeeia neeueiaa,
/ai o HTLV-1 e HTLV-2. Eae nae/an noaei ynii, ca yoio i?ioeann o AE*
ioaa/atho ii e?aeiae ia?a, 2 aaia: tat-3 e art (trs). Ia?aue ec ieo
eiaee?oaony e?IE ?acia?ii ieiei 2000 ioeeaioeaeia, ia?acothuaeny a
?acoeueoaoa neiaeiiai nieaeneiaa (ni. ?enoiie 2). Iaoaieci aeaenoaey
aaeea tat-3 o AE* cia/eoaeueii neiaeiaa, /ai o aiaeiae/iuo aaeeia tat
ae?onia HTLV-1 e HTLV-2.
I?iaeoeo aaia tat-3 - aaeie n iie. iannie 14 eAe, auyaeyaiue n iiiiuueth
nuai?ioie aieueiuo NIEAe. Iooaoeee a 5`-iaeanoe ia?aiai eiaee?othuaai
yeciia tat-3 ia?ooatho niiniaiinoue ae?ona neioace?iaaoue no?oeoo?iua
aaeee e ?aieeoee?iaaoueny. Yoe iooaoeee iiaoo auoue eiiieaiaioe?iaaiu a
eeaoi/iuo eeieyo, iinoiyiii yeni?anne?othueo tat-3 aaeie. Nae/an
iieo/aiu eeiee eae A- oae e O-eeioioeeoia, noaaeeueii o?ainoi?ie?iaaiiuo
tat-3 aaiii e i?iaeooee?othueo aaeie-o?ainaeoeaaoi?. Ae?oaea eeaoi/iua
eeiee, iai?eia? HeLa, i?iaeooee?othuea ooieoeeiiaeueiue tat-3 aaeie,
oaeaea iiaoo iiaeaea?aeeaaoue ?aciiiaeaiea iooaioiiai ii tat-3 AE*.
Eniieueciaaiea iiaeiaiuo eeaoi/iuo eeiee e eeiie?iaaiiuo i?iae?oniuo
AeIE, niaea?aeaueo ?acee/iiai ?acia?a aeaeaoeee a tat-3 aaia, iicaieeei
eco/eoue iaoaieciu aeaenoaey eiaee?oaiiai yoei aaiii aaeea.
art (trs). Ae?oaei aaeeii, o/anoaothuei a ?aaoeyoeee yeni?annee
no?oeoo?iuo aaiia AE* yaeyaony i?iaeoeo aaia art (antirepression
transactivator - aioe?ai?anni?iue o?ainaeoeaaoi?). O?ainee?oaony ii,
ii-aeaeeiiio, n e?IE, i?eiaaeeaaeauae e oiio aea eeanno iieaeoe
?acia?ii 2000 ioeeaioeaeia, /oi e e?IEtat-3. Eiaee?othuea yeciiu aaia
art ia?ae?uaathony yeciiaie tat-3 (ni. ?enoiie 2), a i?e nieaeneiaa
eniieuecothony oa aea aeoeaioi?iua e aeiii?iua naeou. Iaeiaei i?e
o?aineyoeee art ooieoeeiie?oao eieoeeaoi?iue AUG n eii?aeeiaoie 5500, a
ia 5412, eae aeey aaia tat-3. A ?acoeueoaoa, art /eoaaony ni naeaeaii
?aiee ioiinoeoaeueii tat-3, /oi i?eaiaeeo e oiaiueoaieth aa eiaee?othuae
?aiee a ia?aii o?ainee?oaiii yeciia n 214 aei 76 ioeeaioeaeia e e
oaaee/aieth ai aoi?ii n 44 aei 271 ioeeaioeaea. Neioace?oaiue aaeie
ninoieo ec 116 aieiieeneioiuo inoaoeia, i?e/ai iniiaiay aeiey
i?eoiaeeony ia aieiieeneiou, i?iyaeythuea iniiaiua naienoaa. Iiaeiaiua
aaeee iaeaaeatho n?iaenoaii e ioeeaeiiaui eeneioai e /anoi ?aaoee?otho
yeni?anneth aaiia.
Aeaenoaea i?iaeoeoa art inouanoaeyaony ia iinoo?aine?eioeeiiiii o?iaia.
Ii-aeaeeiiio, ii aeoeae?oao o?aineyoeeth e?IE no?oeoo?iuo aaiia gag e
env, nieiay aeaenoaea niaoeeoe/aneeo iaaaoeaiuo ?aaoeyoi?ia (ni. ieaea).
Ia?yaeo n yoei i?iaeoeo art o/anoaoao e a ?aaoeyoeee nieaeneiaa ?IE, a
nayce n /ai aeey oeacaiiiai aaia auei i?aaeeiaeaii ae?oaia iacaaiea -
trs (transregulator of splicing - o?ain?aaoeyoi? nieaeneiaa).
?AAOEssOeEss YENI?ANNEE AE?ONIUO AAIIA.
Eae auei ioia/aii auoa, aaiii AE*, iiieii iau/iuo ?ao?iae?oniuo aaiia
(gag, pol, env), niaea?aeeo aua ?yae aaiia, ooieoeee eioi?uo
caeeth/athony a ?aaoeyoeee yeni?annee neioaca no?oeoo?iuo aaeeia
ae?eiia. Anee i ooieoeee i?iaeoeoia aaiia sor e 3`-orf iaei /oi
ecaanoii, e?iia oiai, /oi iie ia yaeythony iaiaoiaeeiuie aeey
?aieeeaoeee ae?ona, i aeaenoaee i?iaeoeoia aaiia tat-3 e art eiaaony
iiiai aeaiiuo, oeeaaeuaathueony a ii?aaeaeaiioth noaio.
Ia?aua iiuou ii eco/aieth neioaca iaeioi?uo oa?iaioia a eeaoeao,
o?ainoi?ie?iaaiiuo ?aeiiaeiaioiuie AeIE, niaea?aeaueie aaiu yoeo
oa?iaioia iiae eiio?ieai LTR AE*, iieacaee, /oi eiee/anoai
niaoeeoe/aneeo e?IE ?acei oaaee/eaaaony (a 100-1000 ?ac) iinea aaaaeaiey
a eeaoee aeiiieieoaeueii aeoeaii yeni?anne?othuaainy tat-3 aaia.
Aeaeueiaeoea iiuou iieacaee, /oi i?iaeoeo aaia tat-3 oaaee/eaaao
eiee/anoai niaoeeoe/aneeo e?IE i?eia?ii a 10 ?ac, i?e/ai aai aeaenoaea
iiin?aaeiaaii iineaaeiaaoaeueiinoueth, i?enoonoaothuae a R-yeaiaioa LTR
AE*. Iaeiaei aeey iaeneiaeueiiai yooaeoa tat-3-caaeneiie o?ainaeoeaaoeee
iaiaoiaeeii i?enoonoaea iineaaeiaaoaeueiinoe U3 - yeaiaioa LTR. Oaeei
ia?acii, i?iaeoeo aaia tat-3 aucuaaao aeoeaaoeeth o?aine?eioeee, e aai
aeoeae?othuaa aeaenoaea inouanoaeyaony ia yoaia eieoeeaoeee
o?aine?eioeee.
Aaaeiie /anoueth tat-3-caaeneiie o?ainaeoeaaoeee yaeyaony aeoeaaoeey
o?aineyoeee e?IE. Yoio iinoo?aine?eioeeiiiue yooaeo tat-3-aaeea oaeaea
iiin?aaeiaai iineaaeiaaoaeueiinoueth R-yeaiaioa LTR AE*. Yoa
iineaaeiaaoaeueiinoue auea iaicia/aia TAR (trains acting responsive) e
eieaeeciaaia iaaeaeo -17 e +80 ioeeaioeaeaie a LTR AE*. Aiaeec
ia?ae/iie ioeeaioeaeiie iineaaeiaaoaeueiinoe yoiai o/anoea iieacae
iaee/ea oai 24-o ioeeaioeaeiiai ia?auaiiiai iiaoi?a (iaaeaeo 1-i e 59-i
ioeeaioeaeaie), eioi?ue iiaeao oi?ie?iaaoue iaoeth a e?IE. Oaeay
aoi?e/iay no?oeoo?a e?IE iiaeao iaoaoue 40S noauaaeeieoea ?eainiiu
ia?aaeaeaaoueny aaeieue e?IE i?e eieoeeaoeee o?aineyoeee e
i?aiyonoaiaaoue, oaeei ia?acii, neioaco i?iaeoeoa. Acaeiiaeaenoaea
i?iaeoeoa aaia tat-3 n yoei o/anoeii e?IE ?aeaene?oao no?oeoo?o e
nieiaao, oaeei ia?acii, i?aiyonoaea aeey o?aineyoeee. A yenia?eiaioa
auei auyniaii, /oi aeaeaoeee a TAR o/anoea nieiaee oi?iicyuaa aeaenoaea
R-yeaiaioa ia o?aineyoeeth, iaeiaei iieiinoueth eeeaeaee?iaaee yooaeo
o?ainaeoeaaoeee. Oaeei ia?acii, tat-3 eiaee?oaiue aaeie eee
eiaeooee?iaaiiua ei eeaoi/iua oaeoi?u ociatho TAR iineaaeiaaoaeueiinoue
eae a AeIE (i?iae?on), oae e a e?IE e aeoeae?oao niioaaonoaaiii
o?aine?eioeeth eee o?aineyoeeth.
Aeaenoaea ae?oaiai aaia-o?ainaeoeaaoi?a - art- inouanoaeyaony oieueei ia
iinoo?aine?eioeeiiiii o?iaia. I?iaeoeo aaia art(trs) o/anoaoao a
?aaoeyoeee nieaeneiaa. Ii nieiaao ?ai?anneth niaoeeoe/aneeo iaaaoeaiuo
?aaoeyoi?ia o?aineyoeee, ?aniieiaeaiiuo ia e?IE, eiaee?othuae aaeee gag
e env. A ionoonoaea aeoeaiiai aaia art(trs) ia?ooaaony neioac eiaiii
yoeo aaeeia, a oi a?aiy eae yeni?anney ae?oaeo aaiia (iai?eia? tat-3)
ia ia?ooaaony.
Anee noiie?iaaoue i?eaaaeaiiua aeaiiua, oi iiaeii i?aaeeiaeeoue oaeoth
iiaeaeue ?aaoeyoeee yeni?annee aaiia AE*. I?iaeoeo aaia tat-3,
acaeiiaeaenoaoy n TAR iineaaeiaaoaeueiinoueth a LTR i?iae?ona,
aeoeae?oao o?aine?eioeeth i?iae?oniie AeIE. Aiciiaeii, yoi i?ienoiaeeo
ca n/ao oiaiueoaiey oi?iicyuaai aeaenoaey ia i?ioeann o?aine?eioeee
niaoeeoe/aneiai iaaaoeaiiai ?aaoeyoi?iiai yeaiaioa (NRE),
?aniieiaeaiiiai iaaeaeo -340-i e -185-i ioeeaioeaeaie a U3
iineaaeiaaoaeueiinoe LTR AE*.
Oio aea tat-3 aaeie aeoeae?oao e o?aineyoeeth e?IE, nieiay eiaeae?othuaa
aeaenoaea ia eieoeeaoeeth o?aineyoeee TAR-yeaiaioa. Aeey iieiioeaiiiai
neioaca no?oeoo?iuo aaeeia ae?eiia iaiaoiaeeii aeaenoaea aua iaeiiai
aaeea - i?iaeoeoa aaia art(trs). Yoio aaeie iiyaeyaony a ?acoeueoaoa
iienaiiuo auoa niauoee e ia?aeeth/aao nieaeneia ia i?iecaiaenoai e?IE
no?oeoo?iuo aaiia. Yoio aea aaeie nieiaao aeaenoaea iaaaoeaiuo
?aaoeyoi?ia o?aineyoeee, ?aniieiaeaiiuo ia e?IE, eiaee?othueo
no?oeoo?iua aaeee (gag e env). I?aaeiieaaaaiay oeaiue niauoee
i?aaenoaaeaia ia ?enoiea 3.
Eiia/ii, i?aaeiieaaaaiay noaia niaea?aeeo iiiai aaeuo iyoai. Oae, iiea
ia ynii, /oi yaeyaony enoiaeiui oie/eii e aeoeaaoeee i?iae?ona. Oaeay
aeoeaaoeey i?ienoiaeeo i?e aioeaaiiie noeioeyoeee ca?aaeaiiiai AE*
O-eeioioeeoa, iaeiaei iieaeoey?iua iaoaieciu yoiai yaeaiey ia eco/aiu.
Aaaeioth ?ieue a aeoeaaoeee i?iae?ona iiaeao ea?aoue e acaeiiaeaenoaea
ae?oniuo aaiia n eeaoi/iuie aaeeaie. Oae, oaeoi? o?aine?eioeee Sp1,
i?enoonoaothuee a eeaoeao ieaeiieoathueo, naycuaaaony n i?iiioi?iui
o/anoeii a LTR i?iiioi?a AE* e aeoeae?oao neioac ?IE a 5-10 ?ac.
OAI?EE I?IENOIAEAeAIEss AE*.
Aii?in i i?ienoiaeaeaiee AE* 1-ai e 2-ai oeiia yaeyaony iaeiei ec
eeth/aauo a nia?aiaiiii iiieiaiee i?iaeaiu NIEAea, iineieueeo aai
?aoaiea a cia/eoaeueiie ia?a ii?aaeaeyao iai?aaeaiey aeeaaiinoeee,
ea/aiey e i?ioeeaeoeee aeaiiie iaoieiaee.
Eoae, ecaanoiu neaaeothuea aicaoaeeoaee NIEAe:
n ae?on eiioiiaeaoeoeeoa /aeiaaea(AE*) - LAV/HTLV-3 (HIV, AE*-1),
?ani?ino?aiaiiue a iniiaiii a Aia?eea, Aa?iia, oeaio?aeueiuo, ainoi/iuo
e thaeiuo ?aeiiao Ao?eee;
n ?iaenoaaiiua iaacueyiueei ae?onu iiaea?oiiu caiaaeii-ao?eeaineeo
O-eeioio?iiiuo ?ao?iae?onia (LAV-2, HIV-2, AE*-2), auaeaeaiiua a?oiiie
E.Iiioaiuea a 1986 a. Io aieueiuo NIEAe ao?eeaioeaa ec Aaeiae.
n ae?on HTLV-4, auaeaeaiiue aia?eeaineeie o/aiuie io i?aaenoaaeoaeae
a?oii iiauoaiiiai ?enea (Naiaaae). ?ani?ino?aiai a
iniiaiii a Ao?eea.
Iienaiu neo/ae iaeiia?aiaiiiai nouanoaiaaiey a i?aaiecia /aeiaaea AE*-1,
AE*-2 e HTLV-4 a ?acee/iuo ni/aoaieyo.
Ii iiaiaeo i?ienoiaeaeaiey ae?onia eiioiiaeaoeoeeoa /aeiaaea a
eeoa?aoo?a i?aaenoaaeaii iiiai aeaiiuo, ii?ith i?ioeai?a/eauo e ia
anaaaea iieiuo. Nii?u i?iaeieaeathony. Ii ia?a iaeiieaiey iaoa?eaea
aicieeee aeiioacu i?ienoiaeaeaiey AE*, iniiaiua ec eioi?uo aoaeoo
i?eaaaeaiu ieaea.
1. Ae?on nicaeai eneonnoaaiii a eiioea 70-o aiaeia oaeouaai noieaoey
iin?aaenoaii iaoiaeia aaiiie eiaeaia?ee ia iniiaa iiauo ciaiee i aeeyiee
?acee/iiai ?iaea eceo/aiee, eiioiiaeai?annaioia e iiiiioeeaa?iuo
aioeoae ia ?acee/iua caaiuey eiioiiie nenoaiu.
2. A anoanoaaiiuo oneiaeyo ae?on eiioiiaeaoeoeeoa /aeiaaea iiaeao
eiaoue aio?iiiaaiiia i?ienoiaeaeaiea, a eiaiii:
· AE* - oeie/iue yeciaaiiue ?ao?iae?on, nouanoaiaaaoee o ethaeae n
ae?aaieo a?aiai e yaiethoeeiie?iaaaoee aianoa n /aeiaaeii i?e aai
?annaeaiee ia Caiea;
· a aeooeo oaieeao Oeaio?aeueiie Ao?eee AE* oee?eoee?iaae e
aucuaae yiaeaie/aneea caaieaaaiey NIEAe aeeeoaeueiia a?aiy, caoai /a?ac
i. Aaeoe iiiae a NOA e a iineaaeothuai aeiaieueii auno?i ?ani?ino?aiyeny
ia ana eiioeiaiou;
· AE* - ia ao?eeaineiai i?ienoiaeaeaiey, a aiciee e aei iuiaoiae
iaiaeaiee, nouanoaiaae a no?aiao oia?aiiiai eeeiaoa (Naaa?iay Aia?eea,
Aa?iia), a neeo neaaie iaoiaaiiinoe aucuaay ioaeaeueiua caaieaaaiey,
i?aeoe/anee ia aeeaaiinoe?oaiua eae NIEAe
3. Ciiiiciia i?ienoiaeaeaiea ae?ona eiioiiaeaoeoeeoa /aeiaaea, /oi
iiaei auoue ?aaeeciaaii neaaeothueie iooyie:
· a ia/aea 50-o aiaeia iaoaai noieaoey eiino?oe?iaaiea AE* i?iecioei
i?e aaiaoe/aneeo ?aeiiaeiaoeeyo (aeaeeii, neo/aeiuo) ae?ona eaeeica
/aeiaaea e aeeaioiuo (?ao?iae?ona oeia N) n ae?onii iiooiee iiei/iie
aeaeacu iuoae (?ao?iae?on oeia A) eee n ae?onii iaacueyiueaai NIEAe
(?ao?iae?on oeia D);
· a ae?aaiea a?aiaia iooaiou ae?ona eiioiiaeaoeoeeoa caeaiie
ia?ouoee o?ainoi?ie?iaaeenue e ia?aee iiaiai oicyeia - /aeiaaea;
· ii no?oeoo?a aaiiia e aeieiae/aneei naienoaai AE* aeecie e
eaioeae?ono aenia e ae?ono eioaeoeeiiiie aiaiee eioaaeae, ioia/aaony
au?aaeaiiay iauiinoue eo aioo?aiieo (na?aeoeaaeiiuo) aaeeia.
?yae aaoi?ia ooaa?aeaeatho, /oi i?iaae a no?oeoo?a e naienoaao iaaeaeo
ae?onaie eiioiiaeaoeoeeoa iaacueyi e /aeiaaea oaea /anoe/ii caiieiai
noiaeiuie ae?onaie HTLV-4, AE*-2, a oaeaea iaaeaaii ioe?uoui oaaaeneei
o/aiui ae?onii SBL, e i?ioeann yoio aoaeao i?iaeieaeaoueny.
Iaeiaei i?iaeaia NIEAea naaiaeiy i?aaenoaaeyaony ianoieueei
iao?eaeaeueiie e iiiaiieaiiaie, /oi o?aaeeoeeiiiue yieaeaieieiae/aneee
iiaeoiae e oeacaiiiio caaieaaaieth eae e iau/iie aio?iiiciiiiciie
eioaeoeee a?yae ee iiaeao auoue en/a?iuaathuei a o?aeoiaea aaiaca AE*. A
iiyniaiea yoiio iaiaoiaeeii ioiaoeoue, /oi a yaiethoeeiiiii aniaeoa
?ao?iae?onu (a ia?aoth i/a?aaeue iieiaaiiua) /anoi e aaniethoii
ii?aaaeaiii ?anniao?eaathony a ia?ac?uaiie nayce n iiaeeueiuie
eeaoi/iuie yeaiaioaie aaiiia yoea?eio. I?eia/aoaeueiui yaeyaony oaeo
oaeeaeoaeueiiai no?oeoo?iiai noiaenoaa i?iae?oniuo ioeeaioeaeiuo
iineaaeiaaoaeueiinoae e ia?aiauathueony yeaiaioia yoea?eioe/aneeo
aaiiiia.
A ia?aoth i/a?aaeue ia?auaao ia naay aieiaiea oio oaeo, /oi eae
i?i?ao?iae?onu, oae e iiaeeueiua aaiaoe/aneea yeaiaiou ia?aie/aiu n
iaaeo noi?ii ?aaoeyoi?iuie iineaaeiaaoaeueiinoyie - aeeeiiuie eiioeaauie
iiaoi?aie (LTR).
Aieaa oiai, LTR i?i?ao?iae?onia e iiaeaeaeiuo aaiaoe/aneeo yeaiaioia
naie oa?aeoa?ecothony noiaenoaii iieaeoey?iie i?aaiecaoeee. O anao
ia?a/eneaiiuo iieeioeeaioeaeiuo iineaaeiaaoaeueiinoae LTR ianoo ia
eiioeao eiaa?oe?iaaiiua eiioeaaua iiaoi?u. Iiyaeaiea ei?ioeeo eiioeaauo
iiaoi?ia ii e?ayi i?i?ao?iae?onia e ia?aiauathueony yeaiaioia aaiiia
yoea?eio naycaii n oaeaiaieai ninaaeieo o/anoeia AeIE, oi anoue
oeacuaaao ia iauee iaoaieci eo eioaa?aoeee n eeaoi/iui aaiiiii. Iaeiie
ec iaueo oa?aeoa?enoee i?ioeanna eioaa?aoeee a aaiii iiaeeueiuo
yeaiaioia (?ao?iiiciiia) e ?ao?iae?onia yaeyaony eniieueciaaiea ia?aoiie
o?aine?eioeee.
Noiaeiui ia?acii inouanoaeyaony e eo i?yiay o?aine?eioeey: eae
i?iae?onu, oae e iiaeeueiua aaiaoe/aneea yeaiaiou o?aine?eae?othony a
aeaea iieii?acia?iie ?IE io ia/aea iaeiiai LTR aei eiioea ae?oaiai. Iaa
aeaea ia?acothueony o?aine?eioia eiatho ii/oe iaeeiaeiaoth aeeeio.
I?eaaaeaiiua auoa e iaeioi?ua ae?oaea i?eciaee
no?oeoo?ii-ooieoeeiiaeueiiai noiaenoaa ?ao?iae?onia e iiaeeueiuo
aaiaoe/aneeo yeaiaioia aeaee iniiaaiey O. Oaieio auaeaeiooue aeiioaco i
i?ienoiaeaeaiee ?ao?iae?onia ec iiaeeueiuo eeaoi/iuo yeaiaioia
yoea?eioe/aneiai aaiiia. Niaeanii i?aaeiieiaeaieth Oaieia yaiethoeey
?ao?iae?onia ia/eiaeanue n oiai, /oi aeaa iaaieueoeo iiaeeueiuo
yeaiaioa, ia?aianoeaoenue e e?ayi aaia AeIE-iieeia?acu, a aeaeueiaeoai a
aeaea aaeeiiai o?ainiiciia iea?e?iaaee niaianoii n iacaaiiui aaiii,
i?e/ai iineaaeiee iinoaiaiii o?ainoi?ie?iaaeny a aai ?IE-caaeneiie
AeIE-iieeia?acu (ia?aoiie o?aine?eioacu), a oeaiee?othuea
iineaaeiaaoaeueiinoe i?aa?aoeeenue a LTR. A aeaeueiaeoai iiaeiaiue
iiaiia?aciaaiiue iiaeeueiue yeaiaio a i?ioeanna o?ainiiceoeee iia
caoaaoeoue e aeeth/eoue a naie ninoaa ae?oaea no?oeoo?iua aaiu,
oa?aeoa?iua aeey ?ao?iae?onia (gag, env).
Iaeiei ec oaaaeeoaeueiuo nia?aiaiiuo iiaeoaa?aeaeaiee Oaieia iiaoo
neoaeeoue aeaiiua, oeacuaathuea ia aunieoth noaiaiue
no?oeoo?ii-ooieoeeiiaeueiie aeecinoe ?ao?iae?onia e iiaeeueiiai yeaiaioa
aaiiia ae?iaeaeae Oo. ?ao?io?ainiicii Oo iaeaaeaao aeeeiiuie eiioeaauie
iiaoi?aie e aeaoiy no?oeoo?iuie aaiaie: Oo A e Oo A. I?e yoii aai Oo A
yaeyaony aiaeiaii aaia gag ?ao?iae?onia, eiaee?othuaai neioac
na?aeoeaaeiiuo aaeeia ae?eiia, a Oo A - aiaeiaii aaia pol, oi?aaeythuaai
neioacii ia?aoiie o?aine?eioacu e i?ioaacu.
Anee i?eciaoue i?aaiii/iui auoaeathuaa ec eceiaeaiiiai i?aaeiieiaeaiey
i i?ienoiaeaeaiee AE* ec ?ao?io?ainiiciiia eeioieaeiuo eeaoie /aeiaaea,
oi neaaeothuei caeiiiia?iui yoaiii auei au ?aoaiea aii?ina i iaoaieciao
aeoeaaoeee ii?aaeaeaiiuo ?ao?io?ainiiciiia e i?eia?aoaiey eie
aaoiiiiiinoe n iineaaeothuei ooieoeeiie?iaaiee a oi?ia AE*.
Iaiaoiaeeii ioiaoeoue, /oi eaeay nayce eiioiiaeaoeoeeoiuo ninoiyiee a
oeaeii n ianoaaeeueiinoueth aaiiia oaea iieo/eea aeinoaoi/ii oe?ieia
?ani?ino?aiaiea a eeeie/aneeo iaaethaeaieyo e yenia?eiaioaeueiuo
enneaaeiaaieyo. Iaeiaei a ea/anoaa oa?aeoa?enoeee ianoaaeeueiinoe aaiiia
a aieueoae /anoe i?iaiaeece?iaaiiuo ?aaio ?anniao?eaaaony oieueei
o?iaaiue o?iiiniiiuo aaa??aoeee, yaeythueeny iieacaoaeai a?oauo
ia?ooaiee no?oeoo?u o?iiaoeia. Eiie?aoiua iieaeoey?iua iaoaieciu
eaaeeecaoeee aaiiia a oiiiyioouo enneaaeiaaieyo ia inaauaiu.
Iaeiei ec oaeeo i?eioeeieaeueiuo iaoaieciia iiaeii n/eoaoue
ianiaoeeoe/aneea ?aaeoeee eeaoi/iiai no?anna, nii?iaiaeaeathueany
neioacii aaeeia oaieiaiai oiea. Oaaaeeoaeueii iieacaii, /oi oaieiaie oie
e iaeioi?ua oeie/aneea eiaeoeoi?u eeaoi/iiai no?anna, i?eaiaeyuea e
yeno?aiiiio neioaco no?anniauo aaeeia, ?acei aeoeae?otho yeni?anneth
aeeeiiuo eiioeaauo iiaoi?ia AE* a eoeueoo?a eeaoie. Aieaa oiai, ciia LTR
AE*, eioi?ay naycuaaao aaeee, ?aniiciathuea AeIE, ieacuaaaony
aiiieiae/iie niioaaonoaothuae ciia a ninoaaa aaiia neioaca aaeeia
oaieiaiai oiea. Yoi oeacuaaao ia io/aoeeaoth acaeiinaycue yeni?annee
aaiaoe/aneeo yeaiaioia ?ao?iae?ona (?ao?io?ainiiciia?) n eeaoi/iui
no?annii. Anee iiaeiaiua yaeaiey eiatho ianoi in vivo, oi yoi iicaieeei
au i?eaeeceoueny e iiieiaieth ia oieueei naieo aioo?eeeaoi/iuo
i?ioeannia, ii e i?e?iaeu eiie?aoiuo aeioeie/aneeo iaaeeaoi?ia (oeia
aaeeia oaieiaiai oiea), niinianoaothueo oaaee/aieth eaaeeueiinoe aaiiia.
N?aaee oaeoi?ia-eiaeoeoi?ia eeaoi/iiai no?anna iniaay ?ieue
i?eiaaeeaaeeo oeueo?aoeieaoiaiio eceo/aieth. I?iaeaiiino?e?iaaia
eioaineaiay ia?aaioea i?IE, aea?eaeecothuaeny n AeIE aaia aaeea
oaieiaiai oiea hsp 70, iiae aeeyieai oeueo?aoeieaoa in vivo.
Neaaeiaaoaeueii, OO, eiaeooee?oy neioac aaeeia oaieiaiai oiea a
iaeo/aiiuo eeaoeao, aeieaeii auei au oai naiui oneeeaaoue yeni?anneth
yeaiaioia aaiiia AE*. Aeaenoaeoaeueii, a yenia?eiaioao onoaiiaeai oaeo
aieaa /ai 150-e?aoiiai oaaee/aiey yeni?annee AE*-niaoeeoe/iuo LTR,
eioaa?e?iaaiiuo a aaiii eeaoie HeLa, iinea iaeo/aiey eo OO. Aieaa oiai,
noaiaiue aa eioaineoeeaoeee ieacaeanue i?iii?oeeiiaeueiie aeica
eceo/aiey.
I?e aiaeeca ?acoeueoaoia enneaaeiaaiee iinoiyiii aicieeae aii?in i
eiie?aoiuo iaoaieciao aeaenoaey OO-eceo/aiey eae oaeoi?a aaiiiiiai
no?anna, i?eaiaeyuaai e aeoeaaoeee yeni?annee LTR AE*. Iniaia aieiaiea
i?eaeaeea aeiioaca o/anoey a iacaaiiii i?ioeanna OO-yiaeiioeeaacu -
oa?iaioa, eaoaeece?othuaai ia?aciaaiea iaeiiieoaauo ?ac?uaia AeIE iiae
aeeyieai OO-eceo/aiey e eieoeee?othuaai aa ?aia?aoeeth.
Iinea ?yaea yenia?eiaioia aeey iiaeoaa?aeaeaiey aeaiiie aeiioacu aue
naeaeai auaiae, /oi eeioioeeou e?iae aieueiuo AE*-eioaeoeeae
oa?aeoa?ecothony iiauoaiiie eaaeeueiinoueth aaiiia, noaiaiue eioi?iai
aic?anoaao ii ia?a ?acaeoey caaieaaaiey. Iaeiei ec eeth/aauo
iaoiaeioeie/aneeo iaoaieciia aeanoaaeeecaoeee aaiiia eeioioeeoia a yoeo
oneiaeyo yaeythony i?ioeannu naiaiaeii?aaeeeaeueiiai ieeneaiey. Aoaea
AeIE eeioioeeoia naiaiaeiuie ?aaeeeaeaie aucuaaao ia?aciaaiea
iaeiiieoaauo ?ac?uaia, /oi iaeiia?aiaiii neoaeeo eieoeee?othuei neaiaeii
aeey ?aia?aoeee oeacaiiuo iia?aaeaeaiee.
OO-yiaeiioeeaaca, aeoeae?oaiay iiae aeeyieai OO-ieiaoe/aneiai aeaenoaey
aeoeaiuo oi?i eenei?iaea, eieoeee?oao ?aia?aoeeiiiua i?ioeannu, eioi?ua
a neeo naiae ecauoi/iie eioaineaiinoe i?eaiaeyo e oi?ie?iaaieth
ieeaiioeeaioeaeiuo iineaaeiaaoaeueiinoae ai?acaei aieueoae
i?ioyaeaiiinoe, /ai yoi iaiaoiaeeii aeey ?aia?aoeee ?ac?uaia AeIE.
Aiciiaeii, /oi ia?acothueany iineaaeiaaoaeueiinoe iiaoo neoaeeoue eeai
oaeoi?aie ?aaoeyoeee i?iaeoeoeee e yeni?annee ?ao?io?ainiiciiia (a
caaeneiinoe io naeoia eo ano?aeaaiey a ?aia?e?othuoth AeIE), eeai aeaaea
no?oeoo?iuie eo yeaiaioaie. A iieueco aeaiiiai i?aaeiieiaeaiey einaaiiui
ia?acii naeaeaoaeuenoaotho ?acoeueoaou ?aaiou, niaeanii eioi?ui oaieiaie
oie e ieeneeoaeueiue no?ann nouanoaaiii oneeeaatho o?aine?eioeeth
?ao?io?ainiiciiia o ae?icioeeu.
Iineaaeothuay aaoiiiiecaoeey ?ao?io?ainiiciiia a eeioieaeiuo eeaoeao (a
oii /enea a i?ioeanna ianne?iaaiey /a?ac i?aaieci ?aoeeieaioa
aaiaoe/aneiai iaoa?eaea eeioioeeoia) iin?aaenoaii niioaaonoaothueo
?aa?aiaee?iaie e nieaeneiaa, niaeanii i?aaenoaaeaiiie aeiioaca,
i?eaiaeeo e iinoaiaiiie o?ainoi?iaoeee ?ao?io?ainiiciiia a AE*.
Ianiiiaiii, cia/aiea oaeoa cia/eoaeueiie eaaeeecaoeee aaiiia eeioioeeoia
a oneiaeyo AE*-eioaeoeee iiaeao auoue eioa?i?aoe?iaaii iaiaeiicia/ii.
Iiaeii i?aaeiieiaeeoue, /oi aeanoaaeeece?iaaiiue aaiii eeioieaeiie
eeaoee yaeyaony ai?acaei aieaa aini?eei/eaui e eioaa?aoeee a iaai
AeIE-o?aine?eioia AE* e, oaeei ia?acii, iiaeiaiua eeioioeeou yaeythony
eeoue aeaaiaeaoiie ii/aie aeey ?ani?ino?aiaiey AE*-eioaeoeee. Iaeiaei
eiaaony ?yae ?acoeueoaoia, eioi?ua iiaoo naeaeaoaeuenoaiaaoue a iieueco
i?aaeeiaeaiiie auoa aeiioacu.
I?e ianeaaeiaaiee naie iaoeeaioia, a eeaoeao eioi?uo ionoonoaiaae
aaiaoe/aneee iaoa?eae AE* (ii aeaiiui enneaaeiaaiey iaoiaeii
AeIE-ciiaeia), a a nuai?ioea ionoonoaiaaee aioeoaea e aaeeai AE*, auei
onoaiiaeaii, /oi iinea ia?aeeaaiey aeiii?neie e?iae (ia eiaaoae ieeaeeo
ia?ea?ia AE*) e iineaaeothuae i?ioeaaeo?u ?aeioocee aooie?iae,
iaeo/aiiie oeueo?aoeieaoii, a n?iee io 1 aei 3 ianyoeaa a nuai?ioea yoeo
iaoeeaioia iiyaeythony aioeoaea e aaeeai ?17 e ?24 AE*. ?acoeueoaou
iaia?oaeaiey i?iae?oniuo iineaaeiaaoaeueiinoae n iiiiuueth AeIE-ciiaeia
a eeioioeeoao ianeaaeiaaiiuo e ianoiyuaio iiiaioo ioeaieaathony eae
iaii?aaeaeaiiua.
Aaconeiaii, yoe aeaiiua aua o?oaeii o?aeoiaaoue eae iaeiicia/iua,
iaeiaei a oeaeii iie iiaoo yaeyoueny iiaeoaa?aeaeaieai iieiaeaiey:
i?iaeaia NIEAea eae a ooiaeaiaioaeueiuo, oae e a i?eeeaaeiuo aa aniaeoao
ia iiaeao auoue ?aoaia a ?aieao o?aaeeoeeiiiuo iiaeoiaeia e
?anniao?eaaaiie iaoieiaee eae e o?eaeaeueiie ae?oniie eioaeoeee.
I/aaeaeii, /oi iiiaea ec eiathueony naaaeaiee e aeiioac i i?e?iaea
aicaoaeeoaey neiae?iia i?eia?aoaiiiai eiioiiaeaoeoeeoa /aeiaaea o?aaotho
ooi/iaiey, aeiiieieoaeueiuo enneaaeiaaiee e ananoi?iiiaai aiaeeca.
IA?AAeA*A AE*-EIOAEOeEE.
AE* ia?aaeaaony oeie/iui aeey anao ?ao?iae?onia niiniaaie, oi anoue
aa?oeeaeueii (?aaaieo io iaoa?e) e ai?eciioaeueii, iniaaiii i?e iieiauo
eiioaeoao. E?iia yoiai e ai?eciioaeueiiio iooe ia?aaea/e ioiinyony
ia?aioa?aeueiue - eiuaeoeeiiiue, i?e iiiaaeaiee ethaie aeieiae/aneie
aeeaeeinoe io AE*-eioeoee?iaaiiiai ia eiaeo e neecenoua i?e iaee/ee ia
ieo iee?io?aai. Neaaeoao, i?aaaea, ioiaoeoue, /oi a ?aciuo aeieiae/aneeo
aeeaeeinoyo oeo? ae?ona iiaeao auoue i/aiue ?acee/ai: iaeneiaeueiay
eiioeaio?aoeey iaaethaeaaony a nia?ia e e?iae, a, iai?eia?, a nethia eee
neaciie aeeaeeinoe iiaoo iaoiaeeoueny eeoue aaeeie/iua yecaiiey?u
ae?ona. Aua iaeii ianoiyoaeuenoai aeeythuaa ia ia?aaea/o eioaeoeee:
iaeioi?ua iineoaee AE* auaeaeytho iaiiiai aieueoa ae?ona /ai ae?oaea,
oioy oeo? ae?ona a ca?aaeaiiii iaoa?eaea ecia?eoue aeiaieueii o?oaeii.
Ia?aaea/a ae?ona ii?aaeaeyaony oaeaea ae?oaeie oaeoi?aie, oaeeie eae
o?aaiu, aoi?e/iua eioaeoeee, yooaeoeaiinoue yieoaeeaeueiuo aa?uea?ia, a
oaeaea i?enoonoaea eee ionoonoaea eeaoie n ?aoeaioi?aie aeey AE*.. Yoe
oaeoi?u iicaieytho iauynieoue, ii/aio i?e iaeieo ianoiyoaeuenoaao,
iai?eia?, i?e aiiinaenoaeueiuo eiioaeoao, ae?on ?ani?ino?aiyaony
auno?aa, /ai i?e ae?oaeo.
Aaaeiui oaeoi?ii, aeeythuei ia ca?aciinoue, iiaeao auoue noaaeey
eioaeoeee. I?e aieueoeinoaa ae?oniuo eioaeoeee iaeaunoea oeo?u ae?ona
aeinoeaathony ia ?aiieo noaaeeyo, aua aei ia?aciaaiey aioeoae. A neo/aa
AE* yoo oaco o?oaeii eco/aoue, iineieueeo iia iau/ii aanneiioiiia, a
aoii?aeueiue i?ioeaiae?oniue ioaao aua neaa eee aiiaua ia auyaeyaony.
Oai ia iaiaa, yoa noaaeey, ii-aeaeeiiio, iaeaieaa iiania aeey
ie?oaeathueo. Anoue oaeaea aeaiiua i oii, /oi aieueiie aiiaue noaiiaeony
aieaa eioaeoeeiiiui, eiaaea oaea ?acaeaaaony NIEAe.
Noiie?oy ana auoaneacaiiia, iiaeii auaeaeeoue neaaeothuea oaeoi?u,
aeeythuea ia ia?aaea/o AE*-eioaeoeee:
· oeo? ae?ona
· o?aaia
· aoi?e/iay eioaeoeey
· yieoaeeaeueiua ?aoeaioi?u
· eioaineaiinoue yeniiceoeee
· oaca eioaeoeee
EI-OAEOI?U AE*-EIOAEOeEE.
A iaiaeaiee AE*-eioaeoeee aaeeea ?ieue ei-oaeoi?ia, oi anoue oaeoi?ia,
niinianoaothueo aa ?ani?ino?aiaieth. Iie eeai aeoeaece?otho oa eee eiua
iooe eioeoee?iaaiey, eeai iiauoatho /oanoaeoaeueiinoue i?aaiecia e
ca?aaeaieth.
Iaeei ec aaaeiuo ei-oaeoi?ia - /enei iieiauo ia?oia?ia. Aiiinaenoaeenou,
aieueiua NIEAeii, eiatho a n?aaeiai a oa/aiea aeecie ieiei 1100 iieiauo
ia?oia?ia, caei?iaua aiiinaenoaeenou - 500, aaoa?inaenoaeenou -25.
Iaeaa/atho ?ani?ino?aiaiea yieaeaiee e aaia?e/aneea caaieaaaiey. *a?ac
iiyaeythueany i?e ieo ecuycaeaiey e ae?oaea ia?ooaiey oeaeinoiinoe
neecenouo iaiei/ae e eiaeiuo iie?iaia iieiauo i?aaiia i?iieeaao ae?on
NIEAea.
?acee/iua ae?oniua eioaeoeee ineaaeytho, a oi e naiaeyo ia iao eiioieoao
i?aaiecia. A ia?aoth i/a?aaeue ?a/ue eaeao i ae?oniii aaiaoeoa A. A ie?a
ian/eouaaaony i?eia?ii 200 ieeeeiiia iineoaeae yoiai ae?ona. Ei
aaeaaiaeii ca?aaeathony 10-15 i?ioeaioia aiiinaenoaeenoia - iiiaea ec
ieo o?iie/anee eioeoee?iaaiu. ?acei iiauoatho /oanoaeoaeueiinoue e AE*
oaeea eioaeoeee, eae ooaa?eoeac. Aiiinaenoaeenou iau/ii
i?aae?aniieiaeaiu e eiioiiaeai?anne ec-ca nenoaiaoe/aneiai iinooieaiey a
i?aaieci nia?iu, eioi?ay iaeaaeaao au?aaeaiiui eiioiiaeai?anneaiui
aeaenoaeai.
E ei-oaeoi?ai ioiineoueny oaeaea aic?ano: 90% aieueiuo NIEAeii
caaieaaaao a aic?anoa iaaeaeo 20 e 45 aiaeaie. NIEAe - i?e/eia nia?oe
ioae/ei a i?iiaaeooea iaaeaeo 25 e 44 aiaeaie, /oi naycaii n aieueoie
naenoaeueiie aeoeaiinoueth e ia?eiiaieae eiaiii a yoio ia?eiae.
Aieaa ceiea/anoaaiiia oa/aiea NIEAea o aeaoae iauyniyaony iac?aeinoueth
eo eiioiiie nenoaiu.
Iiaoi?iua eioaeoeee e ia?aeeaaiey e?iae o aieueiuo aaiioeeeae
noeioee?otho eiioiioth nenoaio, /oi oiaea aeaaii?eyonoaoao iaino?aieth
/oanoaeoaeueiinoe yoeo eeoe e AE*.
Ei-oaeoi?aie iiaoo auoue e ae?onu, eioi?ua iaaeaaii iaia?oaeeee o
aieueiuo NIEAeii. O/aiua ec Einoeoooa iaoieiaee Aii?oaeaiiuo nee NOA
auaeaeeee ec i?aaiecia 23 ec 24 aieueiuo NIEAeii ?aiaa iaecaanoiue
ae?on. I?aaeiieaaaaony, /oi eiiia?aoeey yoiai ae?ona n AE* aaaeao e
na?eiia Eaiioe, eioi?ay /anoi ?acaeaaaony i?e NIEAea.
?.Aaeei n nio?oaeieeaie ioe?uee iiaue ae?on, ioiinyueeny e a?oiia
aa?iana. Aai auyaeee a eeaoeao aieueiuo n eeioiaaeaiiiaoeae, eioi?ua
auee eioeoee?iaaiu AE*. Ae?on aue iacaai NBLV (/aeiaa/aneee
A-eeioio?iiiue ae?on). Aiieia aiciiaeii, /oi e ii - ei-oaeoi? AE* e
o/anoaoao a ia?aciaaiee iiooieae eeioieaeiie oeaie.
IAOIAAIAC E EEEIEEA AE*-EIOAEOeEE.
IAOIAAIAC. O ?aciuo eiaeeaeaeooiia iocua/eainoue i?aaiecia ia ca?aaeaiea
AE* iaiaeeiaeiaa. Yoi caaeneo io niaoeeoeee eo nenoaiu
aenoiniaianoeiinoe. O AE*-eioeoee?iaaiiuo /aua, /ai o ae?oaeo,
ano?a/aaony HLA-B35 oaiioei. Onoaiiaeaii, /oi oio aea oaiioei - aeaaiue
oaeoi? ?enea aeey ca?aaeaiey AE* ia?eiiaiia, aaiaeyueo ia?eioeee
aioo?eaaiii.
A i?aaiecia ae?on aiaae?yaony a /oanoaeoaeueiua eeaoee. Iniiaiua eeaoee
ieoaie CD4-eeioioeeou (oaeia?u), ia eo iiaa?oiinoe anoue iieaeoeu
CD4-?aoeaioi?u, niiniaiua naycuaaoueny n iiaa?oiinoiui aaeeii AE* -
gp120. A iaiueoai /enea iie niaea?aeaoueny ia iaia?aiao iae?ioaaia, aua
a iaiueoai ia iaia?aiao A-eeioioeeoia. E?iia oiai, AE* i?iieeaao a OeIN,
ii?aaeay ia?aiua eeaoee e eeaoee iae?iaeee, a o?iiaooeiiua eeaoee
eeoa/ieea, a nia?io.
IAOAIECIU ACAEIIAeAENOAEss AE* N ?ACEE*IUIE CAAIUessIE EIIOIIIE
NENOAIU
Ecaanoii, /oi i?iaeoeoeaiia acaeiiaeaenoaea ae?ona e eeaoee aeeth/aao
ianeieueei oac: aaeni?aoeeth ae?ona e aai i?iieeiiaaiea a eeaoeo,
?acaeaaaiea ae?ona, aeineioac ae?oniuo eiiiiiaioia, oi?ie?iaaiea
ae?oniuo /anoeoe e auoiae ae?ona ec eeaoee. Ae?on nouanoaaiii eciaiyao
iaoaaieeci eeaoee, e o?ainoi?ie?iaaiiay eeaoea oaea ii iniaiio
acaeiiaeaenoaoao eae n ?iaenoaaiiuie, oae e n ae?oaeie eeaoeaie
i?aaiecia
Ia/aei caaieaaaiey iau/ii i?iyaeyaony ia oiia eioaineaiie ?ai?iaeoeoeee
ae?onia a eeaoeao ?YN, yieoaeee aeuoaoaeueiie eee ieuaaa?eoaeueiie
nenoai, e?iae e ae?. Aicieeathuea a ?acoeueoaoa eiioiiiai ioaaoa
aioeoaea a ii?aaeaeaiiie noaiaie i?aiyonoaotho ?ani?ino?aiaieth ae?ona a
i?aaiecia, ii nouanoaaiii ia aeeytho ia i?ioeannu aai ?ai?iaeoeoeee.
Nicaeaaony aia/aoeaiea, /oi aioeoaea ia oieueei ia ii?aaeaeytho enoiae
ia?ae/iie ae?oniie eioaeoeee, a aieaa oiai, iiaoo ianee?iaaoue
oee?eoee?othuee ae?on a e?iae e ae?oaeo aeeaeeinoyo i?aaiecia. Aieaa
au?aaeaiu a ia/aeueiii ia?eiaea eioeoee?iaaiey oaeoi?u ianiaoeeoe/aneie
caueou - iiauoaiiay oaiia?aoo?a, iiauoaiea o?iaiy ?acee/iuo eiaeaeoi?ia,
eioa?oa?iia e ae?.
A iaoiaaiaca NIEAe, ii iiaieth aieueoeinoaa enneaaeiaaoaeae, ?aoathuaa
cia/aiea eiaao ecae?aoaeueiia oeeoiiaoe/aneia aicaeaenoaea ae?ona NIEAe
ia O-eeioioeeou-oaeia?u-eiaeoeoi?u, /oi a ia?aoth i/a?aaeue i?iyaeyaony
a nieaeaiee i?ioeaiae?oniiai, i?ioeaiiee?iaiiai e i?ioeaiiiooieaaiai
eiioieoaoa. Neaaenoaeai oeacaiiiai yaeyaony iaeiieaiea ae?ona a e?iae e
eioaineaiia aai ?ani?ino?aiaiea a i?aaiecia, onoaoaeaiea oa/aiey e
iaia?aoeiia ?acaeoea iiii?ooienoe/aneeo eioaeoeee, onei?aiea
ceiea/anoaaiiiai ?inoa aneaaenoaea i?aii?aeaeiiai aeaenoaey
ia?nenoe?othuaai a eeaoeao iiooiee /anoeoe ae?ona e ii?aaeaiey
iaoo?aeueiuo eeeea?ia. Ia?ae/iia naeaeoeaiia oeeoiaeano?oeoeaiia
aeaenoaea ae?ona ia O-oaeia?u-eiaeoeoi?u i?iyaeyaony a ?acaeoee
eeioiiaiee, nieaeaiee /enea oee?eoee?othueo a e?iae O4-eeaoie, ia?ooaiee
niioiioaiey O4/O8 e oaiaoaiea i?ieeoa?aoeee O-eeioioeeoia a ioaao ia
aeaenoaea ieoiaaiia (oeoiaaiaaaethoeiei, eiieaaaeei A, niaoeeoe/aneea
aioeaaiu), nieaeaiee eee iieiii ionoonoaee ?aaeoeee eiaeiie
aeia?/oanoaeoaeueiinoe e eiaeiui aeea?aaiai, nieaeaiee i?ieeoa?aoeee
aooieiae/iuo eeioioeeoia a niaoaiiie ?aaeoeee, oiaiueoaiea i?iaeoeoeee
aaiia-aeiaoeeia eaeeioeeoaie aieueiuo iiii?ooienoe/aneeie eioaeoeeyie,
ineaaeaiea yeni?anne O-eeaoi/iuo ?aoeaioi?ia e eioa?eaeeeio-2,
aeaoaeoiinoe i?iaeoeoeee eeioieeiia, iieeeeiiaeueiie aeoeaaoeee
A-eeioioeeoia n i?iaeoeoeeae aieueoiai /enea o?aeoeee aaiia-aeiaoeeia.
Eiioiieiae/aneea ia?ooaiey i?e NIEAe i?iyaeythony oaeaea a iiauoaiee
o?iaiy oee?eoee?othueo eiioiiuo eiiieaenia, aioeeeioioeeoa?iuo aioeoae
iaauyniaiiie niaoeeoe/iinoe, a oaaee/aiee eiee/anoaa e eaaeeueiinoe
aeueoa-eioa?oa?iia. Iaeiaei iienaiiua auoa eiioiieiae/aneea aiiiaeee ia
yaeythony no?iai niaoeeoe/iuie eiaiii aeey NIEAe , iie ano?a/athony e
i?e eiioiiaeaoeoeeoao ae?oaie yoeieiaee; aeeooa?aioeeaoeey
niaoeeoe/iinoe ii?aaeaiey iniaaiii cao?oaeieoaeueia a ia/aeueiue ia?eiae
caaieaaaiey.
Aicaoaeeoaeue NIEAe eiaao au?aaeaiiue o?iieci e O-eeioioeeoai e ae?oaei
eeaoeai n aioeaaiiie oi?ioeie - IEO-4 (O-oaeia?u, A-eeaoee, iiiioeeou,
iae?ioaae). Oeacaiiia n?iaenoai iaoneiaeaii /?acau/aeii aunieei
aooeieoaoii aeeeii?ioaeaea ia?oaeiie iaiei/ee ae?eiia e ?aoeaioi?o O4
(CD4), ?aniieaaathuaiony ia iiaa?oiinoe O-oaeia?ia. Auei aeieacaii, /oi
iaia?aiiue aaeie eeioioeeoia CD4 neoaeeo ?aoeaioi?ii aeey ae?ona NIEAe.
*oi eanaaony ae?oniuo aaeeia, oi eeoue iaeei ec ieo n iieaeoey?iie
iannie 11000 Ae (aaeie gp120) niiniaai naycuaaoueny n CD4 aaeeii.
Aeey ?yaea ae?onia /aeiaaea onoaiiaeaia naycue eeaoi/iie
/oanoaeoaeueiinoe e iei n ii?aaeaeaiiuie o?iiiniiaie /aeiaa/aneeo
eeaoie. Iai?eia?, a o?iiiniia19 eieaeeciaaiu aaiu /oanoaeoaeueiinoe e
ae?onai iieeiieaeeoa, a o?iiiniia 3 - e ae?ono aa?iana, a o?iiiniia 21 -
e ae?onai Eienaee A. A eaeie o?iiiniia nouanoaotho aaiu
/oanoaeoaeueiinoe e ae?ono NIEAe, iiea ia onoaiiaeaii.
Aaiaoe/aneea enneaaeiaaiey iieacaee naycue ?acaeoey NIEAe n
ii?aaeaeaiiui oeiii aioeaaiia aeaaiiai eiiieaena aenoiniaianoeiinoe
(IIN). Onoaiiaeaii, /oi n?aaee aieueiuo NIEAe aanueia cia/eoaeueii
eiee/anoai eeoe, eiathueo HLA-DR5 aioeaaiu. Iiaeoaa?aeaeaii, /oi eeoea n
oaeei oaiioeiii eeioioeeoia ninoaaeytho a?oiio n iiauoaiiui ?eneii
caaieaaaiey na?eiiie Eaiioe, ano?a/athuaeny a 6 ?ac /aua, /ai a ae?oaeo
a?oiiao.
Ecaanoii, /oi eiioii?aaeoeaiinoue caaeneo eae io no?oeoo?u aioeaaia, oae
e io aaiaoe/aneeo iniaaiiinoae i?aaiecia e naycaia n iaeiei ec oeiia
eeaoie eee eo noaiiioeyoeee, o/anoaothueo a eiioiiuo ?aaeoeeyo. O neaai
?aaae?othuaai i?aaiecia iao Ir-aaia (eee ii ii eaeie-eeai i?e/eia ia
?aaeecoao naie ooieoeee), iicaieythuaai O-oaeia?ai ?aniiciaoue aioeaai e
ieacaoue iiiiuue A-eeioioeeoai. Iaaeinoaoi/iinoue eiioiiiai ioaaoa ia
o?iaia A-eeaoie ia?aaeei iaoneiaeaia ionoonoaeai ae?oaiai aaia,
eiio?iee?othuaai neioac aauanoa eeaoi/iie iiaa?oiinoe (aeoeaioi?ia),
eioi?ua aini?eieiatho aeiiieieoaeueiue neaiae io O-oaeia?ia (Leu 3a+).
Oeaiue niauoee a eiioiiie nenoaia ?acaa?ouaaaony neaaeothuei ia?acii.
Aioeaai, caoaa/aiiue iae?ioaaii, ?ac?ooaaony aei ioaeaeueiuo o?aaiaioia
aeae?ieeoe/aneeie oa?iaioaie. Caoai a ?aaioo anooiatho Ir-aaiu, eioi?ua
eiio?iee?otho ia?aciaaiea naiaenoaa oae iacuaaaiuo Ia-aaeeia. O ?aciuo
eiaeeaaeooiia eee eeiee aeeaioiuo yoe aaeee ioee/athony ae?oa io ae?oaa
ii no?oeoo?a, io?aaeay ?acee/ea a aaiao, eioi?ua iaania/eaatho eo
neioac. Anee aaeee iae?ioaaia niiniaiu anooiaoue ai acaeiiaeaenoaea n
aeaiiui aioeaaiii, oi ia?aciaaaoeeny eiiieaen aioeaai-aaeie iea?e?oao e
iaia?aia iae?ioaaa e ieacuaaaony ia aa iiaa?oiinoe. A ?acoeueoaoa
nicaeathony oneiaey aeey ?aaiou O-oaeia?ia. O-oaeia?u iiaoo iaeaieaa
/aoei ?aniiciaaaoue aioeaai oieueei a annioeeaoeee aai n Ia-aaeeii.
Eaeaioeoeoee?iaaa aioeaai, eciaiaiiue Ia-aaeeii, O-oaeia?u ieacuaatho
iaiaoiaeeioth iiiiuue A-eeaoeai, eioi?ua aac yoiai ia i?enooiatho e
neioaco eiioiiaeiaoeeiia. Iiiiuieeaie O-A-eiiia?aoeee neoaeao oaeaea
?acee/iua aaeee ?aaoeyoi?u, eeioieeiu, nae?aoe?oaiua O-eeaoeaie.
Iaia?oaeaiu aioeoaea, iaeo?aeecothuea ae?on NIEAe, o aieueiuo ni NIEAe e
NIEAe-eiiieaenii..
A iineaaeiaa a?aiy onoaiiaeaii, /oi AE* a eiioiiie nenoaia eioeoee?oao
i?aaeaea anaai iae?ioaae e iiiioeeou, n iiiiuueth eioi?uo e
?ani?ino?aiyaony a i?aaiecia. Ianoii nio?aiaiey aiieia iiaoo auoue
oaeaea o?iiaioeeou, A-eeioioeeou, yieoaeeaeueiua eeaoee, aeeaeueiua
eeaoee ia?aiie nenoaiu.
Aioeaai ano?a/aaony n eeaoeaie Eaiaa?aaina, eioi?ua i?aaenoaaeytho aai
(a eiiieaena n aioeaaiii aenoiniaianoeiinoe) O-eeaoeai,
cai?ia?aiie?iaaiiui ioaa/aoue ia aeaiiue aioeaai ( iiae?iaiaa i eeaoeao
Eaiaa?aaina ieaea). Aeoeae?iaaiiua oaeei ia?acii eeaoee yeni?anne?otho
?aoeaioi?u e eioa?eaeeeio-1 (EE-1). EE-1 e?iia eeioieaeiuo eeaoie eiaao
e ?yae eiuo eeaoie-ieoaiae, /oi iaoneaaeeaaao iiiaeanoaaiioth
iai?aaeaiiinoue aeieiae/aneie aeoeaiinoe yoiai aauanoaa e aai o/anoea a
oeaeii ?yaea i?ioeannia, ia ioiinyueony nianoaaiii e eiioiiui.
Auaeaeyaiue ea?aoeiioeeoaie (e, aiciiaeii, eeaoeaie Eaiaa?aaina) oaeoi?
canoaaeyao aeoeae?iaaiiua O-eeaoee nae?aoe?iaaoue eioa?eaeeei-2 (EE-2) -
aaaeiaeoee oei eeioieeia. ?aoeaioi?ii aeey EE-2 ia eeaoea yaeyaony
no?oeoo?a iinyuay iacaaiea Tac-aioeaaia. EE-2 anooiaao a naycue n
?aoeaioi?aie ia iiaa?oiinoe ae?oaeo O-eeaoie, ioaa/athueo ia aeaiiue
aioeaai e iaoiaeyueony a aea?ia, eeioaoe/aneeo oceao, naeacaiea, e
eieoeee?oao eo i?ieeoa?aoeeth. ?acoeueoaoii oeacaiiiai yaeyaony iiaay
iiioeyoeey O-eeaoie, au?aaaouaathueo aioeoaea e aeaiiiio aioeaaio.
AEEssIEA AE* IA O-OAEIA?U
Nouanoaoao oeaeue ?yae aeiiieiythueo ae?oa ae?oaa iaoaieciia
acaeiiaeaenoaey AE* n eeaoeaie O-oaeia?ia. Iineaaeiea noeioee?otho
?aaioo O-eeeea?ia e iae?ioaaia, eiaeooee?otho i?iaeoeoeeth aioeoae
A-eeioioeeoaie. Eeioioeeou-iineoaee iieaeoe O8 (CD8) iiaoo auoue eeai
eeeea?aie, eeai noi?anni?aie. Iaeioi?ua ec iaoaieciia aua nii?iu,
iiaeaa?aathony eciaiaieyi; iinoiyiii iiyaeythony iiaua aeaoaee e ithainu
aeeyiey AE* ia eiioiioth nenoaio
1-e iaoaieci. I?e i?iaeoeoeaiii i?ioeanna ninoiyaoaeny ?ai?iaeoeoeee e
ianne?iaaiiii (ianeieueei ouny/ ae?eiiia a aaia?aoeee iaeiie eeaoee)
auoiaea ec eeioioeeoia AE* eioaineaii eece?oao O-oaeia?u. Ii aeaaea anee
ae?onu niiioaiii ioii/eiauaathony io O-eeaoee-oaeia?a (aac aa eecena),
eeaoea ia oniaaaao ainnoaiaaeeaaoue oeaeinoiinoue iaia?ai, iieaeoeu
oeeoiieaciu naiaiaeii yeeieie?otho ec eeaoee, e O-oaeia? aeaiao.
Iineieueeo O-oaeia?u ninoaaeytho ii?yaeea 60% oee?eoee?othueo O-eeaoie,
auno?ay eo aeaaeue i?eaiaeeo e aeoaieei ia?ooaieyi eiioiiie nenoaiu
eioeoee?iaaiiiai /aeiaaea. NIEAe ?acaeaaaony ia oiia ino?ie
iaaeinoaoi/iinoe CD4-eeioioeeoia.
2-e iaoaieci. Ia oiia iauae noeioeyoeee iaoaaieecia eeioioeeoia iinea eo
eioeoee?iaaiey ae?onii, i?eaiaeyuae eo e aeaaee io enoiuaiey,
i?ienoiaeeo eioaa?aoeey aaiiiia ae?ona e eeaoee. Aeenneieiaoeey
eioaeoeee caoaaouaaao cia/eoaeueiia /enei oaeia?iuo O-eeioioeeoia CD4+
oaiioeia, i?e yoii o?iie/aneea eioaeoeee e ?yae ae?oaeo aicaeaenoaee
aaaeoo e aeiiieieoaeueiie noeioeyoeee CD4+ iiioeyoeee. Oneeaiiay
i?ieeoa?aoeey O-eeaoie aaaeao e aeoeaaoeee noi?anni?iuo iaoaieciia,
oaaee/aieth eiee/anoaa CD8-eeioioeeoia (Leu2a+ - O-noi?anni?u) e ?aceiio
iiauoaieth eo ooieoeee.
3-e iaoaieci. *anoeoeu AE* eciaiytho ?aaeoiaaiiua ciiu iiaa?oiinoe
O-oaeia?ia, /oi i?eaiaeeo e ia?aciaaieth iaaeecianiiniaiuo neioeeoeaa.
Eiiiiiaiou ae?oniie iaiei/ee, neioace?oaiua a i?ioeanna ?ai?iaeoeoeee
ae?ona, ?acei ia?ooatho oeeoiieaciaoe/aneoth iaia?aio eeaoee-oicyeia: a
?acoeueoaoa yeeieiaoeee i?ioiieaciu eeaoee neeaathony, ia?acothony
iaaeecianiiniaiua iiiaiyaea?iua no?oeoo?u
Enneaaeiaaiey iiaeoaa?aeeee, /oi ae?on ?acei eciaiyao iaia?aiu
O-eeioioeeoia e i?eaiaeeo e eo neeyieth a iaaeecianiiniaiua
iiiaiyaea?iua eeaoee-iiino?u. Ia?aciaaiea neioeeoeaa aiciiaeii ii oeio
aaiaaaethoeie?othuaai yooaeoa, eiaaea caei?iaua eeioioeeou i?e
nii?eeiniiaaiee n eioeoee?iaaiiuie a naith iaiei/eo aeeth/atho
iiaa?oiinoiua aaeee ae?ona, e acaeiiaeaenoaea ?aoeaioi?iuo cii i?eaiaeeo
e ia?aciaaieth e?oiiuo iaaeecianiiniaiuo eiiaeiia?aoia.
4-e iaoaieci. AE* ia ?ac?ooaao CD4-eeioioeeou, a eciaiyao e
cia/eoaeueii caiaaeeyao eo ?ino a ia?eiaee/aneie eoeueoo?a, oiaaea eae
ae?oaea aeaeu O-eeaoie i?iaeieaeatho ?aciiiaeaoueny ii?iaeueii.
Ioia/aii, /oi nei?inoue aeaaee ca?aaeaiiuo eeaoie i?iii?oeeiiaeueia
eiee/anoao CD4-?aoeaioi?ia ia eo iiaa?oiinoe. Ni a?aiaiai /enei
CD4-eeaoie noaiiaeoueny iaiueoa, oioy iaeioi?ay eo /anoue auaeeaaao e
nio?aiyao ae?on a eaoaioiii ninoiyiee a aeaea i?iae?ona.
5-e iaoaieci. AE* ianee?oao CD4-ia?ea?. Auei iieacaii, /oi a auaeeaoeo
CD4-eeioioeeoao ae?on iiaeao ianee?iaaoue CD4-ia?ea? ia iiaa?oiinoe
eeaoie eee i?aaeioa?auaoue aai iiyaeaiea oai. A ?acoeueoaoa iieo/aaony,
/oi /enei CD4-eeaoie aua iaiueoa, /ai ia naiii aeaea. N en/aciiaaieai
CD4-eeaoie iaaeaao o?iaaiue EE-2 e a ?acoeueoaoa caiaaeeyaony ?ino
eeiiia c?aeuo O-eeaoie, eiaeooee?oaiuo yoei eeioieeiii. Ec-ca ineaaeaiey
neioaca eioa?eaeeeia e eioa?oa?iia iaaeaao aeoeaiinoue E-eeaoie e
iae?ioaaia, eioi?ua a iiia noeioee?othoy yoeie aaeeaie.
A eioeoee?iaaiiuo AE* eeaoeao i?ienoiaeeo nieaeaiea aaeeia IIN eeanna 1
ia eo iiaa?oiinoe. Iineieueeo oeeoioiene/aneea CD8-eeioioeeou iiaoo
naycuaaoue aioeaai oieueei aianoa n aaeeaie IIN eeanna 1, yoio yooaeo
i?aiyonoaoao ociaaaieth e ?ac?ooaieth eioeoee?iaaiiuo ae?onii eeaoie.
Oaeei iooai AE* ecaaaaao ethauo aicaeaenoaee ni noi?iiu eiioiiie
nenoaiu, oi anoue nicaeaaony neooaoeey eiioiiiai ia?aee/a.
Aioeaaiu 1 eeanna aeaaiiai eiiieaena aenoiniaianoeiinoe - iieaeoeu
HLA-A,B,C e 2 eeanna - HLA-DR- iieaeoeu, eiathueany ia iiaa?oiinoe
iae?ioaaia, A-eeioioeeoia, aeoeae?iaaiiuo O-eeioioeeoia. Iieaeoeu 1
eeanna iaiaoiaeeiu aeey ?aniiciaaaiey iiaa?oiinoiuo eeaoi/iuo aioeaaiia,
a 2 eeanna - aeey eiio?iey ioaaoa. AE* i?aa?auaao O-oaeia? a aeiii?a
noi?anneaiiai oaeoi?a. ?.Aaeei auei niiauaii, /oi AE* aucuaaao ia
oieueei oiaiueoaiea /enea CD4-eeaoie e auaeaeaiea ?anoai?eiiai oaeoi?a
noi?annee inoaaoeieny eeioioeeoaie, ii e aeaeaao yoe ooeaeaaoea eeaoee
ia niiniaiuie inouanoaeyoue ia?aoth ?aoathuoth noaaeeth eiioiiiai ioaaoa
- ociaaaiea aioeaaia. Yoi iiaeii iauynieoue oai, /oi ae?on aucuaaao
iia?aaeaeaiea ?aoeaioi?ia aioeaaia ia iiaa?oiinoe CD4-eeaoie. Yoio
?aoeaioi? iiaeiaai caieo: aeey oiai, /oiau ia/aeny O-eeaoi/iue ioaao a
iaai aeieaeai auoue anoaaeai eeth/, eioi?ui neoaeeo ni/aoaiea aioeaaia e
aaeea IIN eeanna. Aiciiaeii oaeaea, /oi ae?on eiaee?oao aaeie,
iiiaaeathuee ia iiaa?oiinoue eioeoee?iaaiiie eeaoee e i?aiyonoaothuee
ii?iaeueiie ?aoeaioeee.
6-e iaoaieci. A eioeoee?iaaiiuo CD4-eeaoeao AE* aucuaaao nae?aoeeth
?anoai?eiiai oaeoi?a noi?annee. Yoi aauanoai aeiee?oao eiioiiua
?aaeoeee, caaenyuea io O-eeaoie eae in vitro, oae e in vivo. I?e yoii
oaiaoaaony ia?aciaaiea niaoeeoe/aneeo aioeoae e i?ieeoa?aoeey O-eeaoie.
N/eoatho, /oi aaiii ae?ona ia eiaee?oao iineaaeiaaoaeueiinoue
?anoai?eiuo oaeoi?ia noi?annee, a oieueei eiaeooee?oao a CD4-eeaoeao aai
neioac. Oaeie aea iaoaieci, aiciiaeii, eaaeeo a iniiaa eiioiinoi?annee
i?e ae?oaeo eioaeoeeyo. Eioa?anii auei au n?aaieoue yoio noi?anneaiue
oaeoi? n eiioiinoi?anneaiui oaeoi?ii i?iaeoeoia ia?aeeniiai ieeneaiey
eeieaeia.
7-e iaoaieci. Ae?on eiioiiaeaoeoeeoa /aeiaaea aucuaaao eciaiaiey
iiaa?oiinoe CD4-eeioioeeoia, /oi i?iaioee?oao eo oie/oiaeaiea eae
/oaeaeuo eiioiiie nenoaia. CD4-eeaoee, aoaeo/e eioeoee?iaaiiuie,
iiaeaatho io oiai, /oi ia ieo iaiaaeatho O-eeioioeeou-eeeea?u. Oaeei
iooai eaeao iai?a?uaiia nieaeaiea eiee/anoaa O-oaeia?ia a e?iae,
eeioioceao, naeacaiea e ae?oaeo oeaiyo. A oi aea a?aiy eiee/anoai
noi?anni?iuo CD8-eeioioeeoia ia oiaiueoaaony e aeaaea ianeieueei
aic?anoaao, /oi i?eaiaeeo e nieaeaieth iieacaoaey Oo/On.
8-e iaoaieci. I?iieeoee a eeioioeeou AE* eciaiyao aaiii O-oaeia?ia, a
?acoeueoaoa /aai iie eeoathony niiniaiinoe e o?ainoi?iaoeee e
ii?iaeueiiio ioaaoo ia EE-2.
ACAEIIAeAENOAEA AE* N O-NOI?ANNI?AIE
Aeae.Eaae n nio?oaeieeaie Eaeeoi?ieeneiai oieaa?neoaoa onoaiiaeee, /oi
eiioiiay nenoaia i?aaiecia niiniaia eiio?iee?iaaoue ?aciiiaeaiea ae?ona
NIEAe a ca?aaeaiiuo eeaoeao, a O-noi?anni?u iiaeaaeyoue ?aciiiaeaiea
AE*. O/eouaay, /oi oieueei oeeoioiene/aneea eeaoee e O-noi?anni?u
niiniaia iiaeaaeyoue ?aciiiaeaiea AE*, a eo ?aoeaioi?u ono?iaiu oaeei
ia?acii, /oi aioeaai naycuaaaony eeoue iaeiia?aiaiii n aaeeaie IIN
eeanna1, a ioee/ea io O-oaeia?ia, naycuaathueony n aaeeaie IIN eeanna 2,
iiaeii naeaeaoue caeeth/aiea i aiciiaeiii iia?aaeaeaiee AE* aaeeia IIN
eeanna 2.
?ACOEUeOAOU ACAEIIAeAENOAEss AE* N A-EEAOEAIE
E?iia O-eeaoie i?e AE*-eioaeoeee ia?ooaaony eiioii?aaoeyoi?iay ?ieue e
ae?oaeo noaiiioeyoeee eeioioeeoia. Ianiio?y ia ii?iaeueiia eiee/anoai
oee?eoee?othueo A-eeioioeeoia, ?aaeoeey eo ia O-caaeneiua aioeaaiu ?acei
nieaeaia, eae iiieaeaiu e ioaaou ia O-caaeneiua e iacaaeneiua
iieeeeiiaeueiua aeoeaaoi?u. A oi aea a?aiy oaaee/aii /enei A-eeioioeeoia
niiioaiii nae?aoe?othueo eiioiiaeiaoeeiu.
Nio?oaeieee Einoeoooa Aeea?aee e Eioaeoeeiiiuo Caaieaaaiee a Aaoanaea
(Bethesda) onoaiiaeee, /oi AE* iaiin?aaenoaaiii aac iin?aaeie/anoaa
O-eeaoie, aeoeae?oao A-eeioioeeou. Iee eioaineaiinoe nic?aaaiey e
aeeooa?aioee?iaee A-eeioioeeoia ioia/aaony ia /aoaa?oua nooee n iiiaioa
eieoaaoeee eo n ae?onii HIV, a a iau/iuo oneiaeyo ia aeoeaaoeeth
A-eeioioeeoia O-eeaoeaie ooiaeeo cia/eoaeueii aieueoa a?aiaie. Iaeneioi
auaeaeaiey aioeoae i?eoiaeeony ia 10-a nooee.
O aieueiuo NIEAe iiauoai o?iaaiue IgA e IgG. O?iaaiue IgM ia eciaiai, a
oi aea a?aiy iiauoai o?iaaiue ino?ioaciuo aaeeia, iai?eia?,
N-?aaeoeaiiai aaeea. Iineieueeo o A-eeioioeeoia ionoonoaotho ?aoeaioi?u
CD4, a ae?on ana aea ni?ae?oaony ia eo iiaa?oiinoe, aa?iyoii, /oi
?ao?iae?on HIV niiniaai acaeiiaeaenoaiaaoue e n ae?oaeie ?aoeaioi?aie
eee ?aoeaioi?iuie iieyie eiioiieiiiaoaioiuo eeaoie.
IAE?IOAAE E AE*
A ?yaea ?aaio oaaaeeoaeueii iieacaii, /oi yieaea?iaeueiua iae?ioaae
(eeaoee Eaiaa?aaina) i?aaenoaaeytho aioeaai oaeei ia?acii, /oi
i?aeiouanoaaiii aeoeae?oaony oeeee O-oaeia?ia. Anee yoe eeaoee auaanoe
ec eiioiiie ea?u (iai?eia?, oaea aieueoie aeicie OO-iaeo/aiey,
?aaeeaoeeae), eee aioeaai eaeei-eeai iooai ieioao eo, a i?aaiecia iiaeao
aicieeiooue niaoeeoe/aneee eiioiiue ia?aee/. Iiaeiaiia ?acaeoea niauoee
aiciiaeii e i?e AE*-eioaeoeee. Ae?oaea i?aaenoaaeythuea eeaoee, iai?eia?
aeaiae?eoiua eeaoee A?yinoaeia, iaiin?aaenoaaiii noeioee?otho
aeoeaiinoue niaoeeoe/aneeo O-noi?anni?ia, /oi aeiiieiyao auneacaiiie
i?aaeiieiaeaiea.
Ecaanoii, /oi eeoue iaee/ea o?ao eeaoi/iuo oeiia (O e A-eeaoie e
iae?ioaaia) a eiiia?aoeee eiaeooee?oao iieiioeaiiue eiioiiue ioaao.
Eaeay-eeai iaeia eee aeaa ec oeacaiiuo iiioeyoeee eeaoie ia niiniaiu
aeaoue noeioe e aioeoaeiia?aciaaieth. I?e AE*-eioaeoeee nei?aa anaai
iaiieiioeaiiu aeaa caaia - O-oaeia?iia e iae?ioaaaeueiia.
I?e AE*-eioaeoeee ec eeaoie ?YN iae?ioaae ii?aaeathony a ia?aoth
i/a?aaeue. Aoaeo/e eioeoee?iaaiu ae?onii, yoe eeaoee iiaeaatho ia oae
auno?i, eae eeioioeeou. Yoi, aiciiaeii, iauyniyaony iaeui eiee/anoaii
?aoeaioi?ia CD4 ia eo iaia?aia.
Enoiaey ec i?aaeiieiaeaiey, /oi AE* o?iiai e iaeiie ec iiioeyoeee
iae?ioaaia, a eiaiii - e eeaoeai Eaiaa?aaina, i?ineaaeei ca naeaeaaie a
eiioiiie nenoaia eioeoee?iaaiiiai AE*. Iaee/ea a e?iae oaeeo ethaeae
aeinoaoi/ii aunieiai o?iaiy aioeoae e ae?ono eiioiiaeaoeoeeoa /aeiaaea
naeaeaoaeuenoaoao i oii, /oi Ir-aaiu iae?ioaaa ?aaeecotho a iieiie ia?a
naith ooieoeeth, a oi a?aiy eae ieceea eiioeaio?aoeee niaoeeoe/aneeo
aioeoae iauyniythony ii?aaeaieai iae?ioaaia. Ii?aaeaiea iae?ioaaia
ioaeaeueiuo i?aaiia (einoiiai iicaa, naeacaiee, eeioioceia, eaaeeo), a
oaeaea aenoeioeeoia niaaeeieoaeueiie oeaie, iee?iaeee, inoaieeanoia,
ia?eoiiaaeueiuo e ieaa?aeueiuo iae?ioaaia, caacae/aouo ?aoeeoeioeeoia
ia/aie iaoneaaeeaaao iai?aaeaiiinoue i?aeiouanoaaiiiai ii?aaeaiey oiai
eee eiiai i?aaia eee oeaie, /oi i?iyaeyaony a eeeie/aneii oa/aiee NIEAea
e oacao aai ?acaeoey. A oi aea a?aiy acaeiiaeaenoaea AE* n eeaoeaie
Eaiaa?aaina e A?yinoaeia i?aaeoanoaoao eieaeueiui ii?aaeaieyi ae?oaeo
iiioeyoeee iae?ioaaia e yaeyaony oiiii aeey aieaa aa?anneaiiai
i?iyaeaiey O-eeeea?ia, i?aaeii?aaeaeythueo aeaaeue eeaoie-ieoaiae.
Acaeiiaeaenoaea AE* n eeaoeaie Eaiaa?aaina e A?yinoaeia eioa?anii e n
ae?oaie noi?iiu. Eiaaea Ia-aaeie a neeo no?oeoo?iuo iniaaiiinoae
aioeaaia ia iiaeao ia?aciaaoue n iei eiiieaen, iineaaeiee ieacuaaaony ia
iiaa?oiinoe iae?ioaaa a naiaiaeiie oi?ia. Oaeie aioeaai eiiia?e?oaony n
O-noi?anni?ii; a ?acoeueoaoa iaaethaeaaony iiaeaaeaiea eee iieiia
ionoonoaea eiioiiiai ioaaoa. Ecaanoii, /oi noi?anni?iua eeaoee iiaoo
naycuaaoue aioeaai n iiiiuueth iieaeoe, noiaeiuo n eiioiiaeiaoeeiaie.
Iiaeiaii ae?oaei iae?ioaaai, eeaoee Eaiaa?aaina ianoo ?aoeaioi?u aeey Fc
e C3. Aeaaiaea?y eo iaee/eth eeaoee Eaiaa?aaina iiaoo i?iyaeyoue naay a
ea/anoaa eeaoie-eeeea?ia. Anee yoi oae, oi aiieia iauynieiu aanueia
/anoua iiooieaaua i?ioeannu i?e NIEAea, oae eae eeaoee iiaiia?aciaaiee
a ia?aoth i/a?aaeue ianeaaeothony eeeea?aie.
AE*, iiiaa a i?aaieci, ia/eiaao i?aaenoaaeyoueny iae?ioaaai ?acee/iuo
iiioeyoeee, O-eeeea?ai, O-oaeia?ai, O-noi?anni?ai, A-eeaoeai i?aaiecia.
Eciaiaiea /enea e ooieoeee eeaoie Eaiaa?aaina i?eaiaeeo e ia?ooaieyi a
eiioiieiae/aneie oeaii/ea iae?ioaa (eeaoea Eaiaa?aaina) - O-oaeia? -
A-eeaoea. Ai iiiaeo ?aaioao i?yii eee einaaiii ooaa?aeaeaaony, /oi
O-oaeia?, a iniiaiii, iieo/aao aioeaai io eeaoee Eaiaa?aaina, a aioeaai
O-noi?anni?ai, a iniiaiii, i?aaenoaaeyao eeaoea A?yinoaeia. Iiyoiio
iac?aeua O-oaeia?u ia iiaoo aeoeaece?iaaoueny, nic?aoue, ?aciiiaeeoueny
e (oae eae eo /enei nie?aoeony ii n?aaiaieth n eiee/anoaii
aeoeae?iaaiiuo, nic?aaoeo e ?aciiiaeeaoeony i?e yoii O-eeeea?ia e
O-noi?anni?ia, iieo/eaoeo io naieo iae?ioaaia aioeaai) aeoeaece?iaaoue
A-eeaoeo. A anee o/anoue oiaiueoaiea iiioeyoeee O-oaeia?ia,
eioeoee?iaaiiuo AE* a /enea ia?auo i?e ia?aioa?aeueiii ca?aaeaiee eee
iieo/eaoeo AE* io ca?aaeaiiuo eeaoie Eaiaa?aaina (i?e i?i/eo, aeeth/ay
ia?aioa?aeueiue niiniaao ca?aaeaiey), oi noaiiaeoueny i/aaeaeiui, /oi
/enei O-eeaoie-oaeia?ia anei?a noaiao caiaoii iaiueoei , oae eae
ca?aaeaiiua AE* eeaoee oie/oiaeathony eeeea?aie. Ionthaea e ana
ia?ooaiey a iiaaaeaiee A-eeaoee. Iineieueeo iia iiaeao e aeieaeia
io?aaae?iaaoue ia ae?on NIEAea a e?iae, ia?yaeo n iaaieueoei eiee/anoaii
aioeoae i?ioea AE* iiyaeyaony oaaee/aiiia /enei niiioaiii nae?aoe?oaiuo
A-eeioioeeoaie eiioiiaeiaoeeiia. Oae eae nieaeai nithc n O-oaeia?aie,
ianiio?y ia ii?iaeueiia eiee/anoai oee?eoee?othueo A-eeioioeeoia,
?aaeoeey eo ia O-caaeneiua e O-iacaaeneiua iieeeeiiaeueiua aeoeaaoi?u
?acei nieaeaia. I?e yoii naii ii naaa i?iieeiiaaiea iai?aaenoaaeaiiiai
iae?ioaaii aioeaaia a eeioioceu ia eiaeooee?oao eiioieoao, i?e yoii ia
aicieeatho eeaoee iaiyoe.
I?aaenoaaeaiiay ea?oeia ia?ooaiee i?e AE*-eioaeoeee, aucaaiiay
o?iiiinoueth ae?ona e eeaoeai Eaiaa?aaina, i/aiue aeecea e iaoaieciai
eiioiiuo ia?ooaiee aieacie O-oaeia?ia. Ia eneeth/ay iineaaeiaai, oi
anoue /oi i?e NIEAea aeaioo i?aaeaea anaai O-oaeia?u, aiciiaeii, /oi ana
aea aieueoay ?ieue i?eiaaeeaaeeo eeaoeai Eaiaa?aaina eae ia?ae/iui
ieoaiyi e ?aca?aoa?ai iaeiieaiey AE* e iineaaeothuaai ca?aaeaiey
O-oaeia?ia ( n iaeiie eeaoeie Eaiaa?aaina iiaoo iaeiia?aiaiii
eiioaeoe?iaaoue io 1 aei 7 O-oaeia?ia). Ii aeaeeiiio, iiae aicaeaenoaeai
AE* a i?aaiecia iiyaeythony eee aauanoaa oaiaoathuea aeaiiua eeaoee ( ii
oeio ei?oeeinoa?ieaeia) eee aea i?e aeaeueiaeoae aeoeaaoeee i/a?aaeiie
eioaeoeeae eeaoee Eaiaa?aaina iiaeaa?aathony onei?aiiie aeaaee, oae eae
, io?aaae?iaaa ia ethaie iiaue aioeaai, eeaoea Eaiaa?aaina iaycaoaeueii
i?aaenoaaeo ia naiae iiaa?oiinoe aieueooth aeico CD4 ?aoeaioi?ia,
iaiaoiaeeiuo ae aeey nayce n O-oaeia?aie.
ACAEIIAeAENOAEA AE* N IIIIOeEOAIE
Iiiioeeou iiae aeaenoaeai AE* aeaioo iaaeeaiiaa, /ai CD4-eeioioeeou.A
ca?aaeaiiuo eeaoeao ae?on niiniaai ?aciiiaeaoueny (?aca?aoa? ae?ona a
i?aaiecia), /oi i?eaiaeeo eeai e eo aeaaee, eeai e oiaiueoaieth
eiee/anoaa auaeaeyaiuo eie oaeoi?ia ?inoa CD4-eeioioeeoia. Iiiioeeou
aieueiuo NIEAeii ieacaeenue niiniaiuie i?iaeooee?iaaoue ?anoai?eiue
noi?anneaiue oaeoi?, iiaeaaeythuee ioaao O- e A-eeioioeeoia ia ieoiaaiu.
Yoio oaeoi? caaeneo io O-eeaoie e , aeaeeii, naycai n oaaee/aieai
noi?anne?othuaai aeeyiey ni noi?iiu iineaaeieo. I?e NIEAea aioeiee?iaiua
ooieoeee iiiioeeoia nio?aiythony, ii iie oa?ytho niiniaiinoue e
oaiioaeneno, iaaeaao eo oeeoioiene/aneay aeoeaiinoue e niiniaiinoue e
i?iaeoeoeee eioa?eaeeeia-1.
ACAEIIAeAENOAEA AE* N Ae?OAEIE EEAOEAIE I?AAIECIA .
Iiieii eeaoie e?iae ?aca?aoa?ii ae?ona iiaoo auoue eeaoee yiaeioaeey
e?iaaiiniuo e eeioaoe/aneeo ninoaeia, yieoaeeaeueiua eeaoee eiaee e
?iaenoaaiiuo oeaiae, aeeaeueiua eeaoee ia?aiie nenoaiu e ia?aiua eeaoee.
Iau/iua i?e NIEAea ineoicu e ao?ioey iicaa ?acaeaathony eiaiii ec-ca
niiniaiinoe ae?ona eioeoee?iaaoue OeIN. Eeaoee ca i?aaeaeaie
ninoaeenoiai ?onea ia anaaaea niaea?aeao iiaa?oiinoiua ?aoeaioi?iua
aaeee e ae?ono, /oi ia iicaieyao aio aaeni?ae?iaaoueny e i?iieeaoue a
eeaoeo iaiin?aaenoaaiii, iaeiaei eioeoee?iaaiea iiaeao i?iecieoe i?e
neeyiee n ca?aaeaiiuie CD4-eeaoeaie e iae?ioaaaie.
I?iieeay /a?ac aaiaoiyioeaoaee/aneee aa?uea?, ae?on aucuaaao a aieiaiii
iicao aiiiaeueiia ?aciiiaeaiea aeeaeueiuo eeaoie, ie?oaeathueo iae?iiu,
a oaeaea ii?aaeaiey, ianooiathuea a ?acoeueoaoa iioa?e aaeiai aauanoaa
iicaa, ?acaeoey ia?ae/iie eeioiiu iicaa e ao?ioee iaeioi?uo ia?aia
(c?eoaeueiiai a ia?aoth i/a?aaeue).
Ii?aaeaiea ia?aiie nenoaiu ioia/aaony o o?aoe aieueiuo NIEAeii e
i?iyaeyaony a /aou?ao iniiaiuo eeeie/aneeo oi?iao:
· aanoeannu iicaa (i?ia?anne?othuay iiiaii/aaiaay eaeeiyioeaoaeiiaoey,
e?eioieieeiaue iaieiaeo, iiaeino?ue yioeaoaeeo, aiciiaeii,
oeeoiiaaaeiae?oniie yoeieiaee.);
· iiooiee iicaa, iai?eia? ia?ae/iay e aoi?e/iay eeioiiu aieiaiiai
iicaa;
· ii?aaeaiey ninoaeia iicaa (oea?aa?aeueiua aaii??aaee) e na?aeoea
(iaaaeoa?eaeueiue o?iiaioe/aneee yiaeiea?aeeo);
· i/aaiaua ii?aaeaiey iaiei/ae iicaa, oa?aeoa?ecothueany
naiiia?aie/eaaueiny iaieiaeoii.
NENOAIA EIOA?OA?IIA I?E AE*-EIOAEOeEE.
Nenoaia eioa?oa?iia (EO) yaeyaony eioaa?aeueiie /anoueth eiioiiie
nenoaiu e iaania/eaaao eii?aeeiaoeeth i?ieeoa?aoeee, aeeooa?aioee?iaee e
aeoeaaoeee yooaeoi?iuo eeaoie eiioieoaoa. A i?ioeanna eiioiiiai ioaaoa
EO auiieiyao ?ieue ei?ioeiaeenoaioiuo iaaeeaoi?ia iaaeeeaoi/iuo
acaeiiaeaenoaee. EO ii?aaeaeyao yooaeoeaiinoue eiioiiiai ?aniiciaaaiey
aioeaaiia, aeeyy ia yeni?anneth aioeaaiia aeaaiiai eiiieaena
aenoiniaianoeiinoe 1-ai e 2-ai eeannia, a oaeaea ea?oeeiiyia?eiiaeueiuo
e iiooieaauo aioeaaiia. EO ea?atho ii?aaeaeythuoth ?ieue a i?ioeannao
yeeieiaoeee aioeaaiii-eciaiaiiuo naieo e /oaea?iaeiuo eeaoie, yaeyynue
iniiaiuie aeoeaaoi?aie oeeoieeoe/aneeo e oaaioeeoe?othueo yooaeoi?ia
eiioieoaoa:g-EO yaeyaony iacaiaieiui oaeoi?ii aeeooa?aioee?iaee
A-eeioioeeoia.
AE*-eioaeoeey oa?aeoa?ecoaony i?ia?anne?othuae aeenooieoeeae eiioiiie
nenoaiu, eioi?ay nii?yaeaia n aeoaieeie ia?ooaieyie a nenoaia EO. Aeey
oaeianoaa eceiaeaiey AE*-eioaeoeey ?acaeaeaia ia 3 o?aaeeoeeiiiua
noaaeee: 1) AE*-na?ieiiaa?neth, eiaaea a nuai?ioea ia?eiaee/anee
auyaeythony aioeoaea e AE*, ii ae?oaea eeeie/aneea i?eciaee
ionoonoaotho, 2) noaaeeth aaia?aeeciaaiiie ianiaoeeoe/aneie
eeioaaeaiiiaoee e 3) eeeie/anee au?aaeaiiue NIEAe. Aeaoaeou a nenoaia EO
i?ineaaeeaathony ia eaaeaeie ec noaaeee, ii eo oa?aeoa? e aeoaeia
niaa?oaiii ?acee/iu.
AE* iaeaaeaao eioa?oa?iiiaaiiuie naienoaaie, iaoneiaeaiiuie iaee/eai a
eeaea?iie iineaaeiaaoaeueiinoe ?IE 3`-LTR aei i?iiioi?a SP-6 aeaieiie
nie?aee, ninoiyuae ec 40 ia? ioeeaioeaeia. Yoa iniaaiiinoue aaiiia AE*
oeacuaaao oaeaea ia iioaioeeaeueioth /oanoaeoaeueiinoue ae?ona e
eiaeooee?oaiui EO eeanne/aneei i?ioeaiae?oniui iaoaieciai -
aen?IE-caaeneiui 2`, 5`-ieeai(A)neioaoaca e i?ioaeieeiaca oaeoi?a
eieoeeaoeee neioaca aaeea eiF2. Iaeiaei iiae aeaenoaeai EO ia
i?ienoiaeeo iieiiai iiaeaaeaiey ?ai?iaeoeoeee AE*. A yoii ioiioaiee
?ao?iae?onu i?eioeeieaeueii ioee/athony io eeoe/aneeo ae?onia. I?e
aeaenoaee EO aeoeaiinoue ia?aoiie o?aine?eioacu e neioac ae?oniuo aaeeia
nieaeathony oieueei ia 70%.
Iieiiai iiaeaaeaiey ?ai?iaeoeoeee AE* oaeaeinue aeiaeoueny ia
yenia?eiaioaeueiie iiaeaee i?e iinoiyiiie i?iaeoeoeee EO yiaeiaaiii. A
eeaoee ii/ae caeaiuo ia?ouoae aaaee ieacieaeo, niaea?aeauoth
AE*-i?iiioi? (3`-LTR), eioaa?e?iaaiiue n aaiii /aeiaa/aneiai b2-EO,
yeni?anney eioi?iai ?aaoee?oaony o?ainaeoeae?othuei oaeoi?ii -
i?iaeoeoii aaia tat. Yeni?anney ieacieaeiiai aaia a2-EO a o?ainoaeoiuo
eeaoeao i?eaiaeeea e aeoeaaoeee aioo?eeeaoi/iie 2`,
5`-ieeai(A)neioaoacu. Aiciiaeiinoue iieiie yeeieiaoeee AE* ec eoeueoo?u
i?e iinoiyiiie yeni?annee EO yiaeiaaiii i?aaenoaaeyao cia/eoaeueiue
eioa?an. Oioy iaoaieci yoiai yaeaiey iiea ia onoaiiaeai, ana aea ia
aucuaaao niiiaiey iaiaoiaeeiinoue eco/aiey eiaeoeoi?ia EO ii e?aeiae
ia?a ia 1 noaaeee AE*-eioaeoeee.
A eeeie/aneeo iaaethaeaieyo auee a iniiaiii iiaeoaa?aeaeaiu
yenia?eiaioaeueiua aeaiiua i iaiieiii iiaeaaeaiee AE* i?e ea/aiee
yeciaaiiui EO. I?e aaeaaeiaaiii iiaeeiaeiii aaaaeaiee 35.000.000 IA
?aeiiaeiaioiiai a-EO a oa/aiea 8-12 iaaeaeue aieueiui NIEAe, o ieo
ioia/aii cia/eoaeueiia, a iaeioi?uo aeaaea iieiia iiaeaaeaiea ae?oniuo
aioeaaiia a oee?eoeyoeee. Iaeiaei eaeiai eeai aeeyiey EO-oa?aiee ia
aeeiaieeo oee?eoee?othueo aioeoae e ei?o AE* iaia?oaeaii ia auei, /oi
iiaeoaa?aeaeaao ia?nenoaioeeth eioaeoeee.
O caei?iauo eeoe EO a nuai?ioea, eae i?aaeei, ia iaia?oaeeaaaony eee
oee?eoee?oao a i?aaeaeueii ieceeo oeo?ao. I?e ?acee/iuo ae?oniuo
eioaeoeeyo, a oaeaea iieieiae/aneeo e aooieiioiiuo caaieaaaieyo EO a
nuai?ioeao iiyaeyaony iinoiyiii, i?e/ai oeo? aai ia?anoaao ia?aeeaeueii
oyaeanoe caaieaaaiey. E ianoiyuaio a?aiaie iaeiieai iaoe?iue iaoa?eae,
iicaieythuee caeeth/eoue, /oi iiyaeaiea EO a nuai?ioea iiaeao neoaeeoue
aeieiae/aneei ia?ea?ii ae?oniie eioaeoeee, a ai iiiaeo neo/ayo e
iieieiae/aneiai caaieaaaiey. I?e/ai oee?eoee?othuee EO, eae i?aaeei,
ioiineony e aeaeo a, ii ii e?aeiae ia?a, /anoue oee?eoee?othuaai EO
ioee/aaony iaiau/iui naienoaii -eeneioieaaeeueiinoueth.
I?enoonoaea eeneioieaaeeueiiai a-EO a oee?eoeyoeee o aieueiuo NIEAe
auei onoaiiaeaii oaea ia ?aiieo yoaiao enneaaeiaaiey eioaeoeee: ii
iaia?oaeeaaeny o 60-80% aieueiuo n aaia?aeeciaaiiie eeioiaaeaiiiaoeae e
eeeie/anee au?aaeaiiui NIEAeii. Oeo? oee?eoee?othuaai eeneioieaaeeueiiai
a-EO ia?anoae ii ia?a oaaee/aiey eeeie/aneie oyaeanoe eioaeoeee: ia
noaaeee aaia?aeeciaaiiie eeioaaeaiiiaoee oeo? a n?aaeiai aue ?aaai 7,7
IA/ie, a i?e i?iyaeaiee eeeie/aneeo neiioiiia NIEAe - 28,7 IA/ie. A
ae?oaeo iaaethaeaiey auei iieacaii, /oi oaaee/aiea oeo?a
oee?eoee?othuaai EO ei??aee?iaaei n aaiaoieiae/aneeie neiioiiaie
eiioiiaeaoeoeeoa. Ia?aoiay ei??aeyoeey i?ineaaeeaaeanue n iauei /eneii
eeioioeeoia e n noaiiioeyoeeae O-oaeia?ia, e i?yiay - n eiioeaio?aoeeae
IgA a nuai?ioea.
Ii aeaiiui iiiaeo enneaaeiaaiee iiyaeaiea oee?eoee?othuaai a e?iae
eeneioieaaeeueiiai a-EO iaia?oaeeaaaony a n?aaeiai ca 6,5 ianyoeaa aei
eeeie/aneeo neiioiiia NIEAea e iiaeao neoaeeoue iaeaieaa ?aiiei
i?iaiinoe/aneei iieacaoaeai.
Iaeiaei, eeneioieaaeeueiue a-EO iaia?oaeeaaeny oieueei o 65-70%
aieueiuo. Inoaeueiua na?iiiceoeaiua aieueiua ia eiaee yoiai
aeeaaiinoe/aneiai i?eciaea. Yoio oaeo aei ianoiyuaai a?aiaie ia iieo/ee
iauyniaiey e caneoaeeaaao niaoeeaeueiiai enneaaeiaaiey.
Oaeei ia?acii, iaee/ea oee?eoee?othuaai eeneioieaaeeueiiai a-EO a
iinoiyiiuo oeo?ao >16IA/ie a a?oiia ?enea yaeyaony i?iaiinoe/aneei
i?eciaeii e oeacuaaao ia aunieoth aa?iyoiinoue (60-80%) ?acaeoey
eeeie/aneeo neiioiiia NIEAea a oa/aiea ianeieueeeo ianyoeaa.
Ae?oaie iniaaiiinoueth AE*-eioaeoeee, eioi?ay oiaea eiaao
aeeaaiinoe/aneia cia/aiea, yaeyaony i?enoonoaea a oee?eoeyoeee
eiaeaeoi?a (eee eiaeoeaaoi?a EO).
Ecaanoii, /oi a oeceieiae/aneie ii?ia a nuai?ioea ia?eoa?e/aneie e?iae
iiaoo iaia?oaeeaaoueny eiaeaeoi?u EO oeia 1 ( a e b). I?e ae?oniie
eioaeoeee /anoioa eo auyaeaiey nouanoaaiii aic?anoaao.
I?e eco/aiee nuai?ioee aieueiuo NIEAe ineiaeiaiiui na?eiiie Eaiioe,
eiaeaeoi? auyaeai o 80%, i?e/ai o aeaoo o?aoae ec ieo aai oeo? aue
aeinoaoi/ai aeey eiaeoeaaoeee aieaa 50 IA/ie a-EO. Aianoa n oai, a
ae?oaie a?oiia aieueiuo n na?eiiie Eaiioe, ia eiaaoeo aeeaaiinoe/aneeo
i?eciaeia NIEAea, ie o iaeiiai aieueiiai eiaeaeoi?a a nuai?ioea ia auei.
Ia auyaeyeny eiaeaeoi? e o iaineiaeiaiiuo aieueiuo n eeioiaaeaiiiaoeae.
Oaeei ia?acii, oee?eoee?othuee eiaeaeoi? EO oeia 1 yaeyaony
aeeaaiinoe/aneei i?eciaeii, i?iyaeythueiny ia III noaaeee
AE*-eioaeoeee, iaeiia?aiaiii n eeeie/aneeie i?eciaeaie NIEAea.
Oeie/aneay i?e?iaea eiaeaeoi?a EO oeia 1 eco/aia aua iaaeinoaoi/ii. Ii
iaeioi?ui aeaiiui aai no?oeoo?a iaiiieiaao no?oeoo?o g-EO.
Acaeiiaeaenoaea EO n eeaoeie inouanoaeyaony /a?ac niaoeeoe/aneea
?aoeaioi?u n eneeth/eoaeueii aunieei aooeieoaoii. Eiioiiaeieiae/aneea
yooaeou EO ?aaeecothony oieueei /a?ac ?aoeaioi?u. EO oeia 1 eiatho iauee
?aoeaioi? n iie. iannie 110 eAe, ?aniiciathuay /anoue yaeyaony
aaiaeeiceaeii. ?aoeaioi? g-EO ninoieo ec 2-o aaeeiauo eiiiiiaioia n iie.
iannie 50 e 90 eAe.
Yeni?anney ?aoeaioi?ia ia eeaoea iiaeaa?aeaia ooieoeeiiaeueiui
eciaiaieyi e iiaeaaeyaony iiae aeaenoaeai EO. Iinoiyiiia i?enoonoaea
eeneioieaaeeueiiai a-EO a oee?eoeyoeee i?e AE*-eioaeoeee i?eaiaeeo e
iiaeaaeaieth yeni?annee eeaoi/iuo ?aoeaioi?ia e EO oeia 1, a oi aea
a?aiy yeni?anney ?aoeaioi?ia e EO oeia 2 ia anao eeeie/aneeo noaaeeyo ia
eciaiyaony.
Aeieiae/aneea yooaeou EO iaoneiaeaiu niaoeeoe/aneeie eciaiaieyie a
iaoaaieecia eeaoee. Ecaanoii, /oi iiae aeaenoaeai EO a oeeoiieacia
iiyaeyaony aieaa 20 iiauo aaeeia. Iaeaieaa eco/aiiui EO-caaeneiui
oa?iaioii yaeyaony 2`,5`-ieeai(A)neioaoaca, eioi?ay aeoeae?oaony anaie 3
aeaeaie EO (a, b e g) a i?enoonoaee aeaonie?aeueiie ?IE ii e?aeiae ia?a
ec 20 ioeeaioeaeia. Iiae aeaenoaeai yoiai oa?iaioa ia iniiaa AOO
neioace?oaony ?yae ei?ioeeo iieeaaeaieeaoia, niaaeeiaiiuo iaiau/iie
2`-5`-oinoiaeeyoe?iie naycueth. 2`,5`-ieeaiaaeaieeaou yaeythony
neeueiuie aeoeaaoi?aie eeaoi/iuo yiaeiioeeaac, a /anoiinoe ?IEacu L.
Aeoeaaoeey yiaeiioeeaac i?aaeioa?auaao n/eouaaiea ae?oniie eioi?iaoeee.
I?e AE*-eioaeoeee ioia/aiu aeaoi?iaoeee a nenoaia
2`,5`-ieeai(A)neioaoacu. O aieueiuo ia noaaeee aaia?aeeciaaiiie
eeioaaeaiiiaoee aeoeaiinoue yoiai oa?iaioa cia/eoaeueii aic?anoaao, a
i?e ineiaeiaiee NIEAe iiii?ooienoe/aneeie eioaeoeeyie eee na?eiiie
Eaiioe aeinoeaaao iaeneiaeueiuo cia/aiee.
I?e yoii iiauoaiiue oii aeoeaiinoe 2`,5`-ieeai(A)neioaoacu o aieueiuo
NIEAeii nii?iaiaeaeaaony nieaeaieai /oanoaeoaeueiinoe oa?iaioa e
aeoeae?othuaio aeaenoaeth EO.
O aieueiuo NIEAeii iienai aeaoaeo e a ae?oaii caaia
2`,5`-ieeai(A)neioaoacu - ia o?iaia ?IEacu L. Oaea ia noaaeee
aaia?aeeciaaiiie eeioaaeaiiiaoee aeoeaiinoue yoiai oa?iaioa auea a
n?aaeiai ia 55% ieaea, /ai o caei?iauo aeiii?ia.
Oeeoieec aioeaaiii eciaiaiiuo eeaoie anoanoaaiiuie eeeea?aie (AE)
yaeyaony aaaeiui iaoaieciii i?ioeaiae?oniiai eiioieoaoa. Aeaoa?ieiaioaie
aeey eiioiiiai ?aniiciaaaiey ieoaiae aeey AE neoaeao aioeaaiu aeaaiiai
eiiieaena aenoiniaianoeiinoe, iiyoiio eo aeoeaiinoue ia caaeneo io
naineaeeecaoeee, i?enoonoaey aioeoae eee eiiieaiaioa.
AE*-eioeoee?iaaiiua eeioioeeou ieacuaathony auniei/oanoaeoaeueiuie e
aeaenoaeth AE. Iiiioeeou e iae?ioaae, eioeoee?iaaiiua AE*, oaeaea
eioaineaii iiaeaa?aathony oeeoieeco AE, auaeaeaiiuie ec e?iae
AE*-na?iiaaaoeaiuo ethaeae. Iaeiaei, AE, auaeaeaiiua io
AE*-na?iiiceoeaiuo ethaeae n aeaaiinoueth na?ieiiaa?nee 15 ianyoeaa,
iaeaaeaee oaea a 2-2,5 ?aca iaiueoae aeoeaiinoueth. Aua aieaa aeoaieay
aeai?anney AE ioia/aia o 90% aieueiuo n eeeie/anee au?aaeaiiui NIEAeii.
Ecaanoii, /oi oeeoieeoe/aneay ooieoeey iaoiaeeoueny iiae
aooie?eiiui-ia?ae?eiiui eiio?ieai EO. I?e acaeiiaeaenoaee n aioeaaiii
eciaiaiiie eeaoeie-ieoaiueth AE i?iaeooee?otho a- eee g-EO, iaania/eaay
?ae?ooe?iaaiea yooaeoi?iuo eeaoie ec i?aaeoanoaaiieeia e eo aeoeaaoeeth.
A oi aea a?aiy, AE, auaeaeaiiua io AE*-na?iiiceoeaiuo aeiii?ia eee
aieueiuo NIEAeii i?e acaeiiaeaenoaee n eeaoeaie-ieoaiyie i?iaeooee?iaaee
eeoue iacia/eoaeueiia eiee/anoai EO. Yoi oeacuaaao ia aeoaieoth
aeai?anneth AE o aieueiuo n eeeie/anee au?aaeaiiui NIEAeii.
Eoae, ec anaai auoaneacaiiiai noaiiaeony ynii, /oi nenoaia EO aiaea/aia
a iaoiaaiac AE*-eioaeoeee. Aeoaeia aeaoi?iaoeee nenoaiu EO aic?anoaao
ia?aeeaeueii n ooyaeaeaieai eeeie/aneeo i?iyaeaiee eioaeoeee. Ia noaaeee
na?ieiiaa?nee iniiaiui aeaoaeoii, eiathuei i?iaiinoe/aneia cia/aiea,
yaeyaony iiyaeaiea a nuai?ioea ia?eoa?e/aneie e?iae aieueiiai
eeneioieaaeeueiiai a-EO. Oee?eoee?othuee EO iaecaaaeii i?eaiaeeo e
iiaeaaeaieth yeni?annee eeaoi/iuo ?aoeaioi?ia e EO oeia 1 e iinoiyiiiio
iiauoaiiiio o?iaith aeoeaiinoe 2`,5`-ieeai(A)neioaoacu. Ia noaaeee
aaia?aeeciaaiiie eeioaaeaiiiaoee oeacaiiua aeaoaeou i?iaeieaeatho
oaeoaeyoueny e ia/eiaao i?iyaeyoueny ?ao?aeoa?iinoue eeaoie e?iae e
i?iaeoeoeee a-EO a ioaao ia ae?onioth eee aioeaaiioth eiaeoeoeeth.
Iaeiia?aiaiii (a iiaeao auoue e aneaaenoaea yoiai) nieaeaaony
oeeoieeoe/aneay aeoeaiinoue AE a ioiioaiee AE*-eioeoee?iaaiiuo eeaoie.
Nieaeaaony aeoeaiinoue ?IEacu L.
Ia noaaeee eeeie/anee au?aaeaiiiai NIEAea aeai?anney nenoaiu EO aua
aieueoa ia?anoaao, a nuai?ioea iiyaeyaony eiaeaeoi?/eiaeoeaaoi? a-EO.
I?e aiaeeca ninoiyiey nenoaiu EO i?e AE*-eioaeoeee iaiaoiaeeii
o/eouaaoue, /oi ana iienaiiua auoa yaeaiey eiioiiaeai?annee i?iyaeythony
oieueei a ioiioaiee EO oeia 1, aeaaiui ia?acii a-EO. Nenoaia g-EO ia
anao noaaeeyo AE*-eioaeoeee eaeei-eeai nouanoaaiiui aeaoi?iaoeeyi ia
iiaeaa?aaaony.
Noaia eiioiieiae/aneeo eciaiaiee i?e ?acaeoee AE*-eioaeoeee.
Э Aioeoaea e aaeeo ?24 Э Ianiaoeeoe/aneea Я Ooieoeey
iiiioeeoia Я Aioeoaea e
Э Aioeoaea e iaiei/ea eiioiiaeiaoeeiu e iae?ioaaia
aaeeo ?24
ae?ona
Я Niaoeeoe/aneea
Ioaao ia aioeaaiu,
Aeoeaiinoue eiioiiaeiaoeeiu
Э Oeeoioiene/aneea eee Я e eioi?ui eiaaony Я i?e?iaeiuo
noi?anni?iua O-eeaoee eiioiieiae/aneay
eeaoie-eeeea?ia Я Eeaoee CD8
CD8 iaiyoue
Я Я Eeaoee CD4
Я Eeaoee
CD4/CD8<1 Я Я Я Eeaoee CD4
===================================================>
Ca?aaeaiea
IAE Aieacie, annioeee?iaaiiua NIEAe
ni NIEAeii
EEEIE*ANEEA I?IssAEAIEss. Eeeie/aneay ea?oeia i?e ca?aaeaiee AE* iiaeao
auoue aanueia ?aciiia?aciie, ia/eiay io ino?ie na?ieiiaa?nee e eii/ay
iieiinoueth au?aaeaiiui enoeiiui NIEAeii iiiai eao nionoy. Eioaeoeey
iiaeao i?ioaeaoue aanneiioiiii eee i?iyaeyoueny eeeie/anee.
Ia/aeueiue ia?eiae iinea ia?aiai eiioaeoa n ae?onii iau/ii auaaao
aanneiioiiiui e iiaeao i?iaeieaeaoueny aei oanoe iaaeaeue. Eiaaea
iaeiiaoe iiyaeythony neiioiiu, iie /anoi iinyo ianiaoeeoe/aneee
oa?aeoa?. Aicieeaao oae iacuaaaiay aieaciue na?ieiiaa?nee. A ia?eiae
ino?ie na?ieiiaa?nee iaaethaeaaony caaieaaaiea , noiaeiia n ainiaeaieai
aeaeac: aieueiie no?aaeaao io eeoi?aaeee, iaaeiiiaaiey, ayeinoe, aieae a
iuooeao e nonoaaao, eaoa?a ai?ea, eeioaaeaiiiaoee. A ia/aeueiii ia?eiaea
oaeaea iiaeao ioia/aoueny ia?aoeiay yioeaoaeiiaoey n iioa?ae
i?eaioaoeee, iaiyoe, naeaeaaie niciaiey, ino?ue iaieiaeo, ieaeiiaoey e
iaa?iiaoey.
Aa?iyoii, ia o anao, o eiai i?iecioea na?ieiiaa?ney, aeaei aeieaeao aei
o?iie/aneie eioaeoeee. O iiiaeo aiciiaeai ia?aoiae eioaeoeee a
eaoaioioth oaco. Oai ia iaiaa, e a yoo oaco aieueiie yaeyaony
eioaeoeeiiiui, oioy e ia a oaeie noaiaie eae a ia?eiae na?ieiiaa?nee eee
a noaaeeth au?aaeaiiiai NIEAea.
O?iie/aneay eioaeoeey oiaea iiaeao auoue aanneiioiiiie. Aa ecaanoiua
eeeie/aneea i?eciaee aeeth/atho oeeoiiaieth, ieii?iua niioonoaothuea
eioaeoeee e eiaeiua caaieaaaiey, eeioaaeaiiiaoeth, a oaeaea
NIEAe-annioeee?iaaiiue eiiieaen.
Eeanneoeeaoeey ninoiyiee i?e eioaeoeee AE*.
A?oiia 1: Ino?ay eioaeoeey
A?oiia 2: Aanneiioiiiay eioaeoeey
A?oiia 3: Ia?nenoe?othuay aaia?aeeciaaiiay eeioaaeaiiiaoey
A?oiia 4: Ae?oaea aieacie
Iiaea?oiia A: Eiinoeoooeeiiaeueiua caaieaaaiey
Iiaea?oiia A: Iaa?ieiae/aneea caaieaaaiey
Iiaea?oiia N: Aoi?e/iua eioaeoeeiiiua aieacie
Eaoaai?ey N1: Aoi?e/iua eioaeoeeiiiua aieacie, ia?a/eneaiiua a
nienea CDC eae eiathuea ioiioaiea e NIEAeo
Eaoaai?ey N2: Ae?oaea aoi?e/iua eioaeoeeiiiua aieacie
Iiaea?oiia D: Aoi?e/iua ceiea/anoaaiiua iiooiee
Iiaea?oiia E: Ae?oaea caaieaaaiey
IA?NENOE?OTHUAss AAIA?AEECIAAIIAss EEIOAAeAIIIAOEss.
Eeioaaeaiiiaoeth, iaaethaeaaioth i?e o?iie/aneie eioaeoeee, iacuaatho
neiae?iiii ia?nenoe?othuae aaia?aeeciaaiiie eeioaaeaiiiaoee.
Ii?aaeaeaiea yoiai neiae?iia oaeiai: oaaee/aiiua eeioioceu ia iaiaa 1 ni
a aeeaiao?a a aeaoo eee aieaa ianii?eeanathueony aiaiaoiauo eieonao,
nio?aiythuea naie aeae ii iaiueoae ia?a o?e ianyoea a ionoonoaea
eaeiai-eeai oaeouaai caaieaaaiey eee ea/aiey, eioi?ia iiaei au aucaaoue
oaeie yooaeo.
Eeioioceu auaatho cao?iioou neiiao?e/iu; /aua anaai oaaee/eaathony oceu,
?aniieiaeaiiua a ia?aaeiae e caaeiae oaeiuo oeaii/eao, a oaeaea a
iiaeiuoa/iie e iiae/aethnoiie iaeanoyo, ?aaea - a noaiaaoaeueiie,
caooiie, yieo?ioeaa?iie e caa?thoeiiie iaeanoyo. I?eia?ii o o?aoe
aieueiuo eiaaony oaeaea annioeee?iaaiiay nieaiiiaaaeey. Aeiiney ocea
iau/ii auyaeyao aeia?iea/anoaaiioth oieeeeoey?ioth aeia?ieaceth, ca
eioi?ie ia aieaa iicaeieo noaaeeyo neaaeoao eiaiethoeey oieeeeoeia. A
aieueoeinoaa neo/aaa a aeiinee iao ieeaeie iaiaoiaeeiinoe. Iieacaiey e
i?iecaaaeaieth aeiinee aoaeoo ?anniio?aiu aeaeaa.
NIEAe-ANNIOeEE?IAAIIUE EIIIEAEN.
Anee o aieueiiai eiathony eaeea-eeai iauea neiioiiu eee i?eciaee NIEAea
aac aeiiieieoaeueiuo eioaeoeee eee iiooieae, ano?a/athueony ia iicaeieo
noaaeeyo caaieaaaiey, oi yoi ninoiyiea iienuaatho eae
NIEAe-annioeee?iaaiiue eiiieaen. Yoio oa?iei ioaaouaaao oe?ieee e?oa
yaeaiee. A ianoiyuaa a?aiy, eiaaea ?ac?aaioai oano ia aioeoaea, yoi
iiiyoea eiaao iaiueoaa cia/aiea, iaeiaei iii ana aua iiaeao auoue
iieaciui a eeeie/aneie i?aeoeea aeey auaeaeaiey oie a?oiiu aieueiuo, a
eioi?ie iiaeii iaeeaeaoue ia?aoiaea a noaaeeth ianoiyuaai NIEAea. Aieaa
iaaeaaeiua eeeie/aneea iieacaoaee aeey ioeaiee i?iaiica aoaeoo
?anniio?aiu /ooue ieaea.
E iaeiiaoe, o?iie/aneay eioaeoeey AE* nii?iaiaeaeaaony ?yaeii ieii?iuo
aeiaaai/iuo eioaeoeee e eiaeiuo caaieaaaiee. Nthaea ioiinyony
naai??aeiue aea?iaoeo e aieinenoay eaeeiieaeey, a oaeaea ae?oniua,
aaeoa?eaeueiua e a?eaeiaua eioaeoeee, eioi?ua aieaa iiae?iaii aoaeoo
iienaiu aeaeaa.
Aeeaaiic NIEAe-annioeee?iaaiiue eiiieaen noaaeoueny a oii neo/aa, anee
iaoeeaio eiaao aieaa aeaoo neiioiiia, nio?aiythueony a oa/aiea o?ao eee
aieaa ianyoeaa, a oaeaea aiiiaeee ii aeaiiui aieaa /ai aeaoo
eaai?aoi?iuo oanoia.
Neiioiiu eee i?eciaee
Eeoi?aaeea: ~ 38oN, ia?aiaaeathuayny eee iinoiyiiay
Iioa?y aana: > 10%
Eeioioceu: ia?nenoe?othuay aaia?aeeciaaiiay eeioaaeaiiiaoey
Aeea?ay: ia?aiaaeathuayny eee iinoiyiiay
Auno?ay ooiieyaiinoue
Ii/iie iio
Ioeeiiaiey a eaai?aoi?iuo iieacaoaeyo
Eeioiiaiey, eaeeiiaiey
O?iiaioeeoiiaiey
Aiaiey
Iiieaeaiiia niioiioaiea iaaeaeo CD4 e CD8
Iiieaeaiiia eiee/anoai O-oaeia?ia
Oaiaoaiiue aeanoiaaiac
Iiauoaiiue o?iaaiue aaiia-aeiaoeeiia
Eiaeiay aia?aey
IIII?OOIENOE*ANEEA EIOAEOeEE E IIOOIEE.
Aeaa iniiaiuo i?iyaeaiey NIEAea - yoi iiooiee e ?yae iiii?ooienoe/aneeo
eioaeoeee. Na?eiia Eaiioe - naiue ?ani?ino?aiaiiue e iienaiiue ia?aui
i?eia?; a ianoiyuaa a?aiy auaeaeytho e ae?oaea iiooiee:
iaoiaeaeeeiianeay eeioiia (iau/ii yeno?aiiaeaeueiay) e ieineieeaoi/iua
ea?oeeiiiu ?ioiaie iieinoe e i?yiie eeoee. O aieueoeinoaa aieueiuo
aia/aea aicieeaao iiaaiiiey, aucaaiiay Pneumocystis carinii, ca eioi?ie
neaaeotho ae?oaea aeiiieieoaeueiua eioaeoeee e na?eiia Eaiioe.
?aciiia?aciua niioonoaothuea NIEAeo eioaeoeee cao?aaeaatho i?aeoe/anee
ethaoth nenoaio i?aaiecia. Aieueoa anaai ?ani?ino?aiaia e oa?aeoa?ia
aeey aieueiuo eae a NOA, oae e a Aaeeeia?eoaiee iiaaiioeenoiay
iiaaiiiey. Aicaoaeeoaeyie iiaaiiiee o aieueiuo NIEAeii iiaoo auoue e
ae?oaea i?aaieciu (ni. oaaeeoeo).
O aieueiuo NIEAeii a Ao?eea na?eiia Eaiioe iiaeao ni/aoaoueny n oae
iacuaaiie aieaciueth Neeia (aeea?ay) e ae?oaeie iiii?ooienoe/aneeie
eioaeoeeyie. Aieaa oeie/iu aeey ao?eeaineiai eiioeiaioa - ooaa?eoeac,
e?eioieieeic, e?eioinii?eaeeic.
Niaeo? eeeie/aneeo i?iyaeaiee ana a?aiy ?anoe?yaony. Ia?aiia/aeueii
iienaiiua i?iyaeaiey na?eiiu Eaiioe e iaaiioeenoiie iiaaiiiee
ioiineeenue e aieacie n ei?ioeei eieoaaoeeiiiui ia?eiaeii. Iaeiaei o oao
aieueiuo, o eioi?uo NIEAe ?acaeaaaony iinea aieaa aeeeoaeueiiai
ia?eiaea, eeeie/aneay ea?oeia iiaeao auoue eiie. Yoi eae aoaeoi oaea
iaaethaeaaony: iai?eia?, iiyaeythony iiaua aeaeu iiooieae e
iaa?ieiae/aneeo caaieaaaiee. Iaeiiaoe, iaeaieeaathony aeaiiua a iieueco
oiai, /oi iicaeiyy noaaeey aieacie nii?yaeaia n eeioieaeiie
eioa?noeoeeaeueiie iiaaiiieae, a?aioeaiaoiciui aaiaoeoii e yioa?iiaoeae.
N?aaeiyy i?iaeieaeeoaeueiinoue aeecie aieueiuo NIEAeii iinea iinoaiiaee
aeeaaiica aa?uee?oao a caaeneiinoe io eiathueony eeeie/aneeo i?iyaeaiee.
A Aia?eea iia ninoaaeyao ieiei 9 ianyoeaa aeey aieueiuo n iiaaiioeenoiie
iiaaiiieae e 31 ianyoe aeey aieueiuo n na?eiiie Eaiioe.
Aeaaiaea?y iiiaiia?aceth i?iyaeaiee eioaeoeee AE* - io aanneiioiiiiai
ninoiyiey aei ?acaa?iooiai NIEAea - Oeaio?u eiio?iey iaae caaieaaaieyie
i?aaei?eiyee iiiuoeo ?acaeaeeoue aanue aeeaiacii eioaeoeee ia /aou?a
a?oiiu.
Neiae?ii I?eciaee Oeie/iua
aicaoaeeoaee
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I?inoaeoea
Ae?onu Aaeoa?ee A?eau
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Ii?aaeaiey Eaoaeue, cao?oae- P. Carinii
Oeeoiiaaaeiae?on Ieeiaaeoa?ee E?eioieiee
eaaeeo iaiiinoue aeuoa-
Ae?on i?inoiai Str. pneumoniae
iey, eeoi?aaeea,
aa?iana H. influenzae
aeiieney
B. catarrhalis
Aeaeeiua ia ?aio-
No?aioieieee
aaia eioeeueo?aou
a?oiiu A
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Ii?aaeaiey Iaieiaeo, Oieniieacia
Oeeoiiaaaeiae?on Ieeiaaeoa?ee Ania?aeeeu,
OeIN yioeaoaeeo eee
Ae?on i?inoiai e?eioieiee,
eieaeueiua ii?aaea-
aa?iana Candida
iey
Iaiiaaae?onu
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Ii?aaeaiey Aeenoaaey E?eioinii?eaeee
Oeeoiiaaaeiae?on M. Avium Candida
eeoa/ieea Iaeeueiay aeea?ay Isospora belli Ae?on
i?inoiai M. tuberculosis
Aeea?ay n e?iaueth Iee?inii?eaeee
aa?iana Naeueiiiaeea
Eieeo
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Aeia?oa?iey Eeoi?aaeea Iiaoo o/anoaiaaoue ana
aicaoaeeoaee i/aaiauo eee ?annayiiuo
iaecaanoiiai Iioa?y aana eioaeoeee
i?ienoiaeaea- Eeioaaeaiiiaoey
iey
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Ana oiiiyiooua auoa caaieaaaiey i?e eo auyaeaiee iiaoo einaaiii
oeacuaaoue ia iaee/ea eiioiiaeaoeoeeoiiai ninoiyiey, oi anoue yaeythony
AE*-ia?ea?iuie. Ieaea i?eaiaeeony iieiue nienie AE*-ia?ea?iuo
caaieaaaiee .
I?ioicieiua aaeueieioiciua
E?eioinii?eaeeic - aeea?ay, i?iaeieaeathuayny aieaa 1 ianyoea
Ecinii?ic - oi aea
Iiaaiiiey, aucaaiiay Pneumocystis carinii
No?iiaeeieaeic - iiaaiiiey, ?anno?ienoaa OeIN, ?annayiiua iaoieiaee
Oieniieaciic - iiaaiiiey, ?anno?ienoaa OeIN
A?eaeiaua
Ania?aeeeac - ?anno?ienoaa OeIN, ?annayiiua iaoieiaee
Eaiaeeaeic - Ii?aaeaiey a?iioia, eaaeeo ieuaaiaea
E?eioieieeic - ?anno?ienoaa OeIN, eaai/iua e ?annayiiua iaoieiaee
Aenoiieaciic - ?annayiiua iaoieiaee
Aaeoa?eaeueiua
Aoeie/iue ieeiaaeoa?eic - ?annayiiua iaoieiaee, aucaaiiua
ieeiaaeoa?eyie, ii ia aicaoaeeoaeyie ooaa?eoeaca eee eai?u.
Ae?oniua
Aucaaiiua oeeoiiaaaeiae?onii - ii?aaeaiey eaaeeo, eeoa/ieea e OeIN
Aucaaiiua ae?onii i?inoiai aa?iana - oyaeaeua ii?aaeaiey eiaee e
neecenoie, aeeyueany aieaa ianyoea; ii?aaeaiey eaaeeo, eeoa/ieea,
?annayiiua iaoieiaee
I?ia?anne?othuay iiiaii/aaiaay eaeeiyioeaoaeiiaoey
Iieieiae/aneea
Na?eiia Eaiioe - a ethaii aic?anoa
Oea?aa?aeueiay eeioiia
Iaoiaeaeeeineay eeioiia - aeeooociay, iaaeeooa?aioee?iaaiiay, ia?aciaaia
A-eeaoeaie eee eeaoeaie iaecaanoiiai oaiioeia
Eeioi?aoeeoey?iua iiaiia?aciaaiey - ii iaiueoae ia?a /a?ac 3 ianyoea
iinea iiii?ooienoe/aneeo eioaeoeee
I?i/ea
O?iie/aneee eeioieaeiue eioa?noeoeeaeueiue ioeueiiieo o aeaoae aei 13
eao
Oaia?ue iieoai iineaaeiaaoaeueiinoue ?acaeoey eeeie/aneeo neiioiiia i?e
AE*-eioaeoeee.
I?eia?ii /a?ac 2-4 iaaeaee iinea aiaae?aiey AE* o iieiaeiu ca?aaeaiiuo
iiyaeyaony eeoi?aaeea, aeeyuayny io 2 aei 10 aeiae, oaaee/eaathony
eeioaoe/aneea oceu, ia/aiue e naeacaiea, nieaeaaony eiee/anoai
eeioioeeoia a e?iae. Caoai ana i?ioiaeeo aoaeoi au aanneaaeii:
eioeoee?iaaiiue /aeiaae ie ia /oi ia aeaeoaony. Iaeiaei /a?ac ianeieueei
ianyoeaa (a /aua eao) o iaai iaaeeaiii ii iaoeeiiii ia/eiatho
iaia?oaeeaaoueny neiioiiu caaieaaaiey.
Ioia/aii, /oi i?e ia?aeeaaiee e?iae, eioeoee?iaaiiie AE*, n?aaeiyy
i?iaeieaeeoaeueiinoue eieoaaoeeiiiiai ia?eiaea ninoaaeyao o aeaoae aeaa
aiaea, o iiaeeeuo eeoe - iyoue eao, o ethaeae n?aaeiaai aic?anoa -
ainaiue.
Iau/ii, i?aaeaea /ai ?acaa?iooueny iieiie ea?oeia caaieaaaiey, o
aieueiiai ianooiaao i?a-NIEAe: iinoaiaiii iiauoaaony oaiia?aoo?a aei
38-39oN, ioia/aaony iaeeueiia iioiioaeaeaiea, iniaaiii a ii/iia a?aiy,
?aceay ooiieyaiinoue, ?acaeoinoue, en/acaao aiiaoeo. Aaaeiue, a oi e
naiue ?aiiee i?eciae - noieeia oaaee/aiea eeioaoe/aneeo oceia: oaeiuo,
iiae/aethnoiuo, caouei/iuo, ii, eae i?aaeei, ia iaoiauo. ?anno?aeaaaony
aeayoaeueiinoue eeoa/ieea: /anoue aiaeyienoue nooe. I?ienoiaeeo
i?ia?anne?othuay iioa?y aana.
Ana yoe neiioiiu ?anniao?eaathony eae i?a-NIEAe oieueei a oii neo/aa,
anee o aieueiuo onoaiiaeaii ae?oniiineoaeuenoai e anee i?e ianeaaeiaaiee
eiioiiie nenoaiu iaia?oaeeaaaony nieaeaiea eiee/anoaa O-oaeia?ia i?e
ioiineoaeueii oaaee/aiiii eee iaeciaiaiiii eiee/anoaa O-noi?anni?ia. A
i?enoonoaee ae?ona iniaia cia/aiea eiaao eeioaaeaiiiaoey iayniie
yoeieiaee. E /oiau eneeth/eoue eeioiiu, neoeeen, ooaa?eoeac, aeaeaaony
aeiiney eeioaoe/aneeo oceia.
A aeaeueiaeoai aieaciaiiua neiioiiu ia/eiatho ia?anoaoue. Iiooaeaiea
iiaeao aeinoeaaoue 10-15 eeeia?aiiia e aieaa. Ia?aaeei i?eniaaeeiythony
iiii?ooienoe/aneea eioaeoeee, e i?aaeaea anaai iiaaiioeenoiay iiaaiiiey.
O cia/eoaeueiie /anoe aieueiuo ?acaeaaaony na?eiia Eaiioe. Iaee/ea aa o
eeoe iieiaea 60 eao a ni/aoaiee n iieiaeeoaeueiuie ?acoeueoaoaie
eaai?aoi?iuo enneaaeiaaiee (iiyaeaiea aioeoae e AE*, nieaeaiea /enea
O-oaeia?ia) neoaeeo ianiiiaiiui aeieacaoaeuenoaii NIEAea. Oae aea eae
eeioiiu aieiaiiai iicaa.
Ceiea/anoaaiiua iiooiee oa?aeoa?iu aeey 40% aieueiuo NIEAeii, i?e/ai ec
yoie oeeo?u 85% i?eoiaeeony ia na?eiio Eaiioe e 10% ia ceiea/anoaaiiua
eeioiiu.
Caaieaaaiea aeeeony io ianeieueeeo ianyoeaa aei 4-5 eao. Enoiae aai -
nia?oue.
I?e NIEAea iiaoo auoue ia?eiaee/aneea iaino?aiey e a?aiaiiua oeo/oaiey.
O ?aciuo aieueiuo ioia/aaony i?aiaeaaeaiea oao eee eiuo neiioiiia: o
iaeieo ii?aaeathony i?aeiouanoaaiii eaaeea, o ae?oaeo - ia?aiay nenoaia,
o?aoueeo io/aao ino?ay aeea?ay e ae?. Ii, eae i?aaeei, naiue ?aiiee
i?eciae - eeioaaeaiiiaoey, oai aieaa anee iia i?iaeieaeaaony aieueoa
aeaoo ianyoeaa aac aeaeeiuo i?e/ei.
I?e aeeaaiinoeea i?eieiathony ai aieiaiea yieaeaieieiae/aneea aeaiiua:
iniaaiii iiaeic?eoaeueii, anee na?eiia Eaiioe e eeioiiu
aeeaaiinoe?othony o aiiinaenoaeenoia, ia?eiiaiia, eeoe n aanii?yaei/iuie
iieiauie naycyie.
A iineaaeiea aiaeu aucuaatho o?aaiao nii?iaiaeaeathuea NIEAe, a oaeaea
i?a-NIEAe i?eciaee ii?aaeaiey oeaio?aeueiie ia?aiie nenoaiu. Iaeaieaa
iianiue e /anoue neiioii - i?ia?anne?othuaa neaaioiea (aeaiaioeey) eae
?acoeueoao ao?ioee ei?u aieiaiiai iicaa. Yoio neiioii ?aaeno?e?oaony
nae/an i?eia?ii o 50% aieueiuo. Ii iiaieth iiiaeo niaoeeaeenoia,
iicaiaua ia?ooaiey, i?aeiouanoaaiii neaaioiea, iiaoo ?acaeoueny o
eaaeaeiai /aeiaaea, eioeoee?iaaiiiai AE*. I?e ane?uoee o 2/3 aieueiuo,
oia?oeo io NIEAea, iaaethaeaeanue ao?ioey oeaie iicaa.
I?aaeiieaaaaony, /oi o ac?ineuo ia?ooaiey ia?aiie aeayoaeueiinoe iiaoo
ianooieoue aeaaea /a?ac 20-30 eao iinea ca?aaeaiey e /oi n?aaeiyy
i?iaeieaeeoaeueiinoue ne?uoiai ia?eiaea c?athuaai neaaioiey ninoaaeyao
15 eao. Ioia/athony oaeaea ii?aaeaiey ninoaeia iicaa, iaieiaeo. Aieueiua
/anoi aeaeothony ia aieiaioth aieue, nieaeaiea ino?iou c?aiey.
Aicieeatho aanoeannu, aucaaiiua oieniieaciaie, ieeiaaeoa?eyie, a?eaaie
Candida.
?aciiiaeaiea AE* a eeaoeao iicaa i?eaiaeeo e oo?aoa e?aoeia?aiaiiie
iaiyoe, ia?ooaieth eii?aeeiaoeee, iuoa/iie neaainoe, ?anno?ienoao ?a/e,
ineoeee. I?e yoii ii?aaeaiea iicaa ia anaaaea nii?iaiaeaeaaony
eiioiiaeaoeoeeoii.
I?e ouaoaeueiii iaa?ieiae/aneii ianeaaeiaaiee oa eee eiua naie a ?aaioa
iicaiaie aeayoaeueiinoe - ineaaeaiiia aieiaiea, cao?oaeiaiiay
eii?aeeiaoeey aeaeaeaiee, caiaaeeaiiinoue ?aaeoeee - oaeaaony
?aniiciaoue e o oae iacuaaaiuo aanneiioiiiuo iineoaeae. Iiyoiio
/?acau/aeii aaaeii iiaeaa?aaoue oaeiio ianeaaeiaaieth anao
eioeoee?iaaiiuo eeoe, oai aieaa anee io ieo caaeneo aeeciue e caei?iauea
ae?oaeo ethaeae. A neo/aa, anee o ieo iiaeoaa?aeaeathony
niioaaonoaothuea eciaiaiey a ooieoeeyo iicaa, eo iono?aiytho io ?aaiou.
A?a/ae i/aiue o?aaiaeeo, /oi yieaeaiey neaaioiey ?ani?ino?aieony n?aaee
iieiaeaaee, eioeoee?iaaiiie AE*.
Aianoa n oai naiua ?aiiea e au?aaeaiiua iicaiaua ia?ooaiey
iaaethaeathony o aeaoae, iniaaiii - o ca?aceaoeony a oo?iaa iaoa?e eee
n?aco iinea ?iaeaeaiey.
Iniaaiiinoe eioeoee?iaaiey e caaieaaaiey aeaoae.
AE*-eioaeoeey o aeaoae iiaeao auoue naycaia n caaieaaaieai iaoa?ae,
ia?aeeaaieai ca?aaeaiiie e?iae i?e aaiioeeee, iaea/anoaaiiuie
eiuaeoeeyie, ia?eiiaieae. Ia?aiin AE* io ca?aaeaiiuo iaoa?ae
iaaethaeaaony o 25-30% iioiieia.
Naia ii naaa aa?aiaiiinoue aeaaii?eyonoaoao ?acaeoeth NIEAea, oae eae
iia iau/ii nii?iaiaeaeaaony eiioiiaeai?anneae, iniaaiii aeai?anneae
eeaoi/iiai eiioieoaoa. I?e ii?iaeueiie aa?aiaiiinoe, aeaaiui ia?acii a
o?aoueai o?eiano?a, ioiioaiea /enea O-oaeia?ia e O-noi?anni?ai
nieaeaaony. Eiioieoao ainnoaiaaeeaaaony i?eia?ii /a?ac 3 ianyoea iinea
?iaeia. Eiathony oeacaiey ia iiauoaiiue ?ene aa?aiaiiuo aeaiuei a
ioiioaiee NIEAea, iineieueeo ?iaeu o eioeoee?iaaiiuo AE*, i/aaeaeii,
niinianoaotho aieaa auno?iio ?acaeoeth caaieaaaiey.
Ca?aaeaiea aeaoae i?ienoiaeeo i?aeiouanoaaiii a iaoea, ?iaeiauo iooyo e
iinea ?iaeia. AE* niiniaai i?iieeaoue /a?ac ieaoeaioo. Ca?aaeaiea
iioiieia iiaeao auoue naycaii e n a?oaeiui anea?ieeaaieai, oae eae ae?on
auaeaeai ec iieiea eioeoee?iaaiiuo iaoa?ae.
Iienaiu neo/ae, eiaaea eioeoee?iaaiiua iaoa?e ?iaeaee aeeciaoeia, ec
eioi?uo oieueei iaeei aue eioeoee?iaai.
Aeaoe ca?aaeaiiua io iaoa?ae ia/eiatho aieaoue /a?ac 4-6 ianyoeaa iinea
eioeoee?iaaiey, e aieueoeinoai ec ieo iau/ii iiaeaaao a oa/aiea 2 eao.
NIEAe o aeaoae oa?aeoa?ecoaony ?yaeii iniaaiiinoae. O ieo iaiueoa, /ai o
ac?ineuo, i?iaeieaeeoaeueiinoue ne?uoiai ia?eiaea, /anoi ii aeeeony ia
aiaeu, a ianyoeu. Aeeaaiinoe?iaaoue caaieaaaiea o aeaoae o?oaeiaa,
iniaaiii a ia?aue aiae aeecie. Iauyniyaony yoi i?aaeaea anaai oai, /oi
ii?aaeaeaiea o ieo aioeoae e AE* naycaii ni cia/eoaeueiuie neiaeiinoyie:
iaynii, iieo/ee ee aieueiie aioeoaea ec e?iae iaoa?e /a?ac ieaoeaioo eee
aea iie ia?acothony o iaai a ?acoeueoaoa ca?aaeaiey. I?iaeaio iiaeii
?aoeoue, auaeaeea ae?on. Ii e yoi neiaeii. Ooo ia?aaeei iaaethaeaaony
?aoeeaeeae?othuay eioaeoeey aeuoaoaeueiuo iooae - eeioieaeiay
eioa?noeoeeaeueiay iiaaiiiey.
Ii?aaeaiea OeIN o aeaoae iiaeao au?aaeaoueny a oo?aoa iniiaiuo aao
?acaeoey. Iai?eia?, ?aaaiie, eioi?ue a niioaaonoaee n aic?anoii iia oaea
neaeaoue e aiai?eoue, oa?yao yoo niiniaiinoue. O iaai ia?anoaao
oaaee/eaaoueny ?acia? aieiau. E ia/aeueiui i?eciaeai caaieaaaiey
ioiineony oaeaea ionoonoaea i?eaaaee a aana, o?iie/aneee iiiin,
aaeoa?eaeueiua eioaeoeee.
Iaeaieaa aaaeiay eiioiieiae/aneay iniaaiiinoue aeaoae, aieueiuo NIEAeii,
- iaee/ea a eo e?iae eneeth/eoaeueii aunieiai niaea?aeaiey
eiioiiaeiaoeeiia e iaeiia?aiaiii ianiiniaiinoue au?aaaouaaoue aioeoaea
i?e aaaaeaiee aioeaaiia, eioi?ua aucuaatho a ii?iaeueiuo oneiaeyo
ia?aciaaiea aioeoae, a /anoiinoe e AE*.
Oaeei ia?acii, anee a ia?eiae iiai?iaeaeaiiinoe a ?acoeueoaoa ca?aaeaiey
/a?ac ieaoeaioo eee i?e ia?aeeaaiee e?iae i?ienoiaeeo ca?aaeaiea AE*, oi
i?iaiic aeey yoeo aeaoae eneeth/eoaeueii iaaeaaii?eyoiue: o ieo neaaeoao
iaeeaeaoue i?ia?anne?othuaai ?acaeoey caaieaaaiey iniaaiii n ii?aaeaieai
OeIN, iaoneiaeaiiiai iaiin?aaenoaaiii AE*.
Ana neacaiiia auoa iiaeaiaeeo e iaeiicia/iiio auaiaeo: aeaoae ia
aeieaeiu ?iaeaoue ia oieueei eioeoee?iaaiiua aeaiueiu, ii e oa, /oi
iauathony n eioeoee?iaaiiuie ia?oia?aie.
AE?ON EIIOIIAeAOEOeEOA *AEIAAEA OEIA 2 (AE*-2).
AE*-2 aue aia?aua auaeaeai a 1985 aiaeo io aieueiuo NIEAeii a
Aaeiaa-Aennao e Ino?iaao Caeaiiai Iuna. A aeaeueiaeoai auee eco/aiu
iniaaiiinoe aicaoaeeoaey e a iaiueoae noaiaie
eeeieei-yieaeaieieiae/aneea iniaaiiinoe eioaeoeee. A ianoiyuaa a?aiy
aeieacaii, /oi AE*-2 e AE*-1 yaeythony naiinoiyoaeueiuie eioaeoeeyie,
iineieueeo eiathony ?acee/ey a iniaaiiinoyo aicaoaeeoaeae, eeeieea e
yieaeaieieiaee. Ieaea i?eaiaeeony iaci? naaaeaiee, iieo/aiiuo e
ianoiyuaio a?aiaie ii AE*-2.
Aaia?aoe/aneia ?ani?ino?aiaiea. Aaaeiie ioee/eoaeueiie iniaaiiinoueth
eioaeoeee AE*-2 yaeyaony aa i?aeiouanoaaiiia ?ani?ino?aiaiea a no?aiao
Caiaaeiie Ao?eee. Aioeoaea e AE*-2 iaia?oaeaiu o aeeoaeae 15 ao?eeaineeo
no?ai: Aiaieu, Ao?eeia-Oani, Aaiu, Aaiaee, Aaeiae, Aaeiae-Aennao,
Ceiaaaaa, Eaia?oia, Eio Ae`Eaoa?, Iaee, Iicaiaeea, Naiaaaea,
Nuea??a-Eaiia, Oiai e Oeaio?aeueiiao?eeaineie ?anioaeeee. Eioaeoeey ca
i?aaeaeaie Caiaaeiie Ao?eee ?aaeno?e?oaony aeiaieueii ?aaeei.
Neaaeoao eiaoue a aeaeo, /oi a iaeioi?uo no?aiao Caiaaeiie Ao?eee, oaeeo
eae Aaeiay-Aennao, AE*-2 yaeyaony i?aeoe/anee aaeeinoaaiiui
oee?eoee?othuei n?aaee ianaeaiey ae?onii eiioiiaeaoeoeeoa. A Naiaaaea,
Aaiaee, Iaee e Iicaiaeea a iauae ianna eioeoee?iaaiiuo AE* ia aeieth
eioeoee?iaaiiuo AE*-2 i?eoiaeeony io 37 aei 68%. Ia?auaao ia naay
aieiaiea iaee/ea a yoeo no?aiao cia/eoaeueiiai /enea eeoe (aei 50%) n
aeaieiie eioaeoeeae.
Ii eioeoee?iaaiiua AE*-2 e?aeia ?aaeei ano?a/athony a Aa?iia e Aia?eea.
A nayce n yoei anoaao aii?in i oeaeaniia?aciinoe ianeaaeiaaiey a yoeo
no?aiao aeiii?ia ia eioeoee?iaaiiinoue AE*-2. Ianeaaeiaaiea n aeaoiy
oano-nenoaiaie cia/eoaeueii aei?iaea. Iaeiaei /oiau ia i?iaeyaeaoue
aeaaea aaeeie/iuo neo/aaa, i?aaeeaaaaony eniieueciaaoue iaoiaeu, eioi?ua
iaeaieaa /anoi aeatho ia?ae?anoiua ?aaeoeee iaaeaeo AE*-1 e AE*-2. Eeai
i?aaeeaaaaony ?ac?aaioaoue oaeea oano-nenoaiu, eioi?ua niaea?aeao
iaeiia?aiaiii aioeaaiu AE*-2 e AE*-1. A /anoiinoe oaeea nenoaiu
(combitest) oaea i?aaeeiaeaiu ?yaeii eiiia?/aneeo oe?i. Iineieueeo ?ene
ca?aaeaiey AE*-2 a Aa?iia e Aia?eea aanueia iae, a neo/ayo
iaaeinoaoi/iinoe eiiaeie?iaaiiuo oano-nenoai ?aeiiaiaeoaony
ianeaaeiaaoue ia AE*-2 oieueei oao aeiii?ia, eioi?ua eiaee nayce n
Caiaaeiie Ao?eeie eee iieiaua eiioaeou n auoiaeoeaie ec yoeo no?ai.
?aeiiaiaeoaony oaeaea ianeaaeiaaoue ia AE*-2 oao aeiii?ia, o eioi?uo
iaii?aaeaeaiiay ?aaeoeey ia AE*-1.
No?iaiea ae?ona. I?iaaaeaiiua aeaoaeueiua enneaaeiaaiey naienoa AE*-2
iieacaee, /oi i?e ii?aaeaeaiiii noiaenoaa n AE*-1, ii ioee/aaony io
iineaaeiaai ii aioeaaiiie no?oeoo?a e ii iineaaeiaaoaeueiinoe iniiaaiee
a ioeeaeiiauo eeneioao. AE*-2 aieaa aeecie ii naiei naienoaai (a oii
/enea ii aioeaaiiie no?oeoo?a e ninoaao aaiaoe/aneiai iaoa?eaea) e
ae?ono eiioiiaeaoeoeeoa iaacueyi (SIV/AEI), /ai e AE*-1.
AE*-1 e AE*-2 eioeoee?otho oa aea iiioeyoeee eeaoie, naycuaathony n oaie
aea CD4-?aoeaioi?aie. I?iaaaeai aiaeec iieiiai aaiiia AE*-2. A oeaeii
aai i?aaiecaoeey noiaeia n oaeiaie AE*-1. A aeiiieiaiea e eeanne/aneei
?ao?iae?oniui aaiai gag, pol e env iaa ae?ona niaea?aeao aaiu vif, vpr,
tat, nef e rev.
Iaeiei ec iaeaieaa nouanoaaiiuo ?acee/ee iaaeaeo ae?onaie yaeyaony
iaee/ea o AE*-1 aaia vpu, ia iaia?oaeeaaaiiai o AE*-2. A oiaea a?aiy
AE*-2 niaea?aeeo aai vpx, eioi?iai iao o AE*-1. I?iaeoeoii aaia vpu
yaeyaony aaeie n iieaeoey?iie iannie 14-16 eAe, a aaia vpx - aaeie n
iieaeoey?iie iannie 12-14 eAe. I?iaeoeo aaia vpu aanueia aaaeai aeey
nic?aaaiey e aunaiaiaeaeaiey ae?ona ec eeaoee. Aaiu tat, ref e nef
iaiaoiaeeiu aeey ae?oniie ?aieeeaoeee e yeni?anne ae?oniiai aaiiia.
?ieue aaiia vif e vpr iiea iaynia. Iieaaatho, /oi vif iiaeao ea?aoue
?ieue a iinoo?aineyoeeiiiie iiaeeoeeaoeee ae?oniuo aaeeia.
Iaeaieaa eiina?aaoeaiuie o/anoeaie aaiiiia AE*-1 e AE*-2 yaeythony aaiu
gag e pol. Iie niioaaonoaaiii eiatho 57 e 59% aiiieiaee. Iaiaa
eiina?aaoeaai o/anoie, eiaee?othuee iaiei/a/iua aaeee, iniaaiii
niaea?aeaueany a ia?oaeiie /anoe iaiei/ee ae?ona (37% eaeaioe/iuo
aieiieeneio). Auei onoaiiaeaii, /oi aieueoeinoai oeenoaeiiauo inoaoeia a
AE*-1 e AE*-2 noaaeeueii, yoi naeaeaoaeuenoaoao i oii, /oi o?aoe/iay
no?oeoo?a aaeea iiaeao eiaoue aaaeiia ooieoeeiiaeueiia cia/aiea.
O?ainiaia?aiiay /anoue iaiei/a/iiai aaeea - gp41- aieaa noaaeeueia, /ai
ia?oaeiay - gp120. Aaaeioth ?ieue a oeeoiiaoiaaiiinoe AE* ioaiaeyo
N-eiioeo o?ainiaia?aiiiai aaeea. N-oa?ieiaeueiue eiiaoe yoiai aaeea
yaeyaony oieeaeueiui ?aaeiiii, niaoeeoe/iui aeey eaaeaeiai ec AE*. Ia
iniiaaiee yoie oieeaeueiinoe iiaeii inouanoaeoue aeeooa?aioeeaoeeth
AE*-1 e AE*-2. AE*-2 ioee/aaony io AE*-1 ii iaiei/a/iui aeeeii?ioaeiai
e a iaiueoae noaiaie - ii na?aeoeaaeiiui aioeaaiai. Nuai?ioee
aieueoeinoaa ethaeae, eioeoee?iaaiiuo AE*-2, ia ?aaae?otho n
iaiei/a/iuie aioeaaiaie AE*-1, ii aeatho ia?ae?anoiua ?aaeoeee n
aioeaaiaie, eiaee?oaiuie aaiii gag.
Eiathony ?acee/ey a iieaeoey?iie ianna aaeeia AE*-1 e AE*-2. A
/anoiinoe, ia?oaeiue iaiei/a/iue aeeeii?ioaei eiaao iieaeoey?ioth ianno
120 eAe, o AE*-2 yoio aaeie eiaao iie. Ianno 140 eAe. O?ainiaia?aiiue
aaeie o AE*-2 - 36 eAe, a o AE*-1 - 41eAe Aaeee eiaee?oaiua aaiii gag o
AE*-1 eiatho iie. Ianno 24 e 17 eAe, a o AE*-2 - 26 e 15 eAe.
Yieaeaieieiaey. Yieaeaieieiaey AE*-2 eco/aia ioiineoaeueii iaei.
Iieaaatho, /oi ?ani?ino?aiaiea AE*-2 aua oieueei ia/eiaaony. AE*-2
ia?aaeaaony oaie aea iooyie, /oi e AE*-1. Ae?on auaeaeai eae io eeoe n
eeeie/anee au?aaeaiiui NIEAeii, oae e io aanneiioiiiuo iineoaeae.
Iineieueeo eioeoee?iaaiiua eeoea ia yaeyeenue ie aiiinaenoaeenoaie, ie
ia?eiiaiaie, iieaaatho, /oi AE*-2 ia?aaeaaony i?aeiouanoaaiii iooai
aaoa?inaenoaeueiuo iieiauo naycae. I?e ianeaaeiaaiee ?acee/iuo a?oii
ianaeaiey auei auyaeaii, /oi /enei na?iiieiaeeoaeueiuo ?acoeueoaoia e
AE*-2 auei a 10-15 ?ac aieueoa n?aaee i?inoeoooie, /ai n?aaee ae?oaeo
a?oii ianaeaiey. A no?aiao Caiaaeiie Ao?eee /enei na?iiieiaeeoaeueiuo n
aioeaaiaie AE*-1 eeoe auei cia/eoaeueii ieaea, /ai n oaeiauie AE*-2.
Aianoa n oai AE*-2 i?aeoe/anee ionoonoaiaae a oeaio?aeueiiao?eeaineeo
no?aiao. O?aoeaoiaa iaaethaeaiea ca i?inoeoooeaie iieacaei, /oi
aieaciue o ca?aaeaiiuo AE*-2 ?acaeaaaony cia/eoaeueii iaaeeaiiaa, /ai
i?e eioeoee?iaaiee AE*-1. *a?ac 3 aiaea iinea auyaeaiey na?iiiceoeaiinoe
e AE*-2 ia auei au?aaeaiiuo eeioaaeaiiiaoeae eee NIEAea, /oi, aiciiaeii,
naeaeaoaeuenoaoao i iaiueoae ae?oeaioiinoe AE*-2. Enoiaey ec ?acee/ee a
oeeoiiaoe/aneie aeoeaiinoe ?acee/iuo ooaiiia AE*-2, iieaaatho, /oi
ooaiiu AE*-2 iiaoo oe?iei aa?uee?iaaoue a iaoiaaiiinoe e ae?oeaioiinoe
aeey /aeiaaea. Ae/-2 iaiaa ae?oeaioai, /ai AE*-1. Ia?auaao ia naay
aieiaiea, /oi i?ioeaio eioeoee?iaaiiinoe a a?oiiao iiauoaiiiai ?enea
oaaee/eaaaony n aic?anoii. A /anoiinoe, ia thaa Naiaaaea a a?oiia ec 140
i?inoeoooie eioeoee?iaaiiinoue AE*-2 aeinoeaaea 40%. Iaeaieueoaa /enei
iieiaeeoaeueiuo ?acoeueoaoia auei auyaeaii o aeaiuei noa?oa 50 eao,
eiaaoeo iaeaieueoaa /enei iieiauo ia?oia?ia.
Nenoaiaoe/aneea iaaethaeaiey naeaeaoaeuenoaotho i oii, /oi AE*-2 ia
ia?aaeaaony noieue eaaei, eae AE*-1. Aeey ia?aaea/e AE*-2 iaiaoiaeeiu
iiaoi?iua eiioaeou. Iniiaiui iooai ia?aaea/e eioaeoeee yaeyaony
aaoa?inaenoaeueiue iooue (a 40% naiae auee na?iiieiaeeoaeueiu iaa
noi?oaa). Ia ca?aaeno?e?iaaiu neo/ae aa?oeeaeueiie ia?aaea/e AE*-2, ia
iaaethaeaeanue oaeaea ia?aaea/a eioaeoeee aneaaenoaea ei?ieaiey
a?oaeueth. Auei iaia?oaeaii, /oi aieueoeinoai na?iiiceoeaiuo aeaoae
iieo/eei eioaeoeeth i?e ia?aeeaaiee e?iae. Iaeiaei iaaeaaii niiauaii i
neo/aa aa?oeeaeueiie ia?aaea/e io iaoa?e e ?aaaieo. I?aaeaa?eoaeueiua
aeaiiua naeaeaoaeuenoaotho, /oi eieoaaoeeiiiue ia?eiae yaeyaony
aeiaieueii aeeeoaeueiui.
Noaey ii na?ieiae/aneei aeaiiui e ii iaeiia?aiaiiiio auaeaeaieth iaieo
ae?onia io iaeieo e oao aea eeoe eee ii ae?oaei ae?oniui ia?ea?ai, a
?aeiiao oee?eoeyoeee iaieo ae?onia eiatho ianoi aeaieiua eioaeoeee.
Aianoa n oai, neaaeoao ioiaoeoue, /oi neo/ae aeaieiie eioaeoeee,
iniiaaiiua eneeth/eoaeueii ia na?ieiae/aneeo aeaiiuo, aeieaeiu
eioa?i?aoe?iaaoueny aanueia inoi?iaeii a nayce n iaee/eai ia?ae?anoiuo
?aaeoeee.
Eeeie/aneea ioee/ey. Aieueoeinoai enneaaeiaaoaeae, eco/aaoeo AE*-2,
iaoee, /oi yoa eioaeoeey ?acaeaaaony iaaeeaiiaa, /ai AE*-1. Neiioiiaoeea
NIEAe aucaaiiiai AE*-2 a oeaeii ia ioee/aaony io neiioiiaoeee NIEAea,
aucaaiiiai AE*-1. Ae?on oeia 2 aucuaaao oa aea eeeie/aneea neiae?iiu. O
aieueiuo iaaethaeaaony ?aceia nieaeaiea eiee/anoaa oee?eoee?othueo
CD4-eeioioeeoia. I?aaeaa?eoaeueiua aeaiiua naeaeaoaeuenoaotho i aieaa
aeaaii?eyoiii oa/aiee NIEAea, aucaaiiiai AE*-2. O eeoe eioeoee?iaaiiuo
AE*-2 aeaaea /a?ac 3 aiaea ia auei au?aaeaiiuo eeioaaeaiiiaoeae eee
NIEAea. A nayce n iiaeiaiuie iaaethaeaieyie iieaaatho, /oi ?ene ?acaeoey
NIEAea o ethaeae, eioeoee?iaaiiuo AE*-2 ieaea, /ai i?e ca?aaeaiee AE*-1.
Aianoa n oai a iaaethaeaieyo Clavel 7 ec 17 aieueiuo NIEAeii, aucaaiiui
AE*-2, oia?ee a oa/aiea 1 aiaea.
Neaaeiaaoaeueii, aii?in i oyaeanoe oa/aiey eioaeoeee ioaeaeaaony a
aeaeueiaeoai eco/aiee. Inoaaony oaeaea iayniui aeeyiea aeaieiie
eioaeoeee (AE*-1 e AE*-2) ia oyaeanoue eeeie/aneiai oa/aiey.
Eaai?aoi?iay aeeaaiinoeea. Aeey auaeaeaiey AE*-2 eniieuecotho oa aea
iaoiaeu, /oi e aeey AE*-1. Eeioioeeou aieueiuo nieoeueoeae?othony n
ii?iaeueiuie, noeioee?iaaiiuie OAA eeioioeeoaie, i?e iinoiyiiii
i?enoonoaee eioa?eaeeeia-2. I?e iaee/ee AE*-2 iaia?oaeeaathony
iiiaiyaea?iua aeaaioneea eeaoee, oiaiueoaaony iauaa eiee/anoai eeaoie,
iiyaeyaony ia?aoiio?aine?eioaciay aeoeaiinoue, eioi?ay aeinoeaaao ieea
/a?ac 2-3 iaaeaee.
Iaaethaeathony oe?ieea ooaiiiaua aa?eaoeee a nei?inoe ianooieaiey e
au?aaeaiiinoe iienaiiuo yaeaiee.
*oi eanaaony auyaeaiey aioeoae e AE*-2, oi a oeaeii nouanoaothuea
eecaoiua aeeaaiinoe/aneea nenoaiu EOA, i?aaeiacia/aiiua aeey
aeeaaiinoeee AE*-1, iicaieytho oaeaea ?aniiciaoue eioaeoeeth AE*-2 a
82-84% neo/aaa, iineieueeo aioeaaiu, eiaee?oaiua aaiaie gag e pol,
iaia?oaeeaatho cia/eoaeueioth aiiieiaeth. Ia?ae?anoiua ?aaeoeee iiaoo
iaaethaeaoueny ia oieueei a EOA, ii e a eiioiiaeioa, e a ?aaeoeee
iaeo?aeecaoeee ae?onia. Cia/eoaeueii ?aaea ia?ae?anoiua ?aaeoeee eiatho
ianoi i?e eniieueciaaiee eiieo?aioiiai EOA.
Aianoa n oai ie iaeei ec oiiiyioouo iaoiaeia i?e eniieueciaaiee
aioeaaiia AE*-1 ia aeaao 100% /oanoaeoaeueiinoe n aioeoaeaie e AE*-2.
Yoi ianiaiaaeaiea iniai io/aoeeai i?iyaeyaony o aieueiuo NIEAeii,
eioi?ua ii ia?a ?acaeoey caaieaaaiey oo?a/eaatho aioeoaea eiaiii e
aioeaaiai, aeathuei ia?ae?anoiua ?aaeoeee. Iiyoiio aeey iieo/aiey
oano-nenoai ni 100% niaoeeoe/iinoueth e /oanoaeoaeueiinoueth ii
ioiioaieth e AE*-2 ?aeiiaiaeoaony eniieueciaaoue oeiiniaoeeoe/aneea
iaioeaeu AE*-2 iieo/aiiua neioaoe/aneei eee ?aeiiaeiaioiui iaoiaeii. I?e
niaoaiee iaioeaeia AE*-1 e AE*-2 oaeaaony a EOA iaeiia?aiaiii auyaeyoue
aioeoaea e iaiei ae?onai (oae iacuaaaiue eiiaeoano oe?iu Aaaio).
Iineaaeothuaa eniuoaiea n ?acaeaeueiuie aioeaaiaie iicaieyao i?iaanoe
oeiiniaoeeoe/aneoth aeeaaiinoeeo.
Aieueoea iaaeaaeaeu aiceaaathony ia aiciiaeiinoue aeeooa?aioeeaoeee
aioeoae i?e iiiiue aioeaaiia, eiaee?oaiuo aaiaie vpu e vpx, eioi?ua
niioaaonoaaiii oieeaeueiu aeey AE*-1 e AE*-2.
A oeaeii a a?oiiao ianaeaiey, aaea aiciiaeia oee?eoeyoeey iaieo
ae?onia, ?aeiiaiaeoaony EOA, iniiaaiiue ia i?eiaiaiee neioaoe/aneeo eee
?aeiiaeiaioiuo iaioeaeia.
AeEAAIINOEEA AE*-EIOAEOeEE.
Aioeoaea e AE* iiyaeythony ia/eiay io o?ao iaaeaeue aei o?ao ianyoeaa
iinea eioeoee?iaaiey ae?onii, e a aeaeueiaeoai eo iiaeii ii/oe anaaaea
iaia?oaeeoue, aeaaea anee ae?on iiaeaaeyao a eaeie-oi ia?a ooieoeeth
eeioioeeoia e au?aaioeo aioeoae. Iaeiaei oeo? auyaeyaiuo iaeo?aeecothueo
aioeoae iecie, a aeaenoaea iacia/eoaeueii - iie ia i?einoaiaaeeaatho
caiaoiui ia?acii ?acaeoea eioaeoeee e caaieaaaiey.
Aeey oeaeae aeeaaiinoeee AE* iiaeii auaeaeyoue a aieueoeo eiee/anoaao ec
eeaoi/iuo eeiee, i/euaoue e eniieueciaaoue eae aioeaai a na?ieiae/aneeo
oanoao. Nouanoaotho ianeieueei oeiia oanoia ia aioeAE*-AO. Aio o?e ec
ieo, eioi?ua iinooiatho a i?iaeaaeo:
Iai?yiie iaoiae ELISA:
Aioeaai - i?iaa - aioe-Ig oa?iaio
Eiieo?aioiue iaoiae ELISA:
Aioeaai - i?iaa
aioeAE*-AO
Nyiaeae/aaue iaoiae ELISA eee aaaethoeiaoeey:
Aioeaai - i?iaa - Aioeaai (n i?eniaaeeiaiiui oa?iaioii)
ELISA - Enzyme-Linked Immunosorbent Assay eee eiioiioa?iaioiue aiaeec -
EOA
A aieueoeinoaa oanoia i?eiaiyaony eiiuethaao aioeaaia n oa?iaioii, a
neaiaeii neoaeeo oeaaoiay ?aaeoeey iaaeaeo niaoeeoe/anee naycaiiui
oa?iaioii e aai noano?aoii. A ae?oaeo oanoao eniieuecotho ?aaeeiecioiiu,
aioeaai-oeoi?anoeei eee aaaethoeiaoeeth iie?uouo ae?onii /anoeoe eaoaena
eee aeaeaoeiu.
N oao ii?, eae a 1985 aiaeo oanou ia aioeAE*-AO iinooieee a i?iaeaaeo,
iie iaoee oe?ieia i?eiaiaiea a ?acaeouo no?aiao e eaai?aoi?eyo ii
aeeaaiinoeea e ia?aeeaaieth e?iae. Oi/iinoue oanoia - eae eo
/oanoaeoaeueiinoue, oae e niaoeeoe/iinoue - iaoeeiiii iiauoaaony: neo/ae
eiaeiiiaaaoeaiuo e eiaeiiiiceoeaiuo ioaaoia noaiiayony ana ?aaea.
A aeiiieiaiea e oanoai, auyaeythuei aioeoaea e AE* noiia?ii, nouanoaotho
aieaa oiieea oanou aeey auyaeaiey oao eee eiuo eiiiiiaioia eiioiiiai
ioaaoa. ?aaeoeey ia eiaeeaeaeoaeueiua aaeee AE* aeaoaeueii eco/aia
iaoiaeaie eiioiiaeioeiaa e ?aaeeieiioiii?aoeeieoaoeee. Ia?yaeo n yoei
iiaeii ii?aaeaeyoue ioaeaeueiua eeannu eiioiiaeiaoeeiia a e?iae e
ae?oaeo aeeaeeinoyo. Iniaue eioa?an i?aaenoaaeytho n yoie iiceoeee
aioeAE*-eiioiiaeiaoeeiu eeanna I, oae eae iie a ia/aea eioaeoeee
iiyaeythony ?aiueoa, /ai IgG.
Aeey ianniauo enneaaeiaaiee ia aioeAE*-AO a iaiioeiaeueiuo eaai?aoi?iuo
oneiaeyo ?ac?aaaouaathony oi?iuaiiua aa?eaiou oanoia. Iie oaeiaiu
oiaaea, eiaaea ?acoeueoao iaiaoiaeeii iieo/eoue n?i/ii. ?anniao?eaaaony
aiciiaeiinoue eniieueciaaiey nethiu eae iaoa?eaea aeey aeeaaiinoeee.
Ai iiiaeo no?aiao aaaaeaiu aeiiieieoaeueiua i?ioeaaeo?u, iaania/eaathuea
aeinoiaa?iinoue ?acoeueoaoia. I?iaa?ea ninoieo a oii, /oi a neo/aa
iieiaeeoaeueiiai ioaaoa i?iaa ia aioeAE*-AO iiaoi?yaony, oanoe?oaiua
iaoa?eaeu i?iaa?ythony ae?oaeie, iaoiaee/anee iacaaeneiuie niiniaaie.
Oioy yoi e i?eaiaeeo e iaeioi?ie caaea?aeea, caoi ?acoeueoao iieo/aaony
aieaa oi/iui. Iaeaieueoee inoaoi/iue ?ene iinea yoiai naycai n oai, /oi
o ioaeaeueiuo eioeoee?iaaiiuo eeoe iiaeao ia auoue aioeAE*-AO, eeai eo
eiioeaio?aoeey aoaeao oae iecea, /oi aeaaea i/aiue /oanoaeoaeueiua oanou
ia niiaoo eo auyaeoue. Yoi aanueia aiciiaeii ia ?aiieo noaaeeyo
eioaeoeee, e aac aeaeueiaeoaai iaaethaeaiey oaeea neo/ae eaaei
i?iionoeoue.
Iiieii aioeoae, a nuai?ioea i?enoonoaotho ae?oniua aioeaaiu, a
/anoiinoe, iniiaiie aaeie na?aeoeaaeiu ?24. Aai iiaeii auyaeyoue iiea ii
aua a ecauoea ii ioiioaieth e aioeoaeai i?ioea iaai, - iau/ii a naiii
ia/aea eioaeoeee. Oanou ia AE*-aioeaai iinooieee a i?iaeaaeo e iiaoo
eniieueciaaoueny a ea/anoaa aeiiieiaiey e oanoo ia aioeoaea. Iie
iiiiaatho a aeeaaiinoeea ?aiiae oacu eioaeoeee, a oaeaea a ?aniiciaaaiee
eioaeoeee o aeaoae. Ia aieaa iicaeieo noaaeeyo i?enoonoaea aioeaaiia AE*
a nuai?ioea aiai?eo ia eiioiiii enoiuaiee e iiaeao neoaeeoue iieacaieai
aeey i?ioeaiae?oniie oa?aiee.
Ae?aiey, ia eioi?oth oeacuaaao aiciiaeiinoue auaeaeeoue AE* ec
eeioioeeoia, iiaeao auoue iaia?oaeaia aeaaea ia oiia aunieeo oeo?ia
aioeoae e ?24 e ae?oaei aaeeai ae?ona. Iaeiaei auaeaeaiea ae?ona -
i?ioeaaeo?a, o?aaothuay a?aiaie, e aeey oniaoiie eaai?aoi?iie
aeeaaiinoeee AE* o ethaeae n iaeui eiee/anoaii aioeoae eee aiana aac ieo
aaaeiaa ?aaoey?ii iieo/aoue i?iau a iineaaeothuee ia?eiae. Iaaethaeaiey
ca ?acaeoeai eioaeoeee n iiiaioa ca?aaeaiey iieacuaatho, /oi eae oeo?,
oae e iaai? aioeoae e AE* iau/ii oaaee/eaathony. O eeoe, ca?aaeaiiuo
ianeieueei ianyoeaa iacaae eee ?aiueoa ii/oe anaaaea auyaeyaony neeueiue
aioeae?oniue ioaao.
Iiieii oeacaiiuo auoa iaoiaeia aeeaaiinoeee AE*-eioaeoeee a i?aeoeea
eniieuecotho iieeia?acioth oeaiioth ?aaeoeeth (IOe?) e AeIE-ciiaeiaua
iaoiaeu. IOe? eniieuecotho aeey eiee/anoaaiiie ioeaiee aeoeaiinoe
?aieeeaoeee ae?ona ii /eneo ae?oniuo ?IE. AeIE-ciiaeiaua iaoiaeu
iicaieytho auyaeyoue AE* a oi?ia i?iae?ona. Yoi iniaaiii iaiaoiaeeii,
eiaaea oanou ia aioeoaea e AE* e aioeaaiu aeatho io?eoeaoaeueiua
?acoeueoaou., a eaoaioiue ia?eiae aieacie.
EA*AIEA.
A ?aciuo no?aiao aaaeoony eioaineaiua enneaaeiaaiey n oeaeueth
iaia?oaeeoue yooaeoeaiua ea/aaiua n?aaenoaa i?ioea NIEAea. Iniiaiua
no?aoaae/aneea iai?aaeaiey yoeo ?aaio - iiene i?ioeaiae?oniuo
i?aia?aoia, aeeythueo ia AE* a ?aciua noaaeee aai ?aciiiaeaiey, e
i?eiaiaiea iaoiaeia ainnoaiiaeaiey ia?ooaiiuo i?e NIEAea ooieoeee
eiioieoaoa. E?iia oiai, eco/athony iioeiaeueiua oneiaey ea/aiey
?acaeaathueony i?e NIEAea eioaeoeeiiiuo ineiaeiaiee e iiooieae, iniaaiii
na?eiiu Eaiioe.
Iaeei ec ia?niaeoeaiuo iooae - ecuneaiea i?aia?aoia, aeiee?othueo neioac
ia?aoiie o?aine?eioacu, oi anoue i?ioeann, eiaaea i?ienoiaeeo
ia?aienuaaiea aaiaoe/aneie eioi?iaoeee n ?IE ia AeIE. Nae/an iaeaieaa
ia?niaeoeaiuie a niunea i?ioeaiaeaenoaey ia?aoiie o?aine?eioaca
n/eoathony aiaeiae ioeeaioeaeia. Iaeiei ec ia?auo aieaa eee iaiaa
yooaeoeaiuo i?aia?aoia noae aceaeioeieaeei (ceaeiaoaeei, AZT). Ii
oaaee/eaaao n?aaeiaa a?aiy auaeeaaiey aieueiuo a aeaeaei caoaaeoae
noaaeee NIEAea i?eia?ii ia aiae. Iaeiaei aceaeioeieaeei a cia/eoaeueiie
noaiaie oiene/ai - io iaai aieueoa ae?oaeo no?aaeaao einoiue iica, /oi
i?eaiaeeo e aiaiee. A ianoiyuaa a?aiy iuoathony i?eiaiyoue ae?oaea
aiaeiae ioeeaioeaeia naiinoiyoaeueii eee a ?acee/iuo eiiaeiaoeeyo ae?oa
n ae?oaii. Aieueoeinoai i?aia?aoia aua iaoiaeeoueny a noaaeee
eeeie/aneeo eniuoaiee. A nayce n yoei eeeieee e eaai?aoi?ee iinoiyiii
i?iecaiaeyo iaai? aieiioa?ia aeey yoiai. Aio ia?a/aiue iniiaiuo
i?aia?aoia, eioi?ua ia iae 1997 aiaea iaoiaeeeenue a noaaeee eeeie/aneeo
eniuoaiee e aeaaaee iaeaieaa yooaeoeaiua ?acoeueoaou:
Adefovirdipivoxil - ioee/aaony aoeeeee/iui inoaoeii naoa?a e iaeiie
oinoaoiie a?oiiie, a nayce n /ai eaa/a oinoi?eee?oaony a eeaoea, /ai
ae?oaea aiaeiae ioeeaioeaeia.
Beta-fluoro-ddA - oethi?iaiaeia aeeaeaiiceia; aeaaiaea?y aoiio ooi?a
onaaeaaaony eo/oa, /ai aeeaeaiicei. Yooaeoeaai i?ioea oao ooaiiia
ae?ona, eioi?ua eiatho iiiaeanoaaiioth onoie/eainoue e
aeeaeaieneioeeaioeaeai ec-ca iooaoeee a 151 o?eieaoa aaia ia?aoiie
o?aine?eioacu.
Didanozine - iaiaa oiene/iue /ai AZT, aiaeia ioeeaioeaea; eo/oa
iaoaaieece?oao a eeaoea.
Ae?oaia iai?aaeaiea aioeae?oniuo i?aia?aoia - aauanoaa, eiaeae?othuea
i?ioaaco AE*; oai naiui iiaeaaeyaony i?ioeann nic?aaaiey ae?oniuo
aaeeia, oi?ie?othony iaiieiioeaiiua, iaeioaeoeeiiiua ae?oniua /anoeoeu.
Yoe i?aia?aou oaeaea iaoiaeyony a noaaeee eeeie/aneeo eniuoaiee. Aio
iaeaieaa yooaeoeaiua ec ieo:
Ritonavir, ABT-378 (a 10 ?ac neeueiaa Ritonavir), Saquinavir, Indinavir.
Yooaeoeaii eiiieaeniia eniieueciaaiea yoeo i?aia?aoia.
Iaiaaeaaeeaathuea ?acoeueoaou iieo/aiu i?e i?eiaiaiee Ro 24-7429. Aai
aeaenoaea iniiaaii ia naycuaaiee aaeea - i?iaeoeoa aaia tat, oi anoue
iiaeaaeyaony yooaeo o?ainaeoeaaoeee ae?ona.
Eoae, yooaeoeaiua i?ioeaiae?oniua i?aia?aou iieo/eoue aiciiaeii, ii
aeaei ineiaeiyao oio oaeo, /oi AE* iaeaaeaao i/aiue aieueoie
eciai/eainoueth. A iaeiii i?aaiecia iiaeii iinoiyiii auaeaeyoue iiaua
na?iaa?eaiou ae?ona. A nayce n yoei AE* auno?i i?eia?aoaao
eaea?noaaiioth onoie/eainoue, e yooaeoeaiua ?aiaa i?aia?aou noaiiayony
ii/oe aaniieaciu.
?ac?aaaouaathony e iaoiaeu neiioiiaoe/aneie e iaoiaaiaoe/aneie oa?aiee.
Iaeia ec iaiaaeaaeeaathueo ?ac?aaioie - i?aia?ao ec ?anoai?eiuo iieaeoe
CD4, niiniaiuo naycuaaoueny n AE* e i?aiyonoaiaaoue aai aaeni?aoeee ia
iaia?aiao niaoeeoe/aneeo eeaoie.
Iiea aea aeaaiua ia?u ia?auaiu ia oa?aieth na?eiiu Eaiioe,
iiii?ooienoe/aneeo eioaeoeee. Neeueiaa iiaeaeathony ea/aieth
caaieaaaiey, aucaaiiua a?eaeaie, oieniieaciaie. Aicaeaenoaea ia
aicaoaeeoaey iiaaiioeenoica ia oae yooaeoeaii. Aua iaiaa aeaenoaaiii
ea/aiea eioaeoeee, aucaaiiuo iaeioi?uie ae?onaie, aeoeae?othueieny i?e
NIEAea.
Iiiuoee ainnoaiiaeaiey eiioiiie nenoaiu n iiiiuueth EE-2, eioa?oa?iiia,
oeioniuo oaeoi?ia eee o?ainieaioaoeee einiiai iicaa ia eiatho
cia/eoaeueiiai oniaoa. Iaaethaeathony eeoue a?aiaiiua oeo/oaiey. I?e
yoii, eiioiioa?aiey iiaeao ni?iaioee?iaaoue oneeaiea ?aieeeaoeee AE*,
oae eae ae?on ?aciiiaeaaony a iniiaiii a aeaeyueony eeaoeao.
AICIIAEIINOE ?AC?AAIOEE AAEOeEI.
Eiioiecaoeey i?ioea aieaciaoai?iiai aaaioa, iia?aaeaeathuaai aaaeiue
eiiiiiaio eiioiiie nenoaiu, naycaia n iniauie o?oaeiinoyie. E oiio aea
iaoaao neeueiay eciai/eainoue ae?ona. Iia iaoneiaeaia i?aeiouanoaaiii
iaeiieaieai iooaoeee. Iaeuecy eneeth/eoue ?ieue e aaiaoe/aneeo
?aeiiaeiaoeee - iaiaia aaiaie iaaeaeo ?aciuie aa?eaioaie AE* e ae?oaeo
ae?onia, eioi?ua /anoi iaoiaeyony a i?aaiecia ii?aaeaiiii NIEAeii, a
oaeaea iaaeaeo aaiaie AE* e eeaoi/iuie aaiaie aieueiiai. Aei neo ii? ai
anao iiiuoeao eiioiecaoeee i?ioea ae?ona eniieueciaaeny i/euaiiue eee
eeiie?iaaiiue aeeeii?ioaei iaiei/ee. O yenia?eiaioaeueiuo aeeaioiuo ii
aeaenoaeoaeueii aucuaaao ia?aciaaiea iaeo?aeecothueo aioeoae e ae?ono,
ii oieueei e oiio ooaiio, eioi?ue aue eniieueciaai aeey eiioiecaoeee.
Eiiaaea au?aaaouaathony iaeo?aeecothuea aioeoaea, eioi?ua aeaenoaotho ia
ianeieueei ooaiiia, ii eo oeo?, eae i?aaeei, i/aiue iecie. Aieaa oiai,
aei neo ii? oi/ii iaecaanoii i?ioea eaeiai eiiiiiaioa ae?ona iai?aaeaiu
iaeo?aeecothuea aioeoaea. Oai ia iaiaa iaiei/ea ae?ona nio?aiyao naith
i?eaeaeaoaeueiinoue a ea/anoaa aioeaaia aeey eiioiecaoeee, oae eae
i?ioeann naycuaaiey n iieaeoeie CD4 ieacaeny iauei aeey anao eco/aiiuo
ia naaiaeiyoiee aeaiue ooaiiia, e yoi aiai?eo i aiciiaeiinoe iaee/ey
iaueo yieoiiia o eo iaiei/ae. Aa?iyoii, iaeo?aeecothuea aioeoaea e yoei
eiina?aaoeaiui o/anoeai iiaeii iieo/eoue, eniieuecoy a ea/anoaa aioeaaia
aioeoaea e CD4 (aioeeaeeioeie/aneee iaoiae).
?acoeueoaou yenia?eiaioia n aeeaioiuie iicaieytho aeoiaoue, /oi aaaeii
ia oieueei oi, eaeie ec eiiiiiaioia ae?ona eniieuecoaony aeey
aaeoeeiaoeee, ii e oi, eaeei niiniaii aaeoeeia i?aaeeaaaaony eiioiiie
nenoaia. Auei iieacaii, /oi a ea/anoaa aaeoeeiu iiaoo auoue aanueia
yooaeoeaiu ae?oniua aioeaaiu, aeeth/aiiua a eneiiu -
eiioiinoeioee?othuea eiiieaenu.
E?iia oiai, aaeaeaaoiay ioeaiea aaeoeei cao?oaeiaia, oae eae iiea ia
ecaanoai ie iaeei aeae, e?iia /aeiaaea, o eioi?iai AE* aucuaae au
iiaeiaiua NIEAeo caaieaaaiey (oioy o iaeioi?uo i?eiaoia aiciiaeia
e?aoeia?aiaiiay eioaeoeey).
Iiyoiio yooaeoeaiinoue aaeoeei iiaeii enneaaeiaaoue oieueei ia
aeia?iaieueoeao. Iiaeiaiua eniuoaiey oaea i?iaiaeyony a iaeioi?uo
no?aiao. Iaeiaei eae aeieai i?eaeaony aeaeaoue ?acoeueoaoia eco/aiey
yooaeoeaiinoe aaeoeeiu, anee ne?uoue ia?eiae i?e NIEAea aeeeony iiiaea
aiaeu? A yoii ninoieo eeoue iaeia ec o?oaeiinoae.
E ana aea iaeioi?ua ia?niaeoeau oaea iaiaoeeenue. Eco/athony
aaiiieiaeaia?iua iaoiaeu nicaeaiey aaeoeeiu i?ioea AE*: a aaiaoe/aneee
aiia?ao ae?ona ei?iaueae iniu ano?aeaaaony aai iaeiiai ec aaeeia AE*.
Eioa?an i?aaenoaaeyao ?aaioa, aaaeouayny a Einoeoooa eiioiieiaee
Ieienoa?noaa cae?aaiio?aiaiey ?innee. Iaoiae iniiaai ia i?eiaiaiee
neioaoe/aneeo eiioiiaaiia, iicaieythueo noeioee?iaaoue A-eeioioeeou,
ieioy O-eeaoi/iue eiio?ieue.
A iaa 1997 aiaea a NOA iiyaeeanue ioaeeeaoeey i oii, /oi a aeeaeaeoaa
a?aiy aeieaeiu ia/aoueny eeeie/aneea eniuoaiey aaeoeeiu, eioi?ay
aeaenoaoao ia eiioiiaaiiua eeaoee neecenoie iaiei/ee iieiauo iooae. A
niiauaiee aiai?eoueny i oii, /oi aua i/aiue ieioi eco/ai eiioieoao
naycaiiue ni neecenouie iaiei/eaie, a yoi iiaei au i/aiue
niinianoaiaaoue nicaeaieth aaeoeeiu i?ioea aicaoaeeoaeae, ia?aaea/a
eioi?uo naycaia ni neecenouie iaiei/eaie.
Eiioiieiae i?aaeuyaeytho aeanoeea o?aaiaaiey e aaeoeeia: iia ia aeieaeia
i?iioneaoue AE* a eeaoee-ieoaie; iaeo?aeeciaaoue AE* aei i?iieeiiaaiey
aai a iica; iaania/eaaoue ?aniiciaaaiea eiioiiie nenoaiie anao
aiciiaeiuo aa?eaioia AE* e aa?aioe?iaaoue caueoo anao aaeoeeie?iaaiiuo.
Oae ianoiyo aeaea n iieo/aieai aaeoeeiu i?ioea AE*. A enneaaeiaaiey
aeeth/eeenue e?oiiaeoea o/aiua ?yaea no?ai. Ianiio?y ia /?acau/aeioth
neiaeiinoue i?iaeaiu, iaiaoeeenue ?acee/iua iooe aa ?aoaiey, iinoiyiii
aaia?e?othony iiaua eaeae, a iaeioi?uo eaai?aoi?eyo oaea ia/aou
eeeie/aneea eniuoaiey aaeoeeiu ia ethaeyo. Ana yoi aeaao iniiaaiey
iaaeayoueny, /oi aaeoeeia i?ioea ae?ona NIEAea aoaeao iieo/aia. Ii ana
aea iiaeaaeythuaa aieueoeinoai o/aiuo, ?aaioathueo a yoie iaeanoe,
n/eoatho, /oi oe?ieiai i?eiaiaiey aaeoeeiu iaaei iaeeaeaoue ia ?aiaa,
/ai /a?ac 5-7 eao.
A anee a aeeaeaeoaa a?aiy ?ann/eouaaoue ia aaeoeeio ia i?eoiaeeony, oi
oioy au aeey i?einoaiiaee ?inoa yieaeaiee iaiaoiaeeii ia?ae?uoue
iniiaiua iooe ia?aaea/e AE*. A nayce n yoei AIC nicaeaea niaoeeaeueiua,
iai?aaeaiiua ia yoi i?ia?aiiu. Iniiaiua ioieou yoeo i?ia?aii:
· Naieoa?iia i?inaauaiea
· I?aaeioa?auaiea ia?aaea/e ae?ona iieiaui iooai
· I?aaeioa?auaiea ia?aaea/e ae?ona i?e eiuaeoeee ia?eioeeia
· I?aaeioa?auaiea aa?oeeaeueiie ia?aaea/e ae?ona
· Ai?ueaa n ia?aaea/ae ae?ona /a?ac e?iaue, i?aia?aou e?iae,
aeiii?neea i?aaiu
· I?ioanneiiaeueiua ?aaioieee cae?aaiio?aiaiey eae i?iiaaaiaeenou
· Yieaeaieieiae/aneee iaaeci?
CAEETH*AIEA.
Eoae, nae/an oaea iiiaei ynii, /oi NIEAe - iaeia ec aaaeiaeoeo e
o?aae/aneeo i?iaeai, aicieeoeo ia?aae anai /aeiaa/anoaii a eiioea OO
aaea. E aeaei ia oieueei a oii, /oi a ie?a oaea ca?aaeno?e?iaaiu iiiaea
ieeeeiiu eioeoee?iaaiiuo AE* e aieaa 200 ouny/ oaea iiaeaei, /oi
eaaeaeua iyoue ieioo ia caiiii oa?a i?ienoiaeeo ca?aaeaiea iaeiiai
/aeiaaea. NIEAe - yoi neiaeiaeoay iao/iay i?iaeaia. Aei neo ii?
iaecaanoiu aeaaea oai?aoe/aneea iiaeoiaeu e ?aoaieth oaeie caaea/e, eae
i/enoea aaiaoe/aneiai aiia?aoa eeaoie io /oaea?iaeiie (a /anoiinoe,
ae?oniie) eioi?iaoeee. Aac ?aoaiey yoie i?iaeaiu ia aoaeao iieiie
iiaaaeu iaae NIEAeii. A oaeeo iao/iuo aii?inia yoi caaieaaaiea iinoaaeei
iiiai...
NIEAe - yoi oyaeaeaeoay yeiiiie/aneay i?iaeaia. Niaea?aeaiea e ea/aiea
aieueiuo e eioeoee?iaaiiuo, ?ac?aaioea e i?iecaiaenoai aeeaaiinoe/aneeo
e ea/aaiuo i?aia?aoia, i?iaaaeaiea ooiaeaiaioaeueiuo iao/iuo
enneaaeiaaiee e o. Ae. Oaea nae/an noiyo ieeeea?aeu aeieea?ia. Aanueia
iai?inoa e i?iaeaia caueou i?aa aieueiuo NIEAeii e eioeoee?iaaiiuo, eo
aeaoae, ?iaeiuo e aeeceeo. O?oaeii ?aoaoue e ineoinioeeaeueiua aii?inu,
aicieeoea a nayce n yoei caaieaaaieai.
NIEAe - yoi ia oieueei i?iaeaia a?a/ae e ?aaioieeia cae?aaiio?aiaiey, ii
e o/aiuo iiiaeo niaoeeaeueiinoae, ainoaea?noaaiiuo aeayoaeae e
yeiiiienoia, th?enoia e nioeeieiaia.
Ana aeieaeiu ciaoue e iiieiaoue, /oi NIEAe aieaeao n iaie a XXI aae. E
aeey oiai, /oiau auaeeoue, oiaiueoeoue ?ene ca?aaeaiey e ?ani?ino?aiaiey
caaieaaaiey, eae iiaeii aieueoa ethaeae ai anao no?aiao aeieaeiu iiiaia
ciaoue i NIEAea - i ?acaeoee e eeeie/aneeo i?iyaeaieyo caaieaaaiey, aai
i?ioeeaeoeea e ea/aiee, ooiaeo ca aieueiuie, ineoioa?aiee aieueiuo e
eioeoee?iaaiiuo.
Nienie eniieueciaaiiie eeoa?aoo?u.
1. A.N. Oaaaeaa, NIEAe - caaaaeea aaea; I.,1991a.
2. A.E. Aa?eei, TH.E. Aieyineee, E.I. Ia?/oe e ae?., Neiae?ii
i?eia?aoaiiiai eiioiiaeaoeoeeoa. Aiciiaeiua iaoaieciu acaeiiaeaenoaey
ae?ona eiioiiaeaoeoeeoa /aeiaaea n eeaoeaie i?aaiecia; Oa?ueeia, 1988.
3. I. Aaeea?, Acaoea NIEAea; I.: Ie?, 1991.
4. I.E. Oa?iaa, A.A. Aoe?eineay, Iniaaiiinoe acaeiiaeaenoaey aaeeia a
ninoaaa ae?eiiia AE*-1; Aii?inu eiioiieiaee, 1990, o.3, ?3, n. 202-206.
5. Aiciiaeii auaeaeai iiaue oei ae?ona eiioiiaeaoeoeeoa /aeiaaea -
AE*-3; Aii?inu ae?onieiaee, 1990, o.35, ?1, n. 82.
6. E.A. Eiaeaiyeei, A.A. Aiiaea?aiei; Ianoaaeeueiinoue aaiiia e NIEAe.
Aeioeiey, 1992, o. 57, a. 9, n. 1417-1426.
7. A.I. Eociaoeia. Nenoaia eioa?oa?iia i?e AE*-eioaeoeee. Aii?inu
ae?onieiaee. 1991, o. 36, ?2, n. 92-96.
8. O.A. Aaeoeie?ia. Ae?on eiioiiiai aeaoeoeeoa /aeiaaea oeia 2.
Aii?inu ae?onieiaee. 1990, o. 35, ?3, n. 180-183.
9. I.E. Aoe?eineee. No?iaiea aaiiia e yeni?anney aaiia ae?ona
eiioiiaeaoeoeeoa /aeiaaea (iaci? eiino?aiiie eeoa?aoo?u). Aii?inu
ae?onieiaee. 1987, o.32, ? 6, n. 649-656.
10. MED/96036380. Haubrich RH, Flexner C, Lederman MM, Hirsch M,
Pettinelli CP, Ginsberg R, Lietman P, Hamzeh FM, Spector SA, Richman DD.
A randomized trial of the activity and safety of Ro 24-7429 (Tat
antagonist) versus nucleoside for human immunodeficiency virus
infection. The AIDS Clinical Trials Group 213 Team. J Infect Dis 1995
Nov;172(5):1246-52.
11. MED/96217734. Jacobsen H, Hanggi M, Ott M, Duncan IB, Owen S,
Andreoni M, Vella S, Mous J. In vivo resistance to a human
immunodeficiency virus type 1 proteinase inhibitor: mutations, kinetics,
and frequencies. J Infect Dis. 1996 Jun;173(6):1379-87.
12. MED/96147316. Goldman AI, Carlin BP, Crane LR, Launer C, Korvick
JA, Deyton L, Abrams DI. Response of CD4 lymphocytes and clinical
consequences of treatment using ddI or ddC in patients with advanced HIV
infection. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Feb
1;11(2):161-9.
13. CDC AIDS Daily Summary 5/12/97. "AIDS Vaccine Proving to Be an
Elusive Goal"
Los Angeles Times--Washington Edition (05/12/97) P. A4; Cimons, Marlene.
14. Information presented at the 4th Conference on Retroviruses and
Opportunistic Infections in Washington, DC, January 22-26, 1997.
Ana eiino?aiiua noaouee, noaoenoeea e iaeioi?ua ae?oaea aeaiiua ii
?aciui ?acaeaeai acyou ec Eioa?iaoa ii aae?anai:
gopher://gopher.niaref-nih.gov (na?aa? Iaoeeiiaeueiiai einoeoooa
caei?iauey NOA)
NOA)
gopher://gopher.hivnet.org
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