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首页> 外文期刊>Nature reviews. Urology >Urological aspects of HIV and AIDS
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Urological aspects of HIV and AIDS

机译：艾滋病毒的泌尿学方面

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The use of highly active antiretroviral therapy (HAART) in HIV-infected people has led to a dramatic decrease in the incidence of opportunistic infections and virus-related malignancies such as non-Hodgkin lymphoma and Kaposi sarcoma, but not cervical or anal cancer. Advanced-stage cervical cancer is associated with a high incidence of urological complications such as hydronephrosis, renal failure, and vesicovaginal fistula. Adult male circumcison can significantly reduce the risk of male HIV acquisition. Although HAART does not completely eradicate HIV, compliance with medication increases life expectancy. HIV infection or treatment can result in renal failure, which can be managed with dialysis and transplantation (as for HIV-negative patients). Although treatment for erectile dysfunction - including phosphodiesterase 5 inhibitors, intracavernosal injection therapy, and penile prosthesis - can increase the risk of HIV transmission, treatment decisions for men with erectile dysfunction should not be determined by HIV status. The challenges faced when administering chemotherapy to HIV-infected patients with cancer include late presentation, immunodeficiency, drug interactions, and adverse effects associated with compounded medications. Nonetheless, HIV-infected patients should receive the same cancer treatment as HIV-negative patients. The urologist is increasingly likely to encounter HIV-positive patients who present with the same urological problems as the general population, because HAART confers a prolonged life expectancy. Performing surgery in an HIV-infected individual raises safety issues for both the patient (if severely immunocompromised) and the surgeon, but the risk of HIV transmission from patients on fully suppressive HAART is small.
机译：在感染HIV的人群中使用高效抗逆转录病毒疗法（HAART）导致机会性感染和与病毒有关的恶性肿瘤（例如非霍奇金淋巴瘤和卡波西肉瘤）的发生率显着下降，但宫颈癌或肛门癌却没有。晚期宫颈癌与泌尿外科并发症（如肾积水，肾衰竭和膀胱阴道瘘）的发生率高有关。成年男性割礼可以大大降低男性感染艾滋病毒的风险。尽管HAART不能完全根除HIV，但服药可延长预期寿命。 HIV感染或治疗可能导致肾功能衰竭，可以通​​过透析和移植来控制（如HIV阴性患者）。尽管对勃起功能障碍的治疗（包括磷酸二酯酶5抑制剂，海绵体腔内注射疗法和阴茎假体）可以增加HIV传播的风险，但是对勃起功能障碍的男性的治疗决定不应取决于HIV的状况。对感染了HIV的艾滋病毒患者进行化学疗法时面临的挑战包括迟发，免疫缺陷，药物相互作用以及与复合药物相关的不良反应。但是，感染HIV的患者应接受与HIV阴性患者相同的癌症治疗。由于HAART可以延长寿命，因此泌尿科医师越来越有可能遇到与一般人群一样存在泌尿科问题的HIV阳性患者。在感染了HIV的个体中进行手术会给患者（如果免疫功能严重受损）和外科医生都带来安全问题，但是在完全抑制性HAART的情况下，患者传播HIV的风险很小。

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