监测在治疗过程中应着重于评价治疗、药物毒性和免疫重建炎症综合征(IRIS)。[124]Dhasmana DJ, Dheda K, Ravn P, et al. Immune reconstitution inflammatory syndrome in HIV-infected patients receiving antiretroviral therapy: pathogenesis, clinical manifestations and management. Drugs. 2008;68:191-208.http://www.ncbi.nlm.nih.gov/pubmed/18197725?tool=bestpractice.com
如果在开始高效抗逆转录病毒治疗(HAART)后,卡氏肺孢子虫肺炎(PCP)出现临床恶化,在诊断IRIS前需要排除PCP治疗失败、药物反应、新发感染、恶性肿瘤或其他病变,如充血性心力衰竭。一项关于非 ICU 的 PCP 患者的研究显示,早期开始 HAART(2 周内)较在治疗结束后开始 HAART 的死亡风险更低,因此建议早期开始 HAART 治疗。[18]Kaplan JE, Masur H, Holmes KK. Guidelines for preventing opportunistic infections among HIV-infected persons--2002. Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America. MMWR Recomm Rep. 2002;51(RR-8):1-52.[125]Lawn SD, Török ME, Wood R. Optimum time to start antiretroviral therapy during HIV-associated opportunistic infections. Curr Opin Infect Dis. 2011;24:34-42.http://www.ncbi.nlm.nih.gov/pubmed/21150593?tool=bestpractice.com