[HIV cofactors in the course of AIDS]

The responsibility of HIV in the occurrence of AIDS is definitely established, but "cofactors" are strongly suspected to intervene, which would explain the difference courses followed by the disease in one patient or the other. Some of these cofactors are related to the host or result from his behaviour. Thus, age at the time of HIV acquisition and the patient's HLA group are associated with differences in the speed of progression towards AIDS. Attitudes that lead to reexposure to the virus by the sexual or intravenous routes shorten the duration of the asymptomatic phase. Other cofactors are environmental in nature. Among the infectious agents, cytomegalovirus and some mycoplasmas have been the object of the most through studies. The responsibility of some physicochemical substances, such as cocaine, vitamin D and corticosteroids, acting as cofactors of increasing severity, mostly rests on data obtained in vitro and need clinical confirmation in man. However, the study of cofactors already seems to be a promising line of research aimed at understanding AIDS and hence its therapeutic approach.