Assessment, Diagnosis, and Treatment of HIV-Associated Neurocognitive Disorder: A Consensus Report of the Mind Exchange Program
Assessment, Diagnosis, and Treatment of HIV-Associated Neurocognitive Disorder: A Consensus Report of the Mind Exchange Program
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DOI：
10.1093/cid/cis975
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发表时间：
2013-04-01
影响因子：
11.8
通讯作者：
Munoz-Moreno, Jose A.
中科院分区：
文献类型：
--
作者：
Antinori, Andrea;Arendt, Gabriele;Munoz-Moreno, Jose A.
关于人类免疫缺陷病毒（HIV）相关神经认知障碍（HAND）的管理，许多实际的临床问题仍然没有答案。我们试图确定和开发实用的答案，在手管理的关键临床问题。来自30个国家的66名专家为该方案提供了投入，该方案由一个指导委员会监督。14个问题被评为最具临床重要性。答案是由一个专家组根据全面的文献综述起草的。63名专家召开会议，以确定答案的共识和证据水平。就所有答案达成了共识。例如，良好做法表明，所有艾滋病毒患者都应在疾病早期使用标准化工具进行HAND筛查。随访频率取决于是否已经存在HAND或临床数据是否提示发生HAND的风险。当排除其他原因时，神经认知障碍恶化可能会引发抗逆转录病毒药物调整的考虑。心灵交流计划为手的诊断、监测和治疗提供了实用的指导。
Many practical clinical questions regarding the management of human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) remain unanswered. We sought to identify and develop practical answers to key clinical questions in HAND management. Sixty-six specialists from 30 countries provided input into the program, which was overseen by a steering committee. Fourteen questions were rated as being of greatest clinical importance. Answers were drafted by an expert group based on a comprehensive literature review. Sixty-three experts convened to determine consensus and level of evidence for the answers. Consensus was reached on all answers. For instance, good practice suggests that all HIV patients should be screened for HAND early in disease using standardized tools. Follow-up frequency depends on whether HAND is already present or whether clinical data suggest risk for developing HAND. Worsening neurocognitive impairment may trigger consideration of antiretroviral modification when other causes have been excluded. The Mind Exchange program provides practical guidance in the diagnosis, monitoring, and treatment of HAND.