Alzheimer's disease neuropathology may not predict functional impairment in HIV: a report of two individuals.
Alzheimer's disease neuropathology may not predict functional impairment in HIV: a report of two individuals.
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DOI：
10.1007/s13365-018-0663-z
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发表时间：
2018-10
影响因子：
3.2
通讯作者：
Crary J
中科院分区：
文献类型：
--
作者：
Morgello S;Jacobs M;Murray J;Byrd D;Neibart E;Mintz L;Meloni G;Chon C;Crary J
随着HIV人群的老龄化，人们担心阿尔茨海默病（AD）可能会变得普遍，并且难以与HIV相关的神经认知障碍区分开来。到目前为止，还没有报告记录在艾滋病毒和痴呆症患者中组织学证实的阿尔茨海默氏症神经病理学。在此，我们报告两个抗逆转录病毒治疗，病毒抑制，艾滋病毒感染的个人尸检的曼哈顿艾滋病毒脑银行。受试者A在52岁时参加研究，已经依赖于工具性日常生活活动（ADL），伴有严重认知障碍，包括学习和记忆功能障碍。她的病史对教育障碍和头部创伤具有重要意义。她的认知能力迅速下降，到59岁去世时，她已经卧床不起，大小便失禁，无法交流。尸检时，她表现出严重的AD神经病理学变化（NIA-AA评分A3 B3 C3）和年龄相关的tau星形胶质细胞病（ARTAG）。她是APOE ε3/ε3纯合子。巢式聚合酶链反应在额叶未检出HIV DNA。受试者B是一名居住在社区的81岁女性，因肺栓塞猝死。在死亡之前，她功能完全，独立生活，并管理所有ADL。尸检时，她表现出中度淀粉样蛋白和重度tau AD神经病理学变化（A2 B3 C2）、ARTAG和脑嗜酸性血管病。她是APOE ε3/ε4杂合子，尽管20年的治疗诱导的病毒抑制，但在额叶中检测到HIV DNA，而不是RNA。我们的结论是，在艾滋病毒的设置，AD神经病理学可能会发生或没有症状的认知功能障碍，与血清阴性的个人，有可能是复杂的因素，在产生临床相关的障碍。
With aging of HIV populations, there is concern that Alzheimer’s disease (AD) may become prevalent and difficult to distinguish from HIV-Associated Neurocognitive Disorders. To date, there are no reports documenting histologically verified Alzheimer’s neuropathology in individuals with HIV and dementia. Herein, we report two antiretroviral-treated, virally suppressed, HIV-infected individuals autopsied by the Manhattan HIV Brain Bank. Subject A presented to study at 52 years, already dependent in instrumental activities of daily living (ADLs), with severe cognitive impairment inclusive of learning and memory dysfunction. Her history was significant for educational disability and head trauma. She had rapid cognitive decline, and by death at age 59, was bed-bound, incontinent, and non-communicative. At autopsy, she exhibited severe AD neuropathologic change (NIA-AA score A3B3C3) and age-related tau astrogliopathy (ARTAG). She was homozygous for APOE ε3/ε3. No HIV DNA was detected in frontal lobe by nested polymerase chain reaction. Subject B was a community dwelling 81-year-old woman who experienced sudden death by pulmonary embolus. Prior to death, she was fully functional, living independently, and managing all ADLs. At autopsy, she displayed moderate amyloid and severe tau AD neuropathologic changes (A2B3C2), ARTAG, and cerebral congophilic angiopathy. She was an APOE ε3/ε4 heterozygote, and HIV DNA, but not RNA, was detected in frontal lobe, despite 20 years of therapy-induced viral suppression. We conclude that in the setting of HIV, AD neuropathology may occur with or without symptomatic cognitive dysfunction; as with seronegative individuals, there are likely to be complex factors in the generation of clinically relevant impairments.
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影响因子：
5.8
作者：
Mosher, Kira Irving;Wyss-Coray, Tony
通讯作者：
Wyss-Coray, Tony
DOI：
10.1016/j.jalz.2011.03.005
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
McKhann GM;Knopman DS;Chertkow H;Hyman BT;Jack CR Jr;Kawas CH;Klunk WE;Koroshetz WJ;Manly JJ;Mayeux R;Mohs RC;Morris JC;Rossor MN;Scheltens P;Carrillo MC;Thies B;Weintraub S;Phelps CH
通讯作者：
Phelps CH
影响因子：
3.2
作者：
Heaton, Robert K.;Franklin, Donald R.;Ellis, Ronald J.;McCutchan, J. Allen;Letendre, Scott L.;LeBlanc, Shannon;Corkran, Stephanie H.;Duarte, Nichole A.;Clifford, David B.;Woods, Steven P.;Collier, Ann C.;Marra, Christina M.;Morgello, Susan;Mindt, Monica Rivera;Taylor, Michael J.;Marcotte, Thomas D.;Atkinson, J. Hampton;Wolfson, Tanya;Gelman, Benjamin B.;McArthur, Justin C.;Simpson, David M.;Abramson, Ian;Gamst, Anthony;Fennema-Notestine, Christine;Jernigan, Terry L.;Wong, Joseph;Grant, Igor
通讯作者：
Grant, Igor
影响因子：
120.7
作者：
Jansen, Willemijn J.;Ossenkoppele, Rik;Knol, Dirk L.;Tijms, Betty M.;Scheltens, Philip;Verhey, Frans R. J.;Visser, Pieter Jelle
通讯作者：
Visser, Pieter Jelle
影响因子：
9.4
作者：
ALBERT, J;FENYO, EM
通讯作者：
FENYO, EM