Chronic inflammation and the role for cofactors (hepatitis C, drug abuse, antiretroviral drug toxicity, aging) in HAND persistence.
Chronic inflammation and the role for cofactors (hepatitis C, drug abuse, antiretroviral drug toxicity, aging) in HAND persistence.
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DOI：
10.1007/s11904-014-0210-3
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发表时间：
2014-09
影响因子：
4.6
通讯作者：
Kolson, Dennis L.
中科院分区：
文献类型：
--
作者：
Gill, Alexander J.;Kolson, Dennis L.
关键词：
InflammationHuman immunodeficiency virusHIVHIV associated neurocognitive disordersHANDImmune activationNeurotoxicityHepatitis CHCVAgingDrug abuseNeuropathogenesisMRIMagnetic resonance imagingfMRIFunctional magnetic resonance imagingNeurocognitive testingMicrobial translocationAntiretroviral therapyART
HIV相关神经认知障碍(HAND)是一组不同程度的认知障碍综合征，影响高达50%的HIV感染者。HAND的神经发病机制被认为是由HIV在脑血管周围巨噬细胞和内源性小胶质细胞内的入侵和生产性复制，以及在一定程度上由星形胶质细胞的限制性感染所驱动的。抗逆转录病毒疗法(ART)抑制全身HIV病毒载量的个体手部持续存在的原因尚未完全解释，建议的因素包括慢性炎症、脑巨噬细胞中持续的HIV复制、衰老对大脑脆弱性的影响，以及抗逆转录病毒疗法(ART)合并感染、药物滥用和中枢神经系统毒性等并存条件。这篇综述讨论了其中的几种情况：慢性炎症、合并丙型肝炎病毒感染、滥用药物、衰老和抗逆转录病毒药物的作用。在有手和没有手的个体中有效地管理这些共病情况对于改善神经认知结果和降低艾滋病毒相关发病率至关重要。
HIV-associated neurocognitive disorders (HAND) is a group of syndromes of varying degrees of cognitive impairment affecting up to 50 % of HIV-infected individuals. The neuropathogenesis of HAND is thought to be driven by HIV invasion and productive replication within brain perivascular macrophages and endogenous microglia, and to some degree by restricted infection of astrocytes. The persistence of HAND in individuals experiencing suppression of systemic HIV viral load with antiretroviral therapy (ART) is incompletely explained, and suggested factors include chronic inflammation, persistent HIV replication in brain macrophages, effects of aging on brain vulnerability, and comorbid conditions including hepatitis C (HCV) co-infection, substance abuse, and CNS toxicity of ART, among other factors. This review discusses several of these conditions: chronic inflammation, co-infection with HCV, drugs of abuse, aging, and antiretroviral drug effects. Effectively managing these co-morbid conditions in individuals with and without HAND is critical for improving neurocognitive outcomes and decreasing HIV-associated morbidity.
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影响因子：
1
作者：
Cisneros IE;Ghorpade A
通讯作者：
Ghorpade A
DOI：
10.1097/qai.0b013e318229ba41
发表时间：
2011-10-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
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CHARTER Group
影响因子：
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作者：
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Evans, S. R.
影响因子：
25.7
作者：
Byrnes, Valerie;Miller, Anne;Afdhal, Nezam H.
通讯作者：
Afdhal, Nezam H.
DOI：
10.1097/qad.0b013e32836010bd
发表时间：
2013-06-01
期刊：
AIDS (London, England)
影响因子：
--
作者：
Burdo TH;Weiffenbach A;Woods SP;Letendre S;Ellis RJ;Williams KC
通讯作者：
Williams KC