Neurologic manifestations of human immunodeficiency virus-2: dementia, myelopathy, and neuropathy in West Africa.
Neurologic manifestations of human immunodeficiency virus-2: dementia, myelopathy, and neuropathy in West Africa.
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DOI：
10.1007/s13365-011-0022-9
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发表时间：
2011-04
影响因子：
3.2
通讯作者：
Clifford, David B.
中科院分区：
文献类型：
--
作者：
Choi, Youngjee;Townend, John;Vincent, Tim;Zaidi, Irfan;Sarge-Njie, Ramu;Jaye, Assan;Clifford, David B.
虽然人类免疫缺陷病毒（HIV）-1相关的神经系统后遗症已有详尽记载，但HIV - 2相关的神经系统后遗症尚未得到系统评估。在排除混杂的合并症后，对几内亚比绍一个农村队列中的67人（22名HIV - 2感染者，45名血清阴性对照者）进行了评估。将HIV阳性个体按CD4＜350和CD4≥350进行分组分析。以国际HIV痴呆量表（IHDS）评估的HIV相关神经认知障碍（HAND）、远端感觉性多发性神经病（DSPN）和脊髓病是主要的结果变量。单变量分析显示，各组之间的IHDS评分无差异。按是否接受过小学教育进行分析时，受教育程度越高，IHDS评分越高，但差异无统计学意义（p = 0.06）。各组之间DSPN的患病率无显著差异；总体而言，45%的参与者患有DSPN。没有脊髓病病例。在多元线性回归中，较高的IHDS评分与年龄较大显著相关（系数 = -0.11，p＜0.001）。逻辑回归分析显示，年龄较大（比值比（OR）95%置信区间1.04 - 1.20）、CD4计数较低（OR 95%置信区间0.996 - 0.999）和体重指数较高（OR 95%置信区间1.02 - 1.43）显著预示着DSPN的存在。虽然在HIV - 2感染者中未观察到认知障碍的显著增加，但该研究表明，在几内亚比绍农村这种教育程度较低的环境中，IHDS可能是一种对HAND不太有效的筛查工具。与HIV - 1类似，HIV - 2感染者中DSPN似乎也在CD4计数较低时发生。进一步研究HIV - 2中的病毒 - 宿主相互作用及其导致的神经系统疾病，可能为理解HIV - 1的流行问题提供一条途径。
While well documented in human immunodeficiency virus (HIV)-1, neurologic sequelae have not been systematically evaluated in HIV-2. After excluding for confounding comorbidities, 67 individuals from a rural cohort in Guinea-Bissau (22 HIV-2 participants, 45 seronegative controls) were evaluated. HIV+individuals were divided into CD4<350 and CD4≥350 for analysis. HIV-associated neurocognitive disorders (HAND), assessed by the International HIV Dementia Scale (IHDS), distal sensory polyneuropathy (DSPN), and myelopathy were the main outcome variables. In univariate analysis, there was no difference in IHDS scores among groups. When analyzed by primary education attainment, IHDS scores were nonsignificantly higher (p=0.06) with more education. There was no significant difference in DSPN prevalence among groups; overall, 45% of participants had DSPN. There were no cases of myelopathy. In multivariate linear regression, higher IHDS scores were significantly correlated with older age (coefficient=−0.11, p<0.001). Logistic regression analysis showed that older age (odds ratio (OR) 95% CI 1.04–1.20), lower CD4 count (OR 95% CI 0.996–0.999), and higher BMI (OR 95% CI 1.02–1.43) significantly predicted the presence of DSPN. While a significant increase in cognitive impairment was not observed in HIV-2-infected individuals, the study suggests the IHDS may be a less effective screening tool for HAND in settings of lower educational attainment as encountered in rural Guinea-Bissau. Similar to HIV-1, DSPN seems to occur with lower CD4 counts in HIV-2. Further study of the viral–host interactions in HIV-2 and its consequent neurological diseases may provide an avenue for understanding the epidemic problems of HIV-1.
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DOI：
10.1097/qai.0b013e318183a9df
发表时间：
2008-12-01
影响因子：
3.6
作者：
Njamnshi, Alfred K.;Djientcheu, Vincent de Paul;Muna, Walinjom F.
通讯作者：
Muna, Walinjom F.
影响因子：
9.9
作者：
BACELLAR, H;MUNOZ, A;MCARTHUR, JC
通讯作者：
MCARTHUR, JC
影响因子：
9.9
作者：
Childs, EA;Lyles, RH;McArthur, JC
通讯作者：
McArthur, JC
影响因子：
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作者：
Morgello, S;Estanislao, L;Sharp, V
通讯作者：
Sharp, V
影响因子：
3.4
作者：
England, JD;Gronseth, GS;Sumner, AJ
通讯作者：
Sumner, AJ