The comorbidity of depression and neurocognitive disorder in persons with HIV infection: call for investigation and treatment.
The comorbidity of depression and neurocognitive disorder in persons with HIV infection: call for investigation and treatment.
复制标题
艾滋病毒感染患者的抑郁症和神经认知障碍的合并症：呼吁进行调查和治疗。
DOI：
10.3389/fncel.2023.1130938
复制
发表时间：
2023
影响因子：
5.3
通讯作者：
中科院分区：
文献类型：
--
作者：
抑郁症和神经认知障碍仍然是影响艾滋病毒携带者(PWH)的主要神经精神障碍。严重抑郁障碍的患病率在威斯康星医院中是普通人群的两到四倍(∼6.7%)。威尔斯亲王的神经认知障碍患病率估计从25%到47%以上--取决于所用的定义(目前正在演变)、所用测试单元的大小，以及参与者的人口统计和艾滋病毒疾病特征，如年龄范围和性别分布。严重的抑郁障碍和神经认知障碍也会导致大量的发病率和过早死亡。然而，尽管预计这两种疾病在PWH中相对常见，但这两种疾病的共病尚未得到正式研究。这在一定程度上是由于这两种疾病的神经认知症状的临床重叠。两者还都有神经行为方面的共同点--特别是冷漠--以及不坚持抗逆转录病毒治疗的风险增加。共同的病理生理机制可能解释这些交叉的表型，包括神经炎性、血管和微生物组，以及神经内分泌/神经递质的动态机制。任何一种疾病的治疗都会影响另一种疾病的症状减轻和药物毒性。我们提出了一个基于严重抑郁障碍和HIV相关神经认知障碍的多巴胺能传递缺陷的共病的统一模型。减少神经炎症和/或恢复多巴胺能传递的相关缺陷的共病的特定治疗方法可能是值得研究的。
Depression and neurocognitive disorder continue to be the major neuropsychiatric disorders affecting persons with HIV (PWH). The prevalence of major depressive disorder is two to fourfold higher among PWH than the general population (∼6.7%). Prevalence estimates of neurocognitive disorder among PWH range from 25 to over 47% – depending upon the definition used (which is currently evolving), the size of the test battery employed, and the demographic and HIV disease characteristics of the participants included, such as age range and sex distribution. Both major depressive disorder and neurocognitive disorder also result in substantial morbidity and premature mortality. However, though anticipated to be relatively common, the comorbidity of these two disorders in PWH has not been formally studied. This is partly due to the clinical overlap of the neurocognitive symptoms of these two disorders. Both also share neurobehavioral aspects — particularly apathy — as well as an increased risk for non-adherence to antiretroviral therapy. Shared pathophysiological mechanisms potentially explain these intersecting phenotypes, including neuroinflammatory, vascular, and microbiomic, as well as neuroendocrine/neurotransmitter dynamic mechanisms. Treatment of either disorder affects the other with respect to symptom reduction as well as medication toxicity. We present a unified model for the comorbidity based upon deficits in dopaminergic transmission that occur in both major depressive disorder and HIV-associated neurocognitive disorder. Specific treatments for the comorbidity that decrease neuroinflammation and/or restore associated deficits in dopaminergic transmission may be indicated and merit study.
登录
查看更多内容
影响因子：
5.9
作者：
Brown, GK;Beck, AT;Grisham, JR
通讯作者：
Grisham, JR
影响因子：
0.2
作者：
Chavda, Nilesh;Kantharia, N. D.;Jayakaran
通讯作者：
Jayakaran
影响因子：
1.9
作者：
Grima P;Guido M;Chiavaroli R;De Donno A;Tana M;Zizza A
通讯作者：
Zizza A
影响因子：
3.4
作者：
Rabkin, Judith G.;McElhiney, Martin C.;Rabkin, Richard
通讯作者：
Rabkin, Richard
影响因子：
6.8
作者：
Carboni, Lucia;McCarthy, Dennis J.;Domenici, Enrico
通讯作者：
Domenici, Enrico