HIV-associated neurocognitive disorder.
HIV-associated neurocognitive disorder.
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DOI：
10.1016/s1473-3099(13)70269-x
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发表时间：
2013-11
影响因子：
56.3
通讯作者：
Ances, Beau M.
中科院分区：
文献类型：
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作者：
Clifford, David B.;Ances, Beau M.
HIV的神经系统受累通常与认知障碍有关。虽然在有效的抗逆转录病毒治疗时代，严重和进行性神经认知障碍在艾滋病毒诊所已变得罕见，但全球大多数艾滋病毒患者在正式的神经认知测试中的表现低于预期。共病情况有助于减值，但不足以解释遇到减值的频率。HIV疾病标志物如当前病毒载量和CD4计数不再与治疗的持续损害密切相关，而心血管疾病标志物和炎症标志物似乎更密切相关。需要新的脑脊液和神经影像学生物标志物来检测和跟踪损伤。正在进行的研究，以优化艾滋病毒治疗的中枢神经系统，并有可能干预下游机制的神经毒性仍然是重要的途径，未来的调查。最终，完全控制大脑中的病毒是实现根除艾滋病毒目标的必要步骤。每周检索1988年至2013年8月期间涉及HIV神经认知障碍、HIV神经病变、HIV脊髓病、HIV痴呆和HIV的英文出版物。此外，提交人自己的档案也是人工搜索的。
Neurological involvement in HIV is commonly associated with cognitive impairment. While severe and progressive neurocognitive impairment has become rare in HIV clinics in the era of potent antiretroviral therapy, a majority of HIV patients worldwide perform below expectations on formal neurocognitive tests. Co-morbid conditions contribute to impairment, but they are insufficient to explain the frequency of impairment encountered. HIV disease markers like current viral load and CD4 counts are no longer strongly associated with ongoing impairment on therapy, while cardiovascular disease markers and inflammatory markers appear more closely associated. Novel cerebrospinal fluid and neuroimaging biomarkers are needed to detect and follow impairment. Ongoing research to optimize HIV therapy within the central nervous system, and potentially to intervene in downstream mechanisms of neurotoxicity remain important avenues of future investigation. Ultimately, the full control of virus in the brain is a necessary step in the goal of HIV eradication. Weekly searches of English language publications referring to HIV neurocognitive impairment, HIV neuropathy, HIV myelopathy, HIV dementia, and HIV from 1988 to August 2013 were performed. In addition, the authors’ own files were manually searched.