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艾滋病病毒(HIV)感染中枢神经系统,引起神经认知功能的改变。随着联合抗反转录病毒治疗的应用,严重的HIV相关的痴呆发病率在下降,然而,轻度的HIV相关神经认知障碍(HAND)的发病率却在上升。HAND影响了HIV感染者和艾滋病(AIDS)病人的生活质量,降低其对抗反转录病毒药物的依从性。早期识别和诊断HAND具有重要的临床意义。HAND的发病机制尚未明确。文章就HAND的脑内机制,精神神经测试和影像诊断,影响HAND发病的病毒因素、宿主因素、抗病毒药物治疗因素等方面进行综述。
The AIDS virus (HIV) infects the central nervous system and causes changes in neurocognitive function. With the combination of antiretroviral therapy, the incidence of severe HIV-related dementia is declining, however, the incidence of mild HIV-associated neurocognitive impairment (HAND) is on the rise. HAND affects the quality of life of HIV-infected and AIDS patients and reduces their adherence to antiretroviral drugs. Early identification and diagnosis of HAND has important clinical significance. The pathogenesis of HAND is not yet clear. The article reviews HAND brain mechanisms, neuro-neurological tests and imaging diagnosis, viral factors affecting HAND incidence, host factors, antiviral therapy factors and so on.