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首页> 外文期刊>Journal of neurology >HIV-1-associated neurocognitive disorder: epidemiology, pathogenesis, diagnosis, and treatment
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HIV-1-associated neurocognitive disorder: epidemiology, pathogenesis, diagnosis, and treatment

机译：HIV-1相关神经认知障碍：流行病学，发病机制，诊断和治疗

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摘要

The modern antiretroviral treatment of human immunodeficiency virus (HIV-1) infection has considerably lowered the incidence of opportunistic infections. With the exception of the most severe dementia manifestations, the incidence and prevalence of HIV-associated neurocognitive disorders (HAND) have not decreased, and HAND continues to be relevant in daily clinical practice. Now, HAND occurs in earlier stages of HIV infection, and the clinical course differs from that before the widespread use of combination antiretroviral treatment (cART). The predominant clinical feature is a subcortical dementia with deficits in the domains concentration, attention, and memory. Motor signs such as gait disturbance and impaired manual dexterity have become less prominent. Prior to the advent of cART, the cerebral dysfunction could at least partially be explained by the viral load and by virus-associated histopathological findings. In subjects where cART has led to undetectable or at least very low viral load, the pathogenic virus-brain interaction is less direct, and an array of poorly understood immunological and probably toxic phenomena are discussed. This paper gives an overview of the current concepts in the field of HAND and provides suggestions for the diagnostic and therapeutic management.
机译：人类免疫缺陷病毒（HIV-1）感染的现代抗逆转录病毒治疗大大降低了机会性感染的发生率。除了最严重的痴呆表现形式外，艾滋病毒相关神经认知障碍（手）的发病率和患病率没有减少，并且手仍然在日常临床实践中相关。现在，手中发生在艾滋病毒感染的早期阶段，并且临床过程不同于在广泛使用组合抗逆转录病毒治疗（推车）之前的不同。主要的临床特征是具有缺乏域浓度，注意力和记忆缺陷的皮下痴呆症。电机标志，如步态障碍和手工障碍障碍效果变得不那么突出。在推车出现之前，脑功能障碍至少可以部分地解释病毒载荷和病毒相关的组织病理学发现。在推车导致无法察觉或至少非常低的病毒载荷的受试者中，致病病毒 - 脑相互作用不太直接，并且讨论了一系列难以理解的免疫学和可能有毒现象。本文概述了手领域的当前概念，并为诊断和治疗管理提供了建议。

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