Wendel Karen A, McArthur Justin C
Division of Infectious Diseases, Oklahoma University Health Science Center, Oklahoma City, OK 73104, USA.
Clin Infect Dis. 2003 Oct 15;37(8):1107-11. doi: 10.1086/378300. Epub 2003 Sep 24.
We describe 3 patients with chronic human immunodeficiency virus (HIV) infection who presented with syndromes compatible with acute meningoencephalitis secondary to HIV; these syndromes were characterized by elevated cerebrospinal spinal fluid (CSF) HIV viral loads and T2-weighted signal abnormalities on magnetic resonance imaging of the brain. After the initiation of or a change in highly active antiretroviral therapy (HAART), each of the patients had significant and rapid improvement in neurologic symptoms and dramatic reductions in CSF HIV viral loads. Although further investigation is needed, these findings suggest that measurement of CSF HIV viral load and treatment with central nervous system-penetrating HAART should be considered for patients with acute neurologic complaints, chronic HIV infection, and no other identifiable cause of neurologic illness.
我们描述了3例慢性人类免疫缺陷病毒（HIV）感染患者，他们表现出与HIV继发的急性脑膜脑炎相符的综合征；这些综合征的特征是脑脊液（CSF）中HIV病毒载量升高以及脑部磁共振成像T2加权信号异常。在开始高效抗逆转录病毒治疗（HAART）或改变治疗方案后，每位患者的神经症状均有显著且迅速的改善，CSF中HIV病毒载量也大幅降低。尽管还需要进一步研究，但这些发现表明，对于有急性神经症状、慢性HIV感染且无其他可识别神经疾病病因的患者，应考虑检测CSF中HIV病毒载量并采用能穿透中枢神经系统的HAART进行治疗。
