Tadesse Tizeta, Langford Dianne, Manji Karim, Mehari Enawgaw
Department of Biology, Georgia State University, Atlanta, Georgia, USA.
J Neurovirol. 2005;11 Suppl 1:22-6.
According to UNAIDS, the African population accounts for greater than half of persons infected with HIV. Nevertheless, little information exists characterizing HIV in this population. Thus, the natural history and progression of HIV in the African population is virtually undocumented and therefore, poorly understood. Information regarding virtually every aspect of the disease including microbiology, pathogenicity, virulence, and clinical manifestation is based largely on data from select and limited populations. During the HAART-era, we have seen dramatic and significant changes in patterns of NeuroAIDS in patients in clinical cohorts from the United States and Western Europe. These observations have led to increased understanding of the progression of NeuroAIDS and have improved our ability to design treatment regimens to combat CNS complications resulting from HIV. Despite the existence of antiretroviral therapy for HIV, its absence in Africa along with poor treatments for opportunistic infections associated with HIV have become the main sources of neurological morbidity and mortality. In this context, we are presented with a unique opportunity to cultivate and enhance our understanding of the natural history and progression of NeuroAIDS in the African population thereby, better equipping healthcare providers, patients and their families in addressing this epidemic. This concept is particularly important as rapidly improving and more accessible anti-HIV medications and medications for the treatment of opportunistic infections become available to third world countries such as Africa. We believe that it is imperative to foster research, education and training between institutions in the industrialized world and Africa to close the gap in understanding patterns of NeuroAIDS in Africa.
据联合国艾滋病规划署称，非洲感染艾滋病毒的人口占全球艾滋病毒感染者的一半以上。然而，关于该人群中艾滋病毒特征的信息却很少。因此，非洲人群中艾滋病毒的自然史和病程几乎没有记录，人们对此了解甚少。关于该疾病几乎各个方面的信息，包括微生物学、致病性、毒力和临床表现，大多基于特定有限人群的数据。在高效抗逆转录病毒治疗（HAART）时代，我们看到美国和西欧临床队列中的患者神经艾滋病模式发生了巨大而显著的变化。这些观察结果增进了我们对神经艾滋病病程的了解，并提高了我们设计治疗方案以对抗艾滋病毒引起的中枢神经系统并发症的能力。尽管存在针对艾滋病毒的抗逆转录病毒疗法，但非洲缺乏这种疗法以及对与艾滋病毒相关的机会性感染治疗不力，已成为神经疾病发病率和死亡率的主要来源。在这种背景下，我们面临着一个独特的机会来培养和增进我们对非洲人群中神经艾滋病自然史和病程的理解，从而使医疗服务提供者、患者及其家属更好地应对这一流行病。随着快速改进且更容易获得的抗艾滋病毒药物以及治疗机会性感染的药物在非洲等第三世界国家变得可用，这一概念尤为重要。我们认为，必须促进工业化世界和非洲各机构之间的研究、教育和培训，以缩小对非洲神经艾滋病模式理解上的差距。
