Morgello Susan, Estanislao Lydia, Ryan Elizabeth, Gerits Pieter, Simpson David, Verma Susama, DiRocco Alessandro, Sharp Victoria
Department of Pathology, Mount Sinai Medical Center, New York, NY 10029, USA.
AIDS. 2005 Oct;19 Suppl 3:S116-22. doi: 10.1097/01.aids.0000192079.49185.f9.
To examine the effects of liver function and hepatitis C virus (HCV) serostatus on neurological, neuropsychological, and psychiatric abnormalities in an advanced-stage HIV-infected cohort.
A correlational analysis of baseline data accumulated on 137 participants in the Manhattan HIV Brain Bank, a longitudinal study of HIV-infected individuals.
Patients underwent a battery of neuropsychological tests, a semi-structured psychiatric interview, and a neurological examination. The resulting diagnostic data were correlated with biochemical indices of hepatic function and HCV serostatus.
Biochemical indices of liver function correlated with motor dysfunction determined by neurological evaluation, but not with neuropsychological or psychiatric disorders. Discrete neurological diagnostic entities showed no relationship with biochemical indices, with one exception: patients with cryptococcal leptomeningitis had worse liver function than those without. HCV had no relationship with any neurological disorder or symptom complex. In contrast, HCV serostatus was related to neuropsychological and psychiatric abnormalities, and indices of liver function were not. HCV-seropositive patients were more likely to have histories of opiate, cocaine or stimulant dependency, to have greater impairment in executive functioning, and to meet diagnostic criteria for AIDS dementia, compared with HCV-negative individuals of similar immunological and virological status.
HCV and biochemical indices of liver function associate differentially with nervous system abnormalities in this HIV-infected population. Neurological abnormalities correlate with biochemical indices of liver function, whereas neuropsychological and psychiatric dysfunction are linked to HCV infection. We postulate that multifactorial impacts of HCV and liver disease on HIV-related nervous system disorders may originate in different anatomical and cellular compartments.
在晚期HIV感染队列中，研究肝功能和丙型肝炎病毒（HCV）血清学状态对神经、神经心理和精神异常的影响。
对曼哈顿HIV脑库中137名参与者积累的基线数据进行相关性分析，这是一项对HIV感染者的纵向研究。
患者接受了一系列神经心理测试、半结构化精神科访谈和神经学检查。所得诊断数据与肝功能生化指标和HCV血清学状态相关。
肝功能生化指标与神经学评估确定的运动功能障碍相关，但与神经心理或精神障碍无关。离散的神经学诊断实体与生化指标无关联，但有一个例外：隐球菌性软脑膜炎患者的肝功能比无此疾病的患者更差。HCV与任何神经疾病或症状复合体均无关联。相比之下，HCV血清学状态与神经心理和精神异常相关，而肝功能指标则不然。与免疫和病毒学状态相似的HCV阴性个体相比，HCV血清阳性患者更有可能有阿片类药物、可卡因或兴奋剂依赖史，执行功能受损更严重，并且符合艾滋病痴呆的诊断标准。
在这个HIV感染人群中，HCV和肝功能生化指标与神经系统异常的关联不同。神经学异常与肝功能生化指标相关，而神经心理和精神功能障碍与HCV感染有关。我们推测，HCV和肝病对HIV相关神经系统疾病的多因素影响可能源于不同的解剖和细胞区室。
Zotero 插件