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国际神经艾滋病:HIV-1相关神经并发症的前景

International NeuroAIDS: prospects of HIV-1 associated neurological complications.

作者信息

Trujillo J Roberto, Jaramillo-Rangel Gilberto, Ortega-Martinez Marta, Penalva de Oliveira Augusto C, Vidal Jose E, Bryant Joseph, Gallo Robert C

机构信息

Institute of Human Virology, University of Maryland Biotechnology Institute, Baltimore, MD 21201, USA.

出版信息

Cell Res. 2005 Nov-Dec;15(11-12):962-9. doi: 10.1038/sj.cr.7290374.

Abstract

Neurological complications associated with HIV-1/AIDS are being recognized with a high frequency that parallels the increased number of AIDS cases. The early infiltration by HIV-1 into the nervous system can cause primary and/or secondary neurological complications. The most common neurocognitive disorder is AIDS Dementia Complex (ADC). In developing countries of Asia the three most opportunistic infections are tuberculosis (TB), cryptococcosis, and Pneumocystis carinii pneumonia. Therefore, it is expected that secondary neurological complications due to TB and cryptococcosis will be the most common cause of morbility and mortality in HIV-1/AIDS cases in China. Research of NeuroAIDS in China is necessary to understand the impact and the biology of HIV-1 in the nervous system. Future studies would include, the molecular epidemiology and the description of opportunistic infections associated to HIV-1; the neuropathological description of primary and secondary HIV-1 complications in different groups; the HIV-1 neurotropism and immune response studies for China's unique HIV-1 strains and recombinant forms derived from the nervous system, including experimental models such as the use of transgenic rats; and the study of potential resistant virus, primarily when the anti-retroviral therapy (ART) has not full access in the brain.

摘要

与人类免疫缺陷病毒1型(HIV-1)/艾滋病(AIDS)相关的神经并发症正以较高频率被发现,这与AIDS病例数的增加情况相似。HIV-1早期侵入神经系统可导致原发性和/或继发性神经并发症。最常见的神经认知障碍是艾滋病痴呆综合征(ADC)。在亚洲发展中国家,三种最常见的机会性感染是结核病(TB)、隐球菌病和卡氏肺孢子虫肺炎。因此,预计在中国,由TB和隐球菌病引起的继发性神经并发症将成为HIV-1/AIDS病例发病和死亡的最常见原因。在中国开展艾滋病神经科学(NeuroAIDS)研究对于了解HIV-1在神经系统中的影响及生物学特性十分必要。未来的研究将包括:HIV-1的分子流行病学以及与之相关的机会性感染的描述;不同群体中原发性和继发性HIV-1并发症的神经病理学描述;针对中国独特的HIV-1毒株及其源自神经系统的重组形式的HIV-1嗜神经性和免疫反应研究,包括使用转基因大鼠等实验模型;以及对潜在耐药病毒的研究,主要是在抗逆转录病毒疗法(ART)在大脑中未能充分发挥作用的情况下。

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