Mehling Matthias, Drechsler Henning, Kuhle Jens, Hardmeier Martin, Doerries Ruediger, Ruegg Stephan, Gass Achim
Department of Neurology, University Hospital of Basel, Switzerland.
J Neurovirol. 2008 Jan;14(1):78-84. doi: 10.1080/13550280701793940.
The authors describe a patient with known human immunodeficiency virus (HIV)-1 infection who presented with two generalized seizures and was found to have extensive white matter disease and a left/bilateral temporo-occipital focal slowing on electroencephalography (EEG). There were no magnetic resonance imaging (MRI) or cerebrospinal fluid (CSF) indications for opportunistic infection. Plasma viremia was controlled, whereas viral replication was uncontrolled in CSF. CSF-specific genotype-guided adaptation of the antiretroviral therapy in order to optimize central nervous system (CNS) penetration resulted in clinical improvement and normalization of MRI and EEG. Our case report illustrates the importance of individualized antiretroviral therapy in HIV infected patients with neurological complications.
作者描述了一名已知感染人类免疫缺陷病毒1型（HIV-1）的患者，该患者出现两次全身性癫痫发作，脑电图（EEG）显示有广泛的白质病变以及左/双侧颞枕叶局灶性慢波。磁共振成像（MRI）或脑脊液（CSF）检查均未显示机会性感染迹象。血浆病毒血症得到控制，而脑脊液中的病毒复制未得到控制。根据脑脊液特异性基因型指导调整抗逆转录病毒疗法，以优化中枢神经系统（CNS）的药物渗透，从而使临床症状改善，MRI和EEG恢复正常。我们的病例报告说明了个体化抗逆转录病毒疗法在伴有神经系统并发症的HIV感染患者中的重要性。
