Norman Lisa R, Basso Michael, Kumar Anil, Malow Robert
AIDS Research Program, Ponce School of Medicine, Ponce, PR 00732.
Curr Drug Abuse Rev. 2009 May;2(2):143-56. doi: 10.2174/1874473710902020143.
Neuropsychological dysfunction, ranging from mild cognitive symptoms to dementia has been a consistent part of the clinical picture of HIV/AIDS. However, advances in clinical management, particularly antiretroviral (ARV) treatment, have mitigated the neuropsychological effects of HIV and revised the pattern and nature of cognitive deficits, which are observed in HIV-infected individuals. The attendant improvements in mortality and morbidity have led to a need for programs and interventions that sustain healthy behavior and prevent a resurgence of HIV transmission risk. Psychiatric risk factors, particularly substance use, which often contribute to initial acquisition of HIV, still require attention. These risk factors may also exacerbate neuropsychological dysfunction and compromise adherence to prevention recommendations and treatment. Specifically, a more complete understanding of the effects of substance abuse on the progression of HIV related cognitive decline can inform evaluation and management of HIV seropositives with concurrent substance use disorders. This review provides an overview of the neuropsychology of HIV and substance abuse and the extant research that has examined the effects of both HIV disease and substance use on neuropsychological functioning and implications for treatment and future research.
神经心理功能障碍，从轻度认知症状到痴呆，一直是艾滋病毒/艾滋病临床症状的一个持续组成部分。然而，临床管理方面的进展，特别是抗逆转录病毒（ARV）治疗，已经减轻了艾滋病毒的神经心理影响，并改变了在艾滋病毒感染者中观察到的认知缺陷的模式和性质。随之而来的死亡率和发病率的改善导致需要有维持健康行为和预防艾滋病毒传播风险再次出现的项目和干预措施。精神风险因素，特别是物质使用，这往往是导致最初感染艾滋病毒的原因，仍然需要关注。这些风险因素也可能加剧神经心理功能障碍，并损害对预防建议和治疗的依从性。具体而言，更全面地了解药物滥用对艾滋病毒相关认知衰退进展的影响，可以为同时患有物质使用障碍的艾滋病毒血清阳性者的评估和管理提供参考。本综述概述了艾滋病毒和物质滥用的神经心理学，以及现有研究，这些研究探讨了艾滋病毒疾病和物质使用对神经心理功能的影响以及对治疗和未来研究的意义。
