Hahn K, Husstedt I W
Klinik für Neurologie, Charité-Universitätsklinikum, Campus Mitte, Humboldt-Universität zu Berlin, 10117 Berlin.
Nervenarzt. 2010 Apr;81(4):409-17. doi: 10.1007/s00115-010-2931-x.
Human immunodeficiency virus (HIV)-associated polyneuropathy has become the most common neurological complication of HIV infection and is one of the main risk factors for development of a neuropathy worldwide. Therefore HIV should always be considered as an underlying cause in patients with neuropathy. Many types of peripheral neuropathies are seen in HIV infection depending on the stage of infection. The inflammatory demyelinating neuropathies both acute (Guillain-Barré syndrome, GBS) and chronic (chronic inflammatory demyelinating neuropathy, CIDP) occur mainly at the time of seroconversion or early in the course of the disease while syndromes associated with opportunistic infections like CMV (i.e. polyradiculoneuropathy) occur in the late phase of HIV infection and are related to the loss of immune function. Distal symmetrical polyneuropathy (DSP) is the most common neuropathy in HIV-infected patients. We review the clinical manifestations, epidemiology, clinical diagnostics, pathophysiology and management strategies for HIV-associated polyneuropathies.
人类免疫缺陷病毒(HIV)相关的多发性神经病已成为HIV感染最常见的神经并发症,并且是全球范围内发生神经病的主要危险因素之一。因此,对于患有神经病的患者,应始终将HIV视为潜在病因。根据感染阶段的不同,HIV感染可见多种类型的周围神经病。炎性脱髓鞘性神经病,包括急性(格林-巴利综合征,GBS)和慢性(慢性炎性脱髓鞘性多发性神经病,CIDP),主要发生在血清转化时或疾病早期,而与机会性感染(如巨细胞病毒,即多发性神经根神经病)相关的综合征则发生在HIV感染的晚期,并且与免疫功能丧失有关。远端对称性多发性神经病(DSP)是HIV感染患者中最常见的神经病。我们综述了HIV相关多发性神经病的临床表现、流行病学、临床诊断、病理生理学和管理策略。