UCLA AIDS Institute, Department of Medicine, University of California-Los Angeles, 11301 Wilshire Blvd., Los Angeles, CA 90073, USA.
Immunol Res. 2010 Dec;48(1-3):40-58. doi: 10.1007/s12026-010-8166-x.
It is estimated that half of HIV-infected adults and children will present at one time during their disease course with a neurologic disorder. The neurologic sequelae of HIV infection arise as a direct result of viral replication as well as from the subsequent neuroinflammatory processes. HIV enters the CNS early in infection and resides primarily in long-lived perivascular macrophages and microglia. CNS immunosurveillance is an integral part of normal brain function. Circulating lymphocytes play a vital role in support of brain plasticity under normal and traumatic circumstances. Malfunctions of this immunologic niche can impair brain homeostasis, resulting in neural impairment. Combination therapies that lower CNS viral load and improve immune homeostasis and neuroprotection will be required to address the neuropathogenesis of HIV infection.
据估计，在感染 HIV 的成年人和儿童中，有一半的人在其疾病过程中的某个时间会出现神经系统疾病。HIV 感染的神经系统后遗症是由病毒复制以及随后的神经炎症过程直接引起的。HIV 在感染早期进入中枢神经系统，主要存在于长期存在的血管周围巨噬细胞和小胶质细胞中。中枢神经系统的免疫监视是正常大脑功能的一个组成部分。循环淋巴细胞在正常和创伤情况下支持大脑可塑性方面发挥着至关重要的作用。这个免疫生态位的功能障碍会损害大脑的内稳态，导致神经损伤。需要联合治疗来降低中枢神经系统的病毒载量，改善免疫稳态和神经保护，以解决 HIV 感染的神经发病机制。
