Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Semin Neurol. 2011 Jul;31(3):254-65. doi: 10.1055/s-0031-1287653. Epub 2011 Sep 30.
Despite the widespread success of combination antiretroviral therapy (cART) in reducing morbidity and mortality in human immunodeficiency virus 1 (HIV-1) infection, HIV-associated neurologic disease remains prevalent. Although the virus is unable to infect neurons or muscle fibers directly, it can still injure these structures by a variety of mechanisms, many of which are yet to be elucidated. Additionally, antiretroviral medications used to treat HIV infection can cause damage to the nervous system both by direct toxicity and via modulation of host-virus interactions. Some neurologic complications of HIV infection are rarely seen and are poorly understood; nevertheless, they are important to recognize. In this review article, the authors focus on the uncommon neurologic manifestations of HIV infection, including mononeuropathies, inflammatory demyelinating polyneuropathies, motor neuron disease, polymyositis, diffuse infiltrative lymphocytosis syndrome, mononeuritis multiplex, HIV-associated neuromuscular weakness syndrome, immune reconstitution inflammatory syndrome, and central nervous system HIV-escape meningoencephalomyelitis and myelitis.
尽管联合抗逆转录病毒疗法（cART）在降低人类免疫缺陷病毒 1（HIV-1）感染的发病率和死亡率方面取得了广泛成功，但与 HIV 相关的神经系统疾病仍然普遍存在。尽管病毒无法直接感染神经元或肌肉纤维，但它仍可以通过多种机制对这些结构造成损伤，其中许多机制仍有待阐明。此外，用于治疗 HIV 感染的抗逆转录病毒药物不仅可以通过直接毒性，还可以通过调节宿主-病毒相互作用对神经系统造成损伤。一些 HIV 感染的神经系统并发症很少见且了解甚少；然而，认识它们很重要。在这篇综述文章中，作者重点介绍了 HIV 感染的罕见神经系统表现，包括单神经病、炎症性脱髓鞘性多发性神经病、运动神经元病、多肌炎、弥漫性浸润性淋巴细胞增多综合征、多发性单神经炎、HIV 相关的神经肌肉无力综合征、免疫重建炎症综合征以及中枢神经系统 HIV 逃逸性脑膜脑炎和脊髓炎。
