HIV Neuroscience Program, Johns Hopkins University, Baltimore, MD 21287, USA.
Lancet Neurol. 2012 Jul;11(7):605-17. doi: 10.1016/S1474-4422(12)70098-4.
Survival in people infected with HIV has improved because of an increasingly powerful array of antiretroviral treatments, but neurological symptoms due to comorbid conditions, including infection with hepatitis C virus, malnutrition, and the effects of accelerated cardiovascular disease and ageing, are increasingly salient. A therapeutic gap seems to exist between the salutary effects of antiretroviral regimens and the normalisation of neurological function in HIV-associated neurocognitive disorders. Despite the advances in antiretroviral therapy, CNS opportunistic infections remain a serious burden worldwide. Most opportunistic infections can be recognised by a combination of characteristic clinical and radiological features and are treatable, but some important challenges remain in the diagnosis and management of HIV-associated opportunistic infections.
由于越来越强大的抗逆转录病毒治疗方法,感染 HIV 的人的生存状况得到了改善,但由于合并症,包括感染丙型肝炎病毒、营养不良以及加速的心血管疾病和衰老的影响,导致神经症状越来越突出。抗逆转录病毒治疗方案的有益效果与 HIV 相关认知障碍的神经功能正常化之间似乎存在治疗差距。尽管抗逆转录病毒治疗取得了进展,但中枢神经系统机会性感染仍然是全世界的严重负担。大多数机会性感染可以通过特征性的临床和影像学特征相结合来识别,并且是可治疗的,但在 HIV 相关机会性感染的诊断和管理方面仍存在一些重要挑战。