Arendt G, Nolting T
Neurologische Klinik, Medizinische Fakultät der Heinrich-Heine-Universität Düsseldorf, Moorenstrasse 5, Düsseldorf.
Fortschr Neurol Psychiatr. 2012 Aug;80(8):450-7. doi: 10.1055/s-0032-1313191. Epub 2012 Aug 15.
After the introduction of antiretroviral combination therapy for the treatment of HIV infection in 1996 (highly active antiretroviral therapy = HAART, nowadays called combination antiretroviral therapy = cART), a steady decline in infection associated complications had been expected, especially with respect to central and peripheral nervous system manifestations. Until the beginning of the new millenium this hope came in fact true, but since then there has been a slow, but constant rise in the prevalence, and later on also in the incidence of directly virus-associated neurological complications in HIV infected patients. HIV-associated diseases that neurologists might see in their routine work include HIV-associated dementia (HAD) and its precursor stages, HIV-associated myelopathy, HIV-associated polyneuropathies and myopathies as well as the opportunistic brain infections and immune reconstitution phenomena (IRIS). This article describes practical diagnostic procedures according to the guidelines of the German Neurological Society and the respective therapeutic options.
1996年引入抗逆转录病毒联合疗法用于治疗HIV感染(高效抗逆转录病毒疗法=HAART,如今称为联合抗逆转录病毒疗法=cART)后,预计与感染相关的并发症会稳步下降,尤其是在中枢和周围神经系统表现方面。直到新千年伊始,这一希望事实上得以实现,但自那时起,HIV感染患者中直接与病毒相关的神经并发症的患病率开始缓慢但持续上升,随后发病率也上升。神经科医生在日常工作中可能会见到的HIV相关疾病包括HIV相关痴呆(HAD)及其前驱阶段、HIV相关脊髓病、HIV相关多发性神经病和肌病,以及机会性脑部感染和免疫重建现象(IRIS)。本文根据德国神经学会的指南描述了实际的诊断程序以及相应的治疗选择。