Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe St, Meyer 6113, Baltimore, MD, 21287, USA,
Curr Infect Dis Rep. 2013 Feb;15(1):61-6. doi: 10.1007/s11908-012-0312-2.
Neurologic complications for HIV-infected persons retain significant prevalence despite an increasingly global use of antiretroviral therapies. Such complications are often ascribed to advanced immunosuppression; however, the most common neurologic problems for HIV-infected persons, distal sensory polyneuropathy and HIV-associated neurocognitive disorders, affect a significant proportion of patients who have successfully achieved immunologic restoration with normal or near-normal CD4 count levels and undetectable HIV RNA in the periphery. Understanding specific considerations for HIV-associated complications, including the epidemiology, risk factors, medication-adverse effects, and benefits of appropriate management, is vital for all providers caring for those with HIV. This review will describe such considerations, as well as providing a more detailed review of the most common neurologic complications of HIV infection, and will highlight some of the challenges involved with diagnosis, management, and long-term effects.
尽管抗逆转录病毒疗法在全球范围内的应用日益广泛,但艾滋病毒感染者的神经并发症仍然普遍存在。这些并发症通常归因于严重的免疫抑制;然而,艾滋病毒感染者最常见的神经问题,即远端感觉性多发性神经病和与艾滋病毒相关的认知障碍,影响了很大一部分成功实现免疫重建的患者,这些患者外周血 CD4 计数水平正常或接近正常,外周血 HIV RNA 检测不到。了解与艾滋病毒相关并发症的具体注意事项,包括流行病学、危险因素、药物不良反应以及适当管理的益处,对于所有照顾艾滋病毒感染者的医务人员都至关重要。这篇综述将描述这些注意事项,并更详细地介绍艾滋病毒感染的最常见神经并发症,并强调诊断、管理和长期影响所涉及的一些挑战。