Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain.
Department of Psychiatry, University of California, San Diego, California.
Semin Neurol. 2014 Feb;34(1):27-34. doi: 10.1055/s-0034-1372340. Epub 2014 Apr 8.
With the introduction of combination antiretroviral therapy, many human immunodeficiency virus-positive (HIV+) individuals are reaching advanced age. The proportion of people living with HIV older than 50 years already exceeds 50% in many communities, and is expected to reach this level nationally by 2015. HIV and aging are independently associated with neuropathological changes, but their concurrence may have a more deleterious effect on the central nervous system (CNS). Published data about neurocognitive and neuroimaging markers of HIV and aging are reviewed. Putative factors contributing to neurocognitive impairment and neuroimaging changes in the aging HIV+ brain, such as metabolic disturbances, cardiovascular risk factors, immune senescence, and neuroinflammation, are described. The possible relationship between HIV and some markers of Alzheimer's disease is presented. Current research findings emphasize multiple mechanisms related to HIV and combination antiretroviral therapy that compromise CNS structure and function with advancing age.
随着联合抗逆转录病毒疗法的引入，许多艾滋病毒阳性（HIV+）个体已经进入老年。在许多社区，50 岁以上的艾滋病毒感染者比例已经超过 50%，预计到 2015 年全国将达到这一水平。HIV 和衰老都与神经病理学变化独立相关，但它们的同时发生可能对中枢神经系统（CNS）产生更有害的影响。本文综述了关于 HIV 和衰老的神经认知和神经影像学标志物的已发表数据。描述了导致衰老 HIV+大脑认知障碍和神经影像学改变的推测因素，如代谢紊乱、心血管危险因素、免疫衰老和神经炎症。还介绍了 HIV 与阿尔茨海默病某些标志物之间的可能关系。目前的研究结果强调了与 HIV 和联合抗逆转录病毒疗法相关的多种机制，这些机制会随着年龄的增长损害中枢神经系统的结构和功能。
