Department of Neurology, New England Regional Headache Center, University of Massachusetts Medical School, Worcester, MA, USA.
Headache. 2014 May;54(5):946-50. doi: 10.1111/head.12356. Epub 2014 Apr 15.
The pathophysiology of human immunodeficiency virus (HIV) is complex. The etiology of headache in the HIV population is often multifactorial, and attributing causality to specific pathophysiological mechanisms is challenging. Headaches can occur any time during the infection and may be primary (as in non-HIV-infected patients) or secondary (either from HIV directly or due to opportunistic disease).
Direct HIV related headaches are due to the underlying viral pathophysiology. For example, acute meningitis can be seen during HIV-1 seroconversion. Headaches can occur during symptomatic HIV and also after an AIDS-defining illness. Late-stage HIV headache can occur without any pleocytosis. A correlation between viral load and neurological symptoms including headache has been suggested. There may be similar mechanisms involving migraine, tension-type headache, and HIV infection.
Secondary HIV headaches can be related to opportunistic infections, malignancy, medications used to treat HIV, and immune restoration inflammatory syndrome.
人类免疫缺陷病毒（HIV）的发病机制较为复杂。HIV 感染者头痛的病因通常是多因素的，将病因归因于特定的病理生理机制具有挑战性。头痛可在感染的任何时间发生，可能是原发性的（如非 HIV 感染者），也可能是继发性的（由 HIV 直接引起或由机会性疾病引起）。
直接与 HIV 相关的头痛是由潜在的病毒发病机制引起的。例如，HIV-1 血清转换期间可出现急性脑膜炎。在有症状的 HIV 期间以及在出现艾滋病定义性疾病后，也会出现头痛。晚期 HIV 头痛可无任何白细胞增多。有人提出病毒载量与包括头痛在内的神经系统症状之间存在相关性。可能存在与偏头痛、紧张型头痛和 HIV 感染类似的机制。
继发性 HIV 头痛可能与机会性感染、恶性肿瘤、用于治疗 HIV 的药物以及免疫重建炎症综合征有关。
