Sanmarti Montserrat, Ibáñez Laura, Huertas Sonia, Badenes Dolors, Dalmau David, Slevin Mark, Krupinski Jerzy, Popa-Wagner Aurel, Jaen Angeles
Servei de Medicina Interna, Unitat VIH/Sida, Hospital Universitari MútuaTerrassa, Pl.Dr.Robert, 5, 088221 Terrassa, Barcelona, Spain ; Fundació Docència i Recerca MútuaTerrassa, Terrassa, Barcelona, Spain.
Fundació Docència i Recerca MútuaTerrassa, Terrassa, Barcelona, Spain.
J Mol Psychiatry. 2014 Mar 4;2(1):2. doi: 10.1186/2049-9256-2-2. eCollection 2014.
Currently, neuropsychological impairment among HIV+ patients on antiretroviral therapy leads to a reduction in the quality of life and it is an important challenge due to the high prevalence of HIV-associated neurocognitive disorders and its concomitant consequences in relation to morbidity and mortality- including those HIV+ patients with adequate immunological and virological status. The fact that the virus is established in CNS in the early stages and its persistence within the CNS can help us to understand HIV-related brain injury even when highly active antiretroviral therapy is effective. The rising interest in HIV associated neurocognitive disorders has let to development new diagnostic tools, improvement of the neuropsychological tests, and the use of new biomarkers and new neuroimaging techniques that can help the diagnosis. Standardization and homogenization of neurocognitive tests as well as normalizing and simplification of easily accessible tools that can identify patients with increased risk of cognitive impairment represent an urgent requirement. Future efforts should also focus on diagnostic keys and searching for useful strategies in order to decrease HIV neurotoxicity within the CNS.
目前，接受抗逆转录病毒治疗的HIV阳性患者存在神经心理障碍，这导致生活质量下降，并且由于HIV相关神经认知障碍的高患病率及其在发病率和死亡率方面的伴随后果（包括那些免疫和病毒学状态良好的HIV阳性患者），这是一个重要挑战。病毒在早期就已在中枢神经系统中定植，并且其在中枢神经系统中的持续存在有助于我们理解HIV相关的脑损伤，即使高效抗逆转录病毒治疗是有效的。对HIV相关神经认知障碍兴趣的增加促使了新诊断工具的开发、神经心理测试的改进以及新生物标志物和新神经成像技术的使用，这些有助于诊断。神经认知测试的标准化和同质化，以及对易于获取的工具进行规范化和简化，以识别认知障碍风险增加的患者，是一项紧迫的要求。未来的努力还应集中在诊断关键以及寻找有用策略，以降低中枢神经系统内的HIV神经毒性。
