Almeida Sérgio Monteiro de
Laboratório de Clínica Patológica, Departamento de Patologia Médica; Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
Arq Neuropsiquiatr. 2015 Jul;73(7):624-9. doi: 10.1590/0004-282X20150071.
The nervous system plays an important role in HIV infection. The purpose of this review is to discuss the indications for cerebrospinal fluid (CSF) analysis in HIV infection in clinical practice. CSF analysis in HIV infection is indicated for the diagnosis of opportunistic infections and co-infections, diagnosis of meningitis caused by HIV, quantification of HIV viral load, and analysis of CNS HIV compartmentalization. Although several CSF biomarkers have been investigated, none are clinically applicable. The capacity of HIV to generate genetic diversity, in association with the constitutional characteristics of the CNS, facilitates the generation of HIV quasispecies in the CNS that are distinct from HIV in the systemic circulation. CSF analysis has a well-defined and valuable role in the diagnosis of CNS infections in HIV/AIDS patients. Further research is necessary to establish a clinically applicable biomarker for the diagnosis of HIV-associated neurocognitive disorders.
神经系统在HIV感染中起着重要作用。本综述的目的是讨论临床实践中HIV感染时脑脊液（CSF）分析的指征。HIV感染时进行CSF分析适用于机会性感染和合并感染的诊断、HIV引起的脑膜炎的诊断、HIV病毒载量的定量以及中枢神经系统HIV分区分析。尽管已经对几种CSF生物标志物进行了研究，但尚无一种可应用于临床。HIV产生基因多样性的能力，与中枢神经系统的结构特征相结合，促进了中枢神经系统中HIV准种的产生，这些准种与全身循环中的HIV不同。CSF分析在HIV/AIDS患者中枢神经系统感染的诊断中具有明确且有价值的作用。有必要进一步开展研究以建立一种可应用于临床的生物标志物来诊断HIV相关神经认知障碍。
