Zhang Y-L, Ouyang Y-B, Liu L-G, Chen D-X
STD/AIDS Research Center, Beijing Key Laboratory (No. BZ0089), Capital Medical University affiliated Beijing You An Hospital, Beijing Institute of Hepatology, Beijing, China.
Eur Rev Med Pharmacol Sci. 2015 Dec;19(24):4927-39.
Neuro-AIDS is becoming a major health problem among AIDS patients who experience improved survival under combined antiretroviral therapy (cART). Neuronal injury and loss are the critical issues of neuro-AIDS that need the entry of HIV into the central nervous system (CNS) via peripheral infected monocyte/macrophage carriers or viral direct penetration of blood-brain barrier (BBB). The mechanisms of HIV enhancing BBB permeability and entering CNS and the effect of drug abuse in HIV traffic across BBB are discussed. In addition, the current anti-HIV drugs, although they are effective in reducing plasma viral level, cannot eradicate the viruses completely from CNS. The possible mechanism of BBB hindrance and anti-HIV drug efflux by transport proteins, and general methods used to deliver antiretroviral drugs into brain are also discussed.
在接受联合抗逆转录病毒疗法（cART）后生存率有所提高的艾滋病患者中，神经艾滋病正成为一个主要的健康问题。神经元损伤和丧失是神经艾滋病的关键问题，这需要HIV通过外周感染的单核细胞/巨噬细胞载体进入中枢神经系统（CNS），或者病毒直接穿透血脑屏障（BBB）。本文讨论了HIV增强血脑屏障通透性并进入中枢神经系统的机制，以及药物滥用在HIV穿越血脑屏障过程中的作用。此外，目前的抗HIV药物虽然能有效降低血浆病毒水平，但无法将病毒从中枢神经系统完全清除。本文还讨论了血脑屏障阻碍和转运蛋白导致抗HIV药物外排的可能机制，以及将抗逆转录病毒药物输送到大脑的常用方法。
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