一组未接受抗逆转录病毒治疗的HIV感染患者中HIV相关神经认知障碍（HAND）的临床和病毒免疫相关性

Clinical and viro-immunological correlates of HIV associated neurocognitive disorders (HAND) in a cohort of antiretroviral-naïve HIV-infected patients.

作者信息

Bai Francesca, Iannuzzi Francesca, Merlini Esther, Borghi Lidia, Tincati Camilla, Trunfio Mattia, Bini Teresa, Monforte Antonella d'Arminio, Marchetti Giulia

机构信息

aDepartment of Health Sciences, Clinic of Infectious Diseases and Tropical Medicine, S.Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan bDepartment of Health Sciences, Unit of Clinical Psychology, S.Paolo Hospital, ASST Santi Paolo e Carlo, University of Milan, Milan cDepartment of Medical Sciences, Clinic of Infectious and Tropical Diseases, Amedeo di Savoia Hospital, University of Turin, Turin, Italy.

出版信息

AIDS. 2017 Jan 14;31(2):311-314. doi: 10.1097/QAD.0000000000001346.

DOI:10.1097/QAD.0000000000001346

PMID:28005574

Abstract

The multifactorial pathogenesis of HIV-associated neurocognitive disorders may explain the inconsistent association between neurocognitive impairment and cerebrospinal fluid (CSF) HIV RNA. Clinical and viro-immunological (CSF and plasma HIV RNA, CSF/plasma HIV RNA ratio, circulating T-cell phenotypes) parameters were investigated in 155 HIV-infected, antiretroviral-naïve, asymptomatic study participants undergoing a neuropsychological evaluation. HIV associated neurocognitive disorders (HAND) was independently associated with AIDS events and a CSF/plasma ratio of at least one, after adjustment for CD4 nadir of less than 200 cells/mmc, suggesting a role for active central nervous system (CNS) viral replication in the pathogenesis of neurocognitive impairment.

摘要

HIV相关神经认知障碍的多因素发病机制可能解释了神经认知障碍与脑脊液（CSF）HIV RNA之间不一致的关联。对155名接受神经心理学评估的未接受过抗逆转录病毒治疗、无症状的HIV感染研究参与者的临床和病毒免疫（CSF和血浆HIV RNA、CSF/血浆HIV RNA比值、循环T细胞表型）参数进行了研究。在调整CD4最低点低于200个细胞/mmc后，HIV相关神经认知障碍（HAND）与艾滋病事件以及CSF/血浆比值至少为1独立相关，提示中枢神经系统（CNS）病毒活跃复制在神经认知障碍发病机制中起作用。