Vera Jaime H, Ridha Basil, Gilleece Yvonne, Amlani Aliza, Thorburn Patrick, Dizdarevic Sabina
Department of Infection and Global Health, Brighton and Sussex Medical School, Brighton, UK.
HIV Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Eur J Nucl Med Mol Imaging. 2017 May;44(5):895-902. doi: 10.1007/s00259-016-3602-3. Epub 2017 Jan 5.
Effective combination antiretroviral therapy (cART) has lead to a significant reduction in the prevalence and incidence of central nervous system (CNS) HIV-associated brain disease, particularly CNS opportunistic infections and HIV encephalitis. Despite this, cognitive deficits in people living with HIV, also known as HIV-associated neurocognitive disorders (HAND) have become more prevalent in recent years. The pathogenesis of HAND is likely to be multifactorial, however recent evidence suggests that brain microglial activation is the most likely pathogenic mechanism. Recent developments in positron emission tomography (PET) brain neuroimaging using novel brain radioligands targeting a variety of physiological changes in the brains of HIV-positive individuals have improved our understanding of the mechanisms associated with the development of HAND. This review will highlight recent PET brain neuroimaging studies in the cART era, focusing on physiological and neurochemical changes associated with HAND in people living with HIV.
有效的联合抗逆转录病毒疗法（cART）已使中枢神经系统（CNS）与HIV相关的脑部疾病的患病率和发病率显著降低，尤其是中枢神经系统机会性感染和HIV脑炎。尽管如此，近年来，HIV感染者的认知缺陷，即所谓的HIV相关神经认知障碍（HAND）变得更加普遍。HAND的发病机制可能是多因素的，然而最近的证据表明，脑小胶质细胞激活是最可能的致病机制。正电子发射断层扫描（PET）脑神经成像的最新进展，使用针对HIV阳性个体大脑中各种生理变化的新型脑放射性配体，提高了我们对与HAND发展相关机制的理解。本综述将重点介绍cART时代最近的PET脑神经成像研究，重点关注与HIV感染者HAND相关的生理和神经化学变化。
