Cornblath D R
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Ann Neurol. 1988;23 Suppl:S88-91. doi: 10.1002/ana.410230723.
Neuromuscular disorders are increasingly being reported in individuals with human immunodeficiency virus (HIV) infection. The majority of these disorders resemble diseases occurring in HIV-seronegative patients and include inflammatory demyelinating polyneuropathies, multiple mononeuropathies, and polymyositis. In HIV-seronegative patients, these diseases are believed to be immune system-mediated. It is likely that similar pathogenic mechanisms are present in HIV-seropositive patients and reflect an altered immune system caused by viral infection and the loss of CD4 cells. Therapy is similar in both seropositive and seronegative patients with inflammatory demyelinating polyneuropathies, but plasmapheresis is preferred in seropositive patients as it is less likely than corticosteroids to induce further immunosuppression. Distal sensory neuropathy is characteristic in patients infected with HIV, especially those with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex, and may be a consequence of HIV infection. Therefore, antiviral agents may have a therapeutic role for this disorder.
越来越多的报告指出，人类免疫缺陷病毒（HIV）感染者会出现神经肌肉疾病。这些疾病大多与HIV血清阴性患者所患疾病相似，包括炎性脱髓鞘性多发性神经病、多发性单神经病和多发性肌炎。在HIV血清阴性患者中，这些疾病被认为是由免疫系统介导的。HIV血清阳性患者可能也存在类似的致病机制，这反映了病毒感染和CD4细胞丧失导致的免疫系统改变。炎性脱髓鞘性多发性神经病的血清阳性和血清阴性患者的治疗方法相似，但血清阳性患者更倾向于采用血浆置换，因为与皮质类固醇相比，血浆置换诱发进一步免疫抑制的可能性较小。远端感觉神经病是HIV感染者尤其是获得性免疫缺陷综合征（AIDS）或AIDS相关综合征患者的特征性表现，可能是HIV感染的结果。因此，抗病毒药物可能对这种疾病具有治疗作用。
