Department of Neurology, Washington University in St. Louis, School of Medicine, Campus Box 8111, 660 South Euclid Avenue, St. Louis, MO, 63110, USA.
Curr HIV/AIDS Rep. 2021 Jun;18(3):221-228. doi: 10.1007/s11904-021-00548-z. Epub 2021 Feb 25.
This review highlights neuroimaging studies of HIV conducted over the last 2 years and discusses how relevant findings further our knowledge of the neuropathology of HIV. Three major avenues of neuroimaging research are covered with a particular emphasis on inflammation, aging, and substance use in persons living with HIV (PLWH).
Neuroimaging has been a critical tool for understanding the neuropathological underpinnings observed in HIV. Recent studies comparing levels of neuroinflammation in PLWH and HIV-negative controls show inconsistent results but report an association between elevated neuroinflammation and poorer cognition in PLWH. Other recent neuroimaging studies suggest that older PLWH are at increased risk for brain and cognitive compromise compared to their younger counterparts. Finally, recent findings also suggest that the effects of HIV may be exacerbated by alcohol and drug abuse. These neuroimaging studies provide insight into the structural, functional, and molecular changes occurring in the brain due to HIV. HIV triggers a strong neuroimmune response and may lead to a cascade of events including increased chronic inflammation and cognitive decline. These outcomes are further exacerbated by age and age-related comorbidities, as well as lifestyle factors such as drug use/abuse.
本文重点介绍了过去 2 年中 HIV 的神经影像学研究,并讨论了相关研究结果如何进一步了解 HIV 的神经病理学。本文涵盖了神经影像学研究的三个主要领域,特别强调了 HIV 感染者的炎症、衰老和物质使用。
神经影像学一直是理解 HIV 观察到的神经病理学基础的关键工具。最近比较 HIV 感染者和 HIV 阴性对照者神经炎症水平的研究结果不一致,但报告称 HIV 感染者神经炎症水平升高与认知能力下降有关。其他最近的神经影像学研究表明,与年轻的 HIV 感染者相比,年龄较大的 HIV 感染者大脑和认知功能受损的风险增加。最后,最近的研究结果还表明,HIV 的影响可能因酗酒和药物滥用而加剧。这些神经影像学研究深入了解了 HIV 引起的大脑结构、功能和分子变化。HIV 引发强烈的神经免疫反应,可能导致一系列事件,包括慢性炎症增加和认知能力下降。这些结果进一步因年龄和与年龄相关的合并症以及药物使用/滥用等生活方式因素而加剧。