Bhalerao Aditya, Cucullo Luca
Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA.
Center for Blood Brain Barrier Research, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA.
Z Gesundh Wiss. 2020 Jun;28(3):259-270. doi: 10.1007/s10389-019-01062-8. Epub 2019 Mar 9.
With the advent of highly active and combination antiretroviral therapy have substantially increased the life expectancy of patients infected with human immunodeficiency virus (HIV). However, this has brought into sharp contrast the incidence of several 'Non-acquired immunodeficiency syndrome (AIDS) diseases such as NeuroAIDS which identifies a group of neurological disorders caused primarily by HIV-mediated damage to the central and peripheral nervous systems. Given the patients depleted immune condition, the use and abuse of drug and addictive substances such as tobacco smoking can further deteriorates their overall health and accelerate the progression and severity of the disease. In this review we detail the pathogenesis, progression and characteristics of HIV and the impact of tobacco smoking as a risk factor for the progression of the disease to NeuroAIDS. This is a poorly understood aspect of HIV-related complications that needs to be addressed.
Review of theoretical approaches and knowledge synthesis.
Tobacco smoking is highly prevalent in HIV patients when compared to the general population. The oxidative damage and inflammatory stress caused by chronic smoking on the cerebrovascular system have been well established. Considering that HIV patients have an impaired immune system and smokers per se are more susceptible to viral and bacterial inflammatory neuropathologies than non-smokers, it is conceivable that tobacco smoking as a risk factor for the progression of HIV into NeuroAIDS and related neurological impairments.
Tobacco smoke (TS) may bring about a synergistic effect in the context of persistent inflammatory state and cerebrovascular damage which facilitate HIV infection and progression to NeuroAIDS when compared to non-smokers.
随着高效联合抗逆转录病毒疗法的出现，感染人类免疫缺陷病毒（HIV）患者的预期寿命显著延长。然而，这与几种“非获得性免疫缺陷综合征（AIDS）疾病”的发病率形成了鲜明对比，比如神经艾滋病，它指的是一组主要由HIV介导的对中枢和外周神经系统的损害所引起的神经障碍。鉴于患者免疫状况不佳，药物和成瘾物质（如吸烟）的使用和滥用会进一步损害他们的整体健康，并加速疾病的进展和严重程度。在本综述中，我们详细阐述了HIV的发病机制、进展和特征，以及吸烟作为疾病进展为神经艾滋病的危险因素所产生的影响。这是HIV相关并发症中一个尚未得到充分理解的方面，需要加以探讨。
对理论方法和知识综合进行综述。
与普通人群相比，吸烟在HIV患者中非常普遍。长期吸烟对脑血管系统造成的氧化损伤和炎症应激已得到充分证实。鉴于HIV患者免疫系统受损，而且吸烟者本身比不吸烟者更容易患病毒和细菌性炎症性神经病变，可以想象吸烟是HIV进展为神经艾滋病及相关神经损伤的一个危险因素。
与不吸烟者相比，在持续炎症状态和脑血管损伤的情况下，烟草烟雾（TS）可能会产生协同效应，促进HIV感染并进展为神经艾滋病。
