Qi Yu, Ailixire A, Gao Yu-Xun, Li Rui-Li, Li Hong-Jun
Department of Radiology, Beijing YouAn Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing YouAn Hospital, Capital Medical University; Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China.
AIDS Rev. 2021 Mar 24;23(2):74-81. doi: 10.24875/AIDSRev.20000044.
Standards of HIV/AIDS prevention and control in some areas of China are still poor. People live longer with the use of therapeutic drugs, which may lead to an increase in the number of HIV-associated neurocognitive disorders (HAND). However, only a few multicenter and large-scale studies investigating the prevalence and incidence of HAND have been undertaken in China. While the number of HIV/AIDS cases in China is still large, the prevalence of HAND is remains unclear. The diagnosis of HAND in China is mainly based on the international diagnostic scale, to which Chinese features are added. At present, five classes of antiretroviral therapy drugs widely used in China: nucleoside reverse transcriptase inhibitors (NRTIs), non-NRTIs (NNRTIs), protease inhibitors, integrase inhibitors, and membrane fusion inhibitors (FIs). There is no specific treatment or drug for HAND in China. Efforts are needed in the following aspects: trying to understand more epidemic features of HAND in China; formulating a unified neuropsychological scale with Chinese characteristics to diagnose HAND and adopt new approaches to identify different stages of HAND; early stage (reversible) accurate hierarchical prediction and diagnosis, combined with artificial intelligence to improve the work efficiency of doctors, and to solve the failure of outpatient diagnosis cases (asymptomatic patients); and exploring and establishing a perfect system for target treatment with HAND.
中国部分地区的艾滋病防治水平仍较差。人们因使用治疗药物而寿命延长，这可能导致与艾滋病相关的神经认知障碍（HAND）病例数增加。然而，中国仅开展了少数几项调查HAND患病率和发病率的多中心大规模研究。尽管中国艾滋病病例数量仍然庞大，但HAND的患病率仍不清楚。中国对HAND的诊断主要基于国际诊断标准，并加入了中国特色。目前，中国广泛使用五类抗逆转录病毒治疗药物：核苷类逆转录酶抑制剂（NRTIs）、非核苷类逆转录酶抑制剂（NNRTIs）、蛋白酶抑制剂、整合酶抑制剂和膜融合抑制剂（FIs）。中国尚无针对HAND的特异性治疗方法或药物。需要在以下方面做出努力：努力了解中国HAND更多的流行特征；制定具有中国特色的统一神经心理量表以诊断HAND，并采用新方法识别HAND的不同阶段；进行早期（可逆性）准确分层预测和诊断，结合人工智能提高医生工作效率，解决门诊诊断病例（无症状患者）漏诊问题；探索并建立完善的HAND靶向治疗体系。
